Partial knee replacement

MedlinePlus

... guideline: surgical management of osteoarthritis of the knee: evidence-based guideline. J Am Acad Orthop ... UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, ...

UCSF Center for HIV Information

MedlinePlus

... This patient educational brochure offers a primer on hepatitis C, including information on the liver's functions, laboratory tests, and treatment. HIV and Aging Toolkit Subscribe Subscribe to receive ...

Otosclerosis

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Cholesteatoma

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Mastoiditis

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Recurrent hepatocellular carcinoma after liver transplant: identifying the high-risk patient

PubMed Central

Nissen, Nicholas N; Menon, Vijay; Bresee, Catherine; Tran, Tram T; Annamalai, Alagappan; Poordad, Fred; Fair, Jeffrey H; Klein, Andrew S; Boland, Brendan; Colquhoun, Steven D

2011-01-01

Background Recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) is rarely curable. However, in view of the advent of new treatments, it is critical that patients at high risk for recurrence are identified. Methods Patients undergoing LT for HCC at a single centre between 2002 and 2010 were reviewed and data on clinical parameters and explant pathology were analysed to determine factors associated with HCC recurrence. All necrotic and viable tumour nodules were included in explant staging. All patients underwent LT according to the United Network for Organ Sharing (UNOS) Model for End-stage Liver Disease (MELD) tumour exception policies. Results Liver transplantation was performed in 122 patients with HCC during this period. Rates of recurrence-free survival in the entire cohort at 1 year and 3 years were 95% and 89%, respectively. Thirteen patients developed HCC recurrence at a median of 14 months post-LT. In univariate analysis the factors associated with HCC recurrence were bilobar tumours, vascular invasion, and stage exceeding either Milan or University of California San Francisco (UCSF) Criteria. Multivariate analysis showed pathology outside UCSF Criteria was the major predictor of recurrence; when pathology outside UCSF Criteria was found in combination with vascular invasion, the predicted 3-year recurrence-free survival was only 26%. Conclusions Explant pathology can be used to predict the risk for recurrent HCC after LT, which may allow for improved adjuvant and management strategies. PMID:21843263

Can living donor liver transplantation offer similar outcomes to deceased donor liver transplantation using expanded selection criteria for hepatocellular carcinoma?

PubMed Central

Chen, Li-Ping; Li, Chuan; Wen, Tian-Fu; Yan, Lu-Nan; Li, Bo; Yang, Jia-Yin

2015-01-01

Objective: To compare the outcomes of living donor liver transplantation (LDLT) versus deceased donor liver transplantation (DDLT) for patients with hepatocellular carcinoma (HCC) in different selection criteria. Methods: Data of patients with HCC who underwent liver transplantation between 2005 and 2013 at our center were reviewed. Clinical data of LDLT recipients and DDLT recipients were compared. The postoperative recurrence-free survival (RFS) rate and overall survival (OS) rate after LDLT versus DDLT were compared in the Milan recipients, the University of California, San Francisco (UCSF) recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients. Results: Data of 255 patients were retrospectively reviewed in this study. Seventeen DDLT recipient and 9 LDLT recipients died during the perioperative period. Among the remaining 229 recipients (NLDLT=66, NDDLT=163), 96 patients met the Milan criteria, 123 recipients met the UCSF criteria, 135 patients met the up-to-seven criteria, 216 patients met the Hangzhou criteria, and 229 recipients met the Chengdu criteria. The overall RFS and OS rates of the Milan recipients, the UCSF recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients after LDLT and DDLT were all similar. Conclusion: Using well-studied selection criteria, LDLT offers similar outcomes to DDLT for patient with HCC, even using expanded selection criteria. PMID:26430399

Can living donor liver transplantation offer similar outcomes to deceased donor liver transplantation using expanded selection criteria for hepatocellular carcinoma?

PubMed

Chen, Li-Ping; Li, Chuan; Wen, Tian-Fu; Yan, Lu-Nan; Li, Bo; Yang, Jia-Yin

2015-01-01

To compare the outcomes of living donor liver transplantation (LDLT) versus deceased donor liver transplantation (DDLT) for patients with hepatocellular carcinoma (HCC) in different selection criteria. Data of patients with HCC who underwent liver transplantation between 2005 and 2013 at our center were reviewed. Clinical data of LDLT recipients and DDLT recipients were compared. The postoperative recurrence-free survival (RFS) rate and overall survival (OS) rate after LDLT versus DDLT were compared in the Milan recipients, the University of California, San Francisco (UCSF) recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients. Data of 255 patients were retrospectively reviewed in this study. Seventeen DDLT recipient and 9 LDLT recipients died during the perioperative period. Among the remaining 229 recipients (NLDLT=66, NDDLT=163), 96 patients met the Milan criteria, 123 recipients met the UCSF criteria, 135 patients met the up-to-seven criteria, 216 patients met the Hangzhou criteria, and 229 recipients met the Chengdu criteria. The overall RFS and OS rates of the Milan recipients, the UCSF recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients after LDLT and DDLT were all similar. Using well-studied selection criteria, LDLT offers similar outcomes to DDLT for patient with HCC, even using expanded selection criteria.

Palatal myoclonus

MedlinePlus

... Updated by: Sumana Jothi MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Infectious myringitis

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Aural polyps

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Headache

MedlinePlus

... ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 30. Review Date 11/22/2017 Updated by: Luc Jasmin, ... of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by ...

Malignant otitis externa

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Surveillance Tools Emerging From Search Engines and Social Media Data for Determining Eye Disease Patterns.

PubMed

Deiner, Michael S; Lietman, Thomas M; McLeod, Stephen D; Chodosh, James; Porco, Travis C

2016-09-01

Internet-based search engine and social media data may provide a novel complementary source for better understanding the epidemiologic factors of infectious eye diseases, which could better inform eye health care and disease prevention. To assess whether data from internet-based social media and search engines are associated with objective clinic-based diagnoses of conjunctivitis. Data from encounters of 4143 patients diagnosed with conjunctivitis from June 3, 2012, to April 26, 2014, at the University of California San Francisco (UCSF) Medical Center, were analyzed using Spearman rank correlation of each weekly observation to compare demographics and seasonality of nonallergic conjunctivitis with allergic conjunctivitis. Data for patient encounters with diagnoses for glaucoma and influenza were also obtained for the same period and compared with conjunctivitis. Temporal patterns of Twitter and Google web search data, geolocated to the United States and associated with these clinical diagnoses, were compared with the clinical encounters. The a priori hypothesis was that weekly internet-based searches and social media posts about conjunctivitis may reflect the true weekly clinical occurrence of conjunctivitis. Weekly total clinical diagnoses at UCSF of nonallergic conjunctivitis, allergic conjunctivitis, glaucoma, and influenza were compared using Spearman rank correlation with equivalent weekly data on Tweets related to disease or disease-related keyword searches obtained from Google Trends. Seasonality of clinical diagnoses of nonallergic conjunctivitis among the 4143 patients (2364 females [57.1%] and 1776 males [42.9%]) with 5816 conjunctivitis encounters at UCSF correlated strongly with results of Google searches in the United States for the term pink eye (ρ, 0.68 [95% CI, 0.52 to 0.78]; P < .001) and correlated moderately with Twitter results about pink eye (ρ, 0.38 [95% CI, 0.16 to 0.56]; P < .001) and with clinical diagnosis of influenza (ρ, 0.33 [95% CI, 0.12 to 0.49]; P < .001), but did not significantly correlate with seasonality of clinical diagnoses of allergic conjunctivitis diagnosis at UCSF (ρ, 0.21 [95% CI, -0.02 to 0.42]; P = .06) or with results of Google searches in the United States for the term eye allergy (ρ, 0.13 [95% CI, -0.06 to 0.32]; P = .19). Seasonality of clinical diagnoses of allergic conjunctivitis at UCSF correlated strongly with results of Google searches in the United States for the term eye allergy (ρ, 0.44 [95% CI, 0.24 to 0.60]; P < .001) and eye drops (ρ, 0.47 [95% CI, 0.27 to 0.62]; P < .001). Internet-based search engine and social media data may reflect the occurrence of clinically diagnosed conjunctivitis, suggesting that these data sources can be leveraged to better understand the epidemiologic factors of conjunctivitis.

Cluster headache

MedlinePlus

... ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 30. Review Date 11/22/2017 Updated by: Luc Jasmin, ... of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by ...

BAER - brainstem auditory evoked response

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Benign ear cyst or tumor

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Osteotomy of the knee

MedlinePlus

... joint. A tibial osteotomy may make you look "knock-kneed." A femoral osteotomy may make you look " ... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic ...

Elbow sprain -- aftercare

MedlinePlus

... MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice . 4th ed. Philadelphia, PA: Elsevier ... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, ...

Achilles tendon repair

MedlinePlus

... MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice . 4th ed. Philadelphia, PA: Elsevier ... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, ...

Crutches and children - stairs

MedlinePlus

... Put the good foot on the step and push up. Push down hard on the crutches to help lift ... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic ...

Surveillance Tools Emerging From Search Engines and Social Media Data for Determining Eye Disease Patterns

PubMed Central

Deiner, Michael S.; Lietman, Thomas M.; McLeod, Stephen D.; Chodosh, James; Porco, Travis C.

2016-01-01

IMPORTANCE Internet-based search engine and social media data may provide a novel complementary source for better understanding the epidemiologic factors of infectious eye diseases, which could better inform eye health care and disease prevention. OBJECTIVE To assess whether data from internet-based social media and search engines are associated with objective clinic-based diagnoses of conjunctivitis. DESIGN, SETTING, AND PARTICIPANTS Data from encounters of 4143 patients diagnosed with conjunctivitis from June 3, 2012, to April 26, 2014, at the University of California San Francisco (UCSF) Medical Center, were analyzed using Spearman rank correlation of each weekly observation to compare demographics and seasonality of nonallergic conjunctivitis with allergic conjunctivitis. Data for patient encounters with diagnoses for glaucoma and influenza were also obtained for the same period and compared with conjunctivitis. Temporal patterns of Twitter and Google web search data, geolocated to the United States and associated with these clinical diagnoses, were compared with the clinical encounters. The a priori hypothesis was that weekly internet-based searches and social media posts about conjunctivitis may reflect the true weekly clinical occurrence of conjunctivitis. MAIN OUTCOMES AND MEASURES Weekly total clinical diagnoses at UCSF of nonallergic conjunctivitis, allergic conjunctivitis, glaucoma, and influenza were compared using Spearman rank correlation with equivalent weekly data on Tweets related to disease or disease-related keyword searches obtained from Google Trends. RESULTS Seasonality of clinical diagnoses of nonallergic conjunctivitis among the 4143 patients (2364 females [57.1%] and 1776 males [42.9%]) with 5816 conjunctivitis encounters at UCSF correlated strongly with results of Google searches in the United States for the term pink eye (ρ, 0.68 [95%CI, 0.52 to 0.78]; P < .001) and correlated moderately with Twitter results about pink eye (ρ, 0.38 [95%CI, 0.16 to 0.56]; P < .001) and with clinical diagnosis of influenza (ρ, 0.33 [95%CI, 0.12 to 0.49]; P < .001), but did not significantly correlate with seasonality of clinical diagnoses of allergic conjunctivitis diagnosis at UCSF (ρ, 0.21 [95%CI, −0.02 to 0.42]; P = .06) or with results of Google searches in the United States for the term eye allergy (ρ, 0.13 [95%CI, −0.06 to 0.32]; P = .19). Seasonality of clinical diagnoses of allergic conjunctivitis at UCSF correlated strongly with results of Google searches in the United States for the term eye allergy (ρ, 0.44 [95%CI, 0.24 to 0.60]; P < .001) and eye drops (ρ, 0.47 [95%CI, 0.27 to 0.62]; P < .001). CONCLUSIONS AND RELEVANCE Internet-based search engine and social media data may reflect the occurrence of clinically diagnosed conjunctivitis, suggesting that these data sources can be leveraged to better understand the epidemiologic factors of conjunctivitis. PMID:27416554

Lifting and bending the right way

MedlinePlus

... MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine . 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap ... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, ...

Improving Graduate Education to Support a Branching Career Pipeline: Recommendations Based on a Survey of Doctoral Students in the Basic Biomedical Sciences

PubMed Central

Fuhrmann, C. N.; Halme, D. G.; O’Sullivan, P. S.; Lindstaedt, B.

2011-01-01

Today's doctoral programs continue to prepare students for a traditional academic career path despite the inadequate supply of research-focused faculty positions. We advocate for a broader doctoral curriculum that prepares trainees for a wide range of science-related career paths. In support of this argument, we describe data from our survey of doctoral students in the basic biomedical sciences at University of California, San Francisco (UCSF). Midway through graduate training, UCSF students are already considering a broad range of career options, with one-third intending to pursue a non–research career path. To better support this branching career pipeline, we recommend that national standards for training and mentoring include emphasis on career planning and professional skills development to ensure the success of PhD-level scientists as they contribute to a broadly defined global scientific enterprise. PMID:21885820

Lost Dollars Threaten Research in Public Academic Health Centers.

PubMed

Bourne, Henry R; Vermillion, Eric B

2017-03-01

The decrease of federal and state support threatens long-term sustainability of research in publicly supported academic health centers. In weathering these financial threats, research at the University of California, San Francisco (UCSF), has undergone 3 substantial changes: institutional salary support goes preferentially to senior faculty, whereas the young increasingly depend on grants; private and government support for research grows apace in clinical departments but declines in basic science departments; and research is judged more on its quantity (numbers of investigators and federal and private dollars) than on its goals, achievements, or scientific quality. We propose specific measures to alleviate these problems. Other large public academic health centers probably confront similar issues, but-except for UCSF-such centers have not been subjected to detailed public analysis.-Bourne, H. R., Vermillion, E. B. Lost dollars threaten research in public academic health centers. © FASEB.

The key role of a transition course in preparing medical students for internship.

PubMed

Teo, Alan R; Harleman, Elizabeth; O'sullivan, Patricia S; Maa, John

2011-07-01

Among the core transitions in medical education is the one from medical school to residency. Despite this challenging transition, the final year of medical school is known as lacking structure and clarity. The authors examine the preparation of medical students for the professional and personal challenges of internship in the context of transition courses. They first describe the development of a residency transition course, offered since 2001 at the University of California, San Francisco, School of Medicine (UCSF), exploring aspects of a needs assessment, course goals and content, core competencies, and course implementation. They then critically analyze the course, judging it successful based on high subjective satisfaction scores and increased perceived preparedness data. Next, the authors discuss the national context of transition courses, perspectives of various stakeholders, and lessons learned from the UCSF experience. Finally, they consider future directions, suggesting that internship transition courses be a standard part of the medical school curriculum.

From Hahnemann's hand to your computer screen: building a digital homeopathy collection

PubMed Central

Mix, Lisa A; Cameron, Kathleen

2011-01-01

The University of California, San Francisco (UCSF), Library holds the unique manuscript of the sixth edition of Samuel Hahnemann's Organon der Heilkunst, the primary text of homeopathy. The manuscript volume is Hahnemann's own copy of the fifth edition of the Organon with his notes for the sixth edition, handwritten throughout the volume. There is a high level of interest in the Organon manuscript, particularly among homeopaths. This led to the decision to present a digital surrogate on the web to make it accessible to a wider audience. Digitizing Hahnemann's manuscript and determining the best method of presentation on the web posed several challenges. Lessons learned in the course of this project will inform future digital projects. This article discusses the historical significance of the sixth edition of Hahnemann's Organon, its context in UCSF's homeopathy collections, and the specifics of developing the online homeopathy collection. PMID:21243055

Improving graduate education to support a branching career pipeline: recommendations based on a survey of doctoral students in the basic biomedical sciences.

PubMed

Fuhrmann, C N; Halme, D G; O'Sullivan, P S; Lindstaedt, B

2011-01-01

Today's doctoral programs continue to prepare students for a traditional academic career path despite the inadequate supply of research-focused faculty positions. We advocate for a broader doctoral curriculum that prepares trainees for a wide range of science-related career paths. In support of this argument, we describe data from our survey of doctoral students in the basic biomedical sciences at University of California, San Francisco (UCSF). Midway through graduate training, UCSF students are already considering a broad range of career options, with one-third intending to pursue a non-research career path. To better support this branching career pipeline, we recommend that national standards for training and mentoring include emphasis on career planning and professional skills development to ensure the success of PhD-level scientists as they contribute to a broadly defined global scientific enterprise.

Analysis of the UCSF Symptom Management Theory: Implications for Pediatric Oncology Nursing

PubMed Central

Linder, Lauri

2015-01-01

Symptom management research is a priority for both children and adults with cancer. The UCSF Symptom Management Theory (SMT) is a middle range theory depicting symptom management as a multidimensional process. A theory analysis using the process described by Walker and Avant evaluated the SMT with attention to application in research involving children with cancer. Application of the SMT in studies involving children has been limited to descriptive studies testing only portions of the theory. Findings of these studies have provided empiric support for the relationships proposed within the SMT. Considerations for future research involving children include attention to measurement of symptoms and clarity regarding the location of the parents and family within the model. With additional testing and refinement, the SMT has the potential to guide nursing research and practice to improve symptoms for children with cancer. PMID:20639345

English language proficiency, health literacy, and trust in physician are associated with shared decision-making in rheumatoid arthritis

PubMed Central

Barton, Jennifer L.; Trupin, Laura; Tonner, Chris; Imboden, John; Katz, Patricia; Schillinger, Dean; Yelin, Edward H.

2014-01-01

Objective Treat to Target guidelines promote shared decision-making (SDM) in rheumatoid arthritis (RA). Also, due to high cost and potential toxicity of therapies, SDM is central to patient safety. Our objective was to examine patterns of perceived communication around decision-making in two cohorts of adults with RA. Methods Data were derived from patients enrolled in one of two longitudinal, observational cohorts (UCSF RA Cohort and RA Panel). Subjects completed a telephone interview in their preferred language that included a measure of patient-provider communication, including items about decision-making. Measures of trust in physician, education, and language proficiency were also asked. Logistic regression was performed to identify correlates of suboptimal SDM communication. Analyses were performed on each sample separately. Results Of 509 patients across two cohorts, 30% and 32% reported suboptimal SDM communication. Low trust in physician was independently associated with suboptimal SDM communication in both cohorts. Older age and limited English proficiency were independently associated with suboptimal SDM in the UCSF RA Cohort, as was limited health literacy in the RA Panel. Conclusions This study of over 500 adults with RA from two demographically distinct cohorts found that nearly one-third of subjects report suboptimal SDM communication with their clinicians, regardless of cohort. Lower trust in physician was independently associated with suboptimal SDM communication in both cohorts, as was limited English language proficiency and older age in the UCSF RA Cohort and limited health literacy in the Panel. These findings underscore the need to examine the impact of SDM on health outcomes in RA. PMID:24931952

What's in It for Me? Maintenance of Certification as an Incentive for Faculty Supervision of Resident Quality Improvement Projects.

PubMed

Rosenbluth, Glenn; Tabas, Jeffrey A; Baron, Robert B

2016-01-01

Residents are required to engage in quality improvement (QI) activities, which requires faculty engagement. Because of increasing program requirements and clinical demands, faculty may be resistant to taking on additional teaching and supervisory responsibilities without incentives. The authors sought to create an authentic benefit for University of California, San Francisco (UCSF) Pediatrics Residency Training Program faculty who supervise pediatrics residents' QI projects by offering maintenance of certification (MOC) Part 4 (Performance in Practice) credit. The authors identified MOC as an ideal framework to both more actively engage faculty who were supervising QI projects and provide incentives for doing so. To this end, in 2011, the authors designed an MOC portfolio program which included faculty development, active supervision of residents, and QI projects designed to improve patient care. The UCSF Pediatrics Residency Training Program's Portfolio Sponsor application was approved by the American Board of Pediatrics (ABP) in 2012, and faculty whose projects were included in the application were granted MOC Part 4 credit. As of December 2013, six faculty had received MOC Part 4 credit for their supervision of residents' QI projects. Based largely on the success of this program, UCSF has transitioned to the MOC portfolio program administered through the American Board of Medical Specialties, which allows the organization to offer MOC Part 4 credit from multiple specialty boards including the ABP. This may require refinements to screening, over sight, and reporting structures to ensure the MOC standards are met. Ongoing faculty development will be essential.

Trigger finger

MedlinePlus

... by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Related MedlinePlus Health Topics Finger Injuries and Disorders ...

Metatarsal fracture (acute) - aftercare

MedlinePlus

... Krettek C, Anderson PA, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction . 5th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 67. Review Date 11/27/2016 Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic ...

Taking narcotics for back pain

MedlinePlus

... Turk DC, Argoff CE, Hurley RW, eds. Practical Management of Pain . 5th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 12. Review Date 9/7/2017 Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic ...

Synovial biopsy

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Autoimmune Diseases Read more Biopsy Read more Fungal ...

Carpal tunnel biopsy

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Amyloidosis Read more Biopsy Read more Carpal Tunnel ...

Metatarsus adductus

MedlinePlus

... 2016 Updated by: C. Benjamin Ma, MD, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Foot Injuries and Disorders Read more NIH MedlinePlus ...

Tendon repair

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Sprains and Strains Read more NIH MedlinePlus Magazine ...

Compartment syndrome

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Muscle Disorders Read more NIH MedlinePlus Magazine Read ...

Kyphosis

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Spine Injuries and Disorders Read more NIH MedlinePlus ...

Tenosynovitis

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Tendinitis Read more NIH MedlinePlus Magazine Read more ...

Bunion removal

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Toe Injuries and Disorders Read more NIH MedlinePlus ...

Hammer toe

MedlinePlus

... by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Toe Injuries and Disorders Read more NIH MedlinePlus ...

Replantation of digits

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Finger Injuries and Disorders Read more Toe Injuries ...

THE EFFECT OF PRE-OPERATIVE NUTRITIONAL STATUS ON POST-OPERATIVE OUTCOMES IN CHILDREN UNDERGOING SURGERY FOR CONGENITAL HEART DEFECTS IN SAN FRANCISCO (UCSF) AND GUATEMALA CITY (UNICAR)

PubMed Central

Radman, Monique; Mack, Ricardo; Barnoya, Joaquin; Castañeda, Aldo; Rosales, Monica; Azakie, Anthony; Mehta, Nilesh; Keller, Roberta; Datar, Sanjeev; Oishi, Peter; Fineman, Jeffrey

2013-01-01

Objective To determine the association between preoperative nutritional status and postoperative outcomes in children undergoing surgery for congenital heart defects (CHD). Methods Seventy-one patients with CHD were enrolled in a prospective, two-center cohort study. We adjusted for baseline risk differences using a standardized risk adjustment score for surgery for CHD. We assigned a World Health Organization Z-score for each subjects’ preoperative triceps skinfold measurement, an assessment of total body fat mass. We obtained preoperative plasma concentrations of markers of nutritional status (prealbumin, albumin) and myocardial stress (B-type natriuretic peptide, BNP). Associations between indices of preoperative nutritional status and clinical outcomes were sought. Results Subjects had a median (IQR) age of 10.2 (33) months. In the UCSF cohort, duration of mechanical ventilation (median 19 hours, IQR 29), length of ICU stay (median 5 days, IQR 5), duration of any continuous inotropic infusion (median 66 hours, IQR 72) and preoperative BNP levels (median 30 pg/mL, IQR 75) were associated with a lower preoperative triceps skinfold Z-score (p<0.05). Longer duration of any continuous inotropic infusion and higher preoperative BNP levels were also associated with lower preoperative prealbumin (12.1 ± 0.5 mg/dL) and albumin (3.2 ± 0.1) (p<0.05). Conclusions Lower total body fat mass and acute and chronic malnourishment are associated with worse clinical outcomes in children undergoing surgery for CHD at UCSF, a resource-abundant institution. There is an inverse correlation between total body fat mass and BNP levels. Duration of inotropic support and BNP increase concomitantly as measures of nutritional status decrease, supporting the hypothesis that malnourishment is associated with decreased myocardial function. PMID:23583172

Does mentoring matter: results from a survey of faculty mentees at a large health sciences university

PubMed Central

Feldman, Mitchell D.; Arean, Patricia A.; Marshall, Sally J.; Lovett, Mark; O'Sullivan, Patricia

2010-01-01

Background To determine the characteristics associated with having a mentor, the association of mentoring with self-efficacy, and the content of mentor–mentee interactions at the University of California, San Francisco (UCSF), we conducted a baseline assessment prior to implementing a comprehensive faculty mentoring program. Method We surveyed all prospective junior faculty mentees at UCSF. Mentees completed a web-based, 38-item survey including an assessment of self-efficacy and a needs assessment. We used descriptive and inferential statistics to determine the association between having a mentor and gender, ethnicity, faculty series, and self-efficacy. Results Our respondents (n=464, 56%) were 53% female, 62% white, and 7% from underrepresented minority groups. More than half of respondents (n=319) reported having a mentor. There were no differences in having a mentor based on gender or ethnicity (p≥0.05). Clinician educator faculty with more teaching and patient care responsibilities were statistically significantly less likely to have a mentor compared with faculty in research intensive series (p<0.001). Having a mentor was associated with greater satisfaction with time allocation at work (p<0.05) and with higher academic self-efficacy scores, 6.07 (sd = 1.36) compared with those without a mentor, 5.33 (sd = 1.35, p<0.001). Mentees reported that they most often discussed funding with the mentors, but rated highest requiring mentoring assistance with issues of promotion and tenure. Conclusion Findings from the UCSF faculty mentoring program may assist other health science institutions plan similar programs. Mentoring needs for junior faculty with greater teaching and patient care responsibilities must be addressed. PMID:20431710

Concept formation: a supportive process for early career nurses.

PubMed

Thornley, Tracey; West, Sandra

2010-09-01

Individuals come to understand abstract constructs such as that of the 'expert' through the formation of concepts. Time and repeated opportunity for observation to support the generalisation and abstraction of the developing concept are essential if the concept is to form successfully. Development of an effective concept of the 'expert nurse' is critical for early career nurses who are attempting to integrate theory, values and beliefs as they develop their clinical practice. This study explores the use of a concept development framework in a grounded theory study of the 'expert nurse'. Qualitative. Using grounded theory methods for data collection and analysis, semi-structured interviews were conducted with registered nurses. The participants were asked to describe their concept of the 'expert nurse' and to discuss their experience of developing this. Participants reported forming their concept of the 'expert nurse', after multiple opportunities to engage with nurses identified as 'expert'. This identification did not necessarily relate to the designated position of the 'expert nurse' or assigned mentors. When the early career nurse does not successfully form a concept of the 'expert nurse', difficulties in personal and professional development including skill/knowledge development may arise. To underpin development of their clinical practice effectively, early career nurses need to be provided with opportunities that facilitate the purposive formation of their own concept of the 'expert nurse'. Formation of this concept is not well supported by the common practice of assigning mentors. Early career nurses must be provided with the time and the opportunity to individually develop and refine their concept of the 'expert nurse'. To achieve this, strategies including providing opportunities to engage with expert nurses and discussion of the process of concept formation and its place in underpinning personal judgments may be of assistance. © 2010 Blackwell Publishing Ltd.

Bursitis of the heel

MedlinePlus

... by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Bursitis Read more Heel Injuries and Disorders Read ...

Limited range of motion

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Joint Disorders Read more NIH MedlinePlus Magazine Read ...

Heritability of MMPI-2 scales in the UCSF Family Alcoholism Study

PubMed Central

Gizer, Ian R.; Seaton-Smith, Kimberley L.; Ehlers, Cindy L.; Vietan, Cassandra; Wilhelmsen, Kirk C.

2009-01-01

The present study evaluated the heritability of personality traits and psychopathology symptoms assessed by the Minnesota Multiphasic Personality Interview 2nd edition (MMPI-2) in a family-based sample selected for alcohol dependence. Participants included 950 probands and 1204 first-degree relatives recruited for the UCSF Family Alcoholism Study. Heritability estimates (h2) for MMPI-2 scales ranged from .25–.49. When alcohol dependence was used as a covariate, heritability estimates remained significant but generally declined. However, when the MMPI-2 scales were used as covariates to estimate the heritability of alcohol dependence, scales measuring antisocial behavior (ASP), depressive symptoms (DEP), and addictive behavior (MAC-R) led to moderate increases in the heritability of alcohol dependence. This suggests that the ASP, DEP, and MAC-R scales may explain some of the non-genetic variance in the alcohol dependence diagnosis in this population when utilized as covariates, and thus may serve to produce a more homogeneous and heritable alcohol dependence phenotype. PMID:20390702

The Key Role of a Transition Course in Preparing Medical Students for Internship

PubMed Central

Teo, Alan R.; Harleman, Elizabeth; O’Sullivan, Patricia S.; Maa, John

2011-01-01

Among the core transitions in medical education is the one from medical school to residency. Despite this challenging transition, the final year of medical school is known as lacking structure and clarity. The authors examine the preparation of medical students for the professional and personal challenges of internship in the context of transition courses. They first describe the development of a residency transition course, offered since 2001 at the University of California, San Francisco, School of Medicine (UCSF), exploring aspects of a needs assessment, course goals and content, core competencies, and course implementation. They then critically analyze the course, judging it successful based on high subjective satisfaction scores and increased perceived preparedness data. Next, the authors discuss the national context of transition courses, perspectives of various stakeholders, and lessons learned from the UCSF experience. Finally, they consider future directions, suggesting that internship transition courses be a standard part of the medical school curriculum. PMID:21617513

Development of the Paris definition of early Crohn's disease for disease-modification trials: results of an international expert opinion process.

PubMed

Peyrin-Biroulet, Laurent; Billioud, Vincent; D'Haens, Geert; Panaccione, Remo; Feagan, Brian; Panés, Julian; Danese, Silvio; Schreiber, Stefan; Ogata, Haruhiko; Hibi, Toshifumi; Higgins, Peter D R; Beaugerie, Laurent; Chowers, Yehuda; Louis, Edouard; Steinwurz, Flávio; Reinisch, Walter; Rutgeerts, Paul; Colombel, Jean-Frédéric; Travis, Simon; Sandborn, William J

2012-12-01

We report the findings and outputs of an international expert opinion process to develop a definition of early Crohn's disease (CD) that could be used in future disease-modification trials. Nineteen experts on inflammatory bowel diseases held an international expert opinion meeting to discuss and agree on a definition for early CD to be used in disease-modification trials. The process included literature searches for the relevant basic-science and clinical evidence. A published preliminary definition of early CD was used as the basis for development of a proposed definition that was discussed at the expert opinion meeting. The participants then derived a final definition, based on best current knowledge, that it is hoped will be of practical use in disease-modification trials in CD.

Repair of webbed fingers or toes

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Finger Injuries and Disorders Read more Toe Injuries ...

Early-career experts essential for planetary sustainability

USGS Publications Warehouse

Lim, Michelle; Lynch, Abigail J.; Fernández-Llamazares, Alvaro; Balint, Lenke; Basher, Zeenatul; Chan, Ivis; Jaureguiberry, Pedro; Mohamed, A.A.A.; Mwampamba, Tuyeni H.; Palomo, Ignacio; Pliscoff, Patricio; Salimov, R.A.; Samakov, Aibek; Selomane, Odirilwe; Shrestha, Uttam B.; Sidorovich, Anna A.

2017-01-01

Early-career experts can play a fundamental role in achieving planetary sustainability by bridging generational divides and developing novel solutions to complex problems. We argue that intergenerational partnerships and interdisciplinary collaboration among early-career experts will enable emerging sustainability leaders to contribute fully to a sustainable future. We review 16 international, interdisciplinary, and sustainability-focused early-career capacity building programs. We conclude that such programs are vital to developing sustainability leaders of the future and that decision-making for sustainability is likely to be best served by strong institutional cultures that promote intergenerational learning and involvement.

$10M Gift Supports "Data Recycling" at UCSF.

PubMed

2017-10-01

The University of California, San Francisco's Institute for Computational Health Sciences has received a $10 million gift to support "data recycling" investigations. The approach to medical research involves mining existing data to potentially uncover new uses for existing drugs and help improve clinical care. ©2017 American Association for Cancer Research.

The Needs and Difficulties in Socializing the Young in Contemporary China: Early Childhood Education Experts' Perspectives

ERIC Educational Resources Information Center

Hsueh, Yeh; Hao, Jun; Zhang, Hui

2016-01-01

This study was the first of its kind in China to examine early childhood education experts' perspectives on the urgent educational needs of preschool-aged children. Twenty-one nationally and regionally recognized experts, including university professors, practitioners and government officials, participated in interviews. They offered critical…

McCormick to Aid Frederick National Laboratory in Developing RAS Cancer Genetics Initiative | Frederick National Laboratory for Cancer Research

Cancer.gov

Frank McCormick, Ph.D., director of the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco, and associate dean of the UCSF School of Medicine, has signed a consulting agreement with SAIC-Frederick Inc. to w

A Changing Health Care Environment: Its Impact on UCSF Graduates' Practice Patterns and Perceptions.

ERIC Educational Resources Information Center

Sauer, Barbara L.; Koda-Kimble, Mary Anne

1998-01-01

A survey of 754 University of California at San Francisco doctoral pharmacy graduates from 1980 to 1994 investigated how managed care affected practice patterns and perceptions of the profession. Graduates generally remained satisfied with their education and were optimistic about the profession. Although managed care has created a stressful…

Recruitment of Chinese American Elders into Dementia Research: The UCSF ADRC Experience

ERIC Educational Resources Information Center

Chao, Steven Z.; Lai, Ngan B.; Tse, Marian M.; Ho, Rachel J.; Kong, Joanne P.; Matthews, Brandy R.; Miller, Bruce L.; Rosen, Howard J.

2011-01-01

Purpose: To describe the results of efforts to recruit Asian Americans into longitudinal research on cognitive decline in aging. Design and Methods: Recruitment strategies include clinics for assessment of cognitive impairment at the University of California, San Francisco campus and San Francisco's Chinatown, lectures to local health care…

Caring Wisely: A Program to Support Frontline Clinicians and Staff in Improving Healthcare Delivery and Reducing Costs.

PubMed

Gonzales, Ralph; Moriates, Christopher; Lau, Catherine; Valencia, Victoria; Imershein, Sarah; Rajkomar, Alvin; Prasad, Priya; Boscardin, Christy; Grady, Deborah; Johnston, S

2017-08-01

We describe a program called "Caring Wisely"®, developed by the University of California, San Francisco's (UCSF), Center for Healthcare Value, to increase the value of services provided at UCSF Health. The overarching goal of the Caring Wisely® program is to catalyze and advance delivery system redesign and innovations that reduce costs, enhance healthcare quality, and improve health outcomes. The program is designed to engage frontline clinicians and staff-aided by experienced implementation scientists-to develop and implement interventions specifically designed to address overuse, underuse, or misuse of services. Financial savings of the program are intended to cover the program costs. The theoretical underpinnings for the design of the Caring Wisely® program emphasize the importance of stakeholder engagement, behavior change theory, market (target audience) segmentation, and process measurement and feedback. The Caring Wisely® program provides an institutional model for using crowdsourcing to identify "hot spot" areas of low-value care, inefficiency and waste, and for implementing robust interventions to address these areas. © 2017 Society of Hospital Medicine.

Interview: the National Institute of Neurological Diseases and Stroke/American Epilepsy Society benchmarks and research priorities for epilepsy research.

PubMed

Lowenstein, Daniel H

2011-10-01

Daniel H Lowenstein, MD, is the Robert B and Ellinor Aird Professor and Vice-Chairman of Neurology, Director of the Epilepsy Center, and Director of Physician-Scientist Education and Training at the University of California, San Francisco (UCSF). He received his BA in Mathematics from the University of Colorado and MD from Harvard Medical School. He completed his neurology residency training at UCSF. Dr Lowenstein is a clinician-scientist who has studied both basic science and clinical aspects of epilepsy. In recent years, he has been an organizer of a large-scale, international effort to study the complex genetics of epilepsy, known as the Epilepsy Phenome/Genome Project. He has been actively involved in advancing the cause of epilepsy at the national and international level. Dr Lowenstein served as President of the American Epilepsy Society from 2003 to 2004 and the National Institute of Neurological Diseases and Stroke (NINDS) Advisory Council from 2000 to 2004, and has overseen the development of the NINDS Epilepsy Research Benchmarks since their inception in 2000.

The effect of preoperative nutritional status on postoperative outcomes in children undergoing surgery for congenital heart defects in San Francisco (UCSF) and Guatemala City (UNICAR).

PubMed

Radman, Monique; Mack, Ricardo; Barnoya, Joaquin; Castañeda, Aldo; Rosales, Monica; Azakie, Anthony; Mehta, Nilesh; Keller, Roberta; Datar, Sanjeev; Oishi, Peter; Fineman, Jeffrey

2014-01-01

The objective of this study was to determine the association between preoperative nutritional status and postoperative outcomes in children undergoing surgery for congenital heart defects (CHD). Seventy-one patients with CHD were enrolled in a prospective, 2-center cohort study. We adjusted for baseline risk differences using a standardized risk adjustment score for surgery for CHD. We assigned a World Health Organization z score for each subject's preoperative triceps skin-fold measurement, an assessment of total body fat mass. We obtained preoperative plasma concentrations of markers of nutritional status (prealbumin, albumin) and myocardial stress (B-type natriuretic peptide [BNP]). Associations between indices of preoperative nutritional status and clinical outcomes were sought. Subjects had a median (interquartile range [IQR]) age of 10.2 (33) months. In the University of California at San Francisco (UCSF) cohort, duration of mechanical ventilation (median, 19 hours; IQR, 29 hours), length of intensive care unit stay (median, 5 days; IQR 5 days), duration of any continuous inotropic infusion (median, 66 hours; IQR 72 hours), and preoperative BNP levels (median, 30 pg/mL; IQR, 75 pg/mL) were associated with a lower preoperative triceps skin-fold z score (P < .05). Longer duration of any continuous inotropic infusion and higher preoperative BNP levels were also associated with lower preoperative prealbumin (12.1 ± 0.5 mg/dL) and albumin (3.2 ± 0.1; P < .05) levels. Lower total body fat mass and acute and chronic malnourishment are associated with worse clinical outcomes in children undergoing surgery for CHD at UCSF, a resource-abundant institution. There is an inverse correlation between total body fat mass and BNP levels. Duration of inotropic support and BNP increase concomitantly as measures of nutritional status decrease, supporting the hypothesis that malnourishment is associated with decreased myocardial function. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Expert Practitioner's Views about the Chinese Early Childhood Environment Rating Scale

ERIC Educational Resources Information Center

Hu, Bi Ying; Vong, Keang-ieng; Chen, Yuewen; Li, Kejian

2015-01-01

This study aims to examine the views of 176 expert practitioners on the relevance and feasibility of applying the Chinese Early Childhood Environment Rating Scale (CECERS), which is developed based on the Chinese version of Harms, Clifford, and Cryer's (2005) world renowned Early Childhood Environment Rating Scale-revised (ECERS-R). The CECERS…

Promoting pedagogical content knowledge development for early career secondary teachers in science and technology using content representations

NASA Astrophysics Data System (ADS)

Williams, John; Eames, Chris; Hume, Anne; Lockley, John

2012-11-01

Background: This research addressed the key area of early career teacher education and aimed to explore the use of a 'content representation' (CoRe) as a mediational tool to develop early career secondary teacher pedagogical content knowledge (PCK). This study was situated in the subject areas of science and technology, where sound teacher knowledge is particularly important to student engagement. Purpose: The study was designed to examine whether such a tool (a CoRe), co-designed by an early career secondary teacher with expert content and pedagogy specialists, can enhance the PCK of early career teachers. The research questions were: How can experts in content and pedagogy work together with early career teachers to develop one science topic CoRe and one technology topic CoRe to support the development of PCK for early career secondary teachers? How does the use of a collaboratively designed CoRe affect the planning of an early career secondary teacher in science or technology? How has engagement in the development and use of an expert-informed CoRe developed an early career teacher's PCK? Sample: The research design incorporated a unique partnership between two expert classroom teachers, two content experts, four early career teachers, and four researchers experienced in science and technology education. Design: This study employed an interpretivist-based methodology and an action research approach within a four-case study design. Data were gathered using qualitative research methods focused on semi-structured interviews, observations and document analysis. Results: The study indicated that CoRes, developed through this collaborative process, helped the early career teachers focus on the big picture of the topic, emphasize particularly relevant areas of content and consider alternative ways of planning for their teaching. Conclusions: This paper presents an analysis of the process of CoRe development by the teacher-expert partnerships and the effect that had on the early career teachers' PCK. In addition, as the same tools and methodology were applied to both a science and a technology teaching context, differences between the two learning areas are discussed.

Internship Experiences Contribute to Confident Career Decision Making for Doctoral Students in the Life Sciences

ERIC Educational Resources Information Center

Schnoes, Alexandra M.; Caliendo, Anne; Morand, Janice; Dillinger, Teresa; Naffziger-Hirsch, Michelle; Moses, Bruce; Gibeling, Jeffery C.; Yamamoto, Keith R.; Lindstaedt, Bill; McGee, Richard; O'Brien, Theresa C.

2018-01-01

The Graduate Student Internships for Career Exploration (GSICE) program at the University of California, San Francisco (UCSF), offers structured training and hands-on experience through internships for a broad range of PhD-level careers. The GSICE program model was successfully replicated at the University of California, Davis (UC Davis). Here, we…

Engaging a University in Self-Assessment and Strategic Planning to Build Partnership Capacity: The UCSF Experience

ERIC Educational Resources Information Center

Wortis, Naomi; Goldstein, Ellen; Vargas, Roberto Ariel; Grumbach, Kevin

2006-01-01

In an effort to better fulfill its public service mission, the University of California, San Francisco, has undertaken an intensive assessment and strategic planning process to build institutional capacity for civic engagement and community partnership. The first stage was a qualitative assessment focused primarily on three local communities,…

Targeting BRCAness in Gastric Cancer

DTIC Science & Technology

2017-10-01

modified CRISPR system using dCas9-KRAB expressing variants of these cells, and validated them for CRISPRi screening. These reagents will next be used...OE19 Adherent Stable Oesophagus/ gastric cardia - - - OE33 Adherent Stable Esophageal adenocarcinoma - - - Figure 2. Validation of CRISPR ...project planning and reporting Patrick O’Leary Postdoctoral Fellow UCSF PH.D. Design, execution, and interpretation of CRISPR experiments

78 FR 77289 - Endangered and Threatened Wildlife and Plants; Designation of Critical Habitat for Arctostaphylos...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-20

... request, and we removed the existing off-leash dog play area from Corona Heights (Unit 6) and eliminated... in Corona Heights is fenced off and modified with wood chips. We visited Bernal Heights on November...; Bayview Hill; UCSF, Laurel Hill Campus; Buena Vista Park; Corona Heights Park; Starr King Open Space; and...

Cloning of the poly(ADP-ribose) Gene from Rat Liver.

DTIC Science & Technology

1986-09-24

Levinson, Ph.D. (Cetus Corp., Berkeley). 5. Amino acid analysis done in UCSF Bioanal. Lab. TABLE OF CONTENTS Page METHOD I...TABLE I ............. ............................... ... 12 Proteolytic degradation, isolation of peptide and amino acid sequences...technique developed for enzyme quantitation in biological materials. The amino- acid sequence of the enzyme has so far been determined because the amino

Early psychosis workforce development: Core competencies for mental health professionals working in the early psychosis field.

PubMed

Osman, Helen; Jorm, Anthony F; Killackey, Eoin; Francey, Shona; Mulcahy, Dianne

2017-08-09

The aim of this study was to identify the core competencies required of mental health professionals working in the early psychosis field, which could function as an evidence-based tool to support the early psychosis workforce and in turn assist early psychosis service implementation and strengthen early psychosis model fidelity. The Delphi method was used to establish expert consensus on the core competencies. In the first stage, a systematic literature search was conducted to generate competency items. In the second stage, a panel consisting of expert early psychosis clinicians from around the world was formed. Panel members then rated each of the competency items on how essential they are to the clinical practice of all early psychosis clinicians. In total, 1023 pieces of literature including textbooks, journal articles and grey literature were reviewed. A final 542 competency items were identified for inclusion in the questionnaire. A total of 63 early psychosis experts participated in 3 rating rounds. Of the 542 competency items, 242 were endorsed as the required core competencies. There were 29 competency items that were endorsed by 62 or more experts, and these may be considered the foundational competencies for early psychosis practice. The study generated a set of core competencies that provide a common language for early psychosis clinicians across professional disciplines and country of practice, and potentially are a useful professional resource to support early psychosis workforce development and service reform. © 2017 John Wiley & Sons Australia, Ltd.

A novel approach for effective integration of new faculty leadership

PubMed Central

Hastings, Natalie B; Centore, Linda S; Gansky, Stuart A; Finzen, Frederick C; White, Joel M; Wong, Eric; Marshall, Grayson W; Chung, Lisa; Kalenderian, Elsbeth

2017-01-01

Purpose We report on an accelerated and effective way of assimilating a new leader into a team at a large academic dental school department. Methods At University of California, San Francisco (UCSF), a new Chair was recruited through a national search to lead its largest department in the School of Dentistry. Two months after arrival, the new Chair embarked on a process of leadership assimilation among her executive team, facilitated by a professional consultant. Within four weeks, team members participated in one-on-one interviews with the professional facilitator consultant and then completed the leadership assimilation questionnaire and returned it electronically to the facilitator. The facilitator then summarized all answers into themes and met with the team members without the Chair to debrief. Thereafter, the facilitator met with the Chair to discuss the major themes. Next, the Chair met with the team members in a facilitated session to discuss the results and negotiate a path forward. Results Approximately half of the feedback described the “how” of leadership: comments on communication, building relationships, building trust, and understanding UCSF history. The remaining half described the “what”: comments on vision, strategy, and operations. Team members indicated that the first debriefing session was helpful to alleviate initial anxiety and to start building team spirit. The session with the Chair was perceived as open and fruitful in which team members were able to express their concerns and hopes for the Department, while the Chair showed commitment to the team and the communication process. Conclusion Leader assimilation allows teams to share their expectations and anxieties with the new leader early in the relationship in an open way, before new habits and beliefs are formed. Conversely, for the leader, it effectively and efficiently allows a window into the team members’ thinking at a critical time period when otherwise first impressions occur. With a safe space created for open communication, the process allowed siloed individual division leaders to move toward a cohesive group while at the same time solidifying a commitment to the success of the new leader. PMID:29720883

A novel approach for effective integration of new faculty leadership.

PubMed

Hastings, Natalie B; Centore, Linda S; Gansky, Stuart A; Finzen, Frederick C; White, Joel M; Wong, Eric; Marshall, Grayson W; Chung, Lisa; Kalenderian, Elsbeth

2017-01-01

We report on an accelerated and effective way of assimilating a new leader into a team at a large academic dental school department. At University of California, San Francisco (UCSF), a new Chair was recruited through a national search to lead its largest department in the School of Dentistry. Two months after arrival, the new Chair embarked on a process of leadership assimilation among her executive team, facilitated by a professional consultant. Within four weeks, team members participated in one-on-one interviews with the professional facilitator consultant and then completed the leadership assimilation questionnaire and returned it electronically to the facilitator. The facilitator then summarized all answers into themes and met with the team members without the Chair to debrief. Thereafter, the facilitator met with the Chair to discuss the major themes. Next, the Chair met with the team members in a facilitated session to discuss the results and negotiate a path forward. Approximately half of the feedback described the "how" of leadership: comments on communication, building relationships, building trust, and understanding UCSF history. The remaining half described the "what": comments on vision, strategy, and operations. Team members indicated that the first debriefing session was helpful to alleviate initial anxiety and to start building team spirit. The session with the Chair was perceived as open and fruitful in which team members were able to express their concerns and hopes for the Department, while the Chair showed commitment to the team and the communication process. Leader assimilation allows teams to share their expectations and anxieties with the new leader early in the relationship in an open way, before new habits and beliefs are formed. Conversely, for the leader, it effectively and efficiently allows a window into the team members' thinking at a critical time period when otherwise first impressions occur. With a safe space created for open communication, the process allowed siloed individual division leaders to move toward a cohesive group while at the same time solidifying a commitment to the success of the new leader.

The UCSF AIDS Health Project Guide to Counseling: Perspectives on Psychotherapy, Prevention, and Therapeutic Practice.

ERIC Educational Resources Information Center

Dilley, James W., Ed.; Marks, Robert, Ed.

The University of California San Francisco AIDS Health Project has more than 15 years' experience in working with thousands of people with AIDS. This guide, developed by the Project, provides practical, state-of-the-art resources in the field. Part 1, "Risk and Behavior: Helping Clients Remain Uninfected," covers the following topics:…

Targeting BRCAness in Gastric Cancer

DTIC Science & Technology

2017-10-01

generated a modified CRISPR system using dCas9-KRAB expressing variants of these cells, and validated them for CRISPRi screening. These reagents will...adenocarcinoma - - - Figure 2. Validation of CRISPR activity following transduction with sgRNAs targeting CD55 and FACS staining with the anti...execution, and interpretation of CRISPR experiments Morgan Diolaiti Specialist UCSF PH.D. Experimental planning and reporting Jefferson Woods SRA

Expediting Clinician Adoption of Safety Practices: The UCSF Venous Access Patient Safety Interdisciplinary Education Project

DTIC Science & Technology

2005-01-01

knowledge in the digital age. New York: McGraw- Hill; 2001. p. 11. 37. Sackett D, Straus S, Richardson W, et al. Evidence - based medicine . 2nd ed. New...249. 46. Evidence - Based Medicine Working Group. Evidence - based medicine . A new approach to teaching the practice of medicine. JAMA 1992;268(17):2420

Development of a longitudinal integrated clerkship at an academic medical center.

PubMed

Poncelet, Ann; Bokser, Seth; Calton, Brook; Hauer, Karen E; Kirsch, Heidi; Jones, Tracey; Lai, Cindy J; Mazotti, Lindsay; Shore, William; Teherani, Arianne; Tong, Lowell; Wamsley, Maria; Robertson, Patricia

2011-04-04

In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center.

Development of a longitudinal integrated clerkship at an academic medical center

PubMed Central

Poncelet, Ann; Bokser, Seth; Calton, Brook; Hauer, Karen E.; Kirsch, Heidi; Jones, Tracey; Lai, Cindy J.; Mazotti, Lindsay; Shore, William; Teherani, Arianne; Tong, Lowell; Wamsley, Maria; Robertson, Patricia

2011-01-01

In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center. PMID:21475642

Evaluation of the ASCO Value Framework for Anticancer Drugs at an Academic Medical Center.

PubMed

Wilson, Leslie; Lin, Tracy; Wang, Ling; Patel, Tanuja; Tran, Denise; Kim, Sarah; Dacey, Katie; Yuen, Courtney; Kroon, Lisa; Brodowy, Bret; Rodondi, Kevin

2017-02-01

Anticancer drug prices have increased by an average of 12% each year from 1996 to 2014. A major concern is that the increasing cost and responsibility of evaluating treatment options are being shifted to patients. This research compared 2 value-based pricing models that were being considered for use at the University of California, San Francisco (UCSF) Medical Center to address the growing burden of high-cost cancer drugs while improving patient-centered care. The Medication Outcomes Center (MOC) in the Department of Clinical Pharmacy, University of California, San Francisco (UCSF), School of Pharmacy focuses on assessing the value of medication-related health care interventions and disseminating findings to the UCSF Medical Center. The High Cost Oncology Drug Initiative at the MOC aims to assess and adopt tools for the critical assessment and amelioration of high-cost cancer drugs. The American Society of Clinical Oncology (ASCO) Value Framework (2016 update) and a cost-effectiveness analysis (CEA) framework were identified as potential tools for adoption. To assess 1 prominent value framework, the study investigators (a) asked 8 clinicians to complete the ASCO Value Framework for 11 anticancer medications selected by the MOC; (b) reviewed CEAs assessing the drugs; (c) generated descriptive statistics; and (d) analyzed inter-rater reliability, convergence validity, and ranking consistency. On the scale of -20 to 180, the mean ASCO net health benefit (NHB) total score across 11 drugs ranged from 7.6 (SD = 7.8) to 53 (SD = 9.8). The Kappa coefficient (κ) for NHB scores across raters was 0.11, which is categorized as "slightly reliable." The combined κ score was 0.22, which is interpreted as low to fair inter-rater reliability. Convergent validity indicates that the correlation between NHB scores and CEA-based incremental cost-effectiveness ratios (ICERs) was low (-0.215). Ranking of ICERs, ASCO scores, and wholesale acquisition costs indicated different results between frameworks. The ASCO Value Framework requires further specificity before use in a clinical setting, since it currently results in low inter-rater reliability and validity. Furthermore, ASCO scores were unable to discriminate between drugs providing the most and least value. The evaluation provides specific areas of weakness that can be addressed in future updates of the ASCO framework to improve usability. Meanwhile, the UCSF Medical Center should rely on CEAs, which are highly accessible for the highlighted cancer drugs. The MOC role can include summarizing and disseminating available CEA studies for interpretation by clinicians and financial counselors around drug value. Funding for this research was contributed by the University of California, San Francisco, Medical Center Campus Strategic Initiative Program. The authors have no conflicts of interest to disclose. Study concept and design were contributed primarily by Wilson, along with Wang and Patel. Kim, Dacey, and Yuen collected the data, and data interpretation was performed by Wilson and Lin. The manuscript was written by Wilson, Lin, Wang, and Tran and revised by Lin, Redondi, Brodowy, and Kroon.

SKIPing with Teachers: An Early Years Motor Skill Intervention

ERIC Educational Resources Information Center

Brian, Ali; Goodway, Jacqueline D.; Logan, Jessica A.; Sutherland, Sue

2017-01-01

Background: Fundamental motor skill (FMS) interventions when delivered by an expert can significantly improve the FMS of young children with and without developmental delays. However, there is a gap in the literature as few early childhood centers employ experts with the professional background to deliver FMS intervention. Purpose: The primary…

Regional and national guideline recommendations for digital ano-rectal examination as a means for anal cancer screening in HIV positive men who have sex with men: a systematic review.

PubMed

Ong, Jason J; Chen, Marcus; Grulich, Andrew E; Fairley, Christopher K

2014-08-01

Although anal cancer is common in HIV positive men who have sex with men, few centres offer systematic screening. Regular digital ano-rectal examination (DARE) is a type of screening that has been recommended by some experts. How widely this forms part of HIV management guidelines is unclear. The protocol was registered prospectively (CRD42013005188; http://www.crd.york.ac.uk/PROSPERO/). We systematically reviewed 121 regional and national HIV guidelines and searched for guidelines from http://hivinsite.ucsf.edu/global?page=cr-00-04#SauguidelineX, PubMed and Web of Science databases up to 5th August 2013 for recommendations of DARE as a means of anal cancer screening in HIV positive MSM. Guidelines were examined in detail if they were clinical guidelines, including both prevention and treatment protocols and were in English. Guidelines were excluded if they were restricted to limited areas (e.g. antiretroviral therapy only, children or pregnant women, strategies for prevention/testing). Information was extracted regarding recommendation of DARE as a screening method, the frequency of DARE recommended, target population for screening and the strength of evidence supporting this. 30 regional and national guidelines were included and examined in detail. Only 2 recommended DARE. The 'European AIDS Clinical Society Guidelines' recommends DARE every 1-3 years for HIV positive MSM whilst the 'US Guideline for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents' recommends an annual DARE for the HIV + population in general. None of these guidelines specify the age of commencing screening. In each case, the highest level of evidence supporting these two recommendations was expert opinion. Few HIV guidelines discuss or recommend DARE as a means of anal cancer screening. Studies of the efficacy, acceptability and cost-effectiveness of DARE are needed to assess its role in anal cancer screening.

Targeting BRCAness in Gastric Cancer

DTIC Science & Technology

2017-10-01

modified CRISPR system using dCas9-KRAB expressing variants of these cells, and validated them for CRISPRi screening. These reagents will next be... CRISPR activity following transduction with sgRNAs targeting CD55 and FACS staining with the anti-CD55 antibody. Data shown for MKN7 and KATOIII...Oversight, project planning and reporting Patrick O’Leary Postdoctoral Fellow UCSF PH.D. Design, execution, and interpretation of CRISPR experiments

Targeting BRCAness in Gastric Cancer

DTIC Science & Technology

2017-10-01

a modified CRISPR system using dCas9-KRAB expressing variants of these cells, and validated them for CRISPRi screening. These reagents will next be... CRISPR activity following transduction with sgRNAs targeting CD55 and FACS staining with the anti-CD55 antibody. Data shown for MKN7 and KATOIII...Oversight, project planning and reporting Patrick O’Leary Postdoctoral Fellow UCSF PH.D. Design, execution, and interpretation of CRISPR

The virulence of human pathogenic fungi: notes from the South of France.

PubMed

Reedy, Jennifer L; Bastidas, Robert J; Heitman, Joseph

2007-08-16

The Second FEBS Advanced Lecture Course on Human Fungal Pathogens: Molecular Mechanisms of Host-Pathogen Interactions and Virulence, organized by Christophe d'Enfert (Institut Pasteur, France), Anita Sil (UCSF, USA), and Steffen Rupp (Fraunhofer, IGB, Germany), occurred May 2007 in La Colle sur Loup, France. Here we review the advances presented and the current state of knowledge in key areas of fungal pathogenesis.

Policy Options for University of California Budgeting. Research & Occasional Paper Series: CSHE.5.11

ERIC Educational Resources Information Center

Young, Charles E.

2011-01-01

Within a quarter century after the end of World War II (1945-1970), largely because of the support and investment it received from the State, the University of California had changed from two modest-size general campuses (Berkeley and Los Angeles) and the medical campus in San Francisco (UCSF), to a system of eight general campuses. California was…

Rate of tumor growth predicts recurrence of hepatocellular carcinoma after liver transplantation in patients beyond Milan or UCSF criteria.

PubMed

Hanouneh, I A; Macaron, C; Lopez, R; Aucejo, F; Zein, N N

2011-12-01

It is likely that some patients whose tumor burdens exceed the current transplant criteria have favorable tumor biology, and that these patients would have low risk of tumor recurrence after liver transplantation (LT). To assess the rate of tumor growth as selection criteria for LT in patients with hepatocellular carcinoma (HCC). We identified all patients who underwent LT for HCC in our institution from 2002 to 2008. Total tumor volume (TTV) was calculated as the sum of the volumes of all tumors on pretransplantation imaging [(4/3)πr3, where r is the maximum radius of each HCC]. The rate of tumor growth was calculated as per-month change in TTV on sequential pretransplantation imaging before any locoregional therapy. A Kaplan-Meier plot was constructed and Cox regression analysis performed. Ninety-two patients were included in the study. The median follow-up was 19.5 (range 10.7-30.7) months during which 12 patients (13%) experienced recurrence of HCC. Twenty-four patients (26%) had HCC beyond the Milan criteria, and the overall survival rate of the entire group was 72%. Higher pre-LT alpha-fetoprotein (hazard ratio [HR] 1.01; P=.001), poorly differentiated tumors (HR 13; P=.039), the presence of microvascular invasion (HR 7.9; P=.001), higher TTV (HR 1.03; P<.001), and faster tumor growth (HR 1.09; P<.001) were significantly associated with the risk of recurrence. A cutoff value of tumor growth of 1.61 cm3/mo was chosen on the basis of the risk of recurrence with the use of a receiver operating characteristic curve. Patients beyond the Milan criteria with tumor growth<1.61 cm3/mo experienced less recurrence (11% vs 58%; P=.023) than those beyond the Milan criteria with tumor growth>1.61 cm3/mo. Similarly, rate of tumor growth predicted HCC recurrence in those beyond the University of California of San Francisco (UCSF) criteria. Patients with slowly growing tumor who would be currently excluded from LT because tumor burden exceeds traditional Milan and UCSF criteria may have a favorable posttransplantation outcome. Copyright © 2011. Published by Elsevier Inc.

Training and Psychosocial Patterns during the Early Development of Portuguese National Team Athletes

ERIC Educational Resources Information Center

Barreiros, Andre; Cote, Jean; Fonseca, Antonio Manuel

2013-01-01

This study explored the early development of expert athletes compared to a group of athletes that did not achieve an expert level of performance despite being involved in youth events with their national squads. In particular, the activities, training patterns, and psychosocial influences that characterized their paths in competitive sports were…

Quality of Life for Adults with Asthma in a Military Setting

DTIC Science & Technology

1998-05-01

Tilley, Havstead, & Zoratti, 1997). More recently, van der Molen , et al. (1997) conducted a study comparing discriminative aspects of two generic...Symptom Management Faculty Group, UCSF. (1994). IMAGE: Journal of Nursing Scholarship, 26(4), 272-276. van der Molen , T., Postma, D., Schreuers, A...the most important (Earwood, 1996, Rutten- Van Molken, Van Doorslaer, & Rutten, 1992). Purpose of the Study When patients clarify their perceptions of

[Neuroethics].

PubMed

Ramiro, H Manuel

2015-01-01

Neuroethics emerged as a discipline in 2012 after a World Congress organized by the Stanford University, the University of California at San Francisco (UCSF), and sponsored by the Dana Foundation. It has emerged with great force and an important interdisciplinary approach between science and philosophy. Its most relevant lines of action are the study of the ethical consequences of neuroscience research and clinical interventions; as well as the biological factors of human behavior or conduct.

Training the next generation of research mentors: the University of California, San Francisco, Clinical & Translational Science Institute Mentor Development Program.

PubMed

Feldman, Mitchell D; Huang, Laurence; Guglielmo, B Joseph; Jordan, Richard; Kahn, James; Creasman, Jennifer M; Wiener-Kronish, Jeanine P; Lee, Kathryn A; Tehrani, Ariane; Yaffe, Kristine; Brown, Jeanette S

2009-06-01

Mentoring is a critical component of career development and success for clinical translational science research faculty. Yet few programs train faculty in mentoring skills. We describe outcomes from the first two faculty cohorts who completed a Mentor Development Program (MDP) at UCSF. Eligibility includes having dedicated research time, expertise in a scientific area and a desire to be a lead research mentor. A post-MDP survey measured the program's impact on enhancement of five key mentoring skills, change in the Mentors-in-Training (MIT) self-rated importance of being a mentor to their career satisfaction, and overall confidence in their mentoring skills. Since 2007, 29 MITs participated in and 26 completed the MDP. Only 15% of the MITs reported any previous mentor training. Overall, 96% of MITs felt that participation in the MDP helped them to become better mentors. A majority reported a significant increase in confidence in mentoring skills and most reported an increased understanding of important mentoring issues at UCSF. MITs reported increased confidence in overall and specific mentoring skills after completion of the MDP. The MDP can serve as a model for other institutions to develop the next generation of clinical-translational research mentors.

A mentor development program for clinical translational science faculty leads to sustained, improved confidence in mentoring skills.

PubMed

Feldman, Mitchell D; Steinauer, Jody E; Khalili, Mandana; Huang, Laurence; Kahn, James S; Lee, Kathryn A; Creasman, Jennifer; Brown, Jeanette S

2012-08-01

Mentorship is crucial for academic productivity and advancement for clinical and translational (CT) science faculty. However, little is known about the long-term effects of mentor training programs. The University of California, San Francisco (UCSF), Clinical and Translational Science Institute launched a Mentor Development Program (MDP) in 2007 for CT faculty. We report on an evaluation of the first three cohorts of graduates from the MDP. In 2010, all Mentors in Training (MITs) who completed the MDP from 2007 to 2009 (n= 38) were asked to complete an evaluation of their mentoring skills and knowledge; all MITs (100%) completed the evaluation. Two-thirds of MDP graduates reported that they often apply knowledge, attitudes, or skills obtained in the MDP to their mentoring. Nearly all graduates (97%) considered being a mentor important to their career satisfaction. Graduates were also asked about the MDP's impact on specific mentoring skills; 95% agreed that the MDP helped them to become a better mentor and to focus their mentoring goals. We also describe a number of new initiatives to support mentoring at UCSF that have evolved from the MDP. To our knowledge, this is the first evaluation of the long-term impact of a mentor training program for CT researchers. © 2012 Wiley Periodicals, Inc.

Special Issue on Global Health Disparities Focus on Cancer.

PubMed

Lee, Haeok

2016-01-01

Haeok Lee, PhD, RN, FAAN who is a Korean-American nurse scientist, received her doctor al degree from the Nursing Physiology Department, College of Nursing, University of California, San Francisco (UCSF), in 1993, and her post doctor al training from College of Medicine, UCSF. Dr. Lee worked at Case Western Reserve University and University of Colorado Health Sciences Center. She has worked at the UMass Boston since 2008. Dr. Lee has established a long-term commitment to minority health, especially Asian American Pacific Islanders, as a community leader, community health educator, and community researcher, and all these services have become a foundation for her community-based participatory research. Dr. Lee's research addresses current health problems framed in the context of social, political, and economic settings, and her studies have improved racial and ethnic data and developed national health policies to address health disparities in hepatitis B virus (HBV) infections and liver cancer among minorities. Dr. Lee's research, which is noteworthy for its theoretical base, is clearly filling the gap. Especially, Dr. Lee's research is beginning to have a favorable impact on national and international health policies and continuing education programs directed toward the global elimination of cervical and liver cancer-related health disparities in underserved and understudied populations.

Assessment of Expert-Novice Chemistry Problem Solving Using HyperCard: Early Findings.

ERIC Educational Resources Information Center

Kumar, David D.

1993-01-01

Results of a HyperCard method for assessing the performance of expert and novice high school chemistry students solving stoichiometric chemistry problems (balancing chemical equations) is reported. MANOVA results indicate significant difference between expert and novice students solving the five stoichiometric chemistry problems using…

Predicting Prostate Cancer Progression at Time of Diagnosis

DTIC Science & Technology

2015-06-01

shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number...the UCSF specimens given an unexpected finding of different mean scores between the two cohorts and the Canary (Aim 2) specimens. The repeat analysis...PCA3 in an Active Surveillance Cohort: Results from a Baseline Analysis in the Canary Prostate Active Surveillance Study” (Lin DW et al, Clin Cancer

"It's Part of the Fabric": Creating Context for the Successful Involvement of an Outside Expert of Jewish Early Childhood Education in School Change

ERIC Educational Resources Information Center

Brody, David L.; Gorsetman, Chaya R.

2013-01-01

The effectiveness of outside experts in professional development in Jewish schools has been questioned in light of scholarly critique of this approach. This case study examines the sociocultural context of one such long-term project aimed at school improvement through early childhood (EC) curriculum development. The research identifies cultural…

Comparison of diagnosis of early retinal lesions of diabetic retinopathy between a computer system and human experts.

PubMed

Lee, S C; Lee, E T; Kingsley, R M; Wang, Y; Russell, D; Klein, R; Warn, A

2001-04-01

To investigate whether a computer vision system is comparable with humans in detecting early retinal lesions of diabetic retinopathy using color fundus photographs. A computer system has been developed using image processing and pattern recognition techniques to detect early lesions of diabetic retinopathy (hemorrhages and microaneurysms, hard exudates, and cotton-wool spots). Color fundus photographs obtained from American Indians in Oklahoma were used in developing and testing the system. A set of 369 color fundus slides were used to train the computer system using 3 diagnostic categories: lesions present, questionable, or absent (Y/Q/N). A different set of 428 slides were used to test and evaluate the system, and its diagnostic results were compared with those of 2 human experts-the grader at the University of Wisconsin Fundus Photograph Reading Center (Madison) and a general ophthalmologist. The experiments included comparisons using 3 (Y/Q/N) and 2 diagnostic categories (Y/N) (questionable cases excluded in the latter). In the training phase, the agreement rates, sensitivity, and specificity in detecting the 3 lesions between the retinal specialist and the computer system were all above 90%. The kappa statistics were high (0.75-0.97), indicating excellent agreement between the specialist and the computer system. In the testing phase, the results obtained between the computer system and human experts were consistent with those of the training phase, and they were comparable with those between the human experts. The performance of the computer vision system in diagnosing early retinal lesions was comparable with that of human experts. Therefore, this mobile, electronically easily accessible, and noninvasive computer system, could become a mass screening tool and a clinical aid in diagnosing early lesions of diabetic retinopathy.

The Assessment of African Swine Fever Virus Risk to Belgium Early 2014, using the Quick and Semiquantitative Pandora Screening Protocol.

PubMed

Roelandt, S; Van der Stede, Y; D'hondt, B; Koenen, F

2017-02-01

A risk assessment was organized during the early EU ASF outbreaks of early 2014 (February-April) and performed in cooperation with 15 Belgian and European experts on ASFV and its epidemiology in pigs/wild boar. African swine fever (ASF) is considered as one of the most dangerous infectious pig diseases, causing many outbreaks. Since the end of 2013 - early 2014, several outbreaks within the European Union (Lithuania, Poland, Estonia and Latvia) were reported to OIE, which prompted several risk assessments by (inter)national bodies and scientists. In this study, the open source, semiquantitative Pandora risk assessment tool was used for a quick overall screening of the risk posed by ASF to Belgium early 2014. A set of integrated risk scores was calculated within the Pandora framework. Experts scored the questions and uncertainty levels in the Pandora modules individually, after which the calculations were performed and averaged scores were used within pre-defined risk scales to define and visualize the ASF risk to Belgium. Emergence risk was considered low (Pandora score 0.29), while disease consequences were deemed high (0.93); the resulting multiplicative overall risk of ASFV for Belgium was low (0.27). The Belgian experts tended to give lower risk scores than the European experts, especially for entry risk and trade/public opinion consequences. These risk scores are further interpreted with a due consideration of the qualitative data in the expert remarks and of other ASF risk assessments. The results are similar to more extensive and elaborate risk assessment models/procedures which may require more time and resources. The Pandora tool allows sequential updates to monitor (rates of) increasing risk and provides information for risk managers to organize targeted control. © 2015 Blackwell Verlag GmbH.

Enhanced use of CLIPS at the Los Alamos National Laboratory

NASA Technical Reports Server (NTRS)

Duerre, K. H.; Parkinson, W. J.; Osowski, J. J.

1991-01-01

Early efforts for producing expert systems for engineering applications used a limited subset of C Language Integrated Production System (CLIPS) features. The implementation details of previous expert systems and of the current expert system, which is used for training operators in the control of the Isotope Separation System, are discussed.

Does Research Training During Residency Promote Scholarship and Influence Career Choice? A Cross-Sectional Analysis of a 10-Year Cohort of the UCSF-PRIME Internal Medicine Residency Program.

PubMed

Kohlwes, Jeffrey; O'Brien, Bridget; Stanley, Marion; Grant, Ross; Shunk, Rebecca; Connor, Denise; Cornett, Patricia; Hollander, Harry

2016-01-01

The Association of Program Directors in Internal Medicine, the Accreditation Council for Graduate Medical Education, the Alliance for Academic Internal Medicine, and the Carnegie Foundation report on medical education recommend creating individualized learning pathways during medical training so that learners can experience broader professional roles beyond patient care. Little data exist to support the success of these specialized pathways in graduate medical education. We present the 10-year experience of the Primary Care Medicine Education (PRIME) track, a clinical-outcomes research pathway for internal medicine residents at the University of California San Francisco (UCSF). We hypothesized that participation in an individualized learning track, PRIME, would lead to a greater likelihood of publishing research from residency and accessing adequate career mentorship and would be influential on subsequent alumni careers. We performed a cross-sectional survey of internal medicine residency alumni from UCSF who graduated in 2001 through 2010. We compared responses of PRIME and non-PRIME categorical alumni. We used Pearson's chi-square and Student's t test to compare PRIME and non-PRIME alumni on categorical and continuous variables. Sixty-six percent (211/319) of alumni responded to the survey. A higher percentage of PRIME alumni published residency research projects compared to non-PRIME alumni (64% vs. 40%; p = .002). The number of PRIME alumni identifying research as their primary career role was not significantly different from non-PRIME internal medicine residency graduates (35% of PRIME vs. 29% non-PRIME). Process measures that could explain these findings include adequate access to mentors (M 4.4 for PRIME vs. 3.6 for non-PRIME alumni, p < .001, on a 5-point Likert scale) and agreeing that mentoring relationships affected career choice (M 4.2 for PRIME vs. 3.7 for categorical alumni, p = .001). Finally, 63% of PRIME alumni agreed that their research experience during residency influenced their subsequent career choice versus 46% of non-PRIME alumni (p = .023). Our results support the concept that providing residents with an individualized learning pathway focusing on clinical outcomes research during residency enables them to successfully publish manuscripts and access mentorship, and may influence subsequent career choice. Implementation of individualized residency program tracks that nurture academic interests along with clinical skills can support career development within medicine residency programs.

Identification and detection of anomalies through SSME data analysis

NASA Technical Reports Server (NTRS)

Pereira, Lisa; Ali, Moonis

1990-01-01

The goal of the ongoing research described in this paper is to analyze real-time ground test data in order to identify patterns associated with the anomalous engine behavior, and on the basis of this analysis to develop an expert system which detects anomalous engine behavior in the early stages of fault development. A prototype of the expert system has been developed and tested on the high frequency data of two SSME tests, namely Test #901-0516 and Test #904-044. The comparison of our results with the post-test analyses indicates that the expert system detected the presence of the anomalies in a significantly early stage of fault development.

A Controlled Trial of Topiramate Treatment for Alcohol Dependence in Veterans with PTSD

DTIC Science & Technology

2015-10-01

Dieter J. Meyerhoff, Dr.rer.nat., UCSF Rationale and Content: Civilian and military personnel with posttraumatic stress disorder (PTSD) frequently...patients with PTSD, and for some patients alcohol use may be an attempt to “self-medicate” or cope or to respond to symptoms such as insomnia , anxiety...model of stress -enhanced fear learning which mimics several PTSD features, including increased voluntary alcohol intake, and set it in context to other

Improved Ribosome-Footprint and mRNA Measurements Provide Insights into Dynamics and Regulation of Yeast Translation

DTIC Science & Technology

2016-02-11

the White- head Genome Technology Core for sequencing . This work was supported by the UCSF Program for Breakthrough Biomedical Research (funded in...landscape of the yeast genome defined by RNA sequencing . Science 320, 1344–1349. Nedialkova, D.D., and Leidel, S.A. (2015). Optimization of Codon Translation... the CC BY license (http://creativecommons.org/licenses/by/4.0/). SUMMARY Ribosome-footprint profiling provides genome -wide snapshots of translation

Aspm, a Key Element in Medulloblastoma Pathogenesis and a Novel Target for Treatment

DTIC Science & Technology

2013-10-01

pathogenesis ( Wechsler -Reya and Scott, 1999; Kenney and Rowitch, 2000; Zurawel et al., 2000; Ellison et al., 2011; Hatten and Roussel, 2011; Roussel...Laboratories, Bar Harbor, ME, USA) to generate Aspm floxed (Aspmf/+) mice. Math-1 cre mice were generously shared by David Rowitch, MD, PhD, UCSF and...Robert Wechsler -Reya, PhD, 10 Sanford-Burnham Medical Research Institute, La Jolla, CA and have been previously described (Matei et al., 2005

Investigating Genomic Mechanisms of Treatment Resistance in Castration Resistant Prostate Cancer

DTIC Science & Technology

2015-05-01

and genomically profiled. Figure 3 shows data from a series of cell- line experiments showing that PC3 prostate cancer cells are recoverable and...coursework until the second-half of the grant period. I am enrolled in the UCSF Biomedical Sciences Graduate Program class BMS 255: Genetics : Basic... Genetics and Genomics. This class is set to start in January 2016. Given a large number of clinical, teaching, and research duties I will plan to enroll

A Mentor Development Program for Clinical Translational Science Faculty Leads to Sustained, Improved Confidence in Mentoring Skills

PubMed Central

Feldman, Mitchell D.; Steinauer, Jody E.; Khalili, Mandana; Huang, Laurence; Kahn, James S.; Lee, Kathryn A.; Creasman, Jennifer; Brown, Jeanette S.

2012-01-01

Abstract Mentorship is crucial for academic productivity and advancement for clinical and translational (CT) science faculty. However, little is known about the long‐term effects of mentor training programs. The University of California, San Francisco (UCSF), Clinical and Translational Science Institute launched a Mentor Development Program (MDP) in 2007 for CT faculty. We report on an evaluation of the first three cohorts of graduates from the MDP. In 2010, all Mentors in Training (MITs) who completed the MDP from 2007 to 2009 (n= 38) were asked to complete an evaluation of their mentoring skills and knowledge; all MITs (100%) completed the evaluation. Two‐thirds of MDP graduates reported that they often apply knowledge, attitudes, or skills obtained in the MDP to their mentoring. Nearly all graduates (97%) considered being a mentor important to their career satisfaction. Graduates were also asked about the MDP's impact on specific mentoring skills; 95% agreed that the MDP helped them to become a better mentor and to focus their mentoring goals. We also describe a number of new initiatives to support mentoring at UCSF that have evolved from the MDP. To our knowledge, this is the first evaluation of the long‐term impact of a mentor training program for CT researchers. Clin Trans Sci 2012; Volume 5: 362–367 PMID:22883616

Validation of Clinical Testing for Warfarin Sensitivity

PubMed Central

Langley, Michael R.; Booker, Jessica K.; Evans, James P.; McLeod, Howard L.; Weck, Karen E.

2009-01-01

Responses to warfarin (Coumadin) anticoagulation therapy are affected by genetic variability in both the CYP2C9 and VKORC1 genes. Validation of pharmacogenetic testing for warfarin responses includes demonstration of analytical validity of testing platforms and of the clinical validity of testing. We compared four platforms for determining the relevant single nucleotide polymorphisms (SNPs) in both CYP2C9 and VKORC1 that are associated with warfarin sensitivity (Third Wave Invader Plus, ParagonDx/Cepheid Smart Cycler, Idaho Technology LightCycler, and AutoGenomics Infiniti). Each method was examined for accuracy, cost, and turnaround time. All genotyping methods demonstrated greater than 95% accuracy for identifying the relevant SNPs (CYP2C9 *2 and *3; VKORC1 −1639 or 1173). The ParagonDx and Idaho Technology assays had the shortest turnaround and hands-on times. The Third Wave assay was readily scalable to higher test volumes but had the longest hands-on time. The AutoGenomics assay interrogated the largest number of SNPs but had the longest turnaround time. Four published warfarin-dosing algorithms (Washington University, UCSF, Louisville, and Newcastle) were compared for accuracy for predicting warfarin dose in a retrospective analysis of a local patient population on long-term, stable warfarin therapy. The predicted doses from both the Washington University and UCSF algorithms demonstrated the best correlation with actual warfarin doses. PMID:19324988

Validation of clinical testing for warfarin sensitivity: comparison of CYP2C9-VKORC1 genotyping assays and warfarin-dosing algorithms.

PubMed

Langley, Michael R; Booker, Jessica K; Evans, James P; McLeod, Howard L; Weck, Karen E

2009-05-01

Responses to warfarin (Coumadin) anticoagulation therapy are affected by genetic variability in both the CYP2C9 and VKORC1 genes. Validation of pharmacogenetic testing for warfarin responses includes demonstration of analytical validity of testing platforms and of the clinical validity of testing. We compared four platforms for determining the relevant single nucleotide polymorphisms (SNPs) in both CYP2C9 and VKORC1 that are associated with warfarin sensitivity (Third Wave Invader Plus, ParagonDx/Cepheid Smart Cycler, Idaho Technology LightCycler, and AutoGenomics Infiniti). Each method was examined for accuracy, cost, and turnaround time. All genotyping methods demonstrated greater than 95% accuracy for identifying the relevant SNPs (CYP2C9 *2 and *3; VKORC1 -1639 or 1173). The ParagonDx and Idaho Technology assays had the shortest turnaround and hands-on times. The Third Wave assay was readily scalable to higher test volumes but had the longest hands-on time. The AutoGenomics assay interrogated the largest number of SNPs but had the longest turnaround time. Four published warfarin-dosing algorithms (Washington University, UCSF, Louisville, and Newcastle) were compared for accuracy for predicting warfarin dose in a retrospective analysis of a local patient population on long-term, stable warfarin therapy. The predicted doses from both the Washington University and UCSF algorithms demonstrated the best correlation with actual warfarin doses.

The 'indirect costs' of underfunding foreign partners in global health research: A case study.

PubMed

Crane, Johanna T; Andia Biraro, Irene; Fouad, Tamer M; Boum, Yap; R Bangsberg, David

2017-09-16

This study of a global health research partnership assesses how U.S. fiscal administrative policies impact capacity building at foreign partner institutions. We conducted a case study of a research collaboration between Mbarara University of Science and Technology (MUST) in Mbarara, Uganda, and originally the University of California San Francisco (UCSF), but now Massachusetts General Hospital (MGH). Our case study is based on three of the authors' experiences directing and working with this partnership from its inception in 2003 through 2015. The collaboration established an independent Ugandan non-profit to act as a local fiscal agent and grants administrator and to assure compliance with the Ugandan labour and tax law. This structure, combined with low indirect cost reimbursements from U.S. federal grants, failed to strengthen institutional capacity at MUST. In response to problems with this model, the collaboration established a contracts and grants office at MUST. This office has built administrative capacity at MUST but has also generated new risks and expenses for MGH. We argue that U.S. fiscal administrative practices may drain rather than build capacity at African universities by underfunding the administrative costs of global health research, circumventing host country institutions, and externalising legal and financial risks associated with international work. MGH: Massachusetts General Hospital; MUST: Mbarara University of Science and Technology; NIH: National Institutes of Health; UCSF: University of California San Francisco; URI: Uganda Research Institute.

Brain enabled by next-generation neurotechnology: using multiscale and multimodal models.

PubMed

Shenoy, Krishna; Nurmikko, Arto V

2012-03-01

As many articles in this issue of IEEE Pulse demonstrate, interfacing directly with the brain presents several fundamental challenges. These challenges reside at multiple levels and span many disciplines, ranging from the need to understand brain states at the level of neural circuits to creating technological innovations to facilitate new therapeutic options. The goal of our multiuniversity research team, composed of researchers from Stanford University, Brown University, the University of California at San Francisco (UCSF), and the University College London (UCL), is to substantially elevate the fundamental understanding of brain information processing and its relationship with sensation, behavior, and injury. Our team was assembled to provide expertise ranging from neuroscience to neuroengineering and to neurological and psychiatric clinical guidance, all of which are critical to the overarching research goal. By employing a suite of innovative experimental, computational, and theoretical approaches, the Defense Advanced Research Projects Agency (DARPA) Reorganization and Plasticity to Accelerate Injury Recovery (REPAIR) team has set its sights on learning how the brain and its microcircuitry react (e.g., to sudden physiological changes) and what can be done to encourage recovery from such (reversible) injury. In this article, we summarize some of the team's technical goals, approaches, and early illustrative results.

Early vs late age at onset frontotemporal dementia and frontotemporal lobar degeneration.

PubMed

Seo, Sang Won; Thibodeau, Marie-Pierre; Perry, David C; Hua, Alice; Sidhu, Manu; Sible, Isabel; Vargas, Jose Norberto S; Gaus, Stephanie E; Rabinovici, Gil D; Rankin, Katherine D; Boxer, Adam L; Kramer, Joel H; Rosen, Howard J; Gorno-Tempini, Maria Luisa; Grinberg, Lea T; Huang, Eric J; DeArmond, Stephen J; Trojanowski, John Q; Miller, Bruce L; Seeley, William W

2018-03-20

To examine clinicopathologic correlations in early vs late age at onset frontotemporal dementia (FTD) and frontotemporal lobar degeneration (FTLD). All patients were clinically evaluated and prospectively diagnosed at the UCSF Memory and Aging Center. Two consecutive series were included: (1) patients with a clinically diagnosed FTD syndrome who underwent autopsy (cohort 1) and (2) patients with a primary pathologic diagnosis of FTLD, regardless of the clinical syndrome (cohort 2). These series were divided by age at symptom onset (cutoff 65 years). In cohort 1, 48 (25.3%) were 65 years or older at symptom onset. Pathologic causes of behavioral variant FTD (bvFTD) were similar in the early age at onset (EO) and late age at onset (LO) bvFTD groups. In corticobasal syndrome (CBS), however, the most common pathologic substrate differed according to age at onset: progressive supranuclear palsy (42.9%) in LO-CBS and Alzheimer disease (AD; 40.7%) in EO-CBS. In cohort 2, 57 (28.4%) were classified as LO-FTLD. Regarding FTLD major molecular classes, FTLD with transactive response DNA-binding protein of 43 kDa was most common in EO-FTLD (44.4%), whereas FTLD-tau (58.3%) was most common in LO-FTLD. Antemortem diagnosis of a non-FTD syndrome, usually AD-type dementia, was more frequent in LO-FTLD than EO-FTLD (19.3% vs 7.7%, p = 0.017). LO-FTLD was also associated with more prevalent comorbid pathologic changes. Of these, moderate to severe AD neuropathologic change and argyrophilic grain disease were overrepresented among patients who received an antemortem diagnosis of AD-type dementia. Patients with FTD and FTLD often develop symptoms after age 65, and age at onset represents an important consideration when making antemortem neuropathologic predictions. © 2018 American Academy of Neurology.

Clinical predictors of oral leukoplakia recurrence following CO₂ laser vaporization.

PubMed

Chainani-Wu, Nita; Lee, Dustin; Madden, Erin; Sim, Chelsia; Collins, Kornelia; Silverman, Sol

2015-11-01

The objective of this study was to determine whether risk of early leukoplakia recurrence (within 3 months) following carbon dioxide (CO2) laser removal varies by clinical characteristics including lesion size, site and accessibility of margins. A retrospective cohort study included patients with oral leukoplakia who had their first CO2 laser surgery for removal of oral leukoplakia between 2005 and 2010 at the UCSF oral medicine clinic. Twenty-six patients with 32 separate lesions met the eligibility criteria after a clinic database search was followed by review of clinical notes and biopsy reports from existing patient charts. Data analysis included computation of summary statistics, and logistic regression analyses to evaluate recurrence of leukoplakia by clinical characteristics of the lesions. Patient data and the characteristics of lesions were evaluated as possible predictors of early recurrence following laser removal; these included age, sex, duration, size, appearance and histopathology of the lesion. The only one that reached statistical significance was poor accessibility of the margins of the lesion (vs. good accessibility, OR = 24.57 (95% CI: 1.59-16.68), p = 0.016); the probability for trend for good, questionable, and poor accessibility was 0.0028. This finding remained significant after controlling for age, sex, duration and size of lesion. Four out of five lesions with poor accessibility showed recurrence at 3 months. Of these, three involved the gingiva and one the lateral tongue. This study has identified poor accessibility of the lesion margins as a predictor for early recurrence of leukoplakia following laser removal. Other variables evaluated did not reach statistical significance, possibly due to lack of power. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Expert system for online surveillance of nuclear reactor coolant pumps

DOEpatents

Gross, Kenny C.; Singer, Ralph M.; Humenik, Keith E.

1993-01-01

An expert system for online surveillance of nuclear reactor coolant pumps. This system provides a means for early detection of pump or sensor degradation. Degradation is determined through the use of a statistical analysis technique, sequential probability ratio test, applied to information from several sensors which are responsive to differing physical parameters. The results of sequential testing of the data provide the operator with an early warning of possible sensor or pump failure.

Computer-based diagnostic expert systems in rheumatology: where do we stand in 2014?

PubMed

Alder, Hannes; Michel, Beat A; Marx, Christian; Tamborrini, Giorgio; Langenegger, Thomas; Bruehlmann, Pius; Steurer, Johann; Wildi, Lukas M

2014-01-01

Background. The early detection of rheumatic diseases and the treatment to target have become of utmost importance to control the disease and improve its prognosis. However, establishing a diagnosis in early stages is challenging as many diseases initially present with similar symptoms and signs. Expert systems are computer programs designed to support the human decision making and have been developed in almost every field of medicine. Methods. This review focuses on the developments in the field of rheumatology to give a comprehensive insight. Medline, Embase, and Cochrane Library were searched. Results. Reports of 25 expert systems with different design and field of application were found. The performance of 19 of the identified expert systems was evaluated. The proportion of correctly diagnosed cases was between 43.1 and 99.9%. Sensitivity and specificity ranged from 62 to 100 and 88 to 98%, respectively. Conclusions. Promising diagnostic expert systems with moderate to excellent performance were identified. The validation process was in general underappreciated. None of the systems, however, seemed to have succeeded in daily practice. This review identifies optimal characteristics to increase the survival rate of expert systems and may serve as valuable information for future developments in the field.

Novel Adult Stem Cells for Peripheral Nerve Regeneration

DTIC Science & Technology

2012-09-01

were also positive for MSC surface marker CD29 and CD44 (Fig. 1F-G). However, CD29 and CD44 are also expressed in SMCs, so we will not use these non...tubulin. In addition, MVSCs were negative for perivascular MSC marker CD146 (Fig. 1H) and SMC progenitor marker Sca-1 (Fig. 1I). MVSCs were also...University of California, Berkeley, California 94720, USA. 2 UC Berkeley-UCSF Graduate Program in Bioengineering, Berkeley, California 94720, USA. 3

Symposium KK: Structure-Property Relationships in Biomineralized and Bio-mimetic Composites

DTIC Science & Technology

2010-04-06

Preventive and Restorative Dental Sciences, UCSF, San Francisco, California. 4:45 PM KK2.8 Damage and Crack Evolution in Mammalian Enamel James Jin...Technology, Graz, Austria. 9:45AMKK6.S AFM and PFM measurements of Enamel in order to Determine the Crack Tip Toughness and Cohesive Zone of Enamel Gerold...11:00 AM KK9.7 Enamel Matrix Guided Growth of Apatite Vuk Uskokovic1. Li Zhu2, Wu Li2 and Stefan Habelitz1; ’Department of Preventive and

University of California San Francisco (UCSF-2): Gene Expression Profiling of Normal Mouse Skin, Hras WT and Hras -/- | Office of Cancer Genomics

Cancer.gov

This data set contains the transcriptional profiles of 20 dorsal skin samples from eight-week-old mice. Mice were generated by crossing FVB/N to Mus spretus mice to generate F1 mice, and then crossing F1 mice back to the FVB/N strain. 10  FVB/N mice lacking Hras1 (aka HrasKO, Hras-/-) and 10  FVB/N mice with wild-type Hras1 were generated. Read the abstract.

UCSF Protocol for Caries Arrest Using Silver Diamine Fluoride: Rationale, Indications, and Consent

PubMed Central

Horst, Jeremy A; Ellenikiotis, Hellene; Milgrom, Peter M

2016-01-01

The Food and Drug Administration recently cleared silver diamine fluoride for reducing tooth sensitivity. Clinical trials document arrest and prevention of dental caries by silver diamine fluoride; this off-label use is now permissible and appropriate under U.S. law. A CDT code was approved for caries arresting medicaments for 2016 to facilitate documentation and billing. We present a systematic review, clinical indications, clinical protocol, and consent procedure to guide application for caries arrest treatment. PMID:26897901

Matrix Metalloproteinases as a Therapeutic Target to Improve Neurologic Recovery After Spinal Cord Injury

DTIC Science & Technology

2013-10-01

the BMS scale where a score of 0 indicates hindlimb paralysis and a score of 9 reflects normal hindlimb locomotor function. The more mildly injured...graded levels of injury severity based upon the BMS scale . Urologic status shows injury severity-dependent changes with UICs being most pronounced...BMS scale . Exclusion criteria were as follows: any animal showing an average score of > 0.5 at 8 hours post- injury or morbidity as defined in UCSF

End points for validating early warning scores in the context of rapid response systems: a Delphi consensus study.

PubMed

Pedersen, N E; Oestergaard, D; Lippert, A

2016-05-01

When investigating early warning scores and similar physiology-based risk stratification tools, death, cardiac arrest and intensive care unit admission are traditionally used as end points. A large proportion of the patients identified by these end points cannot be saved, even with optimal treatment. This could pose a limitation to studies using these end points. We studied current expert opinion on end points for validating tools for the identification of patients in hospital wards at risk of imminent critical illness. The Delphi consensus methodology was used. We identified 22 experts based on objective criteria; 17 participated in the study. Each expert panel member's suggestions for end points were collected and distributed to the entire expert panel in anonymised form. The experts reviewed, rated and commented the suggested end points through the rounds in the Delphi process, and the experts' combined rating of the usefulness of each suggestion was established. A gross list of 86 suggestions for end points, relating to 13 themes, was produced. No items were uniformly recognised as ideal. The themes cardiac arrest, death, and level of care contained the items receiving highest ratings. End points relating to death, cardiac arrest and intensive care unit admission currently comprise the most obvious compromises for investigating early warning scores and similar risk stratification tools. Additional end points from the gross list of suggested end points could become feasible with the increased availability of large data sets with a multitude of recorded parameters. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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

Miller, M.; Kempner, L. Jr.; Mueller, W. III

The concept of an Expert System is not new. It has been around since the days of the early computers when scientists had dreams of robot automation to do everything from washing windows to automobile design. This paper discusses an application of an expert system and addresses software development issues and various levels of expert system development form a structural engineering viewpoint. An expert system designed to aid the structural engineer in first order inelastic analysis of latticed steel transmission powers is presented. The utilization of expert systems with large numerical analysis programs is discussed along with the software developmentmore » of such a system.« less

The Institute for Global Orthopedics and Traumatology: A Model for Academic Collaboration in Orthopedic Surgery.

PubMed

Conway, Devin James; Coughlin, Richard; Caldwell, Amber; Shearer, David

2017-01-01

In 2006, surgeons at the University of California, San Francisco (UCSF) established the Institute for Global Orthopedics and Traumatology (IGOT), an initiative within the department of orthopedic surgery. The principal aim of IGOT is to create long-term, sustainable solutions to the growing burden of musculoskeletal injury in low- and middle-income countries (LMICs) through academic partnership. IGOT currently has relationships with teaching hospitals in Ghana, Malawi, Tanzania, Nicaragua, and Nepal. The organizational structure of IGOT is built on four pillars: Global Surgical Education (GSE), Global Knowledge Exchange (GKE), Global Research Initiative (GRI), and Global Leadership and Advocacy. GSE focuses on increasing surgical knowledge and technical proficiency through hands-on educational courses. The GKE facilitates the mutual exchange of surgeons and trainees among IGOT and its partners. This includes a global resident elective that allows UCSF residents to complete an international rotation at one of IGOT's partner sites. The GRI strives to build research capacity and sponsor high-quality clinical research projects that address questions relevant to local partners. The fourth pillar, Global Leadership and Advocacy aims to increase awareness of the global impact of musculoskeletal injury through national and international courses and events, such as the Bay Area Global Health Film Festival. At the core of each tenet is the collaboration among IGOT and its international partners. Over the last decade, IGOT has experienced tremendous growth and maturation in its partnership model based on cumulative experience and the needs of its partners.

The impact of intramural grants on educators' careers and on medical education innovation.

PubMed

Adler, Shelley R; Chang, Anna; Loeser, Helen; Cooke, Molly; Wang, Jason; Teherani, Arianne

2015-06-01

The University of California, San Francisco (UCSF), Haile T. Debas Academy of Medical Educators Innovations Funding program awards competitive grants to create novel curricula and faculty development programs, compare pedagogical approaches, and design learner assessment methods. The authors examined the principal investigators' (PIs') perceptions of the impact of these intramural grants on their careers and on medical education innovation. At 12 months (project completion) and 24 months (follow-up), PIs submit a progress report describing the impact of their grant on their careers, work with collaborators, subsequent funding, project dissemination, and the UCSF curriculum. The authors analyzed these reports using qualitative thematic analysis and achieved consensus in coding and interpretation through discussion. From 2001 to 2012, the program funded 77 PIs to lead 103 projects, awarding over $2.2 million. The authors analyzed reports from 88 grants (85.4%) awarded to 68 PIs (88.3%). PIs noted that the funding led to accelerated promotion, expanded networking opportunities, enhanced knowledge and skills, more scholarly publications and presentations, extramural funding, and local and national recognition. They also reported that the funding improved their status in their departments, enhanced their careers as medical educators, laid the foundation for subsequent projects, and engaged an array of stakeholders, including trainees and junior faculty. These modest intramural education grants not only created innovative, enduring programs but also promoted educators' professional identity formation, fostered collaborations, supported junior faculty in finding their desired career paths, provided advancement opportunities, and raised the local and national profiles of recipients.

The Institute for Global Orthopedics and Traumatology: A Model for Academic Collaboration in Orthopedic Surgery

PubMed Central

Conway, Devin James; Coughlin, Richard; Caldwell, Amber; Shearer, David

2017-01-01

In 2006, surgeons at the University of California, San Francisco (UCSF) established the Institute for Global Orthopedics and Traumatology (IGOT), an initiative within the department of orthopedic surgery. The principal aim of IGOT is to create long-term, sustainable solutions to the growing burden of musculoskeletal injury in low- and middle-income countries (LMICs) through academic partnership. IGOT currently has relationships with teaching hospitals in Ghana, Malawi, Tanzania, Nicaragua, and Nepal. The organizational structure of IGOT is built on four pillars: Global Surgical Education (GSE), Global Knowledge Exchange (GKE), Global Research Initiative (GRI), and Global Leadership and Advocacy. GSE focuses on increasing surgical knowledge and technical proficiency through hands-on educational courses. The GKE facilitates the mutual exchange of surgeons and trainees among IGOT and its partners. This includes a global resident elective that allows UCSF residents to complete an international rotation at one of IGOT’s partner sites. The GRI strives to build research capacity and sponsor high-quality clinical research projects that address questions relevant to local partners. The fourth pillar, Global Leadership and Advocacy aims to increase awareness of the global impact of musculoskeletal injury through national and international courses and events, such as the Bay Area Global Health Film Festival. At the core of each tenet is the collaboration among IGOT and its international partners. Over the last decade, IGOT has experienced tremendous growth and maturation in its partnership model based on cumulative experience and the needs of its partners. PMID:28713803

Cigarette smoking and risk of pancreatic cancer: a clinic-based case-control study in the San Francisco Bay Area.

PubMed

Lea, C Suzanne; Holly, Elizabeth A; Bracci, Paige M

2015-11-01

Cigarette smoking is an established risk factor for pancreatic cancer (PC). We examined the association between cigarette smoking and PC in a San Francisco Bay Area clinic-based, case-control study. A total of 536 cases and sex and age frequency-matched controls (n = 869) were recruited predominately from the University of California San Francisco (UCSF) medical clinics between 2006 and 2011. Participants were interviewed in-person using structured questionnaires. Adjusted odds ratios (ORs) were computed. Forty-eight percent of cases and controls reported never having smoked cigarettes; 39% of cases and 40% of controls were former smokers; 13% of cases and 12% of controls were current smokers. No association was found for either former (OR = 0.85, 95% confidence interval [CI] = 0.66-1.1) or current cigarette smoking (men: OR = 1.0, 95% CI = 0.60-1.7; women: OR = 1.2, 95% CI = 0.73-2.1). No dose-response relationships were detected with number of cigarettes/day, smoking intensity, duration, or years since last smoked. Comparisons with a 1995-1999 population-based UCSF study demonstrated a significantly increased proportion of never smokers in this study (P < .001). This study revealed no significant associations between cigarette smoking and PC in the San Francisco Bay Area during 2006-2011. Data suggest a reduction in the duration of smoking within the referral population. Copyright © 2015 Elsevier Inc. All rights reserved.

Rethinking the Educator Portfolio: An Innovative Criteria-Based Model.

PubMed

Shinkai, Kanade; Chen, Chen Amy; Schwartz, Brian S; Loeser, Helen; Ashe, Cynthia; Irby, David M

2017-11-07

Academic medical centers struggle to achieve parity in advancement and promotions between educators and discovery-oriented researchers in part because of narrow definitions of scholarship, lack of clear criteria for measuring excellence, and barriers to making educational contributions available for peer review. Despite recent progress in expanding scholarship definitions and identifying excellence criteria, these advances are not integrated into educator portfolio (EP) templates or curriculum vitae platforms. From 2013 to 2015, a working group from the Academy of Medical Educators (AME) at the University of California, San Francisco (UCSF) designed a streamlined, criteria-based EP (EP 2.0) template highlighting faculty members' recent activities in education and setting rigorous evaluation methods to enable educational scholarship to be objectively evaluated for academic advancement, AME membership, and professional development. The EP 2.0 template was integrated into the AME application, resulting in high overall satisfaction among candidates and the selection committee and positive feedback on the template's transparency, ease of use, and streamlined format. In 2016, the EP 2.0 template was integrated into the campus-wide curriculum vitae platform and academic advancement system. The authors plan to increase awareness of the EP 2.0 template by educating promotions committees and faculty at UCSF and partnering with other institutions to disseminate it for use. They also plan to study the impact of the template on supporting educators by making their important scholarly contributions available for peer review, providing guidance for professional development, and decreasing disparities in promotions.

34 CFR 303.301 - Central directory.

Code of Federal Regulations, 2010 CFR

2010-07-01

... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES Program and Service Components of a Statewide System of Early Intervention Services General § 303...) Public and private early intervention services, resources, and experts available in the State; (2...

34 CFR 303.301 - Central directory.

Code of Federal Regulations, 2011 CFR

2011-07-01

... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES Program and Service Components of a Statewide System of Early Intervention Services General § 303...) Public and private early intervention services, resources, and experts available in the State; (2...

Early esophageal cancer detection using RF classifiers

NASA Astrophysics Data System (ADS)

Janse, Markus H. A.; van der Sommen, Fons; Zinger, Svitlana; Schoon, Erik J.; de With, Peter H. N.

2016-03-01

Esophageal cancer is one of the fastest rising forms of cancer in the Western world. Using High-Definition (HD) endoscopy, gastroenterology experts can identify esophageal cancer at an early stage. Recent research shows that early cancer can be found using a state-of-the-art computer-aided detection (CADe) system based on analyzing static HD endoscopic images. Our research aims at extending this system by applying Random Forest (RF) classification, which introduces a confidence measure for detected cancer regions. To visualize this data, we propose a novel automated annotation system, employing the unique characteristics of the previous confidence measure. This approach allows reliable modeling of multi-expert knowledge and provides essential data for real-time video processing, to enable future use of the system in a clinical setting. The performance of the CADe system is evaluated on a 39-patient dataset, containing 100 images annotated by 5 expert gastroenterologists. The proposed system reaches a precision of 75% and recall of 90%, thereby improving the state-of-the-art results by 11 and 6 percentage points, respectively.

Artificial intelligence and space power systems automation

NASA Technical Reports Server (NTRS)

Weeks, David J.

1987-01-01

Various applications of artificial intelligence to space electrical power systems are discussed. An overview is given of completed, on-going, and planned knowledge-based system activities. These applications include the Nickel-Cadmium Battery Expert System (NICBES) (the expert system interfaced with the Hubble Space Telescope electrical power system test bed); the early work with the Space Station Experiment Scheduler (SSES); the three expert systems under development in the space station advanced development effort in the core module power management and distribution system test bed; planned cooperation of expert systems in the Core Module Power Management and Distribution (CM/PMAD) system breadboard with expert systems for the space station at other research centers; and the intelligent data reduction expert system under development.

How to establish endoscopic submucosal dissection in Western countries.

PubMed

Oyama, Tsuneo; Yahagi, Naohisa; Ponchon, Thierry; Kiesslich, Tobias; Berr, Frieder

2015-10-28

Endoscopic submucosal dissection (ESD) has been invented in Japan to provide resection for cure of early cancer in the gastrointestinal tract. Professional level of ESD requires excellent staging of early neoplasias with image enhanced endoscopy (IEE) to make correct indications for ESD, and high skills in endoscopic electrosurgical dissection. In Japan, endodiagnostic and endosurgical excellence spread through personal tutoring of skilled endoscopists by the inventors and experts in IEE and ESD. To translocate this expertise to other continents must overcome two fundamental obstacles: (1) inadequate expectations as to the complexity of IEE and ESD; and (2) lack of suitable lesions and master-mentors for ESD trainees. Leading endoscopic mucosal resection-proficient endoscopists must pioneer themselves through the long learning curve to proficient ESD experts. Major referral centers for ESD must arise in Western countries on comparable professional level as in Japan. In the second stage, the upcoming Western experts must commit themselves to teach skilled endoscopists from other referral centers, in order to spread ESD in Western countries. Respect for patients with early gastrointestinal cancer asks for best efforts to learn endoscopic categorization of early neoplasias and skills for ESD based on sustained cooperation with the masters in Japan. The strategy is discussed here.

Medical workstation design: enhancing graphical interface with 3D anatomical atlas

NASA Astrophysics Data System (ADS)

Hoo, Kent S., Jr.; Wong, Stephen T. C.; Grant, Ellen

1997-05-01

The huge data archive of the UCSF Hospital Integrated Picture Archiving and Communication System gives healthcare providers access to diverse kinds of images and text for diagnosis and patient management. Given the mass of information accessible, however, conventional graphical user interface (GUI) approach overwhelms the user with forms, menus, fields, lists, and other widgets and causes 'information overloading.' This article describes a new approach that complements the conventional GUI with 3D anatomical atlases and presents the usefulness of this approach with a clinical neuroimaging application.

Using the structure-function linkage database to characterize functional domains in enzymes.

PubMed

Brown, Shoshana; Babbitt, Patricia

2014-12-12

The Structure-Function Linkage Database (SFLD; http://sfld.rbvi.ucsf.edu/) is a Web-accessible database designed to link enzyme sequence, structure, and functional information. This unit describes the protocols by which a user may query the database to predict the function of uncharacterized enzymes and to correct misannotated functional assignments. The information in this unit is especially useful in helping a user discriminate functional capabilities of a sequence that is only distantly related to characterized sequences in publicly available databases. Copyright © 2014 John Wiley & Sons, Inc.

Design a Fuzzy Rule-based Expert System to Aid Earlier Diagnosis of Gastric Cancer.

PubMed

Safdari, Reza; Arpanahi, Hadi Kazemi; Langarizadeh, Mostafa; Ghazisaiedi, Marjan; Dargahi, Hossein; Zendehdel, Kazem

2018-01-01

Screening and health check-up programs are most important sanitary priorities, that should be undertaken to control dangerous diseases such as gastric cancer that affected by different factors. More than 50% of gastric cancer diagnoses are made during the advanced stage. Currently, there is no systematic approach for early diagnosis of gastric cancer. to develop a fuzzy expert system that can identify gastric cancer risk levels in individuals. This system was implemented in MATLAB software, Mamdani inference technique applied to simulate reasoning of experts in the field, a total of 67 fuzzy rules extracted as a rule-base based on medical expert's opinion. 50 case scenarios were used to evaluate the system, the information of case reports is given to the system to find risk level of each case report then obtained results were compared with expert's diagnosis. Results revealed that sensitivity was 92.1% and the specificity was 83.1%. The results show that is possible to develop a system that can identify High risk individuals for gastric cancer. The system can lead to earlier diagnosis, this may facilitate early treatment and reduce gastric cancer mortality rate.

Expert AIV: Study and Prototyping of an Expert System, To Support the Conceptual AIV Phases Of Space Programs

NASA Astrophysics Data System (ADS)

Andrina, G.; Basso, V.; Saitta, L.

2004-08-01

The effort in optimising the AIV process has been mainly focused in the recent years on the standardisation of approaches and on the application of new methodologies. But the earlier the intervention, the greater the benefits in terms of cost and schedule. Early phases of AIV process relied up to now on standards that need to be tailored through company and personal expertise. A study has then been conducted in order to exploit the possibility to develop an expert system helping in making choices in the early, conceptual phase of Assembly, Integration and Verification, namely the Model Philosophy and the test definition. The work focused on a hybrid approach, allowing interaction between historical data and human expertise. The expert system that has been prototyped exploits both information elicited from domain experts and results of a Data Mining activity on the existent data bases of completed projects verification data. The Data Mining algorithms allow the extraction of past experience resident on ESA/ MATD data base, which contains information in the form of statistical summaries, costs, frequencies of on-ground and in flight failures. Finding non-trivial associations could then be utilised by the experts to manage new decisions in a controlled way (Standards driven) at the beginning or during the AIV Process Moreover, the Expert AIV could allow compilation of a set of feasible AIV schedules to support further programmatic-driven choices.

Expert leadership of eating disorder services in South Australia.

PubMed

Long, Randall; Allison, Stephen

2016-06-01

The objective of this study was to describe the history of South Australian Government eating disorder service from the perspective of changing leadership, health policies and politics. The history reveals a foundation of early expert academic clinical leadership changing into a centralised managerial bureaucracy correlating with a diminution of services. A threat to the survival of the service led to a solution involving reinvigoration of expert clinical and academic leadership. Expert leadership was shown to be an important part of an eating disorder service. © The Royal Australian and New Zealand College of Psychiatrists 2016.

The Covariation between Parental and Expert Evaluations of Early Language Skills

ERIC Educational Resources Information Center

Björn, Piia M.; Kakkuri, Irma; Leppänen, Paavo H. T.

2014-01-01

This study investigated the potential interrelationship between parental (maternal) and expert assessments of the expressive and receptive language skills of 12- to 18-month-old children. The language activities of 27 children were monitored by their mothers (MCDI scale: Lyytinen, 2000. "Varhaisen kommunikaation ja kielen kehityksen…

‘A delicate diplomatic situation’: Tobacco industry efforts to gain control of the Framingham study

PubMed Central

Cataldo, J. K.; Bero, L. A.; Malone, R. E.

2010-01-01

The Framingham Heart Study (henceforth Framingham) is among the gold standards for epidemiological research. A prospective cohort study of 5,000+ men and women, it provided early findings about causes of coronary heart disease (CHD), following a cohort over 24 years. After US government funding ended, the tobacco industry-funded Council for Tobacco Research (CTR) provided continued funding for analyses related to smoking. Objective This study sought to understand the tobacco industry's motivation and activities in funding Framingham. Study Design We analyzed previously undisclosed tobacco industry documents, conducting iterative searches of the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu/), and assembled an historical case study. Results CTR funded Framingham to obtain full access to Framingham data. CTR planned for longtime industry consultant Carl Seltzer to reanalyze them to suggest that tobacco-related morbidity and mortality primarily resulted from “constitutional” factors such as age/ethnicity. Once data were obtained, CTR terminated funding for the Framingham principal investigator, who disagreed with Seltzer. Seltzer's critical analyses of subsequently-published work by the Framingham team created confusion about the association between coronary heart disease and cigarette smoking. Conclusion Researchers accepting tobacco industry funding risk losing control of data, analysis, and publication. PMID:20630333

The Development of STAR Early Literacy. Report.

ERIC Educational Resources Information Center

School Renaissance Inst., Inc., Madison, WI.

This report describes the development and testing of a computerized early literacy diagnostic assessment for students in prekindergarten to grade 3 that can measure skills across a variety of preliteracy and reading domains. The STAR Early Literacy assessment was developed by a team of more than 50 people, including literacy experts,…

[China expert consensus on the management of dyslipidemia in postmenopausal patients with early-stage breast cancer].

PubMed

2017-01-23

Estrogen has an impact on the type of lipoproteins and the blood lipid levels, thus protecting the cardiovascular system. Postmenopausal breast cancer patients suffer a significant decrease in estrogen levels due to both physiological changes and the use of drugs, and thus have a higher risk of atherosclerotic cardiovascular diseases. Therefore, strict lipid management is required for postmenopausal breast cancer patients receiving endocrine therapy. However, no guidelines have been developed in terms of lipid management and intervention for postmenopausal breast cancer patients. The Chinese expert group of multidisciplinary management of dyslipidemia in breast cancer patients with endocrine therapy, after deep investigation into the management of dyslipidemia in postmenopausal patients with early-stage breast cancer, has developed the China Expert Consensus on Dyslipidemia Management in Postmenopausal Patients with Early-stage Breast Cancer. The Consensus clearly defines the goals and measures of interventions for dyslipidemia, hoping to effectively reduce the risk of atherosclerotic cardiovascular disease in postmenopausal breast cancer patients and further improve the long-term survival of the patients.

DBMap: a TreeMap-based framework for data navigation and visualization of brain research registry

NASA Astrophysics Data System (ADS)

Zhang, Ming; Zhang, Hong; Tjandra, Donny; Wong, Stephen T. C.

2003-05-01

The purpose of this study is to investigate and apply a new, intuitive and space-conscious visualization framework to facilitate efficient data presentation and exploration of large-scale data warehouses. We have implemented the DBMap framework for the UCSF Brain Research Registry. Such a novel utility would facilitate medical specialists and clinical researchers in better exploring and evaluating a number of attributes organized in the brain research registry. The current UCSF Brain Research Registry consists of a federation of disease-oriented database modules, including Epilepsy, Brain Tumor, Intracerebral Hemorrphage, and CJD (Creuzfeld-Jacob disease). These database modules organize large volumes of imaging and non-imaging data to support Web-based clinical research. While the data warehouse supports general information retrieval and analysis, there lacks an effective way to visualize and present the voluminous and complex data stored. This study investigates whether the TreeMap algorithm can be adapted to display and navigate categorical biomedical data warehouse or registry. TreeMap is a space constrained graphical representation of large hierarchical data sets, mapped to a matrix of rectangles, whose size and color represent interested database fields. It allows the display of a large amount of numerical and categorical information in limited real estate of computer screen with an intuitive user interface. The paper will describe, DBMap, the proposed new data visualization framework for large biomedical databases. Built upon XML, Java and JDBC technologies, the prototype system includes a set of software modules that reside in the application server tier and provide interface to backend database tier and front-end Web tier of the brain registry.

Neural Correlates of Natural Human Echolocation in Early and Late Blind Echolocation Experts

PubMed Central

Thaler, Lore; Arnott, Stephen R.; Goodale, Melvyn A.

2011-01-01

Background A small number of blind people are adept at echolocating silent objects simply by producing mouth clicks and listening to the returning echoes. Yet the neural architecture underlying this type of aid-free human echolocation has not been investigated. To tackle this question, we recruited echolocation experts, one early- and one late-blind, and measured functional brain activity in each of them while they listened to their own echolocation sounds. Results When we compared brain activity for sounds that contained both clicks and the returning echoes with brain activity for control sounds that did not contain the echoes, but were otherwise acoustically matched, we found activity in calcarine cortex in both individuals. Importantly, for the same comparison, we did not observe a difference in activity in auditory cortex. In the early-blind, but not the late-blind participant, we also found that the calcarine activity was greater for echoes reflected from surfaces located in contralateral space. Finally, in both individuals, we found activation in middle temporal and nearby cortical regions when they listened to echoes reflected from moving targets. Conclusions These findings suggest that processing of click-echoes recruits brain regions typically devoted to vision rather than audition in both early and late blind echolocation experts. PMID:21633496

Endometrial Cancer Treatment (PDQ®)—Health Professional Version

Cancer.gov

Endometrial cancer is usually diagnosed at an early stage and can be treated with surgery. Learn about the symptoms, diagnosis, prognosis, staging, and treatment for early- and advanced-stage endometrial cancer in this expert-reviewed summary.

Learning from the Experts: Teacher Leaders on Solving America's Education Challenges

ERIC Educational Resources Information Center

Coggins, Celine, Ed.; Peske, Heather G., Ed.; McGovern, Kate, Ed.

2013-01-01

"Learning from the Experts" offers an intimate look at the ways education policies collide with everyday classroom practices and illustrates how thoughtful, solutions-oriented and results-driven teachers are reframing debates in education today. Early career teachers now make up a "new majority" (52 percent) of the workforce.…

A Web Resource for Standardized Benchmark Datasets, Metrics, and Rosetta Protocols for Macromolecular Modeling and Design.

PubMed

Ó Conchúir, Shane; Barlow, Kyle A; Pache, Roland A; Ollikainen, Noah; Kundert, Kale; O'Meara, Matthew J; Smith, Colin A; Kortemme, Tanja

2015-01-01

The development and validation of computational macromolecular modeling and design methods depend on suitable benchmark datasets and informative metrics for comparing protocols. In addition, if a method is intended to be adopted broadly in diverse biological applications, there needs to be information on appropriate parameters for each protocol, as well as metrics describing the expected accuracy compared to experimental data. In certain disciplines, there exist established benchmarks and public resources where experts in a particular methodology are encouraged to supply their most efficient implementation of each particular benchmark. We aim to provide such a resource for protocols in macromolecular modeling and design. We present a freely accessible web resource (https://kortemmelab.ucsf.edu/benchmarks) to guide the development of protocols for protein modeling and design. The site provides benchmark datasets and metrics to compare the performance of a variety of modeling protocols using different computational sampling methods and energy functions, providing a "best practice" set of parameters for each method. Each benchmark has an associated downloadable benchmark capture archive containing the input files, analysis scripts, and tutorials for running the benchmark. The captures may be run with any suitable modeling method; we supply command lines for running the benchmarks using the Rosetta software suite. We have compiled initial benchmarks for the resource spanning three key areas: prediction of energetic effects of mutations, protein design, and protein structure prediction, each with associated state-of-the-art modeling protocols. With the help of the wider macromolecular modeling community, we hope to expand the variety of benchmarks included on the website and continue to evaluate new iterations of current methods as they become available.

Developing an Assessment Instrument to Measure Early Elementary Teachers' Mathematical Knowledge for Teaching

ERIC Educational Resources Information Center

Schoen, Robert C.; Bray, Wendy; Wolfe, Christopher; Tazaz, Amanda M.; Nielsen, Lynne

2017-01-01

This study reports on the development and field study of K-TEEM, a web-based assessment instrument designed to measure mathematical knowledge for teaching (MKT) at the early elementary level. The development process involved alignment with early elementary curriculum standards, expert review of items and scoring criteria, cognitive interviews with…

Performance of e-ASPECTS software in comparison to that of stroke physicians on assessing CT scans of acute ischemic stroke patients.

PubMed

Herweh, Christian; Ringleb, Peter A; Rauch, Geraldine; Gerry, Steven; Behrens, Lars; Möhlenbruch, Markus; Gottorf, Rebecca; Richter, Daniel; Schieber, Simon; Nagel, Simon

2016-06-01

The Alberta Stroke Program Early CT score (ASPECTS) is an established 10-point quantitative topographic computed tomography scan score to assess early ischemic changes. We compared the performance of the e-ASPECTS software with those of stroke physicians at different professional levels. The baseline computed tomography scans of acute stroke patients, in whom computed tomography and diffusion-weighted imaging scans were obtained less than two hours apart, were retrospectively scored by e-ASPECTS as well as by three stroke experts and three neurology trainees blinded to any clinical information. The ground truth was defined as the ASPECTS on diffusion-weighted imaging scored by another two non-blinded independent experts on consensus basis. Sensitivity and specificity in an ASPECTS region-based and an ASPECTS score-based analysis as well as receiver-operating characteristic curves, Bland-Altman plots with mean score error, and Matthews correlation coefficients were calculated. Comparisons were made between the human scorers and e-ASPECTS with diffusion-weighted imaging being the ground truth. Two methods for clustered data were used to estimate sensitivity and specificity in the region-based analysis. In total, 34 patients were included and 680 (34 × 20) ASPECTS regions were scored. Mean time from onset to computed tomography was 172 ± 135 min and mean time difference between computed tomographyand magnetic resonance imaging was 41 ± 31 min. The region-based sensitivity (46.46% [CI: 30.8;62.1]) of e-ASPECTS was better than three trainees and one expert (p ≤ 0.01) and not statistically different from another two experts. Specificity (94.15% [CI: 91.7;96.6]) was lower than one expert and one trainee (p < 0.01) and not statistically different to the other four physicians. e-ASPECTS had the best Matthews correlation coefficient of 0.44 (experts: 0.38 ± 0.08 and trainees: 0.19 ± 0.05) and the lowest mean score error of 0.56 (experts: 1.44 ± 1.79 and trainees: 1.97 ± 2.12). e-ASPECTS showed a similar performance to that of stroke experts in the assessment of brain computed tomographys of acute ischemic stroke patients with the Alberta Stroke Program Early CT score method. © 2016 World Stroke Organization.

A library for the fifteenth through the twenty-first centuries.

PubMed Central

Cooper, R S

1991-01-01

The University of California, San Francisco (UCSF), began developing a program for a new library in 1977, started the design in 1985, began construction in 1988, and opened the library in September 1990. The primary objectives were to design and build a facility that would house print collections under optimal conditions, allow for ten years' growth, be flexible enough to permit future reconfiguration, support present and future technologies, and provide beautiful spaces in which to study. The planning process is summarized, planning concepts are outlined, and considerations for the electronic library are briefly reviewed. Images PMID:2039900

A Hospital Local Area Communication Network—The First Year's Experience

PubMed Central

Simborg, D. W.; Chadwick, M.; Whiting-O'Keefe, Q. E.; Tolchin, S. G.; Stewart, R. L.; Kahn, S. A.; Bergan, E. S.; Gafke, G. P.

1982-01-01

A local area communications network has been implemented at the University of California, San Francisco Hospital to integrate major components of the hospital's information system. This microprocessor-based network technology was developed by The Applied Physics Laboratory of the Johns Hopkins University. The first year's experience has demonstrated the basic feasibility of this technology in simplifying the integration of diverse hardware and software systems. Four minicomputer-based UCSF systems now use the network to synchronize key patient identification and registration information among the systems. Clinical uses of the network will begin during the second year of the project.

Learning from Experts: Fostering Extended Thinking in the Early Phases of the Design Process

ERIC Educational Resources Information Center

Haupt, Grietjie

2015-01-01

Empirical evidence on the way in which expert designers from different domains cognitively connect their internal processes with external resources is presented in the context of an extended cognition model. The article focuses briefly on the main trends in the extended design cognition theory and in particular on recent trends in information…

Varying Use of Conceptual Metaphors across Levels of Expertise in Thermodynamics

ERIC Educational Resources Information Center

Jeppsson, Fredrik; Haglund, Jesper; Amin, Tamer G.

2015-01-01

Many studies have previously focused on how people with different levels of expertise solve physics problems. In early work, focus was on characterising differences between experts and novices and a key finding was the central role that propositionally expressed principles and laws play in expert, but not novice, problem-solving. A more recent…

Hierarchical Thinking: A Cognitive Tool for Guiding Coherent Decision Making in Design Problem Solving

ERIC Educational Resources Information Center

Haupt, Grietjie

2018-01-01

This paper builds on two concepts, the first of which is the extended information processing model of expert design cognition. This proposes twelve internal psychological characteristics interacting with the external world of expert designers during the early phases of the design process. Here, I explore one of the characteristics, hierarchical…

Lymphedema and employability - Review and results of a survey of Austrian experts.

PubMed

Neubauer, Markus; Schoberwalter, Dieter; Cenik, Fadime; Keilani, Mohammad; Crevenna, Richard

2017-03-01

Literature about lymphedema and its influence on the ability to work and employability is limited. The aim of the present study was to investigate the opinion of Austrian experts on factors influencing the ability to work and employability in patients suffering from lymphedema. A self-administered questionnaire consisting of 6 questions was sent to 12 Austrian lymphedema experts with 6 different specializations from May to August 2016. These experts were asked about suitable and unsuitable professions, the possible influence of lymphedema on the ability to work and employability as well as about existing and additional measures to improve the return to work. The reply rate was 100% (12 out of 12). All experts agreed that lymphedema can restrict the ability to work and employability. The leading reason for limited ability to work and employability was restricted mobility or function of the affected limb along with time-consuming therapeutic modalities, pain and psychological stress. The most suitable job named was teacher and the most unsuitable job named was cook. As easements for return to work, early rehabilitation, self-management, coping strategies, patient education, employer's goodwill and employer's cooperation were reported. Furthermore, experts stressed the need for an adjustment of the legal framework as well as low-barrier and more therapy offers. Adjusted work demands seem to be of greater importance to support the ability to work and employability than recommendations for specific job profiles alone. Experts suggest an adjustment of the legal framework for affected patients, claiming a right for early rehabilitation as well as for life-long therapy. Even though some clinically useful conclusions may be drawn from this article, further research in the field is warranted.

Consensus Development Conference on Early Identification of Hearing Impairment in Infants and Young Children (Bethesda, Maryland, March 1-3, 1993).

ERIC Educational Resources Information Center

National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

This document compiles abstracts of papers that were presented at a 3-day conference of experts which developed a consensus statement on early identification of hearing impairment in infants and young children. Papers addressed taxonomy; epidemiology; developmental consequences of early hearing impairment; methodology, instrumentation, and…

Developing an Assessment Instrument to Measure Early Elementary Teachers' Mathematical Knowledge for Teaching

ERIC Educational Resources Information Center

Schoen, Robert C.; Bray, Wendy; Wolfe, Christopher; Tazaz, Amanda M.; Nielsen, Lynne

2017-01-01

This study reports on the development and field study of K-TEEM, a web-based assessment instrument designed to measure mathematical knowledge for teaching (MKT) at the early elementary level. The development process involved alignment with early elementary curriculum standards, expert review of items and scoring criteria, cognitive interviews with…

Sensitivity and specificity of scanning laser polarimetry using the GDx.

PubMed

Munkwitz, S; Funk, J; Loeffler, K U; Harbarth, U; Kremmer, S

2004-09-01

To determine the sensitivity and the specificity of the GDx in the detection of (1) advanced glaucoma, (2) early glaucoma, and (3) nerve fibre bundle defects (NFBD). Group A comprised 20 eyes with reproducible glaucomatous visual field defects confirmed by octopus perimetry, group B consisted of 10 eyes with normal visual fields but either glaucomatous NFBD or deterioration of the disc over time clearly visible upon flicker comparison, and group C included 16 eyes with glaucomatous or non-glaucomatous NFBD clearly visible on red free photographs. Forty four eyes of 22 healthy volunteers served as controls. The GDx printouts of all subjects were evaluated by three independent observers in a masked fashion and without the clinical picture of the optic disc. Two of the three observers (SK, UH) were GDx experts, one (KUL) was an untrained GDx user. Among the GDx experts, sensitivity/specificity was 100%/100% (SK) and 90%/100% (UH) in detecting advanced glaucoma, and 100%/100% (SK) and 90%/100% (UH) in detecting early glaucoma. The sensitivity in detecting NFBD was only 37.5% (SK and UH). For the untrained GDx user the corresponding values were 50%/100% (group A), 20%/100% (group B), and 12.5%/91% (group C). Detection of (early) glaucoma damage by the GDx, evaluated by trained experts, can be extremely high. To optimise its benefit in clinical routine training in interpreting GDx printouts is highly recommended. Detection of localised NFBD is crucial, even for experts.

Precision Diagnosis Of Melanoma And Other Skin Lesions From Digital Images.

PubMed

Bhattacharya, Abhishek; Young, Albert; Wong, Andrew; Stalling, Simone; Wei, Maria; Hadley, Dexter

2017-01-01

Melanoma will affect an estimated 73,000 new cases this year and result in 9,000 deaths, yet precise diagnosis remains a serious problem. Without early detection and preventative care, melanoma can quickly spread to become fatal (Stage IV 5-year survival rate is 20-10%) from a once localized skin lesion (Stage IA 5- year survival rate is 97%). There is no biomarker for melanoma in clinical use, and the current diagnostic criteria for skin lesions remains subjective and imprecise. Accurate diagnosis of melanoma relies on a histopathologic gold standard; thus, aggressive excision of melanocytic skin lesions has been the mainstay of treatment. It is estimated that 36 biopsies are performed for every melanoma confirmed by pathology among excised lesions. There is significant morbidity in misdiagnosing melanoma such as progression of the disease for a false negative prediction vs the risks of unnecessary surgery for a false positive prediction. Every year, poor diagnostic precision adds an estimated $673 million in overall cost to manage the disease. Currently, manual dermatoscopic imaging is the standard of care in selecting atypical skin lesions for biopsy, and at best it achieves 90% sensitivity but only 59% specificity when performed by an expert dermatologist. Many computer vision (CV) algorithms perform better than dermatologists in classifying skin lesions although not significantly so in clinical practice. Meanwhile, open source deep learning (DL) techniques in CV have been gaining dominance since 2012 for image classification, and today DL can outperform humans in classifying millions of digital images with less than 5% error rates. Moreover, DL algorithms are readily run on commoditized hardware and have a strong online community of developers supporting their rapid adoption. In this work, we performed a successful pilot study to show proof of concept to DL skin pathology from images. However, DL algorithms must be trained on very large labelled datasets of images to achieve high accuracy. Here, we begin to assemble a large imageset of skin lesions from the UCSF and the San Francisco Veterans Affairs Medical Center (VAMC) dermatology clinics that are well characterized by their underlying pathology, on which to train DL algorithms. If trained on sufficient data, we hypothesize that our approach will significantly outperform general dermatologists in predicting skin lesion pathology. We posit that our work will allow for precision diagnosis of melanoma from widely available digital photography, which may optimize the management of the disease by decreasing unnecessary office visits and the significant morbidity and cost of melanoma misdiagnosis.

Early Childhood Discipline: A Review of the Literature

ERIC Educational Resources Information Center

Firmin, Michael W.; Castle, Sally L.

2008-01-01

In this literature review concerning early childhood discipline we particularly highlight American children's discipline with respect to historical perspectives, generational theories, gender issues, parental styles, methods of discipline, and corporal punishment. We also address corporal punishment's history, the debate among experts, beliefs and…

2016 update of the EULAR recommendations for the management of early arthritis.

PubMed

Combe, Bernard; Landewe, Robert; Daien, Claire I; Hua, Charlotte; Aletaha, Daniel; Álvaro-Gracia, Jose María; Bakkers, Margôt; Brodin, Nina; Burmester, Gerd R; Codreanu, Catalin; Conway, Richard; Dougados, Maxime; Emery, Paul; Ferraccioli, Gianfranco; Fonseca, Joao; Raza, Karim; Silva-Fernández, Lucía; Smolen, Josef S; Skingle, Diana; Szekanecz, Zoltan; Kvien, Tore K; van der Helm-van Mil, Annette; van Vollenhoven, Ronald

2017-06-01

Since the 2007 recommendations for the management of early arthritis have been presented, considerable research has been published in the field of early arthritis, mandating an update of the 2007 European League Against Rheumatism (EULAR) recommendations for management of early arthritis. In accordance with the 2014 EULAR Standardised Operating Procedures, the expert committee pursued an approach that was based on evidence in the literature and on expert opinion. The committee involved 20 rheumatologists, 2 patients and 1 healthcare professional representing 12 European countries. The group defined the focus of the expert committee and target population, formulated a definition of 'management' and selected the research questions. A systematic literature research (SLR) was performed by two fellows with the help of a skilled librarian. A set of draft recommendations was proposed on the basis of the research questions and the results of the SLR. For each recommendation, the categories of evidence were identified, the strength of recommendations was derived and the level of agreement was determined through a voting process. The updated recommendations comprise 3 overarching principles and 12 recommendations for managing early arthritis. The selected statements involve the recognition of arthritis, referral, diagnosis, prognostication, treatment (information, education, pharmacological and non-pharmacological interventions), monitoring and strategy. Eighteen items were identified as relevant for future research. These recommendations provide rheumatologists, general practitioners, healthcare professionals, patients and other stakeholders with an updated EULAR consensus on the entire management of early arthritis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

High-intensity focused ultrasound ablation: an effective bridging therapy for hepatocellular carcinoma patients.

PubMed

Cheung, Tan To; Fan, Sheung Tat; Chan, See Ching; Chok, Kenneth S H; Chu, Ferdinand S K; Jenkins, Caroline R; Lo, Regina C L; Fung, James Y Y; Chan, Albert C Y; Sharr, William W; Tsang, Simon H Y; Dai, Wing Chiu; Poon, Ronnie T P; Lo, Chung Mau

2013-05-28

To analyze whether high-intensity focused ultrasound (HIFU) ablation is an effective bridging therapy for patients with hepatocellular carcinoma (HCC). From January 2007 to December 2010, 49 consecutive HCC patients were listed for liver transplantation (UCSF criteria). The median waiting time for transplantation was 9.5 mo. Twenty-nine patients received transarterial chemoembolization (TACE) as a bringing therapy and 16 patients received no treatment before transplantation. Five patients received HIFU ablation as a bridging therapy. Another five patients with the same tumor staging (within the UCSF criteria) who received HIFU ablation but not on the transplant list were included for comparison. Patients were comparable in terms of Child-Pugh and model for end-stage liver disease scores, tumor size and number, and cause of cirrhosis. The HIFU group and TACE group showed no difference in terms of tumor size and tumor number. One patient in the HIFU group and no patient in the TACE group had gross ascites. The median hospital stay was 1 d (range, 1-21 d) in the TACE group and two days (range, 1-9 d) in the HIFU group (P < 0.000). No HIFU-related complication occurred. In the HIFU group, nine patients (90%) had complete response and one patient (10%) had partial response to the treatment. In the TACE group, only one patient (3%) had response to the treatment while 14 patients (48%) had stable disease and 14 patients (48%) had progressive disease (P = 0.00). Seven patients in the TACE group and no patient in the HIFU group dropped out from the transplant waiting list (P = 0.559). HIFU ablation is safe and effective in the treatment of HCC for patients with advanced cirrhosis. It may reduce the drop-out rate of liver transplant candidate.

Progranulin levels in blood in Alzheimer's disease and mild cognitive impairment.

PubMed

Cooper, Yonatan A; Nachun, Daniel; Dokuru, Deepika; Yang, Zhongan; Karydas, Anna M; Serrero, Ginette; Yue, Binbin; Boxer, Adam L; Miller, Bruce L; Coppola, Giovanni

2018-05-01

Changes in progranulin ( GRN ) expression have been hypothesized to alter risk for Alzheimer's disease (AD). We investigated the relationship between GRN expression in peripheral blood and clinical diagnosis of AD and mild cognitive impairment (MCI). Peripheral blood progranulin gene expression was measured, using microarrays from Alzheimer's ( n = 186), MCI ( n = 118), and control ( n = 204) subjects from the University of California San Francisco Memory and Aging Center (UCSF-MAC) and two independent published series (AddNeuroMed and ADNI). GRN gene expression was correlated with clinical, demographic, and genetic data, including APOE haplotype and the GRN rs5848 single-nucleotide polymorphism. Finally, we assessed progranulin protein levels, using enzyme-linked immunosorbent assay, and methylation status using methylation microarrays. We observed an increase in blood progranulin gene expression and a decrease in GRN promoter methylation in males ( P = 0.007). Progranulin expression was 13% higher in AD and MCI patients compared with controls in the UCSF-MAC cohort ( F 2,505 = 10.41, P = 3.72*10 -5 ). This finding was replicated in the AddNeuroMed ( F 2,271 = 17.9, P = 4.83*10 -8 ) but not the ADNI series. The rs5848 SNP (T-allele) predicted decreased blood progranulin gene expression ( P = 0.03). The APOE4 haplotype was positively associated with progranulin expression independent of diagnosis ( P = 0.04). Finally, we did not identify differences in plasma progranulin protein levels or gene methylation between diagnostic categories. Progranulin mRNA is elevated in peripheral blood of patients with AD and MCI and its expression is associated with numerous genetic and demographic factors. These data suggest a role in the pathogenesis of neurodegenerative dementias besides frontotemporal dementia.

[Response of the tobacco industry to the creation of smoke-free environments in Brazil].

PubMed

Bialous, Stella Aguinaga; Presman, Sabrina; Gigliotti, Analice; Muggli, Monique; Hurt, Richard

2010-04-01

To document the response of the tobacco industry to the regulation of smoking in public places in Brazil starting in 1996. The Legacy Tobacco Documents Library (legacy.library.ucsf.edu/) and the British American Tobacco (BAT) Company Documents (bat.library.ucsf.edu/) were searched. The following key words were used: Brasil/Brazil; Souza Cruz; fumo passivo, tabagismo passivo/passive smoking; fumo de segunda mão/secondhand smoking; convivência em harmonia/courtesy of choice; along with the names of institutions, politicians, and individuals associated with tobacco control. We also searched the websites of cigarette manufacturers and hospitality industry organizations and businesses, news websites, and online newspapers and magazines. The search was limited to the period from 1995 to 2005. The text of the first law restricting smoking in Brazil (no. 9 294, of 1996) benefited the industry by stating that smokers and nonsmokers could share the same space provided that specific areas were designated as smoking and nonsmoking. As in other countries, the tobacco industry established partnerships with hotel, bar, and restaurant associations to prevent the passing of laws creating 100% smoke-free environments, as recommended by the World Health Organization. However, local state and city laws in major cities and states (such as Rio de Janeiro and São Paulo) have been successful in ensuring the creation of 100% smoke-free places. It is essential that Brazil recognize the damage caused by smoking and revise its federal law regulating smoking in closed environments. The knowledge concerning the strategies employed by the industry may be useful for politicians and health care professionals to prepare arguments opposing measures that can be detrimental to public health.

SeTES, a Self-Teaching Expert System for the analysis, design and prediction of gas production from shales and a prototype for a new generation of Expert Systems in the Earth Sciences

NASA Astrophysics Data System (ADS)

Kuzma, H. A.; Boyle, K.; Pullman, S.; Reagan, M. T.; Moridis, G. J.; Blasingame, T. A.; Rector, J. W.; Nikolaou, M.

2010-12-01

A Self Teaching Expert System (SeTES) is being developed for the analysis, design and prediction of gas production from shales. An Expert System is a computer program designed to answer questions or clarify uncertainties that its designers did not necessarily envision which would otherwise have to be addressed by consultation with one or more human experts. Modern developments in computer learning, data mining, database management, web integration and cheap computing power are bringing the promise of expert systems to fruition. SeTES is a partial successor to Prospector, a system to aid in the identification and evaluation of mineral deposits developed by Stanford University and the USGS in the late 1970s, and one of the most famous early expert systems. Instead of the text dialogue used in early systems, the web user interface of SeTES helps a non-expert user to articulate, clarify and reason about a problem by navigating through a series of interactive wizards. The wizards identify potential solutions to queries by retrieving and combining together relevant records from a database. Inferences, decisions and predictions are made from incomplete and noisy inputs using a series of probabilistic models (Bayesian Networks) which incorporate records from the database, physical laws and empirical knowledge in the form of prior probability distributions. The database is mainly populated with empirical measurements, however an automatic algorithm supplements sparse data with synthetic data obtained through physical modeling. This constitutes the mechanism for how SeTES self-teaches. SeTES’ predictive power is expected to grow as users contribute more data into the system. Samples are appropriately weighted to favor high quality empirical data over low quality or synthetic data. Finally, a set of data visualization tools digests the output measurements into graphical outputs.

Measuring and Improving Quality in Early Childhood Environments

ERIC Educational Resources Information Center

Bernard van Leer Foundation, 2015

2015-01-01

The International Consultation, convened in Leiden (the Netherlands) in September 2014, brought together early childhood experts and stakeholders--supported by the International Step by Step Association (ISSA), the United Nations Children's Fund (UNICEF), the United Nations Educational, Scientific, and Cultural Organization (UNESCO) and the…

Handbook of Early Childhood Education

ERIC Educational Resources Information Center

Pianta, Robert C., Ed.

2012-01-01

Comprehensive and authoritative, this forward-thinking book reviews the breadth of current knowledge about early education and identifies important priorities for practice and policy. Robert C. Pianta and his associates bring together foremost experts to examine what works in promoting all children's school readiness and social-emotional…

Expert agreements and disagreements on induced seismicity by Enhanced Geothermal Systems

NASA Astrophysics Data System (ADS)

Trutnevyte, E.; Azevedo, I. L.

2016-12-01

Enhanced or Engineered Geothermal Systems (EGS) are at an early stage of development and only a handful of projects exist worldwide. In face of limited empirical evidence on EGS induced seismicity, expert elicitation provides a complementary view to quantitative assessments and basic science. We present the results of an international expert elicitation exercise with 14 experts from 6 countries. The elicitation aimed at evaluating induced seismicity hazard and risk for EGS and characterizing associated uncertainty. The state-of-the-art expert elicitation method was used: it combines technical analysis with behavioral science-informed elicitation of expert judgement in order to minimize subjectivity. The experts assessed a harmonized scenario of an EGS plant, its operational characteristics, geological context, and surrounding buildings and infrastructures. The experts provided quantitative estimates of exceedance probabilities of induced M>=3 and M>=5, maximum magnitudes that could be observed, and made judgements on economic loss, injuries, and fatalities in the case of M=3 and M=5. The experts also rated the importance of factors that influence induced seismicity hazard and risk (e.g. reservoir depth, injected volumes, exposed building stock etc.) and the potential uncertainty reductions through future research. We present the findings of this elicitation and highlight the points of expert agreements and disagreements.

Comment from the Editor to the Special Issue: “Big Data and Precision Medicine Series I: Lung Cancer Early Diagnosis”

PubMed Central

Spaggiari, Lorenzo

2018-01-01

With this Editorial we want to present the Special Issue “Big Data and Precision Medicine Series I: Lung Cancer Early Diagnosis” to the scientific community, which aims to gather experts on the early detection of lung cancer in order to implement common efforts in the fight against cancer. PMID:29425180

Enriching the Early Childhood Expertise of Elementary School Principals: Can a One-Shot College Course Make a Difference?

ERIC Educational Resources Information Center

Henry, Julie J.; Barnett, Marion

2004-01-01

A summer course was specifically designed for principals and aspiring principals to help them become more expert in principles of early childhood education. During the pilot, 10 volunteer participants completed a survey of beliefs on early childhood education before and after the course and submitted a piece of reflective writing each day. Gains…

Congruence of Goals for Early Childhood Between Head Start Parents and Experts.

ERIC Educational Resources Information Center

Lewis, Mary Summers

The purpose of this study was to determine whether there is a difference in opinion between early childhood professionals and low income parents of young children as to what the goals of early childhood programs should be. Three hundred forty parents in local Head Start centers were asked to list goals for their preschool children, and a…

Sparks Fade, Knowledge Stays: The National Early Literacy Panel's Report Lacks Staying Power

ERIC Educational Resources Information Center

Neuman, Susan B.

2010-01-01

In this article, the author talks about "Developing Early Literacy," the report of the National Early Literacy Panel. The panel, which consisted of nine experts, was convened by the National Institute for Literacy to synthesize the research on the development of literacy from birth through age 5. Over the eight years of their work, only 190…

Building Blocks: Making Children Successful in the Early Years of School

ERIC Educational Resources Information Center

Maeroff, Gene I.

2006-01-01

A student's entire journey along the educational spectrum is affected by what occurs--and, crucially, by what does not occur--before the age of eight or nine. Yet early learning has never received the attention it deserves and needs. In his latest book, education expert Gene Maeroff takes a hard look at early learning and the primary grades of…

MicroRNAs to Pathways in Prostate Cancer Progression

DTIC Science & Technology

2015-12-01

PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER Dr. Robert Blelloch and Dr. Cassandra Belair email: Robert.Blelloch@ucsf.edu 5e. TASK...Budget period of: 09/30/2013-09/29/2014: Name  Robert Blelloch  Project  Role  PI  Research Identifier Nearest person month  1.2  Contribution to... Project :  Dr. Blelloch was responsible for overall  coordination of this  project .  He was involved in  the design, interpretation and publication of all

Report of CCI Early Childhood Think Tank on Governance

ERIC Educational Resources Information Center

Child Care, Inc., 2008

2008-01-01

Child Care, Inc. (CCI) invited a group of early childhood experts to help reflect on what CCI had learned from other states about governance and to apply that knowledge to New York City. The goal was to foster more systemic thinking about how to move toward a more coherent early care and education system in New York City that would better meet the…

Discovering and annotating fish early life-stage (FELS) adverse outcome pathways: Putting the research strategy into practice

EPA Science Inventory

In May 2012, a HESI-sponsored expert workshop yielded a proposed research strategy for systematically discovering, characterizing, and annotating fish early life-stage (FELS) adverse outcome pathways (AOPs) as well as prioritizing AOP development in light of current restrictions ...

Expert Views on TPACK for Early Literacy: Priorities for Teacher Education

ERIC Educational Resources Information Center

McKenney, Susan; Voogt, Joke

2017-01-01

Technology applications can make important contributions to improving learning outcomes in the domain of early literacy. However, to fully exploit the potential of educational technologies, teachers must have specific knowledge and skills. This study aimed to articulate the technological pedagogical content knowledge teachers need to make…

Mother Earth, Earth Mother: Gabriela Mistral as an Early Ecofeminist

ERIC Educational Resources Information Center

Finzer, Erin

2015-01-01

Historians have noted that male bureaucrats and natural resource experts tended to dominate early twentieth-century national and hemispheric conservationist movements in Latin America, but a constellation of female activists, notable among them Gabriela Mistral, strengthened conservationism in the cultural sphere. Capitalizing on her leadership in…

Clinical outcome in patients with hepatocellular carcinoma after living-donor liver transplantation

PubMed Central

Choi, Ho Joong; Kim, Dong Goo; Na, Gun Hyung; Han, Jae Hyun; Hong, Tae Ho; You, Young Kyoung

2013-01-01

AIM: To investigate risk factors for hepatocellular carcinoma (HCC) recurrence after living donor liver transplantation (LDLT) and efficacy of various criteria. METHODS: From October 2000 to November 2011, 233 adult patients underwent LDLT for HCC at our institution. After excluding nine postoperative mortality cases, we analyzed retrospectively 224 patients. To identify risk factors for recurrence, we evaluated recurrence, disease-free survival (DFS) rate, survival rate, and various other factors which are based on the characteristics of both the patient and tumor. Additionally, we developed our own criteria based on our data. Next, we compared our selection criteria with various tumor-grading scales, such as the Milan criteria, University of California, San Francisco (UCSF) criteria, TNM stage, Barcelona Clinic Liver Cancer (BCLC) stage and Cancer of the Liver Italian Program (CLIP) scoring system. The median follow up was 68 (6-139) mo. RESULTS: In 224 patients who received LDLT for HCC, 37 (16.5%) experienced tumor recurrence during the follow-up period. The 5-year DFS and overall survival rates after LDLT in all patients with HCC were 80.9% and 76.4%, respectively. On multivariate analysis, the tumor diameter {5 cm; P < 0.001; exponentiation of the B coefficient [Exp(B)], 11.89; 95%CI: 3.784-37.368} and alpha fetoprotein level [AFP, 100 ng/mL; P = 0.021; Exp(B), 2.892; 95%CI: 1.172-7.132] had significant influences on HCC recurrence after LDLT. Therefore, these two factors were included in our criteria. Based on these data, we set our selection criteria as a tumor diameter ≤ 5 cm and AFP ≤ 100 ng/mL. Within our new criteria (140/214, 65.4%), the 5-year DFS and overall survival rates were 88.6% and 81.8%, respectively. Our criteria (P = 0.001), Milan criteria (P = 0.009), and UCSF criteria (P = 0.001) showed a significant difference in DFS rate. And our criteria (P = 0.006) and UCSF criteria (P = 0.009) showed a significant difference in overall survival rate. But Milan criteria did not show significant difference in overall survival rate (P = 0.137). Among stages 0, A, B and C of BCLC, stage C had a significantly higher recurrence rate (P = 0.001), lower DFS (P = 0.001), and overall survival rate (P = 0.005) compared with the other stages. Using the CLIP scoring system, the group with a score of 4 to 5 showed a high recurrence rate (P = 0.023) and lower DFS (P = 0.011); however, the overall survival rate did not differ from that of the lower scoring group. The TNM system showed a trend of increased recurrence rate, decreased DFS, or survival rate according to T stage, albeit without statistical significance. CONCLUSION: LDLT is considered the preferred therapeutic option in patients with an AFP level less than 100 ng/mL and a tumor diameter of less than 5 cm. PMID:23922471

Commentary: ADHD and Social Disadvantage: An Inconvenient Truth?--A Reflection on Russell et al. (2014) and Larsson et al. (2014)

ERIC Educational Resources Information Center

Nigg, Joel T.; Craver, Lindsay

2014-01-01

In the 1950's, many experts believed hyperkinesis was a neurotic reaction to inner conflicts arising from early family experiences. In the 1990's, many experts believed ADHD to be "genetic" (without a mechanistic explanation of what that meant). Both views appear naïve today in a scientific world grappling with the complexity…

The temporal advantage for individuating objects of expertise: perceptual expertise is an early riser.

PubMed

Curby, Kim M; Gauthier, Isabel

2009-06-10

The identification of faces has a temporal advantage over that of other object categories. The orientation-specific nature of this advantage suggests that it stems from our extensive experience and resulting expertise with upright faces. While experts can identify objects faster than novices, it is unclear exactly how the temporal dynamics of identification are changed by expertise and whether the nature of this temporal advantage is similar for face and non-face objects of expertise. Here, we titrated encoding time using a backward-masking paradigm with variable stimulus-mask onset-asynchronies and mapped the resulting effect on recognition for upright and inverted faces (Experiment 1) and for cars among car experts and car novices (Experiment 2). Performance for upright faces and cars among car experts rose above chance between 33 and 70 ms before that for inverted faces or cars among car novices. A shifted exponential function fitted to these data suggested that performance started to rise earlier for experts than for novices, but that additional encoding time increased performance at a similar rate. Experience influences the availability of information early in processing, possibly through the recruitment of more category-selective neurons, while the rate of perceptual processing may be less flexible and limited by inherent physiological constraints.

Sweet-spot training for early esophageal cancer detection

NASA Astrophysics Data System (ADS)

van der Sommen, Fons; Zinger, Svitlana; Schoon, Erik J.; de With, Peter H. N.

2016-03-01

Over the past decade, the imaging tools for endoscopists have improved drastically. This has enabled physicians to visually inspect the intestinal tissue for early signs of malignant lesions. Besides this, recent studies show the feasibility of supportive image analysis for endoscopists, but the analysis problem is typically approached as a segmentation task where binary ground truth is employed. In this study, we show that the detection of early cancerous tissue in the gastrointestinal tract cannot be approached as a binary segmentation problem and it is crucial and clinically relevant to involve multiple experts for annotating early lesions. By employing the so-called sweet spot for training purposes as a metric, a much better detection performance can be achieved. Furthermore, a multi-expert-based ground truth, i.e. a golden standard, enables an improved validation of the resulting delineations. For this purpose, besides the sweet spot we also propose another novel metric, the Jaccard Golden Standard (JIGS) that can handle multiple ground-truth annotations. Our experiments involving these new metrics and based on the golden standard show that the performance of a detection algorithm of early neoplastic lesions in Barrett's esophagus can be increased significantly, demonstrating a 10 percent point increase in the resulting F1 detection score.

Early Adolescence: Perspectives and Recommendations to the National Science Foundation.

ERIC Educational Resources Information Center

Katzenmeyer, Conrad G., Ed.; Rivkin, Mary S., Ed.

Contained in this publication is the final report of a panel of experts, convened by the Assistant Director for Science Education of the National Science Foundation, interested in science education for early adolescence. The document also contains three appendices. Appendix A lists members of the panel and their professional affiliation. Appendix…

School Art in American Culture: Supplement, 1900-15.

ERIC Educational Resources Information Center

Wygant, Foster

This book is intended as a further resource for instructors, advanced students, or others especially interested in art education in the early years of the 20th century. The book presents school art in the early years of cars, airplanes, telephones, cinema, assembly line production, efficiency experts, progressives in politics and education,…

In Early Childhood: What's Language about?

ERIC Educational Resources Information Center

Mozere, Liane

2007-01-01

This paper argues that in daycare centres in France, where children are cared for from four months to age three, the competence of female staff members is usually denied and unvalued vis a vis the expert opinions. The paper highlights empirical research on early childhood and gender, providing pragmatic access to children's languages of desire, a…

TPACK in Teacher Education: Are We Preparing Teachers to Use Technology for Early Literacy?

ERIC Educational Resources Information Center

Voogt, Joke; McKenney, Susan

2017-01-01

This study examines if and how five teacher education institutes are helping students to develop the technological pedagogical content knowledge needed to effectively use technology for early literacy. Focus group discussions were held with teacher educators in which their responses to expert recommendations were probed. Findings indicate that,…

Working with Families of Young Children with Special Needs

ERIC Educational Resources Information Center

McWilliam, R. A., Ed.

2010-01-01

This user-friendly book presents research-based best practices for serving families of children with special needs from birth to age 6. Expert contributors demonstrate how early intervention and early childhood special education can effectively address a wide range of family concerns, which in turn optimizes children's development and learning.…

Adaptability of expert visual anticipation in baseball batting.

PubMed

Müller, Sean; Fadde, Peter J; Harbaugh, Allen G

2017-09-01

By manipulating stimulus variation in terms of opponent pitcher actions, this study investigated the capability of expert (n = 30) and near-expert (n = 95) professional baseball batters to adapt anticipation skill when using the video simulation temporal occlusion paradigm. Participants watched in-game footage of two pitchers, one after the other, that was temporally occluded at ball release and various points during ball flight. They were required to make a written prediction of pitch types and locations. Per cent accuracy was calculated for pitch type, for pitch location, and for type and location combined. Results indicated that experts and near-experts could adapt their anticipation to predict above guessing level across both pitchers, but adaptation to the left-handed pitcher was poorer than the right-handed pitcher. Small-to-moderate effect sizes were found in terms of superior adaptation by experts over near-experts at the ball release and early ball flight occlusion conditions. The findings of this study extend theoretical and applied knowledge of expertise in striking sports. Practical application of the instruments and findings are discussed in terms of applied researchers, practitioners and high-performance staff in professional sporting organisations.

Expert system application education project

NASA Technical Reports Server (NTRS)

Gonzelez, Avelino J.; Ragusa, James M.

1988-01-01

Artificial intelligence (AI) technology, and in particular expert systems, has shown potential applicability in many areas of operation at the Kennedy Space Center (KSC). In an era of limited resources, the early identification of good expert system applications, and their segregation from inappropriate ones can result in a more efficient use of available NASA resources. On the other hand, the education of students in a highly technical area such as AI requires an extensive hands-on effort. The nature of expert systems is such that proper sample applications for the educational process are difficult to find. A pilot project between NASA-KSC and the University of Central Florida which was designed to simultaneously address the needs of both institutions at a minimum cost. This project, referred to as Expert Systems Prototype Training Project (ESPTP), provided NASA with relatively inexpensive development of initial prototype versions of certain applications. University students likewise benefit by having expertise on a non-trivial problem accessible to them at no cost. Such expertise is indispensible in a hands-on training approach to developing expert systems.

Prevention and Early Intervention for Young Children at Risk for Emotional or Behavioral Disorders. Fifth CCBD Mini-Library Series: Meeting the Diverse Needs of Children and Youth with E/BD--Evidence-Based Programs and Practices.

ERIC Educational Resources Information Center

Conroy, Maureen A., Ed.

This document presents discussions of current research and activities by experts in early intervention and behavior disorders. It offers a range of evidence-based strategies, procedures, and models appropriate for prevention and early intervention programs with young children at risk for emotional and/or behavioral disorders. Following an…

Utilization of a multimedia PACS workstation for surgical planning of epilepsy

NASA Astrophysics Data System (ADS)

Soo Hoo, Kent; Wong, Stephen T.; Hawkins, Randall A.; Knowlton, Robert C.; Laxer, Kenneth D.; Rowley, Howard A.

1997-05-01

Surgical treatment of temporal lobe epilepsy requires the localization of the epileptogenic zone for surgical resection. Currently, clinicians utilize electroencephalography, various neuroimaging modalities, and psychological tests together to determine the location of this zone. We investigate how a multimedia neuroimaging workstation built on top of the UCSF Picture Archiving and Communication System can be used to aid surgical planning of epilepsy and related brain diseases. This usage demonstrates the ability of the workstation to retrieve image and textural data from PACS and other image sources, register multimodality images, visualize and render 3D data sets, analyze images, generate new image and text data from the analysis, and organize all data in a relational database management system.

LS-SNP/PDB: annotated non-synonymous SNPs mapped to Protein Data Bank structures.

PubMed

Ryan, Michael; Diekhans, Mark; Lien, Stephanie; Liu, Yun; Karchin, Rachel

2009-06-01

LS-SNP/PDB is a new WWW resource for genome-wide annotation of human non-synonymous (amino acid changing) SNPs. It serves high-quality protein graphics rendered with UCSF Chimera molecular visualization software. The system is kept up-to-date by an automated, high-throughput build pipeline that systematically maps human nsSNPs onto Protein Data Bank structures and annotates several biologically relevant features. LS-SNP/PDB is available at (http://ls-snp.icm.jhu.edu/ls-snp-pdb) and via links from protein data bank (PDB) biology and chemistry tabs, UCSC Genome Browser Gene Details and SNP Details pages and PharmGKB Gene Variants Downloads/Cross-References pages.

Implementation of a Prototype Generalized Network Technology for Hospitals *

PubMed Central

Tolchin, S. G.; Stewart, R. L.; Kahn, S. A.; Bergan, E. S.; Gafke, G. P.; Simborg, D. W.; Whiting-O'Keefe, Q. E.; Chadwick, M. G.; McCue, G. E.

1981-01-01

A demonstration implementation of a distributed data processing hospital information system using an intelligent local area communications network (LACN) technology is described. This system is operational at the UCSF Medical Center and integrates four heterogeneous, stand-alone minicomputers. The applications systems are PID/Registration, Outpatient Pharmacy, Clinical Laboratory and Radiology/Medical Records. Functional autonomy of these systems has been maintained, and no operating system changes have been required. The LACN uses a fiber-optic communications medium and provides extensive communications protocol support within the network, based on the ISO/OSI Model. The architecture is reconfigurable and expandable. This paper describes system architectural issues, the applications environment and the local area network.

The Future of Telepractice for Children Who Are Deaf and Hard of Hearing

ERIC Educational Resources Information Center

Stredler-Brown, Arlene

2012-01-01

Telepractice can be used to deliver early intervention, therapeutic, and educational services to children who are deaf and hard of hearing (DHH). For infants and toddlers, telepractice can provide early access to family-centered services that are delivered by experts in hearing loss, irrespective of where either party lives. For school-age…

Early-Years Absenteeism Seen as Critical

ERIC Educational Resources Information Center

Sparks, Sarah D.

2010-01-01

While efforts to reduce chronic absenteeism typically focus on adolescents, experts say that the early grades are the place to start. Statistics show that rates of absenteeism in kindergarten and 1st grade can rival those in high school. An average of one in 10 pupils in grades K-12 nationwide is considered chronically absent, defined as missing…

Testing and Assessment for the Good of Education: Contributions of AERA Presidents, 1915-2015

ERIC Educational Resources Information Center

Shepard, Lorrie A.

2016-01-01

Early presidents of the American Educational Research Association were leaders in the testing movement. Their intentions were to improve education by means of testing, which included both IQ and achievement tests. Early measurement experts acknowledged in scholarly articles that IQ tests could not measure inherited ability of groups with vastly…

Engaging Young Children in Mathematics: Standards for Early Childhood Mathematics Education. Studies in Mathematical Thinking and Learning Series

ERIC Educational Resources Information Center

Clements, Douglas H., Ed.; DiBiase, Ann-Marie, Ed.; Sarama, Julie, Ed.

2004-01-01

This book brings together the combined wisdom of a diverse group of experts involved with early childhood mathematics. The book originates from the landmark 2000 Conference on Standards for Pre-kindergarten and Kindergarten Mathematics Education, attended by representatives from almost every state developing standards for young children's…

After Early Intervention, Then What? Teaching Struggling Readers in Grades 3 and Beyond.

ERIC Educational Resources Information Center

McCormack, Rachel L., Ed.; Paratore, Jeanne R., Ed.

Noting that early intervention is insufficient for many children because they struggle in learning to read for an array of reasons, this book highlights the need for expert, intensive, and focused instruction in reading beyond the primary years in addition to identifying and describing effective practices for teaching those students in grades 3 to…

Early psychosocial interventions after disasters, terrorism and other shocking events: is there a gap between norms and practice in Europe?

PubMed Central

Te Brake, Hans

2013-01-01

Background Internationally, several initiatives exist to describe standards for post-disaster psychosocial care. Objective This study explored the level of consensus of experts within Europe on a set of recommendations on early psychosocial intervention after shocking events (Dutch guidelines), and to what degree these standards are implemented into mental health care practice. Methods Two hundred and six (mental) health care professionals filled out a questionnaire to assess the extent to which they consider the guidelines’ scope and recommendations relevant and part of the regular practice in their own country. Forty-five European experts from 24 EU countries discussed the guidelines at an international seminar. Results The data suggest overall agreement on the standards although many of the recommendations appear not (yet) to be embedded in everyday practice. Conclusions Although large consensus exists on standards for early psychosocial care, a chasm between norms and practice appears to exist throughout the EU, stressing the general need for investments in guideline development and implementation. PMID:23393613

Comparative Analysis of Automatic Exudate Detection between Machine Learning and Traditional Approaches

NASA Astrophysics Data System (ADS)

Sopharak, Akara; Uyyanonvara, Bunyarit; Barman, Sarah; Williamson, Thomas

To prevent blindness from diabetic retinopathy, periodic screening and early diagnosis are neccessary. Due to lack of expert ophthalmologists in rural area, automated early exudate (one of visible sign of diabetic retinopathy) detection could help to reduce the number of blindness in diabetic patients. Traditional automatic exudate detection methods are based on specific parameter configuration, while the machine learning approaches which seems more flexible may be computationally high cost. A comparative analysis of traditional and machine learning of exudates detection, namely, mathematical morphology, fuzzy c-means clustering, naive Bayesian classifier, Support Vector Machine and Nearest Neighbor classifier are presented. Detected exudates are validated with expert ophthalmologists' hand-drawn ground-truths. The sensitivity, specificity, precision, accuracy and time complexity of each method are also compared.

Virtual building environments (VBE) - Applying information modeling to buildings

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

Bazjanac, Vladimir

2004-06-21

A Virtual Building Environment (VBE) is a ''place'' where building industry project staffs can get help in creating Building Information Models (BIM) and in the use of virtual buildings. It consists of a group of industry software that is operated by industry experts who are also experts in the use of that software. The purpose of a VBE is to facilitate expert use of appropriate software applications in conjunction with each other to efficiently support multidisciplinary work. This paper defines BIM and virtual buildings, and describes VBE objectives, set-up and characteristics of operation. It informs about the VBE Initiative andmore » the benefits from a couple of early VBE projects.« less

Early warning systems for the management of chronic heart failure: a systematic literature review of cost-effectiveness models.

PubMed

Albuquerque De Almeida, Fernando; Al, Maiwenn; Koymans, Ron; Caliskan, Kadir; Kerstens, Ankie; Severens, Johan L

2018-04-01

Describing the general and methodological characteristics of decision-analytical models used in the economic evaluation of early warning systems for the management of chronic heart failure patients and performing a quality assessment of their methodological characteristics is expected to provide concise and useful insight to inform the future development of decision-analytical models in the field of heart failure management. Areas covered: The literature on decision-analytical models for the economic evaluation of early warning systems for the management of chronic heart failure patients was systematically reviewed. Nine electronic databases were searched through the combination of synonyms for heart failure and sensitive filters for cost-effectiveness and early warning systems. Expert commentary: The retrieved models show some variability with regards to their general study characteristics. Overall, they display satisfactory methodological quality, even though some points could be improved, namely on the consideration and discussion of any competing theories regarding model structure and disease progression, identification of key parameters and the use of expert opinion, and uncertainty analyses. A comprehensive definition of early warning systems and further research under this label should be pursued. To improve the transparency of economic evaluation publications, authors should make available detailed technical information regarding the published models.

Mentorship through advisory colleges.

PubMed

Murr, Andrew H; Miller, Carol; Papadakis, Maxine

2002-11-01

Medical students face pressures ranging from the need to create a social network to learning vast amounts of scientific material. Students often feel isolated in this system and lack mentorship. In order to counteract feelings of bureaucratic anonymity and isolation, the University of California San Francisco has created an advisory college to foster the professional and personal growth and well being of students. UCSF has developed a formal structure to advise medical students. A selection committee, chaired by the associate dean of student affairs, appointed five faculty mentors to head advisory colleges. These five colleges serve as the advising and well-being infrastructure for the students. Mentors were chosen from a balanced range of clinical disciplines, both primary and specialty. The disciplines are obstetrics-gynecology, otolaryngology/head and neck surgery, medicine, pediatrics, and psychiatry. The mentors have demonstrated excellence in advising and counseling of students. Mentors meet individually at the beginning of the academic year with incoming first-year and second-year students. They then have bimonthly meetings with eight to ten students within each college throughout the academic year. Curricula for these group sessions include well-being discussions and coping techniques, sessions on the hidden and informal curriculum of professionalism, and discussions on career choices and strategies. For third-year students, advisory college meetings are scheduled during intersessions, which are weeklong courses that occur between the eight-week clerkship blocks. Mentors are available throughout the year to meet with students on an as-needed basis, and advisory colleges may hold group social activities. The dean's office supports each mentor with 20% salary and provides administrative support for the group college activities. Historically, UCSF students feel they receive an excellent education and appropriate job opportunities, but they do not feel they receive adequate advising and mentoring. This may have as its root cause the financial, clinical, and research pressures placed upon a faculty who are also responsible for mentoring residents and fellows. The advisory colleges begin by providing an infrastructure for developing a relationship for the student with a single faculty member. The advisory college system is incorporated into the academic schedule rather than relying on ad-hoc activities from well-meaning but inconsistently available faculty. In the early part of medical school, the advisory college relationship concentrates on assimilation into the new environment and provides the student with advice pertaining to mastering academic material. The college also serves as a sounding board for problems that can then be relayed to course directors to improve the educational experience. For students encountering academic difficulty, the college advisor can provide discreet advice about tutoring resources and can direct the student to a separately staffed Student Well-being Program. As time progresses, the mentors can direct students to key people in different fields of interest such as program directors and keep the students on track to make career decisions in a timely manner. The college system can help transform an anonymous medical school experience into a supportive, rich environment.

Electrophysiological correlates of aesthetic processing of webpages: a comparison of experts and laypersons

PubMed Central

Hösker, Thomas M.; Hirschfeld, Gerrit; Thielsch, Meinald T.

2017-01-01

We investigated whether design experts or laypersons evaluate webpages differently. Twenty participants, 10 experts and 10 laypersons, judged the aesthetic value of a webpage in an EEG-experiment. Screenshots of 150 webpages, judged as aesthetic or as unaesthetic by another 136 participants, served as stimulus material. Behaviorally, experts and laypersons evaluated unaesthetic webpages similarly, but they differed in their evaluation of aesthetic ones: experts evaluated aesthetic webpages as unaesthetic more often than laypersons did. The ERP-data show main effects of level of expertise and of aesthetic value only. There was no interaction of expertise and aesthetics. In a time-window of 110–130 ms after stimulus onset, aesthetic webpages elicited a more negative EEG-amplitude than unaesthetic webpages. In the same time window, experts had more negative EEG-amplitudes than laypersons. This patterning of results continued until a time window of 600–800 ms in which group and aesthetic differences diminished. An interaction of perceiver characteristics and object properties that several interactionist theories postulate was absent in the EEG-data. Experts seem to process the stimuli in a more thorough manner than laypersons. The early activation differences between aesthetic and unaesthetic webpages is in contrast with some theories of aesthetic processing and has not been reported before. PMID:28603676

Electrophysiological correlates of aesthetic processing of webpages: a comparison of experts and laypersons.

PubMed

Bölte, Jens; Hösker, Thomas M; Hirschfeld, Gerrit; Thielsch, Meinald T

2017-01-01

We investigated whether design experts or laypersons evaluate webpages differently. Twenty participants, 10 experts and 10 laypersons, judged the aesthetic value of a webpage in an EEG-experiment. Screenshots of 150 webpages, judged as aesthetic or as unaesthetic by another 136 participants, served as stimulus material. Behaviorally, experts and laypersons evaluated unaesthetic webpages similarly, but they differed in their evaluation of aesthetic ones: experts evaluated aesthetic webpages as unaesthetic more often than laypersons did. The ERP-data show main effects of level of expertise and of aesthetic value only. There was no interaction of expertise and aesthetics. In a time-window of 110-130 ms after stimulus onset, aesthetic webpages elicited a more negative EEG-amplitude than unaesthetic webpages. In the same time window, experts had more negative EEG-amplitudes than laypersons. This patterning of results continued until a time window of 600-800 ms in which group and aesthetic differences diminished. An interaction of perceiver characteristics and object properties that several interactionist theories postulate was absent in the EEG-data. Experts seem to process the stimuli in a more thorough manner than laypersons. The early activation differences between aesthetic and unaesthetic webpages is in contrast with some theories of aesthetic processing and has not been reported before.

Continuing quality improvement procedures for a clinical PACS.

PubMed

Andriole, K P; Gould, R G; Avrin, D E; Bazzill, T M; Yin, L; Arenson, R L

1998-08-01

The University of California at San Francisco (USCF) Department of Radiology currently has a clinically operational picture archiving and communication system (PACS) that is thirty-five percent filmless, with the goal of becoming seventy-five percent filmless within the year. The design and implementation of the clinical PACS has been a collaborative effort between an academic research laboratory and a commercial vendor partner. Images are digitally acquired from three computed radiography (CR) scanners, five computed tomography (CT) scanners, five magnetic resonance (MR) imagers, three digital fluoroscopic rooms, an ultrasound mini-PACS and a nuclear medicine mini-PACS. The DICOM (Digital Imaging and Communications in Medicine) standard communications protocol and image format is adhered to throughout the PACS. Images are archived in hierarchical staged fashion, on a RAID (redundant array of inexpensive disks) and on magneto-optical disk jukeboxes. The clinical PACS uses an object-oriented Oracle SQL (systems query language) database, and interfaces to the Radiology Information System using the HL7 (Health Languages 7) standard. Components are networked using a combination of switched and fast ethernet, and ATM (asynchronous transfer mode), all over fiber optics. The wide area network links six UCSF sites in San Francisco. A combination of high and medium resolution dual-monitor display stations have been placed throughout the Department of Radiology, the Emergency Department (ED) and Intensive Care Units (ICU). A continuing quality improvement (CQI) committee has been formed to facilitate the PACS installation and training, workflow modifications, quality assurance and clinical acceptance. This committee includes radiologists at all levels (resident, fellow, attending), radiology technologists, film library personnel, ED and ICU clinician end-users, and PACS team members. The CQI committee has proved vital in the creation of new management procedures, providing a means for user feedback and education, and contributing to the overall acceptance of, and user satisfaction with the system. Well developed CQI procedures have been essential to the successful clinical operation of the PACS as UCSF Radiology moves toward a filmless department.

Multicentre validation of a sepsis prediction algorithm using only vital sign data in the emergency department, general ward and ICU

PubMed Central

Mao, Qingqing; Jay, Melissa; Calvert, Jacob; Barton, Christopher; Shimabukuro, David; Shieh, Lisa; Chettipally, Uli; Fletcher, Grant; Kerem, Yaniv; Zhou, Yifan; Das, Ritankar

2018-01-01

Objectives We validate a machine learning-based sepsis-prediction algorithm (InSight) for the detection and prediction of three sepsis-related gold standards, using only six vital signs. We evaluate robustness to missing data, customisation to site-specific data using transfer learning and generalisability to new settings. Design A machine-learning algorithm with gradient tree boosting. Features for prediction were created from combinations of six vital sign measurements and their changes over time. Setting A mixed-ward retrospective dataset from the University of California, San Francisco (UCSF) Medical Center (San Francisco, California, USA) as the primary source, an intensive care unit dataset from the Beth Israel Deaconess Medical Center (Boston, Massachusetts, USA) as a transfer-learning source and four additional institutions’ datasets to evaluate generalisability. Participants 684 443 total encounters, with 90 353 encounters from June 2011 to March 2016 at UCSF. Interventions None. Primary and secondary outcome measures Area under the receiver operating characteristic (AUROC) curve for detection and prediction of sepsis, severe sepsis and septic shock. Results For detection of sepsis and severe sepsis, InSight achieves an AUROC curve of 0.92 (95% CI 0.90 to 0.93) and 0.87 (95% CI 0.86 to 0.88), respectively. Four hours before onset, InSight predicts septic shock with an AUROC of 0.96 (95% CI 0.94 to 0.98) and severe sepsis with an AUROC of 0.85 (95% CI 0.79 to 0.91). Conclusions InSight outperforms existing sepsis scoring systems in identifying and predicting sepsis, severe sepsis and septic shock. This is the first sepsis screening system to exceed an AUROC of 0.90 using only vital sign inputs. InSight is robust to missing data, can be customised to novel hospital data using a small fraction of site data and retains strong discrimination across all institutions. PMID:29374661

Change Management in the Governance of Schooling: The Rise of Experts, Planners, and Statistics in the Early OECD

ERIC Educational Resources Information Center

Tröhler, Daniel

2014-01-01

Background/Context: Based on archival material, the following paper analyzes the political strategies of the early OECD stakeholders in transforming schooling from a cultural to a technological system and how they were in need of standardizing different existing patterns of thoughts or institutional behaviors in the member countries. The European…

Learning and Teaching Early Math: The Learning Trajectories Approach, 2nd Edition. Studies in Mathematical Thinking and Learning Series

ERIC Educational Resources Information Center

Clements, Douglas H.; Sarama, Julie

2014-01-01

In this important book for pre- and in-service teachers, early math experts Douglas Clements and Julie Sarama show how "learning trajectories" help diagnose a child's level of mathematical understanding and provide guidance for teaching. By focusing on the inherent delight and curiosity behind young children's mathematical reasoning,…

Background Information for Think Tank on Planning, Governance and System Building Early Care and Education--NYC

ERIC Educational Resources Information Center

Boressoff, Todd

2008-01-01

This document provides some background on early childhood planning and system building around the country. Since mid-December, the author has been studying these efforts for Child Care, Inc. (CCI) interviewing national experts and reading widely. This outline provides insights and lesson learned from those inquiries. The goal at this meeting will…

Science Education and the Emergence of the Specialized Scientist in Nineteenth Century Greece

ERIC Educational Resources Information Center

Tampakis, Konstantinos

2013-01-01

In this paper, I describe the strong and reciprocal relations between the emergence of the specialized expert in the natural sciences and the establishment of science education, in early Modern Greece. Accordingly, I show how science and public education interacted within the Greek state from its inception in the early 1830, to the first decade of…

The Role of Deliberate Practice and Play in Career Progression in Sport: The Early Engagement Hypothesis

ERIC Educational Resources Information Center

Ford, Paul R.; Ward, Paul; Hodges, Nicola J.; Williams, A. Mark

2009-01-01

Experts acquire domain-specific skills as a result of the activities in which they participate throughout their development. We examine the domain-specific activities in which two groups of elite youth soccer players participated between six and 12 years of age. Our goal was to examine early participation differences between those who progressed…

An Interpretable Machine Learning Model for Accurate Prediction of Sepsis in the ICU.

PubMed

Nemati, Shamim; Holder, Andre; Razmi, Fereshteh; Stanley, Matthew D; Clifford, Gari D; Buchman, Timothy G

2018-04-01

Sepsis is among the leading causes of morbidity, mortality, and cost overruns in critically ill patients. Early intervention with antibiotics improves survival in septic patients. However, no clinically validated system exists for real-time prediction of sepsis onset. We aimed to develop and validate an Artificial Intelligence Sepsis Expert algorithm for early prediction of sepsis. Observational cohort study. Academic medical center from January 2013 to December 2015. Over 31,000 admissions to the ICUs at two Emory University hospitals (development cohort), in addition to over 52,000 ICU patients from the publicly available Medical Information Mart for Intensive Care-III ICU database (validation cohort). Patients who met the Third International Consensus Definitions for Sepsis (Sepsis-3) prior to or within 4 hours of their ICU admission were excluded, resulting in roughly 27,000 and 42,000 patients within our development and validation cohorts, respectively. None. High-resolution vital signs time series and electronic medical record data were extracted. A set of 65 features (variables) were calculated on hourly basis and passed to the Artificial Intelligence Sepsis Expert algorithm to predict onset of sepsis in the proceeding T hours (where T = 12, 8, 6, or 4). Artificial Intelligence Sepsis Expert was used to predict onset of sepsis in the proceeding T hours and to produce a list of the most significant contributing factors. For the 12-, 8-, 6-, and 4-hour ahead prediction of sepsis, Artificial Intelligence Sepsis Expert achieved area under the receiver operating characteristic in the range of 0.83-0.85. Performance of the Artificial Intelligence Sepsis Expert on the development and validation cohorts was indistinguishable. Using data available in the ICU in real-time, Artificial Intelligence Sepsis Expert can accurately predict the onset of sepsis in an ICU patient 4-12 hours prior to clinical recognition. A prospective study is necessary to determine the clinical utility of the proposed sepsis prediction model.

Applications of artificial intelligence V; Proceedings of the Meeting, Orlando, FL, May 18-20, 1987

NASA Technical Reports Server (NTRS)

Gilmore, John F. (Editor)

1987-01-01

The papers contained in this volume focus on current trends in applications of artificial intelligence. Topics discussed include expert systems, image understanding, artificial intelligence tools, knowledge-based systems, heuristic systems, manufacturing applications, and image analysis. Papers are presented on expert system issues in automated, autonomous space vehicle rendezvous; traditional versus rule-based programming techniques; applications to the control of optional flight information; methodology for evaluating knowledge-based systems; and real-time advisory system for airborne early warning.

Effects of Long-term Diving Training on Cortical Gyrification.

PubMed

Zhang, Yuanchao; Zhao, Lu; Bi, Wenwei; Wang, Yue; Wei, Gaoxia; Evans, Alan; Jiang, Tianzi

2016-06-20

During human brain development, cortical gyrification, which is believed to facilitate compact wiring of neural circuits, has been shown to follow an inverted U-shaped curve, coinciding with the two-stage neurodevelopmental process of initial synaptic overproduction with subsequent pruning. This trajectory allows postnatal experiences to refine the wiring, which may manifest as endophenotypic changes in cortical gyrification. Diving experts, typical elite athletes who commence intensive motor training at a very young age in their early childhood, serve ideal models for examining the gyrification changes related to long-term intensive diving training. Using local gyrification index (LGI), we compared the cortical gyrification between 12 diving experts and 12 controls. Compared with controls, diving experts showed widespread LGI reductions in regions relevant to diving performance. Negative correlations between LGIs and years of diving training were also observed in diving experts. Further exploratory network efficiency analysis of structural cortical networks, inferred from interregional correlation of LGIs, revealed comparable global and local efficiency in diving experts relative to controls. These findings suggest that gyrification reductions in diving experts may be the result of long-term diving training which could refine the neural circuitry (via synaptic pruning) and might be the anatomical substrate underlying their extraordinary diving performance.

Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease: A Scientific Statement From the American Heart Association.

PubMed

Goldstein, Benjamin I; Carnethon, Mercedes R; Matthews, Karen A; McIntyre, Roger S; Miller, Gregory E; Raghuveer, Geetha; Stoney, Catherine M; Wasiak, Hank; McCrindle, Brian W

2015-09-08

In the 2011 "Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents," several medical conditions among youth were identified that predispose to accelerated atherosclerosis and early cardiovascular disease (CVD), and risk stratification and management strategies for youth with these conditions were elaborated. Major depressive disorder (MDD) and bipolar disorder (BD) among youth satisfy the criteria set for, and therefore merit inclusion among, Expert Panel tier II moderate-risk conditions. The combined prevalence of MDD and BD among adolescents in the United States is ≈10%, at least 10 times greater than the prevalence of the existing moderate-risk conditions combined. The high prevalence of MDD and BD underscores the importance of positioning these diseases alongside other pediatric diseases previously identified as moderate risk for CVD. The overall objective of this statement is to increase awareness and recognition of MDD and BD among youth as moderate-risk conditions for early CVD. To achieve this objective, the primary specific aims of this statement are to (1) summarize evidence that MDD and BD are tier II moderate-risk conditions associated with accelerated atherosclerosis and early CVD and (2) position MDD and BD as tier II moderate-risk conditions that require the application of risk stratification and management strategies in accordance with Expert Panel recommendations. In this scientific statement, there is an integration of the various factors that putatively underlie the association of MDD and BD with CVD, including pathophysiological mechanisms, traditional CVD risk factors, behavioral and environmental factors, and psychiatric medications. © 2015 American Heart Association, Inc.

Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer: ASCO Clinical Practice Guideline Focused Update.

PubMed

Denduluri, Neelima; Chavez-MacGregor, Mariana; Telli, Melinda L; Eisen, Andrea; Graff, Stephanie L; Hassett, Michael J; Holloway, Jamie N; Hurria, Arti; King, Tari A; Lyman, Gary H; Partridge, Ann H; Somerfield, Mark R; Trudeau, Maureen E; Wolff, Antonio C; Giordano, Sharon H

2018-05-22

Purpose To update key recommendations of the ASCO guideline adaptation of the Cancer Care Ontario guideline on the selection of optimal adjuvant chemotherapy regimens for early breast cancer and adjuvant targeted therapy for breast cancer. Methods An Expert Panel conducted targeted systematic literature reviews guided by a signals approach to identify new, potentially practice-changing data that might translate to revised practice recommendations. Results The Expert Panel reviewed phase III trials that evaluated adjuvant capecitabine after completion of standard preoperative anthracycline- and taxane-based combination chemotherapy by patients with early-stage breast cancer HER2-negative breast cancer with residual invasive disease at surgery; the addition of 1 year of adjuvant pertuzumab to combination chemotherapy and trastuzumab for patients with early-stage, HER2-positive breast cancer; and the use of neratinib as extended adjuvant therapy for patients after combination chemotherapy and trastuzumab-based adjuvant therapy with early-stage, HER2-positive breast cancer. Recommendations Patients with early-stage HER2-negative breast cancer with pathologic, invasive residual disease at surgery following standard anthracycline- and taxane-based preoperative therapy may be offered up to six to eight cycles of adjuvant capecitabine. Clinicians may add 1 year of adjuvant pertuzumab to trastuzumab-based combination chemotherapy in patients with high-risk, early-stage, HER2-positive breast cancer. Clinicians may use extended adjuvant therapy with neratinib to follow trastuzumab in patients with early-stage, HER2-positive breast cancer. Neratinib causes substantial diarrhea, and diarrhea prophylaxis must be used. Additional information can be found at www.asco.org/breast-cancer-guidelines .

BAYESIAN META-ANALYSIS ON MEDICAL DEVICES: APPLICATION TO IMPLANTABLE CARDIOVERTER DEFIBRILLATORS

PubMed Central

Youn, Ji-Hee; Lord, Joanne; Hemming, Karla; Girling, Alan; Buxton, Martin

2012-01-01

Objectives: The aim of this study is to describe and illustrate a method to obtain early estimates of the effectiveness of a new version of a medical device. Methods: In the absence of empirical data, expert opinion may be elicited on the expected difference between the conventional and modified devices. Bayesian Mixed Treatment Comparison (MTC) meta-analysis can then be used to combine this expert opinion with existing trial data on earlier versions of the device. We illustrate this approach for a new four-pole implantable cardioverter defibrillator (ICD) compared with conventional ICDs, Class III anti-arrhythmic drugs, and conventional drug therapy for the prevention of sudden cardiac death in high risk patients. Existing RCTs were identified from a published systematic review, and we elicited opinion on the difference between four-pole and conventional ICDs from experts recruited at a cardiology conference. Results: Twelve randomized controlled trials were identified. Seven experts provided valid probability distributions for the new ICDs compared with current devices. The MTC model resulted in estimated relative risks of mortality of 0.74 (0.60–0.89) (predictive relative risk [RR] = 0.77 [0.41–1.26]) and 0.83 (0.70–0.97) (predictive RR = 0.84 [0.55–1.22]) with the new ICD therapy compared to Class III anti-arrhythmic drug therapy and conventional drug therapy, respectively. These results showed negligible differences from the preliminary results for the existing ICDs. Conclusions: The proposed method incorporating expert opinion to adjust for a modification made to an existing device may play a useful role in assisting decision makers to make early informed judgments on the effectiveness of frequently modified healthcare technologies. PMID:22559753

Pelvic Exam

MedlinePlus

... of a routine physical exam to find possible signs of ovarian cysts, sexually transmitted infections, uterine fibroids or early-stage cancer. Pelvic exams are also commonly performed during pregnancy. There is a lot of debate among experts ...

Industry/government seminar on Large Space systems technology: Executive summary

NASA Technical Reports Server (NTRS)

Scala, S. M.

1978-01-01

The critical technology developments which the participating experts recommend as being required to support the early generation large space systems envisioned as space missions during the years 1985-2000 are summarized.

W.a.w (we are watching) smart app: accommodating social perception towards public officers’ performance

NASA Astrophysics Data System (ADS)

Widhoyoko, S. A.; Sasmoko; Nasir, L. A.; Manalu, S. R.; Indrianti, Y.

2018-03-01

This research is a continuation of previous research that is corruption early prevention is expanded by using expert system to analyze data and produce information to build decision. The research method used is neuroresearch method through three stages of research, namely exploratory stage, explanatory stage and confirmatory stages. The exploratory research finds W.aW’s Principles and W.a.W’s Units of Assessment as the basis for the preparation of the application. Stages of explanatory research in the form of W.a.W’s design of IT and confirmatory research stages are the design of expert system W.a.W. Expert System uses this formulation to generate dynamic standard value for each category and current social perception.

Artificial intelligence techniques for ground test monitoring of rocket engines

NASA Technical Reports Server (NTRS)

Ali, Moonis; Gupta, U. K.

1990-01-01

An expert system is being developed which can detect anomalies in Space Shuttle Main Engine (SSME) sensor data significantly earlier than the redline algorithm currently in use. The training of such an expert system focuses on two approaches which are based on low frequency and high frequency analyses of sensor data. Both approaches are being tested on data from SSME tests and their results compared with the findings of NASA and Rocketdyne experts. Prototype implementations have detected the presence of anomalies earlier than the redline algorithms that are in use currently. It therefore appears that these approaches have the potential of detecting anomalies early eneough to shut down the engine or take other corrective action before severe damage to the engine occurs.

Networked Microgrids Scoping Study

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

Backhaus, Scott N.; Dobriansky, Larisa; Glover, Steve

2016-12-05

Much like individual microgrids, the range of opportunities and potential architectures of networked microgrids is very diverse. The goals of this scoping study are to provide an early assessment of research and development needs by examining the benefits of, risks created by, and risks to networked microgrids. At this time there are very few, if any, examples of deployed microgrid networks. In addition, there are very few tools to simulate or otherwise analyze the behavior of networked microgrids. In this setting, it is very difficult to evaluate networked microgrids systematically or quantitatively. At this early stage, this study is relyingmore » on inputs, estimations, and literature reviews by subject matter experts who are engaged in individual microgrid research and development projects, i.e., the authors of this study The initial step of the study gathered input about the potential opportunities provided by networked microgrids from these subject matter experts. These opportunities were divided between the subject matter experts for further review. Part 2 of this study is comprised of these reviews. Part 1 of this study is a summary of the benefits and risks identified in the reviews in Part 2 and synthesis of the research needs required to enable networked microgrids.« less

ERP to chess stimuli reveal expert-novice differences in the amplitudes of N2 and P3 components.

PubMed

Wright, Michael J; Gobet, Fernand; Chassy, Philippe; Ramchandani, Payal Nanik

2013-10-01

ERP experiments were conducted to analyze the underlying neural events when chess players make simple judgments of a board position. Fourteen expert players and 14 age-matched novices viewed, for each of four tasks, 128 unique positions on a mini (4 × 4) chess board each presented for 0.5 s. The tasks were to respond: (a) if white king was in check, (b) if black knight was present, (c) if white king was not in check, and (d) if no black knight was present. Experts showed an enhanced N2 with check targets and a larger P3 with knight targets, relative to novices. Expert-novice differences in posterior N2 began as early as 240 ms on check-related searches. Results were consistent with the view that prolonged N2 components reflect matching of current perceptual input to memory, and thus are sensitive to experts' superior pattern recognition and memory retrieval of chunks. Copyright © 2013 Society for Psychophysiological Research.

Sexual Science and Sexual Forensics in 1920s Germany: Albert Moll as (S)Expert

PubMed Central

Conn, Matthew

2012-01-01

Using court records involving the expert testimony of the Berlin sexologist Albert Moll, my article demonstrates that during the early 1920s a shift in the ‘epistemologies of justice’ concerning the adjudication of sex crimes took place within German courtrooms. Namely, presiding judges considered a greater number of sexual acts as punishable, despite no change in the laws themselves. Central to my argument is the role of expert testimony in practice and its critical reception. By focusing upon the rhetorical strategies presented by attorneys, judges and expert witnesses (as well as defendants themselves and their relatives), it illustrates the functions of expert and tacit knowledge in court, which were often not mutually exclusive. Moll’s stature also enabled him to translate his scientific–medical expertise into state support for his testimonies, as well as the rebuilding of an international community of sexological authorities. It was only under Moll’s leadership that the First International Sexology Congress could take place in 1926, an event that marked the apex of his prestige. PMID:23002293

Creating a Clinical Video-Conferencing Facility in a Security-Constrained Environment Using Open-Source AccessGrid Software and Consumer Hardware

PubMed Central

Terrazas, Enrique; Hamill, Timothy R.; Wang, Ye; Channing Rodgers, R. P.

2007-01-01

The Department of Laboratory Medicine at the University of California, San Francisco (UCSF) has been split into widely separated facilities, leading to much time being spent traveling between facilities for meetings. We installed an open-source AccessGrid multi-media-conferencing system using (largely) consumer-grade equipment, connecting 6 sites at 5 separate facilities. The system was accepted rapidly and enthusiastically, and was inexpensive compared to alternative approaches. Security was addressed by aspects of the AG software and by local network administrative practices. The chief obstacles to deployment arose from security restrictions imposed by multiple independent network administration regimes, requiring a drastically reduced list of network ports employed by AG components. PMID:18693930

Creating a clinical video-conferencing facility in a security-constrained environment using open-source AccessGrid software and consumer hardware.

PubMed

Terrazas, Enrique; Hamill, Timothy R; Wang, Ye; Channing Rodgers, R P

2007-10-11

The Department of Laboratory Medicine at the University of California, San Francisco (UCSF) has been split into widely separated facilities, leading to much time being spent traveling between facilities for meetings. We installed an open-source AccessGrid multi-media-conferencing system using (largely) consumer-grade equipment, connecting 6 sites at 5 separate facilities. The system was accepted rapidly and enthusiastically, and was inexpensive compared to alternative approaches. Security was addressed by aspects of the AG software and by local network administrative practices. The chief obstacles to deployment arose from security restrictions imposed by multiple independent network administration regimes, requiring a drastically reduced list of network ports employed by AG components.

Tandem Repeated Irritation Test (TRIT) Studies and Clinical Relevance: Post 2006.

PubMed

Reddy, Rasika; Maibach, Howard

2018-06-11

Single or multiple applications of irritants can lead to occupational contact dermatitis, and most commonly irritant contact dermatitis (ICD). Tandem irritation, the sequential application of two irritants to a target skin area, has been studied using the Tandem Repeated Irritation Test (TRIT) to provide a more accurate representation of skin irritation. Here we present an update to Kartono's review on tandem irritation studies since 2006 [1]. We surveyed the literature available on PubMed, Embase, Google Scholar, and the UCSF Dermatology library databases since 2006. The studies included discuss the tandem effects of common chemical irritants, organic solvents, occlusion as well as clinical relevance - and enlarge our ability to discern whether multiple chemical exposures are more or less likely to enhance irritation.

The ALMA OT in early science: supporting multiple customers

NASA Astrophysics Data System (ADS)

Bridger, Alan; Williams, Stewart; McLay, Stewart; Yatagai, Hiroshi; Schilling, Marcus; Biggs, Andrew; Tobar, Rodrigo; Warmels, Rein H.

2012-09-01

The ALMA Observatory is currently operating 'Early Science' observing. The Cycle0 and Cycle1 Calls for Proposals are part of this Early Science, and in both the ALMA Observing Tool plays a crucial role. This paper describes how the ALMA OT tackles the problem of making millimeter/sub-millimeter interferometry accessible to the wider community, while allowing "experts" the power and flexibility they need. We will also describe our approach to the challenges of supporting multiple customers, and explore the lessons learnt from the Early Science experiences. Finally we look ahead to the challenges presented by future observing cycles.

Individual risk factors for physician boundary violations: the role of attachment style, childhood trauma and maladaptive beliefs.

PubMed

MacDonald, Kai; Sciolla, Andrés F; Folsom, David; Bazzo, David; Searles, Chris; Moutier, Christine; Thomas, Michael L; Borton, Katherine; Norcross, Bill

2015-01-01

The assessment and remediation of boundary-challenged healthcare professionals is enhanced through examination of individual risk factors. We assessed three such factors--attachment style, childhood trauma and maladaptive beliefs--in 100 attendees (mostly physicians) of a CME professional boundaries course. We propose a theoretical model which draws a causal arc from childhood maltreatment through insecure attachment and maladaptive beliefs to elevated risk for boundary violations. We administered the Experiences in Close Relationship Questionnaire (ECR-R), Childhood Trauma Questionnaire (CTQ), and Young Schema Questionnaire (YSQ) to 100 healthcare professionals (mostly physicians) attending a CME course on professional boundaries. Experts rated participant autobiographies to determine attachment style and early adversities. Correlations and relationships among self- and expert ratings and between different risk factors were examined. Five percent of participants reported CTQ total scores in the moderate to severe range; eleven percent reported moderate to severe emotional neglect or emotional abuse. Average attachment anxiety and attachment avoidance were low, and more than half of participants were rated “secure” by experts. Childhood maltreatment was correlated with attachment anxiety and avoidance and predicted expert-rated insecure attachment and maladaptive beliefs. Our findings support a potential link between childhood adversity and boundary difficulties, partly mediated by insecure attachment and early maladaptive beliefs. Furthermore, these results suggest that boundary education programs and professional wellness programs may be enhanced with a focus on sequelae of childhood maltreatment, attachment and common maladaptive thinking patterns.

Individual risk factors for physician boundary violations: the role of attachment style, childhood trauma and maladaptive beliefs.

PubMed

MacDonald, Kai; Sciolla, Andrés F; Folsom, David; Bazzo, David; Searles, Chris; Moutier, Christine; Thomas, Michael L; Borton, Katherine; Norcross, Bill

2015-01-01

The assessment and remediation of boundary-challenged health care professionals is enhanced through examination of individual risk factors. We assessed three such factors - attachment style, childhood trauma and maladaptive beliefs - in 100 attendees (mostly physicians) of a continuing medical education (CME) professional boundaries course. We propose a theoretical model that draws a causal arc from childhood maltreatment through insecure attachment and maladaptive beliefs to elevated risk for boundary violations. We administered the Experiences in Close Relationships Questionnaire Revised (ECR-R), Childhood Trauma Questionnaire (CTQ) and Young Schema Questionnaire (YSQ) to 100 health care professionals attending a CME course on professional boundaries. Experts rated participant autobiographies to determine attachment style and early adversities. Correlations and relationships between self-ratings and expert ratings and among different risk factors were examined. One fifth of participants reported moderate to severe childhood abuse; sixty percent reported moderate to severe emotional neglect. Despite this, average attachment anxiety and attachment avoidance were low, and more than half of participants were rated "secure" by experts. Childhood maltreatment was correlated with attachment anxiety and avoidance and predicted expert-rated insecure attachment and maladaptive beliefs. Our findings support a potential link between childhood adversity and boundary difficulties, partly mediated by insecure attachment and early maladaptive beliefs. Furthermore, these results suggest that boundary education programs and professional wellness programs may be enhanced with a focus on sequelae of childhood maltreatment, attachment and common maladaptive thinking patterns. Copyright © 2015 Elsevier Inc. All rights reserved.

Starting RIGHT: Reforming Education in the Early Grades (Prekindergarten through Grade 3). Carnegie Meeting Papers.

ERIC Educational Resources Information Center

Copple, Carol E.

Noting that students' failure to master the basic skills by third grade places them at high academic and social risk, this report provides a synthesis of the findings from a meeting that drew 30 of the nation's leading experts on early childhood education and school reform to discuss the plight of primary education. The meeting was designed to…

From Early Child Development to Human Development: Investing in Our Children's Future. Proceedings of a World Bank Conference (Washington, D.C., April 10-11, 2000).

ERIC Educational Resources Information Center

Young, Mary Eming, Ed.

In April 2000, the World Bank hosted a global conference that addressed the benefits and challenges of investing in early child development (ECD). The landmark conference brought together the world's leading experts, academicians, practitioners, and policymakers to focus on various aspects of ECD. This volume contains the proceedings of the…

First S.T.E.P.: A Model for the Early Identification of Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Koegel, Lynn Kern; Koegel, Robert L.; Nefdt, Nicolette; Fredeen, Rosy; Klein, Eileen F.; Bruinsma, Yvonne E. M.

2005-01-01

Even though children with autism spectrum disorder (ASD) can be reliably identified by autism experts at 18 months, and the majority of parents report symptoms before age 2, the average age of diagnosis for children with autism in the United States is 3 to 4 years of age. Early identification is especially vital given the growing amount of…

The effect of observing novice and expert performance on acquisition of surgical skills on a robotic platform

PubMed Central

Harris, David J.; Vine, Samuel J.; Wilson, Mark R.; McGrath, John S.; LeBel, Marie-Eve

2017-01-01

Background Observational learning plays an important role in surgical skills training, following the traditional model of learning from expertise. Recent findings have, however, highlighted the benefit of observing not only expert performance but also error-strewn performance. The aim of this study was to determine which model (novice vs. expert) would lead to the greatest benefits when learning robotically assisted surgical skills. Methods 120 medical students with no prior experience of robotically-assisted surgery completed a ring-carrying training task on three occasions; baseline, post-intervention and at one-week follow-up. The observation intervention consisted of a video model performing the ring-carrying task, with participants randomly assigned to view an expert model, a novice model, a mixed expert/novice model or no observation (control group). Participants were assessed for task performance and surgical instrument control. Results There were significant group differences post-intervention, with expert and novice observation groups outperforming the control group, but there were no clear group differences at a retention test one week later. There was no difference in performance between the expert-observing and error-observing groups. Conclusions Similar benefits were found when observing the traditional expert model or the error-strewn model, suggesting that viewing poor performance may be as beneficial as viewing expertise in the early acquisition of robotic surgical skills. Further work is required to understand, then inform, the optimal curriculum design when utilising observational learning in surgical training. PMID:29141046

Expert vs. novice differences in the detection of relevant information during a chess game: evidence from eye movements

PubMed Central

Sheridan, Heather; Reingold, Eyal M.

2014-01-01

The present study explored the ability of expert and novice chess players to rapidly distinguish between regions of a chessboard that were relevant to the best move on the board, and regions of the board that were irrelevant. Accordingly, we monitored the eye movements of expert and novice chess players, while they selected white's best move for a variety of chess problems. To manipulate relevancy, we constructed two different versions of each chess problem in the experiment, and we counterbalanced these versions across participants. These two versions of each problem were identical except that a single piece was changed from a bishop to a knight. This subtle change reversed the relevancy map of the board, such that regions that were relevant in one version of the board were now irrelevant (and vice versa). Using this paradigm, we demonstrated that both the experts and novices spent more time fixating the relevant relative to the irrelevant regions of the board. However, the experts were faster at detecting relevant information than the novices, as shown by the finding that experts (but not novices) were able to distinguish between relevant and irrelevant information during the early part of the trial. These findings further demonstrate the domain-related perceptual processing advantage of chess experts, using an experimental paradigm that allowed us to manipulate relevancy under tightly controlled conditions. PMID:25202298

Expert vs. novice differences in the detection of relevant information during a chess game: evidence from eye movements.

PubMed

Sheridan, Heather; Reingold, Eyal M

2014-01-01

The present study explored the ability of expert and novice chess players to rapidly distinguish between regions of a chessboard that were relevant to the best move on the board, and regions of the board that were irrelevant. Accordingly, we monitored the eye movements of expert and novice chess players, while they selected white's best move for a variety of chess problems. To manipulate relevancy, we constructed two different versions of each chess problem in the experiment, and we counterbalanced these versions across participants. These two versions of each problem were identical except that a single piece was changed from a bishop to a knight. This subtle change reversed the relevancy map of the board, such that regions that were relevant in one version of the board were now irrelevant (and vice versa). Using this paradigm, we demonstrated that both the experts and novices spent more time fixating the relevant relative to the irrelevant regions of the board. However, the experts were faster at detecting relevant information than the novices, as shown by the finding that experts (but not novices) were able to distinguish between relevant and irrelevant information during the early part of the trial. These findings further demonstrate the domain-related perceptual processing advantage of chess experts, using an experimental paradigm that allowed us to manipulate relevancy under tightly controlled conditions.

Tracking Plasticity: Effects of Long-Term Rehearsal in Expert Dancers Encoding Music to Movement

PubMed Central

Bar, Rachel J.; DeSouza, Joseph F. X.

2016-01-01

Our knowledge of neural plasticity suggests that neural networks show adaptation to environmental and intrinsic change. In particular, studies investigating the neuroplastic changes associated with learning and practicing motor tasks have shown that practicing such tasks results in an increase in neural activation in several specific brain regions. However, studies comparing experts and non-experts suggest that experts employ less neuronal activation than non-experts when performing a familiar motor task. Here, we aimed to determine the long-term changes in neural networks associated with learning a new dance in professional ballet dancers over 34 weeks. Subjects visualized dance movements to music while undergoing fMRI scanning at four time points over 34-weeks. Results demonstrated that initial learning and performance at seven weeks led to increases in activation in cortical regions during visualization compared to the first week. However, at 34 weeks, the cortical networks showed reduced activation compared to week seven. Specifically, motor learning and performance over the 34 weeks showed the typical inverted-U-shaped function of learning. Further, our result demonstrate that learning of a motor sequence of dance movements to music in the real world can be visualized by expert dancers using fMRI and capture highly significant modeled fits of the brain network variance of BOLD signals from early learning to expert level performance. PMID:26824475

Opportunities During Early Life for Cancer Prevention: Highlights From a Series of Virtual Meetings With Experts

PubMed Central

Holman, Dawn M.; Buchanan, Natasha D.

2018-01-01

Compelling evidence suggests that early life exposures can affect lifetime cancer risk. In 2014, the Centers for Disease Control and Prevention’s (CDC’s) Cancer Prevention Across the Lifespan Workgroup hosted a series of virtual meetings with select experts to discuss the state of the evidence linking factors during the prenatal period and early childhood to subsequent risk of both pediatric and adult cancers. In this article, we present the results from a qualitative analysis of the meeting transcripts and summarize themes that emerged from our discussions with meeting participants. Themes included the state of the evidence linking early life factors to cancer risk, research gaps and challenges, the level of evidence needed to support taking public health action, and the challenges of communicating complex, and sometimes conflicting, scientific findings to the public. Opportunities for collaboration among public health agencies and other stakeholders were identified during these discussions. Potential next steps for the CDC and its partners included advancing and building upon epidemiology and surveillance work, developing and using evidence from multiple sources to inform decision-making, disseminating and communicating research findings in a clear and effective way, and expanding collaborations with grantees and other partners. As the science on early life factors and cancer risk continues to evolve, there are opportunities for collaboration to translate science into actionable public health practice. PMID:27940972

Adapting the bioblitz to meet conservation needs.

PubMed

Parker, Sophie S; Pauly, Gregory B; Moore, James; Fraga, Naomi S; Knapp, John J; Principe, Zachary; Brown, Brian V; Randall, John M; Cohen, Brian S; Wake, Thomas A

2018-03-01

When conservation strategies require new, field-based information, practitioners must find the best ways to rapidly deliver high-quality survey data. To address this challenge, several rapid-assessment approaches have been developed since the early 1990s. These typically involve large areas, take many months to complete, and are not appropriate when conservation-relevant survey data are urgently needed for a specific locale. In contrast, bioblitzes are designed for quick collection of site-specific survey data. Although bioblitzes are commonly used to achieve educational or public-engagement goals, conservation practitioners are increasingly using a modified bioblitz approach to generate conservation-relevant data while simultaneously enhancing research capacity and building working partnerships focused on conservation concerns. We term these modified events expert bioblitzes. Several expert bioblitzes have taken place on lands of conservation concern in Southern California and have involved collaborative efforts of government agencies, nonprofit organizations, botanic gardens, museums, and universities. The results of expert bioblitzes directly informed on-the-ground conservation and decision-making; increased capacity for rapid deployment of expert bioblitzes in the future; and fostered collaboration and communication among taxonomically and institutionally diverse experts. As research and conservation funding becomes increasingly scarce, expert bioblitzes can play an increasingly important role in biodiversity conservation. © 2018 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

Motor Cortex Stimulation in Patients Suffering from Chronic Neuropathic Pain: Summary of Expert Meeting and Premeeting Questionnaire, Combined with Literature Review.

PubMed

Kurt, Erkan; Henssen, Dylan J H A; Steegers, Monique; Staal, Michiel; Beese, Ulrich; Maarrawi, Joseph; Pirotte, Benoit; Garcia-Larrea, Luis; Rasche, Dirk; Vesper, Jan; Holsheimer, Jan; Duyvendak, Wim; Herregodts, Patrick; van Dongen, Robert; Moens, Maarten

2017-12-01

Motor cortex stimulation (MCS) was introduced in the early 1990s by Tsubokawa and his group for patients diagnosed with drug-resistant, central neuropathic pain. Inconsistencies concerning the details of this therapy and its outcomes and poor methodology of most clinical essays divide the neuromodulation society worldwide into "believers" and "nonbelievers." A European expert meeting was organized in Brussels, Belgium by the Benelux Neuromodulation Society in order to develop uniform MCS protocols in the preoperative, intraoperative, and postoperative courses. An expert meeting was organized, and a questionnaire was sent out to all the invited participants before this expert meeting. An extensive literature research was conducted in order to enrich the results. Topics that were addressed during the expert meeting were 1) inclusion and exclusion criteria, 2) targeting and methods of stimulation, 3) effects of MCS, and 4) results from the questionnaire. Substantial commonalities but also important methodologic divergencies emerged from the discussion of MCS experts from 7 European Centers. From this meeting and questionnaire, all participants concluded that there is a need for more homogenous standardized protocols for MCS regarding patient selection, implantation procedure, stimulation parameters, and follow-up-course. Copyright © 2017 Elsevier Inc. All rights reserved.

Reported experiences from occupational therapists interacting with teachers in inclusive early childhood classrooms.

PubMed

Bose, Pia; Hinojosa, Jim

2008-01-01

This grounded theory study described the perspectives of school-based occupational therapists working in inclusive early childhood classrooms emphasizing interactions with teaching staff. Six therapists were interviewed multiple times over several months. The participants viewed their interactions with teaching staff as challenging but potentially rewarding experiences. Viewing collaboration as valuable, their descriptions nonetheless generally omitted many collaborative features, with therapists often assigned the role of "expert." Data analysis revealed four major themes: (1) "It's Not Like I Don't Value Collaboration" (the benefits of collaboration); (2) "Collaboration--I Can't Do It Alone" (the challenges of interactions); (3) "My Opinion, Please Ask for It" (attachment to the expert status), and (4) "Is This Collaboration?" (interactions in practice). The results of this study suggest that current recommendations for collaboration for inclusion in school-based occupational therapy are not optimally implemented in all practice settings.

Reflections on the Implementation of Low-Dose Computed Tomography Screening in Individuals at High Risk of Lung Cancer in Spain.

PubMed

Garrido, Pilar; Sánchez, Marcelo; Belda Sanchis, José; Moreno Mata, Nicolás; Artal, Ángel; Gayete, Ángel; Matilla González, José María; Galbis Caravajal, José Marcelo; Isla, Dolores; Paz-Ares, Luis; Seijo, Luis M

2017-10-01

Lung cancer (LC) is a major public health issue. Despite recent advances in treatment, primary prevention and early diagnosis are key to reducing the incidence and mortality of this disease. A recent clinical trial demonstrated the efficacy of selective screening by low-dose computed tomography (LDCT) in reducing the risk of both lung cancer mortality and all-cause mortality in high-risk individuals. This article contains the reflections of an expert group on the use of LDCT for early diagnosis of LC in high-risk individuals, and how to evaluate its implementation in Spain. The expert group was set up by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), the Spanish Society of Thoracic Surgery (SECT), the Spanish Society of Radiology (SERAM) and the Spanish Society of Medical Oncology (SEOM). Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Application of laser speckle contrast image in the evaluation of arthritis animal model

NASA Astrophysics Data System (ADS)

Son, Taeyoon; Jang, Won Hyuk; Park, Jihoon; Yoon, Hyung-Ju; Lee, Jeon; Kim, Wan-Uk; Jung, Byungjo

2013-03-01

Arthritis is a chronic inflammatory disease that induces potentially damaging and commonly disabling. Various imaging modalities have been used for the evaluation of arthritis. This study aimed to investigate the feasibility of laser speckle contrast image (LSCI) in the evaluation of the severity and early stage of arthritis in animal model. Arthritis was induced on mouse foot and evaluated by a trained expert and the LSCI. The arthritis severity was quantitatively evaluated by speckle index (SI) computed from LSCI. In visual inspection by an expert, it was difficult to evaluate the arthritis because there was no noticeable different between control mouse group (CMG) and arthritis mouse group (AMG) in erythema. However, arthritis was easily evaluated by significant SI different between the CMG and AMG. In addition, the LSCI also successfully evaluated the early stage of arthritis, presenting different SI distribution depending on lesion.

Functional MRI reveals expert-novice differences during sport-related anticipation.

PubMed

Wright, Michael J; Bishop, Daniel T; Jackson, Robin C; Abernethy, Bruce

2010-01-27

We examined the effect of expertise on cortical activation during sports anticipation using functional MRI. In experiment 1, recreational players predicted badminton stroke direction and the pattern of active clusters was consistent with a proposed perception-of-action network. This pattern was not replicated in a stimulus-matched, action-unrelated control task. In experiment 2, players of three different skill levels anticipated stroke direction from clips occluded either 160 ms before or 80 ms after racquet-shuttle contact. Early-occluded sequences produced more activation than late-occluded sequences overall, in most cortical regions of interest, but experts showed an additional enhancement in medial, dorsolateral and ventrolateral frontal cortex. Anticipation in open-skill sports engages cortical areas integral to observing and understanding others' actions; such activity is enhanced in experts.

Surgical treatment for apparent early stage endometrial cancer

PubMed Central

2014-01-01

Most experts would agree that the standard surgical treatment for endometrial cancer includes a hysterectomy and bilateral salpingo-oophorectomy; however, the benefit of full surgical staging with lymph node dissection in patients with apparent early stage disease remains a topic of debate. Recent prospective data and advances in laparoscopic techniques have transformed this disease into one that can be successfully managed with minimally invasive surgery. This review will discuss the current surgical management of apparent early stage endometrial cancer and some of the new techniques that are being incorporated. PMID:24596812

Fuzzy Expert System for Heart Attack Diagnosis

NASA Astrophysics Data System (ADS)

Hassan, Norlida; Arbaiy, Nureize; Shah, Noor Aziyan Ahmad; Afizah Afif@Afip, Zehan

2017-08-01

Heart attack is one of the serious illnesses and reported as the main killer disease. Early prevention is significant to reduce the risk of having the disease. The prevention efforts can be strengthen through awareness and education about risk factor and healthy lifestyle. Therefore the knowledge dissemination is needed to play role in order to distribute and educate public in health care management and disease prevention. Since the knowledge dissemination in medical is important, there is a need to develop a knowledge based system that can emulate human intelligence to assist decision making process. Thereby, this study utilized hybrid artificial intelligence (AI) techniques to develop a Fuzzy Expert System for Diagnosing Heart Attack Disease (HAD). This system integrates fuzzy logic with expert system, which helps the medical practitioner and people to predict the risk and as well as diagnosing heart attack based on given symptom. The development of HAD is expected not only providing expert knowledge but potentially become one of learning resources to help citizens to develop awareness about heart-healthy lifestyle.

Simulating Expert Clinical Comprehension: Adapting Latent Semantic Analysis to Accurately Extract Clinical Concepts from Psychiatric Narrative

PubMed Central

Cohen, Trevor; Blatter, Brett; Patel, Vimla

2008-01-01

Cognitive studies reveal that less-than-expert clinicians are less able to recognize meaningful patterns of data in clinical narratives. Accordingly, psychiatric residents early in training fail to attend to information that is relevant to diagnosis and the assessment of dangerousness. This manuscript presents cognitively motivated methodology for the simulation of expert ability to organize relevant findings supporting intermediate diagnostic hypotheses. Latent Semantic Analysis is used to generate a semantic space from which meaningful associations between psychiatric terms are derived. Diagnostically meaningful clusters are modeled as geometric structures within this space and compared to elements of psychiatric narrative text using semantic distance measures. A learning algorithm is defined that alters components of these geometric structures in response to labeled training data. Extraction and classification of relevant text segments is evaluated against expert annotation, with system-rater agreement approximating rater-rater agreement. A range of biomedical informatics applications for these methods are suggested. PMID:18455483

Sensitivity and specificity of the American College of Rheumatology 1987 criteria for the diagnosis of rheumatoid arthritis according to disease duration: a systematic literature review and meta-analysis.

PubMed

Banal, F; Dougados, M; Combescure, C; Gossec, L

2009-07-01

To evaluate the ability of the widely used ACR set of criteria (both list and tree format) to diagnose RA compared with expert opinion according to disease duration. A systematic literature review was conducted in PubMed and Embase databases. All articles reporting the prevalence of RA according to ACR criteria and expert opinion in cohorts of early (<1 year duration) or established (>1 year) arthritis were analysed to calculate the sensitivity and specificity of ACR 1987 criteria against the "gold standard" (expert opinion). A meta-analysis using a summary receiver operating characteristic (SROC) curve was performed and pooled sensitivity and specificity were calculated with confidence intervals. Of 138 publications initially identified, 19 were analysable (total 7438 patients, 3883 RA). In early arthritis, pooled sensitivity and specificity of the ACR set of criteria were 77% (68% to 84%) and 77% (68% to 84%) in the list format versus 80% (72% to 88%) and 33% (24% to 43%) in the tree format. In established arthritis, sensitivity and specificity were respectively 79% (71% to 85%) and 90% (84% to 94%) versus 80% (71% to 85%) and 93% (86% to 97%). The SROC meta-analysis confirmed the statistically significant differences, suggesting that diagnostic performances of ACR list criteria are better in established arthritis. The specificity of ACR 1987 criteria in early RA is low, and these criteria should not be used as diagnostic tools. Sensitivity and specificity in established RA are higher, which reflects their use as classification criteria gold standard.

Clinical management of chronic hepatitis B infection: results from a registry at a German tertiary referral center.

PubMed

Demir, M; Nigemeier, J; Kütting, F; Bowe, A; Schramm, C; Hoffmann, V; Waldschmidt, D; Goeser, T; Steffen, H-M

2015-04-01

We studied a cohort of adult patients with chronic hepatitis B (CHB) infection, followed at a tertiary referral liver center in Germany over 12.5 years to analyze the clinical features and impact of management on disease progression and survival of CHB patients in general and of those with CHB and HCC in particular. We retrospectively evaluated the medical records of 242 adult (age ≥ 18 years) patients. CHB was defined as positive hepatitis B surface antigen (HBsAg) and/or HBV-DNA levels >10 IU/mL for at least 6 months. Patient demographics, HBV markers, antiviral treatment, laboratory parameters, liver imaging and histology were recorded for each visit. HCC patients were divided into two groups and separately analyzed (group 1: n = 24, HCC at first visit and group 2: n = 11, HCC during surveillance). The mean age was 44 years in CHB patients without HCC (63% male) and about 59 years in patients with HCC (77% male). Antiviral therapy was given to 59% of patients without HCC compared to only 25% in group 1 and 18% in group 2 with comparable median HBV DNA levels of approximately 36,000 IU/mL. There was no statistically significant difference concerning the HCC stages (Milan, UCSF, BCLC) at first diagnosis. Five-year survival was 19% in group 1 vs. 64% in group 2 (p = 0.019), with LTx performed in 12 vs. 45%, respectively. Surveillance of CHB patients did not result in early stage detection of HCC but in a higher likelihood to receive potentially curative treatments.

An expert system based software sizing tool, phase 2

NASA Technical Reports Server (NTRS)

Friedlander, David

1990-01-01

A software tool was developed for predicting the size of a future computer program at an early stage in its development. The system is intended to enable a user who is not expert in Software Engineering to estimate software size in lines of source code with an accuracy similar to that of an expert, based on the program's functional specifications. The project was planned as a knowledge based system with a field prototype as the goal of Phase 2 and a commercial system planned for Phase 3. The researchers used techniques from Artificial Intelligence and knowledge from human experts and existing software from NASA's COSMIC database. They devised a classification scheme for the software specifications, and a small set of generic software components that represent complexity and apply to large classes of programs. The specifications are converted to generic components by a set of rules and the generic components are input to a nonlinear sizing function which makes the final prediction. The system developed for this project predicted code sizes from the database with a bias factor of 1.06 and a fluctuation factor of 1.77, an accuracy similar to that of human experts but without their significant optimistic bias.

[Early diagnosis and early treatment for liver cancer in Qidong: survival of patients and effectiveness of screening].

PubMed

Chen, J G; Zhang, Y H; Zhu, J; Lu, J H; Wang, J B; Sun, Y; Xue, X F; Lu, L L; Chen, Y S; Wu, Y; Jiang, X P; Ding, L L; Zhang, Q N; Zhu, Y R

2017-12-23

Objective: To evaluate the patients' survival and effectiveness of the live cancer screening for population at high risk for liver cancer in Qidong. Methods: According to the Expert Scheme proposed the Expert Committee of Early Detection and Early Treatment, China Cancer Foundation, diagnostical screening by using combined methods of alpha-fetoprotein and B ultrasound monitoring were carried out biannually in individuals with positive HBsAg who were screened from Qidong area. The evaluation indices of the effectiveness are task completion rate of screening, detection rate of liver cancer, early diagnosis rate, and treatment rate. The deadline of the follow-up for the surviving outcome was March 31, 2016. The life-table method was used to calculate the observed survival, and to make comparison and significant tests between survival rates in Group A (those found via repeated periodic screening) and Group B (those diagnosed without periodic screening). Results: Since 2007, 38 016 target population have been screened, and 3 703(9.74%) individuals with positive HBsAg were found. Except for 29 patients with liver cancer at the initial screening, 3 674 persons in the cohort were followed up; 268 patients with liver cancer were detected from the 33 199 person-times screening, with an annual detection rate of 1.61%. Of them, 186 patients were found in Group A(1.12%), in which 149 patients were the early cases, with an early detection rate of 80.11%; 167 out of 186(89.78%) patients received treatment after diagnosis. The incidence of liver cancer in this HBsAg (+ ) cohort of 25 452 person-years was 1 052.96 per 100 000 annually, 187 cases in males(1 488.45/100 000)and 81 cases in females(628.46/100 000). The 1-, 3-, 5-, and 8-year survival of all patients with liver cancer were 64.55%, 40.50%, 32.54%, and 19.65%, respectively. The 1-, 3-, 5-, and 8-year survival rates were 77.16%, 49.04%, 38.53%, and 24.25% in Group A, and were 36.25%, 21.21%, 21.21%, and 0% in Group B, respectively, with significant differences between two groups ( P <0.05). Conclusion: The findings show that screening of individuals at high-risk of development of liver cancer, with semiannual AFP and B ultrasound, according to the Expert Scheme, is effective not only in increasing detection rate but also in detecting liver cancer at early stage, and in improving patients' survival as well.

Breast Reference Set Application: Chris Li-FHCRC (2015) — EDRN Public Portal

Cancer.gov

We propose to evaluate nine candidate biomarkers for ER+ breast cancer in samples from the EDRN Breast Cancer Reference Set. These biomarkers have been preliminarily validated in preclinical samples. The intended clinical applications of these markers are to: 1. Inform timing of a subsequent mammogram in women with a negative screening mammogram; 2. Inform continuation of mammographic screening among women 75-79 years; 3. Prioritize women who should be screened with mammography in areas with limited resources. Testing the reference samples would further expedite addressing these intended clinical applications by providing further validation data to support requests for samples from other sources for further Phase 3 evaluation (e.g., WHI, PLCO, and samples collected at the time of mammographic screening from the University of Toronto and UCSF).

Stories from Haiti: a comparison of three approaches.

PubMed

Baumann, Steven L; Bellefleur, Carmelle

2014-04-01

Two stories from Haiti are considered from three different perspectives. The first story is about a boy named Joseph Alvyns, whose mother died from cholera in 2011. His story is told in a short film titled Baseball in the time of Cholera. The second story is about Mme. Yolande Marie Nazaire, who was the Director of the Haiti National School of Nursing in Port-au-Prince on the morning of January 12, 2010, when an earthquake killed 90 students and faculty. The three perspectives discussed here are: (a) Critical Reflective in health professional education as used by the University of California at San Francisco (UCSF) School of Medicine; (b) The Capacities of Stories, which is part of a socio-narratology methodology; and(c) Story Theory with implications for global health nursing.

Paths to Expertise in Portuguese National Team Athletes

PubMed Central

Leite, Nuno; Baker, Joseph; Sampaio, Jaime

2009-01-01

The purpose of this study was to identify the quantity and type of sporting activities undertaken by expert team sport athletes in the earlier stages of the long- term athlete development. Experts in roller-hockey (n = 19), volleyball (n = 14), soccer (n = 42) and basketball (n = 37) provided detailed information about the sporting activities they undertook throughout their careers. Results showed considerable variation between and within sports; however, generally, athletes began participating in sports between 6 and 10 years of age. The pattern of participation in specific and non-specific (team, individual and combat) sports for each stage of involvement demonstrated an increase in the number of activities participated in until early adolescence. Our results suggest that involvement in multiple sports during early stages of development is an alternative to early specialization and add further evidence of the complexity of skill acquisition in sport. Key points Although most athletes began sport participation between 6 and 10 years of age, there was significant variation across groups suggesting considerable flexibility in the pathways to expertise. The path to expertise in volleyball was clearly distinct from the paths of basketball, soccer and roller-hockey. There is a considerable involvement in sports other than the athlete’s primary sport, suggesting early specialization is not required for these sports. The pattern of participation in specific and non-specific sports for each stage of involvement demonstrated an increase in the number of activities participated in until early adolescence. PMID:24149598

Endometrial Cancer Screening (PDQ®)—Patient Version

Cancer.gov

Endometrial cancer screening is currently not recommended because no standard or routine screening test has been shown to be effective. Endometrial cancer is usually found early due to symptoms and survival rates are high. Learn more in this expert-reviewed summary.

Early Warning System.

ERIC Educational Resources Information Center

Lyon, G. Reid; Fletcher, Jack M.

2001-01-01

Despite public skepticism regarding steadily increasing numbers of learning-disabled students, most experts agree that 5 percent of schoolchildren suffer severe difficulties with language and other skills. There are three explanations: remediation is ineffective after second grade; identification comes too late; and federal policies overlook…

Introduction of laparoscopic low anterior resection for rectal cancer early during residency: a single institutional study on short-term outcomes.

PubMed

Ogiso, Satoshi; Yamaguchi, Takashi; Hata, Hiroaki; Kuroyanagi, Hiroya; Sakai, Yoshiharu

2010-11-01

Laparoscopic surgery for rectal cancer is unpopular because it is technically challenging. Suitable training systems have not been widely studied or established despite the steep learning curve for this procedure. We developed a systematic training program that enables resident surgeons to perform laparoscopic low anterior resection (LLAR) for rectal cancer and evaluated the safety and feasibility of this training program. We analyzed prospectively gathered data on all LLARs for rectal cancer performed at a single center over a 7-year period. Patients were assessed for demographic characteristics, tumor characteristics, operative procedure, operative time, blood loss, conversion to open surgery, complications, time to bowel recovery, distal margin, and number of lymph nodes harvested. We compared the early surgical, oncological, and functional outcomes of LLARs performed by expert surgeons with those of LLARs performed by resident surgeons for both intraperitoneal and extraperitoneal rectal cancer. All analyses were performed on an intention-to-treat basis. A total of 137 patients met the inclusion criteria for this study. Of the 75 LLARs for intraperitoneal rectal cancer, 40 were performed by expert surgeons (I-E group) and 35 by resident surgeons (I-R group). Of the 62 LLARs for extraperitoneal rectal cancer, 51 were performed by expert surgeons (E-E group) and 11 by resident surgeons (E-R group). The operative time was longer in the E-R group than in the E-E group. The time to resumption of diet was longer in the I-E group than in the I-R group. The other early outcomes, including blood loss, anastomotic leakage, conversion to open surgery, and number of lymph nodes harvested, were similar in the I-E and I-R groups and in the E-E and E-R groups. Our systematic training program on LLAR for rectal cancer enables resident surgeons to perform this procedure safely early during residency, with acceptable short-term outcomes.

Assessing risk factors for early hip osteoarthritis in activity-related hip pain: a Delphi study

PubMed Central

Jackson, K A; Glyn-Jones, S; Batt, M E; Arden, N K; Newton, J L

2015-01-01

Objective Hip pain and injury as a result of activity can lead to the development of early hip osteoarthritis (OA) in susceptible individuals. Our understanding of the factors that increase susceptibility continues to evolve. The ability to clearly identify individuals (and cohorts) with activity-related hip pain who are at risk of early hip OA is currently lacking. The purpose of this study was to gain expert consensus on which key clinical measures might help predict the risk of early hip OA in individuals presenting with activity-related hip pain. The agreed measures would constitute a standardised approach to initial clinical assessment to help identify these individuals. Methods This Dephi study used online surveys to gain concordance of expert opinion in a structured process of ‘rounds’. In this study, we asked ‘What outcome measures are useful in predicting hip OA in activity-related hip pain?’ The Delphi panel consisted of experts from sport and exercise medicine, orthopaedics, rheumatology, physiotherapy and OA research. Results The study identified key clinical measures in the history, examination and investigations (plain anteroposterior radiograph and femoroacetabular impingement views) that the panel agreed would be useful in predicting future risk of hip OA when assessing activity-related hip pain. The panel also agreed that certain investigations and tests (eg, MR angiography) did not currently have a role in routine assessment. There was a lack of consensus regarding the role of MRI, patient-reported outcome measures (PROMs) and certain biomechanical and functional assessments. Conclusions We provide a standardised approach to the clinical assessment of patients with activity-related hip pain. Assessment measures rejected by the Delphi panel were newer, more expensive investigations that currently lack evidence. Assessment measures that did not reach consensus include MRI and PROMs. Their role remains ambiguous and would benefit from further research. PMID:26419679

The Generic Spacecraft Analyst Assistant (GenSAA): A tool for automating spacecraft monitoring with expert systems

NASA Technical Reports Server (NTRS)

Hughes, Peter M.; Luczak, Edward C.

1991-01-01

Flight Operations Analysts (FOAs) in the Payload Operations Control Center (POCC) are responsible for monitoring a satellite's health and safety. As satellites become more complex and data rates increase, FOAs are quickly approaching a level of information saturation. The FOAs in the spacecraft control center for the COBE (Cosmic Background Explorer) satellite are currently using a fault isolation expert system named the Communications Link Expert Assistance Resource (CLEAR), to assist in isolating and correcting communications link faults. Due to the success of CLEAR and several other systems in the control center domain, many other monitoring and fault isolation expert systems will likely be developed to support control center operations during the early 1990s. To facilitate the development of these systems, a project was initiated to develop a domain specific tool, named the Generic Spacecraft Analyst Assistant (GenSAA). GenSAA will enable spacecraft analysts to easily build simple real-time expert systems that perform spacecraft monitoring and fault isolation functions. Lessons learned during the development of several expert systems at Goddard, thereby establishing the foundation of GenSAA's objectives and offering insights in how problems may be avoided in future project, are described. This is followed by a description of the capabilities, architecture, and usage of GenSAA along with a discussion of its application to future NASA missions.

Integrating Safety and Mission Assurance in Design

NASA Technical Reports Server (NTRS)

Cianciola, Chris; Crane, Kenneth

2008-01-01

This presentation describes how the Ares Projects are learning from the successes and failures of previous launch systems in order to maximize safety and reliability while maintaining fiscal responsibility. The Ares Projects are integrating Safety and Mission Assurance into design activities and embracing independent assessments by Quality experts in thorough reviews of designs and processes. Incorporating Lean thinking into the design process, Ares is also streamlining existing processes and future manufacturing flows which will yield savings during production. Understanding the value of early involvement of Quality experts, the Ares Projects are leading launch vehicle development into the 21st century.

Vibration monitoring of Kraftwerk Union pressurized water reactors - Review, present status, and further development

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

Stolben, H.; Wehling, H.J.

Incipient damage to mechanical structure may be detected early in time by deviations from normal dynamic behavior. For vibration monitoring of coupled systems, only a small number of transducers are necessary, in general. On the basis, Kraftwerk Union has been involved in the development and construction of vibration monitoring systems for pressurized water reactors over the last 20 yr. The current state of the art permits vibration monitoring during normal operation by reactor personnel without expert assistance. The new SUS-86 microprocessor-based system allows further expansion toward an expert system.

Web Spam, Social Propaganda and the Evolution of Search Engine Rankings

NASA Astrophysics Data System (ADS)

Metaxas, Panagiotis Takis

Search Engines have greatly influenced the way we experience the web. Since the early days of the web, users have been relying on them to get informed and make decisions. When the web was relatively small, web directories were built and maintained using human experts to screen and categorize pages according to their characteristics. By the mid 1990's, however, it was apparent that the human expert model of categorizing web pages does not scale. The first search engines appeared and they have been evolving ever since, taking over the role that web directories used to play.

The effects of musical training on structural brain development: a longitudinal study.

PubMed

Hyde, Krista L; Lerch, Jason; Norton, Andrea; Forgeard, Marie; Winner, Ellen; Evans, Alan C; Schlaug, Gottfried

2009-07-01

Long-term instrumental music training is an intense, multisensory and motor experience that offers an ideal opportunity to study structural brain plasticity in the developing brain in correlation with behavioral changes induced by training. Here, for the first time, we demonstrate structural brain changes after only 15 months of musical training in early childhood, which were correlated with improvements in musically relevant motor and auditory skills. These findings shed light on brain plasticity, and suggest that structural brain differences in adult experts (whether musicians or experts in other areas) are likely due to training-induced brain plasticity.

Earlier Visual N1 Latencies in Expert Video-Game Players: A Temporal Basis of Enhanced Visuospatial Performance?

PubMed Central

Latham, Andrew J.; Patston, Lucy L. M.; Westermann, Christine; Kirk, Ian J.; Tippett, Lynette J.

2013-01-01

Increasing behavioural evidence suggests that expert video game players (VGPs) show enhanced visual attention and visuospatial abilities, but what underlies these enhancements remains unclear. We administered the Poffenberger paradigm with concurrent electroencephalogram (EEG) recording to assess occipital N1 latencies and interhemispheric transfer time (IHTT) in expert VGPs. Participants comprised 15 right-handed male expert VGPs and 16 non-VGP controls matched for age, handedness, IQ and years of education. Expert VGPs began playing before age 10, had a minimum 8 years experience, and maintained playtime of at least 20 hours per week over the last 6 months. Non-VGPs had little-to-no game play experience (maximum 1.5 years). Participants responded to checkerboard stimuli presented to the left and right visual fields while 128-channel EEG was recorded. Expert VGPs responded significantly more quickly than non-VGPs. Expert VGPs also had significantly earlier occipital N1s in direct visual pathways (the hemisphere contralateral to the visual field in which the stimulus was presented). IHTT was calculated by comparing the latencies of occipital N1 components between hemispheres. No significant between-group differences in electrophysiological estimates of IHTT were found. Shorter N1 latencies may enable expert VGPs to discriminate attended visual stimuli significantly earlier than non-VGPs and contribute to faster responding in visual tasks. As successful video-game play requires precise, time pressured, bimanual motor movements in response to complex visual stimuli, which in this sample began during early childhood, these differences may reflect the experience and training involved during the development of video-game expertise, but training studies are needed to test this prediction. PMID:24058667

Earlier visual N1 latencies in expert video-game players: a temporal basis of enhanced visuospatial performance?

PubMed

Latham, Andrew J; Patston, Lucy L M; Westermann, Christine; Kirk, Ian J; Tippett, Lynette J

2013-01-01

Increasing behavioural evidence suggests that expert video game players (VGPs) show enhanced visual attention and visuospatial abilities, but what underlies these enhancements remains unclear. We administered the Poffenberger paradigm with concurrent electroencephalogram (EEG) recording to assess occipital N1 latencies and interhemispheric transfer time (IHTT) in expert VGPs. Participants comprised 15 right-handed male expert VGPs and 16 non-VGP controls matched for age, handedness, IQ and years of education. Expert VGPs began playing before age 10, had a minimum 8 years experience, and maintained playtime of at least 20 hours per week over the last 6 months. Non-VGPs had little-to-no game play experience (maximum 1.5 years). Participants responded to checkerboard stimuli presented to the left and right visual fields while 128-channel EEG was recorded. Expert VGPs responded significantly more quickly than non-VGPs. Expert VGPs also had significantly earlier occipital N1s in direct visual pathways (the hemisphere contralateral to the visual field in which the stimulus was presented). IHTT was calculated by comparing the latencies of occipital N1 components between hemispheres. No significant between-group differences in electrophysiological estimates of IHTT were found. Shorter N1 latencies may enable expert VGPs to discriminate attended visual stimuli significantly earlier than non-VGPs and contribute to faster responding in visual tasks. As successful video-game play requires precise, time pressured, bimanual motor movements in response to complex visual stimuli, which in this sample began during early childhood, these differences may reflect the experience and training involved during the development of video-game expertise, but training studies are needed to test this prediction.

Magic of Play: How It Inspires & Aids Early Development

MedlinePlus

... subjects on TV are not appropriate for preschoolers. Young kids also are more influenced by advertising since they can't tell the difference between commercials and actual programs. The same goes for digital advertising inserted in online games and apps. Experts ...

Multicentre validation of a sepsis prediction algorithm using only vital sign data in the emergency department, general ward and ICU.

PubMed

Mao, Qingqing; Jay, Melissa; Hoffman, Jana L; Calvert, Jacob; Barton, Christopher; Shimabukuro, David; Shieh, Lisa; Chettipally, Uli; Fletcher, Grant; Kerem, Yaniv; Zhou, Yifan; Das, Ritankar

2018-01-26

We validate a machine learning-based sepsis-prediction algorithm ( InSight ) for the detection and prediction of three sepsis-related gold standards, using only six vital signs. We evaluate robustness to missing data, customisation to site-specific data using transfer learning and generalisability to new settings. A machine-learning algorithm with gradient tree boosting. Features for prediction were created from combinations of six vital sign measurements and their changes over time. A mixed-ward retrospective dataset from the University of California, San Francisco (UCSF) Medical Center (San Francisco, California, USA) as the primary source, an intensive care unit dataset from the Beth Israel Deaconess Medical Center (Boston, Massachusetts, USA) as a transfer-learning source and four additional institutions' datasets to evaluate generalisability. 684 443 total encounters, with 90 353 encounters from June 2011 to March 2016 at UCSF. None. Area under the receiver operating characteristic (AUROC) curve for detection and prediction of sepsis, severe sepsis and septic shock. For detection of sepsis and severe sepsis, InSight achieves an AUROC curve of 0.92 (95% CI 0.90 to 0.93) and 0.87 (95% CI 0.86 to 0.88), respectively. Four hours before onset, InSight predicts septic shock with an AUROC of 0.96 (95% CI 0.94 to 0.98) and severe sepsis with an AUROC of 0.85 (95% CI 0.79 to 0.91). InSight outperforms existing sepsis scoring systems in identifying and predicting sepsis, severe sepsis and septic shock. This is the first sepsis screening system to exceed an AUROC of 0.90 using only vital sign inputs. InSight is robust to missing data, can be customised to novel hospital data using a small fraction of site data and retains strong discrimination across all institutions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

An Expert System for Diagnosis of Broiler Diseases using Certainty Factor

NASA Astrophysics Data System (ADS)

Setyohadi, D. P. S.; Octavia, R. A.; Puspitasari, T. D.

2018-01-01

Broilers are defined as chickens of meat-type strains raised specifically for meat production. Based on data production from the Ministry of the Republic of Indonesia raised 3.76% from 2015 - 2016. But in reality the price of chicken is expensive, because the amount of market demand is more than the amount of production. Harvest failure due to chicken disease is one of the causes. Detecting diseases at early stage can enable to overcome and treat them appropriately. Identifying the treatment accurately depends on the method that is used in diagnosing the diseases. A Diagnosis expert system can help a great deal in identifying those diseases and describing methods of treatment to be carried out taking into account the user capability in order to deal and interact with expert system easily and clearly. This system has 25 symptoms and 6 diseases using certainty factor method to solve the problem of uncertainty. The result of the research is that Broiler Expert System has been successfully identifying diseases that can solve the problem with accuracy 90%.

Social media and online attention as an early measure of the impact of research in solid organ transplantation.

PubMed

Knight, Simon R

2014-09-15

Traditional measures of the impact of published research, such as citation counts, are limited to measuring academic impact. The use of social media and other online tools as alternative measures of research impact is gaining popularity and used by leading medical journals. MEDLINE was searched for articles published with subject headings relating to solid organ transplantation between August 1, 2011, and July 31, 2012. Citation data were retrieved from SCOPUS, and statistics regarding mentions in social media, social bookmarking sites, news outlets, and expert recommendation sites were retrieved from the data at www.altmetric.com. Data were analyzed for associations between alternative metric data and citation rates. The search retrieved 6,981 publications. Sixty-six percent of the articles had at least one citation. Mentions in social media were 19.3%, 13.1% had social bookmarks, 0.9% had expert recommendations, and online news outlets picked up eight articles. Significantly higher citation rates were associated with mention in social media, expert recommendation, social bookmarking, and for articles identified as meta-analyses, multicenter studies, randomized controlled trials, and reviews (all P<0.001). The odds of an article being highly cited were significantly increased by a mention in social media (odds ratio, 2.58; P<0.001). Qualitative analysis suggests that article topics discussed on social media are more likely to relate to the more controversial and emotive areas of transplantation. Social media and online attention act as early predictors of the impact of transplant research as measured by later citation rate. Blogging and expert recommendation, in particular, are associated with higher citation rates.

Preschool Principal's Curriculum Leadership Indicators: A Taiwan Perspective

ERIC Educational Resources Information Center

Lin, Chia-Fen; Lee, John Chi-Kin

2013-01-01

The role of a principal's curriculum leadership has become an educational issue in Taiwan's early childhood education. This study represents a pioneering attempt in adopting a target school interview, fuzzy Delphi, and analytic hierarchy process for constructing preschool principal's curriculum leadership indicators. Fifteen experts and…

Catching on it early: Bodily and brain anticipatory mechanisms for excellence in sport.

PubMed

Abreu, Ana M; Candidi, Matteo; Aglioti, Salvatore M

2017-01-01

Programming and executing a subsequent move is inherently linked to the ability to anticipate the actions of others when interacting. Such fundamental social ability is particularly important in sport. Here, we discuss the possible mechanisms behind the highly sophisticated anticipation skills that characterize experts. We contend that prediction in sports might rely on a finely tuned perceptual system that endows experts with a fast, partially unconscious, pickup of relevant cues. Furthermore, we discuss the role of the multimodal, perceptuomotor, multiple-duty cells (mirror neurons) that play an important function in action anticipation by means of an inner motor simulation process. Finally, we suggest the role of predictive coding, interoception, and the enteric nervous system as the processual and biological support for intuition and "gut feelings" in sports-the missing link that might explain outstanding expert performance based on action anticipation. © 2017 Elsevier B.V. All rights reserved.

Digital Signal Processing Based Biotelemetry Receivers

NASA Technical Reports Server (NTRS)

Singh, Avtar; Hines, John; Somps, Chris

1997-01-01

This is an attempt to develop a biotelemetry receiver using digital signal processing technology and techniques. The receiver developed in this work is based on recovering signals that have been encoded using either Pulse Position Modulation (PPM) or Pulse Code Modulation (PCM) technique. A prototype has been developed using state-of-the-art digital signal processing technology. A Printed Circuit Board (PCB) is being developed based on the technique and technology described here. This board is intended to be used in the UCSF Fetal Monitoring system developed at NASA. The board is capable of handling a variety of PPM and PCM signals encoding signals such as ECG, temperature, and pressure. A signal processing program has also been developed to analyze the received ECG signal to determine heart rate. This system provides a base for using digital signal processing in biotelemetry receivers and other similar applications.

Introducing quality assurance and medical audit into the UCSF medical center curriculum.

PubMed

Barbaccia, J C

1976-05-01

The experience gained by a medical school faculty in developing and piloting a course for undergraduate medical students in medical care evaluation led to a similar effort for house staff. It is recognized that if the profession is to fulfill the demand by society for social accountability in the use of resources for health care, medical care assessment and quality assurance mechanisms must become an intimate part of the clinical experience of medical students and house officers. Teaching these subjects requires a theoretical framework; introduction of content and skills appropriate to the level of the student and continuation of progressively more advanced training throughout medical education; use of assessment and quality assurance techniques by clinician-teachers themselves to provide models for the student; and continued evolution of pedagogic approach and course content based on developments in the area.

EVAcon: a protein contact prediction evaluation service

PubMed Central

Graña, Osvaldo; Eyrich, Volker A.; Pazos, Florencio; Rost, Burkhard; Valencia, Alfonso

2005-01-01

Here we introduce EVAcon, an automated web service that evaluates the performance of contact prediction servers. Currently, EVAcon is monitoring nine servers, four of which are specialized in contact prediction and five are general structure prediction servers. Results are compared for all newly determined experimental structures deposited into PDB (∼5–50 per week). EVAcon allows for a precise comparison of the results based on a system of common protein subsets and the commonly accepted evaluation criteria that are also used in the corresponding category of the CASP assessment. EVAcon is a new service added to the functionality of the EVA system for the continuous evaluation of protein structure prediction servers. The new service is accesible from any of the three EVA mirrors: PDG (CNB-CSIC, Madrid) (); CUBIC (Columbia University, NYC) (); and Sali Lab (UCSF, San Francisco) (). PMID:15980486

Cognitive Task Analysis (l’Analyse des taches cognitives)

DTIC Science & Technology

2000-10-01

knowledge in the basis for expertise (Glaser, 1984), and, in parallel, the commercialisation of expert systems, starting in the early 1980’s (Hayes...training design. Occupational Psychology, 41, 211-221. Glaser, R. (1984). Education and thinking: The role of knowledge. American Psychologist, 39, 93

Breast Cancer During Pregnancy (PDQ®)—Patient Version

Cancer.gov

Breast cancer treatment during pregnancy is the same as for nonpregnant women in the case of early disease. Advanced disease is usually treated with radiation and/or chemotherapy. Learn about breast cancer during pregnancy as well as possible effects on the baby in this expert-reviewed summary.

Constructing early warning information release system in towns enterprise clean production

NASA Astrophysics Data System (ADS)

Yuwen, Huixin; He, Xueqiu; Qian, Xinming; Yuan, Mengqi

2017-08-01

China’s industry boom has not only brought unprecedented prosperity, but also caused the gradual depletion of various resources and the worsening of the natural environment. Experts admit that China is facing serious environmental problem, but they believe that they can seek a new path to overcome it through joint efforts. Early warning information release and clean production are the important concepts in addressing the imminent crisis. Early warning information release system can monitor and forecast the risk that affects the clean production. The author drawn the experiences and lessons from developed countries, combined with China’s reality, put forward countermeasures and suggestions about constructing early warning information release system in process of Chinese town-scaled enterprises clean production.

Review article: liver transplantation for hepatocellular carcinoma - a critical appraisal of the current worldwide listing criteria.

PubMed

Menon, K V; Hakeem, A R; Heaton, N D

2014-10-01

Liver transplantation (LT) plays an important role in the management of patients with hepatocellular carcinoma (HCC). Although early results following LT for HCC were poor, since the introduction of the Milan criteria in 1996 morphological criteria have since been well established. Thereafter, various expansions of the Milan criteria were introduced worldwide. Listing criteria for LT for HCC in the United Kingdom (UK) initially conformed to the Milan criteria but were re-defined in 2009 by expansion of the Milan criteria. To look at the evidence in literature on listing criteria and management of HCC worldwide in comparison with the UK. Secondly, we aim to review worldwide vs. UK literature on prioritisation models, loco-regional therapy protocols and role of alpha-fetoprotein (AFP) in LT for HCC. An electronic literature search with Medline was carried out to identify articles related to LT for HCC. Although various expansions of the Milan criteria have been described, they remain the gold standard against which other criteria are measured. The UK criteria are an expansion of the Milan criteria that go beyond Milan and University of California, San Francisco (UCSF) criteria. The current UK listing criteria for LT for HCC when compared to the worldwide criteria have a worse survival benefit (projected 5-year survival between 35-50%) when plotted on the metroticket calculator. In keeping with most transplant centres worldwide, the UK have adopted expansions to Milan to allow more patients to benefit from LT. However, currently, as it stands the UK criteria when plotted in the modification of the Metroticket model project worse survival that would seem unjustified. © 2014 John Wiley & Sons Ltd.

Sports specialization in young athletes: evidence-based recommendations.

PubMed

Jayanthi, Neeru; Pinkham, Courtney; Dugas, Lara; Patrick, Brittany; Labella, Cynthia

2013-05-01

Sports specialization is intense training in 1 sport while excluding others. Sports specialization in early to middle childhood has become increasingly common. While most experts agree that some degree of sports specialization is necessary to achieve elite levels, there is some debate as to whether such intense practice time must begin during early childhood and to the exclusion of other sports to maximize potential for success. There is a concern that sports specialization before adolescence may be deleterious to a young athlete. PubMed and OVID were searched for English-language articles from 1990 to 2011 discussing sports specialization, expert athletes, or elite versus novice athletes, including original research articles, consensus opinions, and position statements. For most sports, there is no evidence that intense training and specialization before puberty are necessary to achieve elite status. Risks of early sports specialization include higher rates of injury, increased psychological stress, and quitting sports at a young age. Sports specialization occurs along a continuum. Survey tools are being developed to identify where athletes fall along the spectrum of specialization. Some degree of sports specialization is necessary to develop elite-level skill development. However, for most sports, such intense training in a single sport to the exclusion of others should be delayed until late adolescence to optimize success while minimizing injury, psychological stress, and burnout.

Diagnostic accuracy of ultrasonography in detection of blunt abdominal trauma and comparison of early and late ultrasonography 24 hours after trauma.

PubMed

Feyzi, Ali; Rad, Masoud Pezeshki; Ahanchi, Navid; Firoozabadi, Jalil

2015-01-01

Despite the advantages of ultrasound scan, its use as a screening tool in blunt abdominal trauma is controversial. The aim of this study was to evaluate the diagnostic value of early and late ultrasound in patients with blunt abdominal trauma (BAT). In this study which was performed in a level I trauma center, firstly, 2418 patients with BAT had ultrasound (US) examination by two trauma expert radiologists. Results were compared with the best available gold standards such as laparotomy, CT, repeated ultrasound or clinical course follow-up. Then, 400 patients with BAT were examined by a trained residency student. In the first phase, sensitivity, specificity, negative predictive value, positive predictive value and accuracy of ultrasound were 97%, 98.1%, 99.7%, 83% and 98% respectively. In the second phase, they were 97.3%, 97.2%, 97.7%, 96.8% and 97.3% for the early and 98.5%, 97.6%, 98.5%, 97.5% and 98% for the late ultrasound respectively. Results obtained from this study indicate that negative ultrasound findings associated with negative clinical observation virtually exclude abdominal injury, and confirmation by performing other tests is unnecessary. High sensitivity and negative predictive value is achieved if ultrasound is performed by expert trauma radiologist.

2014 Consensus conference on viscoelastic test-based transfusion guidelines for early trauma resuscitation: Report of the panel.

PubMed

Inaba, Kenji; Rizoli, Sandro; Veigas, Precilla V; Callum, Jeannie; Davenport, Ross; Hess, John; Maegele, Marc

2015-06-01

There has been an increased interest in the use of viscoelastic testing to guide blood product replacement during the acute resuscitation of the injured patient. Currently, no uniformly accepted guidelines exist for how this technology should be integrated into clinical care. In September 2014, an international multidisciplinary group of leaders in the field of trauma coagulopathy and resuscitation was assembled for a 2-day consensus conference in Philadelphia, Pennsylvania. This panel included trauma surgeons, hematologists, blood bank specialists, anesthesiologists, and the lay public.Nine questions regarding the impact of viscoelastic testing in the early resuscitation of trauma patients were developed before the conference by panel consensus. Early use was defined as baseline viscoelastic test result thresholds obtained within the first minutes of hospital arrival-when conventional laboratory results are not available. The available data for each question were then reviewed in person using standardized presentations by the expert panel. A consensus summary document was then developed and reviewed by the panel in an open forum. Finally, a two-round Delphi poll was administered to the panel of experts regarding viscoelastic thresholds for triggering the initiation of specific treatments including fibrinogen, platelets, plasma, and prothrombin complex concentrates. This report summarizes the findings and recommendations of this consensus conference.

The Critical Advantage: Developing Critical Thinking Skills in School

ERIC Educational Resources Information Center

Gormley, William T., Jr.

2017-01-01

In "The Critical Advantage," noted scholar and early childhood expert William T. Gormley, Jr. takes a wide ranging look at the important role of critical thinking in preparing students for college, careers, and civic life. Drawing on research from psychology, philosophy, business, political science, neuroscience, and other disciplines,…

Teaching Elementary School Students to Be Effective Writers. Practice Guide Summary

ERIC Educational Resources Information Center

What Works Clearinghouse, 2017

2017-01-01

An early foundation in writing offers students a valuable tool for learning, communication, and self-expression. Authored by a panel of experts, the "Teaching Elementary School Students to Be Effective Writers" practice guide presents four recommendations educators can use to help elementary students strengthen their writing skills. The…

Fighting Technology for Toddlers

ERIC Educational Resources Information Center

Miller, Edward

2005-01-01

The presence of computers in early childhood classrooms is growing, despite serious doubts about whether young children really need them or benefit from using them. A recent study of child care centers in Texas found that preschool children were using computers in more than 75% of these institutions. According to most child development experts,…

Early-Stage Software Design for Usability

ERIC Educational Resources Information Center

Golden, Elspeth

2010-01-01

In spite of the goodwill and best efforts of software engineers and usability professionals, systems continue to be built and released with glaring usability flaws that are costly and difficult to fix after the system has been built. Although user interface (UI) designers, be they usability or design experts, communicate usability requirements to…

Early Childhood Mathematics.

ERIC Educational Resources Information Center

Smith, Susan Sperry

Most experts believe that young children possess a substantial amount of informal knowledge about mathematics. The teacher's role is to create a link between children's ability to use informal math and the ability to understand the more formal math taught in elementary school. Teachers must help children construct and elaborate upon what they…

Questioning and Oracy in a Reading Program

ERIC Educational Resources Information Center

Vaish, Viniti

2013-01-01

This paper is about the questioning patterns of teachers in an early intervention reading program and the exceptions to this typical interactional pattern. Literacy experts recommend a rich diet of oral language for young learners of English literacy. Teachers offer this rich diet by creating an appropriate learning environment in the classroom…

Center for Early Adolescence Studies Adolescent Literacy.

ERIC Educational Resources Information Center

Koppenhave, David; Jacoby, Monica, Ed.

1986-01-01

The extent and impact of adolescent illiteracy, brief descriptions of several successful programs designed to combat adolescent illiteracy, and a more detailed description of one of those programs are included in this collection of articles. The first article argues that while experts may disagree about the numbers of illiterate adolescents and…

Education versus Family: Institutional Logics in the Early Care and Education Field

ERIC Educational Resources Information Center

Colaner, Anna C.

2016-01-01

Non-parental arrangements for young children serve a dual function as supports for parental activities and educational inputs for children. However, arrangements that are suited to meet families' specific needs and preferences are sometimes in tension with experts' definitions of "quality." Researchers and policymakers increasingly…

Healthy Young Children: A Manual for Programs.

ERIC Educational Resources Information Center

Kendrick, Abby Shapiro, Ed.; And Others

This manual, which was developed as a reference and resource guide for program directors and teachers of young children, describes high standards for health policies. Also provided are information based on current research and recommendations from experts in health and early childhood education. The manual contains 7 sections and 19 chapters.…

Spotlight on Young Children and Assessment

ERIC Educational Resources Information Center

Koralek, Derry

2004-01-01

The articles in this engaging volume, mostly from Young Children, address the purposes of and uses for assessment. Expert commentary from Marian Marion, Gayle Mindes, Richard Clifford, Diane Trister Dodge and others offers an overview of the topic and specific examples to show how assessment informs and improves practice in early childhood…

Emotional Intelligence through Literature.

ERIC Educational Resources Information Center

Ghosn, Irma K.

Children develop emotional intelligence during the early years of life, and according to some experts, emotional intelligence is a more reliable predictor of academic achievement than is IQ. However, today's children appear to be low on emotional well-being. This has potentially negative consequences, not only for academic achievement but also for…

77 FR 26522 - Proposed Priority; Technical Assistance on State Data Collection, Analysis, and Reporting...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

..., parents of individuals with disabilities, data system experts, representatives of other early learning and... to improve their capacity to meet the Individuals with Disabilities Education Act (IDEA) data... data for infants, toddlers, and young children with disabilities (birth through age 5) served through...

Total Habilitation: A Concept Whose Time Has Come--Reactions to Four Responses.

ERIC Educational Resources Information Center

Drash, Philip W.; Raver, Sharon A.

1987-01-01

The original authors address several concerns expressed in four responses to their article: terminology; the need for expert and intensive pedagogy (including early intensive language training); pessimistic attitudes; the need for caution in setting total habilitation as a goal; and a research model. (KM)

An expert system for the selection of building elements during architectural design

NASA Astrophysics Data System (ADS)

Alibaba, Halil Zafer

This thesis explains the development stages of an expert system for the evaluation and selection of building elements during the early stages of architectural design. This expert system is called BES. It is produced after two prototypes were established. Testing of BES is made on professional architects who are from both academia and the practical construction market of Northern Cyprus. BES is intended to be used by experienced and inexperienced architects. The model includes selection of all kinds of main building elements that are available like retaining walls, foundations, external walls, internal walls, floors, external stairs, internal stairs, roofs, external chimneys, internal chimneys, windows and external doors and internal doors and their sub-type building elements. The selection is achieved via SMART Methodology depending on the performance requirements and an expert system shell Exsys Corvid version 1.2.14 is used to structure the expert system. The use of computers in today's world is very important with its advantages in handling vast amount of data. The use of the model through Internet makes the model international, and a useful design aid for architects. In addition, the decision-making feature of this model provides a suitable selection among numerous alternatives. The thesis also explains the development and the experience gained through use of the BES. It discusses the further development of the model.

Expert panel evaluation of health information technology effects on adverse events.

PubMed

Abramson, Erika L; Kern, Lisa M; Brenner, Samantha; Hufstader, Meghan; Patel, Vaishali; Kaushal, Rainu

2014-08-01

Adverse events (AEs) among hospitalized patients occur frequently and result in significant sequelae. Federal policy is incentivizing health information technology (HIT) use, although research demonstrating safety benefits from HIT is mixed. Our objective was to evaluate the potential effects of HIT on reducing 21 different inpatient AEs. Identifying AEs most likely to be reduced by HIT can inform the design of future studies evaluating its effectiveness. We conducted a modified Delphi panel of national experts in HIT and safety. We conducted a focused literature review to inform the experts. Using a novel framework, experts rated each AE as 'definitely reduced by health IT,' 'possibly reduced by health IT' and 'not likely to be reduced by health IT'. From our panel discussion, experts identified six AEs as 'definitely reduced by health IT': (1) adverse drug events (ADEs) associated with digoxin; (2) ADE associated with IV heparin; (3) ADE associated with hypoglycaemic agents; (4) ADE associated with low molecular weight heparin and factor Xa inhibitor; (5) contrast nephropathy associated with catheter angiography; and (6) ADE hospital-acquired antibiotic-associated Clostridium difficile. Understanding the effects of HIT on patient outcomes will be essential to ensuring that the significant federal investment results in anticipated improvements. This study serves as an important early step in helping with the design of future work evaluating level of HIT infrastructure and rates of inpatient AEs. © 2014 John Wiley & Sons, Ltd.

Integrated Knowledge Based Expert System for Disease Diagnosis System

NASA Astrophysics Data System (ADS)

Arbaiy, Nureize; Sulaiman, Shafiza Eliza; Hassan, Norlida; Afizah Afip, Zehan

2017-08-01

The role and importance of healthcare systems to improve quality of life and social welfare in a society have been well recognized. Attention should be given to raise awareness and implementing appropriate measures to improve health care. Therefore, a computer based system is developed to serve as an alternative for people to self-diagnose their health status based on given symptoms. This strategy should be emphasized so that people can utilize the information correctly as a reference to enjoy healthier life. Hence, a Web-based Community Center for Healthcare Diagnosis system is developed based on expert system technique. Expert system reasoning technique is employed in the system to enable information about treatment and prevention of the diseases based on given symptoms. At present, three diseases are included which are arthritis, thalassemia and pneumococcal. Sets of rule and fact are managed in the knowledge based system. Web based technology is used as a platform to disseminate the information to users in order for them to optimize the information appropriately. This system will benefit people who wish to increase health awareness and seek expert knowledge on the diseases by performing self-diagnosis for early disease detection.

Quality assessment of expert answers to lay questions about cystic fibrosis from various language zones in Europe: the ECORN-CF project.

PubMed

d'Alquen, Daniela; De Boeck, Kris; Bradley, Judy; Vávrová, Věra; Dembski, Birgit; Wagner, Thomas O F; Pfalz, Annette; Hebestreit, Helge

2012-02-06

The European Centres of Reference Network for Cystic Fibrosis (ECORN-CF) established an Internet forum which provides the opportunity for CF patients and other interested people to ask experts questions about CF in their mother language. The objectives of this study were to: 1) develop a detailed quality assessment tool to analyze quality of expert answers, 2) evaluate the intra- and inter-rater agreement of this tool, and 3) explore changes in the quality of expert answers over the time frame of the project. The quality assessment tool was developed by an expert panel. Five experts within the ECORN-CF project used the quality assessment tool to analyze the quality of 108 expert answers published on ECORN-CF from six language zones. 25 expert answers were scored at two time points, one year apart. Quality of answers was also assessed at an early and later period of the project. Individual rater scores and group mean scores were analyzed for each expert answer. A scoring system and training manual were developed analyzing two quality categories of answers: content and formal quality. For content quality, the grades based on group mean scores for all raters showed substantial agreement between two time points, however this was not the case for the grades based on individual rater scores. For formal quality the grades based on group mean scores showed only slight agreement between two time points and there was also poor agreement between time points for the individual grades. The inter-rater agreement for content quality was fair (mean kappa value 0.232 ± 0.036, p < 0.001) while only slight agreement was observed for the grades of the formal quality (mean kappa value 0.105 ± 0.024, p < 0.001). The quality of expert answers was rated high (four language zones) or satisfactory (two language zones) and did not change over time. The quality assessment tool described in this study was feasible and reliable when content quality was assessed by a group of raters. Within ECORN-CF, the tool will help ensure that CF patients all over Europe have equal possibility of access to high quality expert advice on their illness. © 2012 d’Alquen et al; licensee BioMed Central Ltd.

Early dialogue with health technology assessment bodies: a European perspective.

PubMed

Cuche, Matthieu; Beckerman, Rachel; Chowdhury, Cyrus A; van Weelden, Marije A

2014-12-01

Evidence requirements may differ across HTA bodies, and so pharmaceutical companies must plan to synergize their evidence generation strategy, across global regulatory and HTA bodies. Until recently, companies had no official platform to discuss the clinical development of a drug with HTA bodies; however, this is changing. To achieve broad usage in the EU, products must achieve both regulatory and reimbursement approval, the latter of which is based on HTA appraisal in many markets. The objective of this study is to present and evaluate the different options available for early HTA consultation (during drug development/Phase III) in the major European markets from the industry perspective. An exploratory (nonsystematic) literature review was performed to identify the European markets offering early HTA consultations, and each process was analyzed using a set of predefined metrics that are relevant to industry (the ability to consult with the regulatory body in parallel, consultation fees, length of consultation meeting, language of consultation meeting, maximum number of pharmaceutical company employees attending, procedural timelines, nature of data for which consultative advice can be sought, the output of the process, and the ability to involve external experts). Four different types of early HTA consultation processes were identified across the major European HTA markets. The nature of these processes varied in terms of the types and number of questions that can be addressed, the length of the meeting, the reporting output, and the ability to involve external experts. The availability of various options for early HTA consultation may help to avoid a mismatch between the evidence generated by means of a product's clinical development program, and the evidence expected by HTA bodies and payers, which can facilitate the pricing and reimbursement process upon a product's market authorization.

Early diagnosis of peripheral nervous system involvement in Fabry disease and treatment of neuropathic pain: the report of an expert panel

PubMed Central

2011-01-01

Background Fabry disease is an inherited metabolic disorder characterized by progressive lysosomal accumulation of lipids in a variety of cell types, including neural cells. Small, unmyelinated nerve fibers are particularly affected and small fiber peripheral neuropathy often clinically manifests at young age. Peripheral pain can be chronic and/or occur as provoked attacks of excruciating pain. Manifestations of dysfunction of small autonomic fibers may include, among others, impaired sweating, gastrointestinal dysmotility, and abnormal pain perception. Patients with Fabry disease often remain undiagnosed until severe complications involving the kidney, heart, peripheral nerves and/or brain have arisen. Methods An international expert panel convened with the goal to provide guidance to clinicians who may encounter unrecognized patients with Fabry disease on how to diagnose these patients early using simple diagnostic tests. A further aim was to offer recommendations to control neuropathic pain. Results We describe the neuropathy in Fabry disease, focusing on peripheral small fiber dysfunction - the hallmark of early neurologic involvement in this disorder. The clinical course of peripheral pain is summarized, and the importance of medical history-taking, including family history, is highlighted. A thorough physical examination (e.g., angiokeratoma, corneal opacities) and simple non-invasive sensory perception tests could provide clues to the diagnosis of Fabry disease. Reported early clinical benefits of enzyme replacement therapy include reduction of neuropathic pain, and adequate management of residual pain to a tolerable and functional level can substantially improve the quality of life for patients. Conclusions Our recommendations can assist in diagnosing Fabry small fiber neuropathy early, and offer clinicians guidance in controlling peripheral pain. This is particularly important since management of pain in young patients with Fabry disease appears to be inadequate. PMID:21619592

The development of the Adolescent Nervios Scale: preliminary findings.

PubMed

Livanis, Andrew; Tryon, Georgiana Shick

2010-01-01

This paper details the construction of a scale to measure the culture-bound syndrome of nervios in Latino early adolescents, ages 11 to 14. Informed by nervios literature and experts, we developed the 31-item Adolescent Nervios Scale (ANS) with items comprised of symptoms representing various psychiatric conditions common to Western culture. In contrast to 277 non-Latino early adolescents who responded to the items as representing disparate constructs, 307 Latino early adolescents responded to ANS items in a unitary fashion. For Latino early adolescents, the ANS demonstrated good internal consistency and stability as well as concurrent, discriminative, and criterion-based validity. The results support the measurement of nervios and its relationship to the school performance and adjustment of Latino youth. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Optimizing the discovery organization for innovation.

PubMed

Sams-Dodd, Frank

2005-08-01

Strategic management is the process of adapting organizational structure and management principles to fit the strategic goal of the business unit. The pharmaceutical industry has generally been expert at optimizing its organizations for drug development, but has rarely implemented different structures for the early discovery process, where the objective is innovation and the transformation of innovation into drug projects. Here, a set of strategic management methods is proposed, covering team composition, organizational structure, management principles and portfolio management, which are designed to increase the level of innovation in the early drug discovery process.

Collaborating to Move Research Forward: Proceedings of the 10th Annual Bladder Cancer Think Tank.

PubMed

Kamat, Ashish M; Agarwal, Piyush; Bivalacqua, Trinity; Chisolm, Stephanie; Daneshmand, Sia; Doroshow, James H; Efstathiou, Jason A; Galsky, Matthew; Iyer, Gopa; Kassouf, Wassim; Shah, Jay; Taylor, John; Williams, Stephen B; Quale, Diane Zipursky; Rosenberg, Jonathan E

2016-04-27

The 10th Annual Bladder Cancer Think Tank was hosted by the Bladder Cancer Advocacy Network and brought together a multidisciplinary group of clinicians, researchers, representatives and Industry to advance bladder cancer research efforts. Think Tank expert panels, group discussions, and networking opportunities helped generate ideas and strengthen collaborations between researchers and physicians across disciplines and between institutions. Interactive panel discussions addressed a variety of timely issues: 1) data sharing, privacy and social media; 2) improving patient navigation through therapy; 3) promising developments in immunotherapy; 4) and moving bladder cancer research from bench to bedside. Lastly, early career researchers presented their bladder cancer studies and had opportunities to network with leading experts.

XBONE: a hybrid expert system for supporting diagnosis of bone diseases.

PubMed

Hatzilygeroudis, I; Vassilakos, P J; Tsakalidis, A

1997-01-01

In this paper, XBONE, a hybrid medical expert system that supports diagnosis of bone diseases is presented. Diagnosis is based on various patient data and is performed in two stages. In the early stage, diagnosis is based on demographic and clinical data of the patient, whereas in the late stage it is mainly based on nuclear medicine image data. Knowledge is represented via an integrated formalism that combines production rules and the Adaline artificial neural unit. Each condition of a rule is assigned a number, called its significance factor, representing its significance in drawing the conclusion of the rule. This results in better representation, reduction of the knowledge base size and gives the system learning capabilities.

A PC based fault diagnosis expert system

NASA Technical Reports Server (NTRS)

Marsh, Christopher A.

1990-01-01

The Integrated Status Assessment (ISA) prototype expert system performs system level fault diagnosis using rules and models created by the user. The ISA evolved from concepts to a stand-alone demonstration prototype using OPS5 on a LISP Machine. The LISP based prototype was rewritten in C and the C Language Integrated Production System (CLIPS) to run on a Personal Computer (PC) and a graphics workstation. The ISA prototype has been used to demonstrate fault diagnosis functions of Space Station Freedom's Operation Management System (OMS). This paper describes the development of the ISA prototype from early concepts to the current PC/workstation version used today and describes future areas of development for the prototype.

Biocuration in the structure-function linkage database: the anatomy of a superfamily.

PubMed

Holliday, Gemma L; Brown, Shoshana D; Akiva, Eyal; Mischel, David; Hicks, Michael A; Morris, John H; Huang, Conrad C; Meng, Elaine C; Pegg, Scott C-H; Ferrin, Thomas E; Babbitt, Patricia C

2017-01-01

With ever-increasing amounts of sequence data available in both the primary literature and sequence repositories, there is a bottleneck in annotating molecular function to a sequence. This article describes the biocuration process and methods used in the structure-function linkage database (SFLD) to help address some of the challenges. We discuss how the hierarchy within the SFLD allows us to infer detailed functional properties for functionally diverse enzyme superfamilies in which all members are homologous, conserve an aspect of their chemical function and have associated conserved structural features that enable the chemistry. Also presented is the Enzyme Structure-Function Ontology (ESFO), which has been designed to capture the relationships between enzyme sequence, structure and function that underlie the SFLD and is used to guide the biocuration processes within the SFLD. http://sfld.rbvi.ucsf.edu/. © The Author 2017. Published by Oxford University Press.

Determination of ubiquitin fitness landscapes under different chemical stresses in a classroom setting.

PubMed

Mavor, David; Barlow, Kyle; Thompson, Samuel; Barad, Benjamin A; Bonny, Alain R; Cario, Clinton L; Gaskins, Garrett; Liu, Zairan; Deming, Laura; Axen, Seth D; Caceres, Elena; Chen, Weilin; Cuesta, Adolfo; Gate, Rachel E; Green, Evan M; Hulce, Kaitlin R; Ji, Weiyue; Kenner, Lillian R; Mensa, Bruk; Morinishi, Leanna S; Moss, Steven M; Mravic, Marco; Muir, Ryan K; Niekamp, Stefan; Nnadi, Chimno I; Palovcak, Eugene; Poss, Erin M; Ross, Tyler D; Salcedo, Eugenia C; See, Stephanie K; Subramaniam, Meena; Wong, Allison W; Li, Jennifer; Thorn, Kurt S; Conchúir, Shane Ó; Roscoe, Benjamin P; Chow, Eric D; DeRisi, Joseph L; Kortemme, Tanja; Bolon, Daniel N; Fraser, James S

2016-04-25

Ubiquitin is essential for eukaryotic life and varies in only 3 amino acid positions between yeast and humans. However, recent deep sequencing studies indicate that ubiquitin is highly tolerant to single mutations. We hypothesized that this tolerance would be reduced by chemically induced physiologic perturbations. To test this hypothesis, a class of first year UCSF graduate students employed deep mutational scanning to determine the fitness landscape of all possible single residue mutations in the presence of five different small molecule perturbations. These perturbations uncover 'shared sensitized positions' localized to areas around the hydrophobic patch and the C-terminus. In addition, we identified perturbation specific effects such as a sensitization of His68 in HU and a tolerance to mutation at Lys63 in DTT. Our data show how chemical stresses can reduce buffering effects in the ubiquitin proteasome system. Finally, this study demonstrates the potential of lab-based interdisciplinary graduate curriculum.

Treatment of Infants Identified by Newborn Screening for Severe Combined Immunodeficiency

PubMed Central

Dorsey, Morna J.; Dvorak, Christopher C.; Cowan, Morton J.; Puck, Jennifer M.

2017-01-01

Background Severe combined immunodeficiency (SCID) is characterized by severely impaired T cell development and is fatal without treatment. Newborn screening (NBS) for SCID permits identification of affected infants before development of opportunistic infections and other complications. Substantial variation exists between treatment centers with regard to pre-transplant care and transplant protocols for NBS identified SCID infants, as well as for infants with other T lymphopenic disorders detected by NBS. Methods We developed approaches to management based on the study of infants identified by SCID NBS who received care at UCSF. Results From August 2010 through October 2016, 32 NBS SCID and leaky SCID cases from California and other states were treated and 42 NBS identified non-SCID T cell lymphopenia (TCL) cases were followed. Conclusions Our center’s approach supports successful outcomes; systematic review of our practice provides a framework for diagnosis and management, recognizing that more data will continue to shape best practices. PMID:28270365

A Historical Review of R. J. Reynolds’ Strategies for Marketing Tobacco to Hispanics in the United States

PubMed Central

Parascandola, Mark

2013-01-01

Hispanics are the fastest growing racial/ethnic group in the United States, and smoking is the leading preventable cause of morbidity and mortality among this population. We analyzed tobacco industry documents on R. J. Reynolds’ marketing strategies toward the Hispanic population using tobacco industry document archives from the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) between February–July 2011 and April–August 2012. Our analysis revealed that by 1980 the company had developed a sophisticated surveillance system to track the market behavior of Hispanic smokers and understand their psychographics, cultural values, and attitudes. This information was translated into targeted marketing campaigns for the Winston and Camel brands. Marketing targeted toward Hispanics appealed to values and sponsored activities that could be perceived as legitimating. Greater understanding of tobacco industry marketing strategies has substantial relevance for addressing tobacco-related health disparities. PMID:23488493

A historical review of R.J. Reynolds' strategies for marketing tobacco to Hispanics in the United States.

PubMed

Iglesias-Rios, Lisbeth; Parascandola, Mark

2013-05-01

Hispanics are the fastest growing racial/ethnic group in the United States, and smoking is the leading preventable cause of morbidity and mortality among this population. We analyzed tobacco industry documents on R. J. Reynolds' marketing strategies toward the Hispanic population using tobacco industry document archives from the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) between February-July 2011 and April-August 2012. Our analysis revealed that by 1980 the company had developed a sophisticated surveillance system to track the market behavior of Hispanic smokers and understand their psychographics, cultural values, and attitudes. This information was translated into targeted marketing campaigns for the Winston and Camel brands. Marketing targeted toward Hispanics appealed to values and sponsored activities that could be perceived as legitimating. Greater understanding of tobacco industry marketing strategies has substantial relevance for addressing tobacco-related health disparities.

Building leadership among laboratory-based and clinical and translational researchers: the University of California, San Francisco experience.

PubMed

Wides, Cynthia; Mertz, Elizabeth; Lindstaedt, Bill; Brown, Jeanette

2014-02-01

In 2005 the University of California, San Francisco (UCSF) implemented the Scientific Leadership and Management (SLM) course, a 2-day leadership training program to assist laboratory-based postdoctoral scholars in their transition to independent researchers managing their own research programs. In 2011, the course was expanded to clinical and translational junior faculty and fellows. The course enrollment was increased from approximate 100 to 123 participants at the same time. Based on course evaluations, the number and percent of women participants appears to have increased over time from 40% (n = 33) in 2007 to 53% (n = 58) in 2011. Course evaluations also indicated that participants found the course to be relevant and valuable in their transition to academic leadership. This paper describes the background, structure, and content of the SLM and reports on participant evaluations of the course offerings from 2007 through 2011. © 2014 Wiley Periodicals, Inc.

Structural neuroplasticity in expert pianists depends on the age of musical training onset.

PubMed

Vaquero, Lucía; Hartmann, Karl; Ripollés, Pablo; Rojo, Nuria; Sierpowska, Joanna; François, Clément; Càmara, Estela; van Vugt, Floris Tijmen; Mohammadi, Bahram; Samii, Amir; Münte, Thomas F; Rodríguez-Fornells, Antoni; Altenmüller, Eckart

2016-02-01

In the last decade, several studies have investigated the neuroplastic changes induced by long-term musical training. Here we investigated structural brain differences in expert pianists compared to non-musician controls, as well as the effect of the age of onset (AoO) of piano playing. Differences with non-musicians and the effect of sensitive periods in musicians have been studied previously, but importantly, this is the first time in which the age of onset of music-training was assessed in a group of musicians playing the same instrument, while controlling for the amount of practice. We recruited a homogeneous group of expert pianists who differed in their AoO but not in their lifetime or present amount of training, and compared them to an age-matched group of non-musicians. A subset of the pianists also completed a scale-playing task in order to control for performance skill level differences. Voxel-based morphometry analysis was used to examine gray-matter differences at the whole-brain level. Pianists showed greater gray matter (GM) volume in bilateral putamen (extending also to hippocampus and amygdala), right thalamus, bilateral lingual gyri and left superior temporal gyrus, but a GM volume shrinkage in the right supramarginal, right superior temporal and right postcentral gyri, when compared to non-musician controls. These results reveal a complex pattern of plastic effects due to sustained musical training: a network involved in reinforcement learning showed increased GM volume, while areas related to sensorimotor control, auditory processing and score-reading presented a reduction in the volume of GM. Behaviorally, early-onset pianists showed higher temporal precision in their piano performance than late-onset pianists, especially in the left hand. Furthermore, early onset of piano playing was associated with smaller GM volume in the right putamen and better piano performance (mainly in the left hand). Our results, therefore, reveal for the first time in a single large dataset of healthy pianists the link between onset of musical practice, behavioral performance, and putaminal gray matter structure. In summary, skill-related plastic adaptations may include decreases and increases in GM volume, dependent on an optimization of the system caused by an early start of musical training. We believe our findings enrich the plasticity discourse and shed light on the neural basis of expert skill acquisition. Copyright © 2015 Elsevier Inc. All rights reserved.

Parenting Talent: A Qualitative Investigation of the Roles Parents Play in Talent Development

ERIC Educational Resources Information Center

Witte, Amanda L.; Kiewra, Kenneth A.; Kasson, Sarah C.; Perry, Kyle R.

2015-01-01

Previous research has linked talent development to four factors--early experience, coaching, practice, and motivation. In addition to these factors, contemporary talent experts suggest that parents play a critical role in talent development. The purpose of the present study was to uncover parents' in-time perspectives on the talent development…

Making Waves: Towards a Pedagogy of Discourse

ERIC Educational Resources Information Center

Kessler-Singh, Lorraine; Robertson, Leena Helavaara

2016-01-01

This article re-examines the classroom discourse context in early years settings and primary schools. It seeks to understand why such slow progress has been made in developing talk for learning in recent years. The article acknowledges that children are already expert language users by the time they start school and offers practitioners practical…

Madness comes a month early. February was chock full of corporate retrenchments, broken deals and red ink.

PubMed

Saphir, A

1999-03-01

After a slew of retrenchments, split-ups and sliding profits last month, healthcare companies are learning that they probably need to change their game plans and get back to basics. Experts say the same cycle has occurred in other industries and is expected in healthcare.

Representing System Behaviors and Expert Behaviors for Intelligent Tutoring

DTIC Science & Technology

1987-02-09

Learned .................................. 44 . Future Directions ................................... 47 Sum m ary...and training environments to assist the instructor in meeting the students’ learning needs. The first application of the IMTS will be in training...identifies and resolves learning deficiencies and minimizes unproductive practice time. Another decision made early in the planning phase was to place

Software Size Estimation Using Expert Estimation: A Fuzzy Logic Approach

ERIC Educational Resources Information Center

Stevenson, Glenn A.

2012-01-01

For decades software managers have been using formal methodologies such as the Constructive Cost Model and Function Points to estimate the effort of software projects during the early stages of project development. While some research shows these methodologies to be effective, many software managers feel that they are overly complicated to use and…

Breast Cancer Screening in a Low Income Managed Care Populaton

DTIC Science & Technology

1999-10-01

early to know for sure if these things affect breast cancer risk. can help prevent heart disease and osteoporosis after menopause. .,.- Experts generally...firmly in small massaging motions with the pads of your fingers (not the tips). Don’t forget the area in your armpit. Gently squeeze the nipple. Switch

Mothering and Fathering: The Gender Differences in Child Rearing.

ERIC Educational Resources Information Center

Thevenin, Tine

Both parents have unique contributions to make in the development of a child. Mothers and fathers think and act differently from one another, and children thrive on these differences. This book examines gender differences in child rearing, focusing on the conflict between male experts' advice promoting early independence and women's desire for…

Mechanical Power Flow Changes during Multijoint Movement Acquisition

ERIC Educational Resources Information Center

Kadota, Koji; Matsuo, Tomoyuki; Hashizume, Ken; Tezuka, Kazushi

2006-01-01

We investigated the differences in mechanical power flow in early and late practice stages during a cyclic movement consisting of upper arm circumduction to clarify the change in mechanical energy use with skill acquisition. Seven participants practiced the task every other day until their joint angular movements conformed to those of an expert.…

Towards Universal Primary Education: Investments, Incentives, and Institutions

ERIC Educational Resources Information Center

Birdsall, Nancy; Levine, Ruth; Ibrahim, Amina

2005-01-01

The UN Millennium Project Task Force on Education and Gender Equality, an expert advisory group commissioned by the UN Secretary-General, was asked to examine how dramatic improvements in education can be achieved in the developing world. The task force investigated the problems of low enrolment, early drop-out and poor learning outcomes that so…

Curriculum Issues in National Policy-Making

ERIC Educational Resources Information Center

Bennett, John

2005-01-01

This discussion of curriculum issues in national policy making is based on the findings of thematic reviews of early childhood education and care, carried out by expert teams in twenty OECD countries. Much consensus is found across the countries reviewed in terms of curricular principles and aspirations, and with regard to official content,…

National Forum: How Schools and Parents Can Work Together to Address Bullying

ERIC Educational Resources Information Center

Australian Government Department of Education, Employment and Workplace Relations, 2012

2012-01-01

On 31 July 2012 the Minister for School Education, Early Childhood and Youth, Peter Garrett convened the "National Forum: How schools and parents can work together to address bullying" at Parliament House. The Forum brought together principals, parents groups, young people, as well as experts in education, child welfare, psychology and…

Challenges of diagnosis and management of axial spondyloarthritis in North Africa and the Middle East: An expert consensus.

PubMed

Hammoudeh, Mohammed; Abdulaziz, Sultana; Alosaimi, Hanan; Al-Rayes, Hanan; Aldeen Sarakbi, Hussam; Baamer, Matouqa; Baraliakos, Xenofon; Dahou Makhloufi, Chafia; Janoudi, Nahid; Shirazy, Khalid; Sieper, Joachim; Sukhbir, Uppal

2016-04-01

Axial spondyloarthritis (SpA) is a spectrum of inflammatory disease with stages characterized by both nonradiographic and radiographic sacroiliitis. Nonradiographic axial SpA is associated with health-related quality-of-life impairment and may progress to ankylosing spondylitis. Axial SpA has a low prevalence in some countries in North Africa and the Middle East, and pooling of data and resources is needed to increase understanding of the regional picture. Early diagnosis and effective treatment are required to reduce disease burden and prevent progression. Anti-TNF therapy is recommended for patients with persistently high disease activity despite conventional treatment, and has been shown to be effective in patients without radiographic damage. Diagnostic delays can be an obstacle to early treatment and appropriate referral strategies are needed. In some countries, restricted access to magnetic resonance imaging and anti-TNF agents presents a challenge. In this article, a group of experts from North Africa and the Middle East evaluated the diagnosis and management of axial SpA with particular reference to this region. © The Author(s) 2016.

Management Strategies for CLN2 Disease.

PubMed

Williams, Ruth E; Adams, Heather R; Blohm, Martin; Cohen-Pfeffer, Jessica L; de Los Reyes, Emily; Denecke, Jonas; Drago, Kristen; Fairhurst, Charlie; Frazier, Margie; Guelbert, Norberto; Kiss, Szilárd; Kofler, Annamaria; Lawson, John A; Lehwald, Lenora; Leung, Mary-Anne; Mikhaylova, Svetlana; Mink, Jonathan W; Nickel, Miriam; Shediac, Renée; Sims, Katherine; Specchio, Nicola; Topcu, Meral; von Löbbecke, Ina; West, Andrea; Zernikow, Boris; Schulz, Angela

2017-04-01

CLN2 disease (neuronal ceroid lipofuscinosis type 2) is a rare, autosomal recessive, pediatric-onset, rapidly progressive neurodegenerative lysosomal storage disorder caused by tripeptidyl peptidase 1 (TPP1) enzyme deficiency, and is characterized by language delay, seizures, rapid cognitive and motor decline, blindness, and early death. No management guidelines exist and there is a paucity of published disease-specific evidence to inform clinical practice, which currently draws upon experience from the field of childhood neurodisability. Twenty-four disease experts were surveyed on CLN2 disease management and a subset met to discuss current practice. Management goals and strategies are consistent among experts globally and are guided by the principles of pediatric palliative care. Goals and interventions evolve as the disease progresses, with a shift in focus from maintenance of function early in the disease to maintenance of quality of life. A multidisciplinary approach is critical for optimal patient care. This work represents an initial step toward the development of consensus-based management guidelines for CLN2 disease. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

“The wondrous eyes of a new technology”—a history of the early electroencephalography (EEG) of psychopathy, delinquency, and immorality

PubMed Central

Schirmann, Felix

2014-01-01

This article presents a history of the early electroencephalography (EEG) of psychopathy, delinquency, and immorality in Great Britain and the United States in the 1940s and 1950s. Then, EEG was a novel research tool that promised ground-breaking insights in psychiatry and criminology. Experts explored its potential regarding the diagnosis, classification, etiology, and treatment of unethical and unlawful persons. This line of research yielded tentative and inconsistent findings, which the experts attributed to methodological and theoretical shortcomings. Accordingly, the scientific community discussed the reliability, validity, and utility of EEG, and launched initiatives to calibrate and standardize the novel tool. The analysis shows that knowledge production, gauging of the research tool, and attempts to establish credibility for EEG in the study of immoral persons occurred simultaneously. The paper concludes with a reflection on the similarities between EEG and neuroimaging—the prime research tool in the current neuroscience of morality—and calls for a critical assessment of their potentials and limitations in the study of immorality and crime. PMID:24860464

"The wondrous eyes of a new technology"-a history of the early electroencephalography (EEG) of psychopathy, delinquency, and immorality.

PubMed

Schirmann, Felix

2014-01-01

This article presents a history of the early electroencephalography (EEG) of psychopathy, delinquency, and immorality in Great Britain and the United States in the 1940s and 1950s. Then, EEG was a novel research tool that promised ground-breaking insights in psychiatry and criminology. Experts explored its potential regarding the diagnosis, classification, etiology, and treatment of unethical and unlawful persons. This line of research yielded tentative and inconsistent findings, which the experts attributed to methodological and theoretical shortcomings. Accordingly, the scientific community discussed the reliability, validity, and utility of EEG, and launched initiatives to calibrate and standardize the novel tool. The analysis shows that knowledge production, gauging of the research tool, and attempts to establish credibility for EEG in the study of immoral persons occurred simultaneously. The paper concludes with a reflection on the similarities between EEG and neuroimaging-the prime research tool in the current neuroscience of morality-and calls for a critical assessment of their potentials and limitations in the study of immorality and crime.

Onwards facing backwards: the rhetoric of science in nineteenth-century Greece.

PubMed

Tampakis, Kostas

2014-06-01

The aim of this paper is to show how the Greek men of science negotiated a role for their enterprise within the Greek public sphere, from the institution of the modern Greek state in the early 1830s to the first decades of the twentieth century. By focusing on instances where they appeared in public in their official capacity as scientific experts, I describe the rhetorical schemata and the narrative strategies with which Greek science experts engaged the discourses prevalent in nineteenth- and early twentieth-century Greece. In the end, my goal is to show how they were neither zealots of modernization nor neutral actors struggling in isolated wastelands. Rather, they appear as energetic agents who used scientific expertise, national ideals and their privileged cultural positions to construct a rhetoric that would further all three. They engaged eagerly and consistently with emerging political views, scientific subjects and cultural and political events, without presenting themselves, or being seen, as doing anything qualitatively different from their peers abroad. Greek scientists cross-contextualized the scientific enterprise, situating it in the space in which they were active.

Multidisciplinary approach to the diagnosis and management of patients with peripheral arterial disease

PubMed Central

Walker, Craig M; Bunch, Frank T; Cavros, Nick G; Dippel, Eric J

2015-01-01

Peripheral arterial disease (PAD) is frequently diagnosed after permanent damage has occurred, resulting in a high rate of morbidity, amputation, and loss of life. Early and ongoing diagnosis and treatment is required for this progressive disease. Lifestyle modifications can prevent or delay disease progression and improve symptoms. Limb-sparing endovascular interventions can restore circulation based on appropriate diagnostic testing to pinpoint vascular targets, and intervention must occur as early as possible to ensure optimal clinical outcomes. An algorithm for the diagnosis and management of PAD was developed to enable a collaborative approach between the family practice and primary care physician or internist and various specialists that may include a diabetologist, endocrinologist, smoking cessation expert, hypertension and lipid specialist, endovascular interventionalist, vascular surgeon, orthopedist, neurologist, nurse practitioner, podiatrist, wound healing expert, and/or others. A multidisciplinary team working together has the greatest chance of providing optimal care for the patient with PAD and ensuring ongoing surveillance of the patient’s overall health, ultimately resulting in better quality of life and increased longevity for patients with PAD. PMID:26203234

Coronary artery disease reporting and data system (CAD-RADSTM): Inter-observer agreement for assessment categories and modifiers.

PubMed

Maroules, Christopher D; Hamilton-Craig, Christian; Branch, Kelley; Lee, James; Cury, Roberto C; Maurovich-Horvat, Pál; Rubinshtein, Ronen; Thomas, Dustin; Williams, Michelle; Guo, Yanshu; Cury, Ricardo C

The Coronary Artery Disease Reporting and Data System (CAD-RADS) provides a lexicon and standardized reporting system for coronary CT angiography. To evaluate inter-observer agreement of the CAD-RADS among an panel of early career and expert readers. Four early career and four expert cardiac imaging readers prospectively and independently evaluated 50 coronary CT angiography cases using the CAD-RADS lexicon. All readers assessed image quality using a five-point Likert scale, with mean Likert score ≥4 designating high image quality, and <4 designating moderate/low image quality. All readers were blinded to medical history and invasive coronary angiography findings. Inter-observer agreement for CAD-RADS assessment categories and modifiers were assessed using intra-class correlation (ICC) and Fleiss' Kappa (κ).The impact of reader experience and image quality on inter-observer agreement was also examined. Inter-observer agreement for CAD-RADS assessment categories was excellent (ICC 0.958, 95% CI 0.938-0.974, p < 0.0001). Agreement among expert readers (ICC 0.925, 95% CI 0.884-0.954) was marginally stronger than for early career readers (ICC 0.904, 95% CI 0.852-0.941), both p < 0.0001. High image quality was associated with stronger agreement than moderate image quality (ICC 0.944, 95% CI 0.886-0.974 vs. ICC 0.887, 95% CI 0.775-0.95, both p < 0.0001). While excellent inter-observer agreement was observed for modifiers S (stent) and G (bypass graft) (both κ = 1.0), only fair agreement (κ = 0.40) was observed for modifier V (high risk plaque). Inter-observer reproducibility of CAD-RADS assessment categories and modifiers is excellent, except for high-risk plaque (modifier V) which demonstrates fair agreement. These results suggest CAD-RADS is feasible for clinical implementation. Copyright © 2017. Published by Elsevier Inc.

Sports Specialization in Young Athletes

PubMed Central

Jayanthi, Neeru; Pinkham, Courtney; Dugas, Lara; Patrick, Brittany; LaBella, Cynthia

2013-01-01

Context: Sports specialization is intense training in 1 sport while excluding others. Sports specialization in early to middle childhood has become increasingly common. While most experts agree that some degree of sports specialization is necessary to achieve elite levels, there is some debate as to whether such intense practice time must begin during early childhood and to the exclusion of other sports to maximize potential for success. There is a concern that sports specialization before adolescence may be deleterious to a young athlete. Evidence Acquisition: PubMed and OVID were searched for English-language articles from 1990 to 2011 discussing sports specialization, expert athletes, or elite versus novice athletes, including original research articles, consensus opinions, and position statements. Results: For most sports, there is no evidence that intense training and specialization before puberty are necessary to achieve elite status. Risks of early sports specialization include higher rates of injury, increased psychological stress, and quitting sports at a young age. Sports specialization occurs along a continuum. Survey tools are being developed to identify where athletes fall along the spectrum of specialization. Conclusion: Some degree of sports specialization is necessary to develop elite-level skill development. However, for most sports, such intense training in a single sport to the exclusion of others should be delayed until late adolescence to optimize success while minimizing injury, psychological stress, and burnout. PMID:24427397

Opportunities for public health communication, intervention, and future research on breast cancer in younger women.

PubMed

Buchanan, Natasha; Roland, Katherine B; Rodriguez, Juan L; Miller, Jacqueline W; Fairley, Temeika

2013-04-01

Approximately 6% of breast cancers in the United States occur in women under the age of 40 years. Compared with women ≥40 years of age, younger women are diagnosed at later stages, have higher rates of recurrence and death, and may be predisposed to secondary breast or ovarian cancer. An informal meeting of experts discussed opportunities for research and public health communication related to breast cancer among young (<40 and/or premenopausal) women. In September 2011, the Centers for Disease Control and Prevention hosted 18 experts in oncology, genetics, behavioral science, survivorship and advocacy, public health, communication, ethics, nutrition, physical activity, and environmental health. They (1) reviewed research and programmatic knowledge on risk and preventive factors, early detection, and survivorship; and (2) discussed ideas for research, communication, and programmatic efforts related to young women diagnosed with or at risk for early onset breast cancer. Levels of evidence and themes for future research regarding risk and preventive factors, including exposures, were discussed. Early detection strategies, including screening, risk assessment, and genetic counseling, as well as survivorship issues, follow-up care, fertility and reproductive health, and psychosocial care were highlighted. Community and academic researchers, providers, advocates, and the federal public health community discussed strategies and opportunities for this unique population. Although the evidence is limited, future research and communication activities may be useful to organize future public health initiatives.

Artificial intelligence against breast cancer (A.N.N.E.S-B.C.-Project).

PubMed

Parmeggiani, Domenico; Avenia, Nicola; Sanguinetti, Alessandro; Ruggiero, Roberto; Docimo, Giovanni; Siciliano, Mattia; Ambrosino, Pasquale; Madonna, Imma; Peltrini, Roberto; Parmeggiani, Umberto

2012-01-01

Our preliminary study examined the development of an advanced innovative technology with the objectives of--developing methodologies and algorithms for a Artificial Neural Network (ANN) system, improving mammography and ultra-sonography images interpretation;--creating autonomous software as a diagnostic tool for the physicians, allowing the possibility for the advanced application of databases using Artificial Intelligence (Expert System). Since 2004 550 F patients over 40 yrs old were divided in two groups: 1) 310 pts underwent echo every 6 months and mammography every year by expert radiologists. 2) 240 pts had the same screening program and were also examined by our diagnosis software, developed with ANN-ES technology by the Engineering Aircraft Research Project team. The information was continually updated and returned to the Expert System, defining the principal rules of automatic diagnosis. In the second group we selected: Expert radiologist decision; ANN-ES decision; Expert radiologists with ANN-ES decision. The second group had significantly better diagnosis for cancer and better specificity for breast lesions risk as well as the highest percentage account when the radiologist's decision was helped by the ANN software. The ANN-ES group was able to select, by anamnestic, diagnostic and genetic means, 8 patients for prophylactic surgery, finding 4 cancers in a very early stage. Although it is only a preliminary study, this innovative diagnostic tool seems to provide better positive and negative predictive value in cancer diagnosis as well as in breast risk lesion identification.

Mathematical models for the early detection and treatment of colorectal cancer.

PubMed

Harper, P R; Jones, S K

2005-05-01

Colorectal cancer is a major cause of death for men and women in the Western world. When the cancer is detected through an awareness of the symptoms by a patient, typically it is at an advanced stage. It is possible to detect cancer at an early stage through screening and the marked differences in survival for early and late stages provide the incentive for the primary prevention or early detection of colorectal cancer. This paper considers mathematical models for colorectal cancer screening together with models for the treatment of patients. Illustrative results demonstrate that detailed attention to the processes involved in diseases, interventions and treatment enable us to combine data and expert knowledge from various sources. Thus a detailed operational model is a very useful tool in helping to make decisions about screening at national and local levels.

Independent Schools Examine Ways to Support Students' Sleep

ERIC Educational Resources Information Center

Stewart, Sarah

2015-01-01

Two-thirds of high school students get less than eight to 10 hours of sleep per night according to the Centers for Disease Control and Prevention (CDC). Sleep deprivation in teens has been linked to poor academic performance, reduced immunity, obesity, ADD-like symptoms, and even drug and alcohol use. For years, experts have said that early school…

A Parents' Guide for Well-Baby Care and Minor Hospitalizations.

ERIC Educational Resources Information Center

Luchini, Alice, Ed.

This manual offers practical guidelines for many of the concerns that parents have about their infants and toddlers. The manual is divided into seven chapters; each is written by an expert in the field of pediatrics, early childhood education, nutrition, or family care. The following areas are covered: (1) newborn and infant care; (2) growth and…

Child at Risk: A Report of the Standing Senate Committee on Health, Welfare and Science.

ERIC Educational Resources Information Center

Senate Committee of Canada (Ontario). Standing Senate Committee on Health, Welfare and Science.

This report of the Standing Senate Committee on Health, Welfare and Science summarizes and coordinates interdisciplinary evidence and expert opinion in order to provide insight into the way early childhood experiences might be considered as causes of later criminal behavior. The material is divided into three categories: the prenatal period, the…

Organizational Training and Relationship Building for Increasing Public Participation in a Public School District

ERIC Educational Resources Information Center

Poynton, John; Makela, Carole; Haddad, Don

2014-01-01

From the early twentieth century to the present, citizen participation in U.S. public institutions--particularly schools--has continually decreased. The trend has been linked to the bureaucratization of public schools and their increasing reliance on expert knowledge for solutions to school- and education-related problems. The purpose of this…

Learning to Labour with Feeling: Class, Gender and Emotion in Childcare Education and Training

ERIC Educational Resources Information Center

Colley, Helen

2006-01-01

There is debate among early years experts about the appropriate degree of emotional engagement between nursery nurses and the children in their care. Through research into the learning cultures of further education (in the Economic and Social Research Council's Teaching and Learning Research Programme), the author considers how prospective nursery…

Comparison of Meaning and Graphophonemic Feedback Strategies for Guided Reading Instruction of Children with Language Delays

ERIC Educational Resources Information Center

Kouri, Theresa A.; Selle, Carrie A.; Riley, Sarah A.

2006-01-01

Purpose: Guided reading is a common practice recommended for children in the early stages of literacy development. While experts agree that oral reading facilitates literacy skills, controversy exists concerning which corrective feedback strategies are most effective. The purpose of this study was to compare feedback procedures stemming from 2…

Guiding Young Children's Behavior: Helpful Ideas for Parents & Teachers from 28 Early Childhood Experts.

ERIC Educational Resources Information Center

Farber, Betty, Ed.

This collection of articles is compiled to offer parents and teachers guidelines to help navigate between a child's intentions and his or her behavior. The book consists of 43 brief chapters divided into 9 sections. Articles in section one, "Guiding Young Children's Behavior," address issues of discipline, setting limits, effective…

The Interplay of Firsthand and Text-Based Investigations in Science Education. Ciera Report.

ERIC Educational Resources Information Center

Palincsar, Annemarie Sullivan; Magnusson, Shirley J.

This paper presents the results of a study concerning the use of text in support of firsthand scientific inquiry instruction in the early elementary grades. A partial transcript of two teaching sessions in which an expert classroom teacher incorporated text into her inquiry instruction is investigated. The knowledge gained from these sessions…

Organizational Training and Relationship Building for Increasing Public Participation in a Public School District

ERIC Educational Resources Information Center

Poynton, John

2012-01-01

From the early twentieth century to the present, citizen participation in U.S. public institutions--particularly schools--has continually decreased. The trend has been linked to the bureaucratization of public schools and their increasing reliance on expert knowledge for solutions to school- and education-related problems. The purpose of this…

Professional Development for Early Reading Teachers. NCEE Evaluation Brief 2009-4055

ERIC Educational Resources Information Center

National Center for Education Evaluation and Regional Assistance, 2009

2009-01-01

A recent national study of state and local No Child Left Behind activities indicated that 80 percent of elementary teachers reported participating in 24 hours or less of professional development on reading instruction during the 2003-2004 school year and summer. Reading and professional development experts are concerned that this is not intensive…

Award for Distinguished Contributions to Research in Public Policy: Charlotte J. Patterson

ERIC Educational Resources Information Center

American Psychologist, 2009

2009-01-01

Charlotte J. Patterson, winner of the Award for Distinguished Contributions to Research in Public Policy, is cited as the world's expert on psychological research on children and youths raised by lesbian and gay parents. Her early analytic syntheses of the literature on the subject greatly influenced other researchers in child and family…

CONFIG - Adapting qualitative modeling and discrete event simulation for design of fault management systems

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Basham, Bryan D.

1989-01-01

CONFIG is a modeling and simulation tool prototype for analyzing the normal and faulty qualitative behaviors of engineered systems. Qualitative modeling and discrete-event simulation have been adapted and integrated, to support early development, during system design, of software and procedures for management of failures, especially in diagnostic expert systems. Qualitative component models are defined in terms of normal and faulty modes and processes, which are defined by invocation statements and effect statements with time delays. System models are constructed graphically by using instances of components and relations from object-oriented hierarchical model libraries. Extension and reuse of CONFIG models and analysis capabilities in hybrid rule- and model-based expert fault-management support systems are discussed.

Assessing and evaluating multidisciplinary translational teams: a mixed methods approach.

PubMed

Wooten, Kevin C; Rose, Robert M; Ostir, Glenn V; Calhoun, William J; Ameredes, Bill T; Brasier, Allan R

2014-03-01

A case report illustrates how multidisciplinary translational teams can be assessed using outcome, process, and developmental types of evaluation using a mixed-methods approach. Types of evaluation appropriate for teams are considered in relation to relevant research questions and assessment methods. Logic models are applied to scientific projects and team development to inform choices between methods within a mixed-methods design. Use of an expert panel is reviewed, culminating in consensus ratings of 11 multidisciplinary teams and a final evaluation within a team-type taxonomy. Based on team maturation and scientific progress, teams were designated as (a) early in development, (b) traditional, (c) process focused, or (d) exemplary. Lessons learned from data reduction, use of mixed methods, and use of expert panels are explored.

Knowing 'something is not right' is beyond intuition: development of a clinical algorithm to enhance surveillance and assist nurses to organise and communicate clinical findings.

PubMed

Brier, Jessica; Carolyn, Moalem; Haverly, Marsha; Januario, Mary Ellen; Padula, Cynthia; Tal, Ahuva; Triosh, Henia

2015-03-01

To develop a clinical algorithm to guide nurses' critical thinking through systematic surveillance, assessment, actions required and communication strategies. To achieve this, an international, multiphase project was initiated. Patients receive hospital care postoperatively because they require the skilled surveillance of nurses. Effective assessment of postoperative patients is essential for early detection of clinical deterioration and optimal care management. Despite the significant amount of time devoted to surveillance activities, there is lack of evidence that nurses use a consistent, systematic approach in surveillance, management and communication, potentially leading to less optimal outcomes. Several explanations for the lack of consistency have been suggested in the literature. Mixed methods approach. Retrospective chart review; semi-structured interviews conducted with expert nurses (n = 10); algorithm development. Themes developed from the semi-structured interviews, including (1) complete, systematic assessment, (2) something is not right (3) validating with others, (4) influencing factors and (5) frustration with lack of response when communicating findings were used as the basis for development of the Surveillance Algorithm for Post-Surgical Patients. The algorithm proved beneficial based on limited use in clinical settings. Further work is needed to fully test it in education and practice. The Surveillance Algorithm for Post-Surgical Patients represents the approach of expert nurses, and serves to guide less expert nurses' observations, critical thinking, actions and communication. Based on this approach, the algorithm assists nurses to develop skills promoting early detection, intervention and communication in cases of patient deterioration. © 2014 John Wiley & Sons Ltd.

Experts' beliefs on physiotherapy for patients with ankylosing spondylitis and assessment of their knowledge on published evidence in the field. Results of a questionnaire among international ASAS members.

PubMed

Mihai, B; van der Linden, S; de Bie, R; Stucki, G

2005-06-01

The aim of this study was to assess both the opinion of an international group of experts about the place and importance of physiotherapy in the management of ankylosing spondylitis (AS) as well as the awareness of the responders about scientific evidence on efficacy and cost-effectiveness of physiotherapy in AS. An e-mail questionnaire ''Experts' Beliefs on Physiotherapy for Patients with Ankylosing Spondylitis'' has been sent to all 71 international ASsessment of Ankylosing Spondylitis (ASAS) members. Completion of the twenty-eight-item questionnaire was done through the ASAS website (www.ASAS-group.org). The number of responders was 53 (response rate 73%). Altogether 94% of the responders regard themselves as experts in the field of clinical care for AS patients. There is almost unanimous (86-92%) consensus on the efficacy of physiotherapy (widely defined, i.e. as physical therapy-including exercises, application of physical modalities and spa-therapy) for patients with axial and peripheral joint manifestations of AS. Physiotherapy is considered to be indicated for both early AS (less than 2 years after diagnosis) (88%) and AS of longer duration (2 to 10 years) (94%), implying that this non-pharmaceutical intervention should be made available for or should be prescribed to AS patients. Also daily exercises at home are considered indicated for both early (less than 2 years after diagnosis) AS (90%) and AS of longer duration of disease (90%). High-level evidence (Cochrane reviews or publications of one or more randomized controlled clinical trials) favoring efficacy of physiotherapy was considered available by 33% of the participants, whereas 43% replied ''no'' and 24% did not know. Finally, excluding the costs of the intervention, 39% of the participants reported that Spa-therapy might reduce health care costs as usage of NSAIDs, physician visits and ability to work or sick leave, whereas 26% said ''no'' and 35% did not know. The international ASAS experts hold a favorable opinion on the efficacy of physiotherapy in AS, including group exercises and spa therapy, almost irrespective of disease duration and type of articular involvement (axial/peripheral). Awareness of published evidence on physiotherapy in AS is unsatisfactory.

Exposure of the developing heart to diabetic environment and early cardiac assessment: A review.

PubMed

Asoglu, Mehmet R; Gabbay-Benziv, Rinat; Turan, Ozhan M; Turan, Sifa

2018-02-01

Hyperglycemia during organogenesis is associated with an increased risk of congenital cardiac defects (CHDs). The pathophysiology leading to CHDs is not completely uncovered. However, elevated oxidative stress is considered to be the primary trigger that causes CHDs in fetuses of diabetic mothers. Maternal diabetes has been found to increase the risk for all types of CHDs. Diabetes may also impact the fetal cardiac performance at all gestational ages. Early detection of CHDs has certain advantages, such as making early decision about termination of pregnancy, enabling early genetic testing, and early reassurance if scan is normal. Combined transabdominal and transvaginal approach at 13-14 weeks of gestation is a reasonable strategy to assess fetal heart in diabetic women. Diagnostic accuracy of early fetal echocardiography has reached to above a reasonable cutoff when it is done in the late first trimester or early second trimester in the hands of expert sonographers. However, the literature is less certain to provide a firm conclusion about functional heart assessment in fetuses of diabetic mothers. © 2018 Wiley Periodicals, Inc.

Non-pharmaceutical public health interventions for pandemic influenza: an evaluation of the evidence base.

PubMed

Aledort, Julia E; Lurie, Nicole; Wasserman, Jeffrey; Bozzette, Samuel A

2007-08-15

In an influenza pandemic, the benefit of vaccines and antiviral medications will be constrained by limitations on supplies and effectiveness. Non-pharmaceutical public health interventions will therefore be vital in curtailing disease spread. However, the most comprehensive assessments of the literature to date recognize the generally poor quality of evidence on which to base non-pharmaceutical pandemic planning decisions. In light of the need to prepare for a possible pandemic despite concerns about the poor quality of the literature, combining available evidence with expert opinion about the relative merits of non-pharmaceutical interventions for pandemic influenza may lead to a more informed and widely accepted set of recommendations. We evaluated the evidence base for non-pharmaceutical public health interventions. Then, based on the collective evidence, we identified a set of recommendations for and against interventions that are specific to both the setting in which an intervention may be used and the pandemic phase, and which can be used by policymakers to prepare for a pandemic until scientific evidence can definitively respond to planners' needs. Building on reviews of past pandemics and recent historical inquiries, we evaluated the relative merits of non-pharmaceutical interventions by combining available evidence from the literature with qualitative and quantitative expert opinion. Specifically, we reviewed the recent scientific literature regarding the prevention of human-to-human transmission of pandemic influenza, convened a meeting of experts from multiple disciplines, and elicited expert recommendation about the use of non-pharmaceutical public health interventions in a variety of settings (healthcare facilities; community-based institutions; private households) and pandemic phases (no pandemic; no US pandemic; early localized US pandemic; advanced US pandemic). The literature contained a dearth of evidence on the efficacy or effectiveness of most non-pharmaceutical interventions for influenza. In an effort to inform decision-making in the absence of strong scientific evidence, the experts ultimately endorsed hand hygiene and respiratory etiquette, surveillance and case reporting, and rapid viral diagnosis in all settings and during all pandemic phases. They also encouraged patient and provider use of masks and other personal protective equipment as well as voluntary self-isolation of patients during all pandemic phases. Other non-pharmaceutical interventions including mask-use and other personal protective equipment for the general public, school and workplace closures early in an epidemic, and mandatory travel restrictions were rejected as likely to be ineffective, infeasible, or unacceptable to the public. The demand for scientific evidence on non-pharmaceutical public health interventions for influenza is pervasive, and present policy recommendations must rely heavily on expert judgment. In the absence of a definitive science base, our assessment of the evidence identified areas for further investigation as well as non-pharmaceutical public health interventions that experts believe are likely to be beneficial, feasible and widely acceptable in an influenza pandemic.

The Role of Functionality in the Mental Representations of Engineering Students: Some Differences in the Early Stages of Expertise

ERIC Educational Resources Information Center

Moss, Jarrod; Kotovsky, Kenneth; Cagan, Jonathan

2006-01-01

As engineers gain experience and become experts in their domain, the structure and content of their knowledge changes. Two studies are presented that examine differences in knowledge representation among freshman and senior engineering students. The first study examines recall of mechanical devices and chunking of components, and the second…

The Emergent Writing Development of Urban Latino Preschoolers: Developmental Perspectives and Instructional Environments for Second-Language Learners

ERIC Educational Resources Information Center

Yaden, David B.; Tardibuono, Joan M.

2004-01-01

This article reports on a study using Piagetian clinical methodology to examine the early writing development of 56, urban, Spanish-speaking preschoolers in a metropolitan area of the United States. In addition, the article draws upon findings by the Expert Study (Flippo, 1998) to underscore the types of instructional environments that have proven…

Utilizing a Positive Behavior Support Approach to Achieve Integrated Mental Health Services

ERIC Educational Resources Information Center

Frey, Andy; Young, Scott; Gold, Allene; Trevor, Earl

2008-01-01

Although experts in early childhood mental health services make clear the need to infuse mental health services into all program components, many have suggested that the mental health services in the majority of Head Start programs are narrowly focused and that mental health consultants are often used in limited ways (see D. J. Cohen, Solnit, &…

Building Blocks for a Strong Preschool to Early Elementary Education System. Testimony. CT-372

ERIC Educational Resources Information Center

Karoly, Lynn A.

2012-01-01

This testimony was presented before the Committe of the Whole Council of the District of Columbia on February 16, 2012. Experts in child development have long known that the earliest years of a child's life are a critical period of development across a range of domains: physical, socio-emotional, behavioral, and cognitive (Shonkoff and Phillips,…

Colloquium on Foreign Languages in the Elementary School Curriculum. Proceedings (New York, New York, September 1991).

ERIC Educational Resources Information Center

Rosenbusch, Marcia, Ed.; Kremer, Douglas, Ed.

A colloquium convened at the Deutsches Haus in New York is summarized that brought together experts to discuss (1) the significance foreign languages have for other elementary school subjects, and (2) what function the other subjects serve for early foreign language learning. The following six topics, guided by session leaders, provided the…

What's Wrong with America's Playgrounds and How to Fix Them: An Interview with Joe L. Frost

ERIC Educational Resources Information Center

American Journal of Play, 2008

2008-01-01

Joe L. Frost is Parker Centennial Professor Emeritus at the University of Texas, Austin, and one of America's leading experts on play and playgrounds. In addition to having taught child development and early childhood education at Texas and several other universities, he has written or edited fifteen university-level textbooks and more than one…

'Leaner' lighting's dramatic impact.

PubMed

Kearney, Steve

2012-04-01

Steve Kearney, business manager for Newey & Eyre - Energy Saving 24/7, a team of 'energy experts' established early last year within one of the UK's leading distributors of electrical supplies, discusses the technologies and simple measures now available to reduce emissions and cut wastage generated by lighting in healthcare facilities, at a time when the NHS, especially, is under increasing pressure to reduce its carbon footprint.

The Impact of Interactive Whiteboard Technology on Medical Students' Achievement in ESL Essay Writing: An Early Study in Egypt

ERIC Educational Resources Information Center

Albaaly, Emad; Higgins, Steven

2012-01-01

This study investigated the impact of the interactive whiteboard on Egyptian medical students' achievement in essay writing in English as a second language (ESL). First, the writing micro-skills judged essential to help these students improve their essay writing were identified, using a questionnaire which investigated experts' views. This gave…

Summary report of the First International Workshop on PET/MR imaging, March 19-23, 2012, Tübingen, Germany.

PubMed

Bailey, Dale L; Barthel, Henryk; Beyer, Thomas; Boellaard, Ronald; Gückel, Brigitte; Hellwig, Dirk; Herzog, Hans; Pichler, Bernd J; Quick, Harald H; Sabri, Osama; Scheffler, Klaus; Schlemmer, Heinz P; Schwenzer, Nina F; Wehrl, Hans F

2013-08-01

We report from the First International Workshop on positron emission tomography/magnetic resonance imaging (PET/MRI) that was organized by the University of Tübingen in March 2012. Approximately 100 imaging experts in MRI, PET and PET/computed tomography (CT), among them early adopters of pre-clinical and clinical PET/MRI technology, gathered from March 19 to 24, 2012 in Tübingen, Germany. The objective of the workshop was to provide a forum for sharing first-hand methodological and clinical know-how and to assess the potential of combined PET/MRI in various applications from pre-clinical research to scientific as well as clinical applications in humans. The workshop was comprised of pro-active sessions including tutorials, specific discussion panels and grand rounds. Pre-selected experts moderated the sessions, and feedback from the subsequent discussions is presented here to a greater readership. Naturally, the summaries provided herein are subjective descriptions of the hopes and challenges of PET/MR imaging as seen by the workshop attendees at a very early point in time of adopting PET/MRI technology and, as such, represent only a snapshot of current approaches.

The Renewed Promise of Medical Informatics

PubMed Central

2016-01-01

Summary The promise of the field of Medical Informatics has been great and its impact has been significant. In 1999, the Yearbook editors of the International Medical Informatics Association (IMIA) - also the authors of the present paper - sought to assess this impact by selecting a number of seminal papers in the field, and asking experts to comment on these articles. In particular, it was requested whether and how the expectations, represented by these papers, had been fulfilled since their publication several decades earlier. Each expert was also invited to comment on what might be expected in the future. In the present paper, these areas are briefly reviewed again. Where did these early papers have an impact and where were they not as successful as originally expected? It should be noted that the extraordinary developments in computer technology observed in the last two decades could not have been foreseen by these early researchers. In closing, some of the possibilities and limitations of research in medical informatics are outlined in the context of a framework that considers six levels of computer applications in medicine and health care. For each level, some predictions are made for the future, concluded with thoughts on fruitful areas for ongoing research in the field. PMID:27199195

The Renewed Promise of Medical Informatics.

PubMed

van Bemmel, J H; McCray, A T

2016-05-20

The promise of the field of Medical Informatics has been great and its impact has been significant. In 1999, the Yearbook editors of the International Medical Informatics Association (IMIA) - also the authors of the present paper - sought to assess this impact by selecting a number of seminal papers in the field, and asking experts to comment on these articles. In particular, it was requested whether and how the expectations, represented by these papers, had been fulfilled since their publication several decades earlier. Each expert was also invited to comment on what might be expected in the future. In the present paper, these areas are briefly reviewed again. Where did these early papers have an impact and where were they not as successful as originally expected? It should be noted that the extraordinary developments in computer technology observed in the last two decades could not have been foreseen by these early researchers. In closing, some of the possibilities and limitations of research in medical informatics are outlined in the context of a framework that considers six levels of computer applications in medicine and health care. For each level, some predictions are made for the future, concluded with thoughts on fruitful areas for ongoing research in the field.

Development of the Communication Complexity Scale

PubMed Central

Brady, Nancy C.; Fleming, Kandace; Thiemann-Bourque, Kathy; Olswang, Lesley; Dowden, Patricia; Saunders, Muriel D.

2011-01-01

Accurate description of an individual's communication status is critical in both research and practice. Describing the communication status of individuals with severe intellectual and developmental disabilities is difficult because these individuals often communicate with presymbolic means that may not be readily recognized. Our goal was to design a communication scale and summary score for interpretation that could be applied across populations of children and adults with limited (often presymbolic) communication forms. Methods The Communication Complexity Scale (CCS) was developed by a team of researchers and tested with 178 participants with varying levels of presymbolic and early symbolic communication skills. Correlations between standardized and informant measures were completed, and expert opinions were obtained regarding the CCS. Results CCS scores were within expected ranges for the populations studied and inter-rater reliability was high. Comparison across other measures indicated significant correlations with standardized tests of language. Scores on informant report measures tended to place children at higher levels of communication. Expert opinions generally favored the development of the CCS. Clinical implications The scale appears to be useful for describing a given individual's level of presymbolic or early symbolic communication. Further research is needed to determine if it is sensitive to developmental growth in communication. PMID:22049404

[Side Effects of Modernity : Dam Building, Health Care, and the Construction of Power in the Context of the Control of Schistosomiasis in Egypt in the 1960s and early 1970s].

PubMed

Brendel, Benjamin

2017-09-01

This article analyzes the modernization campaigns in Egypt in the 1960s and early 1970s. The regulation of the Nile by the Aswan High Dam and the resulting irrigation projects caused the rate of schistosomiasis infestation in the population to rise. The result was a discourse between experts from the global north and Egyptian elites about modernization, development aid, dam building and health care. The fight against schistosomiasis was like a cipher, which combined different power-laden concepts and arguments. This article will decode the cipher and allow a deeper look into the contemporary dimensions of power bound to this subject. The text is conceived around three thematic axes. The first deals with the discursive interplay of modernization, health and development aid in and for Egypt. The second focuses on far-reaching and long-standing arguments within an international expert discourse about these concepts. Finally, the third presents an exemplary case study of West German health and development aid for fighting schistosomiasis in the Egyptian Fayoum oasis.

Ares Project Overview - Quality in Design

NASA Technical Reports Server (NTRS)

Cianciola, Chris; Crane, Kenneth

2008-01-01

This presentation introduces the audience to the overall goals of the Ares Project, which include providing human access to low-Earth orbit, the Moon, and beyond. The presentation also provides an overview of with the vehicles that will execute those goals and progress made on the vehicles to date. The briefing will provide an introduction to Lean, Six Sigma, and Kaizen practices Ares will use to improve the overall effectiveness and quality of its efforts. Finally, the briefing includes a summary of Safety and Mission Assurance practices being implemented within[Ares to ensure safety and quality early in the design process. Integrating Safety and Mission Assurance in Design: This presentation describes how the Ares Projects are learning from the successes and failures of previous launch systems in order to maximize safety and reliability while maintaining fiscal responsibility. The Ares Projects are integrating Safer T and Mission Assurance into design activities and embracing independent assessments by Quality experts in thorough reviews of designs and processes. Incorporating Lean thinking into the design process, Ares is also streamlining existing processes and future manufacturing flows which will yield savings during production. Understanding the value of early involvement of Quality experts, the Ares Projects are leading launch vehicle development into the 21st century.

Review of FEWS NET Biophysical Monitoring Requirements

NASA Technical Reports Server (NTRS)

Ross, K. W.; Brown, Molly E.; Verdin, J.; Underwood, L. W.

2009-01-01

The Famine Early Warning System Network (FEWS NET) provides monitoring and early warning support to decision makers responsible for responding to famine and food insecurity. FEWS NET transforms satellite remote sensing data into rainfall and vegetation information that can be used by these decision makers. The National Aeronautics and Space Administration has recently funded activities to enhance remote sensing inputs to FEWS NET. To elicit Earth observation requirements, a professional review questionnaire was disseminated to FEWS NET expert end-users: it focused upon operational requirements to determine additional useful remote sensing data and; subsequently, beneficial FEWS NET biophysical supplementary inputs. The review was completed by over 40 experts from around the world, enabling a robust set of professional perspectives to be gathered and analyzed rapidly. Reviewers were asked to evaluate the relative importance of environmental variables and spatio-temporal requirements for Earth science data products, in particular for rainfall and vegetation products. The results showed that spatio-temporal resolution requirements are complex and need to vary according to place, time, and hazard: that high resolution remote sensing products continue to be in demand, and that rainfall and vegetation products were valued as data that provide actionable food security information.

Catalyzing Novel Approaches to Rapid, Accurate, and Affordable Early Cancer Detection.

PubMed

Dhar, Asif; Meagher, Beth; Ryscavage, Andrew

Inspired by the Cancer Moonshot, a dedicated team of professionals worked with leaders across the cancer ecosystem to look for an opportunity to radically reduce cancer mortality globally by focusing on early cancer detection. After an initial survey of cancer innovation, progress, and pitfalls, the team believed that if new rapid, affordable, and accurate early detection solutions were appropriately brought to market, it would be possible to intervene earlier when cancer is most treatable.An extensive process began, informed by dozens of experts in the cancer ecosystem. The Cancer XPRIZE team designed a prize competition where "the winning team will develop a means to rapidly, accurately, and affordably screen for early cancers where intervention can reduce human suffering."The following outlines the Cancer XPRIZE's experience using a powerful approach-the radical prize design-to catch more cancers in time to make a difference saving lives, dollars, and suffering.

Improvements in diagnostic tools for early detection of psoriatic arthritis.

PubMed

D'Angelo, Salvatore; Palazzi, Carlo; Gilio, Michele; Leccese, Pietro; Padula, Angela; Olivieri, Ignazio

2016-11-01

Psoriatic arthritis (PsA) is a heterogeneous chronic inflammatory disease characterized by a wide clinical spectrum. The early diagnosis of PsA is currently a challenging topic. Areas covered: The literature was extensively reviewed for studies addressing the topic area "diagnosis of psoriatic arthritis". This review will summarize improvements in diagnostic tools, especially referral to the rheumatologist, the role of patient history and clinical examination, laboratory tests, and imaging techniques in getting an early and correct diagnosis of PsA. Expert commentary: Due to the heterogeneity of its expression, PsA may be easily either overdiagnosed or underdiagnosed. A diagnosis of PsA should be taken into account every time a patient with psoriasis or a family history of psoriasis shows peripheral arthritis, especially if oligoarticular or involving the distal interphalangeal joints, enthesitis or dactylitis. Magnetic resonance imaging and ultrasonography are useful for diagnosing PsA early, particularly when isolated enthesitis or inflammatory spinal pain occur.

Quality Control of Involved Field Radiotherapy in Patients With Early-Favorable (HD10) and Early-Unfavorable (HD11) Hodgkin's Lymphoma: An Analysis of the German Hodgkin Study Group

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

Eich, Hans Theodor; Engenhart-Cabillic, Rita; Hansemann, Katja

2008-08-01

Purpose: The German Hodgkin Study Group (GHSG) set up a radiotherapy (RT) reference center within the Department of Radiation Oncology at University of Cologne to undertake quality assurance of the group's clinical studies. In the HD10 trial (early-favorable stages) and HD11 trial (early-unfavorable stages) all patients received involved field (IF)-RT (30 Gy vs. 20 Gy) within a combined-modality approach. For these patients a central prospective review of all diagnostic imaging was performed by expert radiation oncologists to control disease extension and to define IF treatment volume. Methods and Materials: On the basis of simulation films, verification films, and radiotherapy casemore » report form (CRF) an expert panel evaluated retrospectively the adequacy of irradiated IF treatment portals according to the RT prescription, applied radiation doses, treatment time, and technical parameters. Results: Between 1999 and 2006 a total of 825 of 1370 randomized patients of the HD10 trial (60%) and 954 of 1422 patients of the HD11 trial (67%) were evaluated by the panel. Radiotherapy was rated as suboptimal in 47% of all reviewed cases. Although the participating RT centers received a precise RT prescription, most difficulties occurred in the adequate coverage of the IF (40%), followed by technical faults (12%). Deviations from the prescribed single daily dose (1.8-2 Gy), weekly dose, and total reference dose were rare (1%). Conclusions: As a consequence of these findings, radiation oncologists were trained on the definition of IF-RT at GHSG meetings and at the annual meetings of the German Society for Therapeutic Radiation Oncology. Possible correlations between RT quality and relapse rate will be investigated.« less

Beyond the false negative rate: development of quality indicators for sentinel lymph node biopsy in breast cancer.

PubMed

Quan, May Lynn; Wells, Bryan J; McCready, David; Wright, Frances C; Fraser, Novlette; Gagliardi, Anna R

2010-02-01

Sentinel lymph node biopsy (SNLB) has been adopted as the standard method of axillary staging for women with clinically node-negative early-stage breast cancer. The false negative rate as a quality indicator is impractical given the need for a completion axillary dissection to calculate. The objective of this study was to develop practical quality indicators for SLNB using an expert consensus method and to determine if they were feasible to measure. We used a modified Delphi consensus process to develop quality indicators for SLNB. A multidisciplinary expert panel reviewed potential indicators extracted from the medical literature to select quality indicators that were relevant and measurable. Feasibility was determined by abstracting the quality indicator variables from a retrospective chart review. The expert panel prioritized 11 quality indicators as benchmarks for assessing the quality of surgical care in SNLB. Nine of the indicators were measurable at the chart or institutional level. A systematic evidence- and consensus-based approach was used to develop measurable quality indicators that could be used by practicing surgeons and administrators to evaluate performance of SLNB in breast cancer.

The influence of spatial ability and experience on performance during spaceship rendezvous and docking.

PubMed

Du, Xiaoping; Zhang, Yijing; Tian, Yu; Huang, Weifen; Wu, Bin; Zhang, Jingyu

2015-01-01

Manual rendezvous and docking (manual RVD) is a challenging space task for astronauts. Previous research showed a correlation between spatial ability and manual RVD skills among participants at early stages of training, but paid less attention to experts. Therefore, this study tried to explore the role of spatial ability in manual RVD skills in two groups of trainees, one relatively inexperienced and the other experienced operators. Additionally, mental rotation has been proven essential in RVD and was tested in this study among 27 male participants, 15 novices, and 12 experts. The participants performed manual RVD tasks in a high fidelity simulator. Results showed that experience moderated the relation between mental rotation ability and manual RVD performance. On one hand, novices with high mental rotation ability tended to perform that RVD task more successfully; on the other hand, experts with high mental rotation ability showed not only no performance advantage in the final stage of the RVD task, but had certain disadvantages in their earlier processes. Both theoretical and practical implications were discussed.

The influence of spatial ability and experience on performance during spaceship rendezvous and docking

PubMed Central

Du, Xiaoping; Zhang, Yijing; Tian, Yu; Huang, Weifen; Wu, Bin; Zhang, Jingyu

2015-01-01

Manual rendezvous and docking (manual RVD) is a challenging space task for astronauts. Previous research showed a correlation between spatial ability and manual RVD skills among participants at early stages of training, but paid less attention to experts. Therefore, this study tried to explore the role of spatial ability in manual RVD skills in two groups of trainees, one relatively inexperienced and the other experienced operators. Additionally, mental rotation has been proven essential in RVD and was tested in this study among 27 male participants, 15 novices, and 12 experts. The participants performed manual RVD tasks in a high fidelity simulator. Results showed that experience moderated the relation between mental rotation ability and manual RVD performance. On one hand, novices with high mental rotation ability tended to perform that RVD task more successfully; on the other hand, experts with high mental rotation ability showed not only no performance advantage in the final stage of the RVD task, but had certain disadvantages in their earlier processes. Both theoretical and practical implications were discussed. PMID:26236252

An initial reliability and validity study of the Interaction, Communication, and Literacy Skills Audit.

PubMed

El-Choueifati, Nisrine; Purcell, Alison; McCabe, Patricia; Heard, Robert; Munro, Natalie

2014-06-01

Early childhood educators (ECEs) have an important role in promoting positive outcomes for children's language and literacy development. This paper reports the development of a new tool, The Interaction Communication and Literacy (ICL) Skills Audit, and pilots its reliability and validity. Intra- and inter-rater reliability was examined by three speech-language pathologists (SLPs). Five skill areas relating to ECE language and literacy practice were rated. The face and content validity of the ICL Skills Audit was examined by expert SLPs (n = 8) and expert ECEs (n = 4) via questionnaire. The overall intra-rater reliability for the ICL Skills Audit was excellent with percentage close agreement (PCA) of 91-94. Inter-rater agreement was PCA 68-80. Expert SLPs and ECEs agreed that the content was comprehensive and practical. Based on this preliminary study, the ICL Skills Audit appears to be a promising tool that can be used by SLPs and ECEs in collaboration to measure the skills of ECEs in the areas of language and literacy support. Future psychometric and outcome research on the revised ICL Skills Audit is warranted.

Cutaneous chemical burns: assessment and early management.

PubMed

Gnaneswaran, Neiraja; Perera, Eshini; Perera, Marlon; Sawhney, Raja

2015-03-01

Chemical burns are common and may cause significant physical, psychological, social and economic burden. Despite a wide variety of potentially harmful chemicals, important general principals may be drawn in the assessment and initial management of such injuries. Early treatment of chemical burns is crucial and may reduce the period of resulting morbidity. This article reviews the assessment and management of cutaneous chemical burns. Assessment of the patient should be rapid and occur in conjunction with early emergency management. Rapid history and pri-mary and secondary survey may be required to exclude systemic side effects of the injury. Depth of wound assessment is difficult given that necrosis caused by various chemicals can continue despite cessation of exposure. Early management should be conducted with consideration of clinician's safety, and appropriate precautions should be taken. Excluding specific situations and chemical exposure, copious irrigation with water remains the mainstay of early management. Referral to a centre of higher acuity may be required for expert evaluation.

Expert consensus v. evidence-based approaches in the revision of the DSM.

PubMed

Kendler, K S; Solomon, M

2016-08-01

The development of DSM-III through DSM-5 has relied heavily on expert consensus. In this essay, we provide an historical and critical perspective on this process. Over the last 40 years, medicine has struggled to find appropriate methods for summarizing research results and making clinical recommendations. When such recommendations are issued by authorized organizations, they can have widespread influence (i.e. DSM-III and its successors). In the 1970s, expert consensus conferences, led by the NIH, reviewed research about controversial medical issues and successfully disseminated results. However, these consensus conferences struggled with aggregating the complex available evidence. In the 1990s, the rise of evidence-based medicine cast doubt on the reliability of expert consensus. Since then, medicine has increasingly relied on systematic reviews, as developed by the evidence-based medicine movement, and advocated for their early incorporation in expert consensus efforts. With the partial exception of DSM-IV, such systematic evidence-based reviews have not been consistently integrated into the development of the DSMs, leaving their development out of step with the larger medical field. Like the recommendations made for the NIH consensus conferences, we argue that the DSM process should be modified to require systematic evidence-based reviews before Work Groups make their assessments. Our suggestions - which would require leadership and additional resources to set standards for appropriate evidence hierarchies, carry out systematic reviews, and upgrade the group process - should improve the objectivity of the DSM, increase the validity of its results, and improve the reception of any changes in nosology.

Progression-free survival in advanced ovarian cancer: a Canadian review and expert panel perspective

PubMed Central

Oza, A.M.; Castonguay, V.; Tsoref, D.; Diaz–Padilla, I.; Karakasis, K.; Mackay, H.; Welch, S.; Weberpals, J.; Hoskins, P.; Plante, M.; Provencher, D.; Tonkin, K.; Covens, A.; Ghatage, P.; Gregoire, J.; Hirte, H.; Miller, D.; Rosen, B.; Maroun, J.; Buyse, M.; Coens, C.; Brady, M.F.; Stuart, G.C.E.

2011-01-01

Ovarian cancer is leading cause of gynecologic cancer mortality in Canada. To date, overall survival (os) has been the most-used endpoint in oncology trials because of its relevance and objectivity. However, as a result of various factors, including the pattern of sequential salvage therapies, measurement of os and collection of os data are becoming particularly challenging. Phase ii and iii trials have therefore adopted progression-free survival (pfs) as a more convenient surrogate endpoint; however, the clinical significance of pfs remains unclear. This position paper presents discussion topics and findings from a pan-Canadian meeting of experts that set out to evaluate the relevance of pfs as a valid endpoint in ovarian cancer;reach a Canadian consensus on the relevance of pfs in ovarian cancer; andtry to address how pfs translates into clinical benefit in ovarian cancer. Overall, the findings and the group consensus posit that future studies should ensure that trials are designed to evaluate pfs, os, and other clinically relevant endpoints such as disease-related symptoms or quality of life;incorporate interim futility analyses intended to stop accrual early when the experimental regimen is not active;stop trials early to declare superiority only when compelling evidence suggests that a new treatment provides benefit for a pre-specified, clinically relevant endpoint such as os or symptom relief; anddiscourage early release of secondary endpoint results when such a release might increase the frequency of crossover to the experimental intervention. PMID:21969808

Pediatric Sepsis Guidelines: Summary for resource-limited countries

PubMed Central

Khilnani, Praveen; Singhi, Sunit; Lodha, Rakesh; Santhanam, Indumathi; Sachdev, Anil; Chugh, Krishan; Jaishree, M.; Ranjit, Suchitra; Ramachandran, Bala; Ali, Uma; Udani, Soonu; Uttam, Rajiv; Deopujari, Satish

2010-01-01

Justification: Pediatric sepsis is a commonly encountered global issue. Existing guidelines for sepsis seem to be applicable to the developed countries, and only few articles are published regarding application of these guidelines in the developing countries, especially in resource-limited countries such as India and Africa. Process: An expert representative panel drawn from all over India, under aegis of Intensive Care Chapter of Indian Academy of Pediatrics (IAP) met to discuss and draw guidelines for clinical practice and feasibility of delivery of care in the early hours in pediatric patient with sepsis, keeping in view unique patient population and limited availability of equipment and resources. Discussion included issues such as sepsis definitions, rapid cardiopulmonary assessment, feasibility of early aggressive fluid therapy, inotropic support, corticosteriod therapy, early endotracheal intubation and use of positive end expiratory pressure/mechanical ventilation, initial empirical antibiotic therapy, glycemic control, and role of immunoglobulin, blood, and blood products. Objective: To achieve a reasonable evidence-based consensus on the basis of published literature and expert opinion to formulating clinical practice guidelines applicable to resource-limited countries such as India. Recommendations: Pediatric sepsis guidelines are presented in text and flow chart format keeping resource limitations in mind for countries such as India and Africa. Levels of evidence are indicated wherever applicable. It is anticipated that once the guidelines are used and outcomes data evaluated, further modifications will be necessary. It is planned to periodically review and revise these guidelines every 3–5 years as new body of evidence accumulates. PMID:20606908

Opportunities for Public Health Communication, Intervention, and Future Research on Breast Cancer in Younger Women

PubMed Central

Buchanan, Natasha; Roland, Katherine B.; Rodriguez, Juan L.; Miller, Jacqueline W.; Fairley, Temeika

2015-01-01

Background Approximately 6% of breast cancers in the United States occur in women under the age of 40 years. Compared with women ≥ 40 years of age, younger women are diagnosed at later stages, have higher rates of recurrence and death, and may be predisposed to secondary breast or ovarian cancer. An informal meeting of experts discussed opportunities for research and public health communication related to breast cancer among young (< 40 and/or premenopausal) women. Methods In September 2011, the Centers for Disease Control and Prevention hosted 18 experts in oncology, genetics, behavioral science, survivorship and advocacy, public health, communication, ethics, nutrition, physical activity, and environmental health. They (1) reviewed research and programmatic knowledge on risk and preventive factors, early detection, and survivorship; and (2) discussed ideas for research, communication, and programmatic efforts related to young women diagnosed with or at risk for early onset breast cancer. Results Levels of evidence and themes for future research regarding risk and preventive factors, including exposures, were discussed. Early detection strategies, including screening, risk assessment, and genetic counseling, as well as survivorship issues, follow-up care, fertility and reproductive health, and psychosocial care were highlighted. Conclusion Community and academic researchers, providers, advocates, and the federal public health community discussed strategies and opportunities for this unique population. Although the evidence is limited, future research and communication activities may be useful to organize future public health initiatives. PMID:23514347

Self-management and skills acquisition in boys with haemophilia.

PubMed

Khair, Kate; Meerabeau, Liz; Gibson, Faith

2015-10-01

There is an increasing prevalence of children/young people with long-term conditions (LTC) in the UK due to improvements in health-care management and delivery. These children are often involved, from an early age, in their own care and management; yet, there are little data to support how or when they develop the necessary skills and knowledge to become competent at this care. This study aimed to understand self-management of haemophilia, from a child's perspective, in the 21st century in the UK where intensive prophylactic therapy is given from early childhood. A qualitative study using grounded theory to evaluate life-experiences of children and young people with haemophilia. Thirty boys aged 4-16 with severe haemophilia treated at a single paediatric haemophilia care centre were interviewed at home or in a focus group. Multimethod qualitative research including age-appropriate research tools (draw and write, photo-elicitation and interviews) to facilitate data collection from children. Boys develop self-management skills over time. They learn from health-care professionals, their parents and other family members with haemophilia. Self-management skills (bleed recognition, self-infusion, self and medicines management, pain and risk management and conceptualizing preventative therapy) are developed through experiential learning and individualized education, and not through formalized expert patient programmes. The boys in this study have benefited from early prophylactic factor replacement therapy. They develop skills in haemophilia and self-management at a relatively young age and are experts in their own haemophilia care. © 2013 John Wiley & Sons Ltd.

Implementation of the IHR Joint External Evaluation: Taiwan's Experiences.

PubMed

Lo, Yi-Chun

In February 2016, the World Health Organization developed the Joint External Evaluation (JEE) tool to independently assess country capacity to prevent, detect, and respond to public health threats as part of the International Health Regulations (IHR) (2005) monitoring and evaluation framework. In light of this, the Taiwan government actively engaged at least 19 government agencies or institutions and voluntarily implemented the JEE. An External Assessment Team consisting of 6 US subject matter experts conducted the external evaluation, including site visits, from June 21 to July 1, 2016. The results, published on October 18, 2016, are useful and will be translated into actions and change in the system. Based on Taiwan's experiences, early stakeholder engagement and an experts' pre-JEE pilot visit would contribute to a successful JEE process.

Assessing and Evaluating Multidisciplinary Translational Teams: A Mixed Methods Approach

PubMed Central

Wooten, Kevin C.; Rose, Robert M.; Ostir, Glenn V.; Calhoun, William J.; Ameredes, Bill T.; Brasier, Allan R.

2014-01-01

A case report illustrates how multidisciplinary translational teams can be assessed using outcome, process, and developmental types of evaluation using a mixed methods approach. Types of evaluation appropriate for teams are considered in relation to relevant research questions and assessment methods. Logic models are applied to scientific projects and team development to inform choices between methods within a mixed methods design. Use of an expert panel is reviewed, culminating in consensus ratings of 11 multidisciplinary teams and a final evaluation within a team type taxonomy. Based on team maturation and scientific progress, teams were designated as: a) early in development, b) traditional, c) process focused, or d) exemplary. Lessons learned from data reduction, use of mixed methods, and use of expert panels are explored. PMID:24064432

Knowledge based systems: A preliminary survey of selected issues and techniques

NASA Technical Reports Server (NTRS)

Dominick, Wayne D. (Editor); Kavi, Srinu

1984-01-01

It is only recently that research in Artificial Intelligence (AI) is accomplishing practical results. Most of these results can be attributed to the design and use of expert systems (or Knowledge-Based Systems, KBS) - problem-solving computer programs that can reach a level of performance comparable to that of a human expert in some specialized problem domain. But many computer systems designed to see images, hear sounds, and recognize speech are still in a fairly early stage of development. In this report, a preliminary survey of recent work in the KBS is reported, explaining KBS concepts and issues and techniques used to construct them. Application considerations to construct the KBS and potential KBS research areas are identified. A case study (MYCIN) of a KBS is also provided.

Region-growing approach to detect microcalcifications in digital mammograms

NASA Astrophysics Data System (ADS)

Shin, Jin-Wook; Chae, Soo-Ik; Sook, Yoon M.; Park, Dong-Sun

2001-09-01

Detecting early symptoms of breast cancer is very important to enhance the possibility of cure. There have been active researches to develop computer-aided diagnosis(CAD) systems detecting early symptoms of breast cancer in digital mammograms. An expert or a CAD system can recognize the early symptoms based on microcalcifications appeared in digital mammographic images. Microcalcifications have higher gray value than surrounding regions, so these can be detected by expanding a region from a local maximum. However the resultant image contains unnecessary elements such as noise, holes and valleys. Mathematical morphology is a good solution to delete regions that are affected by the unnecessary elements. In this paper, we present a method that effectively detects microcalcifications in digital mammograms using a combination of local maximum operation and the region-growing operation.

[Treatment of early onset scoliosis : How far can we go?].

PubMed

Studer, D; Hasler, C C; Schulze, A

2015-11-01

Recently, inconsistent definitions of early onset scoliosis (EOS) and a wide variety of treatment options have been observed. To clearly define the term EOS, to depict non-operative and operative treatment options, and to present the limitations of the boundaries of these techniques. Review of the literature, including conference presentations and expert opinions, in addition to personal experiences. Early onset scoliosis (EOS) refers to spine deformity that is present before 10 years of age, regardless of etiology. All existing operative treatment options share a high risk of complications. Therefore, non-operative treatment should act as a time-buying approach to postpone surgery. Awareness of treatment options and their specific indications, in addition to respecting each patient's individual needs and feasibilities, are crucial for the optimal outcome.

Creating More Effective Mentors: Mentoring the Mentor.

PubMed

Gandhi, Monica; Johnson, Mallory

2016-09-01

Given the diversity of those affected by HIV, increasing diversity in the HIV biomedical research workforce is imperative. A growing body of empirical and experimental evidence supports the importance of strong mentorship in the development and success of trainees and early career investigators in academic research settings, especially for mentees of diversity. Often missing from this discussion is the need for robust mentoring training programs to ensure that mentors are trained in best practices on the tools and techniques of mentoring. Recent experimental evidence shows improvement in mentor and mentee perceptions of mentor competency after structured and formalized training on best practices in mentoring. We developed a 2-day "Mentoring the Mentors" workshop at UCSF to train mid-level and senior HIV researchers from around the country [recruited mainly from Centers for AIDS Research (CFARs)] on best practices, tools and techniques of effective mentoring. The workshop content was designed using principles of Social Cognitive Career Theory (SCCT) and included training specifically geared towards working with early career investigators from underrepresented groups, including sessions on unconscious bias, microaggressions, and diversity supplements. The workshop has been held three times (September 2012, October 2013 and May 2015) with plans for annual training. Mentoring competency was measured using a validated tool before and after each workshop. Mentoring competency skills in six domains of mentoring-specifically effective communication, aligning expectations, assessing understanding, fostering independence, addressing diversity and promoting development-all improved as assessed by a validated measurement tool for participants pre- and -post the "Mentoring the Mentors" training workshops. Qualitative assessments indicated a greater awareness of the micro-insults and unconscious bias experienced by mentees of diversity and a commitment to improve awareness and mitigate these effects via the mentor-mentee relationship. Our "Mentoring the Mentors" workshop for HIV researchers/mentors offers a formal and structured curriculum on best practices, tools and techniques of effective mentoring, and methods to mitigate unconscious bias in the mentoring relationship. We found quantitative and qualitative improvements in mentoring skills as assessed by self-report by participants after each workshop and plan additional programs with longitudinal longer-term assessments focused on objective mentee outcomes (grants, papers, academic retention). Mentoring training can improve mentoring skills and is likely to improve outcomes for optimally-mentored mentees.

Creating more effective mentors: Mentoring the mentor

PubMed Central

Gandhi, Monica; Johnson, Mallory

2016-01-01

Introduction Given the diversity of those affected by HIV, increasing diversity in the HIV biomedical research workforce is imperative. A growing body of empirical and experimental evidence supports the importance of strong mentorship in the development and success of trainees and early career investigators in academic research settings, especially for mentees of diversity. Often missing from this discussion is the need for robust mentoring training programs to ensure that mentors are trained in best practices on the tools and techniques of mentoring. Recent experimental evidence shows improvement in mentor and mentee perceptions of mentor’s competency after structured and formalized training on best practices in mentoring. Methods We developed a 2-day “Mentoring the Mentors” workshop at UCSF to train mid-level and senior HIV researchers from around the country (recruited mainly from Centers for AIDS Research (CFARs)) on best practices, tools and techniques of effective mentoring. The workshop content was designed using principles of Social Cognitive Career Theory (SCCT) and included training specific to working with early career investigators from underrepresented groups, including training on unconscious bias, microaggressions, and diversity supplements. The workshop has been held 3 times (September 2012, October 2013 and May 2015) with plans for annual training. Mentoring competency was measured using a validated tool before and after each workshop. Results Mentoring competency skills in six domains of mentoring -specifically effective communication, aligning expectations, assessing understanding, fostering independence, addressing diversity and promoting development - all improved as assessed by a validated measurement tool for participants pre- and-post the “Mentoring the Mentors” training workshops. Qualitative assessments indicated a greater awareness of the micro-insults and unconscious bias experienced by mentees of diversity and a commitment to improve awareness and mitigate these effects via the mentor-mentee relationship. Discussion Our “Mentoring the Mentors” workshop for HIV researchers/mentors offers a formal and structured curriculum on best practices, tools and techniques of effective mentoring, and methods to mitigate unconscious bias in the mentoring relationship and at the institutional level with mentees of diversity. We found quantitative and qualitative improvements in mentoring skills as assessed by self-report by participants after each workshop and plan additional programs with longitudinal longer-term assessments focused on objective mentee outcomes (grants, papers, academic retention). Mentoring training can improve mentoring skills and are likely to improve outcomes for optimally-mentored mentees. PMID:27039092

Acral melanoma detection using a convolutional neural network for dermoscopy images.

PubMed

Yu, Chanki; Yang, Sejung; Kim, Wonoh; Jung, Jinwoong; Chung, Kee-Yang; Lee, Sang Wook; Oh, Byungho

2018-01-01

Acral melanoma is the most common type of melanoma in Asians, and usually results in a poor prognosis due to late diagnosis. We applied a convolutional neural network to dermoscopy images of acral melanoma and benign nevi on the hands and feet and evaluated its usefulness for the early diagnosis of these conditions. A total of 724 dermoscopy images comprising acral melanoma (350 images from 81 patients) and benign nevi (374 images from 194 patients), and confirmed by histopathological examination, were analyzed in this study. To perform the 2-fold cross validation, we split them into two mutually exclusive subsets: half of the total image dataset was selected for training and the rest for testing, and we calculated the accuracy of diagnosis comparing it with the dermatologist's and non-expert's evaluation. The accuracy (percentage of true positive and true negative from all images) of the convolutional neural network was 83.51% and 80.23%, which was higher than the non-expert's evaluation (67.84%, 62.71%) and close to that of the expert (81.08%, 81.64%). Moreover, the convolutional neural network showed area-under-the-curve values like 0.8, 0.84 and Youden's index like 0.6795, 0.6073, which were similar score with the expert. Although further data analysis is necessary to improve their accuracy, convolutional neural networks would be helpful to detect acral melanoma from dermoscopy images of the hands and feet.

International recommendations for outpatient palliative care and prehospital palliative emergencies – a prospective questionnaire-based investigation

PubMed Central

2013-01-01

Background To determine the international recommendations and current practices for the treatment and prevention of palliative emergencies. The primary goal of the study was to gather information from experts on their nationally practised concepts. Methods One hundred and fifty self-report surveys were distributed by email to selected leading experts (palliative and emergency medical care) in Europe, North and South America, Africa, Asia, and Australia. An expert in this context was defined as an author of an article that was ranked by three reviewers as relevant to outpatient palliative and emergency medical . Results The total response rate was 61% (n = 92 experts). Survey responses were obtained from 35 different countries. The following standards in the treatment of palliative emergencies were recommended: (1) early integration of “Palliative Care Teams” (PCTs) and basic outpatient palliative care systems, (2) end-of-life discussions, (3) defined emergency medical documents, drug boxes, and “Do not attempt resuscitation” orders and (4) emergency medical training (physicians and paramedics). Conclusions This study detected structurally and nationally differences in outpatient palliative care regarding the treatment of palliative emergencies. Accordingly, these differences should be discussed and adapted to the respective specifications of individual single countries. A single established outpatient palliative emergency medical care concept may be the basis for an overall out-of-hospital palliative care system. PMID:23432905

A Risk Assessment System with Automatic Extraction of Event Types

NASA Astrophysics Data System (ADS)

Capet, Philippe; Delavallade, Thomas; Nakamura, Takuya; Sandor, Agnes; Tarsitano, Cedric; Voyatzi, Stavroula

In this article we describe the joint effort of experts in linguistics, information extraction and risk assessment to integrate EventSpotter, an automatic event extraction engine, into ADAC, an automated early warning system. By detecting as early as possible weak signals of emerging risks ADAC provides a dynamic synthetic picture of situations involving risk. The ADAC system calculates risk on the basis of fuzzy logic rules operated on a template graph whose leaves are event types. EventSpotter is based on a general purpose natural language dependency parser, XIP, enhanced with domain-specific lexical resources (Lexicon-Grammar). Its role is to automatically feed the leaves with input data.

A Composite Indicator to Assess the Quality of Care in the Management of Patients With Rheumatoid Arthritis in Outpatient Rheumatology Clinics.

PubMed

Martín-Martínez, María Auxiliadora; Andreu-Sanchez, Jose Luis; Sanchez-Alonso, Fernando; Corominas, Hector; Perez-Venegas, Jose Javier; Roman-Ivorra, Jose Andres; Alperi, Mercedes; Blanco-Alonso, Ricardo; Caliz, Rafael; Chamizo-Carmona, Eugenio; Graña-Gil, Jenaro; Hernández, Blanca; Marras, Carlos; Mazzucchelli, Ramon; Medina Luezas, Julio Antonio; Naranjo-Hernández, Antonio; Ortiz, Ana; Roselló, Rosa; Sanchez-Nievas, Ginés; Sanmartí, Raimon; Vela-Casasempere, Paloma

2017-08-05

The current guidelines in the treatment of rheumatoid arthritis (RA) include the early diagnosis and early use of disease modifying drugs to achieve remission or low disease activity level, known as "Treat to Target" (T2T). The objective of this study is to develop a composite indicator (CI) to evaluate the quality of care in the management of patients with RA, according to the T2T strategy and other general recommendations concerning the management of these patients. The phases of the construction of the CI were: 1) selection of quality criteria through expert judgment; 2) prioritization of the criteria, according to relevance and feasibility, applying the Delphi methodology (two rounds) involving 20 experts; 3) design of quality indicators; and 4) calculation of the weighted CI, using the mean value in relevance and feasibility granted by the experts. The source of information for the calculation of the CI are the medical records of patients with RA. Twelve criteria out of 37 required a second Delphi round. Thirty-one criteria were prioritized. These criteria presented a median in relevance and feasibility greater than or equal to 7.5, with an interquartile range of less than 3.5, and a level of agreement (score greater than or equal to 8) greater than or equal to 80%. The constructed CI allows us to evaluate the quality of care of patients with RA following the T2T strategy in the rheumatology units of Spanish hospitals, offering a valid and easily interpretable summary measure. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

The Use and Significance of a Research Networking System

PubMed Central

Yuan, Leslie; Daigre, John; Meeks, Eric; Nelson, Katie; Piontkowski, Cynthia; Reuter, Katja; Sak, Rachael; Turner, Brian; Weber, Griffin M; Chatterjee, Anirvan

2014-01-01

Background Universities have begun deploying public Internet systems that allow for easy search of their experts, expertise, and intellectual networks. Deployed first in biomedical schools but now being implemented more broadly, the initial motivator of these research networking systems was to enable easier identification of collaborators and enable the development of teams for research. Objective The intent of the study was to provide the first description of the usage of an institutional research “social networking” system or research networking system (RNS). Methods Number of visits, visitor location and type, referral source, depth of visit, search terms, and click paths were derived from 2.5 years of Web analytics data. Feedback from a pop-up survey presented to users over 15 months was summarized. Results RNSs automatically generate and display profiles and networks of researchers. Within 2.5 years, the RNS at the University of California, San Francisco (UCSF) achieved one-seventh of the monthly visit rate of the main longstanding university website, with an increasing trend. Visitors came from diverse locations beyond the institution. Close to 75% (74.78%, 208,304/278,570) came via a public search engine and 84.0% (210 out of a sample of 250) of these queried an individual’s name that took them directly to the relevant profile page. In addition, 20.90% (214 of 1024) visits went beyond the page related to a person of interest to explore related researchers and topics through the novel and networked information provided by the tool. At the end of the period analyzed, more than 2000 visits per month traversed 5 or more links into related people and topics. One-third of visits came from returning visitors who were significantly more likely to continue to explore networked people and topics (P<.001). Responses to an online survey suggest a broad range of benefits of using the RNS in supporting the research and clinical mission. Conclusions Returning visitors in an ever-increasing pool of visitors to an RNS are among those that display behavior consistent with using the tool to identify new collaborators or research topics. Through direct user feedback we know that some visits do result in research-enhancing outcomes, although we cannot address the scale of impact. With the rapid pace of acquiring visitors searching for individual names, the RNS is evolving into a new kind of gateway for the university. PMID:24509520

The use and significance of a research networking system.

PubMed

Kahlon, Maninder; Yuan, Leslie; Daigre, John; Meeks, Eric; Nelson, Katie; Piontkowski, Cynthia; Reuter, Katja; Sak, Rachael; Turner, Brian; Weber, Griffin M; Chatterjee, Anirvan

2014-02-07

Universities have begun deploying public Internet systems that allow for easy search of their experts, expertise, and intellectual networks. Deployed first in biomedical schools but now being implemented more broadly, the initial motivator of these research networking systems was to enable easier identification of collaborators and enable the development of teams for research. The intent of the study was to provide the first description of the usage of an institutional research "social networking" system or research networking system (RNS). Number of visits, visitor location and type, referral source, depth of visit, search terms, and click paths were derived from 2.5 years of Web analytics data. Feedback from a pop-up survey presented to users over 15 months was summarized. RNSs automatically generate and display profiles and networks of researchers. Within 2.5 years, the RNS at the University of California, San Francisco (UCSF) achieved one-seventh of the monthly visit rate of the main longstanding university website, with an increasing trend. Visitors came from diverse locations beyond the institution. Close to 75% (74.78%, 208,304/278,570) came via a public search engine and 84.0% (210 out of a sample of 250) of these queried an individual's name that took them directly to the relevant profile page. In addition, 20.90% (214 of 1024) visits went beyond the page related to a person of interest to explore related researchers and topics through the novel and networked information provided by the tool. At the end of the period analyzed, more than 2000 visits per month traversed 5 or more links into related people and topics. One-third of visits came from returning visitors who were significantly more likely to continue to explore networked people and topics (P<.001). Responses to an online survey suggest a broad range of benefits of using the RNS in supporting the research and clinical mission. Returning visitors in an ever-increasing pool of visitors to an RNS are among those that display behavior consistent with using the tool to identify new collaborators or research topics. Through direct user feedback we know that some visits do result in research-enhancing outcomes, although we cannot address the scale of impact. With the rapid pace of acquiring visitors searching for individual names, the RNS is evolving into a new kind of gateway for the university.

Inquiry into the Potential Effects of Establishing a Joint ROTC Program to Be Implemented during the Early Years of College

ERIC Educational Resources Information Center

Meyer, Herman Skeets

2012-01-01

This is the report of a policy research study that examined the potential outcomes of instituting a standardized "Joint Reserve Officer Training Corps" during the first two years of college. Focus groups at three ROTC universities and interviews with subject matter experts were conducted to explore the meaning and purpose of jointness…

Expert Systems on Multiprocessor Architectures. Phase 1

DTIC Science & Technology

1988-08-01

great rate) as early experience indicates what alternative aspect of system operation should have been monitored in any given completed run. The... system operation should have been monitored in any given completed run. The design goals that emerged then were (1) that the simulation system should...ORGANIZATION 6b OFFICE SYMBOL 7a. NAME OF MONITORING ORGANIZATION Stanford University (If applicable) Knowledge Systems Laboratory Rome Air Development

Comparison of Educational Inspectors' Role of Program Leadership in the Foundation Period of Republic of Turkey with Today

ERIC Educational Resources Information Center

Usta, Mehmet Emin

2018-01-01

From the very early periods of accepting management as a science, main goal of inspection is seen as a control mechanism. Classical management approach evaluated staff as people who need strict inspections by experts to better perform since they are perceived as unreliable and irresponsible on their duties. Later on, expertise areas related to…

[Guide for monitoring children's development in pediatric practice].

PubMed

2017-06-01

The pediatrician is the best-informed professional to whom many families look to be the expert, not only on childhood illnesses but also on development. Early identification, diagnosis and monitoring of these patients are a real challenge for physicians who serve children. This guide provides recommendations for development monitoring, evaluation, diagnosis and follow up of patients with developmental delays and disabilities. Sociedad Argentina de Pediatría.

U.S.-Iraq Agreements: Congressional Oversight Activities and Legislative Response

DTIC Science & Technology

2009-05-15

in creating the planned agreements, from negotiation to implementation, and took action to ensure such involvement. Members proposed numerous...matter experts. This has equipped Congress with information pertinent to deciding what further action can be taken to involve Congress more in the...concerning the negotiation, execution, and early implementation of the agreements; the second describes in detail the actions taken by Congress thus

The Implementation and Effects of the Mathematics Design Collaborative (MDC): Early Findings from Kentucky Ninth-Grade Algebra 1 Courses. CRESST Report 845

ERIC Educational Resources Information Center

Herman, Joan L.; Matrundola, Deborah La Torre; Epstein, Scott; Leon, Seth; Dai, Yunyun; Reber, Sarah; Choi, Kilchan

2015-01-01

With support from the Bill and Melinda Gates Foundation, researchers and experts in mathematics education developed the Mathematics Design Collaborative (MDC) as a strategy to support the transition to Common Core State Standards in math. MDC provides short formative assessment lessons known as Classroom Challenges for use in middle and high…

Institute on Outdoor Education for the Handicapped. (Battle Creek Outdoor Education Center, Clear Lake, Dowling, Michigan, June 1969).

ERIC Educational Resources Information Center

Battle Creek Public Schools, MI.

In early June 1969, 55 special education and physical education teachers and experts in outdoor education met for a week at the Battle Creek Public Schools' outdoor education center, Clear Lake Camp (Michigan). The participants shared in the camping activities of children from Battle Creek classes for the physically and mentally handicapped, deaf,…

A Moving Child Is a Learning Child: How the Body Teaches the Brain to Think (Birth to Age 7)

ERIC Educational Resources Information Center

Connell, Gill; McCarthy, Cheryl

2014-01-01

Grounded in best practices and current research, this hands-on resource connects the dots that link brain activity, motor and sensory development, movement, and early learning. The expert authors unveil the Kinetic Scale: a visual map of the active learning needs of infants, toddlers, preschoolers, and primary graders that fits each child's…

Adaptive Acquisitions: Maintaining Military Dominance By Managing Innovation

DTIC Science & Technology

2014-04-01

for the relatively unknown disruptive technologies , even for the technical experts. For example, in the early years of rocket research Jerome Hunsaker...improve along existing performance metrics.19 Since disruptive technologies generally underperform along these old value metrics, customers tend to...since the actual value of the innovation is difficult, if not impossible, to determine a priori. In fact, most of the claimed potential disruptive

Perspectives on Research in Artificial Intelligence and Artificial General Intelligence Relevant to DoD

DTIC Science & Technology

2017-01-01

3.2 Generic Network Architecture ........................................................................................ 11 3.3 Neuron Non ...The magnitude of the importance of these technologies is hard to overstate, and we thus feel that technically minded, non -expert readers should be...The result is often billions of weights and biases which need to be calculated. 13 3.3 Neuron Non -Linearity The big, early advance in

An Oral History Study of Foreign Design Experts' Influence on Taiwanese Early Design Education from 1963 to 1966

ERIC Educational Resources Information Center

Lai, Chien-Tu Jeff

2013-01-01

There are documented accounts of the influential role of U.S. aid in the development of Taiwanese design education. Missing from the historical records of design education, however, are the perspectives of local design practitioners who participated in the design workshops during the period of U.S. aid to Taiwan, 1963 to 1966. Using face-to-face…

Features of asthma which provide meaningful insights for understanding the disease heterogeneity.

PubMed

Deliu, M; Yavuz, T S; Sperrin, M; Belgrave, D; Sahiner, U M; Sackesen, C; Kalayci, O; Custovic, A

2018-01-01

Data-driven methods such as hierarchical clustering (HC) and principal component analysis (PCA) have been used to identify asthma subtypes, with inconsistent results. To develop a framework for the discovery of stable and clinically meaningful asthma subtypes. We performed HC in a rich data set from 613 asthmatic children, using 45 clinical variables (Model 1), and after PCA dimensionality reduction (Model 2). Clinical experts then identified a set of asthma features/domains which informed clusters in the two analyses. In Model 3, we reclustered the data using these features to ascertain whether this improved the discovery process. Cluster stability was poor in Models 1 and 2. Clinical experts highlighted four asthma features/domains which differentiated the clusters in two models: age of onset, allergic sensitization, severity, and recent exacerbations. In Model 3 (HC using these four features), cluster stability improved substantially. The cluster assignment changed, providing more clinically interpretable results. In a 5-cluster model, we labelled the clusters as: "Difficult asthma" (n = 132); "Early-onset mild atopic" (n = 210); "Early-onset mild non-atopic: (n = 153); "Late-onset" (n = 105); and "Exacerbation-prone asthma" (n = 13). Multinomial regression demonstrated that lung function was significantly diminished among children with "Difficult asthma"; blood eosinophilia was a significant feature of "Difficult," "Early-onset mild atopic," and "Late-onset asthma." Children with moderate-to-severe asthma were present in each cluster. An integrative approach of blending the data with clinical expert domain knowledge identified four features, which may be informative for ascertaining asthma endotypes. These findings suggest that variables which are key determinants of asthma presence, severity, or control may not be the most informative for determining asthma subtypes. Our results indicate that exacerbation-prone asthma may be a separate asthma endotype and that severe asthma is not a single entity, but an extreme end of the spectrum of several different asthma endotypes. © 2017 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd.

A transparent model of the human scala tympani cavity.

PubMed

Rebscher, S J; Talbot, N; Bruszewski, W; Heilmann, M; Brasell, J; Merzenich, M M

1996-01-01

A dimensionally accurate clear model of the human scala tympani has been produced to evaluate the insertion and position of clinically applied intracochlear electrodes for electrical stimulation. Replicates of the human scala tympani were made from low melting point metal alloy (LMA) and from polymethylmeth-acrylate (PMMA) resin. The LMA metal casts were embedded in blocks of epoxy and in clear silicone rubber. After removal of the metal alloy, a cavity was produced that accurately models the human scala tympani. Investment casting molds were made from the PMMA scala tympani casts to enable production of multiple LMA casts from which identical models were fabricated. Total dimensional distortion of the LMA casting process was less than 1% in length and 2% in diameter. The models have been successfully integrated into the design process for the iterative development of advanced intracochlear electrode arrays at UCSF. These fabrication techniques are applicable to a wide range of biomedical design problems that require modelling of visually obscured cavities.

Standardization and Optimization of Computed Tomography Protocols to Achieve Low-Dose

PubMed Central

Chin, Cynthia; Cody, Dianna D.; Gupta, Rajiv; Hess, Christopher P.; Kalra, Mannudeep K.; Kofler, James M.; Krishnam, Mayil S.; Einstein, Andrew J.

2014-01-01

The increase in radiation exposure due to CT scans has been of growing concern in recent years. CT scanners differ in their capabilities and various indications require unique protocols, but there remains room for standardization and optimization. In this paper we summarize approaches to reduce dose, as discussed in lectures comprising the first session of the 2013 UCSF Virtual Symposium on Radiation Safety in Computed Tomography. The experience of scanning at low dose in different body regions, for both diagnostic and interventional CT procedures, is addressed. An essential primary step is justifying the medical need for each scan. General guiding principles for reducing dose include tailoring a scan to a patient, minimizing scan length, use of tube current modulation and minimizing tube current, minimizing-tube potential, iterative reconstruction, and periodic review of CT studies. Organized efforts for standardization have been spearheaded by professional societies such as the American Association of Physicists in Medicine. Finally, all team members should demonstrate an awareness of the importance of minimizing dose. PMID:24589403

All-atom ensemble modeling to analyze small angle X-ray scattering of glycosylated proteins

PubMed Central

Guttman, Miklos; Weinkam, Patrick; Sali, Andrej; Lee, Kelly K.

2013-01-01

Summary The flexible and heterogeneous nature of carbohydrate chains often renders glycoproteins refractory to traditional structure determination methods. Small Angle X-ray scattering (SAXS) can be a useful tool for obtaining structural information of these systems. All-atom modeling of glycoproteins with flexible glycan chains was applied to interpret the solution SAXS data for a set of glycoproteins. For simpler systems (single glycan, with a well defined protein structure), all-atom modeling generates models in excellent agreement with the scattering pattern, and reveals the approximate spatial occupancy of the glycan chain in solution. For more complex systems (several glycan chains, or unknown protein substructure), the approach can still provide insightful models, though the orientations of glycans become poorly determined. Ab initio shape reconstructions appear to capture the global morphology of glycoproteins, but in most cases offer little information about glycan spatial occupancy. The all-atom modeling methodology is available as a webserver at http://modbase.compbio.ucsf.edu/allosmod-foxs. PMID:23473666

Dissociable executive functions in behavioral variant frontotemporal and Alzheimer dementias

PubMed Central

Feigenbaum, Dana; Rankin, Katherine P.; Smith, Glenn E.; Boxer, Adam L.; Wood, Kristie; Hanna, Sherrie M.; Miller, Bruce L.; Kramer, Joel H.

2013-01-01

Objective: The objective of this study was to determine which aspects of executive functions are most affected in behavioral variant frontotemporal dementia (bvFTD) and best differentiate this syndrome from Alzheimer disease (AD). Methods: We compared executive functions in 22 patients diagnosed with bvFTD, 26 with AD, and 31 neurologically healthy controls using a conceptually driven and comprehensive battery of executive function tests, the NIH EXAMINER battery (http://examiner.ucsf.edu). Results: The bvFTD and the AD patients were similarly impaired compared with controls on tests of working memory, category fluency, and attention, but the patients with bvFTD showed significantly more severe impairments than the patients with AD on tests of letter fluency, antisaccade accuracy, social decision-making, and social behavior. Discriminant function analysis with jackknifed cross-validation classified the bvFTD and AD patient groups with 73% accuracy. Conclusions: Executive function assessment can support bvFTD diagnosis when measures are carefully selected to emphasize frontally specific functions. PMID:23658382

The evolution of public psychiatry fellowships.

PubMed

Steiner, Jeanne L; Giggie, Marisa A; Koh, Steve; Mangurian, Christina; Ranz, Jules M

2014-12-01

The growth of Public Psychiatry Fellowships (PPFs) has reached a new developmental stage, providing a wide array of academic partnerships and educational opportunities in psychiatric leadership and administration. The authors examine the evolution of these programs and illustrate three distinct models. Data from yearly surveys and discussions with PPF directors were used to identify key similarities and areas of divergence as the programs have evolved. The first period of program expansion took place 8-10 years ago when new programs were modeled on the Columbia PPF, and key elements of that program and the American Association of Community Psychiatrists (AACP) guidelines were incorporated broadly. Examples of multiple source (Columbia), single source (Yale and UCSF), and grant-funded programs (Alabama and UCSD) are presented. A review of the current status of PPFs reveals a diversity of structures and strategies for success, which can be attributed to the range of their funding sources. The advantages and potential disadvantages of those models are outlined with respect to the educational experience and opportunities for growth and sustainability.

Determination of ubiquitin fitness landscapes under different chemical stresses in a classroom setting

PubMed Central

Mavor, David; Barlow, Kyle; Thompson, Samuel; Barad, Benjamin A; Bonny, Alain R; Cario, Clinton L; Gaskins, Garrett; Liu, Zairan; Deming, Laura; Axen, Seth D; Caceres, Elena; Chen, Weilin; Cuesta, Adolfo; Gate, Rachel E; Green, Evan M; Hulce, Kaitlin R; Ji, Weiyue; Kenner, Lillian R; Mensa, Bruk; Morinishi, Leanna S; Moss, Steven M; Mravic, Marco; Muir, Ryan K; Niekamp, Stefan; Nnadi, Chimno I; Palovcak, Eugene; Poss, Erin M; Ross, Tyler D; Salcedo, Eugenia C; See, Stephanie K; Subramaniam, Meena; Wong, Allison W; Li, Jennifer; Thorn, Kurt S; Conchúir, Shane Ó; Roscoe, Benjamin P; Chow, Eric D; DeRisi, Joseph L; Kortemme, Tanja; Bolon, Daniel N; Fraser, James S

2016-01-01

Ubiquitin is essential for eukaryotic life and varies in only 3 amino acid positions between yeast and humans. However, recent deep sequencing studies indicate that ubiquitin is highly tolerant to single mutations. We hypothesized that this tolerance would be reduced by chemically induced physiologic perturbations. To test this hypothesis, a class of first year UCSF graduate students employed deep mutational scanning to determine the fitness landscape of all possible single residue mutations in the presence of five different small molecule perturbations. These perturbations uncover 'shared sensitized positions' localized to areas around the hydrophobic patch and the C-terminus. In addition, we identified perturbation specific effects such as a sensitization of His68 in HU and a tolerance to mutation at Lys63 in DTT. Our data show how chemical stresses can reduce buffering effects in the ubiquitin proteasome system. Finally, this study demonstrates the potential of lab-based interdisciplinary graduate curriculum. DOI: http://dx.doi.org/10.7554/eLife.15802.001 PMID:27111525

Digital Tools for Cancer Prevention: Extending Reach and Engagement

Cancer.gov

Judith (Jodi) Prochaska, PhD, MPH, is Associate Professor of Medicine with the Stanford Prevention Research Center and a member of the Stanford Cancer Institute. Dr. Prochaska is a Principal Investigator on multiple research awards from the National Institutes of Health and the State of California Tobacco-Related Disease Research Program. Her research program is leveraging technology (e.g., web, text, social media) to bring tobacco cessation treatment into novel settings and to populations with high smoking prevalence. With attention to medical education and clinical practice, Dr. Prochaska has disseminated tobacco treatment curricula as part of Rx for Change (http://rxforchange.ucsf.edu). She has authored 175 peer-reviewed publications, serves on the Editorial Board of JAMA Internal Medicine, and is on the advisory board for Optum’s Quit for Life Tobacco Quitline. Dr. Prochaska is President of the Society for Research on Nicotine and Tobacco (SRNT), the international scientific society aimed at stimulating the generation and dissemination of new knowledge concerning nicotine and tobacco from bench to bedside and through to health policy.

Alzheimer’s disease and its treatment costs: case study in the Czech Republic

PubMed Central

Mohelska, Hana; Maresova, Petra; Valis, Martin; Kuca, Kamil

2015-01-01

This paper deals with the analysis of the costs, applied, for example, when treating specific diseases – an important aid in prioritizing the process of resource allocation. In our review, the specific disease is dementia caused by Alzheimer’s disease. This paper aims to provide more information on the partial costs per patient that are calculated according to the aggregated data from publicly available sources as well as from the results of authors’ own investigation. The University Hospital in Hradec Králové and the General Health Insurance Company of the Czech Republic participated in this research. The elementary research objective was to compare the costs per patient diagnosed early onset, to those of the patient diagnosed later. The Czech Republic lacks information regarding dementia. Therefore, these issues require attention. The methods used in this paper included time series analyses, methods of direct questioning, interviews with experts, and analyses of medical documentation. These methods were combined to exploit their particular advantages and to ensure the issues discussed, were covered. The investigation showed that the underpinning of patients with Alzheimer’s disease at early onset is advantageous from an economic perspective, because the cost of outpatient care is much lower compared with that of inpatient care. The international comparisons of the volume of care provided should be approached with great caution. These are based solely on the facts of various expert estimates and are not usually supported by hard data. Yet, they still illustrate the overall view of our ability to take care of people with dementia. According to experts, care in the Czech Republic significantly lags behind the rest of developed Europe. While services are provided to 26% of people with dementia in Germany and 50% in France, the experts estimate that services are provided to only 10% of the population in the Czech Republic. If we were to offer a similar volume of services in the Czech Republic, to the same extent as the average in Europe, we would have to triple the existing capacities. PMID:26396519

Alzheimer's disease and its treatment costs: case study in the Czech Republic.

PubMed

Mohelska, Hana; Maresova, Petra; Valis, Martin; Kuca, Kamil

2015-01-01

This paper deals with the analysis of the costs, applied, for example, when treating specific diseases - an important aid in prioritizing the process of resource allocation. In our review, the specific disease is dementia caused by Alzheimer's disease. This paper aims to provide more information on the partial costs per patient that are calculated according to the aggregated data from publicly available sources as well as from the results of authors' own investigation. The University Hospital in Hradec Králové and the General Health Insurance Company of the Czech Republic participated in this research. The elementary research objective was to compare the costs per patient diagnosed early onset, to those of the patient diagnosed later. The Czech Republic lacks information regarding dementia. Therefore, these issues require attention. The methods used in this paper included time series analyses, methods of direct questioning, interviews with experts, and analyses of medical documentation. These methods were combined to exploit their particular advantages and to ensure the issues discussed, were covered. The investigation showed that the underpinning of patients with Alzheimer's disease at early onset is advantageous from an economic perspective, because the cost of outpatient care is much lower compared with that of inpatient care. The international comparisons of the volume of care provided should be approached with great caution. These are based solely on the facts of various expert estimates and are not usually supported by hard data. Yet, they still illustrate the overall view of our ability to take care of people with dementia. According to experts, care in the Czech Republic significantly lags behind the rest of developed Europe. While services are provided to 26% of people with dementia in Germany and 50% in France, the experts estimate that services are provided to only 10% of the population in the Czech Republic. If we were to offer a similar volume of services in the Czech Republic, to the same extent as the average in Europe, we would have to triple the existing capacities.

Eliciting climate experts' knowledge to address model uncertainties in regional climate projections: a case study of Guanacaste, Northwest Costa Rica

NASA Astrophysics Data System (ADS)

Grossmann, I.; Steyn, D. G.

2014-12-01

Global general circulation models typically cannot provide the detailed and accurate regional climate information required by stakeholders for climate adaptation efforts, given their limited capacity to resolve the regional topography and changes in local sea surface temperature, wind and circulation patterns. The study region in Northwest Costa Rica has a tropical wet-dry climate with a double-peak wet season. During the dry season the central Costa Rican mountains prevent tropical Atlantic moisture from reaching the region. Most of the annual precipitation is received following the northward migration of the ITCZ in May that allows the region to benefit from moist southwesterly flow from the tropical Pacific. The wet season begins with a short period of "early rains" and is interrupted by the mid-summer drought associated with the intensification and westward expansion of the North Atlantic subtropical high in late June. Model projections for the 21st century indicate a lengthening and intensification of the mid-summer drought and a weakening of the early rains on which current crop cultivation practices rely. We developed an expert elicitation to systematically address uncertainties in the available model projections of changes in the seasonal precipitation pattern. Our approach extends an elicitation approach developed previously at Carnegie Mellon University. Experts in the climate of the study region or Central American climate were asked to assess the mechanisms driving precipitation during each part of the season, uncertainties regarding these mechanisms, expected changes in each mechanism in a warming climate, and the capacity of current models to reproduce these processes. To avoid overconfidence bias, a step-by-step procedure was followed to estimate changes in the timing and intensity of precipitation during each part of the season. The questions drew upon interviews conducted with the regions stakeholders to assess their climate information needs. This study is part of the FuturAgua project funded by the Belmont Freshwater Security call. The expert opinions on expected changes in the seasonal precipitation pattern are being used to inform regional efforts to build drought resilience and to create and compare alternative water management strategies with the region's stakeholders.

ART/Ada and CLIPS/Ada

NASA Technical Reports Server (NTRS)

Culbert, Chris

1990-01-01

Although they have reached a point of commercial viability, expert systems were originally developed in artificial intelligence (AI) research environments. Many of the available tools still work best in such environments. These environments typically utilize special hardware such as LISP machines and relatively unfamiliar languages such as LISP or Prolog. Space Station applications will require deep integration of expert system technology with applications developed in conventional languages, specifically Ada. The ability to apply automation to Space Station functions could be greatly enhanced by widespread availability of state-of-the-art expert system tools based on Ada. Although there have been some efforts to examine the use of Ada for AI applications, there are few, if any, existing products which provide state-of-the-art AI capabilities in an Ada tool. The goal of the ART/Ada Design Project is to conduct research into the implementation in Ada of state-of-the-art hybrid expert systems building tools (ESBT's). This project takes the following approach: using the existing design of the ART-IM ESBT as a starting point, analyze the impact of the Ada language and Ada development methodologies on that design; redesign the system in Ada; and analyze its performance. The research project will attempt to achieve a comprehensive understanding of the potential for embedding expert systems in Ada systems for eventual application in future Space Station Freedom projects. During Phase 1 of the project, initial requirements analysis, design, and implementation of the kernel subset of ART-IM functionality was completed. During Phase 2, the effort has been focused on the implementation and performance analysis of several versions with increasing functionality. Since production quality ART/Ada tools will not be available for a considerable time, and additional subtask of this project will be the completion of an Ada version of the CLIPS expert system shell developed by NASA. This tool will provide full syntactic compatibility with any eventual products of the ART/Ada design while allowing SSFP developers early access to this technology.

Expert opinion and key recommendations for the physical therapy and rehabilitation of patients with ankylosing spondylitis.

PubMed

Ozgocmen, Salih; Akgul, Ozgur; Altay, Zuhal; Altindag, Ozlem; Baysal, Ozlem; Calis, Mustafa; Capkin, Erhan; Cevik, Remzi; Durmus, Bekir; Gur, Ali; Kamanli, Ayhan; Karkucak, Murat; Madenci, Ercan; Melikoglu, Meltem A; Nas, Kemal; Senel, Kazim; Ugur, Mahir

2012-06-01

  Physiotherapy is an integral part of the management of ankylosing spondylitis (AS) and there is a need for recommendations which focus on the rehabilitation of patients with AS. We aimed to develop recommendations for the physical therapy and rehabilitation of patients with AS based on the evidence and expertise.   The Anatolian Group for the Assessment in Rheumatic Diseases (ANGARD) is a scientific group of Turkish academicians (physiatrists and rheumatologists) who are experts in the rehabilitation of patients with AS. A systematic literature search summarizing the current available physiotherapy and rehabilitation trials in AS were presented to the experts before a special 2-day meeting. Experts attending this meeting first defined a framework based on the main principles and thereafter collectively constructed six major recommendations on physiotherapy and rehabilitation in AS. After the meeting an email survey was conducted to rate the strength of the recommendations.   Six key recommendations which cover the general principles of rehabilitation in AS in terms of early intervention, initial and follow-up assessments and monitoring, contraindications and precautions, key advice for physiotherapy methods and exercise were constructed.   These recommendations were developed using evidence-based data and expert opinion. The implementation of these recommendations should encourage a more comprehensive and methodical approach in the rehabilitation of patients with AS. Regular lifelong exercise is the mainstay of rehabilitation and there is a considerable need for well-designed studies which will enlighten the role of physical therapy in the management of AS. © 2011 The Authors International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.

Using Topdown Conceptual Analysis To Accelerate The Learning Of New Domains For Knowledge Engineers & Domain Experts

NASA Astrophysics Data System (ADS)

Xuan, Albert L.; Shinghal, Rajjan

1989-03-01

As the need for knowledge-based systems increases, an increasing number of domain experts are becoming interested in taking more active part in the building of knowledge-based systems. However, such a domain expert often must deal with a large number of unfamiliar terms concepts, facts, procedures and principles based on different approaches and schools of thought. He (for brevity, we shall use masculine pronouns for both genders) may need the help of a knowledge engineer (KE) in building the knowledge-based system but may encounter a number of problems. For instance, much of the early interaction between him and the knowl edge engineer may be spent in educating each other about their seperate kinds of expertise. Since the knowledge engineer will usually be ignorant of the knowledge domain while the domain expert (DE) will have little knowledge about knowledge-based systems, a great deal of time will be wasted on these issues ad the DE and the KE train each other to the point where a fruitful interaction can occur. In some situations, it may not even be possible for the DE to find a suitable KE to work with because he has no time to train the latter in his domain. This will engender the need for the DE to be more knowledgeable about knowledge-based systems and for the KE to find methods and techniques which will allow them to learn new domains as fast as they can. In any event, it is likely that the process of building knowledge-based systems will be smooth, er and more efficient if the domain expert is knowledgeable about the methods and techniques of knowledge-based systems building.

[The importance of early diagnosis and intervention in children diagnosed with reading disorder. Case studies].

PubMed

Törö, Krisztina; Balázs, Judit

2015-06-01

Reading Disorder (RD) belongs to Specific Learning Disorders within the chapter of Neurodevelopmental Disorders in the Diagnostic and Statistic Manual of Mental Disorders 5th edition. Previous research shows that the time of the diagnosis of RD - early (before starting school) or late - has a great impact on the prognosis. In the current paper we present the cases of two children diagnosed with RD. Our cases demonstrate that if RD is diagnosed in early childhood, the child's and his/her family's quality of life can be influenced in a positive direction, while late recognition of RD might influence the child's and the family's quality of life negatively. For these reasons it is important that experts recognize RD in time, start appropriate treatment and give proper support to children diagnosed with RD and their families.

Early childhood development: putting knowledge into action.

PubMed

2000-11-01

As part of its continuing mission to serve trustees and staff of health foundations and corporate giving programs, Grantmakers In Health (GIH) convened a select group of grantmakers and national experts who have made a major commitment to improve the health and well being of young children. The roundtable explored the latest research examining early childhood development, as well as public and private programs serving families with young children. The discussion ultimately centered upon the importance of grantmaker involvement to improve early childhood development, including the services delivered to young children and their families, training for professionals, and continued research and evaluation. This report brings together key points from the day's discussion with factual information on demographic, health and human services, and public policy trends drawn from a background paper prepared for the meeting. When available, recent findings, facts, and figures have been incorporated.

The health-promoting nurse as a health policy career expert and entrepreneur.

PubMed

Whitehead, Dean

2003-11-01

A plethora of literature suggests that many nurses struggle in their attempts to develop a political role that allows them to directly influence and implement health policy activity. Nursing curricula are an integral part of ensuring that nurses are capable of taking on a more active role in initiating and developing health policy processes, through a broadening of the health promotion curriculum that focuses on socio-political approaches to health care provision. Despite this, the available literature suggests that the majority of nursing curricula are yet to fulfil this role. Such a role could be supported by attempts to define and promote a specific career route that develops nurses as health policy experts and entrepreneurs early on in their careers. This article aims to put forward a rationale for developing such a position in nursing education.

Astronomy in Buginese-Makassarese culture based on historical and ethnographical sources

NASA Astrophysics Data System (ADS)

Hasanah, N.; Suriamihardja, D. A.

2016-11-01

Our research has been looking for astronomical aspects in Buginese-Makassarese culture from historical to ethnographical sources. We found from history that astronomy had been used by Buginese - Makassar society long before Islam came to South Sulawesi at early 17th century and had their own first telescope at the time of Gowa's Prime Minister, Karaeng Pattingaloang. Meanwhile from ethnographical source, utilization of astronomy penetrated not only at Islamic calendar and worship time, but also at agriculture, sailing navigation, and weather prediction. Some of our literature were taken from Lontaraq (ancient manuscript) which now the experts are not many and old, especially in the field of astronomy. It was found that Lontaraq was using lunar period to characterize local weather [called: Pananrang]. Therefore, we need to excavate immediately more about this matter before the experts reduced in number.

Both Low Blood Glucose and Insufficient Treatment Confer Risk of Neurodevelopmental Impairment in Congenital Hyperinsulinism: A Multinational Cohort Study.

PubMed

Helleskov, Annett; Melikyan, Maria; Globa, Evgenia; Shcherderkina, Inna; Poertner, Fani; Larsen, Anna-Maria; Filipsen, Karen; Brusgaard, Klaus; Christiansen, Charlotte Dahl; Hansen, Lars Kjaersgaard; Christesen, Henrik T

2017-01-01

Congenital hyperinsulinism (CHI) is a heterogeneous disease most frequently caused by KATP-channel (ABCC8 and KCNJ11) mutations, with neonatal or later onset, variable severity, and with focal or diffuse pancreatic involvement as the two major histological types. CHI confers a high risk of neurological impairment; however, sparsely studied in larger patient series. We assessed the neurodevelopmental outcome in children with CHI at follow-up in a mixed international cohort. In two hyperinsulinism expert centers, 75 CHI patients were included (Russian, n  = 33, referred non-Scandinavian, treated in Denmark n  = 27, Scandinavian, n  = 15). Hospital files were reviewed. At follow-up, neurodevelopmental impairment and neurodevelopmental, cognitive and motor function scores were assessed. Median (range) age at follow-up was 3.7 years (3.3 months-18.2 years). Neurodevelopmental impairment was seen in 35 (47%). Impairment was associated with abnormal brain magnetic resonance imaging (MRI); odds ratio (OR) (95% CI) 15.0 (3.0-74.3), p  = 0.001; lowest recorded blood glucose ≤1 mmol/L; OR 3.8 (1.3-11.3), p  = 0.015, being non-Scandinavian patient, OR 3.8 (1.2-11.9), p  = 0.023; and treatment delay from first symptom to expert center >5 days; OR 4.0 (1.0-16.6), trend p  = 0.05. In multivariate analysis ( n  = 31) for early predictors with exclusion of brain MRI, treatment delay from first symptom to expert center >5 days conferred a significantly increased risk of neurodevelopment impairment, adjusted OR (aOR) 15.6 (1.6-146.7), p  = 0.016, while lowest blood glucose ≤1 mmol/L had a trend toward increased risk, aOR 3.5 (1.1-14.3), p  = 0.058. No associations for early vs. late disease onset, K ATP -channel mutations, disease severity, focal vs. diffuse disease, or age at follow-up were seen in uni- or multivariate analysis. Not only very low blood glucose, but also insufficient treatment as expressed by delay until expert center hospitalization, increased the risk of neurodevelopmental impairment. This novel finding calls for improvements in spread of knowledge about CHI among health-care personnel and rapid contact with an expert CHI center on suspicion of CHI.

"The Daily Grunt": Middle-Class Bias and Vested Interests in the "Getting in Early" and "Why Can't They Read?" Reports

ERIC Educational Resources Information Center

Grainger, Karen

2013-01-01

It is a long-standing and commonly held belief in the United Kingdom and elsewhere that the use of elite forms of language reflects superior intellect and education. Expert opinion from sociolinguistics, however, contends that such a view is the result of middle-class bias and cannot be scientifically justified. In the 1960s and 1970s, such…

Characterization of Midface Fractures Incurred in Recent Wars

DTIC Science & Technology

2012-11-01

reconstruction . Key Words: Maxillofacial, facial fractures, early rigid fixation, blast injury (J Craniofac Surg 2012;23: 1587 1591) The percentage of...evaluated by a facial trauma expert that some of these findings are made. Conversely, it is not uncommon to find fractures that are incorrectly...þ Robert G. Hale, DDS,þ and Rodney K. Chan, MDþ Background: Facial injuries sustained by US military personnel during the wars in Iraq and

PHIT for Duty, a Personal Health Intervention Tool for Psychological Health and Traumatic Brain Injury

DTIC Science & Technology

2014-04-01

of this project is to help prevent psychological disorders in high-risk individuals with early symptoms of stress, depression , substance use, and...questionnaires in five domains (i.e., stress, anxiety, sleep quality, depression , and alcohol use). An expert system, called the intelligent virtual...problems mentioned were depression , anxiety and sleep issues. Additional post deployment health problems discussed include stress, aggression, social

The Program Management Challenges of Web 2.0

DTIC Science & Technology

2010-06-01

identifying and keeping abreast of the newly emerging technologies; their fast pace of evolution or modification, changing domain focus areas, their varied...definitive experts. No one knows what the future holds for network-centric materiel development . We are in the early stages of the Information Age and...led to the development and evolution of online Web-based communities and services such as auction houses, knowledge portals, social networking sites

from the Adolescents’ Perspective in Malaysia

PubMed

Mohd Zin, Faridah; Hillaluddin, Azlin Hilma; Mustaffa, Jamaludin

2017-05-01

Objective: This study aims to develop, validate and determine the reliability of an interactive multimedia strategy to prevent tobacco use among the young (TUPY-S) from an adolescents’ perspective. Methods: A descriptive study design was utilized. A modular instruction guideline by Russel (1974) was followed in the entire process, comprising a feasibility study, a review of existing modules, specification of the objectives, identification of the construct criterion items, learner analysis and entry behavior specification, establishment of the sequence instruction and media selection, a tryout with students and a field test. Result: Feasibility was agreed among the researchers and the school authorities. Culturally suitable rigorously developed tobacco use preventive strategies delivered using information technology (IT) are lacking in the literature. The objective of TUPY-S is to prevent tobacco use among adolescents living in Malaysia. Identified construct criterion items include knowledge, attitude, intention to use, self-efficacy, and refusal skill. The target population was early adolescents belonging to generation-Z. Content was developed from the adolescents’ perspective and delivered using IT in Malay language. Content validity, assessed by six experts in the field and module development, was good at 86%. The students’ tryout showed satisfactory face validity subjectively and objectively (85.5%) and high alpha Cronbach reliability (0.91). Conclusion: TUPY-S was confirmed to suit early adolescents of the current generation living in Malaysia. It demonstrated good content validity among the experts, satisfactory face validity and reliability among the target population. TUPY-S is ready to be evaluated for its effectiveness among early adolescents. Creative Commons Attribution License

Tobacco Use Prevention for the Young (TUPY-S): Development, Validity and Reliability of an Interactive Multimedia Strategy from the Adolescents’ Perspective in Malaysia

PubMed Central

Zin, Faridah Mohd; Hillaluddin, Azlin Hilma; Mustaffa, Jamaludin

2017-01-01

Objective: This study aims to develop, validate and determine the reliability of an interactive multimedia strategy to prevent tobacco use among the young (TUPY-S) from an adolescents’ perspective. Methods: A descriptive study design was utilized. A modular instruction guideline by Russel (1974) was followed in the entire process, comprising a feasibility study, a review of existing modules, specification of the objectives, identification of the construct criterion items, learner analysis and entry behavior specification, establishment of the sequence instruction and media selection, a tryout with students and a field test. Result: Feasibility was agreed among the researchers and the school authorities. Culturally suitable rigorously developed tobacco use preventive strategies delivered using information technology (IT) are lacking in the literature. The objective of TUPY-S is to prevent tobacco use among adolescents living in Malaysia. Identified construct criterion items include knowledge, attitude, intention to use, self-efficacy, and refusal skill. The target population was early adolescents belonging to generation-Z. Content was developed from the adolescents’ perspective and delivered using IT in Malay language. Content validity, assessed by six experts in the field and module development, was good at 86%. The students’ tryout showed satisfactory face validity subjectively and objectively (85.5%) and high alpha Cronbach reliability (0.91). Conclusion: TUPY-S was confirmed to suit early adolescents of the current generation living in Malaysia. It demonstrated good content validity among the experts, satisfactory face validity and reliability among the target population. TUPY-S is ready to be evaluated for its effectiveness among early adolescents. PMID:28612599

Early maladaptive schemas of emotional deprivation, social isolation, shame and abandonment are related to a history of suicide attempts among patients with major depressive disorders.

PubMed

Ahmadpanah, Mohammad; Astinsadaf, Sommayyeh; Akhondi, Amineh; Haghighi, Mohammad; Sadeghi Bahmani, Dena; Nazaribadie, Marzieh; Jahangard, Leila; Holsboer-Trachsler, Edith; Brand, Serge

2017-08-01

Patients with psychiatric disorders have an exceptionally high risk of completed or attempted suicide. This holds particularly true for patients with major depressive disorders. The aim of the present study was to explore whether patients with major depressive disorders (MDD) and a history of suicide attempts differed in their early maladaptive schemas from patients with MDD but without such a history or from healthy controls. Ninety participants took part in the study. Of these, 30 were patients with MDD who had made a recent suicide attempt; 30 were patients with MDD but no suicide attempts, and 30 were gender- and age-matched healthy controls. Participants completed questionnaires covering socio-demographic characteristics and the Young Schema Questionnaire (YSQ- RE2R) to assess early maladaptive schemas. Experts rated patients' MDD with the Montgomery-Asberg Depression Rating Scale. Patients did not differ in experts' ratings of symptoms of depression. Compared to healthy controls, patients with MDD recorded higher scores on maladaptive schemas such as recognition seeking, negativity/pessimism, and insufficient self-control. Compared to patients without suicide attempts and healthy controls, those who had made a suicide attempt had higher scores on dimensions such as failure, mistrust, emotional inhibition, social isolation, and abandonment/instability. Compared to healthy controls, patients with MDD had more pronounced maladaptive schemas, but this was more marked in patients with a history of suicide attempts. The results suggest that suicide attempts and poorer psychological functioning are related. Copyright © 2017 Elsevier Inc. All rights reserved.

Astrology in court: The Spanish Inquisition, authority, and expertise.

PubMed

Lanuza-Navarro, Tayra M C

2017-06-01

Astrology, its legitimacy, and the limits of its acceptable practice were debated in sixteenth- and seventeenth-century Europe. Many of the related arguments were mediated by the work of Giovanni Pico della Mirandola and the responses to it. Acknowledging the complexities of the relationship between astrological ideas and Christian teachings, this paper focuses on the Catholic debates by specifically considering the decisions about astrology taken by the Spanish Inquisition. The trials of astrologers are examined with the aim of understanding the role of experts in astrology in early modern Spain. This study brings into view the specific nature of the debate on astrology in Spain, the consequences of the actions of the Inquisition and the social control it exerted. The historical events discussed comprise a particular case and also mirror the general debates about astrology taking place in early modern Europe. The experts' opinions expressed in trials and in reports about the discipline received by the Inquisition reveal two key traits of the debate: the dispute about who had the authority to decide on the legitimacy of astrology and the disagreement about what constituted natural and judicial astrological practices. These led to different opinions about what was to be done with each defendant and about what content in their books ought to be forbidden.

Automatic recognition of severity level for diagnosis of diabetic retinopathy using deep visual features.

PubMed

Abbas, Qaisar; Fondon, Irene; Sarmiento, Auxiliadora; Jiménez, Soledad; Alemany, Pedro

2017-11-01

Diabetic retinopathy (DR) is leading cause of blindness among diabetic patients. Recognition of severity level is required by ophthalmologists to early detect and diagnose the DR. However, it is a challenging task for both medical experts and computer-aided diagnosis systems due to requiring extensive domain expert knowledge. In this article, a novel automatic recognition system for the five severity level of diabetic retinopathy (SLDR) is developed without performing any pre- and post-processing steps on retinal fundus images through learning of deep visual features (DVFs). These DVF features are extracted from each image by using color dense in scale-invariant and gradient location-orientation histogram techniques. To learn these DVF features, a semi-supervised multilayer deep-learning algorithm is utilized along with a new compressed layer and fine-tuning steps. This SLDR system was evaluated and compared with state-of-the-art techniques using the measures of sensitivity (SE), specificity (SP) and area under the receiving operating curves (AUC). On 750 fundus images (150 per category), the SE of 92.18%, SP of 94.50% and AUC of 0.924 values were obtained on average. These results demonstrate that the SLDR system is appropriate for early detection of DR and provide an effective treatment for prediction type of diabetes.

International attitudes of early adopters to current and future robotic technologies in pediatric surgery.

PubMed

Cundy, Thomas P; Marcus, Hani J; Hughes-Hallett, Archie; Najmaldin, Azad S; Yang, Guang-Zhong; Darzi, Ara

2014-10-01

Perceptions toward surgical innovations are critical to the social processes that drive technology adoption. This study aims to capture attitudes of early adopter pediatric surgeons toward robotic technologies in order to clarify 1) specific features that are driving appeal, 2) limiting factors that are acting as diffusion barriers, and 3) future needs. Electronic surveys were distributed to pediatric surgeons with personal experience or exposure in robotic surgery. Participants were classified as experts or nonexperts for subgroup analysis. Coded Likert scale responses were analyzed using the Friedman or Mann-Whitney test. A total of 48 responses were received (22 experts, 26 nonexperts), with 14 countries represented. The most highly rated benefits of robot assistance were wristed instruments, stereoscopic vision, and magnified view. The most highly rated limitations were capital outlay expense, instrument size, and consumables/maintenance expenses. Future technologies of greatest interest were microbots, image guidance, and flexible snake robots. Putative benefits and limitations of robotic surgery are perceived with widely varied weightings. Insight provided by these responses will inform relevant clinical, engineering, and industry groups such that unambiguous goals and priorities may be assigned for the future. Pediatric surgeons seem most receptive toward technology that is smaller, less expensive, more intelligent and flexible. Copyright © 2014 Elsevier Inc. All rights reserved.

Network approaches for expert decisions in sports.

PubMed

Glöckner, Andreas; Heinen, Thomas; Johnson, Joseph G; Raab, Markus

2012-04-01

This paper focuses on a model comparison to explain choices based on gaze behavior via simulation procedures. We tested two classes of models, a parallel constraint satisfaction (PCS) artificial neuronal network model and an accumulator model in a handball decision-making task from a lab experiment. Both models predict action in an option-generation task in which options can be chosen from the perspective of a playmaker in handball (i.e., passing to another player or shooting at the goal). Model simulations are based on a dataset of generated options together with gaze behavior measurements from 74 expert handball players for 22 pieces of video footage. We implemented both classes of models as deterministic vs. probabilistic models including and excluding fitted parameters. Results indicated that both classes of models can fit and predict participants' initially generated options based on gaze behavior data, and that overall, the classes of models performed about equally well. Early fixations were thereby particularly predictive for choices. We conclude that the analyses of complex environments via network approaches can be successfully applied to the field of experts' decision making in sports and provide perspectives for further theoretical developments. Copyright © 2011 Elsevier B.V. All rights reserved.

The development, past achievements, and future directions of brain PET

PubMed Central

Jones, Terry; Rabiner, Eugenii A

2012-01-01

The early developments of brain positron emission tomography (PET), including the methodological advances that have driven progress, are outlined. The considerable past achievements of brain PET have been summarized in collaboration with contributing experts in specific clinical applications including cerebrovascular disease, movement disorders, dementia, epilepsy, schizophrenia, addiction, depression and anxiety, brain tumors, drug development, and the normal healthy brain. Despite a history of improving methodology and considerable achievements, brain PET research activity is not growing and appears to have diminished. Assessments of the reasons for decline are presented and strategies proposed for reinvigorating brain PET research. Central to this is widening the access to advanced PET procedures through the introduction of lower cost cyclotron and radiochemistry technologies. The support and expertize of the existing major PET centers, and the recruitment of new biologists, bio-mathematicians and chemists to the field would be important for such a revival. New future applications need to be identified, the scope of targets imaged broadened, and the developed expertize exploited in other areas of medical research. Such reinvigoration of the field would enable PET to continue making significant contributions to advance the understanding of the normal and diseased brain and support the development of advanced treatments. PMID:22434067

In Situ Distribution Guided Analysis and Visualization of Transonic Jet Engine Simulations.

PubMed

Dutta, Soumya; Chen, Chun-Ming; Heinlein, Gregory; Shen, Han-Wei; Chen, Jen-Ping

2017-01-01

Study of flow instability in turbine engine compressors is crucial to understand the inception and evolution of engine stall. Aerodynamics experts have been working on detecting the early signs of stall in order to devise novel stall suppression technologies. A state-of-the-art Navier-Stokes based, time-accurate computational fluid dynamics simulator, TURBO, has been developed in NASA to enhance the understanding of flow phenomena undergoing rotating stall. Despite the proven high modeling accuracy of TURBO, the excessive simulation data prohibits post-hoc analysis in both storage and I/O time. To address these issues and allow the expert to perform scalable stall analysis, we have designed an in situ distribution guided stall analysis technique. Our method summarizes statistics of important properties of the simulation data in situ using a probabilistic data modeling scheme. This data summarization enables statistical anomaly detection for flow instability in post analysis, which reveals the spatiotemporal trends of rotating stall for the expert to conceive new hypotheses. Furthermore, the verification of the hypotheses and exploratory visualization using the summarized data are realized using probabilistic visualization techniques such as uncertain isocontouring. Positive feedback from the domain scientist has indicated the efficacy of our system in exploratory stall analysis.

Emerging Technologies for Environmental Remediation: Integrating Data and Judgment.

PubMed

Bates, Matthew E; Grieger, Khara D; Trump, Benjamin D; Keisler, Jeffrey M; Plourde, Kenton J; Linkov, Igor

2016-01-05

Emerging technologies present significant challenges to researchers, decision-makers, industry professionals, and other stakeholder groups due to the lack of quantitative risk, benefit, and cost data associated with their use. Multi-criteria decision analysis (MCDA) can support early decisions for emerging technologies when data is too sparse or uncertain for traditional risk assessment. It does this by integrating expert judgment with available quantitative and qualitative inputs across multiple criteria to provide relative technology scores. Here, an MCDA framework provides preliminary insights on the suitability of emerging technologies for environmental remediation by comparing nanotechnology and synthetic biology to conventional remediation methods. Subject matter experts provided judgments regarding the importance of criteria used in the evaluations and scored the technologies with respect to those criteria. The results indicate that synthetic biology may be preferred over nanotechnology and conventional methods for high expected benefits and low deployment costs but that conventional technology may be preferred over emerging technologies for reduced risks and development costs. In the absence of field data regarding the risks, benefits, and costs of emerging technologies, structuring evidence-based expert judgment through a weighted hierarchy of topical questions may be helpful to inform preliminary risk governance and guide emerging technology development and policy.

Pediatric surgeons and anesthesiologists expand the dialogue on the neurotoxicity question, rationale for early and delayed surgeries, and practice changes while awaiting definitive evidence.

PubMed

Byrne, Mary W; Casale, Pasquale; Garzon, Maria; Hyman, Joshua E; Lin, Albert Y; Lynch, Lisa R; Schleien, Charles L; Stylianos, Steven

2014-10-01

The Pediatric Anesthesia NeuroDevelopment Assessment team at Columbia University Medical Center Department of Anesthesiology convened its fourth biennial Symposium to address unresolved issues concerning potential neurotoxic effects of anesthetic agents and sedatives on young children and to assess study findings to date. Dialogue initiated at the third Symposium was continued between anesthesiologists, researchers, and a panel of expert pediatric surgeons representing general surgery and dermatology, orthopedic, and urology specialties. The panel explored the need to balance benefits of early surgery using improved technologies against potential anesthetic risks, practice changes while awaiting definitive answers, and importance of continued interprofessional dialogue.

Experts advise hospitals to heed warning signs, leverage security to prepare against shootings.

PubMed

2014-09-01

While hospital shootings are not commonplace, studies suggest they are happening with increasing frequency, and that EDs are particularly vulnerable to this type of violence. Researchers report that roughly a third of all hospital shootings occur in the emergency setting. Experts say such incidents are typically targeted events, not random acts. Consequently, effective security programs should emphasize preventive steps to defuse potentially volatile situations and prevent weapons from entering the facility. Hospital security departments should be equipped to provide training to employees throughout the facility so that employees know how to respond if an active shooter is identified. Researchers report that between 2000 and 2012 there were 154 shootings in American hospitals, and that the frequency of these events increased markedly in the later years of the study. Experts say hospital shootings may involve disgruntled patients, dementia patients, or psychiatric patients, but the most common perpetrators are prisoners who are brought into the hospital for treatment under guard. Security experts say effective safety plans should focus on identifying threatening language or other signs of agitation early on so that interventions can be employed. They also advise hospitals to install gun lockers at every entrance point so that lawful weapons can be stored before owners enter the facility. Liberalized gun laws in some regions are making security more difficult at public hospitals. Also, hospitals need to be careful with surveillance activities that could raise privacy concerns.

Do family dinners reduce the risk for early adolescent substance use? A propensity score analysis.

PubMed

Hoffmann, John P; Warnick, Elizabeth

2013-01-01

The risks of early adolescent substance use on health and well-being are well documented. In recent years, several experts have claimed that a simple preventive measure for these behaviors is for families to share evening meals. In this study, we use data from the 1997 National Longitudinal Study of Youth (n = 5,419) to estimate propensity score models designed to match on a set of covariates and predict early adolescent substance use frequency and initiation. The results indicate that family dinners are not generally associated with alcohol or cigarette use or with drug use initiation. However, a continuous measure of family dinners is modestly associated with marijuana frequency, thus suggesting a potential causal impact. These results show that family dinners may help prevent one form of substance use in the short term but do not generally affect substance use initiation or alcohol and cigarette use.

Caring for New Mothers: Pressing Problems, New Solutions. Hearing before the Select Committee on Children, Youth, and Families. House of Representatives, One Hundred First Congress, First Session (October 24, 1989).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Children, Youth, and Families.

A hearing was held to consider problems women face in obtaining preventive care or early comprehensive prenatal care. Testimony concerned: (1) the Public Health Service Expert Panel's report on prenatal care; (2) Los Angeles' critical shortage of maternity care providers; (3) new research from Detroit that suggests that even when prenatal care is…

Program Manager: Modeling and Simulation Feature Issue, September - October 1997

DTIC Science & Technology

1997-10-01

with the creations of Walt Disney . The Department of Defense (DoD) is the fortunate benefi- ciary of a concentration of modeling and simulation (M&S...exploration. For example, STRICOM and the Walt Disney Company, the premier expert on the use of M&S in the entertain- ment industry, have an...the start ; • emphasize prevention over cures by using virtual proto- types and simulations to identi- fy and resolve problems early; and

Visualization support for risk-informed decision making when planning and managing software developments

NASA Technical Reports Server (NTRS)

Feather, Martin S.; Kiper, James D.; Menzies, Tim

2005-01-01

Key decisions are made in the early stages of planning and management of software developments. The information basis for these decisions is often a mix of analogy with past developments, and the best judgments of domain experts. Visualization of this information can support to such decision making by clarifying the status of the information and yielding insights into the ramifications of that information vis-a-vis decision alternatives.

Assessing Egyptian Public Support for Security Crackdowns in the Sinai

DTIC Science & Technology

2015-02-01

Leadership and Development contributes to the education of world class senior leaders, develops expert knowledge, and provides solutions to...case when the Ottoman army invaded it in the early stages of World War I, and when the Israelis invaded it in 1956 and 1967). Former Egyptian...much of the Arab world for concluding a so-called “separate peace” with Israel, Sadat and most Egyptian citizens held the view that Egypt had made

Artificial intelligence costs, benefits, risks for selected spacecraft ground system automation scenarios

NASA Technical Reports Server (NTRS)

Truszkowski, Walter F.; Silverman, Barry G.; Kahn, Martha; Hexmoor, Henry

1988-01-01

In response to a number of high-level strategy studies in the early 1980s, expert systems and artificial intelligence (AI/ES) efforts for spacecraft ground systems have proliferated in the past several years primarily as individual small to medium scale applications. It is useful to stop and assess the impact of this technology in view of lessons learned to date, and hopefully, to determine if the overall strategies of some of the earlier studies both are being followed and still seem relevant. To achieve that end four idealized ground system automation scenarios and their attendant AI architecture are postulated and benefits, risks, and lessons learned are examined and compared. These architectures encompass: (1) no AI (baseline), (2) standalone expert systems, (3) standardized, reusable knowledge base management systems (KBMS), and (4) a futuristic unattended automation scenario. The resulting artificial intelligence lessons learned, benefits, and risks for spacecraft ground system automation scenarios are described.

Artificial intelligence costs, benefits, and risks for selected spacecraft ground system automation scenarios

NASA Technical Reports Server (NTRS)

Truszkowski, Walter F.; Silverman, Barry G.; Kahn, Martha; Hexmoor, Henry

1988-01-01

In response to a number of high-level strategy studies in the early 1980s, expert systems and artificial intelligence (AI/ES) efforts for spacecraft ground systems have proliferated in the past several years primarily as individual small to medium scale applications. It is useful to stop and assess the impact of this technology in view of lessons learned to date, and hopefully, to determine if the overall strategies of some of the earlier studies both are being followed and still seem relevant. To achieve that end four idealized ground system automation scenarios and their attendant AI architecture are postulated and benefits, risks, and lessons learned are examined and compared. These architectures encompass: (1) no AI (baseline); (2) standalone expert systems; (3) standardized, reusable knowledge base management systems (KBMS); and (4) a futuristic unattended automation scenario. The resulting artificial intelligence lessons learned, benefits, and risks for spacecraft ground system automation scenarios are described.

Length of stay following percutaneous coronary intervention: An expert consensus document update from the society for cardiovascular angiography and interventions.

PubMed

Seto, Arnold H; Shroff, Adhir; Abu-Fadel, Mazen; Blankenship, James C; Boudoulas, Konstantinos Dean; Cigarroa, Joaquin E; Dehmer, Gregory J; Feldman, Dmitriy N; Kolansky, Daniel M; Lata, Kusum; Swaminathan, Rajesh V; Rao, Sunil V

2018-04-24

Since the publication of the 2009 SCAI Expert Consensus Document on Length of Stay Following percutaneous coronary intervention (PCI), advances in vascular access techniques, stent technology, and antiplatelet pharmacology have facilitated changes in discharge patterns following PCI. Additional clinical studies have demonstrated the safety of early and same day discharge in selected patients with uncomplicated PCI, while reimbursement policies have discouraged unnecessary hospitalization. This consensus update: (1) clarifies clinical and reimbursement definitions of discharge strategies, (2) reviews the technological advances and literature supporting reduced hospitalization duration and risk assessment, and (3) describes changes to the consensus recommendations on length of stay following PCI (Supporting Information Table S1). These recommendations are intended to support reasonable clinical decision making regarding postprocedure length of stay for a broad spectrum of patients undergoing PCI, rather than prescribing a specific period of observation for individual patients. © 2018 Wiley Periodicals, Inc.

Nowcasting system MeteoExpert at Irkutsk airport

NASA Astrophysics Data System (ADS)

Bazlova, Tatiana; Bocharnikov, Nikolai; Solonin, Alexander

2016-04-01

Airport operations are significantly impacted by low visibility concerned with fog. Generation of accurate and timely nowcast products is a basis of early warning automated system providing information about significant weather conditions for decision-makers. Nowcasting system MeteoExpert has been developed that provides aviation forecasters with 0-6 hour nowcasts of the weather conditions including fog and low visibility. The system has been put into operation at the airport Irkutsk since August 2014. Aim is to increase an accuracy of fog forecasts, contributing to the airport safety, efficiency and capacity improvement. Designed for operational use numerical model of atmospheric boundary layer runs with a 10-minute update cycle. An important component of the system is the use of AWOS at the airdrome and three additional automatic weather stations at fogging sites in the vicinity of the airdrome. Nowcasts are visualized on a screen of forecaster's workstation and dedicated website. Nowcasts have been verified against actual observations.

An Expert Opinion on Advanced Insulin Pump Use in Youth with Type 1 Diabetes.

PubMed

Bode, Bruce W; Kaufman, Francine R; Vint, Nan

2017-03-01

Among children and adolescents with type 1 diabetes mellitus, the use of insulin pump therapy has increased since its introduction in the early 1980s. Optimal management of type 1 diabetes mellitus depends on sufficient understanding by patients, their families, and healthcare providers on how to use pump technology. The goal for the use of insulin pump therapy should be to advance proficiency over time from the basics taught at the initiation of pump therapy to utilizing advanced settings to obtain optimal glycemic control. However, this goal is often not met, and appropriate understanding of the full features of pump technology can be lacking. The objective of this review is to provide an expert perspective on the advanced features and use of insulin pump therapy, including practical guidelines for the successful use of insulin pump technology, and other considerations specific to patients and healthcare providers.

A comparative study of middle school and high school students' views about physics and learning physics

NASA Astrophysics Data System (ADS)

Ding, Lin

2013-01-01

Previous studies of student epistemological beliefs about physics and learning physics focused on college and post-college students in Western countries. However, little is known about early-grade students in Asian countries. This paper reports Chinese middle and high school students' views about the nature of physics and learning physics, measured by the Colorado Learning Attitudes Survey about Science (CLASS). Two variables—school level and gender—are examined for a series of comparative analyses. Results show that although middle school students received fewer years of education in physics, they demonstrated more expert-like conceptions about this subject matter than high school students. Also, male students in general exhibited more expert-like views than their female counterparts. While such a gender difference remained constant across both middle and high schools, for the most part it was a small-size difference.

Cortical fMRI activation to opponents' body kinematics in sport-related anticipation: expert-novice differences with normal and point-light video.

PubMed

Wright, M J; Bishop, D T; Jackson, R C; Abernethy, B

2011-08-18

Badminton players of varying skill levels viewed normal and point-light video clips of opponents striking the shuttle towards the viewer; their task was to predict in which quadrant of the court the shuttle would land. In a whole-brain fMRI analysis we identified bilateral cortical networks sensitive to the anticipation task relative to control stimuli. This network is more extensive and localised than previously reported. Voxel clusters responding more strongly in experts than novices were associated with all task-sensitive areas, whereas voxels responding more strongly in novices were found outside these areas. Task-sensitive areas for normal and point-light video were very similar, whereas early visual areas responded differentially, indicating the primacy of kinematic information for sport-related anticipation. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Lessons Learned about Best Practices for Communicating Earthquake Forecasting and Early Warning to Non-Scientific Publics

NASA Astrophysics Data System (ADS)

Sellnow, D. D.; Sellnow, T. L.

2017-12-01

Earthquake scientists are without doubt experts in understanding earthquake probabilities, magnitudes, and intensities, as well as the potential consequences of them to community infrastructures and inhabitants. One critical challenge these scientific experts face, however, rests with communicating what they know to the people they want to help. Helping scientists translate scientific information to non-scientists is something Drs. Tim and Deanna Sellnow have been committed to for decades. As such, they have compiled a host of data-driven best practices for communicating effectively to non-scientific publics about earthquake forecasting, probabilities, and warnings. In this session, they will summarize what they have learned as it may help earthquake scientists, emergency managers, and other key spokespersons share these important messages to disparate publics in ways that result in positive outcomes, the most important of which is saving lives.

Evaluating progressive-rendering algorithms in appearance design tasks.

PubMed

Jiawei Ou; Karlik, Ondrej; Křivánek, Jaroslav; Pellacini, Fabio

2013-01-01

Progressive rendering is becoming a popular alternative to precomputational approaches to appearance design. However, progressive algorithms create images exhibiting visual artifacts at early stages. A user study investigated these artifacts' effects on user performance in appearance design tasks. Novice and expert subjects performed lighting and material editing tasks with four algorithms: random path tracing, quasirandom path tracing, progressive photon mapping, and virtual-point-light rendering. Both the novices and experts strongly preferred path tracing to progressive photon mapping and virtual-point-light rendering. None of the participants preferred random path tracing to quasirandom path tracing or vice versa; the same situation held between progressive photon mapping and virtual-point-light rendering. The user workflow didn’t differ significantly with the four algorithms. The Web Extras include a video showing how four progressive-rendering algorithms converged (at http://youtu.be/ck-Gevl1e9s), the source code used, and other supplementary materials.

[Revision of Quality Indicators for the Endoscopy Quality Improvement Program of the National Cancer Screening Program in Korea].

PubMed

Min, Jun Ki; Cha, Jae Myung; Cho, Yu Kyung; Kim, Jie Hyun; Yoon, Soon Man; Im, Jong Pil; Jung, Yunho; Moon, Jeong Seop; Kim, Jin Oh; Jeen, Yoon Tae

2018-05-25

Gastroscopy and colonoscopy are widely used for the early diagnosis of stomach and colorectal cancer. The present revision integrates recent data regarding previous quality indicators and novel indicators suggested for gastroscopy and colonoscopy procedures for the National Cancer Screening Program in Korea. The new indicators, developed by the Quality Improvement Committee of the Korean Society for Gastrointestinal Endoscopy, vary in the level of supporting evidence, and most are based solely on expert opinion. Updated indicators validated by clinical research were prioritized, but were chosen by expert consensus when such studies were absent. The resultant quality indicators were graded according to the levels of consensus and recommendations. The updated indicators will provide a relevant guideline for high-quality endoscopy. The future direction of quality indicator development should include relevant outcome measures and an evidence-based approach to support proposed performance targets.

The need for a robust 24/7 subspecialty "clearing house" response for telementored trauma care.

PubMed

Kirkpatrick, Andrew W; Hamilton, Douglas; Beckett, Andrew; LaPorta, Anthony; Brien, Susan; Glassberg, Elon; Ball, Chad G; Roberts, Derek J; Tien, Homer

2015-06-01

Traumatic injury is increasing in importance in all settings and environments worldwide. Many preventable deaths are from conditions that are common and treatable. However, as potentially lethal injuries often induce progressive and frequently irreversible physiologic decline, the timing of interventions is critical. Invasive treatments may need to be offered by prehospital care providers who lack extensive training and practice. Telementoring allows experienced experts to guide less experienced providers remotely using information technology (IT). Early experience has shown that these techniques are practical and considered valuable. Their translation to regular practice, however, will require the immediate availability of appropriately trained remote experts willing to serve as mentors. Acute care trauma specialists are acclimatized to responding to out-of-hospital consultations and assuming overall responsibility for critical physiology and transport and may serve as the backbone of such a national/ international call response initiative.

Recurrent issues in efforts to prevent homicidal youth violence in schools: expert opinions.

PubMed

Dill, Karen E; Redding, Richard E; Smith, Peter K; Surette, Ray; Cornell, Dewey G

2011-01-01

Developmental research on social influences on adolescents can guide practices aimed to prevent homicidal youth violence. School shootings have repeatedly raised questions about the contributory role of bullying and entertainment violence, how news media publicity might produce copycat crimes, and whether stiffer criminal sanctions might have a deterrent effect. This article presents the thoughts and recommendations of a group of experts on these topics summarizing the current knowledge base. In brief, bullying reduction programs may be a useful early prevention effort. Television and video games with violent themes can encourage aggressive behavior, but these media can be used to teach more prosocial behavior as well. The potential copycat effects of highly publicized crimes might be diminished with more restrained reporting, although more research is needed. Finally, there is substantial evidence that increased criminal sanctions for youthful offenders have not had a deterrent effect. Copyright © 2011 Wiley Periodicals, Inc., A Wiley Company.

A Validation Argument for a Simulation-Based Training Course Centered on Assessment, Recognition, and Early Management of Pediatric Sepsis.

PubMed

Geis, Gary L; Wheeler, Derek S; Bunger, Amy; Militello, Laura G; Taylor, Regina G; Bauer, Jerome P; Byczkowski, Terri L; Kerrey, Benjamin T; Patterson, Mary D

2018-02-01

Early recognition of sepsis remains one of the greatest challenges in medicine. Novice clinicians are often responsible for the recognition of sepsis and the initiation of urgent management. The aim of this study was to create a validity argument for the use of a simulation-based training course centered on assessment, recognition, and early management of sepsis in a laboratory-based setting. Five unique simulation scenarios were developed integrating critical sepsis cues identified through qualitative interviewing. Scenarios were piloted with groups of novice, intermediate, and expert pediatric physicians. The primary outcome was physician recognition of sepsis, measured with an adapted situation awareness global assessment tool. Secondary outcomes were physician compliance with pediatric advanced life support (PALS) guidelines and early sepsis management (ESM) recommendations, measured by two internally derived tools. Analysis compared recognition of sepsis by levels of expertise and measured association of sepsis recognition with the secondary outcomes. Eighteen physicians were recruited, six per study group. Each physician completed three sepsis simulations. Sepsis was recognized in 19 (35%) of 54 simulations. The odds that experts recognized sepsis was 2.6 [95% confidence interval (CI) = 0.5-13.8] times greater than novices. Adjusted for severity, for every point increase in the PALS global performance score, the odds that sepsis was recognized increased by 11.3 (95% CI = 3.1-41.4). Similarly, the odds ratio for the PALS checklist score was 1.5 (95% CI = 0.8-2.6). Adjusted for severity and level of expertise, the odds of recognizing sepsis was associated with an increase in the ESM checklist score of 1.8 (95% CI = 0.9-3.6) and an increase in ESM global performance score of 4.1 (95% CI = 1.7-10.0). Although incomplete, evidence from initial testing suggests that the simulations of pediatric sepsis were sufficiently valid to justify their use in training novice pediatric physicians in the assessment, recognition, and management of pediatric sepsis.

Does Joint Fact-finding work for Water-energy-food Nexus Issues? A Role of Scientific Evidence in Policy Process

NASA Astrophysics Data System (ADS)

Baba, K.

2014-12-01

A quite famous phrase in risk management "How safe is enough safe?" implies there exists a framing gap among experts, the general public and stakeholders. Scientific evidence that experts provide usually contains uncertainty, while the public tends to have the other type of qualitative local knowledge. As there is no zero-risk society, we have to build consensus on acceptable level of risk and trade-offs of risks based on expert knowledge and local knowledge. Therefore having a dialogue among them in the early stage of the policy process such as problem definition and agenda setting is essential to cultivate trust and to integrate their knowledge. To this end, we especially pay attention to Joint Fact-finding (JFF). The tentative definition of JFF is that a promising strategy for experts, decision makers, and key public rights-holders and stakeholders from opposing sides of an issue to work together to resolve or narrow factual disputes over public policy issues. JFF process usually begins with identifying stakeholders and holding interviews with them to determine their interests. We call this step stakeholder analysis. Then we define the scope of the study including the required scientific evidence and the preliminary list of experts. After that, stakeholders jointly select experts to participate in the study, then they work together on what they would like to clear about scientific evidence. They finally get the common understanding and findings through these collaboration. We applied the stakeholder analysis to the issue of groundwater in Obama City and the issues of hot spring water and geothermal power in Beppu City in Japan. We drew conclusions from these case studies to some extent but at the same time we found that the analysis method has a limitation in applying it to multiple nexus issues because the method based on stakeholders' cognition. For example, in Obama case, we identified a lack of cooperation among stakeholders that especially agricultural sector who should have positive relationship with groundwater in nature is not involved in groundwater issue thoroughly. However, we could not enough furnish stakeholders with the framing of trade-offs between resources. Accordingly we need to raise awareness of stakeholders with scientific evidence of experts on the way of the stakeholder analysis.

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

NASA Astrophysics Data System (ADS)

Sättele, Martina; Bründl, Michael; Straub, Daniel

2013-04-01

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

Prioritizing research for integrated implementation of early childhood development and maternal, newborn, child and adolescent health and nutrition platforms.

PubMed

Sharma, Renee; Gaffey, Michelle F; Alderman, Harold; Bassani, Diego G; Bogard, Kimber; Darmstadt, Gary L; Das, Jai K; de Graft-Johnson, Joseph E; Hamadani, Jena D; Horton, Susan; Huicho, Luis; Hussein, Julia; Lye, Stephen; Pérez-Escamilla, Rafael; Proulx, Kerrie; Marfo, Kofi; Mathews-Hanna, Vanessa; Mclean, Mireille S; Rahman, Atif; Silver, Karlee L; Singla, Daisy R; Webb, Patrick; Bhutta, Zulfiqar A

2017-06-01

Existing health and nutrition services present potential platforms for scaling up delivery of early childhood development (ECD) interventions within sensitive windows across the life course, especially in the first 1000 days from conception to age 2 years. However, there is insufficient knowledge on how to optimize implementation for such strategies in an integrated manner. In light of this knowledge gap, we aimed to systematically identify a set of integrated implementation research priorities for health, nutrition and early child development within the 2015 to 2030 timeframe of the Sustainable Development Goals (SDGs). We applied the Child Health and Nutrition Research Initiative method, and consulted a diverse group of global health experts to develop and score 57 research questions against five criteria: answerability, effectiveness, deliverability, impact, and effect on equity. These questions were ranked using a research priority score, and the average expert agreement score was calculated for each question. The research priority scores ranged from 61.01 to 93.52, with a median of 82.87. The average expert agreement scores ranged from 0.50 to 0.90, with a median of 0.75. The top-ranked research question were: i) "How can interventions and packages to reduce neonatal mortality be expanded to include ECD and stimulation interventions?"; ii) "How does the integration of ECD and MNCAH&N interventions affect human resource requirements and capacity development in resource-poor settings?"; and iii) "How can integrated interventions be tailored to vulnerable refugee and migrant populations to protect against poor ECD and MNCAH&N outcomes?". Most highly-ranked research priorities varied across the life course and highlighted key aspects of scaling up coverage of integrated interventions in resource-limited settings, including: workforce and capacity development, cost-effectiveness and strategies to reduce financial barriers, and quality assessment of programs. Investing in ECD is critical to achieving several of the SDGs, including SDG 2 on ending all forms of malnutrition, SDG 3 on ensuring health and well-being for all, and SDG 4 on ensuring inclusive and equitable quality education and promotion of life-long learning opportunities for all. The generated research agenda is expected to drive action and investment on priority approaches to integrating ECD interventions within existing health and nutrition services.

Prioritizing research for integrated implementation of early childhood development and maternal, newborn, child and adolescent health and nutrition platforms

PubMed Central

Sharma, Renee; Gaffey, Michelle F; Alderman, Harold; Bassani, Diego G; Bogard, Kimber; Darmstadt, Gary L; Das, Jai K; de Graft–Johnson, Joseph E; Hamadani, Jena D; Horton, Susan; Huicho, Luis; Hussein, Julia; Lye, Stephen; Pérez–Escamilla, Rafael; Proulx, Kerrie; Marfo, Kofi; Mathews–Hanna, Vanessa; Mclean, Mireille S; Rahman, Atif; Silver, Karlee L; Singla, Daisy R; Webb, Patrick; Bhutta, Zulfiqar A

2017-01-01

Background Existing health and nutrition services present potential platforms for scaling up delivery of early childhood development (ECD) interventions within sensitive windows across the life course, especially in the first 1000 days from conception to age 2 years. However, there is insufficient knowledge on how to optimize implementation for such strategies in an integrated manner. In light of this knowledge gap, we aimed to systematically identify a set of integrated implementation research priorities for health, nutrition and early child development within the 2015 to 2030 timeframe of the Sustainable Development Goals (SDGs). Methods We applied the Child Health and Nutrition Research Initiative method, and consulted a diverse group of global health experts to develop and score 57 research questions against five criteria: answerability, effectiveness, deliverability, impact, and effect on equity. These questions were ranked using a research priority score, and the average expert agreement score was calculated for each question. Findings The research priority scores ranged from 61.01 to 93.52, with a median of 82.87. The average expert agreement scores ranged from 0.50 to 0.90, with a median of 0.75. The top–ranked research question were: i) “How can interventions and packages to reduce neonatal mortality be expanded to include ECD and stimulation interventions?”; ii) “How does the integration of ECD and MNCAH&N interventions affect human resource requirements and capacity development in resource–poor settings?”; and iii) “How can integrated interventions be tailored to vulnerable refugee and migrant populations to protect against poor ECD and MNCAH&N outcomes?”. Most highly–ranked research priorities varied across the life course and highlighted key aspects of scaling up coverage of integrated interventions in resource–limited settings, including: workforce and capacity development, cost–effectiveness and strategies to reduce financial barriers, and quality assessment of programs. Conclusions Investing in ECD is critical to achieving several of the SDGs, including SDG 2 on ending all forms of malnutrition, SDG 3 on ensuring health and well–being for all, and SDG 4 on ensuring inclusive and equitable quality education and promotion of life–long learning opportunities for all. The generated research agenda is expected to drive action and investment on priority approaches to integrating ECD interventions within existing health and nutrition services. PMID:28685048

A new informant-based questionnaire for instrumental activities of daily living in dementia.

PubMed

Sikkes, Sietske A M; de Lange-de Klerk, Elly S M; Pijnenburg, Yolande A L; Gillissen, Freek; Romkes, Rolinka; Knol, Dirk L; Uitdehaag, Bernard M J; Scheltens, Philip

2012-11-01

Interference in everyday functioning is part of the diagnostic criteria for dementia. Questionnaires measuring "instrumental activities of daily living" (IADL) are used to measure this interference, but the psychometric quality of these questionnaires is often questioned. In addition, these questionnaires are less suited for early-onset patients. This is problematic, given the high frequency of relatively young patients in memory clinics. In this article, we describe the development and psychometric properties of a new informant-based IADL questionnaire aimed at detecting incipient dementia and appropriate for a broad age range. We defined IADL in consensus with experts and constructed items based on existing items and suggestions from experts and informants. Informants of subjects (n = 206) who visited the Alzheimer Center of the VU University Medical Center completed the questionnaire. Factor structure was investigated using classical exploratory factor analysis and item response theory. We assessed test-retest reliability in 73 informants using weighted κ values. The questionnaire consisted of 75 items and was computerized to enhance ease of administration. Exploratory factor analysis supported a single-factor model, with 48.3% of the variance being explained by the first factor. We removed five items, as they did not fit the model. High internal consistency was demonstrated. Test-retest reliability showed that the majority of items (87.9%) had substantial-to-almost perfect κ values. The Amsterdam IADL Questionnaire (Amsterdam IADL questionnaire is a registered trademark of Alzheimer Center VU University Medical Center, Amsterdam, The Netherlands) is a 70-item informant-based computerized questionnaire aimed at detecting early dementia and early-onset dementia. Initial results show that this questionnaire is a promising new tool. Copyright © 2012 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Indicators to facilitate the early identification of patients with major depressive disorder in need of highly specialized care: A concept mapping study.

PubMed

van Krugten, F C W; Goorden, M; van Balkom, A J L M; Spijker, J; Brouwer, W B F; Hakkaart-van Roijen, L

2018-04-01

Early identification of the subgroup of patients with major depressive disorder (MDD) in need of highly specialized care could enhance personalized intervention. This, in turn, may reduce the number of treatment steps needed to achieve and sustain an adequate treatment response. The aim of this study was to identify patient-related indicators that could facilitate the early identification of the subgroup of patients with MDD in need of highly specialized care. Initial patient indicators were derived from a systematic review. Subsequently, a structured conceptualization methodology known as concept mapping was employed to complement the initial list of indicators by clinical expertise and develop a consensus-based conceptual framework. Subject-matter experts were invited to participate in the subsequent steps (brainstorming, sorting, and rating) of the concept mapping process. A final concept map solution was generated using nonmetric multidimensional scaling and agglomerative hierarchical cluster analyses. In total, 67 subject-matter experts participated in the concept mapping process. The final concept map revealed the following 10 major clusters of indicators: 1-depression severity, 2-onset and (treatment) course, 3-comorbid personality disorder, 4-comorbid substance use disorder, 5-other psychiatric comorbidity, 6-somatic comorbidity, 7-maladaptive coping, 8-childhood trauma, 9-social factors, and 10-psychosocial dysfunction. The study findings highlight the need for a comprehensive assessment of patient indicators in determining the need for highly specialized care, and suggest that the treatment allocation of patients with MDD to highly specialized mental healthcare settings should be guided by the assessment of clinical and nonclinical patient factors. © 2018 Wiley Periodicals, Inc.

Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013

PubMed Central

Goldhirsch, A.; Winer, E. P.; Coates, A. S.; Gelber, R. D.; Piccart-Gebhart, M.; Thürlimann, B.; Senn, H.-J.; Albain, Kathy S.; André, Fabrice; Bergh, Jonas; Bonnefoi, Hervé; Bretel-Morales, Denisse; Burstein, Harold; Cardoso, Fatima; Castiglione-Gertsch, Monica; Coates, Alan S.; Colleoni, Marco; Costa, Alberto; Curigliano, Giuseppe; Davidson, Nancy E.; Di Leo, Angelo; Ejlertsen, Bent; Forbes, John F.; Gelber, Richard D.; Gnant, Michael; Goldhirsch, Aron; Goodwin, Pamela; Goss, Paul E.; Harris, Jay R.; Hayes, Daniel F.; Hudis, Clifford A.; Ingle, James N.; Jassem, Jacek; Jiang, Zefei; Karlsson, Per; Loibl, Sibylle; Morrow, Monica; Namer, Moise; Kent Osborne, C.; Partridge, Ann H.; Penault-Llorca, Frédérique; Perou, Charles M.; Piccart-Gebhart, Martine J.; Pritchard, Kathleen I.; Rutgers, Emiel J.T.; Sedlmayer, Felix; Semiglazov, Vladimir; Shao, Zhi-Ming; Smith, Ian; Thürlimann, Beat; Toi, Masakazu; Tutt, Andrew; Untch, Michael; Viale, Giuseppe; Watanabe, Toru; Wilcken, Nicholas; Winer, Eric P.; Wood, William C.

2013-01-01

The 13th St Gallen International Breast Cancer Conference (2013) Expert Panel reviewed and endorsed substantial new evidence on aspects of the local and regional therapies for early breast cancer, supporting less extensive surgery to the axilla and shorter durations of radiation therapy. It refined its earlier approach to the classification and management of luminal disease in the absence of amplification or overexpression of the Human Epidermal growth factor Receptor 2 (HER2) oncogene, while retaining essentially unchanged recommendations for the systemic adjuvant therapy of HER2-positive and ‘triple-negative’ disease. The Panel again accepted that conventional clinico-pathological factors provided a surrogate subtype classification, while noting that in those areas of the world where multi-gene molecular assays are readily available many clinicians prefer to base chemotherapy decisions for patients with luminal disease on these genomic results rather than the surrogate subtype definitions. Several multi-gene molecular assays were recognized as providing accurate and reproducible prognostic information, and in some cases prediction of response to chemotherapy. Cost and availability preclude their application in many environments at the present time. Broad treatment recommendations are presented. Such recommendations do not imply that each Panel member agrees: indeed, among more than 100 questions, only one (trastuzumab duration) commanded 100% agreement. The various recommendations in fact carried differing degrees of support, as reflected in the nuanced wording of the text below and in the votes recorded in supplementary Appendix S1, available at Annals of Oncology online. Detailed decisions on treatment will as always involve clinical consideration of disease extent, host factors, patient preferences and social and economic constraints. PMID:23917950

Research priority setting for integrated early child development and violence prevention (ECD+) in low and middle income countries: An expert opinion exercise.

PubMed

Tomlinson, Mark; Jordans, Mark; MacMillan, Harriet; Betancourt, Theresa; Hunt, Xanthe; Mikton, Christopher

2017-10-01

Child development in low and middle income countries (LMIC) is compromised by multiple risk factors. Reducing children's exposure to harmful events is essential for early childhood development (ECD). In particular, preventing violence against children - a highly prevalent risk factor that negatively affects optimal child development - should be an intervention priority. We used the Child Health and Nutrition Initiative (CHNRI) method for the setting of research priorities in integrated Early Childhood Development and violence prevention programs (ECD+). An expert group was identified and invited to systematically list and score research questions. A total of 186 stakeholders were asked to contribute five research questions each, and contributions were received from 81 respondents. These were subsequently evaluated using a set of five criteria: answerability; effectiveness; feasibility and/or affordability; applicability and impact; and equity. Of the 400 questions generated, a composite group of 50 were scored by 55 respondents. The highest scoring research questions related to the training of Community Health Workers (CHW's) to deliver ECD+ interventions effectively and whether ECD+ interventions could be integrated within existing delivery platforms such as HIV, nutrition or mental health platforms. The priority research questions can direct new research initiatives, mainly in focusing on the effectiveness of an ECD+ approach, as well as on service delivery questions. To the best of our knowledge, this is the first systematic exercise of its kind in the field of ECD+. The findings from this research priority setting exercise can help guide donors and other development actors towards funding priorities for important future research related to ECD and violence prevention. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

An ensemble boosting model for predicting transfer to the pediatric intensive care unit.

PubMed

Rubin, Jonathan; Potes, Cristhian; Xu-Wilson, Minnan; Dong, Junzi; Rahman, Asif; Nguyen, Hiep; Moromisato, David

2018-04-01

Early deterioration indicators have the potential to alert hospital care staff in advance of adverse events, such as patients requiring an increased level of care, or the need for rapid response teams to be called. Our work focuses on the problem of predicting the transfer of pediatric patients from the general ward of a hospital to the pediatric intensive care unit. The development of a data-driven pediatric early deterioration indicator for use by clinicians with the purpose of predicting encounters where transfer from the general ward to the PICU is likely. Using data collected over 5.5 years from the electronic health records of two medical facilities, we develop machine learning classifiers based on adaptive boosting and gradient tree boosting. We further combine these learned classifiers into an ensemble model and compare its performance to a modified pediatric early warning score (PEWS) baseline that relies on expert defined guidelines. To gauge model generalizability, we perform an inter-facility evaluation where we train our algorithm on data from one facility and perform evaluation on a hidden test dataset from a separate facility. We show that improvements are witnessed over the modified PEWS baseline in accuracy (0.77 vs. 0.69), sensitivity (0.80 vs. 0.68), specificity (0.74 vs. 0.70) and AUROC (0.85 vs. 0.73). Data-driven, machine learning algorithms can improve PICU transfer prediction accuracy compared to expertly defined systems, such as a modified PEWS, but care must be taken in the training of such approaches to avoid inadvertently introducing bias into the outcomes of these systems. Copyright © 2018 Elsevier B.V. All rights reserved.

Decision Support Tool for Early Differential Diagnosis of Acute Lung Injury and Cardiogenic Pulmonary Edema in Medical Critically Ill Patients

PubMed Central

Shahjehan, Khurram; Li, Guangxi; Dhokarh, Rajanigandha; Kashyap, Rahul; Janish, Christopher; Alsara, Anas; Jaffe, Allan S.; Hubmayr, Rolf D.; Gajic, Ognjen

2012-01-01

Background: At the onset of acute hypoxic respiratory failure, critically ill patients with acute lung injury (ALI) may be difficult to distinguish from those with cardiogenic pulmonary edema (CPE). No single clinical parameter provides satisfying prediction. We hypothesized that a combination of those will facilitate early differential diagnosis. Methods: In a population-based retrospective development cohort, validated electronic surveillance identified critically ill adult patients with acute pulmonary edema. Recursive partitioning and logistic regression were used to develop a decision support tool based on routine clinical information to differentiate ALI from CPE. Performance of the score was validated in an independent cohort of referral patients. Blinded post hoc expert review served as gold standard. Results: Of 332 patients in a development cohort, expert reviewers (κ, 0.86) classified 156 as having ALI and 176 as having CPE. The validation cohort had 161 patients (ALI = 113, CPE = 48). The score was based on risk factors for ALI and CPE, age, alcohol abuse, chemotherapy, and peripheral oxygen saturation/Fio2 ratio. It demonstrated good discrimination (area under curve [AUC] = 0.81; 95% CI, 0.77-0.86) and calibration (Hosmer-Lemeshow [HL] P = .16). Similar performance was obtained in the validation cohort (AUC = 0.80; 95% CI, 0.72-0.88; HL P = .13). Conclusions: A simple decision support tool accurately classifies acute pulmonary edema, reserving advanced testing for a subset of patients in whom satisfying prediction cannot be made. This novel tool may facilitate early inclusion of patients with ALI and CPE into research studies as well as improve and rationalize clinical management and resource use. PMID:22030803

Technology assessment for Spaceship Two, space tourism, and private spaceflight

NASA Astrophysics Data System (ADS)

Hancock, Randy

A seven-step technology assessment was conducted to address questions regarding the significance and likely consequences associated with the introduction of Spaceship Two, space tourism, and private spaceflight. Impacts were assessed across four categories: the Role and Functions of Government, Private Industry Factors, Cultural and Societal Impacts, and the Time Frame in which these impacts were anticipated to occur. The technology assessment findings were compared to the results of expert interviews that addressed the sane four categories. The researcher noted that, while there was overwhelming agreement between the technology assessment's primary impacts and the expert interview responses, there were several differences. The technology assessment and interviewees agreed that the federal government would likely be both a regulator and user of private spaceflight. Both agreed that business partnerships would be key in pursuing private spaceflight. There was also consensus that, as market forces come to bear, ticket prices would drop and a larger market and broader passenger demographic would emerge. The technology assessment and experts agreed that an accident, especially one early in the industry's evolution, could be disastrous. Both agreed that private spaceflight can serve as a inspiration to students and be a positive influence in society, and both agreed that the start of passenger flights should take place in the 2010 - 2012 timeframe. Due to the potentially disastrous consequences of an accident, there was agreement between the technology assessment and experts on the value of flight and ground crew training, driven by insurance carriers and federal mandate. Most differences between the technology assessment's findings and the expert interview responses were due to omission, rather than direct disagreement. However, this was not the case in every instance. The most significant difference between the technology assessment and the experts involved the viability of point-to-point transport, where the technology assessment found that it is unlikely with current Spaceship technology. Perhaps one of the most notable findings from this research was that SpaceShip Two would likely serve as a milestone in achievement, and the technology's greatest impact could be that it may serve as an important stepping-stone on the path to further innovation.

Experts' recommendations for the management of cardiogenic shock in children.

PubMed

Brissaud, Olivier; Botte, Astrid; Cambonie, Gilles; Dauger, Stéphane; de Saint Blanquat, Laure; Durand, Philippe; Gournay, Véronique; Guillet, Elodie; Laux, Daniela; Leclerc, Francis; Mauriat, Philippe; Boulain, Thierry; Kuteifan, Khaldoun

2016-12-01

Cardiogenic shock which corresponds to an acute state of circulatory failure due to impairment of myocardial contractility is a very rare disease in children, even more than in adults. To date, no international recommendations regarding its management in critically ill children are available. An experts' recommendations in adult population have recently been made (Levy et al. Ann Intensive Care 5(1):52, 2015; Levy et al. Ann Intensive Care 5(1):26, 2015). We present herein recommendations for the management of cardiogenic shock in children, developed with the grading of recommendations' assessment, development, and evaluation system by an expert group of the Groupe Francophone de Réanimation et Urgences Pédiatriques (French Group for Pediatric Intensive Care and Emergencies). The recommendations cover four major fields of application such as: recognition of early signs of shock and the patient pathway, management principles and therapeutic goals, monitoring hemodynamic and biological variables, and circulatory support (indications, techniques, organization, and transfer criteria). Major principle care for children with cardiogenic shock is primarily based on clinical and echocardiographic assessment. There are few drugs reported as effective in childhood in the medical literature. The use of circulatory support should be facilitated in terms of organization and reflected in the centers that support these children. Children with cardiogenic shock are vulnerable and should be followed regularly by intensivist cardiologists and pediatricians. The experts emphasize the multidisciplinary nature of management of children with cardiogenic shock and the importance of effective communication between emergency medical assistance teams (SAMU), mobile pediatric emergency units (SMUR), pediatric emergency departments, pediatric cardiology and cardiac surgery departments, and pediatric intensive care units.

Face and content validity of the virtual reality simulator 'ScanTrainer®'.

PubMed

Alsalamah, Amal; Campo, Rudi; Tanos, Vasilios; Grimbizis, Gregoris; Van Belle, Yves; Hood, Kerenza; Pugh, Neil; Amso, Nazar

2017-01-01

Ultrasonography is a first-line imaging in the investigation of women's irregular bleeding and other gynaecological pathologies, e.g. ovarian cysts and early pregnancy problems. However, teaching ultrasound, especially transvaginal scanning, remains a challenge for health professionals. New technology such as simulation may potentially facilitate and expedite the process of learning ultrasound. Simulation may prove to be realistic, very close to real patient scanning experience for the sonographer and objectively able to assist the development of basic skills such as image manipulation, hand-eye coordination and examination technique. The aim of this study was to determine the face and content validity of a virtual reality simulator (ScanTrainer®, MedaPhor plc, Cardiff, Wales, UK) as reflective of real transvaginal ultrasound (TVUS) scanning. A questionnaire with 14 simulator-related statements was distributed to a number of participants with differing levels of sonography experience in order to determine the level of agreement between the use of the simulator in training and real practice. There were 36 participants: novices ( n  = 25) and experts ( n  = 11) who rated the simulator. Median scores of face validity statements between experts and non-experts using a 10-point visual analogue scale (VAS) ratings ranged between 7.5 and 9.0 ( p  > 0.05) indicated a high level of agreement. Experts' median scores of content validity statements ranged from 8.4 to 9.0. The findings confirm that the simulator has the feel and look of real-time scanning with high face validity. Similarly, its tutorial structures and learning steps confirm the content validity.

Consensus statement on blocking the effects of interleukin-6 and in particular by interleukin-6 receptor inhibition in rheumatoid arthritis and other inflammatory conditions

PubMed Central

Smolen, Josef S; Schoels, Monika M; Nishimoto, Norihiro; Breedveld, Ferdinand C; Burmester, Gerd R; Dougados, Maxime; Emery, Paul; Ferraccioli, Gianfranco; Gabay, Cem; Gibofsky, Allan; Gomez-Reino, Juan Jesus; Jones, Graeme; Kvien, Tore K; Murakami, Miho; Betteridge, Neil; Bingham, Clifton O; Bykerk, Vivian; Choy, Ernest H; Combe, Bernard; Cutolo, Maurizio; Graninger, Winfried; Lanas, Angel; Martin-Mola, Emilio; Montecucco, Carlomaurizio; Ostergaard, Mikkel; Pavelka, Karel; Rubbert-Roth, Andrea; Sattar, Naveed; Scholte-Voshaar, Marieke; Tanaka, Yoshiya; Trauner, Michael; Valentini, Gabriele; Winthrop, Kevin L; de Wit, Maarten; van der Heijde, Désirée

2013-01-01

Background Since approval of tocilizumab (TCZ) for treatment of rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA), interleukin 6 (IL-6) pathway inhibition was evaluated in trials of TCZ and other agents targeting the IL-6 receptor and ligand in various RA populations and other inflammatory diseases. This consensus document informs on interference with the IL-6 pathway based on evidence and expert opinion. Methods Preparation of this document involved international experts in RA treatment and RA patients. A systematic literature search was performed that focused on TCZ and other IL6-pathway inhibitors in RA and other diseases. Subsequently, incorporating available published evidence and expert opinion, the steering committee and a broader expert committee (both including RA patients) formulated the current consensus statement. Results The consensus statement covers use of TCZ as combination- or monotherapy in various RA populations and includes clinical, functional and structural aspects. The statement also addresses the second approved indication in Europe JIA and non-approved indications. Also early phase trials involving additional agents that target the IL-6 receptor or IL-6 were evaluated. Safety concerns, including haematological, hepatic and metabolic issues as well as infections, are addressed likewise. Conclusions The consensus statement identifies points to consider when using TCZ, regarding indications, contraindications, screening, dose, comedication, response evaluation and safety. The document is aimed at supporting clinicians and informing patients, administrators and payers on opportunities and limitations of IL-6 pathway inhibition. PMID:23172750

The Interactive Child Distress Screener: Development and Preliminary Feasibility Testing

PubMed Central

2018-01-01

Background Early identification of child emotional and behavioral concerns is essential for the prevention of mental health problems; however, few suitable child-reported screening measures are available. Digital tools offer an exciting opportunity for obtaining clinical information from the child’s perspective. Objective The aim of this study was to describe the initial development and pilot testing of the Interactive Child Distress Screener (ICDS). The ICDS is a Web-based screening instrument for the early identification of emotional and behavioral problems in children aged between 5 and 12 years. Methods This paper utilized a mixed-methods approach to (1) develop and refine item content using an expert review process (study 1) and (2) develop and refine prototype animations and an app interface using codesign with child users (study 2). Study 1 involved an iterative process that comprised the following four steps: (1) the initial development of target constructs, (2) preliminary content validation (face validity, item importance, and suitability for animation) from an expert panel of researchers and psychologists (N=9), (3) item refinement, and (4) a follow-up validation with the same expert panel. Study 2 also comprised four steps, which are as follows: (1) the development of prototype animations, (2) the development of the app interface and a response format, (3) child interviews to determine feasibility and obtain feedback, and (4) refinement of animations and interface. Cognitive interviews were conducted with 18 children aged between 4 and 12 years who tested 3 prototype animated items. Children were asked to describe the target behavior, how well the animations captured the intended behavior, and provide suggestions for improvement. Their ability to understand the wording of instructions was also assessed, as well as the general acceptability of character and sound design. Results In study 1, a revised list of 15 constructs was generated from the first and second round of expert feedback. These were rated highly in terms of importance (mean 6.32, SD 0.42) and perceived compatibility of items (mean 6.41, SD 0.45) on a 7-point scale. In study 2, overall feedback regarding the character design and sounds was positive. Children’s ability to understand intended behaviors varied according to target items, and feedback highlighted key objectives for improvements such as adding contextual cues or improving character detail. These design changes were incorporated through an iterative process, with examples presented. Conclusions The ICDS has potential to obtain clinical information from the child’s perspective that may otherwise be overlooked. If effective, the ICDS will provide a quick, engaging, and easy-to-use screener that can be utilized in routine care settings. This project highlights the importance of involving an expert review and user codesign in the development of digital assessment tools for children. PMID:29674310

ST-segment monitoring: putting standards into practice.

PubMed

Flanders, Sonya A

2007-01-01

ST-segment monitoring is one key reason that continuous electrocardiographic monitoring is performed in hospitals, and can help with early detection of myocardial ischemia for at-risk patients. Although ST-segment monitoring research, guidelines, and expert consensus statements have been published, ST-segment monitoring has not been implemented in all appropriate clinical areas. The purpose of this article is to present relevant research, review the latest practice standards, and discuss issues important to nurses wishing to implement ST-segment monitoring.

The Roller-Coaster Years: Raising Your Child through the Maddening yet Magical Middle School Years. A Comprehensive Guide for Parents of 10- to 15-Year-Olds.

ERIC Educational Resources Information Center

Giannetti, Charlene C.; Sagarese, Margaret

Intended for parents of 10- to 15-year-olds, this book is a guide to mastering the ups and downs of early adolescence. The book draws together the latest information from experts, supported and advised by the National Middle School Association, and insights from surveys of parents, teachers, and the children themselves to cover every facet of the…

Regulation of Cancer-Causing Food Additives-Time for a Change?

DTIC Science & Technology

1981-12-11

color, flavor, and aid in processing food or maintaining its nutritional quality. WHY THE REVIEW WAS MADE In response to a request from seven Members...a difficult process 16 Conclusions 19 3 REGULATING CANCER-CAUSING FOOD ADDITIVES--A CONTROVERSIAL ISSUE 20 Experts agree on the need for changing the...HISTORY OF FOOD SAFETY REGULATION Innovations in the food processing industry since the early 1900s have resulted in changes in the concerns about the

Spanish Consensus Statement: The Treatment of Muscle Tears in Sport.

PubMed

Fernandez-Jaén, Tomas F; Rey, Guillermo Álvarez; Cuesta, Jordi Ardevol; Loureda, Rafael Arriaza; España, Fernando Ávila; Matas, Ramón Balius; Pazos, Fernando Baró; de Dios Beas Jiménez, Juan; Rosell, Jorge Candel; Fernandez, César Cobián; Ros, Francisco Esparza; Colmenero, Josefina Espejo; de Prado, Jorge Fernández; Cota, Juan José García; González, Jose Ignacio Garrido; Santander, Manuela González; Munilla, Miguel Ángel Herrador; Ruiz, Francisco Ivorra; Díaz, Fernando Jiménez; Marqueta, Pedro Manonelles; Fernandez, Antonio Maestro; Benito, Juan José Muñoz; Vilás, Ramón Olivé; Teres, Xavier Peirau; Amaro, José Peña; Roque, Juan Pérez San; Parenteu, Christophe Ramírez; Serna, Juan Ribas; Álvarez, Mikel Sánchez; Marchori, Carlos Sanchez; Soto, Miguel Del Valle; Alonso, José María Villalón; García, Pedro Guillen; de la Iglesia, Nicolas Hugo; Alcorocho, Juan Manuel Lopez

2015-12-01

On the 21st of March, 2015, experts met at Clínica CEMTRO in Madrid, Spain, under the patronage of The Spanish Society for Sports Traumatology (SETRADE), The Spanish Federation of Sports Medicine (FEMEDE), The Spanish Association of Medical Services for Football Clubs (AEMEF), and The Spanish Association of Medical Services for Basketball Clubs (AEMB) with the aim of establishing a round table that would allow specialists to consider the most appropriate current general actions to be taken when treating muscle tears in sport, based on proven scientific data described in the medical literature. Each expert received a questionnaire prior to the aforementioned meeting comprising a set of questions concerning therapeutic indications generally applied in the different stages present during muscle repair. The present Consensus Document is the result of the answers to the questionnaire and resulting discussion and consensus over which are the best current indications in the treatment of muscle tears in sport. Avoiding immobilization, not taking nonsteroidal anti-inflammatory drugs (NSAIDs) randomly, fostering early mobilization, increasing vascularization of injured, site and regulating inflammatory mechanisms-without inhibiting these from the early stages of the recovery period-all stood out as main points of the Consensus Document. Additionally, there is controversy concerning cell stimulation techniques and the use of growth factors or cell inhibitors. The decision concerning discharge was unanimous, as was the criteria considered when it came to performing sport techniques without pain.

Early-life nutritional exposures and lifelong health: immediate and long-lasting impacts of probiotics, vitamin D, and breastfeeding.

PubMed

Berti, Cristiana; Agostoni, Carlo; Davanzo, Riccardo; Hyppönen, Elina; Isolauri, Erika; Meltzer, Helle M; Steegers-Theunissen, Régine P M; Cetin, Irene

2017-02-01

Pregnancy and infancy comprise the most critical stages for conditioning an individual's health, with a number of implications for subsequent risks of morbidity, mortality, and reproductive health. Nutrition may influence both the overall pregnancy outcome and the growth trajectory and immune system of the fetus and infant, with short- and long-term effects on the health of the offspring. Within this context, leading experts at Expo Milano 2015 in Milan, Italy, discussed up-to-date knowledge while providing suggestions and challenges before, during, and after pregnancy. This narrative review summarizes the key issues raised by the experts concerning the interplay between the nutritional environment from conception to early infancy and the offspring's immediate and lifelong health, with a particular focus on epigenetic mechanisms, probiotics, vitamin D, and breastfeeding. Taken together, the findings strengthen the awareness that nutritional exposures occurring from preconception to the postnatal period may be strong determinants of the offspring's health and may provide supportive evidence for current nutritional recommendations and guidelines for pregnant women and infants. Critical topics to be addressed in future research and translated into recommendations of public health relevance are also highlighted. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Spanish Consensus Statement

PubMed Central

Rey, Guillermo Álvarez; Cuesta, Jordi Ardevol; Loureda, Rafael Arriaza; España, Fernando Ávila; Matas, Ramón Balius; Pazos, Fernando Baró; de Dios Beas Jiménez, Juan; Rosell, Jorge Candel; Fernandez, César Cobián; Ros, Francisco Esparza; Colmenero, Josefina Espejo; de Prado, Jorge Fernández; Cota, Juan José García; González, Jose Ignacio Garrido; Santander, Manuela González; Munilla, Miguel Ángel Herrador; Ruiz, Francisco Ivorra; Díaz, Fernando Jiménez; Marqueta, Pedro Manonelles; Fernandez, Antonio Maestro; Benito, Juan José Muñoz; Vilás, Ramón Olivé; Teres, Xavier Peirau; Amaro, José Peña; Roque, Juan Pérez San; Parenteu, Christophe Ramírez; Serna, Juan Ribas; Álvarez, Mikel Sánchez; Marchori, Carlos Sanchez; Soto, Miguel del Valle; Alonso, José María Villalón; García, Pedro Guillen; de la Iglesia, Nicolas Hugo; Alcorocho, Juan Manuel Lopez

2015-01-01

On the 21st of March, 2015, experts met at Clínica CEMTRO in Madrid, Spain, under the patronage of The Spanish Society for Sports Traumatology (SETRADE), The Spanish Federation of Sports Medicine (FEMEDE), The Spanish Association of Medical Services for Football Clubs (AEMEF), and The Spanish Association of Medical Services for Basketball Clubs (AEMB) with the aim of establishing a round table that would allow specialists to consider the most appropriate current general actions to be taken when treating muscle tears in sport, based on proven scientific data described in the medical literature. Each expert received a questionnaire prior to the aforementioned meeting comprising a set of questions concerning therapeutic indications generally applied in the different stages present during muscle repair. The present Consensus Document is the result of the answers to the questionnaire and resulting discussion and consensus over which are the best current indications in the treatment of muscle tears in sport. Avoiding immobilization, not taking nonsteroidal anti-inflammatory drugs (NSAIDs) randomly, fostering early mobilization, increasing vascularization of injured, site and regulating inflammatory mechanisms—without inhibiting these from the early stages of the recovery period—all stood out as main points of the Consensus Document. Additionally, there is controversy concerning cell stimulation techniques and the use of growth factors or cell inhibitors. The decision concerning discharge was unanimous, as was the criteria considered when it came to performing sport techniques without pain. PMID:27213161

What is the value of occupational therapy in return to work for breast cancer patients? A qualitative inquiry among experts.

PubMed

Désiron, H A M; Donceel, P; Godderis, L; Van Hoof, E; de Rijk, A

2015-03-01

An increasing number of patients are confronted with breast cancer (BC) and functional limitations after treatment. Occupational therapy (OT) is successful in return to work (RTW), but not yet available for BC patients. This paper explores experts' opinions on OT interventions for RTW in BC patients in the Belgian context. Primary data were topic-interviews with all heads of OT departments in Flemish University Hospitals (n = 5). Secondary data were four focus group interviews with care professionals in oncological rehabilitation (n = 41). All data were transcribed and thematic analysis was used. Integrated in multidisciplinary teamwork, OT interventions should have a holistic and client-centred approach, start early in the rehabilitation process, include workplace visits and contacts with relevant stakeholders, and use goal setting to start up tailor made rehabilitation, linking assessment of abilities and work. Occupational therapists are regarded as professionals who can effectively answer BC patients unmet needs regarding RTW due to their skill to bridge between care and workplace. According to the experts, OT interventions supporting RTW in BC patients are useful when integrated in regular healthcare. They agree on the components but organisational barriers should be removed, for example not providing reimbursement for including this type of support trough healthcare insurance. © 2014 John Wiley & Sons Ltd.

Screening for Infectious Diseases among Newly Arrived Migrants: Experiences and Practices in Non-EU Countries of the Mediterranean Basin and Black Sea.

PubMed

Napoli, Christian; Dente, Maria Grazia; Kärki, Tommi; Riccardo, Flavia; Rossi, Pasqualino; Declich, Silvia

2015-12-08

Changing migration dynamics in the Mediterranean Sea and differences in infectious diseases (ID) burden between the countries of origin have raised questions whether public health actions are needed to avoid the transmission of ID. Screening newly arrived migrants for ID is one health monitoring option, offering opportunities for prevention, early detection and treatment. The authors conducted a survey among country experts in non-European Union countries of the Mediterranean and Black Sea, in order to explore current ID screening practices and policies for newly arrived migrants. The association between the existence of guidelines and the proportion of refugees in the population was also estimated. Eighteen country experts responded (90%) out of the 20 invited. Eleven countries (61%) implemented screening programmes and six (38%) had national guidelines. Screening was performed most often for tuberculosis at the holding level. A higher proportion of refugees in the population was associated with the existence of guidelines for screening (p = 0.05). Fourteen experts (88%) considered screening among migrants useful. The results show that screening for ID in newly arrived migrants is relevant for non-EU countries of the Mediterranean and Black Sea. Common guidelines could be promoted focusing on both individual and public health benefits of screening programmes.

International Summit on Laparoscopic Pancreatic Resection (ISLPR) "Coimbatore Summit Statements".

PubMed

Palanivelu, Chinnusamy; Takaori, Kyoichi; Abu Hilal, Mohammad; Kooby, David A; Wakabayashi, Go; Agarwal, Anil; Berti, Stefano; Besselink, Marc G; Chen, Kuo Hsin; Gumbs, Andrew A; Han, Ho-Seong; Honda, Goro; Khatkov, Igor; Kim, Hong Jin; Li, Jiang Tao; Duy Long, Tran Cong; Machado, Marcel Autran; Matsushita, Akira; Menon, Krish; Min-Hua, Zheng; Nakamura, Masafumi; Nagakawa, Yuichi; Pekolj, Juan; Poves, Ignasi; Rahman, Shahidur; Rong, Liu; Sa Cunha, Antonio; Senthilnathan, Palanisamy; Shrikhande, Shailesh V; Gurumurthy, S Srivatsan; Sup Yoon, Dong; Yoon, Yoo-Seok; Khatri, Vijay P

2018-03-01

The International Summit on Laparoscopic Pancreatic Resection (ISLPR) was held in Coimbatore, India, on 7th and 8th of October 2016 and thirty international experts who regularly perform laparoscopic pancreatic resections participated in ISPLR from four continents, i.e., South and North America, Europe and Asia. Prior to ISLPR, the first conversation among the experts was made online on August 26th, 2016 and the structures of ISPLR were developed. The aims of ISPLR were; i) to identify indications and optimal case selection criteria for minimally invasive pancreatic resection (MIPR) in the setting of both benign and malignant diseases; ii) standardization of techniques to increase the safety of MIPR; iii) identification of common problems faced during MIPR and developing associated management strategies; iv) development of clinical protocols to allow early identification of complications and develop the accompanying management plan to minimize morbidity and mortality. As a process for interactive discussion, the experts were requested to complete an online questionnaire consisting of 65 questions about the various technical aspects of laparoscopic pancreatic resections. Two further web-based meetings were conducted prior to ISPLR. Through further discussion during ISPLR, we have created productive statements regarding the topics of Disease, Implementation, Patients, Techniques, and Instrumentations (DIPTI) and hereby publish them as "Coimbatore Summit Statements". Copyright © 2018 Elsevier Ltd. All rights reserved.

Classical Hodgkin's lymphoma: the Lymphoma Study Association guidelines for relapsed and refractory adult patients eligible for transplant.

PubMed

Van Den Neste, Eric; Casasnovas, Olivier; André, Marc; Touati, Mohamed; Senecal, Delphine; Edeline, Véronique; Stamatoullas, Aspasia; Fornecker, Luc; Deau, Bénédicte; Gastinne, Thomas; Reman, Oumédaly; Gaillard, Isabelle; Borel, Cécile; Brice, Pauline; Fermé, Christophe

2013-08-01

The Hodgkin's Lymphoma Committee of the Lymphoma Study Association (LYSA) gathered in 2012 to prepare guidelines on the management of transplant-eligible patients with relapsing or refractory Hodgkin's lymphoma. The working group is made up of a multidisciplinary panel of experts with a significant background in Hodgkin's lymphoma. Each member of the panel of experts provided an interpretation of the evidence and a systematic approach to obtain consensus was used. Grades of recommendation were not required since levels of evidence are mainly based on phase II trials or standard practice. Data arising from randomized trials are emphasized. The final version was endorsed by the scientific council of the LYSA. The expert panel recommends a risk-adapted strategy (conventional treatment, or single/double transplantation and/or radiotherapy) based on three risk factors at progression (primary refractory disease, remission duration < 1 year, stage III/IV), and an early evaluation of salvage chemosensitivity, including (18)fluorodeoxy glucose-positron emission tomography interpreted according to the Deauville scoring system. Most relapsed or refractory Hodgkin's lymphoma patients chemosensitive to salvage should receive high-dose therapy and autologous stem-cell transplantation as standard. Efforts should be made to increase the proportion of chemosensitive patients by alternating non-cross-resistant chemotherapy lines or exploring the role of novel drugs.

Anti-HER2 Therapy Beyond Second-Line for HER2-Positive Metastatic Breast Cancer: A Short Review and Recommendations for Several Clinical Scenarios from a Spanish Expert Panel

PubMed Central

Martínez-Jañez, Noelia; Chacón, Ignacio; de Juan, Ana; Cruz-Merino, Luis; del Barco, Sònia; Fernández, Isaura; García-Teijido, Paula; Gómez-Bernal, Amalia; Plazaola, Arrate; Ponce, José; Servitja, Sonia; Zamora, Pilar

2016-01-01

Summary Background The aim of this project was to provide an expert opinion regarding anti-human epidermal growth factor receptor 2 (HER2) therapy beyond second-line treatment of metastatic breast cancer (mBC). Methods A group of experts discussed specific issues concerning anti-HER2 therapy in late-line settings in mBC. Results Trastuzumab emtansine (T-DM1) or dual HER2 blockade appeared to be good options for HER2-positive mBC after ≥ 2 HER2-targeted therapies. Once an objective response has been achieved with anti-HER2-containing therapy, the anti-HER2 agent can be continued until progression of the disease, unacceptable toxicity or patient decision. mBC treated with ≥ 3 consecutive lines of anti-HER therapy, ≥ 1 being a dual HER2 blockade and with early progression of disease during a fourth or later-line treatment, are clinically resistant to anti-HER therapy. For progression of metastasis in the brain after anti-HER2 therapy, lapatinib and chemotherapy appear to be a good alternative after best local treatment. Conclusions Further clinical trials are needed to provide valuable knowledge about the best treatment options in the later settings of mBC. PMID:27239176

Report of the 5th European expert meeting on rotavirus vaccination (EEROVAC).

PubMed

de Hoog, Marieke L A; Vesikari, Timo; Giaquinto, Carlo; Huppertz, Hans-Iko; Martinon-Torres, Federico; Bruijning-Verhagen, Patricia

2018-04-03

The Fifth European Expert Meeting on Rotavirus Vaccination was convened in Utrecht, The Netherlands, in March 2017. The 2-day meeting included invited lectures as well as original oral and poster presentations and brought together experts from 21 countries. Summary findings of the meeting include: Rotavirus vaccination programmes in Europe have resulted in reductions of 60-90% in rotavirus outpatient visits and hospitalizations. Long term trends indicate this impact is sustained over the years. Herd effects, protecting unvaccinated children and neonates too young to be vaccinated have been observed in many European countries. Early evidence now also suggests that rotavirus vaccination may be instrumental in the prevention of celiac disease. Special attention should be given to preterm infants, who may age out of the vaccination window before hospital discharge and to HIV infected children who are at increased risk of severe rotavirus AGE. There is a small but increased risk of IS following rotavirus vaccination and parents should therefore be informed about possible signs and symptoms of IS. New insights in rotavirus genetic susceptibility and interactions with microbiome may open opportunities for interventions to improve protection by vaccination, in particular in LMIC. The development of several novel rotavirus vaccines discussed at the meeting is also promising in this respect.