Vitamin C supplementation and the common cold--was Linus Pauling right or wrong?

PubMed

Hemilä, H

1997-01-01

In 1970 Linus Pauling claimed that vitamin C prevents and alleviates the episodes of the common cold. Pauling was correct in concluding from trials published up till then, that in general vitamin C does have biological effects on the common cold, but he was rather over-optimistic as regards the size of benefit. His quantitative conclusions were based on a single placebo-controlled trial on schoolchildren in a skiing camp in the Swiss Alps, in which a significant decrease in common cold incidence and duration in the group administered 1 g/day of vitamin C was found. As children in a skiing camp are not a representative sample of the general population, Pauling's extrapolation to the population at large was too bold, erring as to the magnitude of the effect. Nevertheless, Pauling's general conclusion that vitamin C has physiological effects on the common cold is of major importance as it conflicts with the prevailing consensus that the only physiological effect of vitamin C on human beings is to prevent scurvy.

Difficulties with telephone-based surveys on alcohol in high-income countries: the Canadian example

PubMed Central

Shield, Kevin D.; Rehm, Jürgen

2012-01-01

Accurate information concerning alcohol consumption level and patterns is vital to formulating public health policy. The objective of this paper is to critically assess the extent to which survey design, response rate and alcohol consumption coverage obtained in random digit dialing, telephone-based surveys impact on conclusions about alcohol consumption and its patterns in the general population. Our analysis will be based on the Canadian Alcohol and Drug Use Monitoring Survey (CADUMS) 2008, a national survey intended to be representative of the general population. The conclusions of this paper are as follows: 1) ignoring people who are homeless, institutionalized and/or do not have a home phone may lead to an underestimation of the prevalence of alcohol consumption and related problems; 2) weighting of observations to population demographics may lead to a increase in the design effect, does not necessarily address the underlying selection bias, and may lead to overly influential observations; and 3) the accurate characterization of alcohol consumption patterns obtained by triangulating the data with the adult per capita consumption estimate is essential for comparative analyses and intervention planning especially when the alcohol coverage rate is low like in the CADUMS with 34%. PMID:22337654

General Aviation in Nebraska: Nebraska SATS Project Background Paper No. 1

NASA Technical Reports Server (NTRS)

Smith, Russell; Wachal, Jocelyn

2000-01-01

The Nebraska SATS project is a state-level component of NASA's Small Aircraft Transportation System (SATS). During the next several years the project will examine several different factors affecting SATS implementation in Nebraska. These include economic and taxation issues, public policy issues, airport planning processes, information dissemination strategies, and systemic change factors. This background paper profiles the general aviation system in Nebraska. It is written to provide information about the "context" within which SATS will be pursued. The primary focus is thus on describing and providing background information about the current situation. A secondary focus is on drawing general conclusions about the ability of the current system to incorporate the types of changes implied by SATS. First, some brief information on the U.S. aviation system is provided. The next two sections profile the current general aviation aircraft and pilot base. Nebraska's system of general aviation airports is then described. Within this section of the paper, information is provided on the different types of general aviation airports in Nebraska, airport activity levels and current infrastructure. The fourth major section of the background paper looks at Nebraska's local airport authorities. These special purpose local governments oversee the majority of the general aviation airports in the state. Among the items examined are total expenditures, capital expenditures and planning activities. Next, the paper provides background information on the Nebraska Department of Aeronautics (NDA) and recent Federal funding for general aviation in Nebraska. The final section presents summary conclusions.

Chromatographic and computational assessment of lipophilicity using sum of ranking differences and generalized pair-correlation.

PubMed

Andrić, Filip; Héberger, Károly

2015-02-06

Lipophilicity (logP) represents one of the most studied and most frequently used fundamental physicochemical properties. At present there are several possibilities for its quantitative expression and many of them stems from chromatographic experiments. Numerous attempts have been made to compare different computational methods, chromatographic methods vs. computational approaches, as well as chromatographic methods and direct shake-flask procedure without definite results or these findings are not accepted generally. In the present work numerous chromatographically derived lipophilicity measures in combination with diverse computational methods were ranked and clustered using the novel variable discrimination and ranking approaches based on the sum of ranking differences and the generalized pair correlation method. Available literature logP data measured on HILIC, and classical reversed-phase combining different classes of compounds have been compared with most frequently used multivariate data analysis techniques (principal component and hierarchical cluster analysis) as well as with the conclusions in the original sources. Chromatographic lipophilicity measures obtained under typical reversed-phase conditions outperform the majority of computationally estimated logPs. Oppositely, in the case of HILIC none of the many proposed chromatographic indices overcomes any of the computationally assessed logPs. Only two of them (logkmin and kmin) may be selected as recommended chromatographic lipophilicity measures. Both ranking approaches, sum of ranking differences and generalized pair correlation method, although based on different backgrounds, provides highly similar variable ordering and grouping leading to the same conclusions. Copyright © 2015. Published by Elsevier B.V.

Highlighted scientific findings of the Interior Columbia Basin Ecosystem Management Project.

Treesearch

Thomas M. Quigley; Heidi Bigler Cole

1997-01-01

Decisions regarding 72 million acres of Forest Service- and Bureau of Land Management- administered lands will be based on scientific findings brought forth in the Interior Columbia Basin Ecosystem Management Project. Some highlights of the scientific findings are presented here. Project scientists drew three general conclusions: (1) Conditions and trends differ widely...

Environmental Conservation. The Oil and Gas Industries, Volume One.

ERIC Educational Resources Information Center

National Petroleum Council, Washington, DC.

Prepared in response to a Department of the Interior request, this report is a comprehensive study of environmental conservation problems as they relate to or have impact on the petroleum industry. It contains the general comments and conclusions of The National Petroleum Council based on an analysis of detailed data. For presentation of key…

The Status of Proving among US Secondary Mathematics Teachers

ERIC Educational Resources Information Center

Kotelawala, Usha

2016-01-01

This report examines teachers' self-espoused attitudes and beliefs on proving in the secondary mathematics classroom. Conclusions were based on a questionnaire of 78 US mathematics teachers who had completed at least 2 years of teaching mathematics at the secondary level. While these teachers placed importance on proving as a general mathematical…

Ancient India: The Asiatic Ethiopians.

ERIC Educational Resources Information Center

Scott, Carolyn McPherson

This curriculum unit was developed by a participant in the 1993 Fulbright-Hays Program "India: Continuity and Change." The unit attempts to place India in the "picture frame" of the ancient world as a part of a whole, not as a separate entity. Reading materials enable students to draw broader general conclusions based on the…

The Use of Corpus Examples for Language Comprehension and Production

ERIC Educational Resources Information Center

Frankenberg-Garcia, Ana

2014-01-01

One of the many new features of English language learners' dictionaries derived from the technological developments that have taken place over recent decades is the presence of corpus-based examples to illustrate the use of words in context. However, empirical studies have generally not been able to produce conclusive evidence about their…

Part-whole reasoning in medical ontologies revisited--introducing SEP triplets into classification-based description logics.

PubMed

Schulz, S; Romacker, M; Hahn, U

1998-01-01

The development of powerful and comprehensive medical ontologies that support formal reasoning on a large scale is one of the key requirements for clinical computing in the next millennium. Taxonomic medical knowledge, a major portion of these ontologies, is mainly characterized by generalization and part-whole relations between concepts. While reasoning in generalization hierarchies is quite well understood, no fully conclusive mechanism as yet exists for part-whole reasoning. The approach we take emulates part-whole reasoning via classification-based reasoning using SEP triplets, a special data structure for encoding part-whole relations that is fully embedded in the formal framework of standard description logics.

Part-whole reasoning in medical ontologies revisited--introducing SEP triplets into classification-based description logics.

PubMed Central

Schulz, S.; Romacker, M.; Hahn, U.

1998-01-01

The development of powerful and comprehensive medical ontologies that support formal reasoning on a large scale is one of the key requirements for clinical computing in the next millennium. Taxonomic medical knowledge, a major portion of these ontologies, is mainly characterized by generalization and part-whole relations between concepts. While reasoning in generalization hierarchies is quite well understood, no fully conclusive mechanism as yet exists for part-whole reasoning. The approach we take emulates part-whole reasoning via classification-based reasoning using SEP triplets, a special data structure for encoding part-whole relations that is fully embedded in the formal framework of standard description logics. Images Figure 3 PMID:9929335

Clinic Services for Persons with AIDS

PubMed Central

Markson, Leona E; Turner, Barbara J; Cocroft, Jim; Houchens, Robert; Fanning, Thomas R

1997-01-01

OBJECTIVE To profile characteristics of clinics caring for persons with advanced HIV infection. DESIGN AND SETTING Survey of clinic directors in New York State. PARTICIPANTS Newly diagnosed Medicaid-enrolled AIDS patients in New York state in federal fiscal years 1987–1992 (n = 6,184) managed by 62 HIV specialty, 53 hospital-based general medicine/primary care, 36 community-based primary care, and 28 other clinics. MEASUREMENTS AND MAIN RESULTS Telephone survey about clinic hours, emphasis on HIV, staffing, procedures, and directors’ rating of care. Estimates of the number of newly diagnosed, Medicaid-enrolled AIDS patients treated in surveyed clinics were obtained from claims data. We found that community-based clinics were significantly more likely to have longer hours, a physician on call, or to accommodate unscheduled care than were hospital-based general medicine/primary care or other types of clinics. Compared with HIV specialty clinics, general medicine/primary care clinics were less likely to have HIV-specific care attributes such as a director of HIV care (98% vs 72%), multidisciplinary conferences on HIV care (83% vs 32%), or a standard initial HIV workup (90% vs 70%). Of general medicine/primary care clinics, most (83%) were staffed by residents and fellows compared with only 68% of HIV or 25% of community-based clinics (p < .001). General medicine/primary care clinics were less likely than community-based clinics to perform Pap smears (75% vs 94%) or to have case managers on payroll (21% vs 81%). CONCLUSIONS In this sample of clinics, hospital-based general medicine/primary care clinics managing the care of Medicaid enrollees with AIDS appeared to have more limited hours and availability of specific services than HIV specialty or community-based clinics.

Dermal Matrices and Bioengineered Skin Substitutes: A Critical Review of Current Options

PubMed Central

Hamdi, Moustapha; Abberton, Keren; Morrison, Wayne

2015-01-01

Background: Over recent decades, scientists and surgeons have collaborated to develop various bioengineered and synthetic products as an alternative to skin grafts. Despite the numerous articles and reviews written about dermal skin substitutes, there is no general consensus. Methods: This article reviews dermal skin scaffolds used in clinical applications and experimental settings. For scaffold evaluation, we focused on clinical and/or histological results, and conclusions are listed. Explanations for general trends were sought based on existing knowledge about tissue engineering principles and wound healing mechanisms. Results: Decellularized dermis seems to remain the best option with no other acellular scaffold being clinically proven to gain better results yet. In general, chemically cross-linked products were seen to be less effective in skin tissue engineering. Biocompatibility could be enhanced by preseeding substitutes with fibroblasts to allow some natural scaffold remodeling before product application. Conclusions: Skin substitutes are a useful tool in plastic and reconstructive surgery practices as an alternative to skin grafts. In the choice of substitute, the general plastic surgery principle of replacing like tissue with like tissue seems to be still standing, and products most resembling the natural dermal extracellular matrix should be preferred. PMID:25674365

Generalized Onsager's reciprocal relations for the master and Fokker-Planck equations

NASA Astrophysics Data System (ADS)

Peng, Liangrong; Zhu, Yi; Hong, Liu

2018-06-01

The Onsager's reciprocal relation plays a fundamental role in the nonequilibrium thermodynamics. However, unfortunately, its classical version is valid only within a narrow region near equilibrium due to the linear regression hypothesis, which largely restricts its usage. In this paper, based on the conservation-dissipation formalism, a generalized version of Onsager's relations for the master equations and Fokker-Planck equations was derived. Nonlinear constitutive relations with nonsymmetric and positively stable operators, which become symmetric under the detailed balance condition, constitute key features of this new generalization. Similar conclusions also hold for many other classical models in physics and chemistry, which in turn make the current study as a benchmark for the application of generalized Onsager's relations in nonequilibrium thermodynamics.

Evidence-informed recommendations to reduce dissemination bias in clinical research: conclusions from the OPEN (Overcome failure to Publish nEgative fiNdings) project based on an international consensus meeting

PubMed Central

Meerpohl, Joerg J; Schell, Lisa K; Bassler, Dirk; Gallus, Silvano; Kleijnen, Jos; Kulig, Michael; La Vecchia, Carlo; Marušić, Ana; Ravaud, Philippe; Reis, Andreas; Schmucker, Christine; Strech, Daniel; Urrútia, Gerard; Antes, Gerd

2015-01-01

Background Dissemination bias in clinical research severely impedes informed decision-making not only for healthcare professionals and patients, but also for funders, research ethics committees, regulatory bodies and other stakeholder groups that make health-related decisions. Decisions based on incomplete and biased evidence cannot only harm people, but may also have huge financial implications by wasting resources on ineffective or harmful diagnostic and therapeutic measures, and unnecessary research. Owing to involvement of multiple stakeholders, it remains easy for any single group to assign responsibility for resolving the problem to others. Objective To develop evidence-informed general and targeted recommendations addressing the various stakeholders involved in knowledge generation and dissemination to help overcome the problem of dissemination bias on the basis of previously collated evidence. Methods Based on findings from systematic reviews, document analyses and surveys, we developed general and targeted draft recommendations. During a 2-day workshop in summer 2013, these draft recommendations were discussed with external experts and key stakeholders, and refined following a rigorous and transparent methodological approach. Results Four general, overarching recommendations applicable to all or most stakeholder groups were formulated, addressing (1) awareness raising, (2) implementation of targeted recommendations, (3) trial registration and results posting, and (4) systematic approaches to evidence synthesis. These general recommendations are complemented and specified by 47 targeted recommendations tailored towards funding agencies, pharmaceutical and device companies, research institutions, researchers (systematic reviewers and trialists), research ethics committees, trial registries, journal editors and publishers, regulatory agencies, benefit (health technology) assessment institutions and legislators. Conclusions Despite various recent examples of dissemination bias and several initiatives to reduce it, the problem of dissemination bias has not been resolved. Tailored recommendations based on a comprehensive approach will hopefully help increase transparency in biomedical research by overcoming the failure to disseminate negative findings. PMID:25943371

[Static Retinal Vessel Analysis in Population-based Study SHIP-Trend].

PubMed

Theophil, Constanze; Jürgens, Clemens; Großjohann, Rico; Kempin, Robert; Ittermann, Till; Nauck, Matthias; Völzke, Henry; Tost, Frank H W

2017-08-24

Background Interdisciplinary investigations of possible connections between general diseases and ophthalmological changes are difficult to perform in the clinical environment. But they are gaining in importance as a result of the age-related increase in chronic diseases. The collection of health-related parameters in the Study of Health in Pomerania (SHIP) project allows to derive conclusions for the general population. Methods The population-based SHIP trend study was conducted between 2008 and 2012 in Greifswald. The baseline cohort included 4420 subjects (response 50.1%) at the age of 20 to 84 years. The pre-existence of arterial hypertension, diabetes mellitus and smoking status were questioned in a standardized questionnaire, the blood pressure and the HbA 1c were determined by the laboratory. The vascular diameter of retinal arterioles and venules were determined by means of non-mydriatic fundus images and the retinal arterial (CRAE) and venous equivalent (CRVE) were calculated therefrom. The association of diabetes mellitus, HbA 1c , smoking status and blood pressure with the retinal vascular parameters was tested for age and sex with linear regression models. Results In 3218 subjects with evaluable standardized fundus photographs, significant associations of elevated HbA 1c (> 6.5%), smoking status and systolic and diastolic blood pressure were found with the retinal vessel widths CRAE and CRVE. Anamnestic diabetes mellitus, on the other hand, was not associated with any of the vascular parameters. Conclusion This research study reveals a relevant correlation between general diseases and the retinal blood flow in the eye. Therefore, general diseases can induce ophthalmological changes and eye examination can provide information for the assessment of general diseases. Georg Thieme Verlag KG Stuttgart · New York.

Cognitive competencies - Products of genes, experience, and technology. [for training of primates

NASA Technical Reports Server (NTRS)

Rumbaugh, Duane M.; Savage-Rumbaugh, E. S.

1992-01-01

The paper examines methods used in studying cognitive competency in primates. Citing experiments on teaching language skills to chimpanzees, it is shown that some methods used for inquiry might lead to the cultivation and generation of new competencies, and specifically to the development of observational and relational learning skills. It is noted that methods can also limit the generality of conclusions; erroneous conclusions may be made based on certain generally accepted methods, whereby the research might be treatments that profoundly determine the assessment of dependent variables. Particular attention is given to the role of age in learning, showing that young primates can be taught the meaning of lexigrams and many specific tasks in much shorter time than adults; on the basis of these experiments, it was concluded that cultural gains did evolve primarily as a consequence of context within which infants were growing.

The need for an international debate in pediatrics about obesity and nutrition.

PubMed

de Hoyos-Parra, Ricardo

2014-01-01

Non-communicable diseases are at the center of international consultation and there's a general agreement on saying that several issues need to be solved before implementing prevention strategies and intervention programs. A sound knowledge of all the factors involved in the epidemic spread of a disease is the first target that has to be achieved in order to provide governments and policy makers with the best evidence-based conclusions. Present data are still too weak to gather solid decisions. Lack of standardized methods, common definitions or coherence with real life performances results therefore in conclusions that oscillate from one statement to its contrary. From this perspective, pediatricians and general practitioners are of great importance, being the direct link between the scientific community and children, having therefore the possibility to act at the first phases of obesity development, forging the best possible knowledge in order to transform prevention in the best possible cure.

17 CFR 229.910 - (Item 910) Fairness of the transaction.

Code of Federal Regulations, 2011 CFR

2011-04-01

... (b) of this Item (§ 229.910) are based, in whole or in part, on any report, opinion or appraisal... known to the general partner that relate to the conclusions in any such report, opinion or appraisal including, but not limited to, developments or trends that have affected or are reasonably likely to affect...

17 CFR 229.910 - (Item 910) Fairness of the transaction.

Code of Federal Regulations, 2013 CFR

2013-04-01

... (b) of this Item (§ 229.910) are based, in whole or in part, on any report, opinion or appraisal... known to the general partner that relate to the conclusions in any such report, opinion or appraisal including, but not limited to, developments or trends that have affected or are reasonably likely to affect...

17 CFR 229.910 - (Item 910) Fairness of the transaction.

Code of Federal Regulations, 2012 CFR

2012-04-01

... (b) of this Item (§ 229.910) are based, in whole or in part, on any report, opinion or appraisal... known to the general partner that relate to the conclusions in any such report, opinion or appraisal including, but not limited to, developments or trends that have affected or are reasonably likely to affect...

17 CFR 229.910 - (Item 910) Fairness of the transaction.

Code of Federal Regulations, 2014 CFR

2014-04-01

... (b) of this Item (§ 229.910) are based, in whole or in part, on any report, opinion or appraisal... known to the general partner that relate to the conclusions in any such report, opinion or appraisal including, but not limited to, developments or trends that have affected or are reasonably likely to affect...

Implementing evidence-based medicine in general practice: a focus group based study

PubMed Central

Hannes, Karin; Leys, Marcus; Vermeire, Etienne; Aertgeerts, Bert; Buntinx, Frank; Depoorter, Anne-Marie

2005-01-01

Background Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM) in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore the barriers of Flemish GPs (General Practitioners) to the implementation of EBM in routine clinical work and to identify possible strategies for integrating EBM in daily work. Methods We used a qualitative research strategy to gather and analyse data. We organised focus groups between September 2002 and April 2003. The focus group data were analysed using a combined strategy of 'between-case' analysis and 'grounded theory approach'. Thirty-one general practitioners participated in four focus groups. Purposeful sampling was used to recruit participants. Results A basic classification model documents the influencing factors and actors on a micro-, meso- as well as macro-level. Patients, colleagues, competences, logistics and time were identified on the micro-level (the GPs' individual practice), commercial and consumer organisations on the meso-level (institutions, organisations) and health care policy, media and specific characteristics of evidence on the macro-level (policy level and international scientific community). Existing barriers and possible strategies to overcome these barriers were described. Conclusion In order to implement EBM in routine general practice, an integrated approach on different levels needs to be developed. PMID:16153300

Study of 300,486 individuals identifies 148 independent genetic loci influencing general cognitive function.

PubMed

Davies, Gail; Lam, Max; Harris, Sarah E; Trampush, Joey W; Luciano, Michelle; Hill, W David; Hagenaars, Saskia P; Ritchie, Stuart J; Marioni, Riccardo E; Fawns-Ritchie, Chloe; Liewald, David C M; Okely, Judith A; Ahola-Olli, Ari V; Barnes, Catriona L K; Bertram, Lars; Bis, Joshua C; Burdick, Katherine E; Christoforou, Andrea; DeRosse, Pamela; Djurovic, Srdjan; Espeseth, Thomas; Giakoumaki, Stella; Giddaluru, Sudheer; Gustavson, Daniel E; Hayward, Caroline; Hofer, Edith; Ikram, M Arfan; Karlsson, Robert; Knowles, Emma; Lahti, Jari; Leber, Markus; Li, Shuo; Mather, Karen A; Melle, Ingrid; Morris, Derek; Oldmeadow, Christopher; Palviainen, Teemu; Payton, Antony; Pazoki, Raha; Petrovic, Katja; Reynolds, Chandra A; Sargurupremraj, Muralidharan; Scholz, Markus; Smith, Jennifer A; Smith, Albert V; Terzikhan, Natalie; Thalamuthu, Anbupalam; Trompet, Stella; van der Lee, Sven J; Ware, Erin B; Windham, B Gwen; Wright, Margaret J; Yang, Jingyun; Yu, Jin; Ames, David; Amin, Najaf; Amouyel, Philippe; Andreassen, Ole A; Armstrong, Nicola J; Assareh, Amelia A; Attia, John R; Attix, Deborah; Avramopoulos, Dimitrios; Bennett, David A; Böhmer, Anne C; Boyle, Patricia A; Brodaty, Henry; Campbell, Harry; Cannon, Tyrone D; Cirulli, Elizabeth T; Congdon, Eliza; Conley, Emily Drabant; Corley, Janie; Cox, Simon R; Dale, Anders M; Dehghan, Abbas; Dick, Danielle; Dickinson, Dwight; Eriksson, Johan G; Evangelou, Evangelos; Faul, Jessica D; Ford, Ian; Freimer, Nelson A; Gao, He; Giegling, Ina; Gillespie, Nathan A; Gordon, Scott D; Gottesman, Rebecca F; Griswold, Michael E; Gudnason, Vilmundur; Harris, Tamara B; Hartmann, Annette M; Hatzimanolis, Alex; Heiss, Gerardo; Holliday, Elizabeth G; Joshi, Peter K; Kähönen, Mika; Kardia, Sharon L R; Karlsson, Ida; Kleineidam, Luca; Knopman, David S; Kochan, Nicole A; Konte, Bettina; Kwok, John B; Le Hellard, Stephanie; Lee, Teresa; Lehtimäki, Terho; Li, Shu-Chen; Liu, Tian; Koini, Marisa; London, Edythe; Longstreth, Will T; Lopez, Oscar L; Loukola, Anu; Luck, Tobias; Lundervold, Astri J; Lundquist, Anders; Lyytikäinen, Leo-Pekka; Martin, Nicholas G; Montgomery, Grant W; Murray, Alison D; Need, Anna C; Noordam, Raymond; Nyberg, Lars; Ollier, William; Papenberg, Goran; Pattie, Alison; Polasek, Ozren; Poldrack, Russell A; Psaty, Bruce M; Reppermund, Simone; Riedel-Heller, Steffi G; Rose, Richard J; Rotter, Jerome I; Roussos, Panos; Rovio, Suvi P; Saba, Yasaman; Sabb, Fred W; Sachdev, Perminder S; Satizabal, Claudia L; Schmid, Matthias; Scott, Rodney J; Scult, Matthew A; Simino, Jeannette; Slagboom, P Eline; Smyrnis, Nikolaos; Soumaré, Aïcha; Stefanis, Nikos C; Stott, David J; Straub, Richard E; Sundet, Kjetil; Taylor, Adele M; Taylor, Kent D; Tzoulaki, Ioanna; Tzourio, Christophe; Uitterlinden, André; Vitart, Veronique; Voineskos, Aristotle N; Kaprio, Jaakko; Wagner, Michael; Wagner, Holger; Weinhold, Leonie; Wen, K Hoyan; Widen, Elisabeth; Yang, Qiong; Zhao, Wei; Adams, Hieab H H; Arking, Dan E; Bilder, Robert M; Bitsios, Panos; Boerwinkle, Eric; Chiba-Falek, Ornit; Corvin, Aiden; De Jager, Philip L; Debette, Stéphanie; Donohoe, Gary; Elliott, Paul; Fitzpatrick, Annette L; Gill, Michael; Glahn, David C; Hägg, Sara; Hansell, Narelle K; Hariri, Ahmad R; Ikram, M Kamran; Jukema, J Wouter; Vuoksimaa, Eero; Keller, Matthew C; Kremen, William S; Launer, Lenore; Lindenberger, Ulman; Palotie, Aarno; Pedersen, Nancy L; Pendleton, Neil; Porteous, David J; Räikkönen, Katri; Raitakari, Olli T; Ramirez, Alfredo; Reinvang, Ivar; Rudan, Igor; Dan Rujescu; Schmidt, Reinhold; Schmidt, Helena; Schofield, Peter W; Schofield, Peter R; Starr, John M; Steen, Vidar M; Trollor, Julian N; Turner, Steven T; Van Duijn, Cornelia M; Villringer, Arno; Weinberger, Daniel R; Weir, David R; Wilson, James F; Malhotra, Anil; McIntosh, Andrew M; Gale, Catharine R; Seshadri, Sudha; Mosley, Thomas H; Bressler, Jan; Lencz, Todd; Deary, Ian J

2018-05-29

General cognitive function is a prominent and relatively stable human trait that is associated with many important life outcomes. We combine cognitive and genetic data from the CHARGE and COGENT consortia, and UK Biobank (total N = 300,486; age 16-102) and find 148 genome-wide significant independent loci (P < 5 × 10 -8 ) associated with general cognitive function. Within the novel genetic loci are variants associated with neurodegenerative and neurodevelopmental disorders, physical and psychiatric illnesses, and brain structure. Gene-based analyses find 709 genes associated with general cognitive function. Expression levels across the cortex are associated with general cognitive function. Using polygenic scores, up to 4.3% of variance in general cognitive function is predicted in independent samples. We detect significant genetic overlap between general cognitive function, reaction time, and many health variables including eyesight, hypertension, and longevity. In conclusion we identify novel genetic loci and pathways contributing to the heritability of general cognitive function.

Computer Based Intelligence Support: An Integrated Expert System and Decision Support Systems Approach

DTIC Science & Technology

1988-06-01

and for that reason has received considerable attention recently. Of particular interest in this research Is the work of Toulmin et. al. [19793 In...whenever we make a claim there must be some grounds in which to base our conclusion, Toulmin states that our thoughts are generally directed from the...WARRANT will be the absolute reason to believe the CLAIM on the basis of the GROUNDS. For that, Toulmin allows for further BACKING which, in his

Pharmaceutical trials in general practice: the first 100 protocols. An audit by the clinical research ethics committee of the Royal College of General Practitioners.

PubMed Central

Wise, P.; Drury, M.

1996-01-01

OBJECTIVE: To assess the outcome of 100 general practice based, multicentre research projects submitted to the ethics committee of the Royal College of General Practitioners by pharmaceutical companies or their agents between 1984 and 1989. DESIGN: Analysis of consecutive submitted protocols for stated objectives, study design, and outcomes; detailed review of committee minutes and correspondence in relation to amendment and approval; assessment of final reports submitted at conclusion of studies. SUBJECTS: 82 finally approved protocols, embracing 34,523 proposed trial subjects and 1195 proposed general practice investigators. MAIN OUTCOME MEASURES: Success at enrolling subjects and investigators; commencement and completion data; validity of final report's assessment of efficacy, safety, tolerability, and acceptability; and method of use and dissemination of findings. RESULTS: 18 studies were not approved and 45 had to be amended. Randomised controlled trials comprised 46 of the original submissions. Remuneration considerations, inadequate information or consent sheets, pregnancy safety, the need to discontinue existing therapy, and suboptimal scientific content were major reasons for rejecting studies or asking for amendments. Of the 82 approved studies 8 were not started. Shortfalls of investigators (of 39%) and trial subjects (of 37%) and an overall 23% withdrawal rate were responsible for a significant incidence of inconclusive results. Within the six year follow up interval, only 19 of the studies had been formally published. CONCLUSIONS: This audit identified substantial ethical concerns in the process of approving multicentre general practice pharmaceutical research. PMID:8939118

Brief Report: New Evidence for a Social-Specific Imagination Deficit in Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Ten Eycke, Kayla D.; Müller, Ulrich

2015-01-01

Previous research suggests that children with autism have deficits in drawing imaginative content. However, these conclusions are largely based on tasks that require children to draw impossible persons, and performance on this task may be limited by social deficits. To determine the generality of the deficit in imagination in children with autism,…

Financial Performance of Specialized Cotton Farms. Agriculture Information Bulletin Number 538.

ERIC Educational Resources Information Center

Ahearn, Mary; And Others

This United States Department of Agriculture summary report focuses on the revenues, costs, and finances of specialized cotton farms in 1986. The report also provides general information on all farms producing cotton. The data on which the report is based are from the 1986 Farm Costs and Returns Survey. Some of the conclusions drawn from the study…

A stochastic approach for automatic generation of urban drainage systems.

PubMed

Möderl, M; Butler, D; Rauch, W

2009-01-01

Typically, performance evaluation of new developed methodologies is based on one or more case studies. The investigation of multiple real world case studies is tedious and time consuming. Moreover extrapolating conclusions from individual investigations to a general basis is arguable and sometimes even wrong. In this article a stochastic approach is presented to evaluate new developed methodologies on a broader basis. For the approach the Matlab-tool "Case Study Generator" is developed which generates a variety of different virtual urban drainage systems automatically using boundary conditions e.g. length of urban drainage system, slope of catchment surface, etc. as input. The layout of the sewer system is based on an adapted Galton-Watson branching process. The sub catchments are allocated considering a digital terrain model. Sewer system components are designed according to standard values. In total, 10,000 different virtual case studies of urban drainage system are generated and simulated. Consequently, simulation results are evaluated using a performance indicator for surface flooding. Comparison between results of the virtual and two real world case studies indicates the promise of the method. The novelty of the approach is that it is possible to get more general conclusions in contrast to traditional evaluations with few case studies.

The glmS Ribozyme Cofactor is a General Acid-Base Catalyst

PubMed Central

Viladoms, Julia; Fedor, Martha J.

2012-01-01

The glmS ribozyme is the first natural self-cleaving ribozyme known to require a cofactor. The D-glucosamine-6-phosphate (GlcN6P) cofactor has been proposed to serve as a general acid, but its role in the catalytic mechanism has not been established conclusively. We surveyed GlcN6P-like molecules for their ability to support self-cleavage of the glmS ribozyme and found a strong correlation between the pH dependence of the cleavage reaction and the intrinsic acidity of the cofactors. For cofactors with low binding affinities the contribution to rate enhancement was proportional to their intrinsic acidity. This linear free-energy relationship between cofactor efficiency and acid dissociation constants is consistent with a mechanism in which the cofactors participate directly in the reaction as general acid-base catalysts. A high value for the Brønsted coefficient (β ~ 0.7) indicates that a significant amount of proton transfer has already occurred in the transition state. The glmS ribozyme is the first self-cleaving RNA to use an exogenous acid-base catalyst. PMID:23113700

The glmS ribozyme cofactor is a general acid-base catalyst.

PubMed

Viladoms, Júlia; Fedor, Martha J

2012-11-21

The glmS ribozyme is the first natural self-cleaving ribozyme known to require a cofactor. The d-glucosamine-6-phosphate (GlcN6P) cofactor has been proposed to serve as a general acid, but its role in the catalytic mechanism has not been established conclusively. We surveyed GlcN6P-like molecules for their ability to support self-cleavage of the glmS ribozyme and found a strong correlation between the pH dependence of the cleavage reaction and the intrinsic acidity of the cofactors. For cofactors with low binding affinities, the contribution to rate enhancement was proportional to their intrinsic acidity. This linear free-energy relationship between cofactor efficiency and acid dissociation constants is consistent with a mechanism in which the cofactors participate directly in the reaction as general acid-base catalysts. A high value for the Brønsted coefficient (β ~ 0.7) indicates that a significant amount of proton transfer has already occurred in the transition state. The glmS ribozyme is the first self-cleaving RNA to use an exogenous acid-base catalyst.

Prediction Error Representation in Individuals with Generalized Anxiety Disorder During Passive Avoidance

PubMed Central

White, Stuart F.; Geraci, Marilla; Lewis, Elizabeth; Leshin, Joseph; Teng, Cindy; Averbeck, Bruno; Meffert, Harma; Ernst, Monique; Blair, James R.; Grillon, Christian; Blair, Karina S.

2017-01-01

Objective Deficits in reinforcement-based decision-making have been reported in Generalized Anxiety Disorder. However, the pathophysiology of these deficits is largely unknown, extant studies have mainly examined youth and the integrity of core functional processes underpinning decision-making remain undetermined. In particular, it is unclear whether the representation of reinforcement prediction error (PE: the difference between received and expected reinforcement) is disrupted in Generalized Anxiety Disorder. The current study addresses these issues in adults with the disorder. Methods Forty-six un-medicated individuals with Generalized Anxiety Disorder and 32 healthy controls group-matched on IQ, gender and age, completed a passive avoidance task while undergoing functional MRI. Results Behaviorally, individuals with Generalized Anxiety Disorder showed impaired reinforcement-based decision-making. Imaging results revealed that during feedback, individuals with Generalized Anxiety Disorder relative to healthy controls showed a reduced correlation between PE and activity within ventromedial prefrontal cortex, ventral striatum and other structures implicated in decision-making. In addition, individuals with Generalized Anxiety Disorder relative to healthy participants showed a reduced correlation between punishment, but not reward, PEs and activity within bilateral lentiform nucleus/putamen. Conclusions This is the first study to identify computational impairments during decision-making in Generalized Anxiety Disorder. PE signaling is significantly disrupted in individuals with the disorder and may underpin the decision-making deficits observed in patients with GAD. PMID:27631963

New paths in post-graduate medical training in general practice - 8 years of experience with the pilot project Verbundweiterbildungplus Baden-Württemberg.

PubMed

Schwill, Simon; Magez, Julia; Joos, Stefanie; Steinhäuser, Jost; Ledig, Thomas; Rubik, Aline; Niebling, Wilhelm; Szecsenyi, Joachim; Flum, Elisabeth

2017-01-01

Background: In face of the looming shortage of general practitioners, primary healthcare providers and post-graduate training in general practice are increasingly becoming part of the political agenda in Germany. In 2009 the program "Verbundweiterbildung plus Baden-Württemberg" (VWB plus BW) was developed by the Competence Center for General Practice in Baden-Wuerttemberg to ensure primary healthcare in the future by enhancing the attractiveness of general medicine. This paper describes the experiences that have been gathered in developing a post-graduate training-program for physicians undergoing specialist training in general practice. Project description: The Competence Center for General Practice in Baden-Wuerttemberg supports the organization of regional networks dedicated to post-graduate medical education. First core element of the VWB plus BW program is a special seminar series for physicians pursuing post-graduate training. This seminar program is aligned with the German competency-based curriculum in general medicine and is meant to promote medical expertise and other related competencies, such as business and medical practice management and communication skills. Mentoring and advising the physicians regarding professional and personal planning form the second core element. The third core element is seen in the train-the-trainer seminars that address the competencies of the trainers. In order to focus the program's content closely on the needs of the target groups, scientifically based evaluations and research are carried out. Results: Since starting in 2009, 685 physicians have entered the program and 141 have passed the examination to become medical specialists (as of December 2016). In total, 31 networks, 60 hospitals and 211 general practices have participated. The seminar sessions have been rated on average with 1.43 on a six-point Likert scale by the physician trainees (1=extremely satisfied, 6=extremely dissatisfied). Alongside the medical training, these physicians viewed the exchange of information and experiences with other physicians as very positive and important. In 185 seminars lasting 90 minutes each, the seminar program has presently covered 250 out of 320 units in the competency-based curriculum for general medicine. A total of 281 trainers have been trained in 13 train-the-trainer courses and have rated this course on average with 1.36 on a six-point Likert scale. Above all, the trainers emphasized the exchange of information and experiences with other trainers as very positive. In 2013 the DEGAM concept for its Verbundweiterbildung plus program was developed based on that of the VWB plus BW. Since 2008 over 40 articles on the topic of post-graduate medical education have been published. Conclusion: The steadily increasing number of participants over the years demonstrates that the VWB plus BW is relevant for recent medical graduates and contributes to the attractiveness of general practice. The consistently excellent evaluations of the training program and the train-the-trainer course affirm the focus on the needs of the target groups. The post-graduate VWB plus BW program advances structured, competency-based and quality-oriented specialist training and fosters professional sharing between physicians - something that could also be relevant for other fields. The increasing numbers of participating physicians and specialists in general practice in Baden-Württemberg lead to the conclusion that the VWB plus BW program positively influences the number of general practitioners.

Evaluation of a rule base for decision making in general practice.

PubMed Central

Essex, B; Healy, M

1994-01-01

BACKGROUND. Decision making in general practice relies heavily on judgmental expertise. It should be possible to codify this expertise into rules and principles. AIM. A study was undertaken to evaluate the effectiveness, of rules from a rule base designed to improve students' and trainees' management decisions relating to patients seen in general practice. METHOD. The rule base was developed after studying decisions about and management of thousands of patients seen in one general practice over an eight year period. Vignettes were presented to 93 fourth year medical students and 179 general practitioner trainees. They recorded their perception and management of each case before and after being presented with a selection of relevant rules. Participants also commented on their level of agreement with each of the rules provided with the vignettes. A panel of five independent assessors then rated as good, acceptable or poor, the participants' perception and management of each case before and after seeing the rules. RESULTS. Exposure to a few selected rules of thumb improved the problem perception and management decisions of both undergraduates and trainees. The degree of improvement was not related to previous experience or to the stated level of agreement with the proposed rules. The assessors identified difficulties students and trainees experienced in changing their perceptions and management decisions when the rules suggested options they had not considered. CONCLUSION. The rules developed to improve decision making skills in general practice are effective when used with vignettes. The next phase is to transform the rule base into an expert system to train students and doctors to acquire decision making skills. It could also be used to provide decision support when confronted with difficult management decisions in general practice. PMID:8204334

Food, plant food, and vegetarian diets in the US dietary guidelines: conclusions of an expert panel.

PubMed

Jacobs, David R; Haddad, Ella H; Lanou, Amy Joy; Messina, Mark J

2009-05-01

We summarize conclusions drawn from a panel discussion at the "Fifth International Congress on Vegetarian Nutrition" about the roles of and emphasis on food, plant food, and vegetarianism in current and future US dietary guidelines. The most general recommendation of the panel was that future dietary guidelines, following the lead of the 2005 Dietary Guidelines Advisory Committee, should emphasize food-based recommendations and thinking to the full extent that evidence allows. Although nutrient-based thinking and Dietary Reference Intakes (DRIs) may help ensure an adequate diet in the sense that deficiency states are avoided, the emphasis on DRIs may not capture many important nutritional issues and may inhibit a focus on foods. More generally, in the context of the conference on vegetarian nutrition, this report focuses on the history and structure of the Dietary Guidelines Advisory Committee, on various plant food-oriented recommendations that are supported by literature evidence, and on mechanisms for participating in the process of forming dietary guidelines. Among recommendations that likely would improve health and the environment, some are oriented toward increased plant food consumption and some toward vegetarianism. The literature on health effects of individual foods and whole lifestyle diets is insufficient and justifies a call for future food-oriented research, including expanding the evidence base for plant-based and vegetarian diets. The Dietary Guidelines Advisory Committee's role should be carried forward to creation of a publicly accessible icon (eg, the current pyramid) and related materials to ensure that the science base is fully translated for the public.

A Systematic Investigation of Computation Models for Predicting Adverse Drug Reactions (ADRs)

PubMed Central

Kuang, Qifan; Wang, MinQi; Li, Rong; Dong, YongCheng; Li, Yizhou; Li, Menglong

2014-01-01

Background Early and accurate identification of adverse drug reactions (ADRs) is critically important for drug development and clinical safety. Computer-aided prediction of ADRs has attracted increasing attention in recent years, and many computational models have been proposed. However, because of the lack of systematic analysis and comparison of the different computational models, there remain limitations in designing more effective algorithms and selecting more useful features. There is therefore an urgent need to review and analyze previous computation models to obtain general conclusions that can provide useful guidance to construct more effective computational models to predict ADRs. Principal Findings In the current study, the main work is to compare and analyze the performance of existing computational methods to predict ADRs, by implementing and evaluating additional algorithms that have been earlier used for predicting drug targets. Our results indicated that topological and intrinsic features were complementary to an extent and the Jaccard coefficient had an important and general effect on the prediction of drug-ADR associations. By comparing the structure of each algorithm, final formulas of these algorithms were all converted to linear model in form, based on this finding we propose a new algorithm called the general weighted profile method and it yielded the best overall performance among the algorithms investigated in this paper. Conclusion Several meaningful conclusions and useful findings regarding the prediction of ADRs are provided for selecting optimal features and algorithms. PMID:25180585

The Twisting of Thin-walled, Stiffened Circular Cylinders

NASA Technical Reports Server (NTRS)

Schapitz, E

1938-01-01

On the basis of the present investigation of the twisting of thin-walled, stiffened cylinders the following conclusions can be reached: 1) there is as yet no generally applicable formula for the buckling moment of the skin; 2) the mathematical treatment of the condition of the shell after buckling of the skin is based on the tension-field theory, wherein the strain condition is considered homogenous.

Space-Based Space Surveillance Logistics Case Study: A Qualitative Product Support Element Analysis

DTIC Science & Technology

2017-12-01

Facilities and Infrastructure. Product Support Management and Design Interface are also covered, but only in a general manner. Conclusions from the study...core analysis, with the overarching two elements ( Design Interface and Product Support Management) mentioned briefly. G. THESIS STATEMENT This...were implemented. The two overarching elements of Product Support Management and Design Interface will be discussed briefly in the findings section

A Life-Course Analysis of Offense Specialization across Age: Introducing a New Method for Studying Individual Specialization over the Life Course

ERIC Educational Resources Information Center

Nieuwbeerta, Paul; Blokland, Arjan A. J.; Piquero, Alex R.; Sweeten, Gary

2011-01-01

Much of the knowledge base on offense specialization indicates that, although there is some (short-term) specialization, it exists amidst much versatility in offending. Yet this general conclusion is drawn on studies using very different conceptualizations of specialization and emerges with data primarily through the first two to three decades of…

Wood Made from Water?: An Introduction to Photosynthesis Based on a Historical Error

ERIC Educational Resources Information Center

Wrigley, Colin

2012-01-01

Three and a half centuries ago, a five-year experiment was conducted involving the growth of a willow tree in a pot which received only water. The conclusion, that a tree is therefore made solely from water, was not so ridiculous when there was still general acceptance of the Aristotelian view of only four "elements": water, earth, fire and air.…

Preliminary Specifications (Hardware and Software) for a Center for Information Services. Final Report on Mechanized Information Services in the University Library, Phase I - Planning. Part 10.

ERIC Educational Resources Information Center

California Univ., Los Angeles. Inst. of Library Research.

The general conclusions of the planning study on Mechanized Information Services in the University Library are that such services represent a desirable, even necessary, extension of the library's traditional functions. Preliminary specifications for such a library-based "Center for Information Services" (CIS) are presented in this report. Covered…

Service Area Market Analysis: Environmental Scanning.

ERIC Educational Resources Information Center

Front Range Community Coll., Westminster, CO.

This environmental scanning report presents, in brief, various key indicators: political climate, population demographics, secondary education, postsecondary education, welfare, unemployment, industry, labor, and general conclusions. General conclusions made in this report are as follows: higher education is expected to receive a slight increase…

Stimulus-reinforcement Based Decision-making and Anxiety: Impairment in Generalized Anxiety Disorder (GAD), but not in Generalized Social Phobia (GSP)

PubMed Central

DeVido, Jeffrey; Jones, Matthew; Geraci, Marilla; Hollon, Nick; Blair, R. J. R.; Pine, Daniel S.; Blair, Karina

2010-01-01

Background Generalized Social Phobia (GSP) involves the fear/avoidance of social situations while Generalized Anxiety Disorder (GAD) involves an intrusive worry about everyday life circumstances. It remains unclear whether these, highly comorbid, conditions represent distinct disorders or alternative presentations of a single underlying pathology. In this study, we examined stimulus-reinforcement based decision-making in GSP and GAD. Methods Twenty unmedicated patients with GSP, sixteen unmedicated patients with GAD and nineteen age, IQ, and gender matched healthy comparison individuals completed the Differential Reward/ Punishment Learning Task (DRPLT). In this task, the subject chooses between two objects associated with different levels of reward or punishment. Thus, response choice indexes not only reward/ punishment sensitivity but also sensitivity to reward/ punishment level according to between-object reinforcement distance. Results We found that patients with GAD committed a significantly greater number of errors compared to both the patients with GSP and the healthy comparison individuals. In contrast, the patients with GSP and the healthy comparison individuals did not differ in performance on this task. Conclusions These results link GAD with an anomalous non-affective based decision-making. Further, they are indicative that GSP and GAD are associated with distinct pathophysiologies. PMID:19102795

Spectral composition of light and growing of plants in controlled environments

NASA Technical Reports Server (NTRS)

Tikhomirov, Alexander A.

1994-01-01

The main conclusions of many investigations about general requirements of plants for spectral composition of PAR (photosynthetically active radiation) are based on phylogenetic aspects of plant growth. We think that these aspects are not the main criteria in choosing the spectral composition required for growing plants in controlled conditions. Our approach to this problem is based on plant and crop reaction under long duration growth with specific spectra and intensity. Only in this way can we determine correctly the role of light characteristics for developing crops.

What do evidence-based secondary journals tell us about the publication of clinically important articles in primary healthcare journals?

PubMed Central

McKibbon, Kathleen Ann; Wilczynski, Nancy L; Haynes, Robert Brian

2004-01-01

Background We conducted this analysis to determine i) which journals publish high-quality, clinically relevant studies in internal medicine, general/family practice, general practice nursing, and mental health; and ii) the proportion of clinically relevant articles in each journal. Methods We performed an analytic survey of a hand search of 170 general medicine, general healthcare, and specialty journals for 2000. Research staff assessed individual articles by using explicit criteria for scientific merit for healthcare application. Practitioners assessed the clinical importance of these articles. Outcome measures were the number of high-quality, clinically relevant studies published in the 170 journal titles and how many of these were published in each of four discipline-specific, secondary "evidence-based" journals (ACP Journal Club for internal medicine and its subspecialties; Evidence-Based Medicine for general/family practice; Evidence-Based Nursing for general practice nursing; and Evidence-Based Mental Health for all aspects of mental health). Original studies and review articles were classified for purpose: therapy and prevention, screening and diagnosis, prognosis, etiology and harm, economics and cost, clinical prediction guides, and qualitative studies. Results We evaluated 60,352 articles from 170 journal titles. The pass criteria of high-quality methods and clinically relevant material were met by 3059 original articles and 1073 review articles. For ACP Journal Club (internal medicine), four titles supplied 56.5% of the articles and 27 titles supplied the other 43.5%. For Evidence-Based Medicine (general/family practice), five titles supplied 50.7% of the articles and 40 titles supplied the remaining 49.3%. For Evidence-Based Nursing (general practice nursing), seven titles supplied 51.0% of the articles and 34 additional titles supplied 49.0%. For Evidence-Based Mental Health (mental health), nine titles supplied 53.2% of the articles and 34 additional titles supplied 46.8%. For the disciplines of internal medicine, general/family practice, and mental health (but not general practice nursing), the number of clinically important articles was correlated withScience Citation Index (SCI) Impact Factors. Conclusions Although many clinical journals publish high-quality, clinically relevant and important original studies and systematic reviews, the articles for each discipline studied were concentrated in a small subset of journals. This subset varied according to healthcare discipline; however, many of the important articles for all disciplines in this study were published in broad-based healthcare journals rather than subspecialty or discipline-specific journals. PMID:15350200

Advances in medical education and practice: student perceptions of the flipped classroom

PubMed Central

Ramnanan, Christopher J; Pound, Lynley D

2017-01-01

The flipped classroom (FC) approach to teaching has been increasingly employed in undergraduate medical education in recent years. In FC applications, students are first exposed to content via online resources. Subsequent face-to-face class time can then be devoted to student-centered activities that promote active learning. Although the FC has been well received by students in other contexts, the perceptions of medical students regarding this innovation are unclear. This review serves as an early exploration into medical student perceptions of benefits and limitations of the FC. Medical students have generally expressed strong appreciation for the pre-class preparation activities (especially when facilitated by concise, readily accessed online tools) as well as for interactive, engaging small group classroom activities. Some students have expressed concerns with the FC and noted that suboptimal student preparation and insufficient direction and structure during active learning sessions may limit the student-centered benefits. Although students generally perceive that FC approaches can improve their learning and knowledge, this has not been conclusively shown via performances on assessment tools, which may be related to caveats with the assessment tools used. In any case, lifelong self-directed learning skills are perceived by medical students to be enhanced by the FC. In conclusion, medical students have generally expressed strong satisfaction with early applications of the FC to undergraduate medical education, and generally prefer this method to lecture-based instruction. PMID:28144171

Advances in medical education and practice: student perceptions of the flipped classroom.

PubMed

Ramnanan, Christopher J; Pound, Lynley D

2017-01-01

The flipped classroom (FC) approach to teaching has been increasingly employed in undergraduate medical education in recent years. In FC applications, students are first exposed to content via online resources. Subsequent face-to-face class time can then be devoted to student-centered activities that promote active learning. Although the FC has been well received by students in other contexts, the perceptions of medical students regarding this innovation are unclear. This review serves as an early exploration into medical student perceptions of benefits and limitations of the FC. Medical students have generally expressed strong appreciation for the pre-class preparation activities (especially when facilitated by concise, readily accessed online tools) as well as for interactive, engaging small group classroom activities. Some students have expressed concerns with the FC and noted that suboptimal student preparation and insufficient direction and structure during active learning sessions may limit the student-centered benefits. Although students generally perceive that FC approaches can improve their learning and knowledge, this has not been conclusively shown via performances on assessment tools, which may be related to caveats with the assessment tools used. In any case, lifelong self-directed learning skills are perceived by medical students to be enhanced by the FC. In conclusion, medical students have generally expressed strong satisfaction with early applications of the FC to undergraduate medical education, and generally prefer this method to lecture-based instruction.

On the Use of Kronecker Operators for the Solution of Generalized Stochastic Petri Nets

NASA Technical Reports Server (NTRS)

Ciardo, Gianfranco; Tilgner, Marco

1996-01-01

We discuss how to describe the Markov chain underlying a generalized stochastic Petri net using Kronecker operators on smaller matrices. We extend previous approaches by allowing both an extensive type of marking-dependent behavior for the transitions and the presence of immediate synchronizations. The derivation of the results is thoroughly formalized, including the use of Kronecker operators in the treatment of the vanishing markings and the computation of impulse-based reward measures. We use our techniques to analyze a model whose solution using conventional methods would fail because of the state-space explosion. In the conclusion, we point out ideas to parallelize our approach.

A Field Test of Web-Based Screening for Dry Eye Disease to Enhance Awareness of Eye Problems Among General Internet Users: A Latent Strategy to Promote Health

PubMed Central

Uchino, Miki; Kawazoe, Takashi; Kamiyashiki, Masaaki; Sano, Kokoro; Tsubota, Kazuo

2013-01-01

Background A Web-based self-check system including a brief questionnaire would seem to be a suitable tool for rapid disease screening. Objective The purpose of this preliminary study was to test a Web-based self-screening questionnaire for drawing attention to dry eye disease among general Internet users and identifying those with a higher risk of developing the condition. Methods A survey website was launched and used to recruit participants from general Internet users. In the first phase, volunteers were asked to complete a Web-based self-screening questionnaire containing 12 questions on dry eye symptoms. The second phase focused on the respondents who reported five or more dry eye symptoms and expressed their intention to seek medical attention. These participants performed the Schirmer test, for evaluating tear production, and completed a paper-based lifestyle questionnaire to provide relevant background data. Results Of the 1689 visitors to the website, 980 (58.0%) volunteers completed the Web-based self-screening questionnaire. Among these, 355 (36.2%) respondents reported five or more dry eye symptoms. Then, 99 (27.9%) of the symptomatic participants performed the Schirmer test and completed the paper-based lifestyle questionnaire. Out of these, 32 (32.2%) had abnormal tear production (≤5 mm). Conclusions The proposed Web-based self-screening questionnaire seems to be a promising tool for raising awareness of dry eye disease among general Internet users and identifying those with a higher risk of developing the condition, although further research is needed to validate its effectiveness. PMID:24072379

Technical Note: Synchrotron-based high-energy x-ray phase sensitive microtomography for biomedical research

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

Liu, Huiqiang; Wu, Xizeng, E-mail: xwu@uabmc.edu, E-mail: tqxiao@sinap.ac.cn; Xiao, Tiqiao, E-mail: xwu@uabmc.edu, E-mail: tqxiao@sinap.ac.cn

Purpose: Propagation-based phase-contrast CT (PPCT) utilizes highly sensitive phase-contrast technology applied to x-ray microtomography. Performing phase retrieval on the acquired angular projections can enhance image contrast and enable quantitative imaging. In this work, the authors demonstrate the validity and advantages of a novel technique for high-resolution PPCT by using the generalized phase-attenuation duality (PAD) method of phase retrieval. Methods: A high-resolution angular projection data set of a fish head specimen was acquired with a monochromatic 60-keV x-ray beam. In one approach, the projection data were directly used for tomographic reconstruction. In two other approaches, the projection data were preprocessed bymore » phase retrieval based on either the linearized PAD method or the generalized PAD method. The reconstructed images from all three approaches were then compared in terms of tissue contrast-to-noise ratio and spatial resolution. Results: The authors’ experimental results demonstrated the validity of the PPCT technique based on the generalized PAD-based method. In addition, the results show that the authors’ technique is superior to the direct PPCT technique as well as the linearized PAD-based PPCT technique in terms of their relative capabilities for tissue discrimination and characterization. Conclusions: This novel PPCT technique demonstrates great potential for biomedical imaging, especially for applications that require high spatial resolution and limited radiation exposure.« less

Development of an Integrated, Computer-Based, Bibliographical Data System for a Large University Library. Annual Report to the National Science Foundation from the University of Chicago Library, 1967-68.

ERIC Educational Resources Information Center

Fussler, Herman H.; Payne, Charles T.

The project's second year (1967/68) was devoted to upgrading the computer operating software and programs to increase versatility and reliability. General conclusions about the program after 24 months of operation are that the project's objectives are sound and that effective utilization of computer-aided bibliographic data processing is essential…

Applicability of different onboard routing and processing techniques to mobile satellite systems

NASA Technical Reports Server (NTRS)

Craig, A. D.; Marston, P. C.; Bakken, P. M.; Vernucci, A.; Benedicto, J.

1993-01-01

The paper summarizes a study contract recently undertaken for ESA. The study compared the effectiveness of several processing architectures applied to multiple beam, geostationary global and European regional missions. The paper discusses architectures based on transparent SS-FDMA analog, transparent DSP and regenerative processing. Quantitative comparisons are presented and general conclusions are given with respect to suitability of the architectures to different mission requirements.

Justification of Shallow-Water Theory

NASA Astrophysics Data System (ADS)

Ostapenko, V. V.

2018-01-01

The basic conservation laws of shallow-water theory are derived from multidimensional mass and momentum integral conservation laws describing the plane-parallel flow of an ideal incompressible fluid above the horizontal bottom. This conclusion is based on the concept of hydrostatic approximation, which generalizes the concept of long-wavelength approximation and is used for justifying the applicability of the shallow-water theory in the simulation of wave flows of fluid with hydraulic bores.

Generalized Distributed Consensus-based Algorithms for Uncertain Systems and Networks

DTIC Science & Technology

2010-01-01

time linear systems with markovian jumping parameters and additive disturbances. SIAM Journal on Control and Optimization, 44(4):1165– 1191, 2005... time marko- vian jump linear systems , in the presence of delayed mode observations. Proceed- ings of the 2008 IEEE American Control Conference, pages...Markovian Jump Linear System state estimation . . . . 147 6 Conclusions 152 A Discrete- Time Coupled Matrix Equations 156 A.1 Properties of a special

An Official American Thoracic Society Statement: The Importance of Healthy Sleep. Recommendations and Future Priorities

PubMed Central

Mukherjee, Sutapa; Patel, Sanjay R.; Kales, Stefanos N.; Ayas, Najib T.; Strohl, Kingman P.; Gozal, David; Malhotra, Atul

2015-01-01

Rationale: Despite substantial public interest, few recommendations on the promotion of good sleep health exist to educate health care providers and the general public on the importance of sleep for overall health. Objectives: The aim of this American Thoracic Society (ATS) statement is to provide a review of the current scientific literature to assist health care providers, especially pulmonologists and sleep physicians, in making recommendations to patients and the general public about the importance of achieving good quality and adequate quantity of sleep. Methods: ATS members were invited, based on their expertise in sleep medicine, and their conclusions were based on both empirical evidence identified after comprehensive literature review and clinical experience. Main Results: We focus on sleep health in both children and adults, including the impact of occupation on sleep, the public health implications of drowsy driving, and the common sleep disorders of obstructive sleep apnea and insomnia. This ATS statement also delineates gaps in research and knowledge that should be addressed and lead to new focused research priorities to advance knowledge in sleep and sleep health. Conclusions: Good quality and quantity of sleep are essential for good health and overall quality of life; therefore a strong recommendation was made for the implementation of public education programs on the importance of sleep health. PMID:26075423

Search for technological advantages and commercial success in sensor applications: lessons of industrial trials for fiber multianalyzer technology

NASA Astrophysics Data System (ADS)

McMillan, Norman D.; Baker, M.; O'Neill, M.; Smith, Stuart; Augousti, Andreas T.; Mason, Julian; Ryan, Bernard; Ryan, R. A.

1999-01-01

The multianalyzer is a powerful amplitude modulated fiber optic sensor which is perhaps quite typical of so many sensor innovations in that it is a technology looking for an application. Consequently, a series of collaborations with fruit juice, brewing, distilling, biotechnology and polymer industries were made with the objective of identifying potential applications of the multianalyzer. An assessment of these interactions is made for each of the industrial fields explored, by giving for each, just one positive result from the work. The results are then critically assessed. While these studies have illustrated the universal nature of the technology, in every case, lessons have been drawn of a general nature. This experience in particular underlined the difficulty in acceptance of a fiber based technology in industrial process monitoring, against the backdrop of the conservative practice of industry with long established instrumentation. The hard won experience of this product development has shown the vital important of technologists understanding the difference between the marketing concepts of features, benefits and advantages. Three categories of conclusions are drawn, the technical, the commercial, and finally, conclusions drawn from generalizations of the project by the Kingston partners based on their own independent experience in sensor development involving industrial and medical collaborations.

A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome

PubMed Central

Häuser, Winfried; Dobos, Gustav; Langhorst, Jost

2015-01-01

Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety. PMID:26246841

A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome.

PubMed

Lauche, Romy; Cramer, Holger; Häuser, Winfried; Dobos, Gustav; Langhorst, Jost

2015-01-01

Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety.

78 FR 63795 - Endangered and Threatened Wildlife and Plants; Determination of Endangered Status for Chromolaena...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-24

... responses. The peer reviewers generally concurred with our methods and conclusions, and they provided... corallicola, and Harrisia aboriginum. The peer reviewers generally concurred with our methods and conclusions... discussion, below. (6) Comment: One peer reviewer provided research findings on the seed longevity and...

An Analysis of the Evolution of Government Patent Policy in Research and Development Contracts.

DTIC Science & Technology

1981-03-01

LAW AMENDMENTS OF 1980 ------- 94 G. SUMMARY 98 VI . CONCLUSIONS AND RECOMMENDATIONS 100 A. GENERAL --- 100 B. SUMMARY ----- 100 C. CONCLUSIONS 103 D...Note: Appendix D contains a complete text of the 1980 amendments, Public Law 96-517. Chapter VI provides a summary to the evolution of Government...to but a small percentage of Federal R & D contracts. 99 VI . CONCLUSIONS AND RECOMMENDATIONS A. GENERAL This chapter is divided into three sections

Evidence-based Assessment of Cognitive Functioning in Pediatric Psychology

PubMed Central

Brown, Ronald T.; Cavanagh, Sarah E.; Vess, Sarah F.; Segall, Mathew J.

2008-01-01

Objective To review the evidence base for measures of cognitive functioning frequently used within the field of pediatric psychology. Methods From a list of 47 measures identified by the Society of Pediatric Psychology (Division 54) Evidence-Based Assessment Task Force Workgroup, 27 measures were included in the review. Measures were organized, reviewed, and evaluated according to general domains of functioning (e.g., attention/executive functioning, memory). Results Twenty-two of 27 measures reviewed demonstrated psychometric properties that met “Well-established” criteria as set forth by the Assessment Task Force. Psychometric properties were strongest for measures of general cognitive ability and weakest for measures of visual-motor functioning and attention. Conclusions We report use of “Well-established” measures of overall cognitive functioning, nonverbal intelligence, academic achievement, language, and memory and learning. For several specific tests in the domains of visual-motor functioning and attention, additional psychometric data are needed for measures to meet criteria as “Well established.” PMID:18194973

An Overview of Integrated Logistic Support in Medical Material Programs.

DTIC Science & Technology

1980-12-01

OF MEDICAL INTEGRATED LOGISTIC SUPPORT ----------------- 7 B. PROBLEM DEFINITION AND OBJECTIVE ------------ 9 C. GENERAL APPROACH AND METHODOLOGY...SYSTEM ---------------------- 61 C. GENERAL CONCLUSIONS ------------------------- 63 D. RECOMMENDATIONS ----------------------------- 73 E. CONCLUSION...21 Technological advancement has caused major changes in medicine and dentistry in the last several decades. Inten- sive care units, computerized axial

General Aviation Cockpit Weather Information System Simulation Studies

NASA Technical Reports Server (NTRS)

McAdaragh, Ray; Novacek, Paul

2003-01-01

This viewgraph presentation provides information on two experiments on the effectiveness of a cockpit weather information system on a simulated general aviation flight. The presentation covers the simulation hardware configuration, the display device screen layout, a mission scenario, conclusions, and recommendations. The second experiment, with its own scenario and conclusions, is a follow-on experiment.

Depression among Transgender Older adults: General and Minority Stress

PubMed Central

Hoy-Ellis, Charles P.; Fredriksen-Goldsen, Karen I.

2017-01-01

Objectives This study aims to (1) examine the direct and indirect effects internalized heterosexism, concealment of gender identity, and perceived general stress in association with depression among transgender older adults; and (2) to assess the relative contribution of each relationship. Methods Secondary analyses of data from a large community-based study of older sexual and gender minorities were conducted utilizing structural equation modeling with a subsample (n = 174) of transgender adults aged 50 to 86-years old. Results Disclosure of gender identity had no significant direct or indirect effects on either perceived general stress or depression. Internalized heterosexism did not have a direct effect on depression, but did have a significant indirect effect through perceived general stress. Finally, perceived general stress had an additional significant direct effect on depression, over and above internalized heterosexism. Total effect sizes appear to be considerable with standardized betas greater than 5.0. Conclusion Perceived general stress and internalized heterosexism independently and cumulatively have significant direct and indirect effects on depression among transgender older adults. Implications for depression among transgender older adults and the role of community psychology are discussed. PMID:28369987

Randomised trial of personalised computer based information for cancer patients

PubMed Central

Jones, Ray; Pearson, Janne; McGregor, Sandra; Cawsey, Alison J; Barrett, Ann; Craig, Neil; Atkinson, Jacqueline M; Gilmour, W Harper; McEwen, Jim

1999-01-01

Objective To compare the use and effect of a computer based information system for cancer patients that is personalised using each patient's medical record with a system providing only general information and with information provided in booklets. Design Randomised trial with three groups. Data collected at start of radiotherapy, one week later (when information provided), three weeks later, and three months later. Participants 525 patients started radical radiotherapy; 438 completed follow up. Interventions Two groups were offered information via computer (personalised or general information, or both) with open access to computer thereafter; the third group was offered a selection of information booklets. Outcomes Patients' views and preferences, use of computer and information, and psychological status; doctors' perceptions; cost of interventions. Results More patients offered the personalised information said that they had learnt something new, thought the information was relevant, used the computer again, and showed their computer printouts to others. There were no major differences in doctors' perceptions of patients. More of the general computer group were anxious at three months. With an electronic patient record system, in the long run the personalised information system would cost no more than the general system. Full access to booklets cost twice as much as the general system. Conclusions Patients preferred computer systems that provided information from their medical records to systems that just provided general information. This has implications for the design and implementation of electronic patient record systems and reliance on general sources of patient information. PMID:10550090

Pruritus Ani

PubMed Central

Siddiqi, S; Vijay, V; Ward, M; Mahendran, R; Warren, S

2008-01-01

INTRODUCTION Pruritus ani is a common condition with many causes, predominately anorectal pathology. There are some new insights and therapies, but the most recommendations are based on low-level evidence. PATIENTS AND METHODS A literature search was carried out using Medline and the internet with the keywords ‘pruritus ani’ from 1950 to 2007. RESULTS A review of the evidence is presented and a management plan based on the elimination of irritants and scratching, general control measures and active treatment measures is offered. CONCLUSIONS Treatment of primary and secondary pruritus ani has a good prospect of regression of symptoms and skin changes. PMID:18765023

Cluster and propensity based approximation of a network

PubMed Central

2013-01-01

Background The models in this article generalize current models for both correlation networks and multigraph networks. Correlation networks are widely applied in genomics research. In contrast to general networks, it is straightforward to test the statistical significance of an edge in a correlation network. It is also easy to decompose the underlying correlation matrix and generate informative network statistics such as the module eigenvector. However, correlation networks only capture the connections between numeric variables. An open question is whether one can find suitable decompositions of the similarity measures employed in constructing general networks. Multigraph networks are attractive because they support likelihood based inference. Unfortunately, it is unclear how to adjust current statistical methods to detect the clusters inherent in many data sets. Results Here we present an intuitive and parsimonious parametrization of a general similarity measure such as a network adjacency matrix. The cluster and propensity based approximation (CPBA) of a network not only generalizes correlation network methods but also multigraph methods. In particular, it gives rise to a novel and more realistic multigraph model that accounts for clustering and provides likelihood based tests for assessing the significance of an edge after controlling for clustering. We present a novel Majorization-Minimization (MM) algorithm for estimating the parameters of the CPBA. To illustrate the practical utility of the CPBA of a network, we apply it to gene expression data and to a bi-partite network model for diseases and disease genes from the Online Mendelian Inheritance in Man (OMIM). Conclusions The CPBA of a network is theoretically appealing since a) it generalizes correlation and multigraph network methods, b) it improves likelihood based significance tests for edge counts, c) it directly models higher-order relationships between clusters, and d) it suggests novel clustering algorithms. The CPBA of a network is implemented in Fortran 95 and bundled in the freely available R package PropClust. PMID:23497424

Employees’ views on home-based, after-hours telephone triage by Dutch GP cooperatives

PubMed Central

2013-01-01

Background Dutch out-of-hours (OOH) centers find it difficult to attract sufficient triage staff. They regard home-based triage as an option that might attract employees. Specially trained nurses are supposed to conduct triage by telephone from home for after-hours medical care. The central aim of this research is to investigate the views of employees of OOH centers in The Netherlands on home-based telephone triage in after-hours care. Methods The study is a Q methodology study. Triage nurses, general practitioners (GPs) and managers of OOH centers ranked 36 opinion statements on home-based triage. We interviewed 10 participants to help develop and validate the statements for the Q sort, and 77 participants did the Q sort. Results We identified four views on home-based telephone triage. Two generally favor home-based triage, one highlights some concerns and conditions, and one opposes it out of concern for quality. The four views perceive different sources of credibility for nurse triagists working from home. Conclusion Home-based telephone triage is a controversial issue among triage nurses, GPs and managers of OOH centers. By identifying consensus and dissension among GPs, triagists, managers and regulators, this study generates four perspectives on home-based triage. In addition, it reveals the conditions considered important for home-based triage. PMID:24188407

Detection of S-Nitrosothiols

PubMed Central

Diers, Anne R.; Keszler, Agnes; Hogg, Neil

2015-01-01

BACKGROUND S-Nitrosothiols have been recognized as biologically-relevant products of nitric oxide that are involved in many of the diverse activities of this free radical. SCOPE OF REVIEW This review serves to discuss current methods for the detection and analysis of protein S-nitrosothiols. The major methods of S-nitrosothiol detection include chemiluminescence-based methods and switch-based methods, each of which comes in various flavors with advantages and caveats. MAJOR CONCLUSIONS The detection of S-nitrosothiols is challenging and prone to many artifacts. Accurate measurements require an understanding of the underlying chemistry of the methods involved and the use of appropriate controls. GENERAL SIGNIFICANCE Nothing is more important to a field of research than robust methodology that is generally trusted. The field of S-Nitrosation has developed such methods but, as S-nitrosothiols are easy to introduce as artifacts, it is vital that current users learn from the lessons of the past. PMID:23988402

Artificial neural network models for prediction of cardiovascular autonomic dysfunction in general Chinese population

PubMed Central

2013-01-01

Background The present study aimed to develop an artificial neural network (ANN) based prediction model for cardiovascular autonomic (CA) dysfunction in the general population. Methods We analyzed a previous dataset based on a population sample consisted of 2,092 individuals aged 30–80 years. The prediction models were derived from an exploratory set using ANN analysis. Performances of these prediction models were evaluated in the validation set. Results Univariate analysis indicated that 14 risk factors showed statistically significant association with CA dysfunction (P < 0.05). The mean area under the receiver-operating curve was 0.762 (95% CI 0.732–0.793) for prediction model developed using ANN analysis. The mean sensitivity, specificity, positive and negative predictive values were similar in the prediction models was 0.751, 0.665, 0.330 and 0.924, respectively. All HL statistics were less than 15.0. Conclusion ANN is an effective tool for developing prediction models with high value for predicting CA dysfunction among the general population. PMID:23902963

Relativistic chaos is coordinate invariant.

PubMed

Motter, Adilson E

2003-12-05

The noninvariance of Lyapunov exponents in general relativity has led to the conclusion that chaos depends on the choice of the space-time coordinates. Strikingly, we uncover the transformation laws of Lyapunov exponents under general space-time transformations and we find that chaos, as characterized by positive Lyapunov exponents, is coordinate invariant. As a result, the previous conclusion regarding the noninvariance of chaos in cosmology, a major claim about chaos in general relativity, necessarily involves the violation of hypotheses required for a proper definition of the Lyapunov exponents.

A method for assigning species into groups based on generalized Mahalanobis distance between habitat model coefficients

USGS Publications Warehouse

Williams, C.J.; Heglund, P.J.

2009-01-01

Habitat association models are commonly developed for individual animal species using generalized linear modeling methods such as logistic regression. We considered the issue of grouping species based on their habitat use so that management decisions can be based on sets of species rather than individual species. This research was motivated by a study of western landbirds in northern Idaho forests. The method we examined was to separately fit models to each species and to use a generalized Mahalanobis distance between coefficient vectors to create a distance matrix among species. Clustering methods were used to group species from the distance matrix, and multidimensional scaling methods were used to visualize the relations among species groups. Methods were also discussed for evaluating the sensitivity of the conclusions because of outliers or influential data points. We illustrate these methods with data from the landbird study conducted in northern Idaho. Simulation results are presented to compare the success of this method to alternative methods using Euclidean distance between coefficient vectors and to methods that do not use habitat association models. These simulations demonstrate that our Mahalanobis-distance- based method was nearly always better than Euclidean-distance-based methods or methods not based on habitat association models. The methods used to develop candidate species groups are easily explained to other scientists and resource managers since they mainly rely on classical multivariate statistical methods. ?? 2008 Springer Science+Business Media, LLC.

Background studies in support of a feasibility assessment on the use of copper-base materials for nuclear waste packages in a repository in tuff

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

Van Konynenburg, R.A.; Kundig, K.J.A.; Lyman, W.S.

1990-06-01

This report combines six work units performed in FY`85--86 by the Copper Development Association and the International Copper Research Association under contract with the University of California. The work includes literature surveys and state-of-the-art summaries on several considerations influencing the feasibility of the use of copper-base materials for fabricating high-level nuclear waste packages for the proposed repository in tuff rock at Yucca Mountain, Nevada. The general conclusion from this work was that copper-base materials are viable candidates for inclusion in the materials selection process for this application. 55 refs., 48 figs., 22 tabs.

The role of topology in microstructure-property relations: a 2D DEM based study

NASA Astrophysics Data System (ADS)

Saleme Ruiz, Katerine; Emelianenko, Maria

2018-01-01

We compare Rényi entropy-based mesoscale approaches for characterizing 2D polycrystalline network topology and geometry, based on the grain number of sides and grain areas, respectively. We study the effect of microstructure disorder on mechanical properties such as elastic and damage response by performing simulations of quasi-static uniaxial compression loading tests on an idealized material using grain-level micro-mechanical discrete element model. While not comprehensive enough to make general conclusions, this study allows us to make observations about the sensitivity of mechanical parameters such as Young's modulus, proportional limit, first yield stress, toughness and amount of microstructure damage to different entropy measures.

New insights into the correlation structure of DSM-IV depression symptoms in the general population v. subsamples of depressed individuals.

PubMed

Foster, S; Mohler-Kuo, M

2018-06-01

Previous research failed to uncover a replicable dimensional structure underlying the symptoms of depression. We aimed to examine two neglected methodological issues in this research: (a) adjusting symptom correlations for overall depression severity; and (b) analysing general population samples v. subsamples of currently depressed individuals. Using population-based cross-sectional and longitudinal data from two nations (Switzerland, 5883 young men; USA, 2174 young men and 2244 young women) we assessed the dimensions of the nine DSM-IV depression symptoms in young adults. In each general-population sample and each subsample of currently depressed participants, we conducted a standardised process of three analytical steps, based on exploratory and confirmatory factor and bifactor analysis, to reveal any replicable dimensional structure underlying symptom correlations while controlling for overall depression severity. We found no evidence of a replicable dimensional structure across samples when adjusting symptom correlations for overall depression severity. In the general-population samples, symptoms correlated strongly and a single dimension of depression severity was revealed. Among depressed participants, symptom correlations were surprisingly weak and no replicable dimensions were identified, regardless of severity-adjustment. First, caution is warranted when considering studies assessing dimensions of depression because general population-based studies and studies of depressed individuals generate different data that can lead to different conclusions. This problem likely generalises to other models based on the symptoms' inter-relationships such as network models. Second, whereas the overall severity aligns individuals on a continuum of disorder intensity that allows non-affected individuals to be distinguished from affected individuals, the clinical evaluation and treatment of depressed individuals should focus directly on each individual's symptom profile.

A Compact Methodology to Understand, Evaluate, and Predict the Performance of Automatic Target Recognition

PubMed Central

Li, Yanpeng; Li, Xiang; Wang, Hongqiang; Chen, Yiping; Zhuang, Zhaowen; Cheng, Yongqiang; Deng, Bin; Wang, Liandong; Zeng, Yonghu; Gao, Lei

2014-01-01

This paper offers a compacted mechanism to carry out the performance evaluation work for an automatic target recognition (ATR) system: (a) a standard description of the ATR system's output is suggested, a quantity to indicate the operating condition is presented based on the principle of feature extraction in pattern recognition, and a series of indexes to assess the output in different aspects are developed with the application of statistics; (b) performance of the ATR system is interpreted by a quality factor based on knowledge of engineering mathematics; (c) through a novel utility called “context-probability” estimation proposed based on probability, performance prediction for an ATR system is realized. The simulation result shows that the performance of an ATR system can be accounted for and forecasted by the above-mentioned measures. Compared to existing technologies, the novel method can offer more objective performance conclusions for an ATR system. These conclusions may be helpful in knowing the practical capability of the tested ATR system. At the same time, the generalization performance of the proposed method is good. PMID:24967605

Introductory Statistics Students' Conceptual Understanding of Study Design and Conclusions

NASA Astrophysics Data System (ADS)

Fry, Elizabeth Brondos

Recommended learning goals for students in introductory statistics courses include the ability to recognize and explain the key role of randomness in designing studies and in drawing conclusions from those studies involving generalizations to a population or causal claims (GAISE College Report ASA Revision Committee, 2016). The purpose of this study was to explore introductory statistics students' understanding of the distinct roles that random sampling and random assignment play in study design and the conclusions that can be made from each. A study design unit lasting two and a half weeks was designed and implemented in four sections of an undergraduate introductory statistics course based on modeling and simulation. The research question that this study attempted to answer is: How does introductory statistics students' conceptual understanding of study design and conclusions (in particular, unbiased estimation and establishing causation) change after participating in a learning intervention designed to promote conceptual change in these areas? In order to answer this research question, a forced-choice assessment called the Inferences from Design Assessment (IDEA) was developed as a pretest and posttest, along with two open-ended assignments, a group quiz and a lab assignment. Quantitative analysis of IDEA results and qualitative analysis of the group quiz and lab assignment revealed that overall, students' mastery of study design concepts significantly increased after the unit, and the great majority of students successfully made the appropriate connections between random sampling and generalization, and between random assignment and causal claims. However, a small, but noticeable portion of students continued to demonstrate misunderstandings, such as confusion between random sampling and random assignment.

Thinking like a nurse: a research-based model of clinical judgment in nursing.

PubMed

Tanner, Christine A

2006-06-01

This article reviews the growing body of research on clinical judgment in nursing and presents an alternative model of clinical judgment based on these studies. Based on a review of nearly 200 studies, five conclusions can be drawn: (1) Clinical judgments are more influenced by what nurses bring to the situation than the objective data about the situation at hand; (2) Sound clinical judgment rests to some degree on knowing the patient and his or her typical pattern of responses, as well as an engagement with the patient and his or her concerns; (3) Clinical judgments are influenced by the context in which the situation occurs and the culture of the nursing care unit; (4) Nurses use a variety of reasoning patterns alone or in combination; and (5) Reflection on practice is often triggered by a breakdown in clinical judgment and is critical for the development of clinical knowledge and improvement in clinical reasoning. A model based on these general conclusions emphasizes the role of nurses' background, the context of the situation, and nurses' relationship with their patients as central to what nurses notice and how they interpret findings, respond, and reflect on their response.

Calculus domains modelled using an original bool algebra based on polygons

NASA Astrophysics Data System (ADS)

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

2016-08-01

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

The role of feedback in improving the effectiveness of workplace based assessments: a systematic review.

PubMed

Saedon, Habiba; Salleh, Shizalia; Balakrishnan, Arun; Imray, Christopher H E; Saedon, Mahmud

2012-05-02

With recent emphasis placed on workplace based assessment (WBA) as a method of formative performance assessment, there is limited evidence in the current literature regarding the role of feedback in improving the effectiveness of WBA. The aim of this systematic review was to elucidate the impact of feedback on the effectiveness of WBA in postgraduate medical training. Searches were conducted using the following bibliographic databases to identify original published studies related to WBA and the role of feedback: Medline (1950-December 2010), Embase (1980-December 2010) and Journals@Ovid (English language only, 1996-December 2010). Studies which attempted to evaluate the role of feedback in WBA involving postgraduate doctors were included. 15 identified studies met the inclusion criteria and minimum quality threshold. They were heterogeneous in methodological design. 7 studies focused on multi source feedback, 3 studies were based on mini-clinical evaluation exercise, 2 looked at procedural based assessment, one study looked at workplace based assessments in general and 2 studies looked at a combination of 3 to 6 workplace based assessments. 7 studies originated from the United Kingdom. Others were from Canada, the United States and New Zealand. Study populations were doctors in various grades of training from a wide range of specialties including general practice, general medicine, general surgery, dermatology, paediatrics and anaesthetics. All studies were prospective in design, and non-comparative descriptive or observational studies using a variety of methods including questionnaires, one to one interviews and focus groups. The evidence base contains few high quality conclusive studies and more studies are required to provide further evidence for the effect of feedback from workplace based assessment on subsequent performance. There is, however, good evidence that if well implemented, feedback from workplace based assessments, particularly multisource feedback, leads to a perceived positive effect on practice.

Neighborhood determinants of mood and anxiety disorders among men who have sex with men in New York City

PubMed Central

Cerdá, Magdalena; Nandi, Vijay; Frye, Victoria; Egan, James E.; Rundle, Andrew; Quinn, James W.; Sheehan, Daniel; Hoover, Donald R.; Ompad, Danielle C.; Van Tieu, Hong; Greene, Emily; Koblin, Beryl

2017-01-01

Purpose We examined the relationship between economic, physical, and social characteristics of neighborhoods where men who have sex with men (MSM) lived and socialized, and symptom scores of depression and generalized anxiety disorder (GAD). Methods Participants came from a cross-sectional study of a population-based sample of New York City MSM recruited in 2010–2012 (n=1126). Archival and survey-based data were obtained on neighborhoods where the men lived and where they socialized most often. Results MSM who socialized in neighborhoods with more economic deprivation and greater general neighborhood attachment experienced higher GAD symptoms. The relationship between general attachment to neighborhoods where MSM socialized and mental health depended on the level of gay community attachment: in neighborhoods characterized by greater gay community attachment, general neighborhood attachment was negatively associated with GAD symptoms, while in low gay community attachment neighborhoods, general neighborhood attachment had a positive association with GAD symptoms. Conclusions This study illustrates the downsides of having deep ties to social neighborhoods when they occur in the absence of broader access to ties with the community of one’s sexual identity. Interventions that help MSM cross the spatial boundaries of their social neighborhoods and promote integration of MSM into the broader gay community may contribute to the reduction of elevated rates of depression and anxiety in this population. PMID:28382385

Patient participation in general practice based undergraduate teaching: a focus group study of patient perspectives

PubMed Central

Park, Sophie E; Allfrey, Caroline; Jones, Melvyn M; Chana, Jasprit; Abbott, Ciara; Faircloth, Sofia; Higgins, Nicola; Abdullah, Laila

2017-01-01

Background Patients make a crucial contribution to undergraduate medical education. Although a national resource is available for patients participating in research, none is as yet available for education. Aim This study aimed to explore what information patients would like about participation in general practice based undergraduate medical education, and how they would like to obtain this information. Design and setting Two focus groups were conducted in London-based practices involved in both undergraduate and postgraduate teaching. Method Patients both with and without teaching experience were recruited using leaflets, posters, and patient participation groups. An open-ended topic guide explored three areas: perceived barriers that participants anticipated or had experienced; patient roles in medical education; and what help would support participation. Focus groups were audiorecorded, transcribed, and analysed thematically. Results Patients suggested ways of professionalising the teaching process. These were: making information available to patients about confidentiality, iterative consent, and normalising teaching in the practice. Patients highlighted the importance of relationships, making information available about their GPs’ involvement in teaching, and initiating student–patient interactions. Participants emphasised educational principles to maximise exchange of information, including active participation of students, patient identification of student learner needs, and exchange of feedback. Conclusion This study will inform development of patient information resources to support their participation in teaching and access to information both before and during general practice based teaching encounters. PMID:28360073

Free surface profiles in river flows: Can standard energy-based gradually-varied flow computations be pursued?

NASA Astrophysics Data System (ADS)

Cantero, Francisco; Castro-Orgaz, Oscar; Garcia-Marín, Amanda; Ayuso, José Luis; Dey, Subhasish

2015-10-01

Is the energy equation for gradually-varied flow the best approximation for the free surface profile computations in river flows? Determination of flood inundation in rivers and natural waterways is based on the hydraulic computation of flow profiles. This is usually done using energy-based gradually-varied flow models, like HEC-RAS, that adopts a vertical division method for discharge prediction in compound channel sections. However, this discharge prediction method is not so accurate in the context of advancements over the last three decades. This paper firstly presents a study of the impact of discharge prediction on the gradually-varied flow computations by comparing thirteen different methods for compound channels, where both energy and momentum equations are applied. The discharge, velocity distribution coefficients, specific energy, momentum and flow profiles are determined. After the study of gradually-varied flow predictions, a new theory is developed to produce higher-order energy and momentum equations for rapidly-varied flow in compound channels. These generalized equations enable to describe the flow profiles with more generality than the gradually-varied flow computations. As an outcome, results of gradually-varied flow provide realistic conclusions for computations of flow in compound channels, showing that momentum-based models are in general more accurate; whereas the new theory developed for rapidly-varied flow opens a new research direction, so far not investigated in flows through compound channels.

Basic processes in reading aloud and colour naming: towards a better understanding of the role of spatial attention.

PubMed

Robidoux, Serje; Rauwerda, Derek; Besner, Derek

2014-05-01

Whether or not lexical access from print requires spatial attention has been debated intensively for the last 30 years. Studies involving colour naming generally find evidence that "unattended" words are processed. In contrast, reading-based experiments do not find evidence of distractor processing. One theory ascribes the discrepancy to weaker attentional demands for colour identification. If colour naming does not capture all of a subject's attention, the remaining attentional resources can be deployed to process the distractor word. The present study combined exogenous spatial cueing with colour naming and reading aloud separately and found that colour naming is less sensitive to the validity of a spatial cue than is reading words aloud. Based on these results, we argue that colour naming studies do not effectively control attention so that no conclusions about unattended distractor processing can be drawn from them. Thus we reiterate the consistent conclusion drawn from reading aloud and lexical decision studies: There is no word identification without (spatial) attention.

Recommendations for Third Molar Removal: A Practice-Based Cohort Study

PubMed Central

Rothen, Marilynn; Spiekerman, Charles; Drangsholt, Mark; McClellan, Lyle; Huang, Greg J.

2014-01-01

Objectives. We investigated general dentists’ reasons for recommending removal or retention of third molars and whether patients adhered to dentists’ recommendations. Methods. In a 2-year prospective cohort study (2009–2011) in the Pacific Northwest, we followed 801 patients aged 16 to 22 years from 50 general dental practices. Generalized estimating equations logistic regressions related patient and dentist characteristics to dentists' recommendations to remove third molars and to patient adherence. Results. General dentists recommended removal of 1683 third molars from 469 (59%) participants, mainly to prevent future problems (79%) or because a third molar had an unfavorable orientation or was unlikely to erupt (57%). Dentists recommended retention and monitoring of 1244 third molars from 366 (46%) participants, because it was too early to decide (73%), eruption path was favorable (39%), or space for eruption was sufficient (26%). When dentists recommended removal, 55% of participants adhered to this recommendation during follow-up, and the main reason was availability of insurance (88%). Conclusions. General dentists frequently recommended removal of third molars for reasons not related to symptoms or pathology, but rather to prevent future problems. PMID:24524519

Multiconstrained gene clustering based on generalized projections

PubMed Central

2010-01-01

Background Gene clustering for annotating gene functions is one of the fundamental issues in bioinformatics. The best clustering solution is often regularized by multiple constraints such as gene expressions, Gene Ontology (GO) annotations and gene network structures. How to integrate multiple pieces of constraints for an optimal clustering solution still remains an unsolved problem. Results We propose a novel multiconstrained gene clustering (MGC) method within the generalized projection onto convex sets (POCS) framework used widely in image reconstruction. Each constraint is formulated as a corresponding set. The generalized projector iteratively projects the clustering solution onto these sets in order to find a consistent solution included in the intersection set that satisfies all constraints. Compared with previous MGC methods, POCS can integrate multiple constraints from different nature without distorting the original constraints. To evaluate the clustering solution, we also propose a new performance measure referred to as Gene Log Likelihood (GLL) that considers genes having more than one function and hence in more than one cluster. Comparative experimental results show that our POCS-based gene clustering method outperforms current state-of-the-art MGC methods. Conclusions The POCS-based MGC method can successfully combine multiple constraints from different nature for gene clustering. Also, the proposed GLL is an effective performance measure for the soft clustering solutions. PMID:20356386

Urinary 2,5-hexanedione excretion in cryptogenic polyneuropathy compared to the general Swedish population

PubMed Central

2013-01-01

Background 2,5-hexanedione (2,5-HD) is the main neurotoxic metabolite of methyl-n-butyl ketone (MBK) and n-hexane, and known to cause polyneuropathy. The aim of our study was to compare the urinary levels of 2,5-HD between cases with cryptogenic polyneuropathy and the general Swedish population, and to elucidate the role of certain external factors. Methods Morning urine samples were collected from 114 cases with cryptogenic polyneuropathy (77 men and 37 women) and 227 referents (110 men and 117 women) randomly selected from the population registry. None had any current occupational exposure to n-hexane or MBK. The urine samples were analysed by a gas chromatographic method based on acidic hydrolysis. Results Cases had statistically higher urinary levels of 2,5-HD (0.48 mg/L) than the general population (0.41 mg/L) and men higher excretion than women (0.48 mg/L and 0.38 mg/L, respectively). There was no difference in 2,5-HD levels between current smokers and non-smokers. Occupational exposure to xylene, alcohol consumption and ever exposed to general anaesthesia were associated with lower excretion in men while for occupational exposure to nitrous oxide in women higher excretion was seen. Higher excretion of 2,5 HD was inversely related to increasing age. Conclusions Significantly higher levels of urinary 2,5-HD were seen in men and cryptogenic polyneuropathy cases seemingly unexposed to n-hexane. Hypothetically, this might be due to either differences in metabolic patterns or some concealed exposure. The difference in means between cases and the general population is small and can therefore not allow any firm conclusions of the causality, however. PMID:23898939

Bilingual Language Control and General Purpose Cognitive Control among Individuals with Bilingual Aphasia: Evidence Based on Negative Priming and Flanker Tasks

PubMed Central

Dash, Tanya; Kar, Bhoomika R.

2014-01-01

Background. Bilingualism results in an added advantage with respect to cognitive control. The interaction between bilingual language control and general purpose cognitive control systems can also be understood by studying executive control among individuals with bilingual aphasia. Objectives. The current study examined the subcomponents of cognitive control in bilingual aphasia. A case study approach was used to investigate whether cognitive control and language control are two separate systems and how factors related to bilingualism interact with control processes. Methods. Four individuals with bilingual aphasia performed a language background questionnaire, picture description task, and two experimental tasks (nonlinguistic negative priming task and linguistic and nonlinguistic versions of flanker task). Results. A descriptive approach was used to analyse the data using reaction time and accuracy measures. The cumulative distribution function plots were used to visualize the variations in performance across conditions. The results highlight the distinction between general purpose cognitive control and bilingual language control mechanisms. Conclusion. All participants showed predominant use of the reactive control mechanism to compensate for the limited resources system. Independent yet interactive systems for bilingual language control and general purpose cognitive control were postulated based on the experimental data derived from individuals with bilingual aphasia. PMID:24982591

Medical students, early general practice placements and positive supervisor experiences.

PubMed

Henderson, Margaret; Upham, Susan; King, David; Dick, Marie-Louise; van Driel, Mieke

2018-03-01

Introduction Community-based longitudinal clinical placements for medical students are becoming more common globally. The perspective of supervising clinicians about their experiences and processes involved in maximising these training experiences has received less attention than that of students. Aims This paper explores the general practitioner (GP) supervisor perspective of positive training experiences with medical students undertaking urban community-based, longitudinal clinical placements in the early years of medical training. Methods Year 2 medical students spent a half-day per week in general practice for either 13 or 26 weeks. Transcribed semi-structured interviews from a convenience sample of participating GPs were thematically analysed by two researchers, using a general inductive approach. Results Identified themes related to the attributes of participating persons and organisations: GPs, students, patients, practices and their supporting institution; GPs' perceptions of student development; and triggers enhancing the experience. A model was developed to reflect these themes. Conclusions Training experiences were enhanced for GPs supervising medical students in early longitudinal clinical placements by the synergy of motivated students and keen teachers with support from patients, practice staff and academic institutions. We developed an explanatory model to better understand the mechanism of positive experiences. Understanding the interaction of factors enhancing teaching satisfaction is important for clinical disciplines wishing to maintain sustainable, high quality teaching.

International and National Expert Group Evaluations: Biological/Health Effects of Radiofrequency Fields

PubMed Central

Vijayalaxmi; Scarfi, Maria R.

2014-01-01

The escalated use of various wireless communication devices, which emit non-ionizing radiofrequency (RF) fields, have raised concerns among the general public regarding the potential adverse effects on human health. During the last six decades, researchers have used different parameters to investigate the effects of in vitro and in vivo exposures of animals and humans or their cells to RF fields. Data reported in peer-reviewed scientific publications were contradictory: some indicated effects while others did not. International organizations have considered all of these data as well as the observations reported in human epidemiological investigations to set-up the guidelines or standards (based on the quality of published studies and the “weight of scientific evidence” approach) for RF exposures in occupationally exposed individuals and the general public. Scientists with relevant expertise in various countries have also considered the published data to provide the required scientific information for policy-makers to develop and disseminate authoritative health information to the general public regarding RF exposures. This paper is a compilation of the conclusions, on the biological effects of RF exposures, from various national and international expert groups, based on their analyses. In general, the expert groups suggested a reduction in exposure levels, precautionary approach, and further research. PMID:25211777

Human Rights and Private Ordering in Virtual Worlds

NASA Astrophysics Data System (ADS)

Oosterbaan, Olivier

This paper explores the application of human rights in (persistent) virtual world environments. The paper begins with describing a number of elements that most virtual environments share and that are relevant for the application of human rights in such a setting; and by describing in a general nature the application of human rights between private individuals. The paper then continues by discussing the application in virtual environments of two universally recognized human rights, namely freedom of expression, and freedom from discrimination. As these specific rights are discussed, a number of more general conclusions on the application of human rights in virtual environments are drawn. The first general conclusion being that, because virtual worlds are private environments, participants are subject to private ordering. The second general conclusion being that participants and non-participants alike have to accept at times that in-world expressions are to an extent private speech. The third general conclusion is that, where participants represent themselves in-world, other participants cannot assume that such in-world representation share the characteristics of the human player; and that where virtual environments contain game elements, participants and non-participants alike should not take everything that happens in the virtual environment at face value or literally, which does however not amount to having to accept a higher level of infringement on their rights for things that happen in such an environment.

Conclusive identification of quantum channels via monogamy of quantum correlations

NASA Astrophysics Data System (ADS)

Kumar, Asutosh; Singha Roy, Sudipto; Pal, Amit Kumar; Prabhu, R.; Sen(De), Aditi; Sen, Ujjwal

2016-10-01

We investigate the action of global noise and local channels, namely, amplitude-damping, phase-damping, and depolarizing channels, on monogamy of quantum correlations, such as negativity and quantum discord, in three-qubit systems. We discuss the monotonic and non-monotonic variation, and robustness of the monogamy scores. By using monogamy scores, we propose a two-step protocol to conclusively identify the noise applied to the quantum system, by using generalized Greenberger-Horne-Zeilinger and generalized W states as resource states. We discuss a possible generalization of the results to higher number of parties.

The accuracy of general practitioner workforce projections

PubMed Central

2013-01-01

Background Health workforce projections are important instruments to prevent imbalances in the health workforce. For both the tenability and further development of these projections, it is important to evaluate the accuracy of workforce projections. In the Netherlands, health workforce projections have been done since 2000 to support health workforce planning. What is the accuracy of the techniques of these Dutch general practitioner workforce projections? Methods We backtested the workforce projection model by comparing the ex-post projected number of general practitioners with the observed number of general practitioners between 1998 and 2011. Averages of historical data were used for all elements except for inflow in training. As the required training inflow is the key result of the workforce planning model, and has actually determined past adjustments of training inflow, the accuracy of the model was backtested using the observed training inflow and not an average of historical data to avoid the interference of past policy decisions. The accuracy of projections with different lengths of projection horizon and base period (on which the projections are based) was tested. Results The workforce projection model underestimated the number of active Dutch general practitioners in most years. The mean absolute percentage errors range from 1.9% to 14.9%, with the projections being more accurate in more recent years. Furthermore, projections with a shorter projection horizon have a higher accuracy than those with a longer horizon. Unexpectedly, projections with a shorter base period have a higher accuracy than those with a longer base period. Conclusions According to the results of the present study, forecasting the size of the future workforce did not become more difficult between 1998 and 2011, as we originally expected. Furthermore, the projections with a short projection horizon and a short base period are more accurate than projections with a longer projection horizon and base period. We can carefully conclude that health workforce projections can be made with data based on relatively short base periods, although detailed data are still required to monitor and evaluate the health workforce. PMID:23866676

What’s in a dental practice-based research network?

PubMed Central

Cunha-Cruz, Joana; Hilton, Thomas J.; Ferracane, Jack; Berg, Joel; Zhou, Lingmei; Rothen, Marilynn

2011-01-01

Objectives The authors conducted a study to describe the general dentists, practices, patients and patient care patterns of the dental practice-based research network (PBRN) Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT). Methods Northwest PRECEDENT is a dental PBRN of general and pediatric dentists and orthodontists from five U.S. states in the Northwest: Idaho, Montana, Oregon, Utah and Washington. The authors collected data from general dentists in Northwest PRECEDENT (n = 101) regarding the diagnosis and treatment of oral diseases in a survey with a systematic random sample of patients (N = 1,943) visiting their practices. They also obtained demographic data from the general dentists and their patients. Results The authors found that 50 percent of the general dentists were 51 to 60 years of age, 14 percent were female and 76 percent were non-Hispanic white. More than one-half (55 percent) of the dentists had practiced dentistry for more than 20 years, 83 percent had private solo practices and 32 percent practiced in rural community settings. The majority (71 percent) of patients visiting the dental practices was in the age range of 18 to 64 years, 55 percent were female and 84 percent were non-Hispanic white. In terms of reasons for seeking dental care, 52 percent of patients overall visited the dentist for oral examinations, checkups, prophylaxis or caries-preventive treatment. In the preceding year, 85 percent of the patients had received prophylaxis, 49 percent restorative treatments, 34 percent caries-preventive treatments and 10 percent endodontic treatments. Conclusions Northwest PRECEDENT general dentists are dispersed geographically and are racially and ethnically diverse, owing in part to efforts by network administrators and coordinators to enroll minority dentists and those who practice in rural areas. Estimates of characteristics of dentists and patients in Northwest PRECEDENT will be valuable in planning future studies of oral diseases and treatments. PMID:20592411

A systematic investigation of computation models for predicting Adverse Drug Reactions (ADRs).

PubMed

Kuang, Qifan; Wang, MinQi; Li, Rong; Dong, YongCheng; Li, Yizhou; Li, Menglong

2014-01-01

Early and accurate identification of adverse drug reactions (ADRs) is critically important for drug development and clinical safety. Computer-aided prediction of ADRs has attracted increasing attention in recent years, and many computational models have been proposed. However, because of the lack of systematic analysis and comparison of the different computational models, there remain limitations in designing more effective algorithms and selecting more useful features. There is therefore an urgent need to review and analyze previous computation models to obtain general conclusions that can provide useful guidance to construct more effective computational models to predict ADRs. In the current study, the main work is to compare and analyze the performance of existing computational methods to predict ADRs, by implementing and evaluating additional algorithms that have been earlier used for predicting drug targets. Our results indicated that topological and intrinsic features were complementary to an extent and the Jaccard coefficient had an important and general effect on the prediction of drug-ADR associations. By comparing the structure of each algorithm, final formulas of these algorithms were all converted to linear model in form, based on this finding we propose a new algorithm called the general weighted profile method and it yielded the best overall performance among the algorithms investigated in this paper. Several meaningful conclusions and useful findings regarding the prediction of ADRs are provided for selecting optimal features and algorithms.

Develop and test fuel cell powered on-site integrated total energy systems. Phase 3: Full-scale power plant development

NASA Technical Reports Server (NTRS)

1983-01-01

Satisfactory performance is reported for the first three 12-cell sub-stacks of the 5 kW stack rebuild. Early general conclusions are presented from an economic study. Results are reported on a successful 700-hour test of a 3-cell stack in the full-sized configuration (0.33m x 0.56m). Construction of a 5 kW equivalent methanol/steam reformer based on a commercial shell-and-tube heat exchanger was completed. Several test runs are summarized. Preliminary conclusions are presented on the technical and economic aspects of fuel cell/HVAC interaction. Physical data are presented on several dense graphite materials which are candidates for gas-distribution plates. Performance of a new cathode catalyst is reported.

Mini- and microgenerators applicable in the MEMS technology

NASA Astrophysics Data System (ADS)

Fiala, P.; Szabo, Z.; Marcon, P.; Roubal, Z.

2017-06-01

The article presents certain general conclusions obtained from an investigation of a vibration-powered milli- or microgenerator functioning as a harvester. In this context, the authors summarize the parameters that are critical in designing optimal generators to retrieve the residual energy contained in an electromechanical system and transferred through the vibrations of an independent structure. The discussion exploits our previous results, which theoretically define the properties characterizing the models of individual basic configurations of a generator based on Faraday's law of induction.

Marijuana withdrawal and aggression among a representative sample of U.S. marijuana users

PubMed Central

Smith, Philip H.; Homish, Gregory G.; Leonard, Kenneth E.; Collins, R. Lorraine

2013-01-01

Background Previous laboratory-based research suggests that withdrawal from marijuana may cause increased aggression. It is unclear whether this finding extends beyond the laboratory setting to the general population of marijuana users. The purpose of this study was to test a cross-sectional association between marijuana withdrawal symptoms and aggression among a representative sample of U.S. adult marijuana users, and to test whether this association was moderated by previous history of aggression. Methods Data were analyzed from the National Epidemiologic Survey on Alcohol and Related Conditions. Wave Two data (2004–2005) were used for all variables except for history of aggression, which was assessed during the Wave One interview (2001–2002). Two outcomes were examined: self-report general aggression and relationship aggression. Odds ratios for aggression based on withdrawal symptoms and the interaction between withdrawal symptoms and history of aggression were calculated using logistic regression, adjusting for covariates and accounting for the complex survey design. Results Among marijuana users with a history of aggression, marijuana withdrawal was associated with approximately 60% higher odds of past year relationship aggression (p < 0.05). There was no association between withdrawal symptoms and relationship aggression among those without a history of aggression, and no association with general aggression regardless of history of aggression. Conclusions The findings from this study support the notion that laboratory-based increases in aggression due to marijuana withdrawal extend to the general population of marijuana users who have a previous history of aggression. PMID:23380439

On Target Localization Using Combined RSS and AoA Measurements

PubMed Central

Beko, Marko; Dinis, Rui

2018-01-01

This work revises existing solutions for a problem of target localization in wireless sensor networks (WSNs), utilizing integrated measurements, namely received signal strength (RSS) and angle of arrival (AoA). The problem of RSS/AoA-based target localization became very popular in the research community recently, owing to its great applicability potential and relatively low implementation cost. Therefore, here, a comprehensive study of the state-of-the-art (SoA) solutions and their detailed analysis is presented. The beginning of this work starts by considering the SoA approaches based on convex relaxation techniques (more computationally complex in general), and it goes through other (less computationally complex) approaches, as well, such as the ones based on the generalized trust region sub-problems framework and linear least squares. Furthermore, a detailed analysis of the computational complexity of each solution is reviewed. Furthermore, an extensive set of simulation results is presented. Finally, the main conclusions are summarized, and a set of future aspects and trends that might be interesting for future research in this area is identified. PMID:29671832

28 CFR 48.14 - Decision by the Attorney General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Decision by the Attorney General. 48.14... Decision by the Attorney General. (a) The Attorney General shall decide, on the basis of the record as..., the Attorney General shall file therewith a statement of his findings and conclusions and the reasons...

Responsiveness of measures of heartburn improvement in non-erosive reflux disease

PubMed Central

Junghard, Ola; Halling, Katarina

2007-01-01

Background When measuring treatment effect on symptoms, the treatment success variable should be as responsive as possible. The aim of the study was to investigate the responsiveness of various treatment success variables in patients with symptoms of heartburn. Methods A total of 1640 patients with non-erosive reflux disease (NERD) were treated with proton pump inhibitors for 4 weeks. Treatment success variables were based on a symptom questionnaire (Gastrointestinal Symptom Rating Scale) and on investigator-assessed heartburn, measured at baseline and after 4 weeks of treatment. The rates of treatment success were compared with patients' perceived change in symptoms, assessed by the Overall Treatment Effect questionnaire. Results Generally, more stringent treatment success criteria (i.e., those demanding the better response) translated into more responsive treatment success variables. For example, the treatment success variable 'no heartburn' at 4 weeks was more responsive than the variable 'at most mild heartburn' at 4 weeks. Treatment success variables based on change from baseline to 4 weeks were, in general, less responsive than those based on the week 4 assessments only. Conclusion In patients with NERD, responsiveness varied among different treatment success definitions, with more demanding definitions (based on the 4-week assessment) giving better responsiveness. PMID:17562006

The influence of IQ stratification on WAIS-III/WMS-III FSIQ-general memory index discrepancy base-rates in the standardization sample.

PubMed

Hawkins, K A; Tulsky, D S

2001-11-01

Since memory performance expectations may be IQ-based, unidirectional base rate data for IQ-Memory Score discrepancies are provided in the WAIS-III/WMS-III Technical Manual. The utility of these data partially rests on the assumption that discrepancy base rates do not vary across ability levels. FSIQ stratified base rate data generated from the standardization sample, however, demonstrate substantial variability across the IQ spectrum. A superiority of memory score over FSIQ is typical at lower IQ levels, whereas the converse is true at higher IQ levels. These data indicate that the use of IQ-memory score unstratified "simple difference" tables could lead to erroneous conclusions for clients with low or high IQ. IQ stratified standardization base rate data are provided as a complement to the "predicted difference" method detailed in the Technical Manual.

Ultrasound visual feedback treatment and practice variability for residual speech sound errors

PubMed Central

Preston, Jonathan L.; McCabe, Patricia; Rivera-Campos, Ahmed; Whittle, Jessica L.; Landry, Erik; Maas, Edwin

2014-01-01

Purpose The goals were to (1) test the efficacy of a motor-learning based treatment that includes ultrasound visual feedback for individuals with residual speech sound errors, and (2) explore whether the addition of prosodic cueing facilitates speech sound learning. Method A multiple baseline single subject design was used, replicated across 8 participants. For each participant, one sound context was treated with ultrasound plus prosodic cueing for 7 sessions, and another sound context was treated with ultrasound but without prosodic cueing for 7 sessions. Sessions included ultrasound visual feedback as well as non-ultrasound treatment. Word-level probes assessing untreated words were used to evaluate retention and generalization. Results For most participants, increases in accuracy of target sound contexts at the word level were observed with the treatment program regardless of whether prosodic cueing was included. Generalization between onset singletons and clusters was observed, as well as generalization to sentence-level accuracy. There was evidence of retention during post-treatment probes, including at a two-month follow-up. Conclusions A motor-based treatment program that includes ultrasound visual feedback can facilitate learning of speech sounds in individuals with residual speech sound errors. PMID:25087938

Planning for Serious Illness by the General Public: A Population-Based Survey

PubMed Central

Quinlan, Elizabeth; Venne, Rosemary; Hunter, Paulette; Surtees, Doug

2013-01-01

Background. While rates of advance care documentation amongst the general public remain low, there is increasing recognition of the value of informal planning to address patient preferences in serious illness. Objectives. To determine the associations between personal attributes and formal and informal planning for serious illness across age groups. Methods. This population-based, online survey was conducted in Saskatchewan, Canada, in April, 2012, using a nonclinical sample of 827 adults ranging from 18 to 88 years of age and representative of age, sex, and regional distribution of the province. Associations between key predictor variables and planning for serious illness were assessed using binary logistic regression. Results. While 16.6% of respondents had completed a written living will or advance care plan, half reported having conversations about their treatment wishes or states of health in which they would find it unacceptable to live. Lawyers were the most frequently cited source of assistance for those who had prepared advance care plans. Personal experiences with funeral planning significantly increased the likelihood of activities designed to plan for serious illness. Conclusions. Strategies designed to increase the rate of planning for future serious illness amongst the general public must account for personal readiness. PMID:25025030

[Treatment of residents in 74 nursing homes: the opinion of caregivers].

PubMed

van den Elzen, A J

2005-07-01

This study is based on the outcomes of the program "Privacy In Nursing Homes" that has been initiated by the Dutch Department of Health in the late 90's. In this study, personnel of 74 nursing homes were asked to reflect on the way they treat residents. The attitudes of personnel were measured with a questionnaire that contains 80 propositions about their behaviour towards residents. The propositions can be reduced to five factors: kindness, structural environment, control, freedom to choose, and respect. First, we give the general results on these five factors. After that we give insight in the correlations between the five different aspects of treatment and the results of regression analysis. The general conclusion is that the behaviour towards residents in nursing homes at the beginning of the 21st Century is far from optimal. Residents most notably lack personal freedom and control over their received care and their way of living. This result is especially worrying because client conformed care has been an important point of attention for some time now. Another important conclusion is that the care for residents has a positive relation with the mangement policy of an organization and so, it is possible to improve the care.

Virus replication as a phenotypic version of polynucleotide evolution.

PubMed

Antoneli, Fernando; Bosco, Francisco; Castro, Diogo; Janini, Luiz Mario

2013-04-01

In this paper, we revisit and adapt to viral evolution an approach based on the theory of branching process advanced by Demetrius et al. (Bull. Math. Biol. 46:239-262, 1985), in their study of polynucleotide evolution. By taking into account beneficial effects, we obtain a non-trivial multivariate generalization of their single-type branching process model. Perturbative techniques allows us to obtain analytical asymptotic expressions for the main global parameters of the model, which lead to the following rigorous results: (i) a new criterion for "no sure extinction", (ii) a generalization and proof, for this particular class of models, of the lethal mutagenesis criterion proposed by Bull et al. (J. Virol. 18:2930-2939, 2007), (iii) a new proposal for the notion of relaxation time with a quantitative prescription for its evaluation, (iv) the quantitative description of the evolution of the expected values in four distinct "stages": extinction threshold, lethal mutagenesis, stationary "equilibrium", and transient. Finally, based on these quantitative results, we are able to draw some qualitative conclusions.

Case studies, cross-site comparisons, and the challenge of generalization: comparing agent-based models of land-use change in frontier regions

PubMed Central

Parker, Dawn C.; Entwisle, Barbara; Rindfuss, Ronald R.; Vanwey, Leah K.; Manson, Steven M.; Moran, Emilio; An, Li; Deadman, Peter; Evans, Tom P.; Linderman, Marc; Rizi, S. Mohammad Mussavi; Malanson, George

2009-01-01

Cross-site comparisons of case studies have been identified as an important priority by the land-use science community. From an empirical perspective, such comparisons potentially allow generalizations that may contribute to production of global-scale land-use and land-cover change projections. From a theoretical perspective, such comparisons can inform development of a theory of land-use science by identifying potential hypotheses and supporting or refuting evidence. This paper undertakes a structured comparison of four case studies of land-use change in frontier regions that follow an agent-based modeling approach. Our hypothesis is that each case study represents a particular manifestation of a common process. Given differences in initial conditions among sites and the time at which the process is observed, actual mechanisms and outcomes are anticipated to differ substantially between sites. Our goal is to reveal both commonalities and differences among research sites, model implementations, and ultimately, conclusions derived from the modeling process. PMID:19960107

Case studies, cross-site comparisons, and the challenge of generalization: comparing agent-based models of land-use change in frontier regions.

PubMed

Parker, Dawn C; Entwisle, Barbara; Rindfuss, Ronald R; Vanwey, Leah K; Manson, Steven M; Moran, Emilio; An, Li; Deadman, Peter; Evans, Tom P; Linderman, Marc; Rizi, S Mohammad Mussavi; Malanson, George

2008-01-01

Cross-site comparisons of case studies have been identified as an important priority by the land-use science community. From an empirical perspective, such comparisons potentially allow generalizations that may contribute to production of global-scale land-use and land-cover change projections. From a theoretical perspective, such comparisons can inform development of a theory of land-use science by identifying potential hypotheses and supporting or refuting evidence. This paper undertakes a structured comparison of four case studies of land-use change in frontier regions that follow an agent-based modeling approach. Our hypothesis is that each case study represents a particular manifestation of a common process. Given differences in initial conditions among sites and the time at which the process is observed, actual mechanisms and outcomes are anticipated to differ substantially between sites. Our goal is to reveal both commonalities and differences among research sites, model implementations, and ultimately, conclusions derived from the modeling process.

A Pilot Prospective Study of Fetomaternal Hemorrhage Identified by Anemia in Asymptomatic Neonates

PubMed Central

Stroustrup, Annemarie; Plafkin, Callie

2016-01-01

Background Fetomaternal hemorrhage (FMH) is a poorly understood condition in which fetal erythrocytes transfer to the maternal circulation via a faulty placental barrier. Little is known about the true incidence, epidemiology, or pathophysiology of FMH in the general pregnant population as existing studies are based on retrospective cohorts and manifest diagnosis and selection bias. Objective To evaluate the practicability of a prospective study of fetomaternal hemorrhage in the general population based on antepartum maternal blood testing and neonatal anemia. Study Design Prospective cohort study. Result Nineteen pregnant women were enrolled prior to the term delivery of twenty well infants. Five neonates were unexpectedly anemic on first postnatal testing. Antenatal maternal blood samples associated with 2 of 5 anemic newborns had positive Kleihauer-Betke testing while no newborn with a normal postnatal blood count had an associated abnormal Kleihauer-Betke test. Conclusion Clinically significant FMH may be more common than previously thought. Prospective epidemiological study of FMH is feasible. PMID:26765555

Well Clear: General Aviation and Commercial Pilots' Perceptioin of Unmanned Aerial Vehicles in the National Airspace System

NASA Technical Reports Server (NTRS)

Ott, Joseph

2015-01-01

This research explored how different pilots perceived the concept of the Well Clear Boundary (WCB) and observed if that boundary changed when dealing with manned versus unmanned aircraft systems (UAS), and the effects of other variables. Pilots' WCB perceptions were collected objectively through simulator recordings and subjectively through questionnaires. Objectively, significant differences were found in WCB perception between two pilot types (general aviation [GA], and Airline Transport Pilots [ATPs]), and significant WCB differences were evident when comparing two intruder types (manned versus unmanned aircraft). Differences were dependent on other manipulated variables (intruder approach angle, ownship speed, and background traffic levels). Subjectively, there were differences in WCB perception across pilot types; GA pilots trusted UAS aircraft higher than the more experienced ATPs. Conclusions indicate pilots' WCB mental models are more easily perceived as time-based boundaries in front of ownship, and more easily perceived as distance-based boundaries to the rear of ownship.

General Dentists’ Use of Isolation Techniques During Root Canal Treatment: from the National Dental Practice-Based Research Network

PubMed Central

Lawson, Nathaniel C.; Gilbert, Gregg H.; Funkhouser, Ellen; Eleazer, Paul D.; Benjamin, Paul L.; Worley, Donald C.

2015-01-01

Introduction A preliminary study done by a National Dental Practice-Based Research Network precursor observed that 44% of general dentists (GDs) reported always using a rubber dam (RD) during root canal treatment (RCT). This full-scale study quantified use of all isolation techniques, including RD use. Methods Network practitioners completed a questionnaire about isolation techniques used during RCT. Network Enrollment Questionnaire data provided practitioner characteristics. Results 1,490 of 1,716 eligible GDs participated (87%); 697 (47%) reported always using a RD. This percentage varied by tooth type. These GDs were more likely to always use a RD: do not own a private practice; perform less than 10 RCT/month; have postgraduate training. Conclusions Most GDs do not use a RD all the time. Ironically, RDs are used more frequently by GDs who do not perform molar RCT. RD use varies with tooth type and certain dentist, practice, and patient characteristics. PMID:26015159

Patient-centred care in general dental practice - a systematic review of the literature

PubMed Central

2014-01-01

Background Delivering improvements in quality is a key objective within most healthcare systems, and a view which has been widely embraced within the NHS in the United Kingdom. Within the NHS, quality is evaluated across three key dimensions: clinical effectiveness, safety and patient experience, with the latter modelled on the Picker Principles of Patient-Centred Care (PCC). Quality improvement is an important feature of the current dental contract reforms in England, with “patient experience” likely to have a central role in the evaluation of quality. An understanding and appreciation of the evidence underpinning PCC within dentistry is highly relevant if we are to use this as a measure of quality in general dental practice. Methods A systematic review of the literature was undertaken to identify the features of PCC relevant to dentistry and ascertain the current research evidence base underpinning its use as a measure of quality within general dental practice. Results Three papers were identified which met the inclusion criteria and demonstrated the use of primary research to provide an understanding of the key features of PCC within dentistry. None of the papers identified were based in general dental practice and none of the three studies sought the views of patients. Some distinct differences were noted between the key features of PCC reported within the dental literature and those developed within the NHS Patient Experience Framework. Conclusions This systematic review reveals a lack of understanding of PCC within dentistry, and in particular general dental practice. There is currently a poor evidence base to support the use of the current patient reported outcome measures as indicators of patient-centredness. Further research is necessary to understand the important features of PCC in dentistry and patients’ views should be central to this research. PMID:24902842

Health effects of oxygenated fuels.

PubMed Central

Costantini, M G

1993-01-01

The use of oxygenated fuels is anticipated to increase over the next decades. This paper reviews the toxicological and exposure information for methyl tertiary-butyl ether (MTBE), a fuel additive, and methanol, a replacement fuel, and discusses the possible health consequences of exposure of the general public to these compounds. For MTBE, the health effects information available is derived almost exclusively from rodent studies, and the exposure data are limited to a few measurements at some service stations. Based on these data, it appears unlikely that the normal population is at high risk of exposure to MTBE vapor. However, in the absence of health and pharmacokinetic data in humans or in nonhuman primates, this conclusion is not strongly supported. Similarly, there are a number of uncertainties to take into consideration in estimating human risk from the use of methanol as a fuel. Although methanol may be toxic to humans at concentrations that overwhelm certain enzymes involved in methanol metabolism, the data available provide little evidence to indicate that exposure to methanol vapors from the use of methanol as a motor vehicle fuel will result in adverse health effects. The uncertainties in this conclusion are based on the lack of information on dose-response relationship at reasonable, projected exposure levels and of studies examining end points of concern in sensitive species. In developing a quantitative risk assessment, more needs to be known about health effects in primates or humans and the range of exposure expected for the general public for both compounds. PMID:8020439

Bluues: a program for the analysis of the electrostatic properties of proteins based on generalized Born radii

PubMed Central

2012-01-01

Background The Poisson-Boltzmann (PB) equation and its linear approximation have been widely used to describe biomolecular electrostatics. Generalized Born (GB) models offer a convenient computational approximation for the more fundamental approach based on the Poisson-Boltzmann equation, and allows estimation of pairwise contributions to electrostatic effects in the molecular context. Results We have implemented in a single program most common analyses of the electrostatic properties of proteins. The program first computes generalized Born radii, via a surface integral and then it uses generalized Born radii (using a finite radius test particle) to perform electrostic analyses. In particular the ouput of the program entails, depending on user's requirement: 1) the generalized Born radius of each atom; 2) the electrostatic solvation free energy; 3) the electrostatic forces on each atom (currently in a dvelopmental stage); 4) the pH-dependent properties (total charge and pH-dependent free energy of folding in the pH range -2 to 18; 5) the pKa of all ionizable groups; 6) the electrostatic potential at the surface of the molecule; 7) the electrostatic potential in a volume surrounding the molecule; Conclusions Although at the expense of limited flexibility the program provides most common analyses with requirement of a single input file in PQR format. The results obtained are comparable to those obtained using state-of-the-art Poisson-Boltzmann solvers. A Linux executable with example input and output files is provided as supplementary material. PMID:22536964

Specialization and the Current Practices of General Surgeons

PubMed Central

Decker, Marquita R; Dodgion, Christopher M; Kwok, Alvin C; Hu, Yue-Yung; Havlena, Jeff A; Jiang, Wei; Lipsitz, Stuart R; Kent, K Craig; Greenberg, Caprice C

2014-01-01

Background The impact of specialization on the practice of general surgery has not been characterized. Our goal was to assess general surgeons’ operative practices to inform surgical education and workforce planning. Study Design We examined the practices of general surgeons identified in the 2008 State Inpatient and Ambulatory Surgery Databases of the Healthcare Cost and Utilization Project (HCUP) for three US states. Operations were identified using ICD-9 and CPT codes linked to encrypted physician identifiers. For each surgeon, total operative volume and the percentage of practice comprised of their most common operation were calculated. Correlation was measured between general surgeons’ case volume and the number of other specialists in a health service area. Results There were 1,075 general surgeons who performed 240,510 operations in 2008. The mean operative volume for each surgeon was 224 annual procedures. General surgeons performed an average of 23 different types of operations. For the majority of general surgeons, their most common procedure comprised no more than 30% of total practice. The most common operations, ranked by the frequency that they appeared as general surgeons’ top procedure, included: cholecystectomy, colonoscopy, endoscopy, and skin excision. The proportion of general surgery practice comprised of endoscopic procedures inversely correlated with the number of gastroenterologists in the health service area (Rho = - 0.50, p = 0.005). Conclusions Despite trends toward specialization, the current practices of general surgeons remain heterogeneous. This indicates a continued demand for broad-based surgical education to allow future surgeons to tailor their practices to their environment. PMID:24210145

RGG: A general GUI Framework for R scripts

PubMed Central

Visne, Ilhami; Dilaveroglu, Erkan; Vierlinger, Klemens; Lauss, Martin; Yildiz, Ahmet; Weinhaeusel, Andreas; Noehammer, Christa; Leisch, Friedrich; Kriegner, Albert

2009-01-01

Background R is the leading open source statistics software with a vast number of biostatistical and bioinformatical analysis packages. To exploit the advantages of R, extensive scripting/programming skills are required. Results We have developed a software tool called R GUI Generator (RGG) which enables the easy generation of Graphical User Interfaces (GUIs) for the programming language R by adding a few Extensible Markup Language (XML) – tags. RGG consists of an XML-based GUI definition language and a Java-based GUI engine. GUIs are generated in runtime from defined GUI tags that are embedded into the R script. User-GUI input is returned to the R code and replaces the XML-tags. RGG files can be developed using any text editor. The current version of RGG is available as a stand-alone software (RGGRunner) and as a plug-in for JGR. Conclusion RGG is a general GUI framework for R that has the potential to introduce R statistics (R packages, built-in functions and scripts) to users with limited programming skills and helps to bridge the gap between R developers and GUI-dependent users. RGG aims to abstract the GUI development from individual GUI toolkits by using an XML-based GUI definition language. Thus RGG can be easily integrated in any software. The RGG project further includes the development of a web-based repository for RGG-GUIs. RGG is an open source project licensed under the Lesser General Public License (LGPL) and can be downloaded freely at PMID:19254356

37 CFR 1.625 - Conclusion of supplemental examination; publication of supplemental examination certificate...

Code of Federal Regulations, 2014 CFR

2014-07-01

....625 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES Supplemental Examination of Patents § 1.625 Conclusion... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Conclusion of supplemental...

37 CFR 1.625 - Conclusion of supplemental examination; publication of supplemental examination certificate...

Code of Federal Regulations, 2013 CFR

2013-07-01

....625 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES Supplemental Examination of Patents § 1.625 Conclusion... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Conclusion of supplemental...

Exercise-based treatments for substance use disorders: evidence, theory, and practicality

PubMed Central

Linke, Sarah E.; Ussher, Michael

2016-01-01

Background Epidemiological studies reveal that individuals who report risky substance use are generally less likely to meet physical activity guidelines (with the exception of certain population segments, such as adolescents and athletes). A growing body of evidence suggests that individuals with substance use disorders (SUDs) are interested in exercising and that they may derive benefits from regular exercise, in terms of both general health/fitness and SUD recovery. Objectives The aims of this paper were to: (i) summarize the research examining the effects of exercise-based treatments for SUDs; (ii) discuss the theoretical mechanisms and practical reasons for investigating this topic; (iii) identify the outstanding relevant research questions that warrant further inquiry; and (iv) describe potential implications for practice. Methods The following databases were searched for peer-reviewed original and review papers on the topic of substance use and exercise: PubMed Central, MEDLINE, EMBASE, PsycINFO, and CINAHL Plus. Reference lists of these publications were subsequently searched for any missed but relevant manuscripts. Identified papers were reviewed and summarized by both authors. Results The limited research conducted suggests that exercise may be an effective adjunctive treatment for SUDs. In contrast to the scarce intervention trials to date, a relative abundance of literature on the theoretical and practical reasons supporting the investigation of this topic has been published. Conclusions Definitive conclusions are difficult to draw due to diverse study protocols and low adherence to exercise programs, among other problems. Despite the currently limited and inconsistent evidence, numerous theoretical and practical reasons support exercise-based treatments for SUDs, including psychological, behavioral, neurobiological, nearly universal safety profile, and overall positive health effects. PMID:25397661

Application of STEM characterization for investigating radiation effects in BCC Fe-based alloys

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

Parish, Chad M.; Field, Kevin G.; Certain, Alicia G.

2015-04-20

This paper provides a general overview of advanced scanning transmission electron microscopy (STEM) techniques used for characterization of irradiated BCC Fe-based alloys. Advanced STEM methods provide the high-resolution imaging and chemical analysis necessary to understand the irradiation response of BCC Fe-based alloys. The use of STEM with energy dispersive x-ray spectroscopy (EDX) for measurement of radiation-induced segregation (RIS) is described, with an illustrated example of RIS in proton- and self-ion irradiated T91. Aberration-corrected STEM-EDX for nanocluster/nanoparticle imaging and chemical analysis is also discussed, and examples are provided from ion-irradiated oxide dispersion strengthened (ODS) alloys. In conclusion, STEM techniques for void,more » cavity, and dislocation loop imaging are described, with examples from various BCC Fe-based alloys.« less

Foundations for computer simulation of a low pressure oil flooded single screw air compressor

NASA Astrophysics Data System (ADS)

Bein, T. W.

1981-12-01

The necessary logic to construct a computer model to predict the performance of an oil flooded, single screw air compressor is developed. The geometric variables and relationships used to describe the general single screw mechanism are developed. The governing equations to describe the processes are developed from their primary relationships. The assumptions used in the development are also defined and justified. The computer model predicts the internal pressure, temperature, and flowrates through the leakage paths throughout the compression cycle of the single screw compressor. The model uses empirical external values as the basis for the internal predictions. The computer values are compared to the empirical values, and conclusions are drawn based on the results. Recommendations are made for future efforts to improve the computer model and to verify some of the conclusions that are drawn.

Interpreting Signal Amplitudes in Surface Electromyography Studies in Sport and Rehabilitation Sciences

PubMed Central

Vigotsky, Andrew D.; Halperin, Israel; Lehman, Gregory J.; Trajano, Gabriel S.; Vieira, Taian M.

2018-01-01

Surface electromyography (sEMG) is a popular research tool in sport and rehabilitation sciences. Common study designs include the comparison of sEMG amplitudes collected from different muscles as participants perform various exercises and techniques under different loads. Based on such comparisons, researchers attempt to draw conclusions concerning the neuro- and electrophysiological underpinning of force production and hypothesize about possible longitudinal adaptations, such as strength and hypertrophy. However, such conclusions are frequently unsubstantiated and unwarranted. Hence, the goal of this review is to discuss what can and cannot be inferred from comparative research designs as it pertains to both the acute and longitudinal outcomes. General methodological recommendations are made, gaps in the literature are identified, and lines for future research to help improve the applicability of sEMG are suggested. PMID:29354060

Administration of rocuronium based on real body weight versus fat-free mass in patients with lymphedema.

PubMed

Jing, Zhang; Muheremu, Aikeremujiang; Liu, Pengfei; Hu, Xiaoyun; Binjiang, Zhao

2017-12-01

Objective To compare the clinical pharmacokinetics of rocuronium when applied according to fat-free mass versus real body weight during anesthetic induction of patients with lymphedema. Methods Sixty patients with lymphedema (age, 18-60 years; American Society of Anesthesiologists physical status, I-II) undergoing elective surgery with general anesthesia were randomly divided into two groups. Rocuronium was administered based on the fat-free mass in 30 patients and real body weight in 30 patients. General anesthesia was induced with propofol and remifentanil by target-controlled infusion. Intubation was attempted when the onset time (T1) (time from end of bolus injection to 100% twitch depression) reached maximal inhibition, and respiratory support with mechanical ventilation was then applied. The T1, clinical duration (time from end of bolus injection to recovery of twitch tension to 25% of control), recovery index (time from 25% to 75% of recovery of T1), and dosage were recorded. Results Complete data were recorded for 59 patients, and there were no significant differences in the general condition, intubation condition, or median duration of action of rocuronium between the two groups. However, the median T1, recovery index, and dosage of rocuronium were significantly different. Conclusion Good intubation conditions and a shortened clinical duration can be obtained for patients with lymphedema when induction with rocuronium is based on the fat-free mass.

Designing Trials for Testing the Efficacy of Pre- Pro- and Synbiotics

NASA Astrophysics Data System (ADS)

Lewis, Stephen; Atkinson, Charlotte

Providing an evidence base for the rational delivery of medicines and treatments is the cornerstone of modern health care delivery. Much of this evidence base is gained through conducting clinical trials. Superficially, designing a clinical trial seems straightforward. However, in practice many unforeseen difficulties arise with long setting up times, poor recruitment rates and patients or interventions not behaving in the way expected. Unfortunately, clinical trials examining the efficacy of pre-, pro- and synbiotics have developed a reputation for being published in low impact journals and reaching unconvincing conclusions. As a generalization, the reason for this poor reputation is that the trials have tended to be too small and have not used meaningful clinical endpoints.

Cited Brazilian papers in general surgery between 1970 and 2009

PubMed Central

Heldwein, Flavio L.; Hartmann, Antonio A.; Kalil, Antonio N.; Neves, Bruno V. D.; Ratti, Giorigo S. B.; Beber, Moises C.; Souza, Rafael M.; d’Acampora, Armando J.

2010-01-01

OBJECTIVES To identify the most cited articles in general surgery published by Brazilian authors. INTRODUCTION There are several ways for the international community to recognize the quality of a scientific article. Although controversial, the most widely used and reliable methodology to identify the importance of an article is citation analysis. METHODS A search using the Institute for Scientific Information citation database (Science Citation Index Expanded) was performed to identify highly cited Brazilian papers published in twenty-six highly cited general surgery journals, selected based on their elevated impact factors, from 1970 to 2009. Further analysis was done on the 65 most-cited papers. RESULTS We identified 1,713 Brazilian articles, from which nine papers emerged as classics (more than 100 citations received). For the Brazilian contributions, a total increase of about 21-fold was evident between 1970 and 2009. Although several topics were covered, articles covering trauma, oncology and organ transplantation were the most cited. The majority of classic studies were done with international cooperation. CONCLUSIONS This study identified the most influential Brazilian articles published in internationally renowned general surgery journals. PMID:20535371

HPV infection in women with and without cervical cancer in Conakry, Guinea

PubMed Central

Keita, N; Clifford, G M; Koulibaly, M; Douno, K; Kabba, I; Haba, M; Sylla, B S; van Kemenade, F J; Snijders, P J F; Meijer, C J L M; Franceschi, S

2009-01-01

Background: Cervical cancer incidence in western Africa is among the highest in the world. Methods: To investigate human papillomavirus (HPV) infection in Guinea, we obtained cervical specimens from 831 women aged 18–64 years from the general population of the capital Conakry and from 77 locally diagnosed invasive cervical cancers (ICC). Human papillomavirus was detected using a GP5+/6+ PCR-based assay. Results: Among the general population, the prevalence of cervical abnormalities was 2.6% by visual inspection and 9.5% by liquid-based cytology. Fourteen of 15 high-grade squamous intraepithelial lesions were visual inspection-negative. Human papillomavirus prevalence was 50.8% (32.1% for high-risk types) and relatively constant across all age groups. Being single or reporting ⩾3 sexual partners was significantly associated with HPV positivity. HPV16 was the most common type, both among the general population (7.3%) and, notably in ICC (48.6%). HPV45 (18.6%) and HPV18 (14.3%), the next most common types in ICC, were also more common in ICC than in HPV-positive women with normal cytology from the general population. Conclusion: The heavy burden of HPV infection and severe cervical lesions in Guinean women calls for new effective interventions. Sixty-three per cent of cervical cancers are theoretically preventable by HPV16/18 vaccines in Guinea; perhaps more if some cross-protection exists with HPV45. PMID:19536089

Application of 3D Zernike descriptors to shape-based ligand similarity searching

PubMed Central

2009-01-01

Background The identification of promising drug leads from a large database of compounds is an important step in the preliminary stages of drug design. Although shape is known to play a key role in the molecular recognition process, its application to virtual screening poses significant hurdles both in terms of the encoding scheme and speed. Results In this study, we have examined the efficacy of the alignment independent three-dimensional Zernike descriptor (3DZD) for fast shape based similarity searching. Performance of this approach was compared with several other methods including the statistical moments based ultrafast shape recognition scheme (USR) and SIMCOMP, a graph matching algorithm that compares atom environments. Three benchmark datasets are used to thoroughly test the methods in terms of their ability for molecular classification, retrieval rate, and performance under the situation that simulates actual virtual screening tasks over a large pharmaceutical database. The 3DZD performed better than or comparable to the other methods examined, depending on the datasets and evaluation metrics used. Reasons for the success and the failure of the shape based methods for specific cases are investigated. Based on the results for the three datasets, general conclusions are drawn with regard to their efficiency and applicability. Conclusion The 3DZD has unique ability for fast comparison of three-dimensional shape of compounds. Examples analyzed illustrate the advantages and the room for improvements for the 3DZD. PMID:20150998

Application of a metabolic balancing technique to the analysis of microbial fermentation data.

PubMed

de Hollander, J A

1991-01-01

A general method for the development of fermentation models, based on elemental and metabolic balances, is illustrated with three examples from the literature. Physiological parameters such as the (maximal) yield on ATP, the energetic maintenance coefficient, the P/O ratio and others are estimated by fitting model equations to experimental data. Further, phenomenological relations concerning kinetics of product formation and limiting enzyme activities are assessed. The results are compared with the conclusions of the original articles, and differences due to the application of improved models are discussed.

Lying through your teeth.

PubMed

Chambers, David W

2004-01-01

Evidence is presented that the concerns over diminished truth-telling in dentistry are a reflection of changes in society generally. Some of the reasons for dimmed truth-telling are listed, leading to a conclusion that society is in the process of rejecting an "objective" view of truth based on the word of authorities. An alternative, authentic conception of truth is proposed: truth is agreement that it is mutually advantageous for the parties involved to believe the promises they have made as a foundation for common action. Some of the characteristics of this view are discussed.

Perceptions of gender-based discrimination during surgical training and practice

PubMed Central

Bruce, Adrienne N.; Battista, Alexis; Plankey, Michael W.; Johnson, Lynt B.; Marshall, M. Blair

2015-01-01

Background Women represent 15% of practicing general surgeons. Gender-based discrimination has been implicated as discouraging women from surgery. We sought to determine women's perceptions of gender-based discrimination in the surgical training and working environment. Methods Following IRB approval, we fielded a pilot survey measuring perceptions and impact of gender-based discrimination in medical school, residency training, and surgical practice. It was sent electronically to 1,065 individual members of the Association of Women Surgeons. Results We received 334 responses from medical students, residents, and practicing physicians with a response rate of 31%. Eighty-seven percent experienced gender-based discrimination in medical school, 88% in residency, and 91% in practice. Perceived sources of gender-based discrimination included superiors, physician peers, clinical support staff, and patients, with 40% emanating from women and 60% from men. Conclusions The majority of responses indicated perceived gender-based discrimination during medical school, residency, and practice. Gender-based discrimination comes from both sexes and has a significant impact on women surgeons. PMID:25652117

Perceptions of gender-based discrimination during surgical training and practice.

PubMed

Bruce, Adrienne N; Battista, Alexis; Plankey, Michael W; Johnson, Lynt B; Marshall, M Blair

2015-01-01

Background Women represent 15% of practicing general surgeons. Gender-based discrimination has been implicated as discouraging women from surgery. We sought to determine women's perceptions of gender-based discrimination in the surgical training and working environment. Methods Following IRB approval, we fielded a pilot survey measuring perceptions and impact of gender-based discrimination in medical school, residency training, and surgical practice. It was sent electronically to 1,065 individual members of the Association of Women Surgeons. Results We received 334 responses from medical students, residents, and practicing physicians with a response rate of 31%. Eighty-seven percent experienced gender-based discrimination in medical school, 88% in residency, and 91% in practice. Perceived sources of gender-based discrimination included superiors, physician peers, clinical support staff, and patients, with 40% emanating from women and 60% from men. Conclusions The majority of responses indicated perceived gender-based discrimination during medical school, residency, and practice. Gender-based discrimination comes from both sexes and has a significant impact on women surgeons.

Blood Glucose, Diet-Based Glycemic Load and Cognitive Aging Among Dementia-Free Older Adults

PubMed Central

Andel, Ross; McEvoy, Cathy; Dahl Aslan, Anna K.; Finkel, Deborah; Pedersen, Nancy L.

2015-01-01

Background. Although evidence indicates that Type II Diabetes is related to abnormal brain aging, the influence of elevated blood glucose on long-term cognitive change is unclear. In addition, the relationship between diet-based glycemic load and cognitive aging has not been extensively studied. The focus of this study was to investigate the influence of diet-based glycemic load and blood glucose on cognitive aging in older adults followed for up to 16 years. Methods. Eight-hundred and thirty-eight cognitively healthy adults aged ≥50 years (M = 63.1, SD = 8.3) from the Swedish Adoption/Twin Study of Aging were studied. Mixed effects growth models were utilized to assess overall performance and change in general cognitive functioning, perceptual speed, memory, verbal ability, and spatial ability as a function of baseline blood glucose and diet-based glycemic load. Results. High blood glucose was related to poorer overall performance on perceptual speed as well as greater rates of decline in general cognitive ability, perceptual speed, verbal ability, and spatial ability. Diet-based glycemic load was related to poorer overall performance in perceptual speed and spatial ability. Conclusion. Diet-based glycemic load and, in particular, elevated blood glucose appear important for cognitive performance/cognitive aging. Blood glucose control (perhaps through low glycemic load diets) may be an important target in the detection and prevention of age-related cognitive decline. PMID:25149688

The National Children’s Study: Recruitment Outcomes Using the Provider-Based Recruitment Approach

PubMed Central

Wyatt, Sharon B.; Buka, Stephen; Cherry, Debra; Cislo, Kendall K.; Dudley, Donald J.; McElfish, Pearl Anna; Norman, Gwendolyn S.; Reynolds, Simone A.; Siega-Riz, Anna Maria; Wadlinger, Sandra; Walker, Cheryl K.; Robbins, James M.

2016-01-01

OBJECTIVE: In 2009, the National Children’s Study (NCS) Vanguard Study tested the feasibility of household-based recruitment and participant enrollment using a birth-rate probability sample. In 2010, the NCS Program Office launched 3 additional recruitment approaches. We tested whether provider-based recruitment could improve recruitment outcomes compared with household-based recruitment. METHODS: The NCS aimed to recruit 18- to 49-year-old women who were pregnant or at risk for becoming pregnant who lived in designated geographic segments within primary sampling units, generally counties. Using provider-based recruitment, 10 study centers engaged providers to enroll eligible participants at their practice. Recruitment models used different levels of provider engagement (full, intermediate, information-only). RESULTS: The percentage of eligible women per county ranged from 1.5% to 57.3%. Across the centers, 3371 potential participants were approached for screening, 3459 (92%) were screened and 1479 were eligible (43%). Of those 1181 (80.0%) gave consent and 1008 (94%) were retained until delivery. Recruited participants were generally representative of the county population. CONCLUSIONS: Provider-based recruitment was successful in recruiting NCS participants. Challenges included time-intensity of engaging the clinical practices, differential willingness of providers to participate, and necessary reliance on providers for participant identification. The vast majority of practices cooperated to some degree. Recruitment from obstetric practices is an effective means of obtaining a representative sample. PMID:27251870

Two-stage Bayesian model to evaluate the effect of air pollution on chronic respiratory diseases using drug prescriptions.

PubMed

Blangiardo, Marta; Finazzi, Francesco; Cameletti, Michela

2016-08-01

Exposure to high levels of air pollutant concentration is known to be associated with respiratory problems which can translate into higher morbidity and mortality rates. The link between air pollution and population health has mainly been assessed considering air quality and hospitalisation or mortality data. However, this approach limits the analysis to individuals characterised by severe conditions. In this paper we evaluate the link between air pollution and respiratory diseases using general practice drug prescriptions for chronic respiratory diseases, which allow to draw conclusions based on the general population. We propose a two-stage statistical approach: in the first stage we specify a space-time model to estimate the monthly NO2 concentration integrating several data sources characterised by different spatio-temporal resolution; in the second stage we link the concentration to the β2-agonists prescribed monthly by general practices in England and we model the prescription rates through a small area approach. Copyright © 2016 Elsevier Ltd. All rights reserved.

Is international travel useful for general practitioners? A survey of international travel scholarships.

PubMed Central

Holden, J; Evans, P

1998-01-01

BACKGROUND: The Royal College of General Practitioners has offered international travel scholarships for the past decade. Each year a number of general practitioners travel from the UK to work or study assisted by the scheme, while others come to this country for similar purposes. AIM: To investigate the value of international scholarships for recipients and others. METHOD: All those receiving awards in 1988-94 were surveyed by postal questionnaire. RESULTS: Fifty-one out of 58 award winners (88%) replied. Almost all cited some of a wide variety of personal benefits from international travel, and some established continuing links with colleagues overseas. Many gave examples of useful results for others, both patients and colleagues. Scholarships appear to have made a significant contribution to careers, especially for those based outside Britain. CONCLUSION: Relatively modest travel scholarships were viewed both favourably in hindsight and produced a wide range of benefits to recipients, colleagues, and patients. International travel should probably be considered more widely in career planning. PMID:9624751

A note on generalized Genome Scan Meta-Analysis statistics

PubMed Central

Koziol, James A; Feng, Anne C

2005-01-01

Background Wise et al. introduced a rank-based statistical technique for meta-analysis of genome scans, the Genome Scan Meta-Analysis (GSMA) method. Levinson et al. recently described two generalizations of the GSMA statistic: (i) a weighted version of the GSMA statistic, so that different studies could be ascribed different weights for analysis; and (ii) an order statistic approach, reflecting the fact that a GSMA statistic can be computed for each chromosomal region or bin width across the various genome scan studies. Results We provide an Edgeworth approximation to the null distribution of the weighted GSMA statistic, and, we examine the limiting distribution of the GSMA statistics under the order statistic formulation, and quantify the relevance of the pairwise correlations of the GSMA statistics across different bins on this limiting distribution. We also remark on aggregate criteria and multiple testing for determining significance of GSMA results. Conclusion Theoretical considerations detailed herein can lead to clarification and simplification of testing criteria for generalizations of the GSMA statistic. PMID:15717930

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

Not Available

AFP no. 28 (General Electric Lynn Manufacturing dept). is located in the City of Everett, Mass. The facility is composed of 10 buildings having 344,342 square feet of floor space on a 43-acre tract. The plant is engaged in the manufacture of large jet engine components and sub-assemblies. AFT 29 (General Electric River Works Facility) is located in the City of Lynn, Mass. AFT No. 29 is part of the General Electric Aircraft Engine Business Group and the facilities are used for testing and assembly of jet engines. The following conclusions have been developed based on the results of themore » project team's field inspection, review of plant records and files, and interviews with plant personnel. Each of the sites listed below was ranked using the HARM system and was determined to have a sufficient potential for environmental contamination to warrant some degree of follow-on investigation. AFB no. 28: Waste sump and chip storage area; and AFT no. 29: Underground fuel line leaks and underground fuel storage tank leak.« less

FURTHER ANALYSIS OF SUBTYPES OF AUTOMATICALLY REINFORCED SIB: A REPLICATION AND QUANTITATIVE ANALYSIS OF PUBLISHED DATASETS

PubMed Central

Hagopian, Louis P.; Rooker, Griffin W.; Zarcone, Jennifer R.; Bonner, Andrew C.; Arevalo, Alexander R.

2017-01-01

Hagopian, Rooker, and Zarcone (2015) evaluated a model for subtyping automatically reinforced self-injurious behavior (SIB) based on its sensitivity to changes in functional analysis conditions and the presence of self-restraint. The current study tested the generality of the model by applying it to all datasets of automatically reinforced SIB published from 1982 to 2015. We identified 49 datasets that included sufficient data to permit subtyping. Similar to the original study, Subtype-1 SIB was generally amenable to treatment using reinforcement alone, whereas Subtype-2 SIB was not. Conclusions could not be drawn about Subtype-3 SIB due to the small number of datasets. Nevertheless, the findings support the generality of the model and suggest that sensitivity of SIB to disruption by alternative reinforcement is an important dimension of automatically reinforced SIB. Findings also suggest that automatically reinforced SIB should no longer be considered a single category and that additional research is needed to better understand and treat Subtype-2 SIB. PMID:28032344

Working session 5: Operational aspects and risk analysis

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

Cizelj, L.; Donoghue, J.

1997-02-01

A general observation is that both operational aspects and risk analysis cannot be adequately discussed without information presented in other sessions. Some overlap of conclusions and recommendations is therefore to be expected. Further, it was assumed that recommendations concerning improvements in some related topics were generated by other sessions and are not repeated here. These include: (1) Knowledge on degradation mechanisms (initiation, progression, and failure). (2) Modeling of degradation (initiation, progression, and failure). (3) Capabilities of NDE methods. (4) Preventive maintenance and repair. One should note here, however, that all of these directly affect both operational and risk aspects ofmore » affected plants. A list of conclusions and recommendations is based on available presentations and discussions addressing risk and operational experience. The authors aimed at reaching as broad a consensus as possible. It should be noted here that there is no strict delineation between operational and safety aspects of degradation of steam generator tubes. This is caused by different risk perceptions in different countries/societies. The conclusions and recommendations were divided into four broad groups: human reliability; leakage monitoring; risk impact; and consequence assessment.« less

Is the risk for soil arthropods covered by new data requirements under the EU PPP Regulation No. 1107/2009?

PubMed

Kohlschmid, E; Ruf, D

2016-12-01

Testing of effects on earthworms and non-target foliar arthropods is an integral part of the ecotoxicological risk assessment for the authorization of plant protection products. According to the new data requirements, which came into force in 2014 for active substances and in 2016 for plant protection products, the chronic earthworm toxicity test with Eisenia fetida based on reproductive, growth, and behavioral effects instead of the acute earthworm toxicity test based on mortality, has to be conducted routinely. Additional testing of effects on soil arthropods (Folsomia candida, Hyposaspis aculeifer) is required if the risk assessment of foliar applications raises concerns regarding non-target foliar arthropods (Aphidius rhopalosiphi, Typhlodromus pyri) or if the product is applied directly on or into the soil. Thus, it was investigated whether the sublethal earthworm endpoint is more sensitive than the sublethal soil arthropod endpoint for different types of pesticides and whether the risk assessment for non-target arthropods would trigger the testing of effects on soil arthropods in the cases where soil arthropods are more sensitive than earthworms. Toxicity data were obtained from Swiss ecotoxicological database, EFSA Conclusions and scientific literature. For insecticides and herbicides, no general conclusion regarding differences in sensitivity of either earthworms or soil arthropods based on sublethal endpoints were possible. For fungicides, the data indicated that in general, earthworms seemed to be more sensitive than soil arthropods. In total, the sublethal F. candida or H. aculeifer endpoint was lower than the sublethal E. fetida endpoint for 23 (34 %) out of 68 active substances. For 26 % of these 23 active substances, testing of soil arthropods would not have been triggered due to the new data requirement. These results based on sublethal endpoints show that earthworms and soil arthropods differ in sensitivity toward certain active substances and that the risk assessment for non-target foliar arthropods did not always trigger soil arthropod testing in the cases where soil arthropods were more sensitive than earthworms.

Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis

PubMed Central

Sun, Jiale; Gao, Fuqiang; Wang, Yanhua; Sun, Wei; Jiang, Baoguo; Li, Zirong

2017-01-01

Abstract Background: Plantar fasciitis (PF) is the most common reason for heel pain. The efficacy of extracorporeal shock wave therapy (ESWT) as an ideal alternative to conservative treatments and surgery is controversial, and almost all previous articles compared general ESWT with placebo without indicating the kind of shock wave. We undertook a meta-analysis to compare the efficacy of general ESWT, focused shock wave (FSW), and radial shock wave (RSW) with placebo, to assess their effectiveness in chronic PF. Methods: The PubMed, Medline, EmBase, Web of Science, and Cochrane library databases were searched for studies comparing FSW or RSW therapy with placebo in chronic PF. Clinical outcomes included the odds ratios (ORs) of pain relief, pain reduction, and complications. Relevant data were analyzed using RevMan v5.3. Results: Nine studies involving 935 patients were included. ESWT had higher improvement rates than the placebo group (OR 2.58, 95% confidence interval [CI] 1.97–3.39, P < .00001). ESWT had markedly lower standardized mean difference than placebo, with heterogeneity observed (standardized mean difference 1.01, 95% CI −0.01 to 2.03, P = .05, I2 = 96%, P < .00001). FSW and RSW therapies had greater therapeutic success in pain relief than the placebo group (OR 2.17, 95% CI 1.49–3.16, P < .0001; OR 4.63, 95% CI 1.30–16.46, P = .02), but significant heterogeneity was observed in RSW therapy versus placebo (I2 = 81%, P = .005). Conclusion: This meta-analysis suggested that FSW therapy can relieve pain in chronic PF as an ideal alternative option; meanwhile, no firm conclusions of general ESWT and RSW effectiveness can be drawn. Due to variations in the included studies, additional trials are needed to validate these conclusions. PMID:28403111

Characterizing a New Surface-Based Shortwave Cloud Retrieval Technique, Based on Transmitted Radiance for Soil and Vegetated Surface Types

NASA Technical Reports Server (NTRS)

Coddington, Odele; Pilewskie, Peter; Schmidt, K. Sebastian; McBride, Patrick J.; Vukicevic, Tomislava

2013-01-01

This paper presents an approach using the GEneralized Nonlinear Retrieval Analysis (GENRA) tool and general inverse theory diagnostics including the maximum likelihood solution and the Shannon information content to investigate the performance of a new spectral technique for the retrieval of cloud optical properties from surface based transmittance measurements. The cumulative retrieval information over broad ranges in cloud optical thickness (tau), droplet effective radius (r(sub e)), and overhead sun angles is quantified under two conditions known to impact transmitted radiation; the variability in land surface albedo and atmospheric water vapor content. Our conclusions are: (1) the retrieved cloud properties are more sensitive to the natural variability in land surface albedo than to water vapor content; (2) the new spectral technique is more accurate (but still imprecise) than a standard approach, in particular for tau between 5 and 60 and r(sub e) less than approximately 20 nm; and (3) the retrieved cloud properties are dependent on sun angle for clouds of tau from 5 to 10 and r(sub e) less than 10 nm, with maximum sensitivity obtained for an overhead sun.

A study on nonlinear estimation of submaximal effort tolerance based on the generalized MET concept and the 6MWT in pulmonary rehabilitation

PubMed Central

Szczegielniak, Jan; Łuniewski, Jacek; Stanisławski, Rafał; Bogacz, Katarzyna; Krajczy, Marcin; Rydel, Marek

2018-01-01

Background The six-minute walk test (6MWT) is considered to be a simple and inexpensive tool for the assessment of functional tolerance of submaximal effort. The aim of this work was 1) to background the nonlinear nature of the energy expenditure process due to physical activity, 2) to compare the results/scores of the submaximal treadmill exercise test and those of 6MWT in pulmonary patients and 3) to develop nonlinear mathematical models relating the two. Methods The study group included patients with the COPD. All patients were subjected to a submaximal exercise test and a 6MWT. To develop an optimal mathematical solution and compare the results of the exercise test and the 6MWT, the least squares and genetic algorithms were employed to estimate parameters of polynomial expansion and piecewise linear models. Results Mathematical analysis enabled to construct nonlinear models for estimating the MET result of submaximal exercise test based on average walk velocity (or distance) in the 6MWT. Conclusions Submaximal effort tolerance in COPD patients can be effectively estimated from new, rehabilitation-oriented, nonlinear models based on the generalized MET concept and the 6MWT. PMID:29425213

A structured approach to Exposure Based Waiving of human health endpoints under REACH developed in the OSIRIS project.

PubMed

Marquart, Hans; Meijster, Tim; Van de Bovenkamp, Marja; Ter Burg, Wouter; Spaan, Suzanne; Van Engelen, Jacqueline

2012-03-01

Exposure Based Waiving (EBW) is one of the options in REACH when there is insufficient hazard data on a specific endpoint. Rules for adaptation of test requirements are specified and a general option for EBW is given via Appendix XI of REACH, allowing waiving of repeated dose toxicity studies, reproductive toxicity studies and carcinogenicity studies under a number of conditions if exposure is very low. A decision tree is described that was developed in the European project OSIRIS (Optimised Strategies for Risk Assessment of Industrial Chemicals through Integration of Non-Test and Test Information) to help decide in what cases EBW can be justified. The decision tree uses specific criteria as well as more general questions. For the latter, guidance on interpretation and resulting conclusions is provided. Criteria and guidance are partly based on an expert elicitation process. Among the specific criteria a number of proposed Thresholds of Toxicological Concern are used. The decision tree, expanded with specific parts on absorption, distribution, metabolism and excretion that are not described in this paper, is implemented in the OSIRIS webtool on integrated testing strategies. Copyright © 2011 Elsevier Inc. All rights reserved.

Learning styles of medical students, general surgery residents, and general surgeons: implications for surgical education

PubMed Central

2010-01-01

Background Surgical education is evolving under the dual pressures of an enlarging body of knowledge required during residency and mounting work-hour restrictions. Changes in surgical residency training need to be based on available educational models and research to ensure successful training of surgeons. Experiential learning theory, developed by David Kolb, demonstrates the importance of individual learning styles in improving learning. This study helps elucidate the way in which medical students, surgical residents, and surgical faculty learn. Methods The Kolb Learning Style Inventory, which divides individual learning styles into Accommodating, Diverging, Converging, and Assimilating categories, was administered to the second year undergraduate medical students, general surgery resident body, and general surgery faculty at the University of Alberta. Results A total of 241 faculty, residents, and students were surveyed with an overall response rate of 73%. The predominant learning style of the medical students was assimilating and this was statistically significant (p < 0.03) from the converging learning style found in the residents and faculty. The predominant learning styles of the residents and faculty were convergent and accommodative, with no statistically significant differences between the residents and the faculty. Conclusions We conclude that medical students have a significantly different learning style from general surgical trainees and general surgeons. This has important implications in the education of general surgery residents. PMID:20591159

Defining “Normophilic” and “Paraphilic” Sexual Fantasies in a Population‐Based Sample: On the Importance of Considering Subgroups

PubMed Central

2015-01-01

Abstract Introduction According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM‐5), a sexual fantasy (SF) is paraphilic if it concerns activities outside the realm of “genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners” (normophilic). Intensity of the paraphilic SF is also “greater than or equal to normophilic interests.” Surprisingly, however, very few data are available to corroborate that definition of a paraphilic SF. Although the relatively high prevalence of paraphilic SF in the general population is well known, the magnitude of difference between intensity of “normophilic” and “paraphilic” SF remains to be assessed. Aim The main goal of this study was to analyze the SF of adults recruited in the general population to obtain person profiles based on the nature and intensity of their SF. Methods Multiple correspondence analysis (MCA) were used with data collected from 1,501 adults recruited in the general population to generate subgroups of participants based on the nature and intensity of their SF. Main outcome measures The main outcome measures used was a revised version of the Wilson Sex Fantasy Questionnaire. Results When all participants are considered as a unique group, the mean intensity of the most intense “normophilic” SF (oral sex) is significantly higher than the mean intensity of the most intense “paraphilic” SF (being sexually dominated for women and watching two women having sex for men), as expected from the DSM‐5. When clusters of participants are considered separately, however, conclusions are nuanced. Four significant clusters of participants (two predominantly female and two predominantly male) reported at least one paraphilic SF with intensity as high as that of their most intense “normophilic” SF. In fact, 57% of this sample met the criteria of paraphilia. Conclusion These results suggest that the current criteria for paraphilia are too inclusive. Suggestions are given to improve the definition of pathological sexual interests, and the crucial difference between SF and sexual interest is underlined. Joyal CC. Defining “normophilic” and “paraphilic” sexual fantasies in a population‐based sample: On the importance of considering subgroups. Sex Med 2015;3:321–330. PMID:26797067

Optimal Conclusive Teleportation of an Arbitrary d-Dimensional N-Particle Unknown State via a Partially Entangled Quantum Channel

NASA Astrophysics Data System (ADS)

Hao, San-Ru; Hou, Bo-Yu; Xi, Xiao-Qiang; Yue, Rui-Hong

2003-02-01

In this paper we generalize the standard teleportation to the conclusive teleportation case which can teleport an arbitrary d-dimensional N-particle unknown state via the partially entangled quantum channel. We show that only if the quantum channel satisfies a constraint condition can the most general d-dimensional N-particle unknown state be perfect conclusively teleported. We also present a method for optimal conclusively teleportation of the N-particle states and for constructing the joint POVM which can discern the quantum states on the sender's (Alice's) side. Two typical examples are given so that one can see how our method works. The project supported in part by National Natural Science Foundation of China under Grant No. 19975036 and the Foundation of Science and Technology Committee of Hunan Province of China under Grant No. 21000205

Rubber dam use during root canal treatment: findings from The Dental Practice-Based Research Network

PubMed Central

Anabtawi, Mona F.; Gilbert, Gregg H.; Bauer, Michael R.; Reams, Gregg; Makhija, Sonia K.; Benjamin, Paul L.; Williams, O. Dale

2012-01-01

Background The Dental Practice-Based Research Network (DPBRN) provides a venue to investigate whether certain procedures are performed routinely. Study objectives were to: (1) quantify rubber dam use during root canal treatment (RCT) among general dentists; (2) test the hypothesis that certain dentist or practice characteristics are associated with its use. Methods DPBRN practitioner-investigators participated in a questionnaire that included items about rubber dam use and other forms of isolation during root RCT. DPBRN Enrollment Questionnaire data provided certain practitioner and practice characteristics. Results A total of 729 practitioners responded (74%); 524 were general dentists and indicated they do RCT and the percentage of RCT in which they use a rubber dam. Of these 524, 44% use rubber dam for all RCTs; 24% use it for 51%–99% of RCTs; 17% use it for 1%–50%; 15% never use it during RCT. Usage varied significantly by geographic region and practice type. Cotton rolls and other forms of isolation were also reported. Conclusions Similar to other reports in the literature, not all DPBRN general dentists use a rubber dam during RCT. Clinical implications Because the current clinical standard of care is to use a rubber dam during RCT, increasing its use may be important. PMID:23372134

Dr Google

PubMed Central

Pías-Peleteiro, Leticia; Cortés-Bordoy, Javier; Martinón-Torres, Federico

2013-01-01

Objectives: To assess and analyze the information and recommendations provided by Google Web Search™ (Google) in relation to web searches on the HPV vaccine, indications for females and males and possible adverse effects. Materials and Methods: Descriptive cross-sectional study of the results of 14 web searches. Comprehensive analysis of results based on general recommendation given (favorable/dissuasive), as well as compliance with pre-established criteria, namely design, content and credibility. Sub-analysis of results according to site category: general information, blog / forum and press. Results: In the comprehensive analysis of results, 72.2% of websites offer information favorable to HPV vaccination, with varying degrees of content detail, vs. 27.8% with highly dissuasive content in relation to HPV vaccination. The most frequent type of site is the blog or forum. The information found is frequently incomplete, poorly structured, and often lacking in updates, bibliography and adequate citations, as well as sound credibility criteria (scientific association accreditation and/or trust mark system). Conclusions: Google, as a tool which users employ to locate medical information and advice, is not specialized in providing information that is necessarily rigorous or valid from a scientific perspective. Search results and ranking based on Google's generalized algorithms can lead users to poorly grounded opinions and statements, which may impact HPV vaccination perception and subsequent decision making. PMID:23744505

Academic Primer Series: Eight Key Papers about Education Theory

PubMed Central

Gottlieb, Michael; Boysen-Osborn, Megan; Chan, Teresa M.; Krzyzaniak, Sara M.; Pineda, Nicolas; Spector, Jordan; Sherbino, Jonathan

2017-01-01

Introduction Many teachers adopt instructional methods based on assumptions of best practices without attention to or knowledge of supporting education theory. Familiarity with a variety of theories informs education that is efficient, strategic, and evidence-based. As part of the Academic Life in Emergency Medicine Faculty Incubator Program, a list of key education theories for junior faculty was developed. Methods A list of key papers on theories relevant to medical education was generated using an expert panel, a virtual community of practice synthetic discussion, and a social media call for resources. A three-round, Delphi-informed voting methodology including novice and expert educators produced a rank order of the top papers. Results These educators identified 34 unique papers. Eleven papers described the general use of education theory, while 23 papers focused on a specific theory. The top three papers on general education theories and top five papers on specific education theory were selected and summarized. The relevance of each paper for junior faculty and faculty developers is also presented. Conclusion This paper presents a reading list of key papers for junior faculty in medical education roles. Three papers about general education theories and five papers about specific educational theories are identified and annotated. These papers may help provide foundational knowledge in education theory to inform junior faculty teaching practice. PMID:28210367

Reducing Stress Among Mothers in Drug Treatment: A Description of a Mindfulness Based Parenting Intervention.

PubMed

Short, Vanessa L; Gannon, Meghan; Weingarten, Wendy; Kaltenbach, Karol; LaNoue, Marianna; Abatemarco, Diane J

2017-06-01

Background Parenting women with substance use disorder could potentially benefit from interventions designed to decrease stress and improve overall psychosocial health. In this study we assessed whether a mindfulness based parenting (MBP) intervention could be successful in decreasing general and parenting stress in a population of women who are in treatment for substance use disorder and who have infants or young children. Methods MBP participants (N = 59) attended a two-hour session once a week for 12 weeks. Within-group differences on stress outcome measures administered prior to the beginning of the MBP intervention and following the intervention period were investigated using mixed-effects linear regression models accounting for correlations arising from the repeated-measures. Scales assessed for pre-post change included the Perceived Stress Scale-10 (PSS) and the Parenting Stress Index-Short Form (PSI). Results General stress, as measured by the PSS, decreased significantly from baseline to post-intervention. Women with the highest baseline general stress level experienced the greatest change in total stress score. A significant change also occurred across the Parental Distress PSI subscale. Conclusions Findings from this innovative interventional study suggest that the addition of MBP within treatment programs for parenting women with substance use disorder is an effective strategy for reducing stress within this at risk population.

Assessing treatment effects in older breast cancer patients: systematic review of observational research methods.

PubMed

de Glas, N A; Kiderlen, M; de Craen, A J M; Hamaker, M E; Portielje, J E A; van de Velde, C J H; Liefers, G J; Bastiaannet, E

2015-03-01

Solid evidence of treatment effects in older women with breast cancer is lacking, as they are generally underrepresented in randomized clinical trials on which guideline recommendations are based. An alternative way to study treatment effects in older patients could be to use data from observational studies. However, using appropriate methods in analyzing observational data is a key condition in order to draw valid conclusions, as directly comparing treatments generally results in biased estimates due to confounding by indication. The aim of this systematic review was to investigate the methods that have been used in observational studies that assessed the effects of breast cancer treatment on survival, breast cancer survival and recurrence in older patients (aged 65 years and older). Studies were identified through systematic review of the literature published between January 1st 2009 and December 13th 2013 in the PubMed database and EMBASe. Finally, 31 studies fulfilled the inclusion criteria. Of these, 22 studies directly compared two treatments. Fifteen out of these 22 studies addressed the problem of confounding by indication, while seven studies did not. Nine studies used some form of instrumental variable analysis. In conclusion, the vast majority of observational studies that investigate treatment effects in older breast cancer patients compared treatments directly. These studies are therefore likely to be biased. Observational research will be essential to improve treatment and outcome of older breast cancer patients, but the use of accurate methods is essential to draw valid conclusions from this type of data. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effects of Shift and Night Work in the Offshore Petroleum Industry: A Systematic Review

PubMed Central

FOSSUM, Ingrid Nesdal; BJORVATN, Bjørn; WAAGE, Siri; PALLESEN, Ståle

2013-01-01

Shift and night work are associated with several negative outcomes. The aim of this study was to make a systematic review of all studies which examine effects of shift and night work in the offshore petroleum industry, to synthesize the knowledge of how shift work offshore may affect the workers. Searches for studies concerning effects on health, sleep, adaptation, safety, working conditions, family- and social life and turnover were conducted via the databases Web of Knowledge, PsycINFO and PubMed. Search was also conducted through inspection of reference lists of relevant literature. We identified studies describing effects of shift work in terms of sleep, adaptation and re-adaptation of circadian rhythms, health outcomes, safety and accidents, family and social life, and work perceptions. Twenty-nine studies were included. In conclusion, the longitudinal studies were generally consistent in showing that adaptation to night work was complete within one to two weeks of work, while re-adaptation to a daytime schedule was slower. Shift workers reported more sleep problems than day workers. The data regarding mental and physical health, family and social life, and accidents yielded inconsistent results, and were insufficient as a base for drawing general conclusions. More research in the field is warranted. PMID:23803497

A consistent conceptual framework for applying climate metrics in technology life cycle assessment

NASA Astrophysics Data System (ADS)

Mallapragada, Dharik; Mignone, Bryan K.

2017-07-01

Comparing the potential climate impacts of different technologies is challenging for several reasons, including the fact that any given technology may be associated with emissions of multiple greenhouse gases when evaluated on a life cycle basis. In general, analysts must decide how to aggregate the climatic effects of different technologies, taking into account differences in the properties of the gases (differences in atmospheric lifetimes and instantaneous radiative efficiencies) as well as different technology characteristics (differences in emission factors and technology lifetimes). Available metrics proposed in the literature have incorporated these features in different ways and have arrived at different conclusions. In this paper, we develop a general framework for classifying metrics based on whether they measure: (a) cumulative or end point impacts, (b) impacts over a fixed time horizon or up to a fixed end year, and (c) impacts from a single emissions pulse or from a stream of pulses over multiple years. We then use the comparison between compressed natural gas and gasoline-fueled vehicles to illustrate how the choice of metric can affect conclusions about technologies. Finally, we consider tradeoffs involved in selecting a metric, show how the choice of metric depends on the framework that is assumed for climate change mitigation, and suggest which subset of metrics are likely to be most analytically self-consistent.

Quaternion normalization in additive EKF for spacecraft attitude determination

NASA Technical Reports Server (NTRS)

Bar-Itzhack, I. Y.; Deutschmann, J.; Markley, F. L.

1991-01-01

This work introduces, examines, and compares several quaternion normalization algorithms, which are shown to be an effective stage in the application of the additive extended Kalman filter (EKF) to spacecraft attitude determination, which is based on vector measurements. Two new normalization schemes are introduced. They are compared with one another and with the known brute force normalization scheme, and their efficiency is examined. Simulated satellite data are used to demonstrate the performance of all three schemes. A fourth scheme is suggested for future research. Although the schemes were tested for spacecraft attitude determination, the conclusions are general and hold for attitude determination of any three dimensional body when based on vector measurements, and use an additive EKF for estimation, and the quaternion for specifying the attitude.

[Theoretical and methodological bases for formation of future drivers 'readiness to application of physical-rehabilitation technologies].

PubMed

Yemets, Anatoliy V; Donchenko, Viktoriya I; Scrinick, Eugenia O

2018-01-01

Introduction: Experimental work is aimed at introducing theoretical and methodological foundations for the professional training of the future doctor. The aim: Identify the dynamics of quantitative and qualitative indicators of the readiness of a specialist in medicine. Materials and methods: The article presents the course and results of the experimental work of the conditions of forming the readiness of future specialists in medicine. Results: Our methodical bases for studying the disciplines of the general practice and specialized professional stage of experimental training of future physicians have been worked out. Conclusions: It is developed taking into account the peculiarities of future physician training of materials for various stages of experimental implementation in the educational process of higher medical educational institutions.

Students as subjects in food advertising studies. An appraisal of appropriateness.

PubMed

Choi, Hojoon; Reid, Leonard N

2014-10-01

Considerable knowledge on food advertising has been generated by research on consumers' psychological reactions to food advertising messaging using either students or nonstudents as subjects. Building on past research, this article investigates the methodological question of whether students are appropriate surrogates for nonstudents in food advertising studies. Following exposure to print advertisements featuring healthy and unhealthy foods with two different nutrient attribute-based message appeals, student and nonstudent subjects were asked to complete five standard evaluative response measures to the food ads: claim believability, attitude-toward-the ad, attitude-toward-the-product, attitude-toward-the-brand, and purchase intention. Among the findings, students were found to react differently and more negatively to identical food advertisements than nonstudents. Overall, the message sent to health communication researchers, policy officials, and practicing professionals is - unless certain criteria are satisfied - students should be considered inadequate subjects to represent all age groups of the general population in food advertising research. Thus, conclusions drawn from student-based research about advertising processing and effects should be questioned and broad generalizations avoided. Copyright © 2014 Elsevier Ltd. All rights reserved.

A pheromone-rate-based analysis on the convergence time of ACO algorithm.

PubMed

Huang, Han; Wu, Chun-Guo; Hao, Zhi-Feng

2009-08-01

Ant colony optimization (ACO) has widely been applied to solve combinatorial optimization problems in recent years. There are few studies, however, on its convergence time, which reflects how many iteration times ACO algorithms spend in converging to the optimal solution. Based on the absorbing Markov chain model, we analyze the ACO convergence time in this paper. First, we present a general result for the estimation of convergence time to reveal the relationship between convergence time and pheromone rate. This general result is then extended to a two-step analysis of the convergence time, which includes the following: 1) the iteration time that the pheromone rate spends on reaching the objective value and 2) the convergence time that is calculated with the objective pheromone rate in expectation. Furthermore, four brief ACO algorithms are investigated by using the proposed theoretical results as case studies. Finally, the conclusions of the case studies that the pheromone rate and its deviation determine the expected convergence time are numerically verified with the experiment results of four one-ant ACO algorithms and four ten-ant ACO algorithms.

The generalized scattering coefficient method for plane wave scattering in layered structures

NASA Astrophysics Data System (ADS)

Liu, Yu; Li, Chao; Wang, Huai-Yu; Zhou, Yun-Song

2017-02-01

The generalized scattering coefficient (GSC) method is pedagogically derived and employed to study the scattering of plane waves in homogeneous and inhomogeneous layered structures. The numerical stabilities and accuracies of this method and other commonly used numerical methods are discussed and compared. For homogeneous layered structures, concise scattering formulas with clear physical interpretations and strong numerical stability are obtained by introducing the GSCs. For inhomogeneous layered structures, three numerical methods are employed: the staircase approximation method, the power series expansion method, and the differential equation based on the GSCs. We investigate the accuracies and convergence behaviors of these methods by comparing their predictions to the exact results. The conclusions are as follows. The staircase approximation method has a slow convergence in spite of its simple and intuitive implementation, and a fine stratification within the inhomogeneous layer is required for obtaining accurate results. The expansion method results are sensitive to the expansion order, and the treatment becomes very complicated for relatively complex configurations, which restricts its applicability. By contrast, the GSC-based differential equation possesses a simple implementation while providing fast and accurate results.

On a viable first-order formulation of relativistic viscous fluids and its applications to cosmology

NASA Astrophysics Data System (ADS)

Disconzi, Marcelo M.; Kephart, Thomas W.; Scherrer, Robert J.

We consider a first-order formulation of relativistic fluids with bulk viscosity based on a stress-energy tensor introduced by Lichnerowicz. Choosing a barotropic equation-of-state, we show that this theory satisfies basic physical requirements and, under the further assumption of vanishing vorticity, that the equations of motion are causal, both in the case of a fixed background and when the equations are coupled to Einstein's equations. Furthermore, Lichnerowicz's proposal does not fit into the general framework of first-order theories studied by Hiscock and Lindblom, and hence their instability results do not apply. These conclusions apply to the full-fledged nonlinear theory, without any equilibrium or near equilibrium assumptions. Similarities and differences between the approach explored here and other theories of relativistic viscosity, including the Mueller-Israel-Stewart formulation, are addressed. Cosmological models based on the Lichnerowicz stress-energy tensor are studied. As the topic of (relativistic) viscous fluids is also of interest outside the general relativity and cosmology communities, such as, for instance, in applications involving heavy-ion collisions, we make our presentation largely self-contained.

Commonality of Risk Factors for Mothers' Poor Oral Health and General Health: Baseline Analysis of a Population-Based Birth Cohort Study.

PubMed

Ha, Diep H; Spencer, A John; Thomson, W Murray; Scott, Jane A; Do, Loc G

2018-04-01

Objective The association between and commonality of risk factors for poor self-rated oral health (SROH) and general health (SRGH) among new mothers has not been reported. The purpose of this paper is to assess the commonality of risk factors for poor SROH and SRGH, and self-reported obesity and dental pain, among a population-based sample of new mothers in Australia. It also investigated health conditions affecting new mothers' general health. Methods Data collected at baseline of a population-based birth cohort was used. Mothers of newborns in Adelaide were approached to participate. Mothers completed a questionnaire collecting data on socioeconomic status (SES), health behaviours, dental pain, SROH, self-reported height and weight and SRGH. Analysis was conducted sequentially from bivariate to multivariable regression to estimate prevalence rate (PR) of reporting poor/fair SROH and SRGH. Results of the 1895 new mothers, some 21 and 6% rated their SROH and SRGH as poor/fair respectively. Dental pain was associated with low income and smoking status, while being obese was associated with low SES, low education and infrequent tooth brushing. SROH and SRGH was associated with low SES, smoking, and dental pain. SROH was also associated with SRGH [PR: 3.06 (2.42-3.88)]. Conclusion for practice There was a commonality of factors associated with self-rated oral health and general health. Strong associations between OH and GH were also observed. Given the importance of maternal health for future generations, there would be long-term societal benefit from addressing common risk factors for OH and GH in integrated programs.

Chlamydia prevalence in the general population: is there a sex difference? a systematic review

PubMed Central

2013-01-01

Background The focus of Chlamydia trachomatis screening and testing lies more on women than on men. The study aim was to establish by systematic review the prevalence of urogenital Chlamydia trachomatis infection in men and women in the general population. Methods Electronic databases and reference lists were searched from 2000 to 2013 using the key words “Chlamydia trachomatis”, “population-based study” and “disease prevalence”. Reference lists were checked. Studies were included in the analysis if Chlamydia trachomatis prevalence was reported for both men and women in a population-based study. Prevalence rates for men and women were described as well as highest prevalence rate by age and sex. The difference in prevalence between the sexes in each study was calculated. Results Twenty-five studies met the inclusion criteria and quality assessment for the review. In nine of the twenty-five studies there was a statistically significant sex difference in the chlamydia prevalence. In all nine studies the prevalence of chlamydia was higher in women than in men. The prevalence for women varied from 1.1% to 10.6% and for men from 0.1% to 12.1%. The average chlamydia prevalence is highly variable between countries. The highest prevalence of chlamydia occurred predominantly in younger age groups (< 25 years). The absence of symptoms in population-based urogenital chlamydia infection is common in men and women (mean 88.5% versus 68.3%). Conclusions The urogenital chlamydia trachomatis prevalence in the general population is more similar than dissimilar for men and women. A modest sex difference is apparent. The prevalence rates can be used to inform chlamydia screening strategies in general practice. PMID:24215287

WE-FG-207B-05: Iterative Reconstruction Via Prior Image Constrained Total Generalized Variation for Spectral CT

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

Niu, S; Zhang, Y; Ma, J

Purpose: To investigate iterative reconstruction via prior image constrained total generalized variation (PICTGV) for spectral computed tomography (CT) using fewer projections while achieving greater image quality. Methods: The proposed PICTGV method is formulated as an optimization problem, which balances the data fidelity and prior image constrained total generalized variation of reconstructed images in one framework. The PICTGV method is based on structure correlations among images in the energy domain and high-quality images to guide the reconstruction of energy-specific images. In PICTGV method, the high-quality image is reconstructed from all detector-collected X-ray signals and is referred as the broad-spectrum image. Distinctmore » from the existing reconstruction methods applied on the images with first order derivative, the higher order derivative of the images is incorporated into the PICTGV method. An alternating optimization algorithm is used to minimize the PICTGV objective function. We evaluate the performance of PICTGV on noise and artifacts suppressing using phantom studies and compare the method with the conventional filtered back-projection method as well as TGV based method without prior image. Results: On the digital phantom, the proposed method outperforms the existing TGV method in terms of the noise reduction, artifacts suppression, and edge detail preservation. Compared to that obtained by the TGV based method without prior image, the relative root mean square error in the images reconstructed by the proposed method is reduced by over 20%. Conclusion: The authors propose an iterative reconstruction via prior image constrained total generalize variation for spectral CT. Also, we have developed an alternating optimization algorithm and numerically demonstrated the merits of our approach. Results show that the proposed PICTGV method outperforms the TGV method for spectral CT.« less

Variation in distress among women with infertility: evidence from a population-based sample†

PubMed Central

Greil, Arthur L.; Shreffler, Karina M.; Schmidt, Lone; McQuillan, Julia

2011-01-01

BACKGROUND We examine variation in fertility-specific distress (FSD) and general distress according to different experiences of infertility among 1027 US women who have experienced infertility within the previous 10 years. METHODS General distress was measured by a short form of the Center for Epidemiological Studies-Depression. Multiple regression analysis was conducted on self-report data (based on a telephone interview) from a probability-based sample of US women aged 25–45 years. We compare women with infertility who have had a prior pregnancy (secondary infertility, n = 628) to women with infertility with no prior pregnancies (primary infertility, n = 399). We further distinguish between women with infertility who were actually ‘trying’ to become pregnant (the infertile with intent) with those who met the medical definition of infertile but did not describe themselves as trying to become pregnant (infertile without intent). RESULTS Both types of infertility (primary versus secondary) (β = 0.31*) and intentionality (infertile with and without intent) (β = 0.08*) are associated with FSD. These associations persist when we control for resource and demographic variables, life course variables, social support and social pressure variables. General distress does not vary by infertility type or intentionality. CONCLUSIONS Results reveal variation in women's recalled experiences of infertility and that FSD is more sensitive to effects of different experiences than general distress. Women with primary infertility who were explicitly trying to become pregnant at the time of the infertility episode stand out as a particularly distressed group. Caregivers should be aware that the emotional needs of women with primary infertility may differ from those with secondary infertility. PMID:21659313

Beyond the "science of sophomores": does the rational choice explanation of crime generalize from university students to an actual offender sample?

PubMed

Bouffard, Jeff; Bry, Jeff; Smith, Shamayne; Bry, Rhonda

2008-12-01

Much of the criminological literature testing rational choice theory has utilized hypothetical scenarios presented to university students. Although this research generally supports rational choice theory, a common criticism is that conclusions from these studies may not generalize to samples of actual offenders. This study proceeds to examine this issue in two steps. First, a traditional sample of university students is examined to determine how various costs and benefits relate to their hypothetical likelihood of offending. Then the same data collection procedures are employed with a somewhat different sample of younger, adjudicated, and institutionalized offenders to determine whether the conclusions drawn from the student sample generalize to this offender sample. Results generally suggest that the content and process of hypothetical criminal decision making differ in the sample of known offenders relative to the university students. Limitations of the current study, as well as suggestions for future research, are discussed.

On the Use of Gene Ontology Annotations to Assess Functional Similarity among Orthologs and Paralogs: A Short Report

PubMed Central

Thomas, Paul D.; Wood, Valerie; Mungall, Christopher J.; Lewis, Suzanna E.; Blake, Judith A.

2012-01-01

A recent paper (Nehrt et al., PLoS Comput. Biol. 7:e1002073, 2011) has proposed a metric for the “functional similarity” between two genes that uses only the Gene Ontology (GO) annotations directly derived from published experimental results. Applying this metric, the authors concluded that paralogous genes within the mouse genome or the human genome are more functionally similar on average than orthologous genes between these genomes, an unexpected result with broad implications if true. We suggest, based on both theoretical and empirical considerations, that this proposed metric should not be interpreted as a functional similarity, and therefore cannot be used to support any conclusions about the “ortholog conjecture” (or, more properly, the “ortholog functional conservation hypothesis”). First, we reexamine the case studies presented by Nehrt et al. as examples of orthologs with divergent functions, and come to a very different conclusion: they actually exemplify how GO annotations for orthologous genes provide complementary information about conserved biological functions. We then show that there is a global ascertainment bias in the experiment-based GO annotations for human and mouse genes: particular types of experiments tend to be performed in different model organisms. We conclude that the reported statistical differences in annotations between pairs of orthologous genes do not reflect differences in biological function, but rather complementarity in experimental approaches. Our results underscore two general considerations for researchers proposing novel types of analysis based on the GO: 1) that GO annotations are often incomplete, potentially in a biased manner, and subject to an “open world assumption” (absence of an annotation does not imply absence of a function), and 2) that conclusions drawn from a novel, large-scale GO analysis should whenever possible be supported by careful, in-depth examination of examples, to help ensure the conclusions have a justifiable biological basis. PMID:22359495

26 CFR 1.166-2 - Evidence of worthlessness.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of the election. (ii) Conclusive presumption—(A) In general. If a bank satisfies the express... Supervision, 12 CFR 563.160(b)(3). (iii) Election—(A) In general. An election under this paragraph (d)(3) is... determination has not yet been made. (iv) Revocation of Election—(A) In general. Revocation of an election under...

Treatment of category generation and retrieval in aphasia: Effect of typicality of category items.

PubMed Central

Kiran, Swathi; Sandberg, Chaleece; Sebastian, Rajani

2011-01-01

Purpose: Kiran and colleagues (Kiran, 2007, 2008; Kiran & Johnson, 2008; Kiran & Thompson, 2003) have previously suggested that training atypical examples within a semantic category is a more efficient treatment approach to facilitating generalization within the category than training typical examples. The present study extended our previous work examining the notion of semantic complexity within goal-derived (ad-hoc) categories in individuals with aphasia. Methods: Six individuals with fluent aphasia (range = 39-84 years) and varying degrees of naming deficits and semantic impairments were involved. Thirty typical and atypical items each from two categories were selected after an extensive stimulus norming task. Generative naming for the two categories was tested during baseline and treatment. Results: As predicted, training atypical examples in the category resulted in generalization to untrained typical examples in five out the five patient-treatment conditions. In contrast, training typical examples (which was in examined three conditions) produced mixed results. One patient showed generalization to untrained atypical examples, whereas two patients did not show generalization to untrained atypical examples. Conclusions: Results of the present study supplement our existing data on the effect of a semantically based treatment for lexical retrieval by manipulating the typicality of category exemplars. PMID:21173393

Continuing medical education for general practitioners: a practice format

PubMed Central

VanNieuwenborg, Lena; Goossens, Martine; De Lepeleire, Jan; Schoenmakers, Birgitte

2016-01-01

Introduction Our current knowledge-based society and the many actualisations within the medical profession require a great responsibility of physicians to continuously develop and refine their skills. In this article, we reflect on some recent findings in the field of continuing education for professional doctors (continuing medical education, CME). Second, we describe the development of a CME from the Academic Center for General Practice (ACHG) of the KU Leuven. Methods First, we performed a literature study and we used unpublished data of a need assessment performed (2013) in a selected group of general practitioners. Second, we describe the development of a proposal to establish a CME programme for general practitioners. Results CME should go beyond the sheer acquisition of knowledge, and also seek changes in practice, attitudes and behaviours of physicians. The continuing education offerings are subject to the goals of the organising institution, but even more to the needs and desires of the end user. Conclusions Integrated education is crucial to meet the conditions for efficient and effective continuing education. The ACHG KU Leuven decided to offer a postgraduate programme consisting of a combination of teaching methods: online courses (self-study), contact courses (traditional method) and a materials database. PMID:26850504

Metacognition Beliefs and General Health in Predicting Alexithymia in Students

PubMed Central

Babaei, Samaneh; Varandi, Shahryar Ranjbar; Hatami, Zohre; Gharechahi, Maryam

2016-01-01

Objectives: The present study was conducted to investigate the role of metacognition beliefs and general health in alexithymia in Iranian students. Methods: This descriptive and correlational study included 200 participants of high schools students, selected randomly from students of two cities (Sari and Dargaz), Iran. Metacognitive Strategies Questionnaire (MCQ-30); the General Health Questionnaire (GHQ) and Farsi Version of the Toronto Alexithymia Scale (TAS-20) were used for gathering the data. Using the Pearson’s correlation method and regression, the data were analyzed. Results: The findings indicated significant positive relationships between alexithymia and all subscales of general health. The highest correlation was between alexithymia and anxiety subscale (r=0.36, P<0.01). Also, there was a significant negative relationship between alexithymia and some metacognitive strategies. The highest significant negative relationship was seen between alexithymia and the sub-scale of risk uncontrollability (r=-0.359, P < 0.01). Based on the results of multiple regressions, three predictors explained 21% of the variance (R2=0. 21, F=7.238, P<0.01). It was found that anxiety subscale of General Health significantly predicted 13% of the variance of alexithymia (β=0.36, P<0.01) and risk uncontrollability subscale of Metacognition beliefs predicted about 8% of the variance of alexithymia (β=-0.028, P<0.01). Conclusions: The findings demonstrated that metacognition beliefs and general health had important role in predicting of alexithymia in students. PMID:26383206

A gEUD-based inverse planning technique for HDR prostate brachytherapy: Feasibility study

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

Giantsoudi, D.; Department of Radiation Oncology, Francis H. Burr Proton Therapy Center, Boston, Massachusetts 02114; Baltas, D.

2013-04-15

Purpose: The purpose of this work was to study the feasibility of a new inverse planning technique based on the generalized equivalent uniform dose for image-guided high dose rate (HDR) prostate cancer brachytherapy in comparison to conventional dose-volume based optimization. Methods: The quality of 12 clinical HDR brachytherapy implants for prostate utilizing HIPO (Hybrid Inverse Planning Optimization) is compared with alternative plans, which were produced through inverse planning using the generalized equivalent uniform dose (gEUD). All the common dose-volume indices for the prostate and the organs at risk were considered together with radiobiological measures. The clinical effectiveness of the differentmore » dose distributions was investigated by comparing dose volume histogram and gEUD evaluators. Results: Our results demonstrate the feasibility of gEUD-based inverse planning in HDR brachytherapy implants for prostate. A statistically significant decrease in D{sub 10} or/and final gEUD values for the organs at risk (urethra, bladder, and rectum) was found while improving dose homogeneity or dose conformity of the target volume. Conclusions: Following the promising results of gEUD-based optimization in intensity modulated radiation therapy treatment optimization, as reported in the literature, the implementation of a similar model in HDR brachytherapy treatment plan optimization is suggested by this study. The potential of improved sparing of organs at risk was shown for various gEUD-based optimization parameter protocols, which indicates the ability of this method to adapt to the user's preferences.« less

Resting Energy Expenditure Prediction in Recreational Athletes of 18–35 Years: Confirmation of Cunningham Equation and an Improved Weight-Based Alternative

PubMed Central

ten Haaf, Twan; Weijs, Peter J. M.

2014-01-01

Introduction Resting energy expenditure (REE) is expected to be higher in athletes because of their relatively high fat free mass (FFM). Therefore, REE predictive equation for recreational athletes may be required. The aim of this study was to validate existing REE predictive equations and to develop a new recreational athlete specific equation. Methods 90 (53M, 37F) adult athletes, exercising on average 9.1±5.0 hours a week and 5.0±1.8 times a week, were included. REE was measured using indirect calorimetry (Vmax Encore n29), FFM and FM were measured using air displacement plethysmography. Multiple linear regression analysis was used to develop a new FFM-based and weight-based REE predictive equation. The percentage accurate predictions (within 10% of measured REE), percentage bias, root mean square error and limits of agreement were calculated. Results The Cunningham equation and the new weight-based equation and the new FFM-based equation performed equally well. De Lorenzo's equation predicted REE less accurate, but better than the other generally used REE predictive equations. Harris-Benedict, WHO, Schofield, Mifflin and Owen all showed less than 50% accuracy. Conclusion For a population of (Dutch) recreational athletes, the REE can accurately be predicted with the existing Cunningham equation. Since body composition measurement is not always possible, and other generally used equations fail, the new weight-based equation is advised for use in sports nutrition. PMID:25275434

Public preferences on written informed consent for low‐risk pragmatic clinical trials in Spain

PubMed Central

Carcas, Antonio J.; Carné, Xavier; Wendler, David

2017-01-01

Aims Pragmatic randomized clinical trials (pRCTs) collect data that have the potential to improve medical care significantly. However, these trials may be undermined by the requirement to obtain written informed consent, which can decrease accrual and increase selection bias. Recent data suggest that the majority of the US public endorses written consent for low‐risk pRCTs. The present study was designed to assess whether this view is specific to the US. Methods The study took the form of a cross‐sectional, probability‐based survey, with a 2 × 2 factorial design, assessing support for written informed consent vs. verbal consent or general notification for two low‐risk pRCTs in hypertension, one comparing two drugs with similar risk/benefit profiles and the other comparing the same drug being taken in the morning or at night. The primary outcome measures were respondents' personal preference and hypothetical recommendation to a research ethics committee regarding the use of written informed consent vs. the alternatives. Results A total of 2008 adults sampled from a probability‐based online panel responded to the web‐based survey conducted in May 2016 (response rate: 61%). Overall, 77% of respondents endorsed written consent. In both scenarios, the alternative of general notification received significantly more support (28.7–37.1%) than the alternative of verbal consent (12.7–14.0%) (P = 0.001). Forty per cent of respondents preferred and/or recommended general notification rather than written consent. Conclusions The results suggested that, rather than attempting to waive written consent, current pRCTs should focus on developing ways to implement written consent that provide sufficient information without undermining recruitment or increasing selection bias. The finding that around 40% of respondents endorsed general notification over written consent raises the possibility that, with educational efforts, the majority of Spaniards might accept general notification for low‐risk pRCTs. PMID:28419518

Towards improving phenotype representation in OWL

PubMed Central

2012-01-01

Background Phenotype ontologies are used in species-specific databases for the annotation of mutagenesis experiments and to characterize human diseases. The Entity-Quality (EQ) formalism is a means to describe complex phenotypes based on one or more affected entities and a quality. EQ-based definitions have been developed for many phenotype ontologies, including the Human and Mammalian Phenotype ontologies. Methods We analyze formalizations of complex phenotype descriptions in the Web Ontology Language (OWL) that are based on the EQ model, identify several representational challenges and analyze potential solutions to address these challenges. Results In particular, we suggest a novel, role-based approach to represent relational qualities such as concentration of iron in spleen, discuss its ontological foundation in the General Formal Ontology (GFO) and evaluate its representation in OWL and the benefits it can bring to the representation of phenotype annotations. Conclusion Our analysis of OWL-based representations of phenotypes can contribute to improving consistency and expressiveness of formal phenotype descriptions. PMID:23046625

Approaching the Planck scale from a generally relativistic point of view: A philosophical appraisal of loop quantum gravity

NASA Astrophysics Data System (ADS)

Wuthrich, Christian

My dissertation studies the foundations of loop quantum gravity (LQG), a candidate for a quantum theory of gravity based on classical general relativity. At the outset, I discuss two---and I claim separate---questions: first, do we need a quantum theory of gravity at all; and second, if we do, does it follow that gravity should or even must be quantized? My evaluation of different arguments either way suggests that while no argument can be considered conclusive, there are strong indications that gravity should be quantized. LQG attempts a canonical quantization of general relativity and thereby provokes a foundational interest as it must take a stance on many technical issues tightly linked to the interpretation of general relativity. Most importantly, it codifies general relativity's main innovation, the so-called background independence, in a formalism suitable for quantization. This codification pulls asunder what has been joined together in general relativity: space and time. It is thus a central issue whether or not general relativity's four-dimensional structure can be retrieved in the alternative formalism and how it fares through the quantization process. I argue that the rightful four-dimensional spacetime structure can only be partially retrieved at the classical level. What happens at the quantum level is an entirely open issue. Known examples of classically singular behaviour which gets regularized by quantization evoke an admittedly pious hope that the singularities which notoriously plague the classical theory may be washed away by quantization. This work scrutinizes pronouncements claiming that the initial singularity of classical cosmological models vanishes in quantum cosmology based on LQG and concludes that these claims must be severely qualified. In particular, I explicate why casting the quantum cosmological models in terms of a deterministic temporal evolution fails to capture the concepts at work adequately. Finally, a scheme is developed of how the re-emergence of the smooth spacetime from the underlying discrete quantum structure could be understood.

Hydration sites of unpaired RNA bases: a statistical analysis of the PDB structures

PubMed Central

2011-01-01

Background Hydration is crucial for RNA structure and function. X-ray crystallography is the most commonly used method to determine RNA structures and hydration and, therefore, statistical surveys are based on crystallographic results, the number of which is quickly increasing. Results A statistical analysis of the water molecule distribution in high-resolution X-ray structures of unpaired RNA nucleotides showed that: different bases have the same penchant to be surrounded by water molecules; clusters of water molecules indicate possible hydration sites, which, in some cases, match those of the major and minor grooves of RNA and DNA double helices; complex hydrogen bond networks characterize the solvation of the nucleotides, resulting in a significant rigidity of the base and its surrounding water molecules. Interestingly, the hydration sites around unpaired RNA bases do not match, in general, the positions that are occupied by the second nucleotide when the base-pair is formed. Conclusions The hydration sites around unpaired RNA bases were found. They do not replicate the atom positions of complementary bases in the Watson-Crick pairs. PMID:22011380

Maternal hypothyroxinemia during pregnancy and growth of the fetal and infant head.

PubMed

van Mil, Nina H; Steegers-Theunissen, Régine P M; Bongers-Schokking, Jacoba J; El Marroun, Hanan; Ghassabian, Akhgar; Hofman, Albert; Jaddoe, Vincent W V; Visser, Theo J; Verhulst, Frank C; de Rijke, Yolanda B; Steegers, Eric A P; Tiemeier, Henning

2012-12-01

Severe maternal thyroid dysfunction during pregnancy affects fetal brain growth and corticogenesis. This study focused on the effect of maternal hypothyroxinemia during early pregnancy on growth of the fetal and infant head. In a population-based birth cohort, we assessed thyroid status in early pregnancy (median 13.4, 90% range 10.8-17.2), in 4894 women, and measured the prenatal and postnatal head size of their children at 5 time points. Hypothyroxinemia was defined as normal thyroid-stimulating hormone levels and free thyroxine-4 concentrations below the 10th percentile. Statistical analysis was performed using linear generalized estimating equation. Maternal hypothyroxinemia was associated with larger fetal and infant head size (overall estimate β: 1.38, 95% confidence interval 0.56; 2.19, P = .001). In conclusion, in the general population, even small variations in maternal thyroid function during pregnancy may affect the developing head of the young child.

Pseudo-Foster Kennedy Syndrome – a case report

PubMed Central

David, Cătălina; Suvac, Elena; Tăbăcaru, Bogdana; Stanca, T. Horia

2016-01-01

Objective: To report a case of Pseudo-Foster Kennedy (PFK) syndrome and describe its clinical and paraclinical particularities, as well as the diagnostic difficulties and established treatment. Methods: The case of a 60-year-old male patient with sudden, painless visual impairment in the left eye (LE), and a medical history of old optic nerve atrophy in his right eye (RE) was described. Results: The diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION) was established based on the medical history, local and general clinical and paraclinical examination, and temporal artery biopsy. Conclusions: Although there is no current generally accepted treatment for NAION, a correct diagnosis and supportive treatment may contribute to the improvement in visual acuity (VA), improvement that in this case remained stable for 6 months after the onset. The patient is still being monitored and no relapses have been noted. PMID:29450361

Research on Nonlinear Time Series Forecasting of Time-Delay NN Embedded with Bayesian Regularization

NASA Astrophysics Data System (ADS)

Jiang, Weijin; Xu, Yusheng; Xu, Yuhui; Wang, Jianmin

Based on the idea of nonlinear prediction of phase space reconstruction, this paper presented a time delay BP neural network model, whose generalization capability was improved by Bayesian regularization. Furthermore, the model is applied to forecast the imp&exp trades in one industry. The results showed that the improved model has excellent generalization capabilities, which not only learned the historical curve, but efficiently predicted the trend of business. Comparing with common evaluation of forecasts, we put on a conclusion that nonlinear forecast can not only focus on data combination and precision improvement, it also can vividly reflect the nonlinear characteristic of the forecasting system. While analyzing the forecasting precision of the model, we give a model judgment by calculating the nonlinear characteristic value of the combined serial and original serial, proved that the forecasting model can reasonably 'catch' the dynamic characteristic of the nonlinear system which produced the origin serial.

Creep crack-growth: A new path-independent T sub o and computational studies

NASA Technical Reports Server (NTRS)

Stonesifer, R. B.; Atluri, S. N.

1981-01-01

Two path independent integral parameters which show some degree of promise as fracture criteria are the C* and delta T sub c integrals. The mathematical aspects of these parameters are reviewed. This is accomplished by deriving generalized vector forms of the parameters using conservation laws which are valid for arbitrary, three dimensional, cracked bodies with crack surface tractions (or applied displacements), body forces, inertial effects and large deformations. Two principal conclusions are that delta T sub c is a valid crack tip parameter during nonsteady as well as steady state creep and that delta T sub c has an energy rate interpretation whereas C* does not. An efficient, small displacement, infinitestimal strain, displacement based finite element model is developed for general elastic/plastic material behavior. For the numerical studies, this model is specialized to two dimensional plane stress and plane strain and to power law creep constitutive relations.

Development and evaluation of a general aviation real world noise simulator

NASA Technical Reports Server (NTRS)

Galanter, E.; Popper, R.

1980-01-01

An acoustic playback system is described which realistically simulates the sounds experienced by the pilot of a general aviation aircraft during engine idle, take-off, climb, cruise, descent, and landing. The physical parameters of the signal as they appear in the simulator environment are compared to analogous parameters derived from signals recorded during actual flight operations. The acoustic parameters of the simulated and real signals during cruise conditions are within plus or minus two dB in third octave bands from 0.04 to 4 kHz. The overall A-weighted levels of the signals are within one dB of signals generated in the actual aircraft during equivalent maneuvers. Psychoacoustic evaluations of the simulator signal are compared with similar measurements based on transcriptions of actual aircraft signals. The subjective judgments made by human observers support the conclusion that the simulated sound closely approximates transcribed sounds of real aircraft.

A Model for Indexing Medical Documents Combining Statistical and Symbolic Knowledge.

PubMed Central

Avillach, Paul; Joubert, Michel; Fieschi, Marius

2007-01-01

OBJECTIVES: To develop and evaluate an information processing method based on terminologies, in order to index medical documents in any given documentary context. METHODS: We designed a model using both symbolic general knowledge extracted from the Unified Medical Language System (UMLS) and statistical knowledge extracted from a domain of application. Using statistical knowledge allowed us to contextualize the general knowledge for every particular situation. For each document studied, the extracted terms are ranked to highlight the most significant ones. The model was tested on a set of 17,079 French standardized discharge summaries (SDSs). RESULTS: The most important ICD-10 term of each SDS was ranked 1st or 2nd by the method in nearly 90% of the cases. CONCLUSIONS: The use of several terminologies leads to more precise indexing. The improvement achieved in the model’s implementation performances as a result of using semantic relationships is encouraging. PMID:18693792

The Effects of Working Memory on Brain-Computer Interface Performance

PubMed Central

Sprague, Samantha A.; McBee, Matthew; Sellers, Eric W.

2015-01-01

Objective The purpose of the present study is to evaluate the relationship between working memory and BCI performance. Methods Participants took part in two separate sessions. The first session consisted of three computerized tasks. The LSWM was used to measure working memory, the TPVT was used to measure general intelligence, and the DCCS was used to measure executive function, specifically cognitive flexibility. The second session consisted of a P300-based BCI copy-spelling task. Results The results indicate that both working memory and general intelligence are significant predictors of BCI performance. Conclusions This suggests that working memory training could be used to improve performance on a BCI task. Significance Working memory training may help to reduce a portion of the individual differences that exist in BCI performance allowing for a wider range of users to successfully operate the BCI system as well as increase the BCI performance of current users. PMID:26620822

Positional cloning in maize (Zea mays subsp. mays, Poaceae)1

PubMed Central

Gallavotti, Andrea; Whipple, Clinton J.

2015-01-01

• Premise of the study: Positional (or map-based) cloning is a common approach to identify the molecular lesions causing mutant phenotypes. Despite its large and complex genome, positional cloning has been recently shown to be feasible in maize, opening up a diverse collection of mutants to molecular characterization. • Methods and Results: Here we outline a general protocol for positional cloning in maize. While the general strategy is similar to that used in other plant species, we focus on the unique resources and approaches that should be considered when applied to maize mutants. • Conclusions: Positional cloning approaches are appropriate for maize mutants and quantitative traits, opening up to molecular characterization the large array of genetic diversity in this agronomically important species. The cloning approach described should be broadly applicable to other species as more plant genomes become available. PMID:25606355

The Effect of Underwater Gait Training on Balance Ability of Stroke Patients

PubMed Central

Park, Seok Woo; Lee, Kyoung Jin; Shin, Doo Chul; Shin, Seung Ho; Lee, Myung Mo; Song, Chang Ho

2014-01-01

[Purpose] The purpose of this study was to investigate the effects of underwater treadmill gait training on the balance ability of stroke patients. [Subjects] Twenty-two patients with stroke were randomly assigned to an underwater treadmill group (n =11) or a control group (n =11). [Methods] Both groups received general rehabilitation for 30 min per session, 5 times per week, over a 4-week period. The underwater treadmill group received additional underwater gait training for 30 min per session, 5 times per week, over the same 4-week period. Static and dynamic balances were evaluated before and after the intervention. [Results] The means of static and dynamic balance ability increased significantly in both groups, but there was no significant difference between the two groups. [Conclusion] Compared to the general rehabilitation program, underwater treadmill gait training was not more effective at improving the balance ability of stroke patients than land-based training. PMID:25013292

Crop growth and associated life support for a lunar farm

NASA Technical Reports Server (NTRS)

Volk, Tyler; Cullingford, Hatice

1992-01-01

Supporting human life on a lunar base will require growing many different food crops. This paper investigates the growth dynamics of four crops (wheat, soybeans, potatoes, and lettuce) for general similarities and differences, along with associated material flows of the gases, liquids, and solids in a lunar farm. The human dietary requirements are compared with the protein, carbohydrate, and lipid contents of these hydroponically grown, high-productivity crops to derive a lunar farm diet. A simple and general analytical model is used to calculate the mass fluxes of CO2, H2O, HNO3, and O2 during the life cycle of each of the four crops. The resulting farm crop areas and corresponding biomass production rates are given. One significant conclusion of this study is that there is a 'lipid problem' associated with the incorporation of these four crops into a viable diet.

Readability of Online Health Information: A Meta-Narrative Systematic Review.

PubMed

Daraz, Lubna; Morrow, Allison S; Ponce, Oscar J; Farah, Wigdan; Katabi, Abdulrahman; Majzoub, Abdul; Seisa, Mohamed O; Benkhadra, Raed; Alsawas, Mouaz; Larry, Prokop; Murad, M Hassan

2018-01-01

Online health information should meet the reading level for the general public (set at sixth-grade level). Readability is a key requirement for information to be helpful and improve quality of care. The authors conducted a systematic review to evaluate the readability of online health information in the United States and Canada. Out of 3743 references, the authors included 157 cross-sectional studies evaluating 7891 websites using 13 readability scales. The mean readability grade level across websites ranged from grade 10 to 15 based on the different scales. Stratification by specialty, health condition, and type of organization producing information revealed the same findings. In conclusion, online health information in the United States and Canada has a readability level that is inappropriate for general public use. Poor readability can lead to misinformation and may have a detrimental effect on health. Efforts are needed to improve readability and the content of online health information.

Protection motivation theory and physical activity in the general population: a systematic literature review.

PubMed

Bui, Linh; Mullan, Barbara; McCaffery, Kirsten

2013-01-01

An appropriate theoretical framework may be useful for guiding the development of physical activity interventions. This review investigates the effectiveness of the protection motivation theory (PMT), a model based on the cognitive mediation processes of behavioral change, in the prediction and promotion of physical activity participation. A literature search was conducted using the databases MEDLINE, PsycINFO, PubMed, and Web of Science, and a manual search was conducted on relevant reference lists. Studies were included if they tested or applied the PMT, measured physical activity, and sampled from healthy populations. A total of 20 studies were reviewed, grouped into four design categories: prediction, stage discrimination, experimental manipulation, and intervention. The results indicated that the PMT's coping appraisal construct of self-efficacy generally appears to be the most effective in predicting and promoting physical activity participation. In conclusion, the PMT shows some promise, however, there are still substantial gaps in the evidence.

MM/PBSA analysis of molecular dynamics simulations of bovine beta-lactoglobulin: free energy gradients in conformational transitions?

PubMed

Fogolari, Federico; Moroni, Elisabetta; Wojciechowski, Marcin; Baginski, Maciej; Ragona, Laura; Molinari, Henriette

2005-04-01

The pH-driven opening and closure of beta-lactoglobulin EF loop, acting as a lid and closing the internal cavity of the protein, has been studied by molecular dynamics (MD) simulations and free energy calculations based on molecular mechanics/Poisson-Boltzmann (PB) solvent-accessible surface area (MM/PBSA) methodology. The forms above and below the transition pH differ presumably only in the protonation state of residue Glu89. MM/PBSA calculations are able to reproduce qualitatively the thermodynamics of the transition. The analysis of MD simulations using a combination of MM/PBSA methodology and the colony energy approach is able to highlight the driving forces implied in the transition. The analysis suggests that global rearrangements take place before the equilibrium local conformation is reached. This conclusion may bear general relevance to conformational transitions in all lipocalins and proteins in general. (c) 2005 Wiley-Liss, Inc.

Video-assisted feedback in general practice internships using German general practitioner's guidelines

PubMed Central

Bölter, Regine; Freund, Tobias; Ledig, Thomas; Boll, Bernhard; Szecsenyi, Joachim; Roos, Marco

2012-01-01

Introduction: The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the possibility to spend one quarter of the internship, in the last year of their academic studies, in a practice of family medicine. The demonstrated teaching method aims at giving feedback to the student based on video recordings of patient consultations (student-patient) with the help of a checklist. Video-feedback is already successful used in medical teaching in Germany and abroad. This feasibility study aims at assessing the practicability of video-assisted feedback as a teaching method during internship in general practice. Teaching method: First of all, the general practice chooses a guideline as the learning objective. Secondly, a subsequent patient – student – consultation is recorded on video. Afterwards, a video-assisted formative feedback is given by the physician. A checklist with learning objectives (communication, medical examination, a structured case report according to the guideline) is used to structure the feedback content. Feasibility: The feasibility was assessed by a semi structured interview in order to gain insight into barriers and challenges for future implementation. The teaching method was performed in one general practice. Afterwards the teaching physician and the trainee intern were interviewed. The following four main categories were identified: feasibility, performance, implementation in daily routine, challenges of the teaching concept. The results of the feasibility study show general practicability of this approach. Installing a video camera in one examination room may solve technical problems. The trainee intern mentioned theoretical and practical benefits using the guideline. The teaching physician noted the challenge to reflect on his daily routines in the light of evidence-based guidelines. Conclusion: This teaching method supports quality control and standardizing of learning objectives during the internship in general practice by using general practice guidelines. The use of a checklist enhances this method in general practice. We consider the presented teaching method in the context of the planned modification of the Medical Licenses Act is part of quality control and standardisation of medical teaching during general practice internships. In order to validate these presumptions, further, evaluation of this method concerning the learning objectives using the guidelines of general practice need to be carried out. PMID:23255963

Relevance of the c-statistic when evaluating risk-adjustment models in surgery.

PubMed

Merkow, Ryan P; Hall, Bruce L; Cohen, Mark E; Dimick, Justin B; Wang, Edward; Chow, Warren B; Ko, Clifford Y; Bilimoria, Karl Y

2012-05-01

The measurement of hospital quality based on outcomes requires risk adjustment. The c-statistic is a popular tool used to judge model performance, but can be limited, particularly when evaluating specific operations in focused populations. Our objectives were to examine the interpretation and relevance of the c-statistic when used in models with increasingly similar case mix and to consider an alternative perspective on model calibration based on a graphical depiction of model fit. From the American College of Surgeons National Surgical Quality Improvement Program (2008-2009), patients were identified who underwent a general surgery procedure, and procedure groups were increasingly restricted: colorectal-all, colorectal-elective cases only, and colorectal-elective cancer cases only. Mortality and serious morbidity outcomes were evaluated using logistic regression-based risk adjustment, and model c-statistics and calibration curves were used to compare model performance. During the study period, 323,427 general, 47,605 colorectal-all, 39,860 colorectal-elective, and 21,680 colorectal cancer patients were studied. Mortality ranged from 1.0% in general surgery to 4.1% in the colorectal-all group, and serious morbidity ranged from 3.9% in general surgery to 12.4% in the colorectal-all procedural group. As case mix was restricted, c-statistics progressively declined from the general to the colorectal cancer surgery cohorts for both mortality and serious morbidity (mortality: 0.949 to 0.866; serious morbidity: 0.861 to 0.668). Calibration was evaluated graphically by examining predicted vs observed number of events over risk deciles. For both mortality and serious morbidity, there was no qualitative difference in calibration identified between the procedure groups. In the present study, we demonstrate how the c-statistic can become less informative and, in certain circumstances, can lead to incorrect model-based conclusions, as case mix is restricted and patients become more homogenous. Although it remains an important tool, caution is advised when the c-statistic is advanced as the sole measure of a model performance. Copyright © 2012 American College of Surgeons. All rights reserved.

Automatic liver segmentation in computed tomography using general-purpose shape modeling methods.

PubMed

Spinczyk, Dominik; Krasoń, Agata

2018-05-29

Liver segmentation in computed tomography is required in many clinical applications. The segmentation methods used can be classified according to a number of criteria. One important criterion for method selection is the shape representation of the segmented organ. The aim of the work is automatic liver segmentation using general purpose shape modeling methods. As part of the research, methods based on shape information at various levels of advancement were used. The single atlas based segmentation method was used as the simplest shape-based method. This method is derived from a single atlas using the deformable free-form deformation of the control point curves. Subsequently, the classic and modified Active Shape Model (ASM) was used, using medium body shape models. As the most advanced and main method generalized statistical shape models, Gaussian Process Morphable Models was used, which are based on multi-dimensional Gaussian distributions of the shape deformation field. Mutual information and sum os square distance were used as similarity measures. The poorest results were obtained for the single atlas method. For the ASM method in 10 analyzed cases for seven test images, the Dice coefficient was above 55[Formula: see text], of which for three of them the coefficient was over 70[Formula: see text], which placed the method in second place. The best results were obtained for the method of generalized statistical distribution of the deformation field. The DICE coefficient for this method was 88.5[Formula: see text] CONCLUSIONS: This value of 88.5 [Formula: see text] Dice coefficient can be explained by the use of general-purpose shape modeling methods with a large variance of the shape of the modeled object-the liver and limitations on the size of our training data set, which was limited to 10 cases. The obtained results in presented fully automatic method are comparable with dedicated methods for liver segmentation. In addition, the deforamtion features of the model can be modeled mathematically by using various kernel functions, which allows to segment the liver on a comparable level using a smaller learning set.

Concentration of some platinum-group metals in coal

USGS Publications Warehouse

Finkelman, R.B.; Aruscavage, P. J.

1981-01-01

New data on some platinum group metals in coal indicate that the concentration of Pt is generally less than about 5 ppb, that of Pd is generally less than 1 ppb, and that of Rh is generally less than 0.5 ppb. No conclusive evidence was obtained concerning the mode of occurrence of these elements in coal. ?? 1981.

Warm Parenting Associated with Decreasing or Stable Child BMI during Treatment

PubMed Central

Jelalian, Elissa; Boutelle, Kerri; Dickstein, Susan; Seifer, Ronald; Wing, Rena

2016-01-01

Abstract Background: While authoritative parenting, which includes high levels of warmth and behavioral control, has been associated with lower risk of obesity, little is known about how general parenting impacts child weight loss during treatment. Our goal was to examine the relationship between several general parenting dimensions and ‘decreasing /stable’ child BMI during a 16-week family-based behavioral weight control program. Methods: Forty-four overweight parent-child dyads (child age 8 to 12 years) enrolled in the program. Families were videotaped at baseline eating dinner in their home. Using the General Parenting Observational Scale (GPOS), meals were coded for several general parenting dimensions. Primary outcome was percent of children whose BMI ‘decreased or stayed the same.’ Multivariable logistic regression was used to determine the relationship between general parenting and decreasing/stable child BMI. Results: Forty families (91%) completed the program. Children had a mean BMI change of −0.40 (SD 1.57), which corresponds to a −0.15 (SD 0.20) change in BMI z-score (BMI-Z); 75% of children had decreasing/stable BMI. In the unadjusted models, lower parent BMI, higher parent education, and higher levels of parental warmth were significantly associated with decreasing/stable child BMI. In the multivariable model, only higher level of warmth was associated with increased odds of decreasing/stable child BMI (OR = 1.28; 95% CI, 1.01, 1.62). Conclusions: Baseline parental warmth may influence a child's ability to lower/maintain BMI during a standard family-based behavioral weight control program. Efforts to increase parent displays of warmth and emotional support towards their overweight child may help to increase the likelihood of treatment success. PMID:26895374

Patients with cancer and change of general practice: a Danish population-based cohort study

PubMed Central

Grooss, Kasper; Hjertholm, Peter; Carlsen, Anders H; Vedsted, Peter

2016-01-01

Background General practice plays an important role in the cancer care pathway. Patient dissatisfaction with the diagnostic process may be expressed by changing to another general practice. Aim To compare the frequency of change of practice (COP) in patients with cancer (n = 150 216) with a matched cancer-free control cohort (n = 1 502 114) and to analyse associations with cancer type and patient characteristics. Design and setting A population-based matched cohort study using historical and prospectively collected data from Danish nationwide registers. Method COP was defined as a change of practice list, unrelated to change of address or reorganisation of the practice. Data were analysed monthly in the year before and after a cancer diagnosis. Results More patients with cancer than controls changed general practice (4.1% versus 2.6%) from 7 months before and until 12 months after diagnosis. The COP rate varied by cancer type (rectal cancer served as reference). Before the diagnosis, COP was most often seen among patients with ovarian cancer (risk ratio [RR] 1.51, 95% confidence interval [CI] = 1.10 to 2.08) and multiple myeloma (RR 1.89, 95% CI = 1.34 to 2.67). After the diagnosis, COP was most frequent among patients with brain cancer (RR 1.38, 95% CI = 1.05 to 1.82) and ovarian cancer (RR 1.51, 95% CI = 1.21 to 1.88). Conclusion Patients with cancer changed general practice more frequently than the cancer-free controls. COP variations between cancer types may be attributed to lack of diagnostic timeliness due to clinical complexity of the diagnosis and the role of the GP in the diagnostic process. PMID:27215570

Impact of Preoperative Radiotherapy on General and Disease-Specific Health Status of Rectal Cancer Survivors: A Population-Based Study

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

Thong, Melissa S.Y., E-mail: M.Thong@uvt.nl; Comprehensive Cancer Centre South, Eindhoven; Mols, Floortje

Purpose: To date, few studies have evaluated the impact of preoperative radiotherapy (pRT) on long-term health status of rectal cancer survivors. Using a population-based sample, we assessed the impact of pRT on general and disease-specific health status of rectal cancer survivors up to 10 years postdiagnosis. The health status of older ({>=}75 years old at diagnosis) pRT survivors was also compared with that of younger survivors. Methods and Materials: Survivors identified from the Eindhoven Cancer Registry treated with surgery only (SU) or with pRT between 1998 and 2007 were included. Survivors completed the Short Form-36 (SF-36) health survey questionnaire andmore » the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Colorectal 38 (EORTC QLQ-CR38) questionnaire. The SF-36 and EORTC QLQ-CR38 (sexuality subscale) scores of the survivors were compared to an age- and sex-matched Dutch normal population. Results: A total of 340 survivors (response, 85%; pRT survivors, 71%) were analyzed. Overall, survivors had similar general health status. Both short-term (<5 years) and long-term ({>=}5 years) pRT survivors had significantly poorer body image and more problems with gastrointestinal function, male sexual dysfunction, and defecation than SU survivors. Survivors had comparable general health status but greater sexual dysfunction than the normal population. Older pRT survivors had general and disease-specific health status comparable to that of younger pRT survivors. Conclusions: For better survivorship care, rectal cancer survivors could benefit from increased clinical and psychological focus on the possible long-term morbidity of treatment and its effects on health status.« less

Clinical indications for antibiotic use in Danish general practice: results from a nationwide electronic prescription database

PubMed Central

Aabenhus, Rune; Hansen, Malene Plejdrup; Siersma, Volkert; Bjerrum, Lars

2017-01-01

Objective To assess the availability and applicability of clinical indications from electronic prescriptions on antibiotic use in Danish general practice. Design Retrospective cohort register-based study including the Danish National Prescription Register. Setting Population-based study of routine electronic antibiotic prescriptions from Danish general practice. Subjects All 975,626 patients who redeemed an antibiotic prescription at outpatient pharmacies during the 1-year study period (July 2012 to June 2013). Main outcome measures Number of prescriptions per clinical indication. Number of antibiotic prescriptions per 1000 inhabitants by age and gender. Logistic regression analysis estimated the association between patient and provider factors and missing clinical indications on antibiotic prescriptions. Results A total of 2.381.083 systemic antibiotic prescriptions were issued by Danish general practitioners in the study period. We identified three main clinical entities: urinary tract infections (n = 506.634), respiratory tract infections (n = 456.354) and unspecified infections (n = 416.354). Women were more exposed to antibiotics than men. Antibiotic use was high in children under 5 years and even higher in elderly people. In 32% of the issued prescriptions, the clinical indication was missing. This was mainly associated with antibiotic types. We found that a prescription for a urinary tract agent without a specific clinical indication was uncommon. Conclusion Clinical indications from electronic prescriptions are accessible and available to provide an overview of drug use, in casu antibiotic prescriptions, in Danish general practice. These clinical indications may be further explored in detail to assess rational drug use and congruence with guidelines, but validation and optimisation of the system is preferable. PMID:28585886

Paucity of qualitative research in general medical and health services and policy research journals: analysis of publication rates

PubMed Central

2011-01-01

Background Qualitative research has the potential to inform and improve health care decisions but a study based on one year of publications suggests that it is not published in prominent health care journals. A more detailed, longitudinal analysis of its availability is needed. The purpose of this study was to identify, count and compare the number of qualitative and non-qualitative research studies published in high impact health care journals, and explore trends in these data over the last decade. Methods A bibliometric approach was used to identify and quantify qualitative articles published in 20 top general medical and health services and policy research journals from 1999 to 2008. Eligible journals were selected based on performance in four different ranking systems reported in the 2008 ISI Journal Citation Reports. Qualitative and non-qualitative research published in these journals were identified by searching MEDLINE, and validated by hand-searching tables of contents for four journals. Results The total number of qualitative research articles published during 1999 to 2008 in ten general medical journals ranged from 0 to 41, and in ten health services and policy research journals from 0 to 39. Over this period the percentage of empirical research articles that were qualitative ranged from 0% to 0.6% for the general medical journals, and 0% to 6.4% for the health services and policy research journals. Conclusions This analysis suggests that qualitative research it is rarely published in high impact general medical and health services and policy research journals. The factors that contribute to this persistent marginalization need to be better understood. PMID:21992238

Measuring effects of voluntary attention: a comparison among predictive arrow, colour, and number cues.

PubMed

Olk, Bettina; Tsankova, Elena; Petca, A Raisa; Wilhelm, Adalbert F X

2014-10-01

The Posner cueing paradigm is one of the most widely used paradigms in attention research. Importantly, when employing it, it is critical to understand which type of orienting a cue triggers. It has been suggested that large effects elicited by predictive arrow cues reflect an interaction of involuntary and voluntary orienting. This conclusion is based on comparisons of cueing effects of predictive arrows, nonpredictive arrows (involuntary orienting), and predictive numbers (voluntary orienting). Experiment 1 investigated whether this conclusion is restricted to comparisons with number cues and showed similar results to those of previous studies, but now for comparisons to predictive colour cues, indicating that the earlier conclusion can be generalized. Experiment 2 assessed whether the size of a cueing effect is related to the ease of deriving direction information from a cue, based on the rationale that effects for arrows may be larger, because it may be easier to process direction information given by symbols such as arrows than that given by other cues. Indeed, direction information is derived faster and more accurately from arrows than from colour and number cues in a direction judgement task, and cueing effects are larger for arrows than for the other cues. Importantly though, performance in the two tasks is not correlated. Hence, the large cueing effects of arrows are not a result of the ease of information processing, but of the types of orienting that the arrows elicit.

Smartphones and Patient Care: Exploring the Use of Text-Based Messaging for Patient-Related Communication.

PubMed

Goldfarb, Jeremy; Kayssi, Ahmed; Devon, Karen; Rossos, Peter G; Cil, Tulin D

2016-06-01

Background Text messaging (texting) has become a routine medium of communication in society. However, its use among clinicians has not been fully characterized. We explored general surgery residents' practices and views on texting for patient-related communication. Methods An email survey was distributed to all general surgery residents at a large Canadian medical school. Results Overall, 46 (57%) of those surveyed responded. All used texting for patient-related communication. Eleven percent of residents did not have a password on their cell phone and 89% did not have encrypted phones. Texting was the most common way (41%) by which residents communicated routine patient-related information with staff physicians. Most (85%) residents agreed that texting enhances patient care. The majority (66%) did not know if their hospital had a policy on texting and were unaware of legislation surrounding texting in patient care (89%). Conclusions Most general surgery residents use texting for communication of routine patient-related care issues. However, they acknowledge concerns regarding the security of this medium. © The Author(s) 2016.

EVALUATION OF ETHICAL IN INSTRUCTIONS TO AUTHORS OF BRAZILIAN SURGICAL JOURNALS

PubMed Central

TEIXEIRA, Renan Kleber Costa; YAMAKI, Vitor Nagai; PONTES, Ruy Victor Simões; BRITO, Marcus Vinicius Henriques; da SILVA, José Antonio Cordero

2015-01-01

Background: The instructions to authors are the only means of communication between researchers and the editorial standards of a scientific journal. One of the mandatory items to be contained therein is about the ethical part, to prevent new research to carry out abuses with the enrolled on the research are published and stimulated. Aim: To verify the ethical questions on the guidelines of Brazilian surgical journals Method: Thirteen selected journals were divided into two groups: general surgery (n=3), and surgical specialty (n=10). The instructions to authors were analyzed by the quote of ethical requirements based on a specific research protocol, ranging from zero to six points. Results: The average score of the general surgery group was similar than that of the surgical specialty group (3.66±0.57 vs 3.30±1.15, p=0.6154). When each ethical requirement was compared between the groups, there was no significant difference between the ethical requirements (p<0.05). Conclusion: There was respect for most ethical questions evaluated, with no difference between the journals of general or specialty surgery. PMID:26734793

Health Care Utilisation and Attitudes towards Health Care in Subjects Reporting Environmental Annoyance from Electricity and Chemicals

PubMed Central

Eek, Frida; Merlo, Juan; Gerdtham, Ulf; Lithman, Thor

2009-01-01

Environmentally intolerant persons report decreased self-rated health and daily functioning. However, it remains unclear whether this condition also results in increased health care costs. The aim of this study was to describe the health care consumption and attitudes towards health care in subjects presenting subjective environmental annoyance in relation to the general population, as well as to a group with a well-known disorder as treated hypertension (HT). Methods. Postal questionnaire (n = 13 604) and record linkage with population-based register on health care costs. Results. Despite significantly lower subjective well being and health than both the general population and HT group, the environmentally annoyed subjects had lower health care costs than the hypertension group. In contrast to the hypertension group, the environmentally annoyed subjects expressed more negative attitudes toward the health care than the general population. Conclusions. Despite their impaired subjective health and functional capacity, health care utilisation costs were not much increased for the environmentally annoyed group. This may partly depend on negative attitudes towards the health care in this group. PMID:19936124

Racial/Ethnic Differences in Self-Reported Racism and Its Association With Cancer-Related Health Behaviors

PubMed Central

Klassen, Ann C.; Bowie, Janice V.

2010-01-01

Objectives. We used population-based survey data to estimate the prevalence of self-reported racism across racial/ethnic groups and to evaluate the association between self-reported racism and cancer-related health behaviors. Methods. We used cross-sectional data from the 2003 California Health Interview Survey. Questions measured self-reported racism in general and in health care. The cancer risk behaviors we assessed were smoking, binge drinking, not walking, being overweight or obese, and not being up to date with screenings for breast, cervical, colorectal, and prostate cancers. Analyses included descriptive analyses and logistic regression. Results. Prevalences of self-reported racism varied between and within aggregate racial/ethnic groups. In adjusted analyses, general racism was associated with smoking, binge drinking, and being overweight or obese; health care racism was associated with not being up to date with screening for prostate cancer. Associations varied across racial/ethnic groups. Conclusions. Associations between general racism and lifestyle behaviors suggest that racism is a potential stressor that may shape cancer-related health behaviors, and its impact may vary by race/ethnicity. PMID:20019302

Subacute Noninfective Inflammatory Encephalopathy: Our Experience and Diagnostic Problems

PubMed Central

Chandra, Sadanandavalli Retnaswami; Viswanathan, Lakshminarayanapuram Gopal; Sindhu, Dodmalur Malikarjuna; Pai, Anupama Ramakanth

2017-01-01

Introduction: Immune dysregulation associated encephalopathies present with significant psychiatric manifestations and only a few soft neurological and general systemic features. They are generally resistant to treatment with psychiatric medications. Generalized orthostatic myoclonus and faciobrachial dystonic seizures are mistaken as Creutzfeldt-Jakob disease and subacute sclerosing panencephalitis. Patients and Methods: Forty-two patients seen during 2010–2015 and diagnosed as noninfective encephalopathy were analyzed. Those patients with infective causes and those who had significant features of systemic manifestations of vasculitis and other disorders of central nervous system were excluded from the study. They were investigated with cerebrospinal fluid imaging, electroencephalogram (EEG), and antibody profile. Results: More than 70% patients had psychiatric manifestation as presenting features and reported to psychiatrist. Three patients had paraneoplastic and others N-methyl-D-aspartate, voltage-gated potassium channel, thyroid peroxidase, antinuclear antibody related, and few were due to unknown antibody. Conclusion: Serious diagnostic errors are common and early diagnosis is based on high degree suspicion in patients presenting with new-onset refractory psychosis. Soft neurological features should be looked for and EEG serves as a very sensitive tool in establishing organicity. PMID:28515556

An evidence-based diagnostic classification system for low back pain

PubMed Central

Vining, Robert; Potocki, Eric; Seidman, Michael; Morgenthal, A. Paige

2013-01-01

Introduction: While clinicians generally accept that musculoskeletal low back pain (LBP) can arise from specific tissues, it remains difficult to confirm specific sources. Methods: Based on evidence supported by diagnostic utility studies, doctors of chiropractic functioning as members of a research clinic created a diagnostic classification system, corresponding exam and checklist based on strength of evidence, and in-office efficiency. Results: The diagnostic classification system contains one screening category, two pain categories: Nociceptive, Neuropathic, one functional evaluation category, and one category for unknown or poorly defined diagnoses. Nociceptive and neuropathic pain categories are each divided into 4 subcategories. Conclusion: This article describes and discusses the strength of evidence surrounding diagnostic categories for an in-office, clinical exam and checklist tool for LBP diagnosis. The use of a standardized tool for diagnosing low back pain in clinical and research settings is encouraged. PMID:23997245

Predicting Treatment Response in Social Anxiety Disorder From Functional Magnetic Resonance Imaging

PubMed Central

Doehrmann, Oliver; Ghosh, Satrajit S.; Polli, Frida E.; Reynolds, Gretchen O.; Horn, Franziska; Keshavan, Anisha; Triantafyllou, Christina; Saygin, Zeynep M.; Whitfield-Gabrieli, Susan; Hofmann, Stefan G.; Pollack, Mark; Gabrieli, John D.

2013-01-01

Context Current behavioral measures poorly predict treatment outcome in social anxiety disorder (SAD). To our knowledge, this is the first study to examine neuroimaging-based treatment prediction in SAD. Objective To measure brain activation in patients with SAD as a biomarker to predict subsequent response to cognitive behavioral therapy (CBT). Design Functional magnetic resonance imaging (fMRI) data were collected prior to CBT intervention. Changes in clinical status were regressed on brain responses and tested for selectivity for social stimuli. Setting Patients were treated with protocol-based CBT at anxiety disorder programs at Boston University or Massachusetts General Hospital and underwent neuroimaging data collection at Massachusetts Institute of Technology. Patients Thirty-nine medication-free patients meeting DSM-IV criteria for the generalized subtype of SAD. Interventions Brain responses to angry vs neutral faces or emotional vs neutral scenes were examined with fMRI prior to initiation of CBT. Main Outcome Measures Whole-brain regression analyses with differential fMRI responses for angry vs neutral faces and changes in Liebowitz Social Anxiety Scale score as the treatment outcome measure. Results Pretreatment responses significantly predicted subsequent treatment outcome of patients selectively for social stimuli and particularly in regions of higher-order visual cortex. Combining the brain measures with information on clinical severity accounted for more than 40% of the variance in treatment response and substantially exceeded predictions based on clinical measures at baseline. Prediction success was unaffected by testing for potential confounding factors such as depression severity at baseline. Conclusions The results suggest that brain imaging can provide biomarkers that substantially improve predictions for the success of cognitive behavioral interventions and more generally suggest that such biomarkers may offer evidence-based, personalized medicine approaches for optimally selecting among treatment options for a patient. PMID:22945462

The ACA’s Cost-Sharing Reduction Plans: A Key to Affordable Health Coverage for Millions of U.S. Workers.

PubMed

Gabel, Jon; Whitmore, Heidi; Green, Matthew; Call, Adrienne; Stromberg, Sam; Oran, Rebecca

2016-10-01

Issue: Without the cost-sharing reductions (CSRs) made available by the Affordable Care Act, health plans sold in the marketplaces may be unaffordable for many low-income people. CSRs are available to households earning between 100 percent and 250 percent of the federal poverty level that choose a silver-level marketplace plan. In 2016, about 7 million people received cost-sharing reductions that substantially lowered their deductibles, copayments, coinsurance, and out-of-pocket limits. Goal: To examine variations in consumer cost-sharing reductions between silver-level plans with CSRs to traditional marketplace plans and to employer-based insurance. Methods: Data analysis of 1,209 CSR-eligible plans sold in individual marketplaces in all 50 states and Washington, D.C. Key findings and conclusions: Cost-sharing amounts in silver plans with CSRs are much less than those in non-CSR base silver plans; silver plans with CSRs generally offer far better financial protection than those without. General annual deductibles range from $246 for CSR silver plans with a platinum-level actuarial value (94%) to as much as $3,063 for non-CSR silver plans. Out-of-pocket limits vary from $6,223 in base silver plans to $1,102 in silver plans with CSRs and a platinum-level actuarial level.

Therapy of hearing disorders - conservative procedures

PubMed Central

Plontke, Stefan

2005-01-01

A wide range of therapeutic strategies are available for the therapy of hearing disorders including pharmaceutical, acoustic, electrical, surgical, radiological, cognitive-behavioural and so-called "alternative" strategies. This review focuses on general conservative strategies and specific therapeutic approaches mainly for inner ear disorders, whereas surgical and device-based therapies including hearing aids and cochlear implants are described in other chapters in this volume. In addition to the systemic medication-based therapies for the treatment of hearing disorders, the rapidly growing field of local drug delivery to the inner ear as a promising therapeutic strategy is discussed on the background of unresolved issues. After description of non-drug-based therapeutic procedures, the conservative therapy of specific diseases and syndromes is reviewed. In general, there is a major discrepancy between promising animal studies up to regeneration and stem-cell transplantation, and uncontrolled experimental studies in humans on the one hand and the shortage of randomized controlled clinical trials with a high level of evidence on the other hand. Therefore, the review and comments on published clinical studies should assist the reader in making his/her own decision about the effectiveness of various, especially pharmaceutical treatments. From a critical analysis - particularly of the clinical studies presented - conclusions are drawn for the therapy of hearing disorders in the future. PMID:22073049

Effects of a Family-based Diabetes Intervention on Behavioral and Biological Outcomes for Mexican American Adults.

PubMed

McEwen, Marylyn Morris; Pasvogel, Alice; Murdaugh, Carolyn; Hepworth, Joseph

2017-06-01

Purpose The purpose of the study was to investigate the effects of a family-based self-management support intervention for adults with type 2 diabetes (T2DM). Methods Using a 2-group, experimental repeated measures design, 157 dyads (participant with T2DM and family member) were randomly assigned to an intervention (education, social support, home visits, and telephone calls) or a wait list control group. Data were collected at baseline, postintervention (3 months), and 6 months postintervention. A series of 2 × 3 repeated measures ANOVAs were used to test the hypotheses with interaction contrasts to assess immediate and sustained intervention effects. Results Significant changes over time were reported in diet self-management, exercise self-management, total self-management, diabetes self-efficacy for general health and total diabetes self-efficacy, physician distress, regimen distress, interpersonal distress, and total distress. There were likewise sustained effects for diet self-management, total self-management, diabetes self-efficacy for general health, total self-efficacy, physician distress, regimen distress, and interpersonal distress. Conclusions Results support and extend prior research documenting the value of culturally relevant family-based interventions to improve diabetes self-management and substantiate the need for intensive, longer, tailored interventions to achieve glycemic control.

ANALYSIS OF CLINICAL AND DERMOSCOPIC FEATURES FOR BASAL CELL CARCINOMA NEURAL NETWORK CLASSIFICATION

PubMed Central

Cheng, Beibei; Stanley, R. Joe; Stoecker, William V; Stricklin, Sherea M.; Hinton, Kristen A.; Nguyen, Thanh K.; Rader, Ryan K.; Rabinovitz, Harold S.; Oliviero, Margaret; Moss, Randy H.

2012-01-01

Background Basal cell carcinoma (BCC) is the most commonly diagnosed cancer in the United States. In this research, we examine four different feature categories used for diagnostic decisions, including patient personal profile (patient age, gender, etc.), general exam (lesion size and location), common dermoscopic (blue-gray ovoids, leaf-structure dirt trails, etc.), and specific dermoscopic lesion (white/pink areas, semitranslucency, etc.). Specific dermoscopic features are more restricted versions of the common dermoscopic features. Methods Combinations of the four feature categories are analyzed over a data set of 700 lesions, with 350 BCCs and 350 benign lesions, for lesion discrimination using neural network-based techniques, including Evolving Artificial Neural Networks and Evolving Artificial Neural Network Ensembles. Results Experiment results based on ten-fold cross validation for training and testing the different neural network-based techniques yielded an area under the receiver operating characteristic curve as high as 0.981 when all features were combined. The common dermoscopic lesion features generally yielded higher discrimination results than other individual feature categories. Conclusions Experimental results show that combining clinical and image information provides enhanced lesion discrimination capability over either information source separately. This research highlights the potential of data fusion as a model for the diagnostic process. PMID:22724561

Academic health sciences library Website navigation: an analysis of forty-one Websites and their navigation tools

PubMed Central

Brower, Stewart M.

2004-01-01

Background: The analysis included forty-one academic health sciences library (HSL) Websites as captured in the first two weeks of January 2001. Home pages and persistent navigational tools (PNTs) were analyzed for layout, technology, and links, and other general site metrics were taken. Methods: Websites were selected based on rank in the National Network of Libraries of Medicine, with regional and resource libraries given preference on the basis that these libraries are recognized as leaders in their regions and would be the most reasonable source of standards for best practice. A three-page evaluation tool was developed based on previous similar studies. All forty-one sites were evaluated in four specific areas: library general information, Website aids and tools, library services, and electronic resources. Metrics taken for electronic resources included orientation of bibliographic databases alphabetically by title or by subject area and with links to specifically named databases. Results: Based on the results, a formula for determining obligatory links was developed, listing items that should appear on all academic HSL Web home pages and PNTs. Conclusions: These obligatory links demonstrate a series of best practices that may be followed in the design and construction of academic HSL Websites. PMID:15494756

The blind men meet the elephant at the dam: Alternative spatial and taxonomic components reveal different insights about how low-head dams impact fish biodiversity

USGS Publications Warehouse

Fencl, Jane S.; Mather, Martha E.; Smith, Joseph M.; Hitchman, Sean M.

2017-01-01

Dams are ubiquitous environmental impacts that threaten aquatic ecosystems. The ability to compare across research studies is essential to conserve the native biodiversity that is impacted by the millions of low‐head dams that currently fragment streams and rivers. Here, we identify a previously unaddressed obstacle that impedes this generalization. Specifically, divergent spatial and taxonomic approaches that result from different conceptualizations of the dam‐biodiversity problem can produce conflicting science‐based conclusions about the same dam impact. In this research, using the same dammed and undammed sites, we evaluated the scientific generality of different conceptualizations of the dam‐biodiversity problem. We compared two different but commonly used spatial approaches—(1) above dam–below dam vs. (2) undammed–dammed comparisons—and 11 different, commonly used taxonomic approaches (three assemblage summaries, eight guilds). Sites above the dam structure had less diverse fish assemblages than sites below dams, whereas sites below the dam structure were similar to undammed sites. Thus, spatial approach 1 detected a large dam effect and spatial approach 2 detected a small dam effect. Similarly, some taxonomic responses (species richness, diversity, abundance, and number of guilds) detected large dam effects; other responses detected small (riffle specialist guild) or no dam effects (pool generalists). In summary, our results showed that how the problem was framed altered scientific conclusions and created different dam realities. The metaphor of how individual blind men disagree about the structure of an elephant, based on examinations of different body parts, reinforces the need for a coordinated, holistic perspective on dam research. Although no single approach is adequate for all problems, identifying the form, consequences of, and relationships among different research conceptualizations will set the stage for future syntheses of dam‐biodiversity research to advance science‐based conservation.

Influence on general practitioners of teaching undergraduates: qualitative study of London general practitioner teachers

PubMed Central

Hartley, Sarah; Macfarlane, Fraser; Gantley, Madeleine; Murray, Elizabeth

1999-01-01

Objective To examine the perceived effect of teaching clinical skills and associated teacher training programmes on general practitioners' morale and clinical practice. Design Qualitative semistructured interview study. Setting General practices throughout north London. Subjects 30 general practitioners who taught clinical skills were asked about the effect of teaching and teacher training on their morale, confidence in clinical and teaching skills, and clinical practice. Results The main theme was a positive effect on morale. Within teacher training this was attributed to developing peer and professional support; improved teaching skills; and revision of clinical knowledge and skills. Within teaching this was attributed to a broadening of horizons; contact with enthusiastic students; increased time with patients; improved clinical practice; improved teaching skills; and an improved image of the practice. Problems with teaching were due to external factors such as lack of time and space and anxieties about adequacy of clinical cover while teaching. Conclusions Teaching clinical skills can have a positive effect on the morale of general practitioner teachers as a result of contact with students and peers, as long as logistic and funding issues are adequately dealt with. Key messagesThe increase in community based teaching of clinical skills requires an increase in the number of general practitioner teachersLittle evidence is available about the effect of teaching of clinical skills and teacher training on general practitioner teachers and practicesGeneral practitioner teachers reported an increase in morale, improvements in clinical skills, and changes in clinical practice and in practice infrastructure as a result of teaching and trainingGeneral practitioner teachers reported problems because of pressure on time, lack of space, problems recruiting patients, and unsupportive practice partnersPositive effects on morale and clinical practice may be important for sustainable teaching and continuing medical education PMID:10541508

Selection of species and sampling areas: The importance of inference

Treesearch

Paul Stephen Corn

2009-01-01

Inductive inference, the process of drawing general conclusions from specific observations, is fundamental to the scientific method. Platt (1964) termed conclusions obtained through rigorous application of the scientific method as "strong inference" and noted the following basic steps: generating alternative hypotheses; devising experiments, the...

Gonorrhoea and Syphilis Epidemiology in Flemish General Practice 2009–2013: Results from a Registry-based Retrospective Cohort Study Compared with Mandatory Notification

PubMed Central

Schweikardt, Christoph; Goderis, Geert; Elli, Steven; Coppieters, Yves

2016-01-01

Background The number of newly diagnosed gonorrhoea and syphilis cases has increased in Flanders in recent years. Our aim was to investigate, to which extent these diagnoses were registered by general practitioners (GPs), and to examine opportunities and limits of the Intego database in this regard. Methods Data from a retrospective cohort study based on the Flemish Intego general practice database was analyzed for the years 2009–2013. Case definitions were applied. Due to small case numbers obtained, cases were pooled and averaged over the observation period. Frequencies were compared with those calculated from figures of mandatory notification. Results A total of 91 gonorrhoea and 23 syphilis cases were registered. The average Intego annual frequency of gonorrhoea cases obtained was 11.9 (95% Poisson confidence interval (CI) 9.6; 14.7) per 100,000 population, and for syphilis 3.0 (CI 1.9; 4.5), respectively, while mandatory notification was calculated at 14.0 (CI: 13.6, 14.4) and 7.0 (CI: 6.7, 7.3), respectively. Conclusion In spite of limitations such as small numbers and different case definitions, comparison with mandatory notification suggests that the GP was involved in the large majority of gonorrhoea cases, while the majority of new syphilis cases did not come to the knowledge of the GP. PMID:29546196

Response to formal comment on Myhrvold (2016) submitted by Griebeler and Werner (2017)

PubMed Central

2018-01-01

Griebeler and Werner offer a formal comment on Myhrvold, 2016 defending the conclusions of Werner and Griebeler, 2014. Although the comment criticizes several aspects of methodology in Myhrvold, 2016, all three papers concur on a key conclusion: the metabolism of extant endotherms and ectotherms cannot be reliably classified using growth-rate allometry, because the growth rates of extant endotherms and ectotherms overlap. A key point of disagreement is that the 2014 paper concluded that despite this general case, one can nevertheless classify dinosaurs as ectotherms from their growth rate allometry. The 2014 conclusion is based on two factors: the assertion (made without any supporting arguments) that the comparison with dinosaurs must be restricted only to extant sauropsids, ignoring other vertebrate groups, and that extant sauropsid endotherm and ectotherm growth rates in a data set studied in the 2014 work do not overlap. The Griebeler and Werner formal comment presents their first arguments in support of the restriction proposition. In this response I show that this restriction is unsupported by established principles of phylogenetic comparison. In addition, I show that the data set studied in their 2014 work does show overlap, and that this is visible in one of its figures. I explain how either point effectively invalidates the conclusion of their 2014 paper. I also address the other methodological criticisms of Myhrvold 2016, and find them unsupported. PMID:29489880

Response to formal comment on Myhrvold (2016) submitted by Griebeler and Werner (2017).

PubMed

Myhrvold, Nathan P

2018-01-01

Griebeler and Werner offer a formal comment on Myhrvold, 2016 defending the conclusions of Werner and Griebeler, 2014. Although the comment criticizes several aspects of methodology in Myhrvold, 2016, all three papers concur on a key conclusion: the metabolism of extant endotherms and ectotherms cannot be reliably classified using growth-rate allometry, because the growth rates of extant endotherms and ectotherms overlap. A key point of disagreement is that the 2014 paper concluded that despite this general case, one can nevertheless classify dinosaurs as ectotherms from their growth rate allometry. The 2014 conclusion is based on two factors: the assertion (made without any supporting arguments) that the comparison with dinosaurs must be restricted only to extant sauropsids, ignoring other vertebrate groups, and that extant sauropsid endotherm and ectotherm growth rates in a data set studied in the 2014 work do not overlap. The Griebeler and Werner formal comment presents their first arguments in support of the restriction proposition. In this response I show that this restriction is unsupported by established principles of phylogenetic comparison. In addition, I show that the data set studied in their 2014 work does show overlap, and that this is visible in one of its figures. I explain how either point effectively invalidates the conclusion of their 2014 paper. I also address the other methodological criticisms of Myhrvold 2016, and find them unsupported.

Arguments, contradictions, resistances, and conceptual change in students' understanding of atomic structure

NASA Astrophysics Data System (ADS)

Niaz, Mansoor; Aguilera, Damarys; Maza, Arelys; Liendo, Gustavo

2002-07-01

Most general chemistry courses and textbooks emphasize experimental details and lack a history and philosophy of science perspective. The objective of this study is to facilitate freshman general chemistry students' understanding of atomic structure based on the work of Thomson, Rutherford, and Bohr. It is hypothesized that classroom discussions based on arguments/counterarguments of the heuristic principles, on which these scientists based their atomic models, can facilitate students' conceptual understanding. This study is based on 160 freshman students enrolled in six sections of General Chemistry I (three sections formed part of the experimental group). All three models (Thomson, Rutherford, and Bohr) were presented to the experimental and control group students in the traditional manner, as found in most textbooks. After this, the three sections of the experimental group participated in the discussion of six items with alternative responses. Students were first asked to select a response and then participate in classroom discussions leading to arguments in favor or against the selected response and finally select a new response. Three weeks after having discussed the six items, both the experimental and control groups presented a monthly exam (based on the three models) and after another 3 weeks a semester exam. Results obtained show that given the opportunity to argue and discuss, students' understanding can go beyond the simple regurgitation of experimental details. Performance of the experimental group showed contradictions, resistances, and progressive conceptual change with considerable and consistent improvement in the last item. It is concluded that if we want our students to understand scientific progress and practice, then it is important that we include the experimental details not as a rhetoric of conclusions (Schwab, 1962, The teaching of science as enquiry, Cambridge, MA, Harward University Press; Schwab, 1974, Conflicting conceptions of curriculum, Berkeley, CA, McCutchan) but as heuristic principles (Lakatos, 1970, Criticism and the growth of knowledge, Cambridge, UK, Cambridge University Press, pp. 91-195), which were based on arguments, controversies, and interpretations of the scientists.

Parallel Evolution in Science: The Historical Roots and Central Concepts of General Systems Theory; and "General Systems Theory,""Modern Organizational Theory," and Organizational Communication.

ERIC Educational Resources Information Center

Lederman, Linda Costigan; Rogers, Don

The two papers in this document focus on general systems theory. In her paper, Linda Lederman discusses the emergence and evolution of general systems theory, defines its central concepts, and draws some conclusions regarding the nature of the theory and its value as an epistemology. Don Rogers, in his paper, relates some of the important features…

Analytical performance specifications for changes in assay bias (Δbias) for data with logarithmic distributions as assessed by effects on reference change values.

PubMed

Petersen, Per H; Lund, Flemming; Fraser, Callum G; Sölétormos, György

2016-11-01

Background The distributions of within-subject biological variation are usually described as coefficients of variation, as are analytical performance specifications for bias, imprecision and other characteristics. Estimation of specifications required for reference change values is traditionally done using relationship between the batch-related changes during routine performance, described as Δbias, and the coefficients of variation for analytical imprecision (CV A ): the original theory is based on standard deviations or coefficients of variation calculated as if distributions were Gaussian. Methods The distribution of between-subject biological variation can generally be described as log-Gaussian. Moreover, recent analyses of within-subject biological variation suggest that many measurands have log-Gaussian distributions. In consequence, we generated a model for the estimation of analytical performance specifications for reference change value, with combination of Δbias and CV A based on log-Gaussian distributions of CV I as natural logarithms. The model was tested using plasma prolactin and glucose as examples. Results Analytical performance specifications for reference change value generated using the new model based on log-Gaussian distributions were practically identical with the traditional model based on Gaussian distributions. Conclusion The traditional and simple to apply model used to generate analytical performance specifications for reference change value, based on the use of coefficients of variation and assuming Gaussian distributions for both CV I and CV A , is generally useful.

Shift work and chronic disease: the epidemiological evidence

PubMed Central

Armstrong, M. E. G.; Cairns, B. J.; Key, T. J.; Travis, R. C.

2011-01-01

Background Shift work, including night work, has been hypothesized to increase the risk of chronic diseases, including cancer, cardiovascular disease (CVD), metabolic syndrome and diabetes. Recent reviews of evidence relating to these hypotheses have focussed on specific diseases or potential mechanisms, but no general summary of the current data on shift work and chronic disease has been published. Methods Systematic and critical reviews and recent original studies indexed in PubMed prior to 31 December 2009 were retrieved, aided by manual searches of reference lists. The main conclusions from reviews and principle results from recent studies are presented in text and tables. Results Published evidence is suggestive but not conclusive for an adverse association between night work and breast cancer but limited and inconsistent for cancers at other sites and all cancers combined. Findings on shift work, in relation to risks of CVD, metabolic syndrome and diabetes are also suggestive but not conclusive for an adverse relationship. Conclusions Heterogeneity of study exposures and outcomes and emphasis on positive but non-significant results make it difficult to draw general conclusions. Further data are needed for additional disease endpoints and study populations. PMID:21355031

Does an activity based remuneration system attract young doctors to general practice?

PubMed Central

2012-01-01

Background The use of increasingly complex payment schemes in primary care may represent a barrier to recruiting general practitioners (GP). The existing Norwegian remuneration system is fully activity based - 2/3 fee-for-service and 1/3 capitation. Given that the system has been designed and revised in close collaborations with the medical association, it is likely to correspond - at least to some degree - with the preferences of current GPs (men in majority). The objective of this paper was to study which preferences that young doctors (women in majority), who are the potential entrants to general practice have for activity based vs. salary based payment systems. Methods In November-December 2010 all last year medical students and all interns in Norway (n = 1.562) were invited to participate in an online survey. The respondents were asked their opinion on systems of remuneration for GPs; inclination to work as a GP; risk attitude; income preferences; work pace tolerance. The data was analysed using one-way ANOVA and multinomial logistic regression analysis. Results A total of 831 (53%) responded. Nearly half the sample (47%) did not consider the remuneration system to be important for their inclination to work as GP; 36% considered the current system to make general practice more attractive, while 17% considered it to make general practice less attractive. Those who are attracted by the existing system were men and those who think high income is important, while those who are deterred by the system are risk averse and less happy with a high work pace. On the question of preferred remuneration system, half the sample preferred a mix of salary and activity based remuneration (the median respondent would prefer a 50/50 mix). Only 20% preferred a fully activity based system like the existing one. A salary system was preferred by women, and those less concerned with high income, while a fully activity based system was preferred by men, and those happy with a high work pace. Conclusions Given a concern about low recruitment to general practice in Norway, and the fact that an increasing share of medical students is women, we were interested in the extent to which the current Norwegian remuneration system correspond with the preferences of potential GPs. This study suggests that an existing remuneration mechanism has a selection effect on who would like to become a GP. Those most attracted are income motivated men. Those deterred are risk averse, and less happy with a high work pace. More research is needed on the extent to which experienced GPs differ along the questions we asked potential GPs, as well as studying the relative importance of other attributes than payment schemes. PMID:22433750

Research issues in grazing lands under changing climate. Volume 12, Part 16. Environmental and societal consequences of a possible CO/sub 2/-induced climate change

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

Pendleton, D.F.; Van Dyne, G.M.

1982-12-01

A study has been made of issues and researchable questions regarding the influence of potential CO/sub 2/-induced climatic change on grazing lands. Generalized scenarios of possible changes in climate in grazing land regions of the world were constructed based on published and ongoing investigations. These studies were of two general types: (i) general circulation climate, and (ii) analyses of historical data for periods which were warmer than average current conditions, based on the assumption that global warming can be expected. A review of scenarios derived from recent research suggests that surface temperature may increase and precipitation may decrease in somemore » important grazing land regions of the world. Research needs related specifically to climate in grazing lands were discussed. In the second workship, scientists discussed individual abiotic, autotrophic, and heterotrophic processes. Potential studies of these processes which were discussed included (i) work in the laboratory and the field, (ii) modelling, and (iii) analysis and synthesis of existing data bases and scientific literature. Both biological and socio-economic issues were discussed. Several overall conclusions were derived including the following: a planned, time-phased, and integrated study would be desirable to obtain the greatest amount of information for the least amount of funding in future investigations; a relatively small interdisciplinary group should be assembled consisting of individuals with backgrounds in such areas as meteorology, plant ecology, animal ecology, range science, economics, sociology, and systems analysis, and should operate over perhaps 10 years and draw upon specific short-term contractual inputs.« less

Suicide after release from prison - a population-based cohort study from Sweden

PubMed Central

Haglund, Axel; Tidemalm, Dag; Jokinen, Jussi; Långström, Niklas; Liechtenstein, Paul; Fazel, Seena; Runeson, Bo

2015-01-01

Objective Released prisoners have high suicide rates compared with the general population, but little is known about risk factors and possible causal pathways. We conducted a population-based cohort study to investigate rates and risk factors for suicide in people previously imprisoned. Methods We identified individuals released from prison in Sweden between January 1, 2005 and December 31, 2009 through linkage of national population-based registers. Released prisoners were followed from the day of release until death, emigration, new incarceration, or December 31, 2009. Survival analyses were conducted to compare incidence rates and psychiatric morbidity with non-convicted population controls matched on gender and year of birth. Results We identified 38,995 releases among 26,953 prisoners (7.6% females) during 2005-2009. Overall, 127 suicides occurred, accounting for 14% of all deaths after release (n=920). The mean suicide rate was 204 per 100,000 person years yielding an incidence rate ratio of 18.2 (95% CI 13.9-23.8) compared with general population controls. Previous substance use disorder (Hazard Ratio [HR]=2.1, 1.4-3.2), suicide attempt (HR=2.5, 1.7-3.7), and being born in Sweden vs. abroad (HR=2.1, 1.2-3.6) were independent risk factors for suicide after release. Conclusions Released prisoners are at high suicide risk and with a slightly different pattern of psychiatric risk factors for suicide compared with the general population. Results suggest appropriate allocation of resources to facilitate transition to life outside prison and increased attention to prisoners with both a previous suicide attempt and substance use disorder. PMID:25373114

Consensus Guidelines for the Treatment of Atopic Dermatitis in Korea (Part I): General Management and Topical Treatment

PubMed Central

Kim, Jung Eun; Kim, Hyun Jeong; Lew, Bark-Lynn; Lee, Kyung Ho; Hong, Seung Phil; Jang, Yong Hyun; Park, Kui Young; Seo, Seong Jun; Bae, Jung Min; Choi, Eung Ho; Suhr, Ki Beom; Lee, Seung Chul; Ko, Hyun Chang; Park, Young Lip; Son, Sang Wook; Seo, Young Jun; Lee, Yang Won; Cho, Sang Hyun; Park, Chun Wook

2015-01-01

Background Since the treatment guidelines for atopic dermatitis (AD) were released by the Korean Atopic Dermatitis Association (KADA) work group in 2006, there have been several advances in AD management. Objective We aimed to establish updated evidence- and experience-based treatment guidelines for Korean AD. Methods We collected a database of references from relevant systematic AD reviews and guidelines regarding general AD management such as bathing and skin care, avoidance of exacerbating factors, education and psychosocial support, and the use of moisturizers and topical anti-inflammatory and antipruritic drugs. Evidence for each statement was graded and the strength of the recommendation for each statement classified. Thirty-nine KADA council members participated in three rounds of voting to establish an expert consensus of recommendations. Results Basic AD treatment includes proper bathing and skin care, avoidance of exacerbating factors, proper education and psychosocial support, and use of moisturizers. The regular use of moisturizer has a steroid-sparing effect and reduces relapse episodes. The short- and long-term use of topical corticosteroids and calcineurin inhibitors improves AD symptoms and should be encouraged to use in an active and proactive treatment. Wet-wrap therapy can be used for rapid recovery of acute exacerbation. Topical antipruritic drugs cannot be recommended for the treatment of AD. Conclusion This report provides up-to-date evidence- and experience-based treatment guidelines for AD regarding general management and topical treatment. In addition, the average agreement scores obtained by a panel of experts based on the Korean healthcare system and patient adherence are presented. PMID:26512171

A systematic review of diet quality indices in relation to obesity.

PubMed

Asghari, Golaleh; Mirmiran, Parvin; Yuzbashian, Emad; Azizi, Fereidoun

2017-04-01

Tools, called 'diet/dietary quality indices', evaluate the level of adherence to a specified pattern or a set of recommendations in populations. Yet, there are no review studies providing unanimous comprehensive results of dietary indices on obesity. We reviewed observational studies, focusing on the association of diet quality indices with general obesity or abdominal obesity in adults. We systematically conducted a search in all English language publications available on MEDLINE, ISI Web of Science and Embase between January 1990 and January 2016. Among the wide variety of indices and weight-derived variables, studies with dietary-guideline-based indices and mean changes for weight gain or OR for general obesity and abdominal obesity were selected. From a total of 479 articles, thirty-four studies were selected for the current review, ten of which had prospective designs and twenty-six had cross-sectional designs. Associations of weight status with the original Healthy Eating Index (HEI) and other versions of the HEI including alternative HEI, HEI-2005 and HEI-05 were examined in thirteen studies, with ten studies revealing significant associations. The HEI was a better general obesity predictor in men than in women. Diet scores lacked efficacy in assessing overall diet quality and demonstrated no significant findings in developing countries, in comparison with US populations. In addition, indices based on dietary diversity scores were directly associated with weight gain. Despite the insufficient evidence to draw definitive conclusions about the relation between dietary indices and obesity, HEI was found to be inversely associated with obesity and diversity-based indices were positively associated with obesity.

Opinions of general practitioners about psychotherapy and their relationships with mental health professionals in the management of major depression: A qualitative survey

PubMed Central

Dumesnil, Hélène; Apostolidis, Thémis; Verger, Pierre

2018-01-01

Background French general practitioners (GPs) refer their patients with major depression to psychiatrists or for psychotherapy at particularly low rates. Objectives This qualitative study aims to explore general practitioners' (GP) opinions about psychotherapy, their relationships with mental health professionals, their perceptions of their role and that of psychiatrists in treating depression, and the relations between these factors and the GPs' strategies for managing depression. Methods In 2011, in-depth interviews based on a semi-structured interview guide were conducted with 32 GPs practicing in southeastern France. Verbatim transcripts were examined by analyzing their thematic content. Results We identified three profiles of physicians according to their opinions and practices about treatment strategies for depression: pro-pharmacological treatment, pro-psychotherapy and those with mixed practices. Most participants considered their relationships with psychiatrists unsatisfactory, would like more and better collaboration with them and shared the same concept of management in general practice. This concept was based both on the values and principles of practice shared by GPs and on their strong differentiation of their management practices from those of psychiatrists, Conclusion Several attitudes and values common to GPs might contribute to their low rate of referrals for psychotherapy in France: strong occupational identity, substantial variations in GPs' attitudes and practices regarding depression treatment strategies, representations sometimes unfavorable toward psychiatrists. Actions to develop a common culture and improve cooperation between GPs and psychiatrists are essential. They include systems of collaborative care and the development of interdisciplinary training common to GPs and psychiatrists practicing in the same area. PMID:29385155

The effect of feedback to general practitioners on quality of care for people with type 2 diabetes. A systematic review of the literature

PubMed Central

Guldberg, Trine Lignell; Lauritzen, Torsten; Kristensen, Jette Kolding; Vedsted, Peter

2009-01-01

Background There have been numerous efforts to improve and assure the quality of treatment and follow-up of people with Type 2 diabetes (PT2D) in general practice. Facilitated by the increasing usability and validity of guidelines, indicators and databases, feedback on diabetes care is a promising tool in this aspect. Our goal was to assess the effect of feedback to general practitioners (GPs) on the quality of care for PT2D based on the available literature. Methods Systematic review searches were conducted using October 2008 updates of Medline (Pubmed), Cochrane library and Embase databases. Additional searches in reference lists and related articles were conducted. Papers were included if published in English, performed as randomized controlled trials, studying diabetes, having general practice as setting and using feedback to GPs on diabetes care. The papers were assessed according to predefined criteria. Results Ten studies complied with the inclusion criteria. Feedback improved the care for PT2D, particularly process outcomes such as foot exams, eye exams and Hba1c measurements. Clinical outcomes like lowering of blood pressure, Hba1c and cholesterol levels were seen in few studies. Many process and outcome measures did not improve, while none deteriorated. Meta analysis was unfeasible due to heterogeneity of the studies included. Two studies used electronic feedback. Conclusion Based on this review, feedback seems a promising tool for quality improvement in diabetes care, but more research is needed, especially of electronic feedback. PMID:19419548

Neurogenic bowel dysfunction: Clinical management recommendations of the Neurologic Incontinence Committee of the Fifth International Consultation on Incontinence 2013.

PubMed

Cotterill, Nikki; Madersbacher, Helmut; Wyndaele, Jean J; Apostolidis, Apostolos; Drake, Marcus J; Gajewski, Jerzy; Heesakkers, John; Panicker, Jalesh; Radziszewski, Piotr; Sakakibara, Ryuji; Sievert, Karl-Dietrich; Hamid, Rizwan; Kessler, Thomas M; Emmanuel, Anton

2018-01-01

Evidence-based guidelines for the management of neurological disease and lower bowel dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world-wide relevance. To update clinical management of neurogenic bowel dysfunction from the recommendations of the 4th ICI, 2009. A series of evidence reviews and updates were performed by members of the working group. The resulting guidelines were presented at the 2012 meeting of the European Association of Urology for consultation, and modifications applied to deliver evidence based conclusions and recommendations for the scientific report of the 5th edition of the ICI in 2013. The current review is a synthesis of the conclusions and recommendations, including the algorithms for initial and specialized management of neurogenic bowel dysfunction. The pathophysiology is described in terms of spinal cord injury, multiple sclerosis, and Parkinson's disease. Assessment requires detailed history and clinical assessment, general investigations, and specialized testing, if required. Treatment primarily focuses on optimizing stool consistency and regulating bowel evacuation to improve quality of life. Symptom management covers conservative and interventional measures to promote good habits and assist stool evacuation, along with prevention of incontinence. Education is essential to achieving optimal bowel management. The review offers a pragmatic approach to management in the context of complex pathophysiology and varied evidence base. © 2017 Wiley Periodicals, Inc.

Neurogenic lower urinary tract dysfunction: Clinical management recommendations of the Neurologic Incontinence committee of the fifth International Consultation on Incontinence 2013.

PubMed

Drake, Marcus John; Apostolidis, Apostolos; Cocci, Andrea; Emmanuel, Anton; Gajewski, Jerzy B; Harrison, Simon C W; Heesakkers, John P F A; Lemack, Gary E; Madersbacher, Helmut; Panicker, Jalesh N; Radziszewski, Piotr; Sakakibara, Ryuji; Wyndaele, Jean Jacques

2016-08-01

Evidence-based guidelines for the management of neurological disease and lower urinary tract dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world-wide relevance. To update clinical management of neurogenic bladder dysfunction from the recommendations of the fourth ICI, 2009. A series of evidence reviews and updates were performed by members of the working group. The resulting guidelines were presented at the 2012 meeting of the European Association of Urology for consultation, and consequently amended to deliver evidence-based conclusions and recommendations in 2013. The current review is a synthesis of the conclusions and recommendations, including the algorithms for initial and specialized management of neurogenic lower urinary tract dysfunction. The pathophysiology is categorized according to the nature of onset of neurological disease and the part(s) of the nervous system affected. Assessment requires clinical evaluation, general investigations, and specialized testing. Treatment primarily focuses on ensuring safety of the patient and optimizing quality of life. Symptom management covers conservative and interventional measures to aid urine storage and bladder emptying, along with containment of incontinence. A multidisciplinary approach to management is essential. The review offers a pragmatic review of management in the context of complex pathophysiology and varied evidence base. Neurourol. Urodynam. 35:657-665, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Perceptions of Race/Ethnicity-Based Discrimination: A Review of Measures and Evaluation of their Usefulness for the Health Care Setting

PubMed Central

Kressin, Nancy R.; Raymond, Kristal L.; Manze, Meredith

2010-01-01

Background To assess discrimination in health care, reliable, valid, and comprehensive measures of racism/discrimination are needed. Objective To review literature on measures of perceived race/ethnicity-based discrimination and evaluate their characteristics and usefulness in assessing discrimination from health care providers. Methods Literature review of measures of perceived race/ethnicity-based discrimination (1966–2007), using MEDLINE, PsycINFO, and Social Science Citation Index. Results We identified 34 measures of racism/discrimination; 16 specifically assessed dynamics in the health care setting. Few measures were theoretically based; most assessed only general dimensions of racism and focused specifically on the experiences of African American patients. Acceptable psychometric properties were documented for about half of the instruments. Conclusions Additional measures are needed for detailed assessments of perceived discrimination in the health care setting; they should be relevant for a wide variety of racial/ethnic groups, and they must assess how racism/discrimination affects health care decision making and treatments offered. PMID:18677066

Health sciences libraries’ subscriptions to journals: expectations of general practice departments and collection-based analysis

PubMed Central

Barreau, David; Bouton, Céline; Renard, Vincent; Fournier, Jean-Pascal

2018-01-01

Objective The aims of this study were to (i) assess the expectations of general practice departments regarding health sciences libraries’ subscriptions to journals and (ii) describe the current general practice journal collections of health sciences libraries. Methods A cross-sectional survey was distributed electronically to the thirty-five university general practice departments in France. General practice departments were asked to list ten journals to which they expected access via the subscriptions of their health sciences libraries. A ranked reference list of journals was then developed. Access to these journals was assessed through a survey sent to all health sciences libraries in France. Adequacy ratios (access/need) were calculated for each journal. Results All general practice departments completed the survey. The total reference list included 44 journals. This list was heterogeneous in terms of indexation/impact factor, language of publication, and scope (e.g., patient care, research, or medical education). Among the first 10 journals listed, La Revue Prescrire (96.6%), La Revue du Praticien–Médecine Générale (90.9%), the British Medical Journal (85.0%), Pédagogie Médicale (70.0%), Exercer (69.7%), and the Cochrane Database of Systematic Reviews (62.5%) had the highest adequacy ratios, whereas Family Practice (4.2%), the British Journal of General Practice (16.7%), Médecine (29.4%), and the European Journal of General Practice (33.3%) had the lowest adequacy ratios. Conclusions General practice departments have heterogeneous expectations in terms of health sciences libraries’ subscriptions to journals. It is important for librarians to understand the heterogeneity of these expectations, as well as local priorities, so that journal access meets users’ needs. PMID:29632446

A review of carbon-based and non-carbon-based catalyst supports for the selective catalytic reduction of nitric oxide

PubMed Central

Anthonysamy, Shahreen Binti Izwan; Afandi, Syahidah Binti; Khavarian, Mehrnoush

2018-01-01

Various types of carbon-based and non-carbon-based catalyst supports for nitric oxide (NO) removal through selective catalytic reduction (SCR) with ammonia are examined in this review. A number of carbon-based materials, such as carbon nanotubes (CNTs), activated carbon (AC), and graphene (GR) and non-carbon-based materials, such as Zeolite Socony Mobil–5 (ZSM-5), TiO2, and Al2O3 supported materials, were identified as the most up-to-date and recently used catalysts for the removal of NO gas. The main focus of this review is the study of catalyst preparation methods, as this is highly correlated to the behaviour of NO removal. The general mechanisms involved in the system, the Langmuir–Hinshelwood or Eley–Riedeal mechanism, are also discussed. Characterisation analysis affecting the surface and chemical structure of the catalyst is also detailed in this work. Finally, a few major conclusions are drawn and future directions for work on the advancement of the SCR-NH3 catalyst are suggested. PMID:29600136

A review of carbon-based and non-carbon-based catalyst supports for the selective catalytic reduction of nitric oxide.

PubMed

Anthonysamy, Shahreen Binti Izwan; Afandi, Syahidah Binti; Khavarian, Mehrnoush; Mohamed, Abdul Rahman Bin

2018-01-01

Various types of carbon-based and non-carbon-based catalyst supports for nitric oxide (NO) removal through selective catalytic reduction (SCR) with ammonia are examined in this review. A number of carbon-based materials, such as carbon nanotubes (CNTs), activated carbon (AC), and graphene (GR) and non-carbon-based materials, such as Zeolite Socony Mobil-5 (ZSM-5), TiO 2 , and Al 2 O 3 supported materials, were identified as the most up-to-date and recently used catalysts for the removal of NO gas. The main focus of this review is the study of catalyst preparation methods, as this is highly correlated to the behaviour of NO removal. The general mechanisms involved in the system, the Langmuir-Hinshelwood or Eley-Riedeal mechanism, are also discussed. Characterisation analysis affecting the surface and chemical structure of the catalyst is also detailed in this work. Finally, a few major conclusions are drawn and future directions for work on the advancement of the SCR-NH 3 catalyst are suggested.

Understanding patient choices for attending sexually transmitted infection testing services: a qualitative study

PubMed Central

Pollard, Alex; Miners, Alec; Richardson, Daniel; Fisher, Martin; Cairns, John; Smith, Helen

2012-01-01

Objectives To establish which aspects of sexually transmitted infection (STI) testing services are important to STI testing service users. Methods 10 focus groups consisting of previous or existing users of STI testing services were conducted in community settings in the south east of England. Groups were quota sampled based on age, gender and sexual orientation. Data were analysed using Framework Analysis. Results 65 respondents (58% men) participated. Perceived expertise of staff was the key reason for attendance at genitourinary medicine services rather than general practice. Although some respondents voiced a willingness to test for STIs within general practice, the apparent limited range of tests available in general practice and the perceived lack of expertise around sexual health appeared to discourage attendance at general practice. The decision of where to test for STIs was also influenced by past experience of testing, existing relationships with general practice, method of receiving test results and whether the patient had other medical conditions such as HIV. Conclusions No one type of STI testing service is suitable for all patients. This is recognised by policymakers, and it now requires commissioners and providers to make services outside of genitourinary medicine clinics more acceptable and attractive to patients, in particular to address the perceived lack of expertise and limited range of STIs tests available at alternative testing sites. PMID:22628665

Psoriasis and the risk of foot and ankle tendinopathy or enthesopathy in the absence of psoriatic arthritis: a population-based study

PubMed Central

Lewinson, Ryan T; Vallerand, Isabelle A; Parsons, Laurie M; LaMothe, Jeremy M; Frolkis, Alexandra D; Lowerison, Mark W; Kaplan, Gilaad G; Patten, Scott B; Barnabe, Cheryl

2018-01-01

Objectives Imaging studies in patients with cutaneous psoriasis have demonstrated asymptomatic bone and tendon changes, commonly of the foot and ankle. We sought to determine if patients with cutaneous psoriasis have an increased risk of clinically significant foot and ankle tendinopathy or enthesopathy compared with the general population. Methods Patients with cutaneous psoriasis and a general population cohort were identified in The Health Improvement Network, a general practice medical records database from the UK. All patients with psoriatic arthritis were excluded. Cox proportional-hazards models (α=0.05) estimated the HR for development of foot and ankle tendinopathy or enthesopathy among patients with psoriasis, with adjustment for numerous covariates. Results In total, 78 630 patients with cutaneous psoriasis and 5 983 338 persons from the general population were identified. In an unadjusted model, patients with cutaneous psoriasis had a 25% increased risk of developing foot and ankle tendinopathy or enthesopathy compared with the general population (HR 1.25, 95% CI 1.20 to 1.30, p<0.0001). The HR remained unchanged and statistically significant after adjusting for covariates, and in sensitivity analyses. Conclusions These data suggest that patients with psoriasis can have foot and ankle tendinopathy or enthesopathy without having psoriatic arthritis, presenting a diagnostic challenge to physicians. Further research is needed to elucidate mechanisms contributing to this increased risk. PMID:29862046

Review of the Reported Measures of Clinical Validity and Clinical Utility as Arguments for the Implementation of Pharmacogenetic Testing: A Case Study of Statin-Induced Muscle Toxicity.

PubMed

Jansen, Marleen E; Rigter, T; Rodenburg, W; Fleur, T M C; Houwink, E J F; Weda, M; Cornel, Martina C

2017-01-01

Advances from pharmacogenetics (PGx) have not been implemented into health care to the expected extent. One gap that will be addressed in this study is a lack of reporting on clinical validity and clinical utility of PGx-tests. A systematic review of current reporting in scientific literature was conducted on publications addressing PGx in the context of statins and muscle toxicity. Eighty-nine publications were included and information was selected on reported measures of effect, arguments, and accompanying conclusions. Most authors report associations to quantify the relationship between a genetic variation an outcome, such as adverse drug responses. Conclusions on the implementation of a PGx-test are generally based on these associations, without explicit mention of other measures relevant to evaluate the test's clinical validity and clinical utility. To gain insight in the clinical impact and select useful tests, additional outcomes are needed to estimate the clinical validity and utility, such as cost-effectiveness.

Is prostate cancer different in black men? Answers from three natural history models

PubMed Central

Tsodikov, Alex; Gulati, Roman; de Carvalho, Tiago M.; Heijnsdijk, Eveline A. M.; Hunter-Merrill, Rachel A.; Mariotto, Angela B.; de Koning, Harry J.; Etzioni, Ruth

2017-01-01

Background Black men in the US have substantially higher prostate cancer incidence rates than the general population. The extent to which the incidence disparity is due to prostate cancer being more prevalent, more aggressive, and/or more frequently diagnosed in black men is unknown. Methods We estimated three independently developed models of prostate cancer natural history in black men and in the general population using an updated reconstruction of PSA screening, based on the National Health Interview Survey in 2005, and prostate cancer incidence from the Surveillance, Epidemiology, and End Results program in 1975–2000. Using the estimated models, we compared prostate cancer natural history in black men and in the general population. Results The models projected that 30–43% (range across models) of black men develop preclinical prostate cancer by age 85 years, a risk that is (relatively) 28–56% higher than in the general population. Among men who have had preclinical disease onset, black men have a similar risk of diagnosis (35–49%) compared with the general population (32–44%), but their risk of progression to metastatic disease by the time of diagnosis is 44–75% higher than in the general population. Conclusions Prostate cancer incidence patterns implicate higher incidence of preclinical disease and higher risk of metastatic progression among black men. The findings suggest screening black men earlier than white men and support further research into the benefit-harm tradeoffs of more aggressive screening policies for black men. PMID:28436011

Comparison of cardiovascular disease risk in two main forms of periodontitis

PubMed Central

Chopra, Rahul; Patil, Sudhir R.; Mathur, Shivani

2012-01-01

Background: C-reactive protein (CRP) is an acute phase reactant and has been proved to be a significant predictor of future cardiovascular events. Recent studies have demonstrated a correlation between periodontitis and elevated CRP levels. However, comparison between the levels of CRP in two main forms of periodontitis is ambiguous. This study aims at determining and comparing the relative levels of serum CRP in aggressive and chronic periodontitis patients. Materials and Methods: A total of 240 systemically healthy subjects were divided into three groups of 80 based on having generalized aggressive periodontitis, chronic generalized periodontitis and non-periodontitis (NP; controls). Venous blood samples were collected for quantitative CRP analysis using turbidimetric immunoassay. Results: Mean CRP levels were significantly greater in both generalized aggressive periodontitis (7.49±2.31 mg/l) and chronic generalized periodontitis (4.88±1.80 mg/l) groups as compared to NP (0.68±0.23 mg/l) controls. Moreover, CRP levels were significantly higher in aggressive periodontitis as compared to chronic periodontitis patients. Also, CRP levels positively correlated with the amount of periodontal destruction as measured by probing depth and clinical attachment loss for both chronic generalized periodontitis and generalized aggressive periodontitis. Conclusion: Findings of the present study indicated that periodontitis should be of particular concern in younger individuals, where elevated levels of CRP may contribute to early or more rapid cardiovascular disease in susceptible patients. Thus, further research should be carried out at a community level to ascertain these findings. PMID:22363367

Different neural systems contribute to semantic bias and conflict detection in the inclusion fallacy task.

PubMed

Liang, Peipeng; Goel, Vinod; Jia, Xiuqin; Li, Kuncheng

2014-01-01

The inclusion fallacy is a phenomenon in which generalization from a specific premise category to a more general conclusion category is considered stronger than a generalization to a specific conclusion category nested within the more general set. Such inferences violate rational norms and are part of the reasoning fallacy literature that provides interesting tasks to explore cognitive and neural basis of reasoning. To explore the functional neuroanatomy of the inclusion fallacy, we used a 2 × 2 factorial design, with factors for quantification (explicit and implicit) and response (fallacious and non-fallacious). It was found that a left fronto-temporal system, along with a superior medial frontal system, was specifically activated in response to fallacious responses consistent with a semantic biasing of judgment explanation. A right fronto-parietal system was specifically recruited in response to detecting conflict associated with the heightened fallacy condition. These results are largely consistent with previous studies of reasoning fallacy and support a multiple systems model of reasoning.

Universal quantum computation with little entanglement.

PubMed

Van den Nest, Maarten

2013-02-08

We show that universal quantum computation can be achieved in the standard pure-state circuit model while the entanglement entropy of every bipartition is small in each step of the computation. The entanglement entropy required for large-scale quantum computation even tends to zero. Moreover we show that the same conclusion applies to many entanglement measures commonly used in the literature. This includes e.g., the geometric measure, localizable entanglement, multipartite concurrence, squashed entanglement, witness-based measures, and more generally any entanglement measure which is continuous in a certain natural sense. These results demonstrate that many entanglement measures are unsuitable tools to assess the power of quantum computers.

Questionnaire-based evaluation of mobile phone interference with medical-electrical equipment in Swedish hospitals.

PubMed

Wiinberg, Stig; Samuelsson, Göran; Larsson, Stefan; Nilsson, Barbro; Jönsson, Patrik X; Ivarsson, Bodil; Olofsson, Per-Åke

2017-08-09

National recommendations in Sweden recommend a safety distance of 3 meter (m) between mobile phones and medical-electrical (ME) equipment in hospitals. A questionnaire was used to investigate how often mobile phones were reported to interfere with ME products in clinical practice across Sweden. The results confirmed that ME equipment can be affected by mobile phone use but, the risk of the patient's outcome being affected were minimal; no cases were identified which led to injury or death. In conclusion, the results support recommendations for a general safety distance of 0.5 m between mobile phones and ME equipment in care environments.

Analysis of the effectiveness of various cross-sections in large-span post-tensioned ceilings

NASA Astrophysics Data System (ADS)

Bednarz, K.

2018-03-01

The correct construction of large span, slim post-tensioned concrete slabs is conditioned by an appropriate cross-section selection. It is generally accepted that the thinnest slab can be constructed using the full cross-section as the largest compression stress storage. However, completely different cross-sections may help to overcome large spans. The paper presents the results of the computational analysis of several types of cross-sections (full, with internal relieving inserts and ribbed) in the application to a post-tensioned slab with a span of 15.0m. Based on the results presented, appropriate conclusions were drawn.

[Explaining and understanding in psychiatry].

PubMed

Wölk, W

1998-05-01

The philosophical debate on explanation and understanding also led to basic methodological reflections in psychiatry. Subsuming one fact under a general law is the characteristic feature of scientific explanations. In this way, deductive conclusions can be achieved with a high degree of objectivity. Hermeneutical understanding makes way for interpretations in front of a given theoretical matrix. On the other hand, sympathetic understanding is a matter of conceiving single-part items as a consequence of other singular aspects (e.g., tracing back an action to an intention). If one understands the growth of knowledge as a rational and critical process, it seems no more justified to insist on exclusive methodologically based positions.

Final mission design for IRAS

NASA Technical Reports Server (NTRS)

Mclaughlin, W. I.

1984-01-01

The Infrared Astronomical Satellite (IRAS) was operated on orbit from 26 January to 22 November 1983 (GMT). Its primary purpose, successfully accomplished, was to conduct an all-sky survey in the infrared from 8 to 120 microns. The mission design for this project featured orbit selection; numerous exercises in the geometry of the sphere; computer simulation of mission, sky, and telescope; and an active interface with the IRAS Science Team. In addition to mission design, the subject of mission planning after launch is addressed. The paper makes extensive use of reference to other works on the topic and seeks to derive some general conclusions on the subject based upon the IRAS experience.

Views of Dental Providers on Primary Care Coordination at Chairside: A Pilot Study

PubMed Central

Northridge, Mary E.; Birenz, Shirley; Gomes, Danni; Golembeski, Cynthia A.; Greenblatt, Ariel Port; Shelley, Donna; Russell, Stefanie L.

2016-01-01

Purpose There is a need for research to facilitate the widespread implementation, dissemination, and sustained utilization of evidence-based primary care screening, monitoring, and care coordination guidelines, thereby increasing the impact of dental hygienists’ actions on patients’ oral and general health. The aims of this formative study are to: (1) explore dental hygienists’ and dentists’ perspectives regarding the integration of primary care activities into routine dental care; and (2) assess the needs of dental hygienists and dentists regarding primary care coordination activities and use of information technology to obtain clinical information at chairside. Methods This qualitative study recruited ten hygienists and six dentists from ten New York City area dental offices with diverse patient mixes and volumes. A New York University faculty hygienist conducted semi-structured, in-depth interviews, which were digitally recorded and transcribed verbatim. Data analysis consisted of multilevel coding based on the Consolidated Framework for Implementation Research, resulting in emergent themes with accompanying categories. Results The dental hygienists and dentists interviewed as part of this study fail to use evidence-based guidelines to screen their patients for primary care sensitive conditions. Overwhelmingly, dental providers believe that tobacco use and poor diet contribute to oral disease, and report using electronic devices at chairside to obtain web-based health information. Conclusion Dental hygienists are well positioned to help facilitate greater integration of oral and general health care. Challenges include lack of evidence-based knowledge, coordination between dental hygienists and dentists, and systems-level support, with opportunities for improvement based upon a theory-driven framework. PMID:27340183

Experimental data filtration algorithm

NASA Astrophysics Data System (ADS)

Oanta, E.; Tamas, R.; Danisor, A.

2017-08-01

Experimental data reduction is an important topic because the resulting information is used to calibrate the theoretical models and to verify the accuracy of their results. The paper presents some ideas used to extract a subset of points from the initial set of points which defines an experimentally acquired curve. The objective is to get a subset with significantly fewer points as the initial data set and which accurately defines a smooth curve that preserves the shape of the initial curve. Being a general study we used only data filtering criteria based geometric features that at a later stage may be related to upper level conditions specific to the phenomenon under investigation. Five algorithms were conceived and implemented in an original software consisting of more than 1800 computer code lines which has a flexible structure that allows us to easily update it using new algorithms. The software instrument was used to process the data of several case studies. Conclusions are drawn regarding the values of the parameters used in the algorithms to decide if a series of points may be considered either noise, or a relevant part of the curve. Being a general analysis, the result is a computer based trial-and-error method that efficiently solves this kind of problems.

Borderline personality disorder traits and their relationship with dimensions of normative personality: a web-based cohort and twin study

PubMed Central

Kendler, K. S.; Myers, J.; Reichborn-Kjennerud, T.

2011-01-01

Objective To describe the structure of genetic and environmental risk factors for four dimensions of borderline personality disorder (BPD) and to understand the source of resemblance of these dimensions and normal personality. Method A web-based sample (n = 44,112 including 542 twin pairs) completed items from 4 scales of the Dimensional Assessment of Personality Pathology Basic Questionnaire and the Big Five Inventory. Results A one-factor common pathway model best fits the 4 BPD scales producing a highly heritable latent liability (heritability = 60%) and strong loadings on all 4 dimensions. Affective instability had the lowest trait-specific genetic loading, suggesting that it was a core feature of BPD. A complex pattern of genetic and environmental associations was found between the big five personality traits and BPD dimensions. The strongest genetic correlations with the BPD traits were generally seen for neuroticism (positive), followed by conscientiousness and agreeableness, both negative. Conclusion In the general population, these four BPD dimensions reflect one underlying highly heritable factor. The association between normative personality and dimensions of BPD is complex with high degrees of genetic correlation. PMID:21198457

A comprehensive survey of thermoelectric homogeneity of commonly used thermocouple types

NASA Astrophysics Data System (ADS)

Machin, Jonathan; Tucker, Declan; Pearce, Jonathan V.

2018-06-01

Thermocouples are widely used as temperature sensors in industry. The electromotive force generated by a thermocouple is produced in a temperature gradient and not at the thermocouple tip. This means that the thermoelectric inhomogeneity represents one of the most important contributions to the overall measurement uncertainty associated with thermocouples. To characterise this effect, and to provide some general recommendations concerning the magnitude of this contribution to use when formulating uncertainty analyses, a comprehensive literature survey has been performed. Significant information was found for Types K, N, R, S, B, Pt/Pd, Au/Pt and various other Pt/Rh thermocouples. In the case of Type K and N thermocouples, the survey has been augmented by a substantial amount of data based on calibrations of mineral-insulated, metal-sheathed thermocouple cable reels from thermocouple manufacturers. Some general conclusions are drawn and outline recommendations given concerning typical values for the uncertainty arising from thermoelectric inhomogeneity for the most widely used thermocouple types in the as-new state. It is stressed that these recommendations should only be heeded when individual homogeneity measurements are not possible. It is also stressed that the homogeneity can deteriorate rapidly during use, particularly for base metal thermocouples.

Interactions between MAOA and SYP polymorphisms were associated with symptoms of attention-deficit/hyperactivity disorder in Chinese Han subjects.

PubMed

Gao, Qian; Liu, Lu; Li, Hai-Mei; Tang, Yi-Lang; Wu, Zhao-Min; Chen, Yun; Wang, Yu-Feng; Qian, Qiu-Jin

2015-01-01

As candidate genes of attention--deficit/hyperactivity disorder (ADHD), monoamine oxidase A (MAOA), and synaptophysin (SYP) are both on the X chromosome, and have been suggested to be associated with the predominantly inattentive subtype (ADHD-I). The present study is to investigate the potential gene-gene interaction (G × G) between rs5905859 of MAOA and rs5906754 of SYP for ADHD in Chinese Han subjects. For family-based association study, 177 female trios were included. For case-control study, 1,462 probands and 807 normal controls were recruited. The ADHD Rating Scale-IV (ADHD-RS-IV) was used to evaluate ADHD symptoms. Pedigree-based generalized multifactor dimensionality reduction (PGMDR) for female ADHD trios indicated significant gene interaction effect of rs5905859 and rs5906754. Generalized multifactor dimensionality reduction (GMDR) indicated potential gene-gene interplay on ADHD RS-IV scores in female ADHD-I. No associations were observed in male subjects in case-control analysis. In conclusion, our findings suggested that the interaction of MAOA and SYP may be involved in the genetic mechanism of ADHD-I subtype and predict ADHD symptoms. © 2014 Wiley Periodicals, Inc.

Asthma caused by occupational exposures is common – A systematic analysis of estimates of the population-attributable fraction

PubMed Central

Torén, Kjell; Blanc, Paul D

2009-01-01

Background The aim of this paper is to highlight emerging data on occupational attributable risk in asthma. Despite well documented outbreaks of disease and the recognition of numerous specific causal agents, occupational exposures previously had been relegated a fairly minor role relative to other causes of adult onset asthma. In recent years there has been a growing recognition of the potential importance of asthma induced by work-related exposures Methods We searched Pub Med from June 1999 through December 2007. We identified six longitudinal general population-based studies; three case-control studies and eight cross-sectional analyses from seven general population-based samples. For an integrated analysis we added ten estimates prior to 1999 included in a previous review. Results The longitudinal studies indicate that 16.3% of all adult-onset asthma is caused by occupational exposures. In an overall synthesis of all included studies the overall median PAR value was 17.6%. Conclusion Clinicians should consider the occupational history when evaluating patients in working age who have asthma. At a societal level, these findings underscore the need for further preventive action to reduce the occupational exposures to asthma-causing agents. PMID:19178702

Frequency, probability, and prediction: easy solutions to cognitive illusions?

PubMed

Griffin, D; Buehler, R

1999-02-01

Many errors in probabilistic judgment have been attributed to people's inability to think in statistical terms when faced with information about a single case. Prior theoretical analyses and empirical results imply that the errors associated with case-specific reasoning may be reduced when people make frequentistic predictions about a set of cases. In studies of three previously identified cognitive biases, we find that frequency-based predictions are different from-but no better than-case-specific judgments of probability. First, in studies of the "planning fallacy, " we compare the accuracy of aggregate frequency and case-specific probability judgments in predictions of students' real-life projects. When aggregate and single-case predictions are collected from different respondents, there is little difference between the two: Both are overly optimistic and show little predictive validity. However, in within-subject comparisons, the aggregate judgments are significantly more conservative than the single-case predictions, though still optimistically biased. Results from studies of overconfidence in general knowledge and base rate neglect in categorical prediction underline a general conclusion. Frequentistic predictions made for sets of events are no more statistically sophisticated, nor more accurate, than predictions made for individual events using subjective probability. Copyright 1999 Academic Press.

The Nature and Organization of Individual Differences in Executive Functions: Four General Conclusions

PubMed Central

Miyake, Akira; Friedman, Naomi P.

2012-01-01

Executive functions (EFs)—a set of general-purpose control processes that regulate one’s thoughts and behaviors—have become a popular research topic lately and have been studied in many subdisciplines of psychological science. This article summarizes the EF research that our group has conducted to understand the nature of individual differences in EFs and their cognitive and biological underpinnings. In the context of a new theoretical framework that we have been developing (the unity/diversity framework), we describe four general conclusions that have emerged from our research. Specifically, we argue that individual differences in EFs, as measured with simple laboratory tasks, (1) show both unity and diversity (different EFs are correlated yet separable); (2) reflect substantial genetic contributions; (3) are related to various clinically and societally important phenomena; and (4) show some developmental stability. PMID:22773897

Applicability of Markets to Global Scheduling in Grids: Critical Examination of General Equilibrium Theory and Market Folklore

NASA Technical Reports Server (NTRS)

Nakai, Junko; VanDerWijngaart, Rob F.

2003-01-01

Markets are often considered superior to other global scheduling mechanisms for distributed computing systems. This claim is supported by: a casual observation from our every-day life that markets successfully equilibrate supply and demand, and the features of markets which originate in the general equilibrium theory, e.g., efficiency and the lack of necessity of 2 central controller. This paper describes why such beliefs in markets are not warranted. It does so by examining the general equilibrium theory, in terms of scope, abstraction, and interpretation. Not only does the general equilibrium theory fail to provide a satisfactory explanation of actual economies, including a computing-resource economy, it also falls short of supplying theoretical foundations for commonly held views of market desirability. This paper also points out that the argument for the desirability of markets involves circular reasoning and that the desirability can be established only vis-a-vis a scheduling goal. Finally, recasting the conclusion of Arrow's Impossibility Theorem as that for global scheduling, we conclude that there exists no market-based scheduler that is rational (in the sense defined in microeconomic theory), takes into account utility of more than one user, and yet yields a Pareto-optimal outcome for arbitrary user utility functions.

Health Numeracy: The Importance of Domain in Assessing Numeracy

PubMed Central

Levy, Helen; Ubel, Peter A.; Dillard, Amanda J.; Weir, David R.; Fagerlin, Angela

2014-01-01

Background Existing research concludes that measures of general numeracy can be used to predict individuals’ ability to assess health risks. We posit that the domain in which questions are posed affects the ability to perform mathematical tasks, raising the possibility of a separate construct of “health numeracy” that is distinct from general numeracy. Objective To determine whether older adults’ ability to perform simple math depends on domain. Design Community-based participants completed four math questions posed in three different domains: a health domain, a financial domain, and a pure math domain. Participants 962 individuals aged 55 and older, representative of the community-dwelling U.S. population over age 54. Results We found that respondents performed significantly worse when questions were posed in the health domain (54 percent correct) than in either the pure math domain (66 percent correct) or the financial domain (63 percent correct). Limitations Our experimental measure of numeracy consisted of only four questions, and it is possible that the apparent effect of domain is specific to the mathematical tasks that these questions require. Conclusions These results suggest that health numeracy is strongly related to general numeracy but that the two constructs may not be the same. Further research is needed into how different aspects of general numeracy and health numeracy translate into actual medical decisions. PMID:23824401

Approach to Patient with a Generalized Rash

PubMed Central

Leung, Lawrence; Soeyonggo, Tony

2013-01-01

Background: Generalized rash is amongst the most common conditions presented to practicing General Practitioners and common differentials include contact dermatitis, atopic eczema, sun-induced damage, drug eruption and general manifestations of systemic diseases or infections. Materials and Methods: We illustrate with differential diagnoses our clinical case of a generalized rash in a 55-year-old man with pathognomonic signs of a diagnosis, which has received increasing global concern. Conclusion: Despite the array of available laboratory tests, a detailed history and physical examination is still of paramount importance to arrive at the most likely diagnosis for any patient with a generalized skin rash. PMID:26664833

What does locality commissioning in Avon offer? Retrospective descriptive evaluation.

PubMed Central

Hine, C. E.; Bachmann, M. O.

1997-01-01

OBJECTIVE: To describe the impact, direct costs of, and participants' attitudes to the first two years and eight months of locality commissioning in Avon. DESIGN: Retrospective description of programme. SETTING: Thirteen localities in Avon Health Authority area, covering 982000 population and 147 general practices. METHODS: Postal questionnaire survey of 147 general practitioners (one per practice); interviews with and questionnaire survey of 13 lead general practitioners and 13 so called link staff from the health authority. MAIN OUTCOME MEASURES: Locality initiatives, perceived influence, general practitioners' attitudes, management costs. RESULTS: Twenty initiatives were identified that had changed services to patients, and another nine were planned. The commonest initiatives concerned primary mental health care (seven), nurse specialists for primary care of chronic diseases (three), referral and clinical practice guidelines (seven), and access to hospital outpatient departments (one, with two others planned). Localities were more likely to have influenced the authority, trust managers, and consultants than social services, community health councils, and voluntary organisations. Activity varied between localities, lead general practitioners estimating that 120/147 (82%) of practices had been involved in locality meetings (range 44-100% in different localities). The authority had spent 6 p per capita on running the scheme, and the total time used by general practitioners for locality commissioning was estimated at 1.5 whole time equivalents. CONCLUSION: Locality commissioning has selectively changes services with limited extra funding and without delegation of hospital and community health service budgets. General practitioners wanted more policy and financial support. Further development should be based on evidence of costs, benefits, and limitations of locality commissioning schemes. PMID:9154029

Measuring disease prevalence: a comparison of musculoskeletal disease using four general practice consultation databases

PubMed Central

Jordan, Kelvin; Clarke, Alexandra M; Symmons, Deborah PM; Fleming, Douglas; Porcheret, Mark; Kadam, Umesh T; Croft, Peter

2007-01-01

Background Primary care consultation data are an important source of information on morbidity prevalence. It is not known how reliable such figures are. Aim To compare annual consultation prevalence estimates for musculoskeletal conditions derived from four general practice consultation databases. Design of study Retrospective study of general practice consultation records. Setting Three national general practice consultation databases: i) Fourth Morbidity Statistics from General Practice (MSGP4, 1991/92), ii) Royal College of General Practitioners Weekly Returns Service (RCGP WRS, 2001), and iii) General Practice Research Database (GPRD, 1991 and 2001); and one regional database (Consultations in Primary Care Archive, 2001). Method Age-sex standardised persons consulting annual prevalence rates for musculoskeletal conditions overall, rheumatoid arthritis, osteoarthritis and arthralgia were derived for patients aged 15 years and over. Results GPRD prevalence of any musculoskeletal condition, rheumatoid arthritis and osteoarthritis was lower than that of the other databases. This is likely to be due to GPs not needing to record every consultation made for a chronic condition. MSGP4 gave the highest prevalence for osteoarthritis but low prevalence of arthralgia which reflects encouragement for GPs to use diagnostic rather than symptom codes. Conclusion Considerable variation exists in consultation prevalence estimates for musculoskeletal conditions. Researchers and health service planners should be aware that estimates of disease occurrence based on consultation will be influenced by choice of database. This is likely to be true for other chronic diseases and where alternative symptom labels exist for a disease. RCGP WRS may give the most reliable prevalence figures for musculoskeletal and other chronic diseases. PMID:17244418

An investigation of the "jumping to conclusions" data-gathering bias and paranoid thoughts in Asperger syndrome.

PubMed

Jänsch, Claire; Hare, Dougal Julian

2014-01-01

The existence of a data-gathering bias, in the form of jumping to conclusions, and links to paranoid ideation was investigated in Asperger syndrome (AS). People with AS (N = 30) were compared to a neurotypical control group (N = 30) on the Reading the Mind in the Eyes and the Beads tasks, with self-report measures of depression, general anxiety, social anxiety, self-consciousness and paranoid ideation. The AS group performed less well than the control group on the Reading the Mind in the Eyes Task with regard to accuracy but responded more quickly and tended to make decisions on the basis of less evidence on the Beads Task with 50 % demonstrating a clear 'jumping to conclusions bias', whereas none of the control group showed such a bias. Depression and general anxiety were associated with paranoid ideation but not data-gathering style, which was contrary to expectation.

Effect of the Web-Based Intervention MyPlan 1.0 on Self-Reported Fruit and Vegetable Intake in Adults Who Visit General Practice: A Quasi-Experimental Trial

PubMed Central

Crombez, Geert; Van der Mispel, Celien; Verloigne, Maite; Van Stappen, Vicky; De Bourdeaudhuij, Ilse

2016-01-01

Background Web-based interventions typically have small intervention effects on adults’ health behavior because they primarily target processes leading to an intention to change leaving individuals in an intention-behavior gap, they often occur without contact with health care providers, and a limited amount of feedback is provided only at the beginning of these interventions, but not further on in the behavior change process. Therefore, we developed a Web-based intervention (“MyPlan 1.0”) to promote healthy behavior in adults. The intervention was based on a self-regulation perspective that also targets postintentional processes and guides individuals during all phases of behavior change. Objective The study investigated the effectiveness of MyPlan1.0 on fruit and vegetable intake of Flemish adults visiting general practice (3 groups: control group, intervention group recruited by researchers, and intervention group recruited and guided by general practitioners [GPs]). Second, it examined whether there was a larger intervention effect for the intervention group guided by GPs compared to the intervention group recruited by researchers. Methods Adults (≥18 years) were recruited in 19 Flemish general practices. In each general practice, patients were systematically allocated by a researcher either for the intervention group (researchers’ intervention group) or the waiting-list control group that received general advice. In a third group, the GP recruited adults for the intervention (GPs intervention group). The two intervention groups filled in evaluation questionnaires and received MyPlan 1.0 for a behavior of choice (fruit, vegetable, or physical activity). The waiting-list control group filled in the evaluation questionnaires and received only general information. Self-reported fruit and vegetable intake were assessed at baseline (T0), 1 week (T1), and 1 month (T2) postbaseline. Three-level (general practice, adults, time) linear regression models were conducted in MLwiN. Results A total of 426 adults initially agreed to participate (control group: n=149; GPs’ intervention group: n=41; researchers’ intervention group: n=236). A high attrition rate was observed in both intervention groups (71.8%, 199/277) and in the control group (59.1%, 88/149). In comparison to no change in the control group, both the GPs’ intervention group (fruit: χ2 1=10.9, P=.004; vegetable: χ2 1=5.3, P=.02) and the researchers’ intervention group (fruit: χ2 1=18.0, P=.001; vegetable: χ2 1=12.8, P<.001) increased their intake of fruit and vegetables. Conclusions A greater increase in fruit and vegetable intake was found when the Web-based intervention MyPlan 1.0 was used compared to usual care of health promotion in general practice (ie, flyers with general information). However, further investigation on which (or combinations of which) behavior change techniques are effective, how to increase response rates, and the influence of delivery mode in routine practice is required. Trial Registration ClinicalTrials.gov NCT02211040; https://clinicaltrials.gov/ct2/show/NCT02211040 (Archived by WebCite® at http://www.webcitation.org/6f8yxTRii) PMID:26929095

Catalysis in human hypoxanthine-guanine phosphoribosyltransferase: Asp 137 acts as a general acid/base.

PubMed

Xu, Y; Grubmeyer, C

1998-03-24

Hypoxanthine-guanine phosphoribosyltransferase (HGPRTase) catalyzes the reversible formation of IMP and GMP from their respective bases hypoxanthine (Hx) and guanine (Gua) and the phosphoribosyl donor 5-phosphoribosyl-1-pyrophosphate (PRPP). The net formation and cleavage of the nucleosidic bond requires removal/addition of a proton at the purine moiety, allowing enzymic catalysis to reduce the energy barrier associated with the reaction. The pH profile of kcat for IMP pyrophosphorolysis revealed an essential acidic group with pKa of 7.9 whereas those for IMP or GMP formation indicated involvement of essential basic groups. Based on the crystal structure of human HGPRTase, protonation/deprotonation is likely to occur at N7 of the purine ring, and Lys 165 or Asp 137 are each candidates for the general base/acid. We have constructed, purified, and kinetically characterized two mutant HGPRTases to test this hypothesis. D137N displayed an 18-fold decrease in kcat for nucleotide formation with Hx as substrate, a 275-fold decrease in kcat with Gua, and a 500-fold decrease in kcat for IMP pyrophosphorolysis. D137N also showed lower KD values for nucleotides and PRPP. The pH profiles of kcat for D137N were severely altered. In contrast to D137N, the kcat for K165Q was decreased only 2-fold in the forward reaction and was slightly increased in the reverse reaction. The Km and KD values showed that K165Q interacts with substrates more weakly than does the wild-type enzyme. Pre-steady-state experiments with K165Q indicated that the phosphoribosyl transfer step was fast in the forward reaction, as observed with the wild type. In contrast, D137N showed slower phosphoribosyl transfer chemistry, although guanine (3000-fold reduction) was affected much more than hypoxanthine (32-fold reduction). In conclusion, Asp137 acts as a general catalytic acid/base for HGPRTase and Lys165 makes ground-state interactions with substrates.

Environmental volunteer well-being: Managers' perception and actual well-being of volunteers.

PubMed

Kragh, Gitte; Stafford, Rick; Curtin, Susanna; Diaz, Anita

2016-01-01

Background : Environmental volunteering can increase well-being, but environmental volunteer well-being has rarely been compared to participant well-being associated with other types of volunteering or nature-based activities. This paper aims to use a multidimensional approach to well-being to explore the immediately experienced and later remembered well-being of environmental volunteers and to compare this to the increased well-being of participants in other types of nature-based activities and volunteering. Furthermore, it aims to compare volunteer managers' perceptions of their volunteers' well-being with the self-reported well-being of the volunteers. Methods : Onsite surveys were conducted of practical conservation and biodiversity monitoring volunteers, as well as their control groups (walkers and fieldwork students, respectively), to measure general well-being before their nature-based activity and activity-related well-being immediately after their activity. Online surveys of current, former and potential volunteers and volunteer managers measured remembered volunteering-related well-being and managers' perceptions of their volunteers' well-being. Data were analysed based on Seligman's multidimensional PERMA ('positive emotion', 'engagement', 'positive relationship', 'meaning', 'achievement') model of well-being. Factor analysis recovered three of the five PERMA elements, 'engagement', 'relationship' and 'meaning', as well as 'negative emotion' and 'health' as factors. Results : Environmental volunteering significantly improved positive elements and significantly decreased negative elements of participants' immediate well-being, and it did so more than walking or student fieldwork. Even remembering their volunteering up to six months later, volunteers rated their volunteering-related well-being higher than volunteers rated their well-being generally in life. However, volunteering was not found to have an effect on overall mean well-being generally in life. Volunteer managers did not perceive the significant increase in well-being that volunteers reported. Conclusions : This study showed how environmental volunteering immediately improved participants' well-being, even more than other nature-based activities. It highlights the benefit of regarding well-being as a multidimensional construct to more systematically understand, support and enhance volunteer well-being.

Effect of an evidence-based website on healthcare usage: an interrupted time-series study

PubMed Central

Spoelman, Wouter A; Bonten, Tobias N; de Waal, Margot W M; Drenthen, Ton; Smeele, Ivo J M; Nielen, Markus M J; Chavannes, Niels H

2016-01-01

Objectives Healthcare costs and usage are rising. Evidence-based online health information may reduce healthcare usage, but the evidence is scarce. The objective of this study was to determine whether the release of a nationwide evidence-based health website was associated with a reduction in healthcare usage. Design Interrupted time series analysis of observational primary care data of healthcare use in the Netherlands from 2009 to 2014. Setting General community primary care. Population 912 000 patients who visited their general practitioners 18.1 million times during the study period. Intervention In March 2012, an evidence-based health information website was launched by the Dutch College of General Practitioners. It was easily accessible and understandable using plain language. At the end of the study period, the website had 2.9 million unique page views per month. Main outcomes measures Primary outcome was the change in consultation rate (consultations/1000 patients/month) before and after the release of the website. Additionally, a reference group was created by including consultations about topics not being viewed at the website. Subgroup analyses were performed for type of consultations, sex, age and socioeconomic status. Results After launch of the website, the trend in consultation rate decreased with 1.620 consultations/1000 patients/month (p<0.001). This corresponds to a 12% decline in consultations 2 years after launch of the website. The trend in consultation rate of the reference group showed no change. The subgroup analyses showed a specific decline for consultations by phone and were significant for all other subgroups, except for the youngest age group. Conclusions Healthcare usage decreased by 12% after providing high-quality evidence-based online health information. These findings show that e-Health can be effective to improve self-management and reduce healthcare usage in times of increasing healthcare costs. PMID:28186945

FAST TRACK COMMUNICATION: Ferroelectricity in low-symmetry biaxial nematic liquid crystals

NASA Astrophysics Data System (ADS)

Osipov, Mikhail A.; Gorkunov, Maxim V.

2010-09-01

Order parameters and phenomenological theory for both high- and low-symmetry biaxial nematic phases are presented and it is predicted that the chiral low-symmetry biaxial phase must be ferroelectric. This conclusion is based on general symmetry arguments and on the results of the Landau-de Gennes theory. The microscopic mechanism of the ferroelectric ordering in this chiral biaxial phase is illustrated using a simple molecular model based on dispersion interactions between biaxial molecules of low symmetry. Similar to the chiral smectic C* phase, the ferroelectricity in the chiral biaxial nematic phase is improper, i.e., polarization is not a primary order parameter and is not determined by dipolar interactions. Ferroelectric ordering in biaxial nematics may be found, in principle, in materials composed of chiral analogues of the tetrapod molecules which are known to exhibit biaxial phases.

Drug Information Education in Doctor of Pharmacy Programs

PubMed Central

Wang, Fei; Troutman, William G.; Seo, Teresa; Peak, Amy; Rosenberg, Jack M.

2006-01-01

Objective To characterize pharmacy program standards and trends in drug information education. Methods A questionnaire containing 34 questions addressing general demographic characteristics, organization, and content of drug information education was distributed to 86 colleges and schools of pharmacy in the United States using a Web-based survey system. Results Sixty colleges responded (73% response rate). All colleges offered a campus-based 6-year first-professional degree PharmD program. Didactic drug information was a required course in over 70% of these schools. Only 51 of the 60 colleges offered an advanced pharmacy practice experience (APPE) in drug information, and 62% of these did so only on an elective basis. Conclusion Although almost all of the PharmD programs in the US include a required course in drug information, the majority do not have a required APPE in this important area. PMID:17136172

Left Ventricular Hypertrophy: An allometric comparative analysis of different ECG markers

NASA Astrophysics Data System (ADS)

Bonomini, M. P.; Ingallina, F.; Barone, V.; Valentinuzzi, M. E.; Arini, P. D.

2011-12-01

Allometry, in general biology, measures the relative growth of a part in relation to the whole living organism. Left ventricular hypertrophy (LVH) is the heart adaptation to excessive load (systolic or diastolic). The increase in left ventricular mass leads to an increase in the electrocardiographic voltages. Based on clinical data, we compared the allometric behavior of three different ECG markers of LVH. To do this, the allometric fit AECG = δ + β (VM) relating left ventricular mass (estimated from ecocardiographic data) and ECG amplitudes (expressed as the Cornell-Voltage, Sokolow and the ECG overall voltage indexes) were compared. Besides, sensitivity and specifity for each index were analyzed. The more sensitive the ECG criteria, the better the allometric fit. In conclusion: The allometric paradigm should be regarded as the way to design new and more sensitive ECG-based LVH markers.

Google Wave: Have CTSA-Minded Institutions Caught It?

PubMed

Donahue, Amy

2010-01-01

BACKGROUND: Google Wave was touted as the next big communication tool-combining e-mail, social networking, and chat within a single "wave"-with the potential to create a new world for collaboration. Information professionals who are knowledgeable of this tool and its capabilities could become uniquely situated to use it, evaluate it, and teach it. This seemed especially true for those working within Clinical and Translational Science Award (CTSA)-minded institutions, given the promise of interdisciplinary collaboration between investigators and the potential for creating new authorship models. This case study on Google Wave users who are affiliated with CTSA-minded institutions, was designed for and presented at the Evidence-Based Scholarly Communication Conference held by the University of New Mexico Health Sciences Library and Information Center. It provides an early evidence based evaluation of Google Wave's potential. METHODS: Two "waves" were created. The first consisted of five survey questions designed to collect demographic data on the respondents' roles, a general impression of Wave, the specific tools within Wave that might be useful, and potential collaborators with whom the respondents might use Wave. The second wave was a private, guided discussion on Wave's collaboration potential. Individuals from CTSA-minded institutions were invited to participate with messages on Twitter, forums, blogs, and electronic mail lists, although there were difficulties reaching out to these institutions as a group. RESULTS: By the conclusion of the study, only a small number of people (n=11, with a viable n=9) had responded to the survey. Given this small result set, it made sense to group the responses by the respondents' roles (CTSA staff and researchers, support staff, medical librarian, or general public) and to treat them as individual cases. Most of the respondents were librarians and support staff who felt that Wave might have potential for collaboration; there were no CTSA researcher respondents. For the second part of the study, the discussion wave, only one participant explicitly expressed interest in joining. All were invited to join, but there was no participation in the discussion wave at the conclusion of the study. CONCLUSIONS: The results of this study implied that Google Wave was not on the forefront of CTSA-minded institutions' communication strategies. However, it was being used, and it did demonstrate new collaboration and authorship capabilities. Being generally aware of these capabilities may be useful to information professionals who seek to be current and informed regarding developing technology and to those interested in scholarly communication practices. In addition, the difficulties encountered during this case study in attempting to reach out to CTSA-minded institutions raised the question of how members currently communicate with each other as institutions and as individuals. There was a lesson learned in the usefulness of doing case-study research to evaluate new technologies; the cost in terms of time was relatively low, and knowledge about the technology itself was gained while establishing a base level of evidence to potentially build on in the future.

Cost and Economic Benefit of Clinical Decision Support Systems (CDSS) for Cardiovascular Disease Prevention: A Community Guide Systematic Review

PubMed Central

Jacob, Verughese; Thota, Anilkrishna B.; Chattopadhyay, Sajal K.; Njie, Gibril J.; Proia, Krista K.; Hopkins, David P.; Ross, Murray N.; Pronk, Nicolaas P.; Clymer, John M.

2017-01-01

Objective This review evaluates costs and benefits associated with acquiring, implementing, and operating clinical decision support systems (CDSS) to prevent cardiovascular disease (CVD). Materials and Methods Methods developed for The Community Guide were used to review CDSS literature covering the period from January 1976 to October 2015. Twenty-one studies were identified for inclusion. Results It was difficult to draw a meaningful estimate for the cost of acquiring and operating CDSS to prevent CVD from the available studies (n=12) due to considerable heterogeneity. Several studies (n=11) indicated healthcare costs were averted by using CDSS but many were partial assessments that did not consider all components of healthcare. Four cost-benefit studies reached conflicting conclusions about the net benefit of CDSS based on incomplete assessments of costs and benefits. Three cost-utility studies indicated inconsistent conclusions regarding cost-effectiveness based on a conservative $50,000 threshold. Discussion Intervention costs were not negligible but specific estimates were not derived because of the heterogeneity of implementation and reporting metrics. Expected economic benefits from averted healthcare cost could not be determined with confidence because many studies did not fully account for all components of healthcare. Conclusion We were unable to conclude whether CDSS for CVD prevention is either cost-beneficial or cost effective. Several evidence gaps are identified, most prominently the lack of information about major drivers of cost and benefit; the lack of standard metrics for the cost of CDSS; and not allowing for useful life of CDSS that generally extends beyond one accounting period. PMID:28049635

The effect of laughter Yoga on general health among nursing students

PubMed Central

Yazdani, Mohsen; Esmaeilzadeh, Mojtaba; Pahlavanzadeh, Saeid; Khaledi, Firouz

2014-01-01

Background: Promotion and provision of individuals’ health is one of the bases for development in societies. Students’ mental health is very important in each society. Students of medical sciences universities, especially nursing students, are under various stresses in clinical environment, in addition to the stress they experience in theoretical education environment. With regard to the importance of nursing students’ general health and considering the various existing strategies to promote general health components, use of complementary treatments is more considered because of their better public acceptance, low costs, and fewer complications. One of the new strategies in this regard is laughter Yoga. The present study was conducted with an aim to define the effect of laughter Yoga on general health among nursing students. Materials and Methods: This is a quasi-experimental two-group three-step study conducted on 38 male nursing students in the nursing and midwifery school of Isfahan University of Medical Sciences in 2012. In the study group, eight 1 h sessions of laughter Yoga were held (two sessions a week), and in the control group, no intervention was conducted. The data of the present study were collected by Goldberg and Hiller's General Health Questionnaire and analyzed by SPSS version 12. Results: The findings showed a significant difference in the mean scores of general health before and after laughter Yoga intervention in the two groups of study and control. Conclusions: The findings showed that laughter Yoga had a positive effect on students’ general health and improved the signs of physical and sleep disorders, lowered anxiety and depression, and promoted their social function. Therefore, laughter Yoga can be used as one of the effective strategies on students’ general health. PMID:24554958

Effective Inclusive Schools: Designing Successful Schoolwide Programs

ERIC Educational Resources Information Center

Hehir, Thomas; Katzman, Lauren I.

2012-01-01

This book presents lessons learned from in-depth case studies of some of our most effective inclusive public schools. The authors conclusively demonstrate that schools can educate students with mild and severe disabilities in general education classrooms by providing special education services that link to and bolster general education…

Television Violence: Where the Surgeon General's Study Leads.

ERIC Educational Resources Information Center

Comstock, George A.

When judiciously interpreted, the findings of the Report to the Surgeon General on Television and Social Behavior cannot support any conclusion other than that televised violence is a cause of aggressiveness in children and young people. Given this interpretation, policy guidance research into the effects of television on society should include…

Deterministic versus evidence-based attitude towards clinical diagnosis.

PubMed

Soltani, Akbar; Moayyeri, Alireza

2007-08-01

Generally, two basic classes have been proposed for scientific explanation of events. Deductive reasoning emphasizes on reaching conclusions about a hypothesis based on verification of universal laws pertinent to that hypothesis, while inductive or probabilistic reasoning explains an event by calculation of some probabilities for that event to be related to a given hypothesis. Although both types of reasoning are used in clinical practice, evidence-based medicine stresses on the advantages of the second approach for most instances in medical decision making. While 'probabilistic or evidence-based' reasoning seems to involve more mathematical formulas at the first look, this attitude is more dynamic and less imprisoned by the rigidity of mathematics comparing with 'deterministic or mathematical attitude'. In the field of medical diagnosis, appreciation of uncertainty in clinical encounters and utilization of likelihood ratio as measure of accuracy seem to be the most important characteristics of evidence-based doctors. Other characteristics include use of series of tests for refining probability, changing diagnostic thresholds considering external evidences and nature of the disease, and attention to confidence intervals to estimate uncertainty of research-derived parameters.

Novel mechatronic solutions incorporating inerters for railway vehicle vertical secondary suspensions

NASA Astrophysics Data System (ADS)

Matamoros-Sanchez, Alejandra Z.; Goodall, Roger M.

2015-02-01

This paper discusses the effects of inerter-based passive networks in the design of novel mechatronic solutions for improving the vertical performance of a bogied railway vehicle. Combinations of inerter-based structures and active suspensions comprise distinct novel mechatronic solutions for the vertical secondary suspension of the vehicle. The parameters of the active and passive parts of the overall configuration are optimised so that a synergy arises to enhance the vehicle vertical performance and simplify common mechatronic suspension design conflicts. The study is performed by combining inerter-based suspensions with well-established active control (output-based and model-based) strategies for ride quality enhancement. Also, a novel nonlinear control strategy, here called 'Adaptive Stiffness', is incorporated for suspension deflection regulation to complement the well-known local implementation of skyhook damping. This would complete a significant set of control strategies to produce general conclusions. The vehicle performance is assessed through the vertical accelerations of the vehicle body as an initial investigation. Attained results show the potential of the inerter concept for innovating mechatronic technologies to achieve substantial improvements in railway vehicle vertical ride quality with reduced actuator force.

A systematic review of school-based suicide prevention programs.

PubMed

Katz, Cara; Bolton, Shay-Lee; Katz, Laurence Y; Isaak, Corinne; Tilston-Jones, Toni; Sareen, Jitender

2013-10-01

Suicide is one of the leading causes of death among youth today. Schools are a cost-effective way to reach youth, yet there is no conclusive evidence regarding the most effective prevention strategy. We conducted a systematic review of the empirical literature on school-based suicide prevention programs. Studies were identified through MEDLINE and Scopus searches, using keywords such as "suicide, education, prevention and program evaluation." Additional studies were identified with a manual search of relevant reference lists. Individual studies were rated for level of evidence, and the programs were given a grade of recommendation. Five reviewers rated all studies independently and disagreements were resolved through discussion. Sixteen programs were identified. Few programs have been evaluated for their effectiveness in reducing suicide attempts. Most studies evaluated the programs' abilities to improve students' and school staffs' knowledge and attitudes toward suicide. Signs of Suicide and the Good Behavior Game were the only programs found to reduce suicide attempts. Several other programs were found to reduce suicidal ideation, improve general life skills, and change gatekeeper behaviors. There are few evidence-based, school-based suicide prevention programs, a combination of which may be effective. It would be useful to evaluate the effectiveness of general mental health promotion programs on the outcome of suicide. The grades assigned in this review are reflective of the available literature, demonstrating a lack of randomized controlled trials. Further evaluation of programs examining suicidal behavior outcomes in randomized controlled trials is warranted. © 2013 Wiley Periodicals, Inc.

Techniques and Materials Used by General Dentists during Root Canal Treatment Procedures: Findings from the National Dental Practice-Based Research Network

PubMed Central

Eleazer, Paul D.; Gilbert, Gregg H.; Funkhouser, Ellen; Reams, G.J.; Law, A.S.; Benjamin, Paul L.

2015-01-01

Background Little is known about which materials and techniques general dentists (GDs) use during root canal procedures. The objectives were to: (1) quantify GD’s use of specific endodontic armamentarium; (2) quantify inappropriate use; and (3) ascertain if inappropriate use is associated with dentists’ practice characteristics. Methods GDs in the National Dental Practice-Based Research Network reported in a questionnaire materials and techniques they use during root canal procedures. Results 1,490 (87%) of eligible GDs participated. Most (93%; n=1,383) used sodium hypochlorite to irrigate. The most commonly used sealers were zinc oxide-eugenol (43%) and resin (40%), followed by calcium hydroxide (26%). A majority (62%; n=920) used a compaction obturation technique; 36% (n=534) used a carrier-based method. Most (96%; n=1,423) used gutta percha as a filler; 5% used paste fillers. Few used irrigants (n=46), sealers (n=4), techniques (n=49) or fillers (n=10) that investigators classified as ‘inappropriate’. Conclusions GDs use a broad range of endodontic techniques and materials, often adapting to newer technologies as they become available. Few GDs use armamentarium that the investigators classified as inappropriate. Practical Implications GDs use many types of endodontic techniques and materials, but only a very small percentage is not appropriate. PMID:26562726

Childhood cancer and factors related to prolonged diagnostic intervals: a Danish population-based study

PubMed Central

Ahrensberg, J M; Olesen, F; Hansen, R P; Schrøder, H; Vedsted, P

2013-01-01

Background: Early diagnosis of childhood cancer provides hope for better prognoses. Shorter diagnostic intervals (DI) in primary care require better knowledge of the association between presenting symptoms, interpretation of symptoms and the wording of the referral letter. Methods: A Danish nationwide population-based study. Data on 550 children aged <15 years with an incident cancer diagnosis (January 2007–December 2010) were collected through questionnaires to parents (response rate=69%) and general practitioners (GPs) (response rate=87%). The DI from the first presentation in general practice until diagnosis was categorised as short or long based on quartiles. Associations between variables and long DIs were assessed using logistic regression. Results: The GPs interpreted symptoms as ‘vague' in 25.4%, ‘serious' in 50.0% and ‘alarm' in 19.0% of cases. Symptom interpretation varied by cancer type (P<0.001) and was associated with the DI (P<0.001). Vomiting was associated with a shorter DI for central nervous system (CNS) tumours, and pain with a longer DI for leukaemia. Referral letter wording was associated with DI (P<0.001); the shortest DIs were observed when cancer suspicion was raised in the letter. Conclusion: The GPs play an important role in recognising early signs of childhood cancer as their symptom interpretation and referral wording have a profound impact on the diagnostic process. PMID:23449354

Gravitational waves, energy and Feynman’s “sticky bead”

NASA Astrophysics Data System (ADS)

Cooperstock, F. I.

2015-07-01

It is noted that in the broader sense, gravitational waves viewed as spacetime curvature which necessarily accompanies electromagnetic waves at the speed of light, are the routine perception of our everyday experience. We focus on the energy issue and Feynman’s “sticky bead” argument which has been regarded as central in supporting the conclusion that gravitational waves carry energy through the vacuum in general relativity. We discuss the essential neglected aspects of his approach which leads to the conclusion that gravitational waves would not cause Feynman’s bead to heat the stick on which it would supposedly rub. This opens the way to an examination of the entire issue of energy in general relativity. We briefly discuss our naturally-defined totally invariant spacetime energy expression for general relativity incorporating the contribution from gravity. When the cosmological term is included in the field equations, our energy expression includes the vacuum energy as required.

Minorities, the Poor and School Finance Reform. Vol. 9: Summary and Conclusions.

ERIC Educational Resources Information Center

Brischetto, Robert

In this concluding volume of a nine-volume study of the impact of school finance reform on the poor and minorities, the author summarizes the project's methods, variables, findings, and conclusions about reform in the six states of California, Colorado, Florida, Michigan, New Mexico, and Texas. He first discusses the two general approaches to…

Empirically based comparisons of the reliability and validity of common quantification approaches for eyeblink startle potentiation in humans

PubMed Central

Bradford, Daniel E.; Starr, Mark J.; Shackman, Alexander J.

2015-01-01

Abstract Startle potentiation is a well‐validated translational measure of negative affect. Startle potentiation is widely used in clinical and affective science, and there are multiple approaches for its quantification. The three most commonly used approaches quantify startle potentiation as the increase in startle response from a neutral to threat condition based on (1) raw potentiation, (2) standardized potentiation, or (3) percent‐change potentiation. These three quantification approaches may yield qualitatively different conclusions about effects of independent variables (IVs) on affect when within‐ or between‐group differences exist for startle response in the neutral condition. Accordingly, we directly compared these quantification approaches in a shock‐threat task using four IVs known to influence startle response in the no‐threat condition: probe intensity, time (i.e., habituation), alcohol administration, and individual differences in general startle reactivity measured at baseline. We confirmed the expected effects of time, alcohol, and general startle reactivity on affect using self‐reported fear/anxiety as a criterion. The percent‐change approach displayed apparent artifact across all four IVs, which raises substantial concerns about its validity. Both raw and standardized potentiation approaches were stable across probe intensity and time, which supports their validity. However, only raw potentiation displayed effects that were consistent with a priori specifications and/or the self‐report criterion for the effects of alcohol and general startle reactivity. Supplemental analyses of reliability and validity for each approach provided additional evidence in support of raw potentiation. PMID:26372120

Impact of introducing near patient testing for standard investigations in general practice.

PubMed Central

Rink, E; Hilton, S; Szczepura, A; Fletcher, J; Sibbald, B; Davies, C; Freeling, P; Stilwell, J

1993-01-01

OBJECTIVE--To assess the clinical and economic impact of surgery based near patient testing in general practice for six commonly used biochemical and bacteriological tests. DESIGN--After four months' monitoring, equipment for two bacteriological and four biochemical tests was introduced without cost into 12 practices using a crossover design. Structured request forms were used to monitor laboratory investigations. SETTING--12 general practices in west midlands and south west Thames with list sizes above 9000. MAIN OUTCOME MEASURES--Investigation rates per 1000 consultations. Changes from baseline rates. Reasons for requesting investigations and provisional diagnoses. Cost per test and sensitivity of costs to rate of use. RESULTS--Investigation rates for the six tests rose by 16.5% (from 78.6/1000 consultations to 91.6/1000) when equipment was available in the surgery and reverted to baseline rates when it was withdrawn. The average weekly number of tests when equipment was available ranged from 0.5 to 10.5 (mean 9.0). Cholesterol tests were used as an addition to laboratory testing, usually for screening. Midstream urine analysis was often done in the surgery instead of in the laboratory, although 30% of samples were tested by both methods. Doctors' reasons for investigation and conditions tested were largely unaffected by availability of surgery tests. Costs for surgery tests were higher for all tests except midstream urine. CONCLUSIONS--Availability of surgery based testing increased the number of tests performed. It was cost effective only for midstream urine analysis. PMID:8219952

Motor Learning Characterizes Habilitation of Children With Hemiplegic Cerebral Palsy

PubMed Central

Krebs, Hermano I.; Fasoli, Susan E.; Dipietro, Laura; Fragala-Pinkham, Maria; Hughes, Richard; Stein, Joel; Hogan, Neville

2015-01-01

Background This study tested in children with cerebral palsy (CP) whether motor habilitation resembles motor learning. Methods Twelve children with hemiplegic CP ages 5 to 12 years with moderate to severe motor impairments underwent a 16-session robot-mediated planar therapy program to improve upper limb reach, with a focus on shoulder and elbow movements. Participants were trained to execute point-to-point movements (with robot assistance) with the affected arm and were evaluated (without robot assistance) in trained (point-to-point) and untrained (circle-drawing) conditions. Outcomes were measured at baseline, midpoint, immediately after the program, and 1 month postcompletion. Outcome measures were the Fugl-Meyer (FM), Quality of Upper Extremity Skills Test (QUEST), and Modified Ashworth Scale (MAS) scores; parent questionnaire; and robot-based kinematic metrics. To assess whether learning best characterizes motor habilitation in CP, the authors quantified (a) improvement on trained tasks at completion of training (acquisition) and 1 month following completion (retention) and (b) quantified generalization of improvement to untrained tasks. Results After robotic intervention, the authors found significant gains in the FM, QUEST, and parent questionnaire. Robot-based evaluations demonstrated significant improvement in trained movements and that improvement was sustained at follow-up. Furthermore, children improved their performance in untrained movements indicating generalization. Conclusions Motor habilitation in CP exhibits some traits of motor learning. Optimal treatment may not require an extensive repertoire of tasks but rather a select set to promote generalization. PMID:22331211

Why are some evidence-based care recommendations in chronic obstructive pulmonary disease better implemented than others? Perspectives of medical practitioners

PubMed Central

Johnston, Kylie N; Young, Mary; Grimmer-Somers, Karen A; Antic, Ral; Frith, Peter A

2011-01-01

Background Clinical guidelines for management of patients with chronic obstructive pulmonary disease (COPD) include recommendations based on high levels of evidence, but gaps exist in their implementation. The aim of this study was to examine the perspectives of medical practitioners regarding implementation of six high-evidence recommendations for the management of people with COPD. Methods Semi-structured interviews were conducted with medical practitioners involved with care of COPD patients in hospital and general practice. Interviews sought medical practitioners’ experience regarding implementation of smoking cessation, influenza vaccination, pulmonary rehabilitation, guideline-based medications, long-term oxygen therapy for hypoxemia and plan and advice for future exacerbations. Interviews were audiotaped, transcribed verbatim and analyzed using content analysis. Results Nine hospital-based medical practitioners and seven general practitioners participated. Four major categories were identified which impacted on implementation of the target recommendations in the care of patients with COPD: (1) role clarity of the medical practitioner; (2) persuasive communication with the patient; (3) complexity of behavioral change required; (4) awareness and support available at multiple levels. For some recommendations, strength in all four categories provided significant enablers supporting implementation. However, with regard to pulmonary rehabilitation and plans and advice for future exacerbations, all identified categories that presented barriers to implementation. Conclusion This study of medical practitioner perspectives has indicated areas where significant barriers to the implementation of key evidence-based recommendations in COPD management persist. Developing strategies to target the identified categories provides an opportunity to achieve greater implementation of those high-evidence recommendations in the care of people with COPD. PMID:22259242

SU-F-T-268: A Feasibility Study of Independent Dose Verification for Vero4DRT

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

Yamashita, M; Kokubo, M; Institute of Biomedical Research and Innovation, Kobe, Hyogo

2016-06-15

Purpose: Vero4DRT (Mitsubishi Heavy Industries Ltd.) has been released for a few years. The treatment planning system (TPS) of Vero4DRT is dedicated, so the measurement is the only method of dose verification. There have been no reports of independent dose verification using Clarksonbased algorithm for Vero4DRT. An independent dose verification software program of the general-purpose linac using a modified Clarkson-based algorithm was modified for Vero4DRT. In this study, we evaluated the accuracy of independent dose verification program and the feasibility of the secondary check for Vero4DRT. Methods: iPlan (Brainlab AG) was used as the TPS. PencilBeam Convolution was used formore » dose calculation algorithm of IMRT and X-ray Voxel Monte Carlo was used for the others. Simple MU Analysis (SMU, Triangle Products, Japan) was used as the independent dose verification software program in which CT-based dose calculation was performed using a modified Clarkson-based algorithm. In this study, 120 patients’ treatment plans were collected in our institute. The treatments were performed using the conventional irradiation for lung and prostate, SBRT for lung and Step and shoot IMRT for prostate. Comparison in dose between the TPS and the SMU was done and confidence limits (CLs, Mean ± 2SD %) were compared to those from the general-purpose linac. Results: As the results of the CLs, the conventional irradiation (lung, prostate), SBRT (lung) and IMRT (prostate) show 2.2 ± 3.5% (CL of the general-purpose linac: 2.4 ± 5.3%), 1.1 ± 1.7% (−0.3 ± 2.0%), 4.8 ± 3.7% (5.4 ± 5.3%) and −0.5 ± 2.5% (−0.1 ± 3.6%), respectively. The CLs for Vero4DRT show similar results to that for the general-purpose linac. Conclusion: The independent dose verification for the new linac is clinically available as a secondary check and we performed the check with the similar tolerance level of the general-purpose linac. This research is partially supported by Japan Agency for Medical Research and Development (AMED)« less

The Non-Signalling theorem in generalizations of Bell's theorem

NASA Astrophysics Data System (ADS)

Walleczek, J.; Grössing, G.

2014-04-01

Does "epistemic non-signalling" ensure the peaceful coexistence of special relativity and quantum nonlocality? The possibility of an affirmative answer is of great importance to deterministic approaches to quantum mechanics given recent developments towards generalizations of Bell's theorem. By generalizations of Bell's theorem we here mean efforts that seek to demonstrate the impossibility of any deterministic theories to obey the predictions of Bell's theorem, including not only local hidden-variables theories (LHVTs) but, critically, of nonlocal hidden-variables theories (NHVTs) also, such as de Broglie-Bohm theory. Naturally, in light of the well-established experimental findings from quantum physics, whether or not a deterministic approach to quantum mechanics, including an emergent quantum mechanics, is logically possible, depends on compatibility with the predictions of Bell's theorem. With respect to deterministic NHVTs, recent attempts to generalize Bell's theorem have claimed the impossibility of any such approaches to quantum mechanics. The present work offers arguments showing why such efforts towards generalization may fall short of their stated goal. In particular, we challenge the validity of the use of the non-signalling theorem as a conclusive argument in favor of the existence of free randomness, and therefore reject the use of the non-signalling theorem as an argument against the logical possibility of deterministic approaches. We here offer two distinct counter-arguments in support of the possibility of deterministic NHVTs: one argument exposes the circularity of the reasoning which is employed in recent claims, and a second argument is based on the inconclusive metaphysical status of the non-signalling theorem itself. We proceed by presenting an entirely informal treatment of key physical and metaphysical assumptions, and of their interrelationship, in attempts seeking to generalize Bell's theorem on the basis of an ontic, foundational interpretation of the non-signalling theorem. We here argue that the non-signalling theorem must instead be viewed as an epistemic, operational theorem i.e. one that refers exclusively to what epistemic agents can, or rather cannot, do. That is, we emphasize that the non-signalling theorem is a theorem about the operational inability of epistemic agents to signal information. In other words, as a proper principle, the non-signalling theorem may only be employed as an epistemic, phenomenological, or operational principle. Critically, our argument emphasizes that the non-signalling principle must not be used as an ontic principle about physical reality as such, i.e. as a theorem about the nature of physical reality independently of epistemic agents e.g. human observers. One major reason in favor of our conclusion is that any definition of signalling or of non-signalling invariably requires a reference to epistemic agents, and what these agents can actually measure and report. Otherwise, the non-signalling theorem would equal a general "no-influence" theorem. In conclusion, under the assumption that the non-signalling theorem is epistemic (i.e. "epistemic non-signalling"), the search for deterministic approaches to quantum mechanics, including NHVTs and an emergent quantum mechanics, continues to be a viable research program towards disclosing the foundations of physical reality at its smallest dimensions.

Outreach impact study: the case of the Greater Midwest Region*

PubMed Central

Huber, Jeffrey T; Kean, Emily B; Fitzgerald, Philip D; Altman, Trina A; Young, Zach G; Dupin, Katherine M; Leskovec, Jacqueline; Holst, Ruth

2011-01-01

Objectives: The purpose of the study was to assess the impact that funding from the National Network of Libraries of Medicine (NN/LM), Greater Midwest Region (GMR), has on member institutions' ability to conduct outreach on behalf of NN/LM. Methods: The study employed both content analysis and survey methodologies. The final reports from select GMR-funded outreach projects (n = 20) were analyzed based on a set of evaluation criteria. Project principal investigators (n = 13) were then surveyed using the same evaluation criteria. Results: Results indicated that outreach projects supported by GMR funding improved access to biomedical information for professionals and the general public. Barriers to conducting outreach projects included time constraints or commitments, staffing, scheduling and absenteeism, inadequate space, and issues associated with technology (e.g., hardware and software, Internet connectivity and firewall issues, and creation and use of new technologies). Conclusions: The majority of project principal investigators indicated that their attempts to conduct outreach were successful. Moreover, most noted that outreach had a positive impact on professionals as well as the general public. In general, it seems that negative outcomes, as with most barriers to conducting outreach, can be mitigated by more thorough planning. PMID:22022223

A general description of additive and nonadditive elements of sperm competitiveness and their relation to male fertilization success.

PubMed

Engqvist, Leif

2013-05-01

A complete understanding of male reproductive success, and thus sexual selection, often requires an insight into male success in sperm competition. Genuine conclusions on male sperm competitiveness can only be made in real competitive situations. However, statistical analyses of sperm competitiveness from fertilization success data have been shown to be problematic. Here, I first outline a comprehensive general description of the different additive and nonadditive elements relevant for the outcome of sperm competition staged between two males. Based on this description, I will highlight two main problems that are frequently encountered in experiments aiming at estimating sperm competitiveness. First, I focus on potential problems when using standardized competitors versus random mating trials, because trials with standardized competitors do not allow generalization if male-male interactions are important. Second, I illustrate the necessity to analyze data on the logit scale rather than on raw proportions, because only the logit scale allows a clean separation of additive and nonadditive effects (i.e., male × male and female × male interactions). © 2012 The Author(s). Evolution © 2012 The Society for the Study of Evolution.

Bayesian analysis of volcanic eruptions

NASA Astrophysics Data System (ADS)

Ho, Chih-Hsiang

1990-10-01

The simple Poisson model generally gives a good fit to many volcanoes for volcanic eruption forecasting. Nonetheless, empirical evidence suggests that volcanic activity in successive equal time-periods tends to be more variable than a simple Poisson with constant eruptive rate. An alternative model is therefore examined in which eruptive rate(λ) for a given volcano or cluster(s) of volcanoes is described by a gamma distribution (prior) rather than treated as a constant value as in the assumptions of a simple Poisson model. Bayesian analysis is performed to link two distributions together to give the aggregate behavior of the volcanic activity. When the Poisson process is expanded to accomodate a gamma mixing distribution on λ, a consequence of this mixed (or compound) Poisson model is that the frequency distribution of eruptions in any given time-period of equal length follows the negative binomial distribution (NBD). Applications of the proposed model and comparisons between the generalized model and simple Poisson model are discussed based on the historical eruptive count data of volcanoes Mauna Loa (Hawaii) and Etna (Italy). Several relevant facts lead to the conclusion that the generalized model is preferable for practical use both in space and time.

Identification of general characteristics, motivation, and satisfaction of internet-based medical consultation service users in Croatia

PubMed Central

Klinar, Ivana; Balažin, Ana; Baršić, Bruno; Tiljak, Hrvoje

2011-01-01

Aim To identify users’ reasons to look for physician consultation on the internet instead of visiting a physician and to explore their general characteristics, motivation, and satisfaction with internet medical consultation service ‘Your Questions.’ Methods Users of a free internet medical consultation service ‘Your Questions’ (www.plivazdravlje.hr) were invited to participate in a web-based survey designed to explore their general characteristics (age, sex, etc), reasons for using the service, the nature of their health problem or question, and their satisfaction with the service. Respondents were divided into two groups: users who consulted an internet physician only (Group I) and users who used internet consulting before or after visiting a physician (Group II). Results The response rate was 38% (1036/2747), with 79% female respondents. A fifth of the respondents (21%) consulted an internet physician only (Group I). Multivariate analysis revealed that the respondents in Group I were younger (median 24 vs 28 years in Group II), more interested into questions about pregnancy (odds ratio [OR], 1.984; 95% confidence interval [CI], 1.203-3.272), more often embarrassed to talk to a physician in person (OR, 1.828; 95% CI, 1.119-2.989), and more motivated to protect their privacy (OR, 1.727; 95% CI, 1.252-2.380). They also had greater satisfaction with the service (77% vs 60%, P < 0.001). Conclusion The factors associated with the use of internet-based medical consultation services were younger age, need for privacy protection, avoidance of embarrassment at the physician’s office, and having a question related to pregnancy. This reveals the internet medical consultation service as a useful health promotion supplement that is particularly applicable for the population of young adults. PMID:21853551

Use of driving-impairing medicines by a Spanish population: a population-based registry study

PubMed Central

Gutierrez-Abejón, Eduardo; Herrera-Gómez, Francisco; Criado-Espegel, Paloma

2017-01-01

Objective To assess the use of driving-impairing medicines (DIM) in the general population with special reference to length of use and concomitant use. Design Population-based registry study. Setting The year 2015 granted medicines consumption data recorded in the Castile and León (Spain) medicine dispensation registry was consulted. Participants Medicines and DIM consumers from a Spanish population (Castile and León: 2.4 million inhabitants). Exposure Medicines and DIM consumption. Patterns of use by age and gender based on the length of use (acute: 1–7 days, subacute: 8–29 days and chronic use: ≥30 days) were of interest. Estimations regarding the distribution of licensed drivers by age and gender were employed to determine the patterns of use of DIM. Results DIM were consumed by 34.4% (95% CI 34.3% to 34.5%) of the general population in 2015, more commonly with regularity (chronic use: 22.5% vs acute use: 5.3%) and more frequently by the elderly. On average, 2.3 DIM per person were dispensed, particularly to chronic users (2.8 DIM per person). Age and gender distribution differences were observed between the Castile and León medicine dispensation registry data and the drivers’ license census data. Of all DIM dispensed, 83.8% were in the Anatomical Therapeutic Chemical code group nervous system medicines (N), which were prescribed to 29.2% of the population. Conclusions The use of DIM was frequent in the general population. Chronic use was common, but acute and subacute use should also be considered. This finding highlights the need to make patients, health professionals, health providers, medicine regulatory agencies and policy-makers at large aware of the role DIM play in traffic safety. PMID:29170289

Disentangling the determinants of interest and willingness-to-pay for breast cancer susceptibility testing in the general population: a cross-sectional Web-based survey among women of Québec (Canada)

PubMed Central

Blouin-Bougie, Jolyane; Amara, Nabil; Bouchard, Karine; Simard, Jacques; Dorval, Michel

2018-01-01

Objectives To identify common and specific individual factors that favour or impede women’s interest in and willingness-to-pay (WTP) for breast cancer susceptibility testing (BCST) and to identify the most impactful factors on both outcome measures. Design and methods This study used a self-administered cross-sectional Web-based questionnaire that included hypothetical scenarios about the availability of a new genetic test for breast cancer. Participants French-speaking women of the general population of Québec (Canada), aged between 35 and 69 years, were identified from a Web-based panel (2410 met the selection criteria, 1160 were reached and 1031 completed the survey). Measures The outcomes are the level of interest in and the range of WTP for BCST. Three categories of individual factors identified in the literature were used as potential explanatory factors, that is, demographic, clinical and psychosocial. Results Descriptive statistics indicated that the vast majority of sampled women are interested in BCST (90%). Among those, more than half of them are willing-to-pay for such a test (57%). The regression models pointed out several factors associated with both outcomes (eg, age, income, family history, locus of control-powerful others) and marginal effects were used to highlight the most impactful factors for each outcome. Conclusion The results of this study provide a proxy of the readiness of women of the general population to use and to pay for BCST. They also offer insights for developing inclusive and specific strategies to foster informed decision-making and guide the services offered by health organisations corresponding to women’s preferences and needs. PMID:29487071

Glyphosate in the general population and in applicators: a critical review of studies on exposures.

PubMed

Solomon, Keith R

2016-09-01

The recent classification of glyphosate as a probable human carcinogen by the International Agency for Research on Cancer (IARC) was arrived at without a detailed assessment of exposure. Glyphosate is widely used as an herbicide, which might result in exposures of the general public and applicators. Exposures were estimated from information in the open literature and unpublished reports provided by Monsanto Company. Based on the maximum measured concentration in air, an exposure dose of 1.04 × 10  -   6  mg/kg body mass (b.m.)/d was estimated. Assuming consumption of surface water without treatment, the 90th centile measured concentration would result in a consumed dose of 2.25 × 10  -   5  mg/kg b.m./d. Estimates by the Food and Agriculture Organization of the United Nations (FAO) of consumed doses in food provided a median exposure of 0.005 mg/kg b.m./d (range 0.002-0.013). Based on tolerance levels, the conservative estimate by the US Environmental Protection Agency (US EPA) for exposure of the general population via food and water was 0.088 mg/kg b.m./d (range 0.058-0.23). For applicators, 90th centiles for systemic exposures based on biomonitoring and dosimetry (normalized for penetration through the skin) were 0.0014 and 0.021 mg/kg b.m./d, respectively. All of these exposures are less than the reference dose and the acceptable daily intakes proposed by several regulatory agencies, thus supporting a conclusion that even for these highly exposed populations the exposures were within regulatory limits.

Primary care of adults with developmental disabilities

PubMed Central

Sullivan, William F.; Berg, Joseph M.; Bradley, Elspeth; Cheetham, Tom; Denton, Richard; Heng, John; Hennen, Brian; Joyce, David; Kelly, Maureen; Korossy, Marika; Lunsky, Yona; McMillan, Shirley

2011-01-01

Abstract Objective To update the 2006 Canadian guidelines for primary care of adults with developmental disabilities (DD) and to make practical recommendations based on current knowledge to address the particular health issues of adults with DD. Quality of evidence Knowledgeable health care providers participating in a colloquium and a subsequent working group discussed and agreed on revisions to the 2006 guidelines based on a comprehensive review of publications, feedback gained from users of the guidelines, and personal clinical experiences. Most of the available evidence in this area of care is from expert opinion or published consensus statements (level III). Main message Adults with DD have complex health issues, many of them differing from those of the general population. Good primary care identifies the particular health issues faced by adults with DD to improve their quality of life, to improve their access to health care, and to prevent suffering, morbidity, and premature death. These guidelines synthesize general, physical, behavioural, and mental health issues of adults with DD that primary care providers should be aware of, and they present recommendations for screening and management based on current knowledge that practitioners can apply. Because of interacting biologic, psychoaffective, and social factors that contribute to the health and well-being of adults with DD, these guidelines emphasize involving caregivers, adapting procedures when appropriate, and seeking input from a range of health professionals when available. Ethical care is also emphasized. The guidelines are formulated within an ethical framework that pays attention to issues such as informed consent and the assessment of health benefits in relation to risks of harm. Conclusion Implementation of the guidelines proposed here would improve the health of adults with DD and would minimize disparities in health and health care between adults with DD and those in the general population. PMID:21571716

Analysing the operative experience of basic surgical trainees in Ireland using a web-based logbook

PubMed Central

2011-01-01

Background There is concern about the adequacy of operative exposure in surgical training programmes, in the context of changing work practices. We aimed to quantify the operative exposure of all trainees on the National Basic Surgical Training (BST) programme in Ireland and compare the results with arbitrary training targets. Methods Retrospective analysis of data obtained from a web-based logbook (http://www.elogbook.org) for all general surgery and orthopaedic training posts between July 2007 and June 2009. Results 104 trainees recorded 23,918 operations between two 6-month general surgery posts. The most common general surgery operation performed was simple skin excision with trainees performing an average of 19.7 (± 9.9) over the 2-year training programme. Trainees most frequently assisted with cholecystectomy with an average of 16.0 (± 11.0) per trainee. Comparison of trainee operative experience to arbitrary training targets found that 2-38% of trainees achieved the targets for 9 emergency index operations and 24-90% of trainees achieved the targets for 8 index elective operations. 72 trainees also completed a 6-month post in orthopaedics and recorded 7,551 operations. The most common orthopaedic operation that trainees performed was removal of metal, with an average of 2.90 (± 3.27) per trainee. The most common orthopaedic operation that trainees assisted with was total hip replacement, with an average of 10.46 (± 6.21) per trainee. Conclusions A centralised web-based logbook provides valuable data to analyse training programme performance. Analysis of logbooks raises concerns about operative experience at junior trainee level. The provision of adequate operative exposure for trainees should be a key performance indicator for training programmes. PMID:21943313

Risk of bias assessment of randomised controlled trials in high-impact ophthalmology journals and general medical journals: a systematic review.

PubMed

Joksimovic, Lazar; Koucheki, Robert; Popovic, Marko; Ahmed, Yusuf; Schlenker, Matthew B; Ahmed, Iqbal Ike K

2017-10-01

Evidence-based treatments in ophthalmology are often based on the results of randomised controlled trials. Biased conclusions from randomised controlled trials may lead to inappropriate management recommendations. This systematic review investigates the prevalence of bias risk in randomised controlled trials published in high-impact ophthalmology journals and ophthalmology trials from general medical journals. Using Ovid MEDLINE, randomised controlled trials in the top 10 high-impact ophthalmology journals in 2015 were systematically identified and critically appraised for the prevalence of bias risk. Included randomised controlled trials were assessed in all domains of bias as defined by the Cochrane Collaboration. In addition, the prevalence of conflict of interest and industry sponsorship was investigated. A comparison with ophthalmology articles from high-impact general medical journals was performed. Of the 259 records that were screened from ophthalmology-specific journals, 119 trials met all inclusion criteria and were critically appraised. In total, 29.4% of domains had an unclear risk, 13.8% had a high risk and 56.8% had a low risk of bias. In comparison, ophthalmology articles from general medical journals had a lower prevalence of unclear risk (17.1%), higher prevalence of high risk (21.9%) and a higher prevalence of low risk domains (61.9%). Furthermore, 64.7% of critically appraised trials from ophthalmology-specific journals did not report any conflicts of interest, while 70.6% did not report an industry sponsor of their trial. In closing, it is essential that authors, peer reviewers and readers closely follow published risk of bias guidelines. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Are Canadian general surgery residents ready for the 80-hour work week? A nationwide survey

PubMed Central

Sudarshan, Monisha; Hanna, Wael C.; Jamal, Mohammed H.; Nguyen, Lily H.P.; Fraser, Shannon A.

2012-01-01

Background The purpose of this study was to describe Canadian general surgery residents’ perceptions regarding potential implementation of work-hour restrictions. Methods An ethics review board–approved, Web-based survey was submitted to all Canadian general surgery residency programs between April and July 2009. Questions evaluated the perceived effects of an 80-hour work week on length of training, operative exposure, learning and lifestyle. We used the Fisher exact test to compare senior and junior residents’ responses. Results Of 360 residents, 158 responded (70 seniors and 88 juniors). Among them, 79% reported working 75–100 hours per week. About 74% of seniors believed that limiting their work hours would decrease their operative exposure; 43% of juniors agreed (p < 0.001). Both seniors and juniors thought limiting their work hours would improve their lifestyle (86% v. 96%, p = 0.12). Overall, 60% of residents did not believe limiting work hours would extend the length of their training. Regarding 24-hour call, 60% of juniors thought it was hazardous to their health; 30% of seniors agreed (p = 0.001). Both senior and junior residents thought abolishing 24-hour call would decrease their operative exposure (84% v. 70%, p = 0.21). Overall, 31% of residents supported abolishing 24-hour call. About 47% of residents (41% seniors, 51% juniors, p = 0.26) agreed with the adoption of the 80-hour work week. Conclusion There is a training-level based dichotomy of opinion among general surgery residents in Canada regarding the perceived effects of work hour restrictions. Both groups have voted against abolishing 24-hour call, and neither group strongly supports the implementation of the 80-hour work week. PMID:22269303

Are general surgery residents adequately prepared for hepatopancreatobiliary fellowships? A questionnaire-based study

PubMed Central

Osman, Houssam; Parikh, Janak; Patel, Shirali; Jeyarajah, D Rohan

2015-01-01

Background The present study was conducted to assess the preparedness of hepatopancreatobiliary (HPB) fellows upon entering fellowship, identify challenges encountered by HPB fellows during the initial part of their HPB training, and identify potential solutions to these challenges that can be applied during residency training. Methods A questionnaire was distributed to all HPB fellows in accredited HPB fellowship programmes in two consecutive academic years (n = 42). Reponses were then analysed. Results A total of 19 (45%) fellows responded. Prior to their fellowship, 10 (53%) were in surgical residency and the rest were in other surgical fellowships or surgical practice. Thirteen (68%) were graduates of university-based residency programmes. All fellows felt comfortable in performing basic laparoscopic procedures independently at the completion of residency and less comfortable in performing advanced laparoscopy. Eight (42%) fellows cited a combination of inadequate case volume and lack of autonomy during residency as the reasons for this lack of comfort. Thirteen (68%) identified inadequate preoperative workup and management as their biggest fear upon entering practice after general surgery training. A total of 17 (89%) fellows felt they were adequately prepared to enter HPB fellowship. Extra rotations in transplant, vascular or minimally invasive surgery were believed to be most helpful in preparing general surgery residents pursing HPB fellowships. Conclusions Overall, HPB fellows felt themselves to be adequately prepared for fellowship. Advanced laparoscopic procedures and the perioperative management of complex patients are two of the challenges facing HPB fellows. General surgery residents who plan to pursue an HPB fellowship may benefit from spending extra rotations on certain subspecialties. Focus on perioperative workup and management should be an integral part of residency and fellowship training. PMID:25387852

Auditory emotion recognition impairments in Schizophrenia: Relationship to acoustic features and cognition

PubMed Central

Gold, Rinat; Butler, Pamela; Revheim, Nadine; Leitman, David; Hansen, John A.; Gur, Ruben; Kantrowitz, Joshua T.; Laukka, Petri; Juslin, Patrik N.; Silipo, Gail S.; Javitt, Daniel C.

2013-01-01

Objective Schizophrenia is associated with deficits in ability to perceive emotion based upon tone of voice. The basis for this deficit, however, remains unclear and assessment batteries remain limited. We evaluated performance in schizophrenia on a novel voice emotion recognition battery with well characterized physical features, relative to impairments in more general emotional and cognitive function. Methods We studied in a primary sample of 92 patients relative to 73 controls. Stimuli were characterized according to both intended emotion and physical features (e.g., pitch, intensity) that contributed to the emotional percept. Parallel measures of visual emotion recognition, pitch perception, general cognition, and overall outcome were obtained. More limited measures were obtained in an independent replication sample of 36 patients, 31 age-matched controls, and 188 general comparison subjects. Results Patients showed significant, large effect size deficits in voice emotion recognition (F=25.4, p<.00001, d=1.1), and were preferentially impaired in recognition of emotion based upon pitch-, but not intensity-features (group X feature interaction: F=7.79, p=.006). Emotion recognition deficits were significantly correlated with pitch perception impairments both across (r=56, p<.0001) and within (r=.47, p<.0001) group. Path analysis showed both sensory-specific and general cognitive contributions to auditory emotion recognition deficits in schizophrenia. Similar patterns of results were observed in the replication sample. Conclusions The present study demonstrates impairments in auditory emotion recognition in schizophrenia relative to acoustic features of underlying stimuli. Furthermore, it provides tools and highlights the need for greater attention to physical features of stimuli used for study of social cognition in neuropsychiatric disorders. PMID:22362394

Gut Feelings as a Third Track in General Practitioners’ Diagnostic Reasoning

PubMed Central

Van de Wiel, Margje; Van Royen, Paul; Van Bokhoven, Marloes; Van der Weijden, Trudy; Dinant, Geert Jan

2010-01-01

Background General practitioners (GPs) are often faced with complicated, vague problems in situations of uncertainty that they have to solve at short notice. In such situations, gut feelings seem to play a substantial role in their diagnostic process. Qualitative research distinguished a sense of alarm and a sense of reassurance. However, not every GP trusted their gut feelings, since a scientific explanation is lacking. Objective This paper explains how gut feelings arise and function in GPs’ diagnostic reasoning. Approach The paper reviews literature from medical, psychological and neuroscientific perspectives. Conclusions Gut feelings in general practice are based on the interaction between patient information and a GP’s knowledge and experience. This is visualized in a knowledge-based model of GPs’ diagnostic reasoning emphasizing that this complex task combines analytical and non-analytical cognitive processes. The model integrates the two well-known diagnostic reasoning tracks of medical decision-making and medical problem-solving, and adds gut feelings as a third track. Analytical and non-analytical diagnostic reasoning interacts continuously, and GPs use elements of all three tracks, depending on the task and the situation. In this dual process theory, gut feelings emerge as a consequence of non-analytical processing of the available information and knowledge, either reassuring GPs or alerting them that something is wrong and action is required. The role of affect as a heuristic within the physician’s knowledge network explains how gut feelings may help GPs to navigate in a mostly efficient way in the often complex and uncertain diagnostic situations of general practice. Emotion research and neuroscientific data support the unmistakable role of affect in the process of making decisions and explain the bodily sensation of gut feelings.The implications for health care practice and medical education are discussed. PMID:20967509

Recognition and Treatment Recommendations for Generalized Anxiety Disorder and Major Depressive Episode: A Cross-Sectional Study Among General Practitioners in Norway

PubMed Central

Olssøn, Ingrid; Mykletun, Arnstein; Dahl, Alv A.

2006-01-01

Objective: Undertreatment by general practitioners (GPs) of patients who have generalized anxiety disorder (GAD) and major depressive episodes (MDEs) is well known. Overtreatment by GPs of patients without these disorders has received little attention. The aim of this study was to estimate GPs' recommended overtreatment (recommendation of treatment to patients who, on the basis of diagnostic self-ratings, had neither GAD nor MDE) and undertreatment (not recommending treatment to patients who, on the basis of self-ratings, had GAD or MDE) and to describe patient variables associated with overtreatment. Method: In a cross-sectional design (during 3 consecutive days in September 2001), 136 Norwegian GPs evaluated 1332 patients. Diagnostic reference standards were patients' ratings of validated DSM-IV criteria–based questionnaires. GPs identified somatic diseases and mental disorders according to all accumulated information. For their diagnoses of MDE and GAD, the Clinical Global Impressions-Severity of Illness scale was used as a supplement, and GPs suggested treatment for these disorders. Results: The GPs recommended overtreatment in 11% (132/1245) of cases. The rates of under-treatment were 64% (18/28) and 49% (23/47) for GAD and MDE, respectively. For comorbid GAD and MDE the rate of undertreatment was 17% (2/12). Mental reason for patient's current visit and poor self-rated subjective health were strongly associated with overtreatment. Conclusion: Our preliminary study indicates that overtreatment by GPs of patients who, according to self-rating, do not have GAD or MDE could represent a problem. Criteria-based diagnostic descriptions might be of limited relevance for the practice of GPs, and the issue of overtreatment should be investigated further in studies with improved design. PMID:17245455

A cross-sectional survey of experts’ opinions about the relative effectiveness of tobacco control strategies for the general population versus disadvantaged groups: what do we choose in the absence of evidence?

PubMed Central

2013-01-01

Background There is a clear disparity in smoking rates according to social disadvantage. In the absence of sufficiently robust data regarding effective strategies for reducing smoking prevalence in disadvantaged populations, understanding the views of tobacco control experts can assist with funding decisions and research agendas. Methods A web-based cross-sectional survey was conducted with 192 respondents (response rate 65%) sampled from the Australian and New Zealand Tobacco Control Contacts list and a literature search. Respondents were asked to indicate whether a number of tobacco control strategies were perceived to be effective for each of: the general population; Aboriginal and Torres Strait Islander people; those with a low income; and people with a mental illness. Results A high proportion of respondents indicated that mass media and increased tobacco taxation (84% and 89% respectively) were effective for the general population. Significantly lower proportions reported these two strategies were effective for sub-populations, particularly Aboriginal and Torres Strait Islanders (58% and 63% respectively, p’s < .0001). Subsidised medication was the only strategy associated with a greater proportion of respondents perceiving it to be effective in disadvantaged sub-populations compared to the general population. Tailored quit programs and culturally relevant programs were nominated as additional effective strategies for disadvantaged populations. Conclusions Views about subsidised medications in particular, suggest the need for robust cost-effectiveness data relevant to disadvantaged groups to avoid wastage of scarce tobacco control resources. Strategies perceived to be effective for disadvantaged populations such as tailored or culturally relevant programs require rigorous evaluation so that potential adoption of these approaches is evidence-based. PMID:24314097

Comparison of psychological placebo and waiting list control conditions in the assessment of cognitive behavioral therapy for the treatment of generalized anxiety disorder: a meta-analysis

PubMed Central

ZHU, Zhipei; ZHANG, Li; JIANG, Jiangling; LI, Wei; CAO, Xinyi; ZHOU, Zhirui; ZHANG, Tiansong; LI, Chunbo

2014-01-01

Background There is ongoing debate about the efficacy of placebos in the treatment of mental disorders. In randomized control trials (RCTs) about the treatment of generalized anxiety disorder, the administration of a psychological placebo or placement on a waiting list are the two most common control conditions. But there has never been a systematic comparison of the clinical effect of these different strategies. Aim Compare the change in symptom severity among individuals treated with cognitive behavioral therapy, provided a psychological placebo, or placed on a waiting list using data from RCTs on generalized anxiety disorder. Methods The following databases were searched for RCTs on generalized anxiety disorder: PubMed, PsycInfo, EMBASE, The Cochrane Library, CNKI, Chongqing VIP, Wanfang, Chinese Biological Medical Literature Database, and Taiwan Electronic Periodical Services. Studies were selected based on pre-defined inclusion and exclusion criteria and the quality of each included study – based on the risk of bias and the level of evidence – was formally assessed. Meta-analysis was conducted using RevMan5.3 and network meta-analyses comparing the three groups were conducted using R. Results Twelve studies with a combined sample size of 531 were included in the analysis. Compared to either control method (placebo or waiting list), cognitive behavioral therapy was more effective for generalized anxiety disorder. Provision of a psychological placebo was associated with a significantly greater reduction of symptoms than placement on a waiting list. Eight of the studies were classified as ‘high risk of bias’, and the overall level of evidence was classified as ‘moderate’, indicating that further research could change the overall results of the meta-analysis. Conclusions RCTs about the treatment of generalized anxiety disorders are generally of moderate quality; they indicate the superiority of CBT but the results cannot, as yet, be considered robust. There is evidence of a non-negligible treatment effect of psychological placebos used as control conditions in research studies. This effect should be considered when designing and interpreting the results of randomized controlled trials about the effectiveness of psychotherapeutic interventions. PMID:25642106

Impacts of mobility disability and high and increasing body mass index on health-related quality of life and participation in society: a population-based cohort study from Sweden

PubMed Central

2014-01-01

Background Increasing obesity in adults with mobility disability has become a considerable health problem, similar to the increasing trend of obesity in the general population. The aims of this study were to investigate the association of mobility disability with overweight status and obesity in a large population-based Swedish cohort of adults, and to investigate whether mobility disability, high body mass index (BMI), and increasing BMI over time are predictors of health-related quality of life and participation in society after 8 years of follow-up. Methods The study cohort included 13,549 individuals aged 18–64 years who answered questions about mobility disability, weight, height, health-related quality of life and participation in society in the Stockholm Public Health Survey 2002 and 2010. The cohort was randomly selected from the population of Stockholm County, and divided into six subgroups based on data for mobility disability and overweight status. Multiple binary logistic regression analyses were performed to assess the likelihood for low health-related quality of life and lack of participation. Results Respondents with mobility disability had a higher mean BMI than those without mobility disability. Respondents both with and without mobility disability increased in BMI, but with no significant difference in the longitudinal changes (mean difference: 0.078; 95% CI: -0.16 - 0.32). Presence of mobility disability increased the risk of low health-related quality of life and lack of participation in 2010, irrespective of low health-related quality of life and lack of participation in 2002. The risk of pain and low general health (parts of health-related quality of life) increased for every 5 units of higher BMI reported in 2010. In respondents without low general health at baseline, the risk of obtaining low general health increased for every 5 units of higher BMI in 2010 (OR:1.60; CI: 1.47 - 1.74). Conclusions The greatest risk of low general health after 8 years was observed for respondents with both mobility disability and high BMI. These results indicate the importance of working preventively with persons with mobility disability and overweight status or obesity based on the risk of further weight gain. PMID:24742257

Reproducing the nonlinear dynamic behavior of a structured beam with a generalized continuum model

NASA Astrophysics Data System (ADS)

Vila, J.; Fernández-Sáez, J.; Zaera, R.

2018-04-01

In this paper we study the coupled axial-transverse nonlinear vibrations of a kind of one dimensional structured solids by application of the so called Inertia Gradient Nonlinear continuum model. To show the accuracy of this axiomatic model, previously proposed by the authors, its predictions are compared with numeric results from a previously defined finite discrete chain of lumped masses and springs, for several number of particles. A continualization of the discrete model equations based on Taylor series allowed us to set equivalent values of the mechanical properties in both discrete and axiomatic continuum models. Contrary to the classical continuum model, the inertia gradient nonlinear continuum model used herein is able to capture scale effects, which arise for modes in which the wavelength is comparable to the characteristic distance of the structured solid. The main conclusion of the work is that the proposed generalized continuum model captures the scale effects in both linear and nonlinear regimes, reproducing the behavior of the 1D nonlinear discrete model adequately.

Reverse Aging of Composite Materials for Aeronautical Applications

NASA Astrophysics Data System (ADS)

lannone, Michele

2008-08-01

Hygro-thermal ageing of polymer matrix composite materials is a major issue for all the aeronautical structures. For carbon-epoxy composites generally used in aeronautical applications the major effect of ageing is the humidity absorption, which induces a plasticization effect, generally decreasing Tg and elastic moduli, and finally design allowables. A thermodynamical and kinetic study has been performed, aimed to establish a program of periodic heating of the composite part, able to reversing the ageing effect by inducing water desorption. The study was founded on a simple model based on Fick's law, coupled with a concept of "relative saturation coefficient" depending on the different temperature of the composite part and the environment. The behaviour of some structures exposed to humidity and "reverse aged" by heating has been virtually tested. The conclusion of the study allowed to issue a specific patent application for aeronautical structures to be designed on the basis of a "humidity free" concept which allows the use of higher design allowables; having as final results lighter composite structures with a simplified certification process.

Knowledge, attitudes, beliefs and behaviors of general practitioners/family physicians toward their own vaccination: A systematic review

PubMed Central

Collange, Fanny; Verger, Pierre; Launay, Odile; Pulcini, Céline

2016-01-01

ABSTRACT Context: General practitioners and family physicians (GP/FPs) play a key role in the vaccination of the public in many countries and serve as role models for their patients through their own health behaviors. Objectives and Methods: a) To search for and document recommended/mandated vaccines for GP/FPs in high-income countries; b) To systematically search and review the literature on these physicians' knowledge, attitudes, beliefs, and behaviors (KABB) toward their own vaccination with the recommended/mandated vaccines and the factors determining it. Results: a) The 14 countries included recommended or mandated as many as 12 vaccines; b) The systematic review identified 11 studies published in the last 10 y. All considered seasonal influenza vaccination but differed in the variables investigated. Discussion/Conclusions: This review highlights the need for further studies on this topic, including qualitative and interventional studies (based on behavior change theories). These should cover occupational vaccines and determinants known to be associated with vaccine hesitancy. PMID:27078723

The probability heuristics model of syllogistic reasoning.

PubMed

Chater, N; Oaksford, M

1999-03-01

A probability heuristic model (PHM) for syllogistic reasoning is proposed. An informational ordering over quantified statements suggests simple probability based heuristics for syllogistic reasoning. The most important is the "min-heuristic": choose the type of the least informative premise as the type of the conclusion. The rationality of this heuristic is confirmed by an analysis of the probabilistic validity of syllogistic reasoning which treats logical inference as a limiting case of probabilistic inference. A meta-analysis of past experiments reveals close fits with PHM. PHM also compares favorably with alternative accounts, including mental logics, mental models, and deduction as verbal reasoning. Crucially, PHM extends naturally to generalized quantifiers, such as Most and Few, which have not been characterized logically and are, consequently, beyond the scope of current mental logic and mental model theories. Two experiments confirm the novel predictions of PHM when generalized quantifiers are used in syllogistic arguments. PHM suggests that syllogistic reasoning performance may be determined by simple but rational informational strategies justified by probability theory rather than by logic. Copyright 1999 Academic Press.

Practical decoy state for quantum key distribution

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

Ma Xiongfeng; Qi Bing; Zhao Yi

2005-07-15

Decoy states have recently been proposed as a useful method for substantially improving the performance of quantum key distribution (QKD). Here, we present a general theory of the decoy state protocol based on only two decoy states and one signal state. We perform optimization on the choice of intensities of the two decoy states and the signal state. Our result shows that a decoy state protocol with only two types of decoy states - the vacuum and a weak decoy state - asymptotically approaches the theoretical limit of the most general type of decoy state protocol (with an infinite numbermore » of decoy states). We also present a one-decoy-state protocol. Moreover, we provide estimations on the effects of statistical fluctuations and suggest that, even for long-distance (larger than 100 km) QKD, our two-decoy-state protocol can be implemented with only a few hours of experimental data. In conclusion, decoy state quantum key distribution is highly practical.« less

Transcontextual development of motivation in sport injury prevention among elite athletes.

PubMed

Chan, Derwin King Chung; Hagger, Martin S

2012-10-01

The present study investigated the transcontextual process of motivation in sport injury prevention. We examined whether general causality orientation, perceived autonomy support from coaches (PAS), self-determined motivation (SD-Mtv), and basic need satisfaction in a sport context predicted SD-Mtv, beliefs, and adherence with respect to sport injury prevention. Elite athletes (N = 533) completed self-report measures of the predictors (Week 1) and the dependent variables (Week 2). Variance-based structural equation modeling supported hypotheses: SD-Mtv in a sport context was significantly predicted by PAS and basic need satisfaction and was positively associated with SD-Mtv for sport injury prevention when controlling for general causality orientation. SD-Mtv for sport injury prevention was a significant predictor of adherence to injury-preventive behaviors and beliefs regarding safety in sport. In conclusion, the transcontextual mechanism of motivation may explain the process by which distal motivational factors in sport direct the formation of proximal motivation, beliefs, and behaviors of sport injury prevention.

On the thermodynamic framework of generalized coupled thermoelastic-viscoplastic-damage modeling

NASA Technical Reports Server (NTRS)

Arnold, S. M.; Saleeb, A. F.

1991-01-01

A complete potential based framework using internal state variables is put forth for the derivation of reversible and irreversible constitutive equations. In this framework, the existence of the total (integrated) form of either the (Helmholtz) free energy or the (Gibbs) complementary free energy are assumed a priori. Two options for describing the flow and evolutionary equations are described, wherein option one (the fully coupled form) is shown to be over restrictive while the second option (the decoupled form) provides significant flexibility. As a consequence of the decoupled form, a new operator, i.e., the Compliance operator, is defined which provides a link between the assumed Gibb's and complementary dissipation potential and ensures a number of desirable numerical features, for example the symmetry of the resulting consistent tangent stiffness matrix. An important conclusion reached, is that although many theories in the literature do not conform to the general potential framework outlined, it is still possible in some cases, by slight modifications of the used forms, to restore the complete potential structure.

Evidence-informed recommendations to reduce dissemination bias in clinical research: conclusions from the OPEN (Overcome failure to Publish nEgative fiNdings) project based on an international consensus meeting.

PubMed

Meerpohl, Joerg J; Schell, Lisa K; Bassler, Dirk; Gallus, Silvano; Kleijnen, Jos; Kulig, Michael; La Vecchia, Carlo; Marušić, Ana; Ravaud, Philippe; Reis, Andreas; Schmucker, Christine; Strech, Daniel; Urrútia, Gerard; Wager, Elizabeth; Antes, Gerd

2015-05-05

Dissemination bias in clinical research severely impedes informed decision-making not only for healthcare professionals and patients, but also for funders, research ethics committees, regulatory bodies and other stakeholder groups that make health-related decisions. Decisions based on incomplete and biased evidence cannot only harm people, but may also have huge financial implications by wasting resources on ineffective or harmful diagnostic and therapeutic measures, and unnecessary research. Owing to involvement of multiple stakeholders, it remains easy for any single group to assign responsibility for resolving the problem to others. To develop evidence-informed general and targeted recommendations addressing the various stakeholders involved in knowledge generation and dissemination to help overcome the problem of dissemination bias on the basis of previously collated evidence. Based on findings from systematic reviews, document analyses and surveys, we developed general and targeted draft recommendations. During a 2-day workshop in summer 2013, these draft recommendations were discussed with external experts and key stakeholders, and refined following a rigorous and transparent methodological approach. Four general, overarching recommendations applicable to all or most stakeholder groups were formulated, addressing (1) awareness raising, (2) implementation of targeted recommendations, (3) trial registration and results posting, and (4) systematic approaches to evidence synthesis. These general recommendations are complemented and specified by 47 targeted recommendations tailored towards funding agencies, pharmaceutical and device companies, research institutions, researchers (systematic reviewers and trialists), research ethics committees, trial registries, journal editors and publishers, regulatory agencies, benefit (health technology) assessment institutions and legislators. Despite various recent examples of dissemination bias and several initiatives to reduce it, the problem of dissemination bias has not been resolved. Tailored recommendations based on a comprehensive approach will hopefully help increase transparency in biomedical research by overcoming the failure to disseminate negative findings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Radiation induced dissolution of UO 2 based nuclear fuel - A critical review of predictive modelling approaches

NASA Astrophysics Data System (ADS)

Eriksen, Trygve E.; Shoesmith, David W.; Jonsson, Mats

2012-01-01

Radiation induced dissolution of uranium dioxide (UO 2) nuclear fuel and the consequent release of radionuclides to intruding groundwater are key-processes in the safety analysis of future deep geological repositories for spent nuclear fuel. For several decades, these processes have been studied experimentally using both spent fuel and various types of simulated spent fuels. The latter have been employed since it is difficult to draw mechanistic conclusions from real spent nuclear fuel experiments. Several predictive modelling approaches have been developed over the last two decades. These models are largely based on experimental observations. In this work we have performed a critical review of the modelling approaches developed based on the large body of chemical and electrochemical experimental data. The main conclusions are: (1) the use of measured interfacial rate constants give results in generally good agreement with experimental results compared to simulations where homogeneous rate constants are used; (2) the use of spatial dose rate distributions is particularly important when simulating the behaviour over short time periods; and (3) the steady-state approach (the rate of oxidant consumption is equal to the rate of oxidant production) provides a simple but fairly accurate alternative, but errors in the reaction mechanism and in the kinetic parameters used may not be revealed by simple benchmarking. It is essential to use experimentally determined rate constants and verified reaction mechanisms, irrespective of whether the approach is chemical or electrochemical.

Rehabilitation or compensation: time for a fresh perspective on speech and language therapy for dysphagia and Parkinson's disease?

PubMed

Smith, Sarah K; Roddam, Hazel; Sheldrick, Heulwen

2012-01-01

Dysphagia is a common symptom of Parkinson's disease and can have negative consequences for physical health and quality of life. A variety of treatment options are available to clinicians working with people who have dysphagia and Parkinson's disease. These options can be broadly categorized as being compensatory or rehabilitative in nature. To explore the evidence behind treatment options available to clinicians working with dysphagia and Parkinson's disease and to draw conclusions about whether compensatory or rehabilitative approaches are likely to provide the best outcomes for our patients. A critical literature review of compensatory and rehabilitative interventions for dysphagia in Parkinson's disease was undertaken. Relevant studies were analysed for their robustness and potential clinical applications. General conclusions were drawn based on the evidence base identified in this review. This review outlines the lack of evidence supporting both compensatory and rehabilitative methods of treating dysphagia in Parkinson's disease. It directs clinicians and researchers towards areas that require further investigation. To date, compensatory methods of treating dysphagia in Parkinson's disease have received more research attention than rehabilitative methods and yet neither approach has a strong evidence base. This review argues that rehabilitative methods could possibly have greater potential to increase swallowing safety and improve quality of life in the long-term than compensatory methods alone. However, at present there is a lack of research in this area. © 2012 Royal College of Speech and Language Therapists.

Detection of clinically relevant copy-number variants by exome sequencing in a large cohort of genetic disorders

PubMed Central

Pfundt, Rolph; del Rosario, Marisol; Vissers, Lisenka E.L.M.; Kwint, Michael P.; Janssen, Irene M.; de Leeuw, Nicole; Yntema, Helger G.; Nelen, Marcel R.; Lugtenberg, Dorien; Kamsteeg, Erik-Jan; Wieskamp, Nienke; Stegmann, Alexander P.A.; Stevens, Servi J.C.; Rodenburg, Richard J.T.; Simons, Annet; Mensenkamp, Arjen R.; Rinne, Tuula; Gilissen, Christian; Scheffer, Hans; Veltman, Joris A.; Hehir-Kwa, Jayne Y.

2017-01-01

Purpose: Copy-number variation is a common source of genomic variation and an important genetic cause of disease. Microarray-based analysis of copy-number variants (CNVs) has become a first-tier diagnostic test for patients with neurodevelopmental disorders, with a diagnostic yield of 10–20%. However, for most other genetic disorders, the role of CNVs is less clear and most diagnostic genetic studies are generally limited to the study of single-nucleotide variants (SNVs) and other small variants. With the introduction of exome and genome sequencing, it is now possible to detect both SNVs and CNVs using an exome- or genome-wide approach with a single test. Methods: We performed exome-based read-depth CNV screening on data from 2,603 patients affected by a range of genetic disorders for which exome sequencing was performed in a diagnostic setting. Results: In total, 123 clinically relevant CNVs ranging in size from 727 bp to 15.3 Mb were detected, which resulted in 51 conclusive diagnoses and an overall increase in diagnostic yield of ~2% (ranging from 0 to –5.8% per disorder). Conclusions: This study shows that CNVs play an important role in a broad range of genetic disorders and that detection via exome-based CNV profiling results in an increase in the diagnostic yield without additional testing, bringing us closer to single-test genomics. Genet Med advance online publication 27 October 2016 PMID:28574513

Image Understanding and Information Extraction\\

DTIC Science & Technology

1977-11-01

mentation and generalization of DeCarlo’s Nyquist-like stability test [15,161. The last step of the procedure is to check whether this zero ...Several general sta- bility theorems which relate stability to the zero set of B(w,z) have been presented. These theorems led to the conclusion that...Spatial Stochastic Model for Contextual Pattern Recognition . ° . .............. 88 T. S. Yu and K. S. Fu V. PREPROCESSING 1. Stability of General Two

Teleportation of a general two-mode coherent-state superposition via attenuated quantum channels with ideal and/or threshold detectors

NASA Astrophysics Data System (ADS)

An, Nguyen Ba

2009-04-01

Three novel probabilistic yet conclusive schemes are proposed to teleport a general two-mode coherent-state superposition via attenuated quantum channels with ideal and/or threshold detectors. The calculated total success probability is highest (lowest) when only ideal (threshold) detectors are used.

Issues in Proposing a General Model of the Effects of Divorce on Children.

ERIC Educational Resources Information Center

Kurdek, Lawrence A.

1993-01-01

Responds to previous article by Amato on children's adjustment to divorce. Focuses on two aspects of Amato's review: the mechanics of the review (perspectives advanced, criteria used to evaluate generated hypotheses, and accuracy of conclusions) and critical comments raised about the existing literature and in particular the proposed general model…

Smart Management in Effective Schools: Effective Management Configurations in General and Vocational Education in the Netherlands

ERIC Educational Resources Information Center

Hofman, W. H. Adriaan; Hofman, Roelande H.

2011-01-01

Purpose: In this study the authors focus on different (configurations of) leadership or management styles in schools for general and vocational education. Findings: Using multilevel (students and schools) analyses, strong differences in effective management styles between schools with different student populations were observed. Conclusions: The…

Budget Execution (O&M,N) at Navy Shore Activities.

DTIC Science & Technology

1980-12-01

training emphasis at shore commands. Finally, appropriate recommendations for system improvements and further research are made. II II DD O 73 23 14...improvements and further research are made. 44 TABLE OF CONTENTS Page I. INTRODUCTION --------------------------------------- 11 A. GENERAL...253 11. General Conclusion ------------------------- 254 D. FURTHER RESEARCH -------------------------------255 E. CONCLUDING REMARKS

General Revenue Sharing Data Study: Executive Summary. Volume I.

ERIC Educational Resources Information Center

Wilson, Reese C.; Bowditch, E. Francis, Jr.

The results of the General Revenue Sharing Data Study carried out by Stanford Research Institute for the Office of Revenue Sharing are reported in four volumes. This volume, Executive Summary, presents highlights excerpted from Volumes II, III, and IV. Emphasis is placed on those findings, conclusions, and recommendations that deserve special…

Cytosine-based nucleoside analogs are selectively lethal to DNA mismatch repair-deficient tumour cells by enhancing levels of intracellular oxidative stress

PubMed Central

Hewish, M; Martin, S A; Elliott, R; Cunningham, D; Lord, C J; Ashworth, A

2013-01-01

Background: DNA mismatch repair deficiency is present in a significant proportion of a number of solid tumours and is associated with distinct clinical behaviour. Methods: To identify the therapeutic agents that might show selectivity for mismatch repair-deficient tumour cells, we screened a pair of isogenic MLH1-deficient and MLH1-proficient tumour cell lines with a library of clinically used drugs. To test the generality of hits in the screen, selective agents were retested in cells deficient in the MSH2 mismatch repair gene. Results: We identified cytarabine and other related cytosine-based nucleoside analogues as being selectively toxic to MLH1 and MSH2-deficient tumour cells. The selective cytotoxicity we observed was likely caused by increased levels of cellular oxidative stress, as it could be abrogated by antioxidants. Conclusion: We propose that cytarabine-based chemotherapy regimens may represent a tumour-selective treatment strategy for mismatch repair-deficient cancers. PMID:23361057

"Effects of a Web-Based Intervention on Family Functioning Following Pediatric Traumatic Brain Injury"

PubMed Central

Minich, Nori; Taylor, H. Gerry; Kirkwood, Michael; Brown, Tanya Maines; Stancin, Terry; Wade, Shari L

2015-01-01

Objective Investigate effectiveness of an online Counselor-Assisted Problem-Solving (CAPS) intervention on family functioning after traumatic brain injury (TBI). Methods Participants were randomized to CAPS (n = 65) or internet resource comparison (IRC; n = 67). CAPS is a counselor-assisted web-based program. IRC was given access to online resources. Outcomes were examined 6 months, 12 months, and 18 months after baseline. Injury severity, age, and SES were examined as moderators. Results A main effect of time was noted for teen-reported conflict and parent-reported problem solving. CAPS had decreased parent-reported conflict and a reduction in parental effective communication. Effects were specific to subsets of the sample. Conclusions CAPS, a family-based problem-solving intervention designed to address problem behaviors, had modest effects on some aspects of family functioning, when compared to IRC. Effects were generally limited to subsets of the families and were not evident across all follow-up assessments. PMID:26461100

Outcomes of a Pilot Hand Hygiene Randomized Cluster Trial to Reduce Communicable Infections Among US Office-Based Employees

PubMed Central

DuBois, Cathy L.Z.; Grey, Scott F.; Kingsbury, Diana M.; Shakya, Sunita; Scofield, Jennifer; Slenkovich, Ken

2015-01-01

Objective: To determine the effectiveness of an office-based multimodal hand hygiene improvement intervention in reducing self-reported communicable infections and work-related absence. Methods: A randomized cluster trial including an electronic training video, hand sanitizer, and educational posters (n = 131, intervention; n = 193, control). Primary outcomes include (1) self-reported acute respiratory infections (ARIs)/influenza-like illness (ILI) and/or gastrointestinal (GI) infections during the prior 30 days; and (2) related lost work days. Incidence rate ratios calculated using generalized linear mixed models with a Poisson distribution, adjusted for confounders and random cluster effects. Results: A 31% relative reduction in self-reported combined ARI-ILI/GI infections (incidence rate ratio: 0.69; 95% confidence interval, 0.49 to 0.98). A 21% nonsignificant relative reduction in lost work days. Conclusions: An office-based multimodal hand hygiene improvement intervention demonstrated a substantive reduction in self-reported combined ARI-ILI/GI infections. PMID:25719534

Addressing Control Research Issues Leading to Piloted Simulations in Support of the IFCS F-15

NASA Technical Reports Server (NTRS)

Napolitano, Marcello; Perhinschi, Mario; Campa, Giampiero; Seanor, Brad

2004-01-01

This report summarizes the research effort by a team of researchers at West Virginia University in support of the NASA Intelligent Flight Control System (IFCS) F-15 program. In particular, WVU researchers assisted NASA Dryden researchers in the following technical tasks leading to piloted simulation of the 'Gen_2' IFCS control laws. Task #1- Performance comparison of different neural network (NN) augmentation for the Dynamic Inversion (DI) -based VCAS 'Gen_2' control laws. Task #2- Development of safety monitor criteria for transition to research control laws with and without failure during flight test. Task #3- Fine-tuning of the 'Gen_2' control laws for cross-coupling reduction at post-failure conditions. Matlab/Simulink-based simulation codes were provided to the technical monitor on a regular basis throughout the duration of the project. Additional deliverables for the project were Power Point-based slides prepared for different project meetings. This document provides a description of the methodology and discusses the general conclusions from the simulation results.

Huntington disease reduced penetrance alleles occur at high frequency in the general population

PubMed Central

Kay, Chris; Collins, Jennifer A.; Miedzybrodzka, Zosia; Madore, Steven J.; Gordon, Erynn S.; Gerry, Norman; Davidson, Mark; Slama, Ramy A.

2016-01-01

Objective: To directly estimate the frequency and penetrance of CAG repeat alleles associated with Huntington disease (HD) in the general population. Methods: CAG repeat length was evaluated in 7,315 individuals from 3 population-based cohorts from British Columbia, the United States, and Scotland. The frequency of ≥36 CAG alleles was assessed out of a total of 14,630 alleles. The general population frequency of reduced penetrance alleles (36–39 CAG) was compared to the prevalence of patients with HD with genetically confirmed 36–39 CAG from a multisource clinical ascertainment in British Columbia, Canada. The penetrance of 36–38 CAG repeat alleles for HD was estimated for individuals ≥65 years of age and compared against previously reported clinical penetrance estimates. Results: A total of 18 of 7,315 individuals had ≥36 CAG, revealing that approximately 1 in 400 individuals from the general population have an expanded CAG repeat associated with HD (0.246%). Individuals with CAG 36–37 genotypes are the most common (36, 0.096%; 37, 0.082%; 38, 0.027%; 39, 0.000%; ≥40, 0.041%). General population CAG 36–38 penetrance rates are lower than penetrance rates extrapolated from clinical cohorts. Conclusion: HD alleles with a CAG repeat length of 36–38 occur at high frequency in the general population. The infrequent diagnosis of HD at this CAG length is likely due to low penetrance. Another important contributing factor may be reduced ascertainment of HD in those of older age. PMID:27335115

Trust in the Medical Profession: Conceptual and Measurement Issues

PubMed Central

Hall, Mark A; Camacho, Fabian; Dugan, Elizabeth; Balkrishnan, Rajesh

2002-01-01

Objective To develop and test a multi-item measure for general trust in physicians, in contrast with trust in a specific physician. Data Sources Random national telephone survey of 502 adult subjects with a regular physician and source of payment. Study Design Based on a multidimensional conceptual model, a large pool of candidate items was generated, tested, and revised using focus groups, expert reviewers, and pilot testing. The scale was analyzed for its factor structure, internal consistency, construct validity, and other psychometric properties. Principal Findings The resulting 11-item scale measuring trust in physicians generally is consistent with most aspects of the conceptual model except that it does not include the dimension of confidentiality. This scale has a single-factor structure, good internal consistency (alpha=.89), and good response variability (range=11–54; mean=33.5; SD=6.9). This scale is related to satisfaction with care, trust in one's physician, following doctors' recommendations, having no prior disputes with physicians, not having sought second opinions, and not having changed doctors. No association was found with race/ethnicity. While general trust and interpersonal trust are qualitatively similar, they are only moderately correlated with each other and general trust is substantially lower. Conclusions Emerging research on patients' trust has focused on interpersonal trust in a specific, known physician. Trust in physicians in general is also important and differs significantly from interpersonal physician trust. General physician trust potentially has a strong influence on important behaviors and attitudes, and on the formation of interpersonal physician trust. PMID:12479504

[Fax Survey to Elucidate the Information Needs of General Practitioners in Lower Saxony Regarding the Topic of Medical Implants].

PubMed

Schaper, M; Berndt, M; Schrimpf, C; Wilhelmi, M; Elff, M; Haverich, A; Wilhelmi, M

2016-12-01

Background: Medial implants help a multitude of patients to gain more health, mobility and thus, quality of life. In collaboration with a still growing expectation of life especially, i.e., within Western industrial countries, this has led to an increasing use of implants over the last years. However, although biomechanical characteristics of modern implant materials have improved considerably, one big challenge still exists - the implant-associated infection. Early diagnostic and therapeutic interventions could clearly mitigate this issue, but are general practitioners sufficiently informed regarding this topic? Material and Methods: In March 2013 and in close cooperation with the Lower Saxony association of general practitioners, we initiated a survey to elucidate the information demands of general practitioners regarding the topic of medical implants. A total of 939 members of the association were contacted via fax and 101 (10.8 %) responded. Based on the obtained data, we then evaluated which topics are most interesting for this group of medical professionals. Results: The survey clearly indicates that general practitioners request more general implant-related data, e.g., type and specification of an implant as well as its location within the individual patient and contact addresses of the implanting hospital, but also want more specific information regarding diagnostic and therapeutic strategies in the case of implant-associated complications. Conclusion: The present article reports in detail on the conducted fax survey and shows some initial strategies as to how the identified challenges might be faced. Georg Thieme Verlag KG Stuttgart · New York.

First 101 Robotic General Surgery Cases in a Community Hospital

PubMed Central

Robertson, Jarrod C.; Alrajhi, Sharifah

2016-01-01

Background and Objectives: The general surgeon's robotic learning curve may improve if the experience is classified into categories based on the complexity of the procedures in a small community hospital. The intraoperative time should decrease and the incidence of complications should be comparable to conventional laparoscopy. The learning curve of a single robotic general surgeon in a small community hospital using the da Vinci S platform was analyzed. Methods: Measured parameters were operative time, console time, conversion rates, complications, surgical site infections (SSIs), surgical site occurrences (SSOs), length of stay, and patient demographics. Results: Between March 2014 and August 2015, 101 robotic general surgery cases were performed by a single surgeon in a 266-bed community hospital, including laparoscopic cholecystectomies, inguinal hernia repairs; ventral, incisional, and umbilical hernia repairs; and colorectal, foregut, bariatric, and miscellaneous procedures. Ninety-nine of the cases were completed robotically. Seven patients were readmitted within 30 days. There were 8 complications (7.92%). There were no mortalities and all complications were resolved with good outcomes. The mean operative time was 233.0 minutes. The mean console operative time was 117.6 minutes. Conclusion: A robotic general surgery program can be safely implemented in a small community hospital with extensive training of the surgical team through basic robotic skills courses as well as supplemental educational experiences. Although the use of the robotic platform in general surgery could be limited to complex procedures such as foregut and colorectal surgery, it can also be safely used in a large variety of operations with results similar to those of conventional laparoscopy. PMID:27667913

Following the funding trail: Financing, nurses and teamwork in Australian general practice

PubMed Central

2011-01-01

Background Across the globe the emphasis on roles and responsibilities of primary care teams is under scrutiny. This paper begins with a review of general practice financing in Australia, and how nurses are currently funded. We then examine the influence on funding structures on the role of the nurse. We set out three dilemmas for policy-makers in this area: lack of an evidence base for incentives, possible untoward impacts on interdisciplinary functioning, and the substitution/enhancement debate. Methods This three year, multimethod study undertook rapid appraisal of 25 general practices and year-long studies in seven practices where a change was introduced to the role of the nurse. Data collected included interviews with nurses (n = 36), doctors (n = 24), and managers (n = 22), structured observation of the practice nurse (51 hours of observation), and detailed case studies of the change process in the seven year-long studies. Results Despite specific fee-for-service funding being available, only 6% of nurse activities generated such a fee. Yet the influence of the funding was to focus nurse activity on areas that they perceived were peripheral to their roles within the practice. Conclusions Interprofessional relationships and organisational climate in general practices are highly influential in terms of nursing role and the ability of practices to respond to and utilise funding mechanisms. These factors need to be considered, and the development of optimal teamwork supported in the design and implementation of further initiatives that financially support nursing in general practice. PMID:21329506

Narrative Performance of Gifted African American School-Aged Children From Low-Income Backgrounds

PubMed Central

2015-01-01

Purpose This study investigated classroom differences in the narrative performance of school-age African American English (AAE)-speaking children in gifted and general education classrooms. Method Forty-three children, Grades 2–5, each generated fictional narratives in response to the book Frog, Where Are You? (Mayer, 1969). Differences in performance on traditional narrative measures (total number of communication units [C-units], number of different words, and mean length of utterance in words) and on AAE production (dialect density measure) between children in gifted and general education classrooms were examined. Results There were no classroom-based differences in total number of C-units, number of different words, and mean length of utterance in words. Children in gifted education classrooms produced narratives with lower dialect density than did children in general educated classrooms. Direct logistic regression assessed whether narrative dialect density measure scores offered additional information about giftedness beyond scores on the Peabody Picture Vocabulary Test–Fourth Edition (Dunn & Dunn, 2007), a standard measure of language ability. Results indicated that a model with only Peabody Picture Vocabulary Test–Fourth Edition scores best discriminated children in the 2 classrooms. Conclusion African American children across gifted and general education classrooms produce fictional narratives of similar length, lexical diversity, and syntax complexity. However, African American children in gifted education classrooms may produce lower rates of AAE and perform better on standard measures of vocabulary than those in general education classrooms. PMID:25409770

Distinct white matter abnormalities in different idiopathic generalized epilepsy syndromes.

PubMed

Liu, Min; Concha, Luis; Beaulieu, Christian; Gross, Donald W

2011-12-01

By definition idiopathic generalized epilepsy (IGE) is not associated with structural abnormalities on conventional magnetic resonance imaging (MRI). However, recent quantitative studies suggest white and gray matter alterations in IGE. The purpose of this study was to investigate whether there are white and/or gray matter structural differences between controls and two subsets of IGE, namely juvenile myoclonic epilepsy (JME) and IGE with generalized tonic-clonic seizures only (IGE-GTC). We assessed white matter integrity and gray matter volume using diffusion tensor tractography-based analysis of fractional anisotropy and voxel-based morphometry, respectively, in 25 patients with IGE, all of whom had experienced generalized tonic-clonic convulsions. Specifically, 15 patients with JME and 10 patients with IGE-GTC were compared to two groups of similarly matched controls separately. Correlations between total lifetime generalized tonic-clonic seizures and fractional anisotropy were investigated for both groups. Tractography revealed lower fractional anisotropy in specific tracts including the crus of the fornix, body of corpus callosum, uncinate fasciculi, superior longitudinal fasciculi, anterior limb of internal capsule, and corticospinal tracts in JME with respect to controls, whereas there were no fractional anisotropy differences in IGE-GTC. No correlation was found between fractional anisotropy and total lifetime generalized tonic-clonic seizures for either JME or IGE-GTC. Although false discovery rate-corrected voxel-based morphometry (VBM) showed no gray matter volume differences between patient and control groups, spatial extent cluster-corrected VBM analysis suggested a trend of gray matter volume reduction in frontal and central regions in both patient groups, more lateral in JME and more medial in IGE-GTC. The findings support the idea that the clinical syndromes of JME and IGE-GTC have unique anatomic substrates. The fact that the primary clinical difference between JME and IGE-GTC is the occurrence of myoclonus in the former raises the possibility that disruption of white matter integrity may be the underlying mechanism responsible for myoclonus in JME. The cross-sectional study design and relatively small number of subjects limits the conclusions that can be drawn here; however, the absence of a correlation between fractional anisotropy and lifetime seizures is suggestive that the white matter abnormalities observed in JME may not be secondary to seizures. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.

Vibration response of buildings to rail transit groundborne vibration

NASA Astrophysics Data System (ADS)

Phillips, James

2005-09-01

The FTA guidelines for detailed analysis and prediction of groundborne noise and vibration generated by rail transit systems are based on established empirical methods. The procedures for the measurement of vehicle/track system source strength and the attenuation of vibration as it propagates with distance through the ground are generally accepted practice at this time. However, characterization of the building response is open to debate, due in part to the wide array of building construction encountered adjacent to transit systems. Numerous measurements that have been obtained in a variety of building construction types are presented and preliminary conclusions are drawn regarding the responses of several common building types to rail transit groundborne vibration.

Flavor asymmetry of the nucleon sea and the five-quark components of the nucleons.

PubMed

Chang, Wen-Chen; Peng, Jen-Chieh

2011-06-24

The existence of the five-quark Fock states for the intrinsic charm quark in the nucleons was suggested some time ago, but conclusive evidence is still lacking. We generalize the previous theoretical approach to the light-quark sector and study possible experimental signatures for such five-quark states. In particular, we compare the d-ū and ū + d-s-s data with the calculations based on the five-quark Fock states. The qualitative agreement between the data and the calculations is interpreted as evidence for the existence of the intrinsic light-quark sea in the nucleons. The probabilities for the |uuduū and |uuddd Fock states are also extracted.

Scientific-practical and legal problems of implementation of the personalized medicine.

PubMed

Bezdieniezhnykh, N O; Reznikova, V V; Rossylna, O V

2017-09-01

The article is devoted to the comprehensive analysis of scientific, practical and legal issues of personalized medicine that is a rapidly developing science-driven approach to healthcare. It is concluded that there is lack of general legal framework for the encouragement of scientific researches and practical implementation in this field. The article shows foreign experience and prospects for the introduction of personalized medicine as a key concept of healthcare system, which is based on a selection of diagnostic, therapeutic and preventive measures that would be the most effective for a particular person in view of individual characteristics. The conclusions and proposals to improve the current legislation and development of personalized medicine in Ukraine are suggested.

The Conservation Reserve Program: Planting for the future. Proceedings of a National Conference, Fort Collins, Colorado, June 6-9, 2004

USGS Publications Warehouse

Allen, Arthur W.; Vandever, Mark W.

2005-01-01

Contrary to conventions in most USGS publications and current scientific literature, measures of area and length in this publication are generally presented in acres or miles rather than metric measures (e.g., hectares, kilometers). This approach was adopted because townships, sections, and acres define the United States landscape and are the units of measure upon which management of agricultural lands in this nation is based. Unless noted otherwise, the authors of the respective chapters provided all photographs and figures presented in this document. The findings, conclusions, and recommendations expressed in this document are those of the author(s) and do not necessarily represent those of the USGS.

Three-D Flow Analysis of the Alternate SSME HPOT TAD

NASA Technical Reports Server (NTRS)

Kubinski, Cheryl A.

1993-01-01

This paper describes the results of numerical flow analyses performed in support of design development of the Space Shuttle Main Engine Alternate High Pressure Oxidizer Turbine Turn-around duct (TAD). The flow domain has been modeled using a 3D, Navier-Stokes, general purpose flow solver. The goal of this effort is to achieve an alternate TAD exit flow distribution which closely matches that of the baseline configuration. 3D Navier Stokes CFD analyses were employed to evaluate numerous candidate geometry modifications to the TAD flowpath in order to achieve this goal. The design iterations are summarized, as well as a description of the computational model, numerical results and the conclusions based on these calculations.

A Dopaminergic Gene Cluster in the Prefrontal Cortex Predicts Performance Indicative of General Intelligence in Genetically Heterogeneous Mice

PubMed Central

Kolata, Stefan; Light, Kenneth; Wass, Christopher D.; Colas-Zelin, Danielle; Roy, Debasri; Matzel, Louis D.

2010-01-01

Background Genetically heterogeneous mice express a trait that is qualitatively and psychometrically analogous to general intelligence in humans, and as in humans, this trait co-varies with the processing efficacy of working memory (including its dependence on selective attention). Dopamine signaling in the prefrontal cortex (PFC) has been established to play a critical role in animals' performance in both working memory and selective attention tasks. Owing to this role of the PFC in the regulation of working memory, here we compared PFC gene expression profiles of 60 genetically diverse CD-1 mice that exhibited a wide range of general learning abilities (i.e., aggregate performance across five diverse learning tasks). Methodology/Principal Findings Animals' general cognitive abilities were first determined based on their aggregate performance across a battery of five diverse learning tasks. With a procedure designed to minimize false positive identifications, analysis of gene expression microarrays (comprised of ≈25,000 genes) identified a small number (<20) of genes that were differentially expressed across animals that exhibited fast and slow aggregate learning abilities. Of these genes, one functional cluster was identified, and this cluster (Darpp-32, Drd1a, and Rgs9) is an established modulator of dopamine signaling. Subsequent quantitative PCR found that expression of these dopaminegic genes plus one vascular gene (Nudt6) were significantly correlated with individual animal's general cognitive performance. Conclusions/Significance These results indicate that D1-mediated dopamine signaling in the PFC, possibly through its modulation of working memory, is predictive of general cognitive abilities. Furthermore, these results provide the first direct evidence of specific molecular pathways that might potentially regulate general intelligence. PMID:21103339

The Diagnostic Validity and Reliability of an Internet-Based Clinical Assessment Program for Mental Disorders

PubMed Central

Klein, Britt; Meyer, Denny; Austin, David William; Abbott, Jo-Anne M

2015-01-01

Background Internet-based assessment has the potential to assist with the diagnosis of mental health disorders and overcome the barriers associated with traditional services (eg, cost, stigma, distance). Further to existing online screening programs available, there is an opportunity to deliver more comprehensive and accurate diagnostic tools to supplement the assessment and treatment of mental health disorders. Objective The aim was to evaluate the diagnostic criterion validity and test-retest reliability of the electronic Psychological Assessment System (e-PASS), an online, self-report, multidisorder, clinical assessment and referral system. Methods Participants were 616 adults residing in Australia, recruited online, and representing prospective e-PASS users. Following e-PASS completion, 158 participants underwent a telephone-administered structured clinical interview and 39 participants repeated the e-PASS within 25 days of initial completion. Results With structured clinical interview results serving as the gold standard, diagnostic agreement with the e-PASS varied considerably from fair (eg, generalized anxiety disorder: κ=.37) to strong (eg, panic disorder: κ=.62). Although the e-PASS’ sensitivity also varied (0.43-0.86) the specificity was generally high (0.68-1.00). The e-PASS sensitivity generally improved when reducing the e-PASS threshold to a subclinical result. Test-retest reliability ranged from moderate (eg, specific phobia: κ=.54) to substantial (eg, bulimia nervosa: κ=.87). Conclusions The e-PASS produces reliable diagnostic results and performs generally well in excluding mental disorders, although at the expense of sensitivity. For screening purposes, the e-PASS subclinical result generally appears better than a clinical result as a diagnostic indicator. Further development and evaluation is needed to support the use of online diagnostic assessment programs for mental disorders. Trial Registration Australian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG). PMID:26392066

Prevalence of urinary tract infection in acutely unwell children in general practice: a prospective study with systematic urine sampling

PubMed Central

O’Brien, Kathryn; Edwards, Adrian; Hood, Kerenza; Butler, Christopher C

2013-01-01

Background Urinary tract infection (UTI) in children may be associated with long-term complications that could be prevented by prompt treatment. Aim To determine the prevalence of UTI in acutely ill children ≤ 5 years presenting in general practice and to explore patterns of presenting symptoms and urine sampling strategies. Design and setting Prospective observational study with systematic urine sampling, in general practices in Wales, UK. Method In total, 1003 children were recruited from 13 general practices between March 2008 and July 2010. The prevalence of UTI was determined and multivariable analysis performed to determine the probability of UTI. Result Out of 597 (60.0%) children who provided urine samples within 2 days, the prevalence of UTI was 5.9% (95% confidence interval [CI] = 4.3% to 8.0%) overall, 7.3% in those < 3 years and 3.2% in 3–5 year olds. Neither a history of fever nor the absence of an alternative source of infection was associated with UTI (P = 0.64; P = 0.69, respectively). The probability of UTI in children aged ≥3 years without increased urinary frequency or dysuria was 2%. The probability of UTI was ≥5% in all other groups. Urine sampling based purely on GP suspicion would have missed 80% of UTIs, while a sampling strategy based on current guidelines would have missed 50%. Conclusion Approximately 6% of acutely unwell children presenting to UK general practice met the criteria for a laboratory diagnosis of UTI. This higher than previously recognised prior probability of UTI warrants raised awareness of the condition and suggests clinicians should lower their threshold for urine sampling in young children. The absence of fever or presence of an alternative source of infection, as emphasised in current guidelines, may not rule out UTI in young children with adequate certainty. PMID:23561695

Users’ thoughts and opinions about a self-regulation-based eHealth intervention targeting physical activity and the intake of fruit and vegetables: A qualitative study

PubMed Central

De Bourdeaudhuij, Ilse; Verloigne, Maïté; Shadid, Samyah; Crombez, Geert

2017-01-01

Purpose EHealth interventions are effective in changing health behaviours, such as increasing physical activity and altering dietary habits, but suffer from high attrition rates. In order to create interventions that are adapted to end-users, in-depth investigations about their opinions and preferences are required. As opinions and preferences may vary for different target groups, we explored these in two groups: the general population and a clinical sample. Methods Twenty adults from the general population (mean age = 42.65, 11 women) and twenty adults with type 2 diabetes (mean age = 64.30, 12 women) performed ‘MyPlan 1.0’, which is a self-regulation-based eHealth intervention designed to increase physical activity and the intake of fruit and vegetables in the general population. The opinions and preferences of end-users were explored using a think aloud procedure and a questionnaire. During a home visit, participants were invited to think aloud while performing ‘MyPlan 1.0’. The thoughts were transcribed verbatim and inductive thematic analysis was applied. Results Both groups had similar opinions regarding health behaviours and ‘MyPlan 1.0’. Participants generally liked the website, but often experienced it as time-consuming. Furthermore, they regularly mentioned that a mobile application would be useful to remind them about their goals on a daily basis. Finally, users’ ideas about how to pursue health behaviours often hindered them to correctly use the website. Conclusions Although originally created for the general population, ‘MyPlan 1.0’ can also be used in adults with type 2 diabetes. Nevertheless, more adaptations are needed to make the eHealth intervention more convenient and less time-consuming. Furthermore, users’ ideas regarding a healthy lifestyle should be taken into account when designing online interventions. PMID:29267396

Anticipation - the underlying science of sport. Report on research in progress

NASA Astrophysics Data System (ADS)

Nadin, Mihai

2015-05-01

Professional sport practitioners intuitively acknowledge anticipation. Sports researchers sometimes discuss it. Still, there is little data-based evidence to characterize the role anticipation plays in human performance. Even less documented is the distinction between reaction and anticipation. This text presents the real-time quantification environment developed as an AnticipationScope™. Based on a very large data harvest from this experimental set-up, hypotheses regarding the role of anticipation in sport are advanced. The conclusion is that while preparation and reaction play an important role in sports performance, in the final analysis anticipation distinguishes the professional from other sport practitioners. Work in progress is presented with the aim of engaging the community of researchers in the design of alternative methods for quantifying anticipation and for processing the data. Generalization from sport to human performance is one of the intended outcomes of this research.

Issues and Challenges in the Design of Culturally Adapted Evidence-Based Interventions

PubMed Central

Castro, Felipe González; Barrera, Manuel; Holleran Steiker, Lori K.

2014-01-01

This article examines issues and challenges in the design of cultural adaptations that are developed from an original evidence-based intervention (EBI). Recently emerging multistep frameworks or stage models are examined, as these can systematically guide the development of culturally adapted EBIs. Critical issues are also presented regarding whether and how such adaptations may be conducted, and empirical evidence is presented regarding the effectiveness of such cultural adaptations. Recent evidence suggests that these cultural adaptations are effective when applied with certain subcultural groups, although they are less effective when applied with other subcultural groups. Generally, current evidence regarding the effectiveness of cultural adaptations is promising but mixed. Further research is needed to obtain more definitive conclusions regarding the efficacy and effectiveness of culturally adapted EBIs. Directions for future research and recommendations are presented to guide the development of a new generation of culturally adapted EBIs. PMID:20192800

Automatic Match between Delimitation Line and Real Terrain Based on Least-Cost Path Analysis

NASA Astrophysics Data System (ADS)

Feng, C. Q.; Jiang, N.; Zhang, X. N.; Ma, J.

2013-11-01

Nowadays, during the international negotiation on separating dispute areas, manual adjusting is lonely applied to the match between delimitation line and real terrain, which not only consumes much time and great labor force, but also cannot ensure high precision. Concerning that, the paper mainly explores automatic match between them and study its general solution based on Least -Cost Path Analysis. First, under the guidelines of delimitation laws, the cost layer is acquired through special disposals of delimitation line and terrain features line. Second, a new delimitation line gets constructed with the help of Least-Cost Path Analysis. Third, the whole automatic match model is built via Module Builder in order to share and reuse it. Finally, the result of automatic match is analyzed from many different aspects, including delimitation laws, two-sided benefits and so on. Consequently, a conclusion is made that the method of automatic match is feasible and effective.

Maternal alcohol consumption and offspring DNA methylation: findings from six general population-based birth cohorts

PubMed Central

Sharp, Gemma C; Arathimos, Ryan; Reese, Sarah E; Page, Christian M; Felix, Janine; Küpers, Leanne K; Rifas-Shiman, Sheryl L; Liu, Chunyu; Burrows, Kimberley; Zhao, Shanshan; Magnus, Maria C; Duijts, Liesbeth; Corpeleijn, Eva; DeMeo, Dawn L; Litonjua, Augusto; Baccarelli, Andrea; Hivert, Marie-France; Oken, Emily; Snieder, Harold; Jaddoe, Vincent; Nystad, Wenche; London, Stephanie J; Relton, Caroline L; Zuccolo, Luisa

2018-01-01

Aim: Alcohol consumption during pregnancy is sometimes associated with adverse outcomes in offspring, potentially mediated by epigenetic modifications. We aimed to investigate genome-wide DNA methylation in cord blood of newborns exposed to alcohol in utero. Materials & methods: We meta-analyzed information from six population-based birth cohorts within the Pregnancy and Childhood Epigenetics consortium. Results: We found no strong evidence of association at either individual CpGs or across larger regions of the genome. Conclusion: Our findings suggest no association between maternal alcohol consumption and offspring cord blood DNA methylation. This is in stark contrast to the multiple strong associations previous studies have found for maternal smoking, which is similarly socially patterned. However, it is possible that a combination of a larger sample size, higher doses, different timings of exposure, exploration of a different tissue and a more global assessment of genomic DNA methylation might show evidence of association. PMID:29172695

Omega-3 Fatty Acid and Nutrient Deficits in Adverse Neurodevelopment and Childhood Behaviors

PubMed Central

Hibbeln, Joseph. R.; Gow, Rachel V.

2014-01-01

Synopsis Nutritional insufficiencies of omega-3 highly unsaturated fatty acids (HUFAs) may have adverse effects on brain development and neurodevelopmental outcomes. A recent meta-analysis of ten randomized controlled trials of omega-3 HUFAs reported a small to modest effect size for the efficacy of omega-3 for treating symptoms of ADHD in youth. Several controlled trials of omega-3 HUFAs combined with micronutrients (vitamins, minerals) show sizeable reductions in aggressive, antisocial, and violent behavior in youth and in young adult prisoners. Meta-analyses report efficacy for depressive symptoms in adults, and preliminary findings suggest anti-suicidal properties in adults, but studies in youth are insufficient to draw any conclusions regarding mood. Dietary adjustments to increase omega-3 and reduce omega-6 HUFA consumption are sensible recommendations for youth and adults based on general health considerations, while the evidence base for omega-3 HUFAs as potential psychiatric treatments develops. PMID:24975625

Brief Report: Barriers to mental health treatment for military wives

PubMed Central

Lewy, Colleen; Oliver, Celina; McFarland, Bentson H.

2014-01-01

Objective This Internet-based survey provided information about barriers to mental health services for military wives. Methods Following qualitative work, an Internet-based program was created to identify military wives who may have major depressive disorder. Results Women (N = 569, ages 18 to 56) were recruited from 45 states and 8 foreign countries. Most participants (78%) reported notable depression. Many (44%) reported un-addressed mental health needs. Barriers included inability to attend daytime appointments (38%), inability to find a counselor who understands military spouse needs (35%), inability to find a counselor the participant could trust (29%), concerns about confidentiality (29%), and lack of knowledge about where to get services (25%). Barriers reported by the military wives differed markedly from those described by distressed women in the general population. Conclusions Military wives are an under-served population. Knowledge of military culture is essential for civilian mental health providers working with military wives. PMID:24933260

Precision Cosmology: The First Half Million Years

NASA Astrophysics Data System (ADS)

Jones, Bernard J. T.

2017-06-01

Cosmology seeks to characterise our Universe in terms of models based on well-understood and tested physics. Today we know our Universe with a precision that once would have been unthinkable. This book develops the entire mathematical, physical and statistical framework within which this has been achieved. It tells the story of how we arrive at our profound conclusions, starting from the early twentieth century and following developments up to the latest data analysis of big astronomical datasets. It provides an enlightening description of the mathematical, physical and statistical basis for understanding and interpreting the results of key space- and ground-based data. Subjects covered include general relativity, cosmological models, the inhomogeneous Universe, physics of the cosmic background radiation, and methods and results of data analysis. Extensive online supplementary notes, exercises, teaching materials, and exercises in Python make this the perfect companion for researchers, teachers and students in physics, mathematics, and astrophysics.

[Post-marketing surveillance systems for psychoactive prescription drug abuse].

PubMed

Nordmann, Sandra; Frauger, Elisabeth; Pauly, Vanessa; Rouby, Frank; Mallaret, Michel; Micallef, Joëlle; Thirion, Xavier

2011-01-01

Drugs affecting the central nervous system form a unique group of products for surveillance because they could be misused, abused or diverted. Considering the characteristics of this behaviour that is often concealed, specific post-marketing surveillance systems have been developed to monitor abuse of prescription drugs in some countries. The purpose of this review is to list and to describe post-marketing surveillance systems, according their methodology, in France and in foreign countries. These programs are based on adverse effect notifications, medical or legal consequences of abuse, general or specific population-based survey, professional networks or medication databases. Some programs use simultaneously several information sources. In conclusion, the multifaceted nature, the diversity and the inventiveness of post-marketing surveillance systems reflects the complexity of the abuse issue. © 2011 Société Française de Pharmacologie et de Thérapeutique.

[Questions on the first operation with ethyl ether as anaesthetic by Dr. Peter Parker].

PubMed

Chen, Q

2017-01-28

Ethyl ether was the first accepted effective general anaesthetic. It was introduced into China by an America missionary, Dr. Peter Parker. This was one of the historical events of medical communication between China and the West. In the records of the first operation with ether, however, Dr. Parker unusually omitted the patient's medical record number and the date of the operation, while those of other operations with ether anesthetics were all available. This was very unusual for a doctor like Peter Parker who always recorded every important case in detail in the hospital reports. It seems that he deliberately rather than carelessly omitted the information for some reasons. Based on the analysis of Parker's reports, a conclusion is made that the anesthetic effect of the case was actually ineffective. Furthermore, possible answers to this are outlined and question by discussion based on the situation that Parker faced in the late Qing era.

Using complementary tools to characterize the effects of radiation in electro-optic polymeric materials

NASA Astrophysics Data System (ADS)

Perez-Moreno, Javier

2015-09-01

Understanding the fundamental mechanisms behind the radiation resistance of polymers and molecules would allow us to tailor new materials with enhanced performance in space and adverse environments. Previous studies of the radiation effects on polymer-based photonic materials indicate that they are very dependent on the choice of polymer-host and guest-chromophores. The best results have been reported from the combination of CLD1 as a guest-chromophore doped in APC as host polymer, where improvement of the performance was observed upon gamma-irradiation at moderate doses. In this paper, we report on the different complementary tools that have been tried to characterize the origin of such enhancement: characterization of the linear and nonlinear response, characterization of chemical properties, and application of an all-optical protocol. We derive some general conclusions by contrasting the results of each characterization, and propose complementary experiments based on microscopy techniques.

Comparative homology agreement search: An effective combination of homology-search methods

PubMed Central

Alam, Intikhab; Dress, Andreas; Rehmsmeier, Marc; Fuellen, Georg

2004-01-01

Many methods have been developed to search for homologous members of a protein family in databases, and the reliability of results and conclusions may be compromised if only one method is used, neglecting the others. Here we introduce a general scheme for combining such methods. Based on this scheme, we implemented a tool called comparative homology agreement search (chase) that integrates different search strategies to obtain a combined “E value.” Our results show that a consensus method integrating distinct strategies easily outperforms any of its component algorithms. More specifically, an evaluation based on the Structural Classification of Proteins database reveals that, on average, a coverage of 47% can be obtained in searches for distantly related homologues (i.e., members of the same superfamily but not the same family, which is a very difficult task), accepting only 10 false positives, whereas the individual methods obtain a coverage of 28–38%. PMID:15367730

Application of frequency domain handling qualities criteria to the longitudinal landing task

NASA Technical Reports Server (NTRS)

Sarrafian, S. K.; Powers, B. G.

1985-01-01

Under NASA sponsorship, an in-flight simulation of the longitudinal handling qualities of several configurations for the approach and landing tasks was performed on the USAF/AFWAL Total In-Flight Simulator by the Calspan Corporation. The basic configuration was a generic transport airplane with static instability. The control laws included proportional plus integral gain loops to produce pitch-rate and angle-of-attack feedback loops. The evaluation task was a conventional visual approach to a flared touchdown at a designated spot on the runway with a lateral offset. The general conclusions were that the existing criteria are based on pitch-attitude response and that these characteristics do not adequately discriminate between the good and bad configurations of this study. This paper describes the work that has been done to further develop frequency-based criteria in an effort to provide better correlation with the observed data.

Learning and tuning fuzzy logic controllers through reinforcements.

PubMed

Berenji, H R; Khedkar, P

1992-01-01

A method for learning and tuning a fuzzy logic controller based on reinforcements from a dynamic system is presented. It is shown that: the generalized approximate-reasoning-based intelligent control (GARIC) architecture learns and tunes a fuzzy logic controller even when only weak reinforcement, such as a binary failure signal, is available; introduces a new conjunction operator in computing the rule strengths of fuzzy control rules; introduces a new localized mean of maximum (LMOM) method in combining the conclusions of several firing control rules; and learns to produce real-valued control actions. Learning is achieved by integrating fuzzy inference into a feedforward network, which can then adaptively improve performance by using gradient descent methods. The GARIC architecture is applied to a cart-pole balancing system and demonstrates significant improvements in terms of the speed of learning and robustness to changes in the dynamic system's parameters over previous schemes for cart-pole balancing.

Space-based radar for the United Nations's international satellite monitoring agency

NASA Astrophysics Data System (ADS)

Cantafio, L. J.

1984-12-01

A session of the United Nations General Assembly was held in May and June 1978 with the objective to discuss questions related to disarmament. It was decided to consider the establishment of an international Satellite Monitoring Agency (ISMA). The arising questions were studied, and two reports were prepared concerning such a monitoring agency. One report contained preliminary conclusions on the technical, legal, and financial implications of establishing an ISMA, while the second report contained an in-depth study. It was found that from a technical point of view the project appeared possible and feasible, and that there were no provisions in the international law prohibiting the proposed activities. The present investigation has been conducted under the assumption that an ISMA will be estabished. Attention is given to the requirements for the ISMA, the space-based radar design, radar system tradeoff data, critical technologies, and system weight, cost and schedule.

Optimisation of colour schemes to accurately display mass spectrometry imaging data based on human colour perception.

PubMed

Race, Alan M; Bunch, Josephine

2015-03-01

The choice of colour scheme used to present data can have a dramatic effect on the perceived structure present within the data. This is of particular significance in mass spectrometry imaging (MSI), where ion images that provide 2D distributions of a wide range of analytes are used to draw conclusions about the observed system. Commonly employed colour schemes are generally suboptimal for providing an accurate representation of the maximum amount of data. Rainbow-based colour schemes are extremely popular within the community, but they introduce well-documented artefacts which can be actively misleading in the interpretation of the data. In this article, we consider the suitability of colour schemes and composite image formation found in MSI literature in the context of human colour perception. We also discuss recommendations of rules for colour scheme selection for ion composites and multivariate analysis techniques such as principal component analysis (PCA).

Volumetric quantification of bone-implant contact using micro-computed tomography analysis based on region-based segmentation

PubMed Central

Kang, Sung-Won; Lee, Woo-Jin; Choi, Soon-Chul; Lee, Sam-Sun; Heo, Min-Suk; Huh, Kyung-Hoe

2015-01-01

Purpose We have developed a new method of segmenting the areas of absorbable implants and bone using region-based segmentation of micro-computed tomography (micro-CT) images, which allowed us to quantify volumetric bone-implant contact (VBIC) and volumetric absorption (VA). Materials and Methods The simple threshold technique generally used in micro-CT analysis cannot be used to segment the areas of absorbable implants and bone. Instead, a region-based segmentation method, a region-labeling method, and subsequent morphological operations were successively applied to micro-CT images. The three-dimensional VBIC and VA of the absorbable implant were then calculated over the entire volume of the implant. Two-dimensional (2D) bone-implant contact (BIC) and bone area (BA) were also measured based on the conventional histomorphometric method. Results VA and VBIC increased significantly with as the healing period increased (p<0.05). VBIC values were significantly correlated with VA values (p<0.05) and with 2D BIC values (p<0.05). Conclusion It is possible to quantify VBIC and VA for absorbable implants using micro-CT analysis using a region-based segmentation method. PMID:25793178

Visuo-spatial Ability in Individuals with Down Syndrome: Is it Really a Strength?

PubMed Central

Yang, Yingying; Conners, Frances A.; Merrill, Edward C.

2014-01-01

Down syndrome (DS) is associated with extreme difficulty in verbal skills and relatively better visuo-spatial skills. Indeed, visuo-spatial ability is often considered a strength in DS. However, it is not clear whether this strength is only relative to the poor verbal skills, or, more impressively, relative to cognitive ability in general. To answer this question, we conducted an extensive literature review of studies on visuo-spatial abilities in people with Down syndrome from January 1987 to May 2013. Based on a general taxonomy of spatial abilities patterned after Lohman, Pellegrino, Alderton, and Regian (1987) and Carroll (1993) and existing studies of DS, we included five different domains of spatial abilities – visuo-spatial memory, visuo-spatial construction, mental rotation, closure, and wayfinding. We evaluated a total of 49 studies including 127 different comparisons. Most comparisons involved a group with DS vs. a group with typical development matched on mental age and compared on a task measuring one of the five visuo-spatial abilities. Although further research is needed for firm conclusions on some visuo-spatial abilities, there was no evidence that visuo-spatial ability is a strength in DS relative to general cognitive ability. Rather, the review suggests an uneven profile of visuo-spatial abilities in DS in which some abilities are commensurate with general cognitive ability level, and others are below. PMID:24755229

Compatibility of scientific research and specialty training in General Practice. A cross-sectional study

PubMed Central

Kötter, Thomas; Carmienke, Solveig; Herrmann, Wolfram J.

2014-01-01

Objective: In many departments of General Practice (GP) in Germany, young doctors who are trainees also work as researchers. Often these trainees work part time at the university and part time as a trainee in clinical practice. However, little is known about the situation of the actors involved. The aim of the study was to investigate the perspectives of GP trainees, heads of departments and GP trainers regarding the combination of research and GP training. Methods: We conducted a web-based survey with the heads of all German departments of General Practice, GP trainees who also conduct research and their GP trainers. The questionnaires consisted of open and closed questions. The results were analyzed using descriptive statistics and qualitative methods. Results: 28 heads of GP departments and 20 GP trainees responded. The trainees were mostly very satisfied with their situation as a trainee. However, the trainees considered the combination of research and GP training as difficult. The respondents name as problems the coordination of multiple jobs and the lack of credibility given to research in General Practice. They name as solutions research-enabling training programs and uniform requirements in training regarding research. Conclusion: The combination of GP training and scientific research activity is perceived as difficult. However, well-organized and designed programs can improve the quality of the combination. PMID:25228933

[How do general practitioners limit their prescriptions? A qualitative study based on a focus group].

PubMed

Duffaud, Sylvain; Liébart, Sandra

2014-01-01

There is no consensus on prescription of medicines in many situations in general medicine. The aim of this study was to identify the strategies used by general practitioners to limit prescriptions in order to make their prescriptions more effective. A mixed sample of general practitioners in terms of age and types of practice were interviewed using the focus group method until a sufficient number of data were obtained. Fourteen women and ten men aged between 32 and 64 years were interviewed by means of three group interviews. Various strategies were identified: the practitioner's attitude (rapid identification of the patient's needs, listening and evaluation of symptoms, support by physical examination) and the use of resources (reference tools and news) during the consultation; the importance of the conclusion of the consultation (written advice or visit report, review of the previous prescription) and explanation (reasons for limitation, reassurance, arguments, proposal of a follow-up visit). Limitation of prescriptions also depends on the practitioner's own reasons (initial and continued training, motivation and personal objectives, part of a peer group) but equally on the health care system (institutional, specialist support). The study highlights numerous approach to facilitate limitation of prescriptions: training and informing practitioners and patients, consultation management, promote communication at the heart of the health care system and policy-makers. Training organizations and health authorities could facilitate these strategies for the benefit of patients.

Does Spinal Analgesia have Advantage over General Anesthesia for Achieving Success in In-Vitro Fertilization?

PubMed Central

Aghaamoo, Shahrzad; Azmoodeh, Azra; Yousefshahi, Fardin; Berjis, Katayon; Ahmady, Farahnazsadat; Qods, Kamran; Mirmohammadkhani, Majid

2014-01-01

Objective Because of high psychological burden and considerable costs of in-vitro fertilization, it is greatly important to identify all factors that may influence its results. In this study, general anesthesia and spinal analgesia used for oocyte retrieval were compared in terms of success in treating infertility among couples who had undergone in-vitro fertilization at an infertility center in Tehran, Iran. Methods This cohort study that was based on analysis of patient records at Mirza Kochak Khan Hospital, Tehran University of Medical Sciences, in 2008-2009. In this study, the status of chemical pregnancy among those who experienced general anesthesia or spinal anesthesia for in-vitro fertilization for the first time were compared, and the possible effects of clinical and laboratory factors using logistic regression models were considered. Results Considering the number of transferred embryos, underlying cause of infertility and fetus grade, it was found that practicing spinal anesthesia is significantly related to increased chance of chemical pregnancy (adjusted Odds Ratio=2.07; 95% CI: 1.02,4.20; p=0.043). Conclusion According to analysis of recorded data in an infertility treatment center in Iran, it is recommended to use spinal anesthesia instead of general anesthesia for oocyte retrieval to achieve successful in-vitro fertilization outcome. This can be studied and investigated further via a proper multicentric study in the country. PMID:24715934

Application of A Mobile Platform-based System for the Management of Fundus Diease in Outpatient Settings.

PubMed

Dend, Xun; Li, Hong-Yan; Yin, Hong; Liang, Jian-Hong; Chen, Yi; Li, Xiao-Xin; Zhao, Ming-Wei

2016-08-01

Objective To evaluate the application of a mobile platform-based system in the management of fundus disease in outpatient settings. Methods In the outpatient departments of fundus disease,premature babies requiring eye examination under general anesthesia and adults requiring intraocular surgery were enrolled as the subjects. According to the existing clinical practices,we developed a system that met the requirements of clinical practices and optimized the clinical management. Based on the FileMaker database,the tablet computers were used as the mobile platform and the system could also be run in iPad and PC terminals.Results Since 2013,the system recorded 7500 cases of special examinations. Since July 2015,4100 cases of intravitreal drug injection were also recored in the system. Multiple-point and real-time reservation pattern increased the efficiency and opimize the clinical management. All the clinical data were digitalized. Conclusion The mobile platform-based system can increase the efficacy of examination and other clinical processes and standardize data collection;thus,it is feasible for the clinical practices in outpatient departments of ophthalmology.

Exploring the benefits of an optional theatre module on medical student well-being.

PubMed

Nagji, Alim; Brett-MacLean, Pamela; Breault, Lorraine

2013-01-01

Medical students struggle with varied stressors and developing adequate coping mechanisms is essential. This study examined medical student perceptions of the well-being impact of a theatre-based course. Eighteen 1st-year medical students at the University of Alberta participated in 3 focus groups following the conclusion of a theatre-based module that was piloted in the first quarter of 2010. A semistructured protocol was used to guide the focus groups, which were audiotaped and transcribed. Along with general feedback, impact on personal development and student well-being were discussed. Thematic aspects of these discussions were qualitatively analyzed. During the focus groups, medical students identified three aspects of the theatre-based module that contributed to their sense of overall well-being. These included (a) fun/relaxation, (b) enhanced relationships with each other, and (c) personal growth/resilience. Our findings suggest that participating in an optional theatre module can enhance medical student well-being. Our analysis suggests the need to consider novel, humanities-based curriculum offerings in relation to personal development and well- being.

Combining graph and flux-based structures to decipher phenotypic essential metabolites within metabolic networks

PubMed Central

Frioux, Clémence; Nicolas, Jacques; Baroukh, Caroline; Cortes, Maria-Paz; Got, Jeanne; Trottier, Camille; Eveillard, Damien

2017-01-01

Background The emergence of functions in biological systems is a long-standing issue that can now be addressed at the cell level with the emergence of high throughput technologies for genome sequencing and phenotyping. The reconstruction of complete metabolic networks for various organisms is a key outcome of the analysis of these data, giving access to a global view of cell functioning. The analysis of metabolic networks may be carried out by simply considering the architecture of the reaction network or by taking into account the stoichiometry of reactions. In both approaches, this analysis is generally centered on the outcome of the network and considers all metabolic compounds to be equivalent in this respect. As in the case of genes and reactions, about which the concept of essentiality has been developed, it seems, however, that some metabolites play crucial roles in system responses, due to the cell structure or the internal wiring of the metabolic network. Results We propose a classification of metabolic compounds according to their capacity to influence the activation of targeted functions (generally the growth phenotype) in a cell. We generalize the concept of essentiality to metabolites and introduce the concept of the phenotypic essential metabolite (PEM) which influences the growth phenotype according to sustainability, producibility or optimal-efficiency criteria. We have developed and made available a tool, Conquests, which implements a method combining graph-based and flux-based analysis, two approaches that are usually considered separately. The identification of PEMs is made effective by using a logical programming approach. Conclusion The exhaustive study of phenotypic essential metabolites in six genome-scale metabolic models suggests that the combination and the comparison of graph, stoichiometry and optimal flux-based criteria allows some features of the metabolic network functionality to be deciphered by focusing on a small number of compounds. By considering the best combination of both graph-based and flux-based techniques, the Conquests python package advocates for a broader use of these compounds both to facilitate network curation and to promote a precise understanding of metabolic phenotype. PMID:29038751

Hierarchical graphs for rule-based modeling of biochemical systems

PubMed Central

2011-01-01

Background In rule-based modeling, graphs are used to represent molecules: a colored vertex represents a component of a molecule, a vertex attribute represents the internal state of a component, and an edge represents a bond between components. Components of a molecule share the same color. Furthermore, graph-rewriting rules are used to represent molecular interactions. A rule that specifies addition (removal) of an edge represents a class of association (dissociation) reactions, and a rule that specifies a change of a vertex attribute represents a class of reactions that affect the internal state of a molecular component. A set of rules comprises an executable model that can be used to determine, through various means, the system-level dynamics of molecular interactions in a biochemical system. Results For purposes of model annotation, we propose the use of hierarchical graphs to represent structural relationships among components and subcomponents of molecules. We illustrate how hierarchical graphs can be used to naturally document the structural organization of the functional components and subcomponents of two proteins: the protein tyrosine kinase Lck and the T cell receptor (TCR) complex. We also show that computational methods developed for regular graphs can be applied to hierarchical graphs. In particular, we describe a generalization of Nauty, a graph isomorphism and canonical labeling algorithm. The generalized version of the Nauty procedure, which we call HNauty, can be used to assign canonical labels to hierarchical graphs or more generally to graphs with multiple edge types. The difference between the Nauty and HNauty procedures is minor, but for completeness, we provide an explanation of the entire HNauty algorithm. Conclusions Hierarchical graphs provide more intuitive formal representations of proteins and other structured molecules with multiple functional components than do the regular graphs of current languages for specifying rule-based models, such as the BioNetGen language (BNGL). Thus, the proposed use of hierarchical graphs should promote clarity and better understanding of rule-based models. PMID:21288338

A Checklist-based Intervention to Improve Surgical Outcomes in Michigan: Evaluation of the Keystone Surgery Program

PubMed Central

Reames, Bradley N.; Krell, Robert W.; Campbell, Darrell A.; Dimick, Justin B.

2015-01-01

Importance Previous studies of checklist-based quality improvement interventions have reported mixed results. Objective To evaluate whether implementation of a checklist-based quality improvement intervention, Keystone Surgery, was associated with improved outcomes in patients undergoing general surgery in large statewide population. Design, Setting and Exposure Retrospective longitudinal study examining surgical outcomes in Michigan patients using Michigan Surgical Quality Collaborative clinical registry data from the years 2006–2010 (n=64,891 patients in 29 hospitals). Multivariable logistic regression and difference-in-differences analytic approaches were used to evaluate whether Keystone Surgery program implementation was associated with improved surgical outcomes following general surgery procedures, apart from existing temporal trends toward improved outcomes during the study period. Main Outcome Measures Risk-adjusted rates of superficial surgical site infection, wound complications, any complication, and 30-day mortality. Results Implementation of Keystone Surgery in participating centers (n=14 hospitals) was not associated with improvements in surgical outcomes during the study period. Adjusted rates of superficial surgical site infection (3.2 vs. 3.2%, p=0.91), wound complications (5.9 vs. 6.5%, p=0.30), any complication (12.4 vs. 13.2%, p=0.26), and 30-day mortality (2.1 vs. 1.9%, p=0.32) at participating hospitals were similar before and after implementation. Difference-in-differences analysis accounting for trends in non-participating centers (n=15 hospitals), and sensitivity analysis excluding patients receiving surgery in the first 6- or 12-months after program implementation yielded similar results. Conclusions and Relevance Implementation of a checklist-based quality improvement intervention did not impact rates of adverse surgical outcomes among patients undergoing general surgery in participating Michigan hospitals. Additional research is needed to understand why this program was not successful prior to further dissemination and implementation of this model to other populations. PMID:25588183

A controlled trial of internet-based cognitive-behavioural therapy for panic disorder with face-to-face support from a general practitioner or email support from a psychologist

PubMed Central

2008-01-01

Background Panic disorder (PD) is one of the most common anxiety disorders seen in general practice, but provision of evidence-based cognitive-behavioural treatment (CBT) is rare. Many Australian GPs are now trained to deliver focused psychological strategies, but in practice this is time consuming and costly. Objective To evaluate the efficacy of an internet-based CBT intervention (Panic Online) for the treatment of PD supported by general practitioner (GP)-delivered therapeutic assistance. Design Panic Online supported by GP-delivered face-to-face therapy was compared to Panic Online supported by psychologist-delivered email therapy. Methods Sixty-five people with a primary diagnosis of PD (78% of whom also had agoraphobia) completed 12 weeks of therapy using Panic Online and therapeutic assistance with his/her GP (n = 34) or a clinical psychologist (n = 31). The mean duration of PD for participants allocated to these groups was 59 months and 58 months, respectively. Participants completed a clinical diagnostic interview delivered by a psychologist via telephone and questionnaires to assess panic-related symptoms, before and after treatment. Results The total attrition rate was 20%, with no group differences in attrition frequency. Both treatments led to significant improvements in panic attack frequency, depression, anxiety, stress, anxiety sensitivity and quality of life. There were no statistically significant differences in the two treatments on any of these measures, or in the frequency of participants with clinically significant PD at post assessment. Conclusions When provided with accessible online treatment protocols, GPs trained to deliver focused psychological strategies can achieve patient outcomes comparable to efficacious treatments delivered by clinical psychologists. The findings of this research provide a model for how GPs may be assisted to provide evidence-based mental healthcare successfully. PMID:22477844

Automatic Classification of Artifactual ICA-Components for Artifact Removal in EEG Signals

PubMed Central

2011-01-01

Background Artifacts contained in EEG recordings hamper both, the visual interpretation by experts as well as the algorithmic processing and analysis (e.g. for Brain-Computer Interfaces (BCI) or for Mental State Monitoring). While hand-optimized selection of source components derived from Independent Component Analysis (ICA) to clean EEG data is widespread, the field could greatly profit from automated solutions based on Machine Learning methods. Existing ICA-based removal strategies depend on explicit recordings of an individual's artifacts or have not been shown to reliably identify muscle artifacts. Methods We propose an automatic method for the classification of general artifactual source components. They are estimated by TDSEP, an ICA method that takes temporal correlations into account. The linear classifier is based on an optimized feature subset determined by a Linear Programming Machine (LPM). The subset is composed of features from the frequency-, the spatial- and temporal domain. A subject independent classifier was trained on 640 TDSEP components (reaction time (RT) study, n = 12) that were hand labeled by experts as artifactual or brain sources and tested on 1080 new components of RT data of the same study. Generalization was tested on new data from two studies (auditory Event Related Potential (ERP) paradigm, n = 18; motor imagery BCI paradigm, n = 80) that used data with different channel setups and from new subjects. Results Based on six features only, the optimized linear classifier performed on level with the inter-expert disagreement (<10% Mean Squared Error (MSE)) on the RT data. On data of the auditory ERP study, the same pre-calculated classifier generalized well and achieved 15% MSE. On data of the motor imagery paradigm, we demonstrate that the discriminant information used for BCI is preserved when removing up to 60% of the most artifactual source components. Conclusions We propose a universal and efficient classifier of ICA components for the subject independent removal of artifacts from EEG data. Based on linear methods, it is applicable for different electrode placements and supports the introspection of results. Trained on expert ratings of large data sets, it is not restricted to the detection of eye- and muscle artifacts. Its performance and generalization ability is demonstrated on data of different EEG studies. PMID:21810266

Second-degree atrioventricular block.

PubMed

Zipes, D P

1979-09-01

1) While it is possible only one type of second-degree AV block exists electrophysiologically, the available data do not justify such a conclusion and it would seem more appropriate to remain a "splitter," and advocate separation and definition of multiple mechanisms, than to be a "lumper," and embrace a unitary concept. 2) The clinical classification of type I and type II AV block, based on present scalar electrocardiographic criteria, for the most part accurately differentiates clinically important categories of patients. Such a classification is descriptive, but serves a useful function and should be preserved, taking into account the caveats mentioned above. The site of block generally determines the clinical course for the patient. For most examples of AV block, the type I and type II classification in present use is based on the site of block. Because block in the His-Purkinje system is preceded by small or nonmeasurable increments, it is called type II AV block; but the very fact that it is preceded by small increments is because it occurs in the His-Purkinje system. Similar logic can be applied to type I AV block in the AV node. Exceptions do occur. If the site of AV block cannot be distinguished with certainity from the scalar ECG, an electrophysiologic study will generally reveal the answer.

Three treatments for bilingual children with primary language impairment: Examining cross-linguistic and cross-domain effects

PubMed Central

Ebert, Kerry Danahy; Kohnert, Kathryn; Pham, Giang; Disher, Jill Rentmeester; Payesteh, Bita

2014-01-01

Purpose This study examines the absolute and relative effects of three different treatment programs for school-aged bilingual children with primary or specific language impairment (PLI). It serves to expand the evidence base on which service providers can base treatment decisions. It also explores hypothesized relations between languages and cognition in bilinguals with PLI. Method Fifty-nine school-aged Spanish-English bilingual children with PLI were assigned to receive nonlinguistic cognitive processing, English, bilingual (Spanish-English), or deferred treatment. Participants in each of the three active treatments received treatment administered by nationally certified speech-language pathologists. Pre- and post-treatment assessments measured change in nonlinguistic cognitive processing, English, and Spanish skills, and analyses examined change within and across both treatment groups and skill domains. Results All active treatment groups made significant pre- to post-treatment improvement on multiple outcome measures. There were fewer significant changes in Spanish than in English across groups. Between group comparisons indicate that the active treatment groups generally outperformed the deferred treatment control, reaching statistical significance for two tasks. Conclusions Results provide insight into cross-language transfer in bilingual children and advance understanding of the general PLI profile with respect to relationships between basic cognitive processing and higher level language skills. PMID:23900032

Working memory training in older adults: Bayesian evidence supporting the absence of transfer.

PubMed

Guye, Sabrina; von Bastian, Claudia C

2017-12-01

The question of whether working memory training leads to generalized improvements in untrained cognitive abilities is a longstanding and heatedly debated one. Previous research provides mostly ambiguous evidence regarding the presence or absence of transfer effects in older adults. Thus, to draw decisive conclusions regarding the effectiveness of working memory training interventions, methodologically sound studies with larger sample sizes are needed. In this study, we investigated whether or not a computer-based working memory training intervention induced near and far transfer in a large sample of 142 healthy older adults (65 to 80 years). Therefore, we randomly assigned participants to either the experimental group, which completed 25 sessions of adaptive, process-based working memory training, or to the active, adaptive visual search control group. Bayesian linear mixed-effects models were used to estimate performance improvements on the level of abilities, using multiple indicator tasks for near (working memory) and far transfer (fluid intelligence, shifting, and inhibition). Our data provided consistent evidence supporting the absence of near transfer to untrained working memory tasks and the absence of far transfer effects to all of the assessed abilities. Our results suggest that working memory training is not an effective way to improve general cognitive functioning in old age. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Dynamic Analysis of the Carotid-Kundalini Map

NASA Astrophysics Data System (ADS)

Wang, Xingyuan; Liang, Qingyong; Meng, Juan

The nature of the fixed points of the Carotid-Kundalini (C-K) map was studied and the boundary equation of the first bifurcation of the C-K map in the parameter plane is presented. Using the quantitative criterion and rule of chaotic system, the paper reveals the general features of the C-K Map transforming from regularity to chaos. The following conclusions are obtained: (i) chaotic patterns of the C-K map may emerge out of double-periodic bifurcation; (ii) the chaotic crisis phenomena are found. At the same time, the authors analyzed the orbit of critical point of the complex C-K Map and put forward the definition of Mandelbrot-Julia set of the complex C-K Map. The authors generalized the Welstead and Cromer's periodic scanning technique and using this technology constructed a series of the Mandelbrot-Julia sets of the complex C-K Map. Based on the experimental mathematics method of combining the theory of analytic function of one complex variable with computer aided drawing, we investigated the symmetry of the Mandelbrot-Julia set and studied the topological inflexibility of distribution of the periodic region in the Mandelbrot set, and found that the Mandelbrot set contains abundant information of the structure of Julia sets by finding the whole portray of Julia sets based on Mandelbrot set qualitatively.

Psychometric modeling of abuse and dependence symptoms across six illicit substances indicates novel dimensions of misuse

PubMed Central

Clark, Shaunna L.; Gillespie, Nathan A.; Adkins, Daniel E.; Kendler, Kenneth S.; Neale, Michael C.

2015-01-01

Aims This study explored the factor structure of DSM III-R/IV symptoms for substance abuse and dependence across six illicit substance categories in a population-based sample of males. Method DSM III-R/IV drug abuse and dependence symptoms for cannabis, sedatives, stimulants, cocaine, opioids and hallucinogens from 4179 males born 1940-1970 from the population-based Virginia Adult Twin Study of Psychiatric and Substance Use Disorders were analyzed. Confirmatory factor analyses tested specific hypotheses regarding the latent structure of substance misuse for a comprehensive battery of 13 misuse symptoms measured across six illicit substance categories (78 items). Results Among the models fit, the latent structure of substance misuse was best represented by a combination of substance-specific factors and misuse symptom-specific factors. We found no support for a general liability factor to illicit substance misuse. Conclusions Results indicate that liability to misuse illicit substances is drug class specific, with little evidence for a general liability factor. Additionally, unique dimensions capturing propensity toward specific misuse symptoms (e.g., tolerance, withdrawal) across substances were identified. While this finding requires independent replication, the possibility of symptom-specific misuse factors, present in multiple substances, raises the prospect of genetic, neurobiological and behavioral predispositions toward distinct, narrowly defined features of drug abuse and dependence. PMID:26517709

[Appropriateness of direct admissions to acute care geriatric unit for nursing home patients: an adaptation of the AEPf GRID].

PubMed

Abdoulhadi, Dalia; Chevalet, Pascal; Moret, Leila; Fix, Marie-Hélène; Gégu, Marine; Jaulin, Philippe; Berrut, Gilles; de Decker, Laure

2015-03-01

The patient population staying in nursing homes is increasingly vulnerable and dependent and should benefit from a direct access to an acute care geriatric unit. Nevertheless, the easy access by a simple phone call from the general practitioner to the geriatrician, as well as the lack of orientation of these patients by emergency units, might lead to inappropriate admissions. This work studied the appropriateness of direct admissions of 40 patients living in nursing home in an acute care geriatric unit. Based on the AEPf assessment grid, 82.5% of these admissions were considered as appropriate (52.5%) or justified (30% based on an expert panel decision), and 17.5% were inappropriate. In conclusion, the process of direct admission does not seem to increase the rate of inappropriate admissions. Some actions could decrease this rate: implementation of geriatric mobile teams or psychogeriatric mobile teams intervening in nursing home, a better and more adapted use of ambulatory structures, a better information to the general practitioners. In order to reduce the intervention of the panel of experts, an adaptation of the AEPf assessment grid to these geriatric patients has been proposed. The "AEPg" assessment grid should benefit from a validation study.

A telephone survey of cancer awareness among frontline staff: informing training needs

PubMed Central

Cook, N; Hart, A; Nuttall, K; Simpson, K; Turnill, N; Grant-Pearce, C; Damms, P; Allen, V; Slade, K; Dey, P

2011-01-01

Background: Studies have shown limited awareness about cancer risk factors among hospital-based staff. Less is known about general cancer awareness among community frontline National Health Service and social care staff. Methods: A cross-sectional computer-assisted telephone survey of 4664 frontline community-based health and social care staff in North West England. Results: A total of 671 out of 4664 (14.4%) potentially eligible subjects agreed to take part. Over 92% of staff recognised most warning signs, except an unexplained pain (88.8%, n=596), cough or hoarseness (86.9%, n=583) and a sore that does not heal (77.3%, n=519). The bowel cancer-screening programme was recognised by 61.8% (n=415) of staff. Most staff agreed that smoking and passive smoking ‘increased the chance of getting cancer.' Fewer agreed about getting sunburnt more than once as a child (78.0%, n=523), being overweight (73.5%, n=493), drinking more than one unit of alcohol per day (50.2%, n=337) or doing less than 30 min of moderate physical exercise five times a week (41.1%, n=276). Conclusion: Cancer awareness is generally good among frontline staff, but important gaps exist, which might be improved by targeted education and training and through developing clearer messages about cancer risk factors. PMID:21750554

The association between Internet addiction and personality disorders in a general population-based sample

PubMed Central

Zadra, Sina; Bischof, Gallus; Besser, Bettina; Bischof, Anja; Meyer, Christian; John, Ulrich; Rumpf, Hans-Jürgen

2016-01-01

Background and aims Data on Internet addiction (IA) and its association with personality disorder are rare. Previous studies are largely restricted to clinical samples and insufficient measurement of IA. Methods Cross-sectional analysis data are based on a German sub-sample (n = 168; 86 males; 71 meeting criteria for IA) with increased levels of excessive Internet use derived from a general population sample (n = 15,023). IA was assessed with a comprehensive standardized interview using the structure of the Composite International Diagnostic Interview and the criteria of Internet Gaming Disorder as suggested in DSM-5. Impulsivity, attention deficit hyperactivity disorder, and self-esteem were assessed with the widely used questionnaires. Results Participants with IA showed higher frequencies of personality disorders (29.6%) compared to those without IA (9.3%; p < .001). In males with IA, Cluster C personality disorders were more prevalent than among non-addicted males. Compared to participants who had IA only, lower rates of remission of IA were found among participants with IA and additional cluster B personality disorder. Personality disorders were significantly associated with IA in multivariate analysis. Discussion and conclusion: Comorbidity of IA and personality disorders must be considered in prevention and treatment. PMID:28005417

Knowledge levels of intensive care nurses on prevention of ventilator-associated pneumonia.

PubMed

Akın Korhan, Esra; Hakverdioğlu Yönt, Gülendam; Parlar Kılıç, Serap; Uzelli, Derya

2014-01-01

Ventilator-associated pneumonia constitutes a significant concern for ventilated patients in the intensive care unit. This study was planned to evaluate the knowledge of nurses working in general intensive care units concerning evidence-based measures for the prevention of ventilator-associated pneumonia. This study design is cross-sectional. It was carried out on nurses working in the general intensive care units of anesthiology and re-animation clinics. Collection of research data was performed by means of a Nurse Identification Form and a Form of Evidence-Based Knowledge concerning the Prevention of Ventilator-Associated Pneumonia. Characterization statistics were shown by percentage, median and interquartile range. Chi-square and Wilcoxon tests and Kruskal-Wallis tests were used as appropriate. The median value of total points scored by nurses on the questionnaire was 4.00 ± 2.00. The difference between the nurses' education levels, duration of work experience and participation in in-service training programmes on ventilator-associated pneumonia prevention and the median value of their total scores on the questionnaire was found to be statistically significant (p < 0.05). The conclusion of the study was that critical care nurses' knowledge about ventilator-associated pneumonia prevention is poor. © 2013 British Association of Critical Care Nurses.

Accelerated probabilistic inference of RNA structure evolution

PubMed Central

Holmes, Ian

2005-01-01

Background Pairwise stochastic context-free grammars (Pair SCFGs) are powerful tools for evolutionary analysis of RNA, including simultaneous RNA sequence alignment and secondary structure prediction, but the associated algorithms are intensive in both CPU and memory usage. The same problem is faced by other RNA alignment-and-folding algorithms based on Sankoff's 1985 algorithm. It is therefore desirable to constrain such algorithms, by pre-processing the sequences and using this first pass to limit the range of structures and/or alignments that can be considered. Results We demonstrate how flexible classes of constraint can be imposed, greatly reducing the computational costs while maintaining a high quality of structural homology prediction. Any score-attributed context-free grammar (e.g. energy-based scoring schemes, or conditionally normalized Pair SCFGs) is amenable to this treatment. It is now possible to combine independent structural and alignment constraints of unprecedented general flexibility in Pair SCFG alignment algorithms. We outline several applications to the bioinformatics of RNA sequence and structure, including Waterman-Eggert N-best alignments and progressive multiple alignment. We evaluate the performance of the algorithm on test examples from the RFAM database. Conclusion A program, Stemloc, that implements these algorithms for efficient RNA sequence alignment and structure prediction is available under the GNU General Public License. PMID:15790387

Accuracy and speed feedback: Global and local effects on strategy use

PubMed Central

Touron, Dayna R.; Hertzog, Christopher

2013-01-01

Background Skill acquisition often involves a shift from an effortful algorithm-based strategy to more fluent memory-based performance. Older adults’ slower strategy transitions can be ascribed to both slowed learning and metacognitive factors. Experimenters often provide feedback on response accuracy; this emphasis may either inadvertently reinforce older adults’ conservatism or might highlight that retrieval is generally quite accurate. RT feedback can lead to more rapid shift to retrieval (Hertzog, Touron, & Hines, 2007). Methods This study parametrically varied trial-by-trial feedback to examine whether strategy shifts in the noun-pair task in younger (M = 19) and older adults (M = 67) were influenced by type of performance feedback: none, trial accuracy, trial RT, or both accuracy and RT. Results Older adults who received accuracy feedback retrieved more often, particularly on difficult rearranged trials, and participants who receive speed feedback performed the scanning strategy more quickly. Age differences were also obtained in local (trial-level) reactivity to task performance, but these were not affected by feedback. Conclusions Accuracy and speed feedback had distinct global (general) influences on task strategies and performance. In particular, it appears that the standard practice of providing trial-by-trial accuracy feedback might facilitate older adults’ use of retrieval strategies in skill acquisition tasks. PMID:24785594

Development of Clinical Vignettes to Describe Alzheimer's Disease Health States: A Qualitative Study

PubMed Central

Oremus, Mark; Xie, Feng; Gaebel, Kathryn

2016-01-01

Aims To develop clinical descriptions (vignettes) of life with Alzheimer’s disease (AD), we conducted focus groups of persons with AD (n = 14), family caregivers of persons with AD (n = 20), and clinicians who see persons with AD in their practices (n = 5). Methods Group participants read existing descriptions of AD and commented on the realism and comprehensibility of the descriptions. We used thematic framework analysis to code the comments into themes and develop three new vignettes to describe mild, moderate, and severe AD. Results Themes included the types of symptoms to mention in the new vignettes, plus the manner in which the vignettes should be written. Since the vignette descriptions were based on focus group participants’ first-hand knowledge of AD, the descriptions can be said to demonstrate content validity. Conclusion Members of the general public can read the vignettes and estimate their health-related quality-of-life (HRQoL) as if they had AD based on the vignette descriptions. This is especially important for economic evaluations of new AD medications, which require HRQoL to be assessed in a manner that persons with AD often find difficult to undertake. The vignettes will allow the general public to serve as a proxy and provide HRQoL estimates in place of persons with AD. PMID:27589604

Noninvasive delivery systems for peptides and proteins in osteoporosis therapy: a retroperspective.

PubMed

Hoyer, Herbert; Perera, Glen; Bernkop-Schnürch, Andreas

2010-01-01

The aim of this review is to provide the reader general and inspiring prospects in various attempts to make noninvasive delivery systems of calcitonin and teriparatide feasible and as convenient as possible. Calcitonin and teriparatide play an important role in both calcium homeostasis and bone remodelling. Currently calcitonin is available as a subcutaneous injection and as a nasal spray whereas teriparatide is administered subcutaneously. In the past few years, an increasing number of articles about drug delivery systems for calcitonin and teriparatide have been published. These delivery systems have been developed to overcome the inherent barriers for the uptake across the diverse membranes on the various routes for protein and peptide delivery. Co-administration of permeation enhancers, mucoadhesive agents, viscosity modifying agents, multifunctional polymers, protease inhibitors as well as encapsulation and chemical modification are utilized in order to improve calcitonin and teriparatide absorption after oral, nasal, pulmonal, or buccal administration. The majority of research groups have been working on the development of formulations based on the encapsulation of molecules in biodegradable and biocompatible polymeric nanoparticles. However these observations are based on data obtained under different experimental conditions. Hence, it is difficult to compare the obtained results in order to draw general conclusions about the most promising characteristics required for oral and nasal formulations for these peptides.

Visual Categorization of Natural Movies by Rats

PubMed Central

Vinken, Kasper; Vermaercke, Ben

2014-01-01

Visual categorization of complex, natural stimuli has been studied for some time in human and nonhuman primates. Recent interest in the rodent as a model for visual perception, including higher-level functional specialization, leads to the question of how rodents would perform on a categorization task using natural stimuli. To answer this question, rats were trained in a two-alternative forced choice task to discriminate movies containing rats from movies containing other objects and from scrambled movies (ordinate-level categorization). Subsequently, transfer to novel, previously unseen stimuli was tested, followed by a series of control probes. The results show that the animals are capable of acquiring a decision rule by abstracting common features from natural movies to generalize categorization to new stimuli. Control probes demonstrate that they did not use single low-level features, such as motion energy or (local) luminance. Significant generalization was even present with stationary snapshots from untrained movies. The variability within and between training and test stimuli, the complexity of natural movies, and the control experiments and analyses all suggest that a more high-level rule based on more complex stimulus features than local luminance-based cues was used to classify the novel stimuli. In conclusion, natural stimuli can be used to probe ordinate-level categorization in rats. PMID:25100598

Computer Assisted Chronic Disease Management: Does It Work? A Pilot Study Using Mixed Methods

PubMed Central

Jones, Kay M.; Biezen, Ruby; Piterman, Leon

2013-01-01

Background. Key factors for the effective chronic disease management (CDM) include the availability of practical and effective computer tools and continuing professional development/education. This study tested the effectiveness of a computer assisted chronic disease management tool, a broadband-based service known as cdmNet in increasing the development of care plans for patients with chronic disease in general practice. Methodology. Mixed methods are the breakthrough series methodology (workshops and plan-do-study-act cycles) and semistructured interviews. Results. Throughout the intervention period a pattern emerged suggesting GPs use of cdmNet initially increased, then plateaued practice nurses' and practice managers' roles expanded as they became more involved in using cdmNet. Seven main messages emerged from the GP interviews. Discussion. The overall use of cdmNet by participating GPs varied from “no change” to “significant change and developing many the GPMPs (general practice management plans) using cdmNet.” The variation may be due to several factors, not the least, allowing GPs adequate time to familiarise themselves with the software and recognising the benefit of the team approach. Conclusion. The breakthrough series methodology facilitated upskilling GPs' management of patients diagnosed with a chronic disease and learning how to use the broadband-based service cdmNet. PMID:24959576

The generalization of charged AdS black hole specific volume and number density

NASA Astrophysics Data System (ADS)

Wang, Zi-Liang; He, Miao; Fang, Chao; Sun, Dao-Quan; Deng, Jian-Bo

2017-04-01

In this paper, by proposing a generalized specific volume, we restudy the P- V criticality of charged AdS black holes in the extended phase space. The results show that most of the previous conclusions can be generalized without change, but the ratio {\\tilde{ρ }}_c should be 3 {\\tilde{α }}/16 in general case. Further research on the thermodynamical phase transition of black hole leads us to a natural interpretation of our assumption, and more black hole properties can be generalized. Finally, we study the number density for charged AdS black hole in higher dimensions, the results show the necessity of our assumption.

A Review of the Evidence for Birth Order Differences in Anxiety and Affiliation in Stressful Situations.

ERIC Educational Resources Information Center

Kushnir, T.

1978-01-01

Reviews literature on birth order. An important conclusion is that birth order differences in anxiety level and affiliation are not generalized phenomena. Consistent birth order differences in both variables are found only among females. Firstborns are not habitually more anxious than laterborns and are not generally more affiliative than…

Defense.gov Special Report: NATO 25th Summit Meeting

Science.gov Websites

Representatives from 60 countries and organizations are participating in the 25th NATO summit in Chicago - the said at the conclusion of the alliance's summit in Chicago. Story NATO Secretary General Terms Summit a Chicago have accomplished what they set out to do, NATO Secretary General Anders Fogh Rasmussen said

General Electric 20-ampere hour nickel-cadmium battery

NASA Technical Reports Server (NTRS)

Kirsch, W. W.

1974-01-01

The interaction, effect, and controllability of the performance parameters of the General Electric 20-ampere-hour, 24-cell nickel cadmium battery are investigated. The battery was cycled under simulated orbit conditions. The acquired data was analyzed and evaluated in terms of battery parameters and performance characteristics. Conclusions and tests results are presented along with recommendations for further study.

Robert Phillipson Responds to Humphrey Tonkin's "Language and the Ingenuity Gap in Science: The Empire of Scientific English"

ERIC Educational Resources Information Center

Phillipson, Robert

2011-01-01

Humphrey Tonkin's article (2011, this issue) refers to many relevant parameters in the current dominance of English in science. His conclusion that publication in English "is erroneously equated with scientific advancement in general" is a disturbingly valid generalization that ultimately reflects ignorance, prejudice, and myopia.…

The Manipulative Complexity of Lower Paleolithic Stone Toolmaking

PubMed Central

Faisal, Aldo; Stout, Dietrich; Apel, Jan; Bradley, Bruce

2010-01-01

Background Early stone tools provide direct evidence of human cognitive and behavioral evolution that is otherwise unavailable. Proper interpretation of these data requires a robust interpretive framework linking archaeological evidence to specific behavioral and cognitive actions. Methodology/Principal Findings Here we employ a data glove to record manual joint angles in a modern experimental toolmaker (the 4th author) replicating ancient tool forms in order to characterize and compare the manipulative complexity of two major Lower Paleolithic technologies (Oldowan and Acheulean). To this end we used a principled and general measure of behavioral complexity based on the statistics of joint movements. Conclusions/Significance This allowed us to confirm that previously observed differences in brain activation associated with Oldowan versus Acheulean technologies reflect higher-level behavior organization rather than lower-level differences in manipulative complexity. This conclusion is consistent with a scenario in which the earliest stages of human technological evolution depended on novel perceptual-motor capacities (such as the control of joint stiffness) whereas later developments increasingly relied on enhanced mechanisms for cognitive control. This further suggests possible links between toolmaking and language evolution. PMID:21072164

Public participation in GIS via mobile applications

NASA Astrophysics Data System (ADS)

Brovelli, Maria Antonia; Minghini, Marco; Zamboni, Giorgio

2016-04-01

Driven by the recent trends in the GIS domain including Volunteered Geographic Information, geo-crowdsourcing and citizen science, and fostered by the constant technological advances, collection and dissemination of geospatial information by ordinary people has become commonplace. However, applications involving user-generated geospatial content show dramatically diversified patterns in terms of incentive, type and level of participation, purpose of the activity, data/metadata provided and data quality. This study contributes to this heterogeneous context by investigating public participation in GIS within the field of mobile-based applications. Results not only show examples of how to technically build GIS applications enabling user collection and interaction with geospatial data, but they also draw conclusions about the methods and needs of public participation. We describe three projects with different scales and purposes in the context of urban monitoring and planning, and tourism valorisation. In each case, an open source architecture is used, allowing users to exploit their mobile devices to collect georeferenced information. This data is then made publicly available on specific Web viewers. Analysis of user involvement in these projects provides insights related to participation patterns which suggests some generalized conclusions.

The Putative Liquid-Liquid Transition is a Liquid-Solid Transition in Atomistic Models of Water

NASA Astrophysics Data System (ADS)

Chandler, David; Limmer, David

2013-03-01

Our detailed and controlled studies of free energy surfaces for models of water find no evidence for reversible polyamorphism, and a general theoretical analysis of the phase behavior of cold water in nano pores shows that measured behaviors of these systems reflect surface modulation and dynamics of ice, not a liquid-liquid critical point. A few workers reach different conclusions, reporting evidence of a liquid-liquid critical point in computer simulations of supercooled water. In some cases, it appears that these contrary results are based upon simulation algorithms that are inconsistent with principles of statistical mechanics, such as using barostats that do not reproduce the correct distribution of volume fluctuations. In other cases, the results appear to be associated with difficulty equilibrating the supercooled material and mistaking metastability for coarsening of the ordered ice phase. In this case, sufficient information is available for us to reproduce the contrary results and to establish that they are artifacts of finite time sampling. This finding leads us to the conclusion that two distinct, reversible liquid phases do not exist in models of supercooled water.

Long-term opioid treatment of chronic nonmalignant pain: unproven efficacy and neglected safety?

PubMed Central

Kissin, Igor

2013-01-01

Background For the past 30 years, opioids have been used to treat chronic nonmalignant pain. This study tests the following hypotheses: (1) there is no strong evidence-based foundation for the conclusion that long-term opioid treatment of chronic nonmalignant pain is effective; and (2) the main problem associated with the safety of such treatment – assessment of the risk of addiction – has been neglected. Methods Scientometric analysis of the articles representing clinical research in this area was performed to assess (1) the quality of presented evidence (type of study); and (2) the duration of the treatment phase. The sufficiency of representation of addiction was assessed by counting the number of articles that represent (1) editorials; (2) articles in the top specialty journals; and (3) articles with titles clearly indicating that the addiction-related safety is involved (topic-in-title articles). Results Not a single randomized controlled trial with opioid treatment lasting >3 months was found. All studies with a duration of opioid treatment ≥6 months (n = 16) were conducted without a proper control group. Such studies cannot provide the consistent good-quality evidence necessary for a strong clinical recommendation. There were profound differences in the number of addiction articles related specifically to chronic nonmalignant pain patients and to opioid addiction in general. An inadequate number of chronic pain-related publications were observed with all three types of counted articles: editorials, articles in the top specialty journals, and topic-in-title articles. Conclusion There is no strong evidence-based foundation for the conclusion that long-term opioid treatment of chronic nonmalignant pain is effective. The above identified signs indicating neglect of addiction associated with the opioid treatment of chronic nonmalignant pain were present. PMID:23874119

Replicability and other features of a high-quality science: Toward a balanced and empirical approach.

PubMed

Finkel, Eli J; Eastwick, Paul W; Reis, Harry T

2017-08-01

Finkel, Eastwick, and Reis (2015; FER2015) argued that psychological science is better served by responding to apprehensions about replicability rates with contextualized solutions than with one-size-fits-all solutions. Here, we extend FER2015's analysis to suggest that much of the discussion of best research practices since 2011 has focused on a single feature of high-quality science-replicability-with insufficient sensitivity to the implications of recommended practices for other features, like discovery, internal validity, external validity, construct validity, consequentiality, and cumulativeness. Thus, although recommendations for bolstering replicability have been innovative, compelling, and abundant, it is difficult to evaluate their impact on our science as a whole, especially because many research practices that are beneficial for some features of scientific quality are harmful for others. For example, FER2015 argued that bigger samples are generally better, but also noted that very large samples ("those larger than required for effect sizes to stabilize"; p. 291) could have the downside of commandeering resources that would have been better invested in other studies. In their critique of FER2015, LeBel, Campbell, and Loving (2016) concluded, based on simulated data, that ever-larger samples are better for the efficiency of scientific discovery (i.e., that there are no tradeoffs). As demonstrated here, however, this conclusion holds only when the replicator's resources are considered in isolation. If we widen the assumptions to include the original researcher's resources as well, which is necessary if the goal is to consider resource investment for the field as a whole, the conclusion changes radically-and strongly supports a tradeoff-based analysis. In general, as psychologists seek to strengthen our science, we must complement our much-needed work on increasing replicability with careful attention to the other features of a high-quality science. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Pleistocene plants from North Carolina

USGS Publications Warehouse

Berry, Edward Wilber

1926-01-01

The field work upon which this report is based was done in 1906 and 1907 as a part of the cooperative study of the Atlantic Coastal Plain, under the direction of the late William Bullock Clark. Associated with the writer in this work were L. W. Stephenson, B. L. Miller, Jr., and J. E. Pogue. Preliminary accounts of the plants collected were published in 1907 and 1909. As has been frequently emphasized, the study of the Pleistocene floras in this country is in an exceedingly backward state as measured by the volume and precision of our knowledge of Pleistocene floras in Europe. Researches in Pleistocene geology in North America have been confined almost entirely to glaciology, and the problem of the correlation of the glacial deposits with those outside the glaciated area has not been solved, nor is there any general agreement regarding the genesis of the Pleistocene deposits south of the terminal moraines. The present account of what is known of the Pleistocene flora of North Carolina and the conclusions that may be legitimately derived from it is offered in the hope that it may stimulate an interest in a neglected field of research and form a small part of the evidence upon which to base future more comprehensive conclusions and generalizations. A word of explanation regarding the illustrations is required. Nearly all of them have been made from leaves preserved as carbonaceous films in the peaty clays. These specimens were carefully washed out, and blue prints were made directly from them. Outlines and as much of the venation as could be seen were inked on the blue prints, which were then bleached. This procedure made it possible to handle a much larger amount of material and prevented any possible damage to the exceedingly fragile specimens, which were mounted on cards or between glass. The accompanying drawings were made from tracings of the original nature prints.

Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes

PubMed Central

2011-01-01

Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes. Methods General hospital health professionals in Malaysia were randomly allocated one of two vignettes, one describing a patient with mental illness and the other a patient with diabetes, and invited to complete a questionnaire examining attitudes and health care practices in relation to the case. The questionnaires completed by respondents included questions on demographics, training in mental health, exposure in clinical practice to people with mental illness, attitudes and expected health care behaviour towards the patient in the vignette, and a general questionnaire exploring negative attitudes towards people with mental illness. Questionnaires with complete responses were received from 654 study participants. Results Stigmatising attitudes towards persons with mental illness were common. Those responding to the mental illness vignette (N = 356) gave significantly lower ratings on care and support and higher ratings on avoidance and negative stereotype expectations compared with those responding the diabetes vignette (N = 298). Conclusions Results support the view that, in the Malaysian setting, patients with mental illness may receive differential care from general hospital staff and that general stigmatising attitudes among professionals may influence their care practices. More direct measurement of clinician behaviours than able to be implemented through survey method is required to support these conclusions. PMID:21569613

An overview of “The Active by Choice Today” (ACT) trial for increasing physical activity✩

PubMed Central

Wilson, Dawn K.; Kitzman-Ulrich, Heather; Williams, Joel E.; Saunders, Ruth; Griffin, Sarah; Pate, Russell; Van Horn, M. Lee; Evans, Alexandra; Hutto, Brent; Addy, Cheryl L.; Mixon, Gary; Sisson, Susan B.

2008-01-01

Background: Although school-based behavioral interventions for increasing physical activity (PA) in children and adolescents have been conducted, little evidence suggests that these curriculum-based approaches lead to increases in overall activity outside of program days. The overall goal of the “Active by Choice Today” (ACT) trial is to expand the body of knowledge concerning the factors that influence long-term increases in PA in underserved adolescents (low socioeconmic status, minorities) during their middle school years. Design and setting: An overview of the ACT study design, theoretical framework, process evaluation, and primary hypotheses is presented. The trial involves twenty-four middle schools (1560 6th graders) in South Carolina that are randomly assigned to one of two after-school programs (motivational and life skills intervention, or general health education). Intervention: The intervention integrates constructs from Self-Determination and Social Cognitive Theories to enhance intrinsic motivation and behavioral skills for PA. The intervention targets skill development for PA outside of program days and the after-school program social environment (autonomy, choice, participation, belongingness, fun, enjoyment, support) is designed to positively impact cognitive mediators (self-efficacy, perceived competence), and motivational orientation (intrinsic motivation, commitment, positive self-concept). Main hypotheses/outcomes: It is hypothesized that the 17-week motivational and life skills intervention will lead to greater increases in moderate-to-vigorous PA (based on 7-day accelerometry estimates) at post-intervention as compared to the general health education program. Conclusions: Implications of this innovative school-based trial are discussed. PMID:17716952

Differential receipt of sentinel lymph node biopsy within practice-based research networks

PubMed Central

Meyer, Anne-Marie; Reeder-Hayes, Katherine E.; Liu, Huan; Wheeler, Stephanie B.; Penn, Dolly; Weiner, Bryan J.; Carpenter, William R.

2013-01-01

Background Provider-based research networks (PBRNs) are promising for accelerating not only research, but also dissemination of research-based evidence into broader community practice. Sentinel lymph node biopsy (SLNB) is an innovation in breast cancer care associated with equivalent survival and lower morbidity, as compared to standard axillary lymph node dissection. We examined the diffusion of SLNB into practice and whether affiliation with the Community Clinical Oncology Program (CCOP), a cancer-focused PBRN, was associated with more rapid uptake of SLNB. Research Design Surveillance Epidemiology and End Results(SEER)-Medicare data were used to study women diagnosed with stage I or II breast cancer in the years 2000 to 2005 and undergoing breast conserving surgery with axillary staging (n=6,226). The primary outcome was undergoing SLNB. CCOP affiliation of the surgical physician was ascertained from NCI records. Multivariable generalized linear modeling with generalized estimating equations was used to measure association between CCOP exposure and undergoing SLNB, controlling for potential confounders. Results Women treated by a CCOP physician had significantly higher odds of receiving SLNB compared to women treated by a non-CCOP physician (OR 2.68; 95% CI 1.35, 5.34). The magnitude of this association was larger than that observed among patients treated by physicians operating in medical school-affiliated hospitals (OR 1.76; 95% CI 1.30–2.39). Conclusion Women treated by CCOP-affiliated physicians were more likely to undergo SLNB irrespective of the hospital’s medical school affiliation, suggesting that the CCOP PBRN may play a role in the rapid adoption of research-based innovation in community practice. PMID:23942221

Kidney Disease Among Registered Métis Citizens of Ontario: A Population-Based Cohort Study

PubMed Central

Hayward, Jade S.; McArthur, Eric; Nash, Danielle M.; Sontrop, Jessica M.; Russell, Storm J.; Khan, Saba; Walker, Jennifer D.; Nesrallah, Gihad E.; Sood, Manish M.; Garg, Amit X.

2017-01-01

Background: Indigenous peoples in Canada have higher rates of kidney disease than non-Indigenous Canadians. However, little is known about the risk of kidney disease specifically in the Métis population in Canada. Objective: To compare the prevalence of chronic kidney disease and incidence of acute kidney injury and end-stage kidney disease among registered Métis citizens in Ontario and a matched sample from the general Ontario population. Design: Population-based, retrospective cohort study using data from the Métis Nation of Ontario’s Citizenship Registry and administrative databases. Setting: Ontario, Canada; 2003-2013. Patients: Ontario residents ≥18 years. Measurements: Prevalence of chronic kidney disease and incidence of acute kidney injury and end-stage kidney disease. Secondary outcomes among patients hospitalized with acute kidney injury included non-recovery of kidney function and mortality within 1 year of discharge. Methods: Database codes and laboratory values were used to determine study outcomes. Métis citizens were matched (1:4) to Ontario residents on age, sex, and area of residence. The analysis included 12 229 registered Métis citizens and 48 916 adults from the general population. Results: We found the prevalence of chronic kidney disease was slightly higher among Métis citizens compared with the general population (3.1% vs 2.6%, P = 0.002). The incidence of acute kidney injury was 1.2 per 1000 person-years in both Métis citizens and the general population (P = 0.54). Of those hospitalized with acute kidney injury, outcomes were similar among Métis citizens and the general population except 1-year mortality, which was higher for Métis citizens (24.5% vs 15.3%, P = 0.03). The incidence of end-stage kidney disease did not differ between groups (<3.0 per 10 000 person-years, P = 0.73). Limitations: The Métis Nation of Ontario Citizenship Registry only captures about 20% of Métis people in Ontario. Administrative health care codes used to identify kidney disease are highly specific but have low sensitivity. Conclusions: Rates of kidney disease were similar or slightly higher for Métis citizens in Ontario compared with the matched general population. PMID:28491337

Support vector machine regression (SVR/LS-SVM)--an alternative to neural networks (ANN) for analytical chemistry? Comparison of nonlinear methods on near infrared (NIR) spectroscopy data.

PubMed

Balabin, Roman M; Lomakina, Ekaterina I

2011-04-21

In this study, we make a general comparison of the accuracy and robustness of five multivariate calibration models: partial least squares (PLS) regression or projection to latent structures, polynomial partial least squares (Poly-PLS) regression, artificial neural networks (ANNs), and two novel techniques based on support vector machines (SVMs) for multivariate data analysis: support vector regression (SVR) and least-squares support vector machines (LS-SVMs). The comparison is based on fourteen (14) different datasets: seven sets of gasoline data (density, benzene content, and fractional composition/boiling points), two sets of ethanol gasoline fuel data (density and ethanol content), one set of diesel fuel data (total sulfur content), three sets of petroleum (crude oil) macromolecules data (weight percentages of asphaltenes, resins, and paraffins), and one set of petroleum resins data (resins content). Vibrational (near-infrared, NIR) spectroscopic data are used to predict the properties and quality coefficients of gasoline, biofuel/biodiesel, diesel fuel, and other samples of interest. The four systems presented here range greatly in composition, properties, strength of intermolecular interactions (e.g., van der Waals forces, H-bonds), colloid structure, and phase behavior. Due to the high diversity of chemical systems studied, general conclusions about SVM regression methods can be made. We try to answer the following question: to what extent can SVM-based techniques replace ANN-based approaches in real-world (industrial/scientific) applications? The results show that both SVR and LS-SVM methods are comparable to ANNs in accuracy. Due to the much higher robustness of the former, the SVM-based approaches are recommended for practical (industrial) application. This has been shown to be especially true for complicated, highly nonlinear objects.

Google Wave: Have CTSA-Minded Institutions Caught It?

PubMed Central

Donahue, Amy

2011-01-01

Background Google Wave was touted as the next big communication tool—combining e-mail, social networking, and chat within a single “wave”—with the potential to create a new world for collaboration. Information professionals who are knowledgeable of this tool and its capabilities could become uniquely situated to use it, evaluate it, and teach it. This seemed especially true for those working within Clinical and Translational Science Award (CTSA)-minded institutions, given the promise of interdisciplinary collaboration between investigators and the potential for creating new authorship models. This case study on Google Wave users who are affiliated with CTSA-minded institutions, was designed for and presented at the Evidence-Based Scholarly Communication Conference held by the University of New Mexico Health Sciences Library and Information Center. It provides an early evidence based evaluation of Google Wave's potential. Methods Two “waves” were created. The first consisted of five survey questions designed to collect demographic data on the respondents' roles, a general impression of Wave, the specific tools within Wave that might be useful, and potential collaborators with whom the respondents might use Wave. The second wave was a private, guided discussion on Wave's collaboration potential. Individuals from CTSA-minded institutions were invited to participate with messages on Twitter, forums, blogs, and electronic mail lists, although there were difficulties reaching out to these institutions as a group. Results By the conclusion of the study, only a small number of people (n=11, with a viable n=9) had responded to the survey. Given this small result set, it made sense to group the responses by the respondents' roles (CTSA staff and researchers, support staff, medical librarian, or general public) and to treat them as individual cases. Most of the respondents were librarians and support staff who felt that Wave might have potential for collaboration; there were no CTSA researcher respondents. For the second part of the study, the discussion wave, only one participant explicitly expressed interest in joining. All were invited to join, but there was no participation in the discussion wave at the conclusion of the study. Conclusions The results of this study implied that Google Wave was not on the forefront of CTSA-minded institutions' communication strategies. However, it was being used, and it did demonstrate new collaboration and authorship capabilities. Being generally aware of these capabilities may be useful to information professionals who seek to be current and informed regarding developing technology and to those interested in scholarly communication practices. In addition, the difficulties encountered during this case study in attempting to reach out to CTSA-minded institutions raised the question of how members currently communicate with each other as institutions and as individuals. There was a lesson learned in the usefulness of doing case-study research to evaluate new technologies; the cost in terms of time was relatively low, and knowledge about the technology itself was gained while establishing a base level of evidence to potentially build on in the future. PMID:21461135

Flight test and evaluation of Omega navigation for general aviation

NASA Technical Reports Server (NTRS)

Hwoschinsky, P. V.

1975-01-01

A seventy hour flight test program was performed to determine the suitability and accuracy of a low cost Omega navigation receiver in a general aviation aircraft. An analysis was made of signal availability in two widely separated geographic areas. Comparison is made of the results of these flights with other navigation systems. Conclusions drawn from the test experience indicate that developmental system improvement is necessary before a competent fail safe or fail soft area navigation system is offered to general aviation.

Inconsistencies between alcohol screening results based on AUDIT-C scores and reported drinking on the AUDIT-C questions: prevalence in two US national samples

PubMed Central

2014-01-01

Background The AUDIT-C is an extensively validated screen for unhealthy alcohol use (i.e. drinking above recommended limits or alcohol use disorder), which consists of three questions about alcohol consumption. AUDIT-C scores ≥4 points for men and ≥3 for women are considered positive screens based on US validation studies that compared the AUDIT-C to “gold standard” measures of unhealthy alcohol use from independent, detailed interviews. However, results of screening—positive or negative based on AUDIT-C scores—can be inconsistent with reported drinking on the AUDIT-C questions. For example, individuals can screen positive based on the AUDIT-C score while reporting drinking below US recommended limits on the same AUDIT-C. Alternatively, they can screen negative based on the AUDIT-C score while reporting drinking above US recommended limits. Such inconsistencies could complicate interpretation of screening results, but it is unclear how often they occur in practice. Methods This study used AUDIT-C data from respondents who reported past-year drinking on one of two national US surveys: a general population survey (N = 26,610) and a Veterans Health Administration (VA) outpatient survey (N = 467,416). Gender-stratified analyses estimated the prevalence of AUDIT-C screen results—positive or negative screens based on the AUDIT-C score—that were inconsistent with reported drinking (above or below US recommended limits) on the same AUDIT-C. Results Among men who reported drinking, 13.8% and 21.1% of US general population and VA samples, respectively, had screening results based on AUDIT-C scores (positive or negative) that were inconsistent with reported drinking on the AUDIT-C questions (above or below US recommended limits). Among women who reported drinking, 18.3% and 20.7% of US general population and VA samples, respectively, had screening results that were inconsistent with reported drinking. Limitations This study did not include an independent interview gold standard for unhealthy alcohol use and therefore cannot address how often observed inconsistencies represent false positive or negative screens. Conclusions Up to 21% of people who drink alcohol had alcohol screening results based on the AUDIT-C score that were inconsistent with reported drinking on the same AUDIT-C. This needs to be addressed when training clinicians to use the AUDIT-C. PMID:24468406

Prayer Attendance and General Health in the Iranian Adult Urban Population.

PubMed

Sotodehasl, Nemat; Ghorbani, Raheb; Mahdavi-Nejad, Gholamhosein; Haji-Aghajani, Saeed; Mehdizadeh, Jamileh

2016-02-01

This study was conducted to determine the relationship between prayer attendance and general health among adult urban population in Iran. A total of 470 males older than 17 years, chosen by multistage sampling, were investigated. The results showed that people who did not perform prayers compared to those who said prayers on time and performed Nafilahs (supererogatory prayers) were 2.87 (OR 2.87, 95 % CI 1.23-6.70, p = 0.015) times at risk of general health problems. In conclusion, the findings show that increasing the degree of people's belief in prayer can lead to improve general health.

21 CFR 211.103 - Calculation of yield.

Code of Federal Regulations, 2011 CFR

2011-04-01

...: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Production and Process Controls... at the conclusion of each appropriate phase of manufacturing, processing, packaging, or holding of...

21 CFR 211.103 - Calculation of yield.

Code of Federal Regulations, 2010 CFR

2010-04-01

...: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Production and Process Controls... at the conclusion of each appropriate phase of manufacturing, processing, packaging, or holding of...

International Parkinson and movement disorder society evidence-based medicine review: Update on treatments for the motor symptoms of Parkinson's disease.

PubMed

Fox, Susan H; Katzenschlager, Regina; Lim, Shen-Yang; Barton, Brandon; de Bie, Rob M A; Seppi, Klaus; Coelho, Miguel; Sampaio, Cristina

2018-03-23

The objective of this review was to update evidence-based medicine recommendations for treating motor symptoms of Parkinson's disease (PD). The Movement Disorder Society Evidence-Based Medicine Committee recommendations for treatments of PD were first published in 2002 and updated in 2011, and we continued the review to December 31, 2016. Level I studies of interventions for motor symptoms were reviewed. Criteria for inclusion and quality scoring were as previously reported. Five clinical indications were considered, and conclusions regarding the implications for clinical practice are reported. A total of 143 new studies qualified. There are no clinically useful interventions to prevent/delay disease progression. For monotherapy of early PD, nonergot dopamine agonists, oral levodopa preparations, selegiline, and rasagiline are clinically useful. For adjunct therapy in early/stable PD, nonergot dopamine agonists, rasagiline, and zonisamide are clinically useful. For adjunct therapy in optimized PD for general or specific motor symptoms including gait, rivastigmine is possibly useful and physiotherapy is clinically useful; exercise-based movement strategy training and formalized patterned exercises are possibly useful. There are no new studies and no changes in the conclusions for the prevention/delay of motor complications. For treating motor fluctuations, most nonergot dopamine agonists, pergolide, levodopa ER, levodopa intestinal infusion, entacapone, opicapone, rasagiline, zonisamide, safinamide, and bilateral STN and GPi DBS are clinically useful. For dyskinesia, amantadine, clozapine, and bilateral STN DBS and GPi DBS are clinically useful. The options for treating PD symptoms continues to expand. These recommendations allow the treating physician to determine which intervention to recommend to an individual patient. © 2018 International Parkinson and Movement Disorder Society. © 2018 International Parkinson and Movement Disorder Society.

SU-F-T-250: What Does It Take to Correctly Assess the High Failure Modes of an Advanced Radiotherapy Procedure Such as Stereotactic Body Radiation Therapy?

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

Han, D; Vile, D; Rosu, M

Purpose: Assess the correct implementation of risk-based methodology of TG 100 to optimize quality management and patient safety procedures for Stereotactic Body Radiation Therapy. Methods: A detailed process map of SBRT treatment procedure was generated by a team of three physicists with varying clinical experience at our institution to assess the potential high-risk failure modes. The probabilities of occurrence (O), severity (S) and detectability (D) for potential failure mode in each step of the process map were assigned by these individuals independently on the scale from1 to 10. The risk priority numbers (RPN) were computed and analyzed. The highest 30more » potential modes from each physicist’s analysis were then compared. Results: The RPN values assessed by the three physicists ranged from 30 to 300. The magnitudes of the RPN values from each physicist were different, and there was no concordance in the highest RPN values recorded by three physicists independently. The 10 highest RPN values belonged to sub steps of CT simulation, contouring and delivery in the SBRT process map. For these 10 highest RPN values, at least two physicists, irrespective of their length of experience had concordance but no general conclusions emerged. Conclusion: This study clearly shows that the risk-based assessment of a clinical process map requires great deal of preparation, group discussions, and participation by all stakeholders. One group albeit physicists cannot effectively implement risk-based methodology proposed by TG100. It should be a team effort in which the physicists can certainly play the leading role. This also corroborates TG100 recommendation that risk-based assessment of clinical processes is a multidisciplinary team effort.« less

Effects of workplace generalized and sexual harassment on abusive drinking among first year male and female college students: Does prior drinking experience matter?

PubMed Central

Rospenda, Kathleen M.; Fujishiro, Kaori; McGinley, Meredith; Wolff, Jennifer M.; Richman, Judith A.

2017-01-01

Background Workplace harassment, a known risk factor for adult drinking, is understudied in college samples, but may help explain observed gender differences in drinking patterns. Objective We examine effects of sexual and generalized workplace harassment on changes in drinking behavior over the first semesters of college, and the extent to which these effects differ based on prematriculation drinking for men and women students. Method Data derive from two waves of a longitudinal study of eight Midwestern colleges and universities. Data were collected from 2080 employed students via a Web-based survey assessing sexual and generalized workplace harassment, stressful life events, drinking to intoxication, and binge drinking prior to freshman year (fall 2011) and approximately one year later (summer to fall 2012). At baseline, lifetime drinking status, frequency of alcohol consumption, and demographics were also assessed. Results Linear mixed modeling indicated that employed women students who were frequent drinkers prematriculation were at risk for high levels of drinking associated with workplace harassment, while men who were non-drinkers were most at risk of increasing problem drinking over time when exposed to workplace harassment. Conclusions Alcohol use prevention efforts directed towards employed students are needed both prior to and during college, to instruct students how to identify workplace harassment and cope in healthier ways with stressful workplace experiences. These efforts might be particularly useful in stemming problematic drinking among women who drink frequently prior to college, and preventing men who are non-drinkers upon college entry from initiating problematic drinking during subsequent enrollment years. PMID:28426358

Adapting total quality management for general practice: evaluation of a programme.

PubMed Central

Lawrence, M; Packwood, T

1996-01-01

OBJECTIVE: Assessment of the benefits and limitations of a quality improvement programme based on total quality management principles in general practice over a period of one year (October 1993-4). DESIGN: Questionnaires to practice team members before any intervention and after one year. Three progress reports completed by facilitators at four month intervals. Semistructured interviews with a sample of staff from each practice towards the end of the year. SETTING: 18 self selected practices from across the former Oxford Region. Three members of each practice received an initial residential course and three one day seminars during the year. Each practice was supported by a facilitator from their Medical Audit Advisory Group. MEASURES: Extent of understanding and implementation of quality improvement methodology. Number, completeness, and evaluation of quality improvement projects. Practice team members' attitudes to and involvement in team working and quality improvement. RESULTS: 16 of the 18 practices succeeded in implementing the quality improvement methods. 48 initiatives were considered and staff involvement was broad. Practice members showed increased involvement in, and appreciation of, strategic planning and team working, and satisfaction from improved patients services. 11 of the practices intend to continue with the methodology. The commonest barrier expressed was time. CONCLUSION: Quality improvement programmes based on total quality management principles produce beneficial changes in service delivery and team working in most general practices. It is incompatible with traditional doctor centred practice. The methodology needs to be adapted for primary care to avoid quality improvement being seen as separate from routine activity, and to save time. PMID:10161529

Sexually coercive behavior in male youth: population survey of general and specific risk factors.

PubMed

Kjellgren, Cecilia; Priebe, Gisela; Svedin, Carl Göran; Långström, Niklas

2010-10-01

Little is known about risk/protective factors for sexually coercive behavior in general population youth. We used a Swedish school-based population survey of sexual attitudes and experiences (response rate 77%) and investigated literature-based variables across sexually coercive (SEX), non-sexual conduct problem (CP), and normal control (NC) participants to identify general and specific risk/protective factors for sexual coercion. Among 1,933 male youth, 101 (5.2%) reported sexual coercion (ever talked or forced somebody into genital, oral, or anal sex) (SEX), 132 (6.8%) were classified as CP, and the remaining 1,700 (87.9%) as NC. Of 29 tested variables, 25 were more common in both SEX and CP compared to NC youth, including minority ethnicity, separated parents, vocational study program, risk-taking, aggressiveness, depressive symptoms, substance abuse, sexual victimization, extensive sexual experiences, and sexual preoccupation. When compared to CP youth only, SEX youth more often followed academic study programs, used less drugs and were less risk-taking. Further, SEX more frequently than CP youth reported gender stereotypic and pro-rape attitudes, sexual preoccupation, prostitution, and friends using violent porn. Finally, in a multivariate logistic regression, academic study program, pro-rape attitudes, sexual preoccupation, and less risk-taking independently remained more strongly associated with SEX compared to CP offending. In conclusion, several sociodemographic, family, and individual risk/protective factors were common to non-sexual and sexually coercive antisocial behavior in late adolescence. However, pro-rape cognitions, and sexual preoccupation, were sexuality-related, specific risk factors. The findings could inform preventive efforts and the assessment and treatment of sexually coercive male youth.

Generalized in vitro-in vivo relationship (IVIVR) model based on artificial neural networks

PubMed Central

Mendyk, Aleksander; Tuszyński, Paweł K; Polak, Sebastian; Jachowicz, Renata

2013-01-01

Background The aim of this study was to develop a generalized in vitro-in vivo relationship (IVIVR) model based on in vitro dissolution profiles together with quantitative and qualitative composition of dosage formulations as covariates. Such a model would be of substantial aid in the early stages of development of a pharmaceutical formulation, when no in vivo results are yet available and it is impossible to create a classical in vitro-in vivo correlation (IVIVC)/IVIVR. Methods Chemoinformatics software was used to compute the molecular descriptors of drug substances (ie, active pharmaceutical ingredients) and excipients. The data were collected from the literature. Artificial neural networks were used as the modeling tool. The training process was carried out using the 10-fold cross-validation technique. Results The database contained 93 formulations with 307 inputs initially, and was later limited to 28 in a course of sensitivity analysis. The four best models were introduced into the artificial neural network ensemble. Complete in vivo profiles were predicted accurately for 37.6% of the formulations. Conclusion It has been shown that artificial neural networks can be an effective predictive tool for constructing IVIVR in an integrated generalized model for various formulations. Because IVIVC/IVIVR is classically conducted for 2–4 formulations and with a single active pharmaceutical ingredient, the approach described here is unique in that it incorporates various active pharmaceutical ingredients and dosage forms into a single model. Thus, preliminary IVIVC/IVIVR can be available without in vivo data, which is impossible using current IVIVC/IVIVR procedures. PMID:23569360

Improving continuing medical education by enhancing interactivity: lessons from Iran

PubMed Central

FAGHIHI, SEYED ALIAKBAR; KHANKEH, HAMID REZA; HOSSEINI, SEYED JALIL; SOLTANI ARABSHAHI, SEYED KAMRAN; FAGHIH, ZAHRA; PARIKH, SAGAR V.; SHIRAZI, MANDANA

2016-01-01

Introduction Continuing Medical Education (CME) has been considered as a lifelong commitment for doctors to provide the optimal care for patients. Despite a long history of creating CME programs, outcomes are far from ideal. The present qualitative study aims to clarify the barriers affecting effectiveness of the CME programs in Iran based on the experiences of general practitioners. Methods Sixteen general practitioners were recruited to participate in in-depth interviews and field observations concerning experiences with CME. The study was performed using a qualitative content analysis method. The codes, categories and themes were explored through an inductive process in which the researchers moved from specific to general. Results The participants’ experiences identified a number of barriers, particularly insufficient interaction with the instructors; additional problems included the teachers’ use of an undifferentiated approach; unreal and abstract CME; and ignorance of the diverse reasons to participate in CME. Conclusion Based on the study results, there are multiple barriers to effective implementation of CME in Iran. The key barriers include insufficient interaction between the trainees and providers, which must be considered by other stakeholders and program designers. Such interactions would facilitate improved program design, invite more specific tailoring of the education to the participants, allow for more effective educational methods and set the stage for outcome evaluation from the learners actually applying their new knowledge in practice. Replication of these findings with another sample would improve confidence in these recommendations, but these findings are broadly consistent with findings in the educational literature on improving the efficacy of CME. PMID:27104199

Predictors of retest effects in a longitudinal study of cognitive aging in a diverse community-based sample

PubMed Central

Gross, Alden L.; Benitez, Andreana; Shih, Regina; Bangen, Katherine J.; Glymour, M Maria M; Sachs, Bonnie; Sisco, Shannon; Skinner, Jeannine; Schneider, Brooke C.; Manly, Jennifer J.

2016-01-01

OBJECTIVE Better performance due to repeated testing can bias long-term trajectories of cognitive aging and correlates of change. We examined whether retest effects differ as a function of individual differences pertinent to cognitive aging: race/ethnicity, age, sex, language, years of education, and dementia risk factors including APOE ε4 status, baseline cognitive performance, and cardiovascular risk. METHOD We used data from the Washington Heights-Inwood Columbia Aging Project, a community-based cohort of older adults (n=4,073). We modeled cognitive change and retest effects in summary factors for general cognitive performance, memory, executive functioning, and language using multilevel models. Retest effects were parameterized in two ways, as improvement between the first and subsequent testings, and as the square root of the number of prior testings. We evaluated whether the retest effect differed by individual characteristics. RESULTS The mean retest effect for general cognitive performance was 0.60 standard deviations (95%CI: 0.46, 0.74), and was similar for memory, executive functioning, and language. Retest effects were greater for participants in the lowest quartile of cognitive performance, consistent with regression to the mean. Retest did not differ by other characteristics. CONCLUSIONS Retest effects are large in this community-based sample, but do not vary by demographic or dementia-related characteristics. Differential retest effects may not limit the generalizability of inferences across different groups in longitudinal research. PMID:26527240

Validity of the Multidimensional Fatigue Symptom Inventory-Short Form in an African American Community-Based Sample

PubMed Central

Asvat, Yasmin; Malcarne, Vanessa L.; Sadler, Georgia R.; Jacobsen, Paul B.

2014-01-01

Objectives This study examined the psychometric properties of the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) in a community-based sample of African Americans. Design. A sample of 340 African Americans (116 men, 224 women) ranging in age from 18–81 years were recruited from the community (e.g., churches, health fairs, beauty salons). Participants completed a brief demographic survey, the MFSI-SF and the Positive and Negative Affect Schedule. Results The structural validity of the MFSI-SF for a community-based sample of African Americans was not supported. The five dimensions of fatigue (General, Emotional, Physical, Mental, Vigor) found for Whites in prior research were not found for African Americans in this study. Instead, fatigue, while multidimensional for African Americans, was best represented by a unique four-four profile in which general and emotional fatigue are collapsed into a single dimension and physical fatigue, mental fatigue, and vigor are relatively distinct. Hence, in the absence of modifications, the MFSI-SF cannot be considered to be structurally invariant across ethnic groups. A modified four-factor version of the MFSI-SF exhibited excellent internal consistency reliability and evidence supports its convergent validity. Using the modified four-factor version, gender and age were not meaningfully associated with MFSI-SF scores. Conclusion Future research should further examine whether modifications to the MFSI-SF would, as the findings suggest, improve its validity as a measure of multidimensional fatigue in African Americans. PMID:24527980

Transforming family practice in British Columbia

PubMed Central

Cavers, William J.R.; Tregillus, Valerie H.F.; Micco, Angela; Hollander, Marcus J.

2010-01-01

ABSTRACT OBJECTIVE To describe a new approach to primary care reform developed in British Columbia (BC) under the leadership of the General Practice Services Committee (GPSC). COMPOSITION OF THE COMMITTEE The GPSC is a joint committee of the BC Ministry of Health Services, the BC Medical Association, and the Society of General Practitioners of BC. Representatives of BC’s health authorities also attend as guests. METHOD This paper is based on the 2008–2009 annual report of the GPSC. It summarizes the history and main activities of the GPSC. REPORT The GPSC is currently supporting a number of key activities to transform primary care in BC. These activities include the Full Service Family Practice Incentive Program, which provides incentive payments to promote enhanced primary care; the Practice Support Program, which provides family physicians and their medical office assistants with various practical evidence-based strategies and tools for managing practice enhancement; the Family Physicians for BC Program to develop family practices in areas of identified need; the Shared Care Committee, which supports and enables the determination of appropriate scopes of practice among GPs, specialists, and other health care professionals; the Divisions of Family Practice, which are designed to facilitate interactions among family doctors and between doctors and their respective health authorities; and the Community Healthcare and Resource Directory, a Web-based resource to help health care providers find appropriate mental health resources. CONCLUSION Early results indicate that the GPSC’s initiatives are enhancing the delivery of primary care services in BC. PMID:21156899

Public health law for the collection and reporting of health care–associated infections

PubMed Central

Meier, Benjamin Mason; Stone, Patricia W.; Gebbie, Kristine M.

2015-01-01

Background State-based laws for reporting of health care-associated infections (HAI) have developed and changed dramatically in recent years, affecting the costs of reporting and impact on infection rates. It is necessary for practitioners of infection control to understand these changing legal frameworks and their application to practice. Methods Employing systematic state-based research, the researchers have documented legislation and administrative regulations for institution-specific HAI reporting, using this information to create a comprehensive resource on state-based laws for mandatory HAI reporting. Results As of August 27, 2007, 24 states have adopted laws requiring reporting of HAI rates, with an additional 7 states currently considering legislation that would require HAI reporting and 19 states employing detailed regulation in the absence of any current legislative authorization specific to HAI. This study documents (1) which states require reporting of HAI and, if so, whether this is done by legislation or administrative regulation; (2) whether the specific HAIs to be reported are identified in state law or codified generally as “diseases of public health importance,” with reporting specified by administrative regulation; and (3) what reporting policies and procedures are detailed in law. Conclusion Through analysis of the collected information, the researchers have examined the degree to which states have modernized their respective public health laws to approach mandatory reporting by way of general legislation regarding “matters of public health importance” and subsequent detailed administrative regulation to specify those matters. PMID:18926306

Rates, Delays, and Completeness of General Practitioners’ Responses to a Postal Versus Web-Based Survey: A Randomized Trial

PubMed Central

Maisonneuve, Hubert; Cerutti, Bernard; Fournier, Jean Pascal; Senn, Nicolas; Haller, Dagmar M

2017-01-01

Background Web-based surveys have become a new and popular method for collecting data, but only a few studies have directly compared postal and Web-based surveys among physicians, and none to our knowledge among general practitioners (GPs). Objective Our aim is to compare two modes of survey delivery (postal and Web-based) in terms of participation rates, response times, and completeness of questionnaires in a study assessing GPs’ preventive practices. Methods This randomized study was conducted in Western Switzerland (Geneva and Vaud) and in France (Alsace and Pays de la Loire) in 2015. A random selection of community-based GPs (1000 GPs in Switzerland and 2400 GPs in France) were randomly allocated to receive a questionnaire about preventive care activities either by post (n=700 in Switzerland, n=400 in France) or by email (n=300 in Switzerland, n=2000 in France). Reminder messages were sent once in the postal group and twice in the Web-based group. Any GPs practicing only complementary and alternative medicine were excluded from the study. Results Among the 3400 contacted GPs, 764 (22.47%, 95% CI 21.07%-23.87%) returned the questionnaire. Compared to the postal group, the participation rate in the Web-based group was more than four times lower (246/2300, 10.70% vs 518/1100, 47.09%, P<.001), but median response time was much shorter (1 day vs 1-3 weeks, P<.001) and the number of GPs having fully completed the questionnaire was almost twice as high (157/246, 63.8% vs 179/518, 34.6%, P<.001). Conclusions Web-based surveys offer many advantages such as reduced response time, higher completeness of data, and large cost savings, but our findings suggest that postal surveys can be still considered for GP research. The use of mixed-mode approaches is probably a good strategy to increase GPs’ participation in surveys while reducing costs. PMID:28330830

The Relation between Preschool Children's False-Belief Understanding and Domain-General Experimentation Skills

ERIC Educational Resources Information Center

Piekny, Jeanette; Grube, Dietmar; Maehler, Claudia

2013-01-01

The focus of the present study is on the developmental antecedents of domain-general experimentation skills. We hypothesized that false-belief understanding would predict the ability to distinguish a conclusive from an inconclusive experiment. We conducted a longitudinal study with two assessment points (t1 and t2) to investigate this hypothesis.…

Dietary Protein Intake in Young Children in Selected Low-Income Countries Is Generally Adequate in Relation to Estimated Requirements for Healthy Children, Except When Complementary Food Intake Is Low.

PubMed

Arsenault, Joanne E; Brown, Kenneth H

2017-05-01

Background: Previous research indicates that young children in low-income countries (LICs) generally consume greater amounts of protein than published estimates of protein requirements, but this research did not account for protein quality based on the mix of amino acids and the digestibility of ingested protein. Objective: Our objective was to estimate the prevalence of inadequate protein and amino acid intake by young children in LICs, accounting for protein quality. Methods: Seven data sets with information on dietary intake for children (6-35 mo of age) from 6 LICs (Peru, Guatemala, Ecuador, Bangladesh, Uganda, and Zambia) were reanalyzed to estimate protein and amino acid intake and assess adequacy. The protein digestibility-corrected amino acid score of each child's diet was calculated and multiplied by the original (crude) protein intake to obtain an estimate of available protein intake. Distributions of usual intake were obtained to estimate the prevalence of inadequate protein and amino acid intake for each cohort according to Estimated Average Requirements. Results: The prevalence of inadequate protein intake was highest in breastfeeding children aged 6-8 mo: 24% of Bangladeshi and 16% of Peruvian children. With the exception of Bangladesh, the prevalence of inadequate available protein intake decreased by age 9-12 mo and was very low in all sites (0-2%) after 12 mo of age. Inadequate protein intake in children <12 mo of age was due primarily to low energy intake from complementary foods, not inadequate protein density. Conclusions: Overall, most children consumed protein amounts greater than requirements, except for the younger breastfeeding children, who were consuming low amounts of complementary foods. These findings reinforce previous evidence that dietary protein is not generally limiting for children in LICs compared with estimated requirements for healthy children, even after accounting for protein quality. However, unmeasured effects of infection and intestinal dysfunction on the children's protein requirements could modify this conclusion.

Impact of wind turbine sound on general health, sleep disturbance and annoyance of workers: a pilot- study in Manjil wind farm, Iran.

PubMed

Abbasi, Milad; Monazzam, Mohammad Reza; Akbarzadeh, Arash; Zakerian, Seyyed Abolfazl; Ebrahimi, Mohammad Hossein

2015-01-01

The wind turbine's sound seems to have a proportional effect on health of people living near to wind farms. This study aimed to investigate the effect of noise emitted from wind turbines on general health, sleep and annoyance among workers of manjil wind farm, Iran. A total number of 53 workers took part in this study. Based on the type of job, they were categorized into three groups of maintenance, security and office staff. The persons' exposure at each job-related group was measured by eight-hour equivalent sound level (LAeq, 8 h). A Noise annoyance scale, Epworth sleepiness scale and 28-item general health questionnaire was used for gathering data from workers. The data were analyzed through Multivariate Analysis of variance (MANOVA) test, Pillai's Trace test, Paired comparisons analysis and Multivariate regression test were used in the R software. The results showed that, response variables (annoyance, sleep disturbance and health) were significantly different between job groups. The results also indicated that sleep disturbance as well as noise exposure had a significant effect on general health. Noise annoyance and distance from wind turbines could significantly explain about 44.5 and 34.2 % of the variance in sleep disturbance and worker's general health, respectively. General health was significantly different in different age groups while age had no significant impact on sleep disturbance. The results were reverse for distance because it had no significant impact on health, but sleep disturbance was significantly affected. We came to this conclusion that wind turbines noise can directly impact on annoyance, sleep and health. This type of energy generation can have potential health risks for wind farm workers. However, further research is needed to confirm the results of this study.

Quantifying Cardiometabolic Risk Using Modifiable Non–Self-Reported Risk Factors

PubMed Central

Marino, Miguel; Li, Yi; Pencina, Michael J.; D’Agostino, Ralph B.; Berkman, Lisa F.; Buxton, Orfeu M.

2014-01-01

Background Sensitive general cardiometabolic risk assessment tools of modifiable risk factors would be helpful and practical in a range of primary prevention interventions or for preventive health maintenance. Purpose To develop and validate a cumulative general cardiometabolic risk score that focuses on non–self-reported modifiable risk factors such as glycosylated hemoglobin (HbA1c) and BMI so as to be sensitive to small changes across a span of major modifiable risk factors, which may not individually cross clinical cut off points for risk categories. Methods We prospectively followed 2,359 cardiovascular disease (CVD)-free subjects from the Framingham offspring cohort over a 14–year follow-up. Baseline (fifth offspring examination cycle) included HbA1c and cholesterol measurements. Gender–specific Cox proportional hazards models were considered to evaluate the effects of non–self-reported modifiable risk factors (blood pressure, total cholesterol, high–density lipoprotein cholesterol, smoking, BMI, and HbA1c) on general CVD risk. We constructed 10–year general cardiometabolic risk score functions and evaluated its predictive performance in 2012–2013. Results HbA1c was significantly related to general CVD risk. The proposed cardiometabolic general CVD risk model showed good predictive performance as determined by cross-validated discrimination (male C-index=0.703, 95% CI=0.668, 0.734; female C-index=0.762, 95% CI=0.726, 0.801) and calibration (lack-of-fit χ2=9.05 [p=0.338] and 12.54 [p=0.128] for men and women, respectively). Conclusions This study presents a risk factor algorithm that provides a convenient and informative way to quantify cardiometabolic risk based on modifiable risk factors that can motivate an individual’s commitment to prevention and intervention. PMID:24951039

Cost analysis of spinal and general anesthesia for the surgical treatment of lumbar spondylosis.

PubMed

Walcott, Brian P; Khanna, Arjun; Yanamadala, Vijay; Coumans, Jean-Valery; Peterfreund, Robert A

2015-03-01

Lumbar spine surgery is typically performed under general anesthesia, although spinal anesthesia can also be used. Given the prevalence of lumbar spine surgery, small differences in cost between the two anesthetic techniques have the potential to make a large impact on overall healthcare costs. We sought to perform a cost comparison analysis of spinal versus general anesthesia for lumbar spine operations. Following Institutional Review Board approval, a retrospective cohort study was performed from 2009-2012 on consecutive patients undergoing non-instrumented, elective lumbar spine surgery for spondylosis by a single surgeon. Each patient was evaluated for both types of anesthesia, with the decision for anesthetic method being made based on a combination of physical status, anatomical considerations, and ultimately a consensus agreement between patient, surgeon, and anesthesiologist. Patient demographics and clinical characteristics were compared between the two groups. Operating room costs were calculated whilst blinded to clinical outcomes and reported in percentage difference. General anesthesia (n=319) and spinal anesthesia (n=81) patients had significantly different median operative times of 175 ± 39.08 and 158 ± 32.75 minutes, respectively (p<0.001, Mann-Whitney U test). Operating room costs were 10.33% higher for general anesthesia compared to spinal anesthesia (p=0.003, Mann-Whitney U test). Complications of spinal anesthesia included excessive movement (n=1), failed spinal attempt (n=3), intraoperative conversion to general anesthesia (n=2), and a high spinal level (n=1). In conclusion, spinal anesthesia can be performed safely in patients undergoing lumbar spine surgery. It has the potential to reduce operative times, costs, and possibly, complications. Further prospective evaluation will help to validate these findings. Copyright © 2014 Elsevier Ltd. All rights reserved.

Integrated consensus-based frameworks for unmanned vehicle routing and targeting assignment

NASA Astrophysics Data System (ADS)

Barnawi, Waleed T.

Unmanned aerial vehicles (UAVs) are increasingly deployed in complex and dynamic environments to perform multiple tasks cooperatively with other UAVs that contribute to overarching mission effectiveness. Studies by the Department of Defense (DoD) indicate future operations may include anti-access/area-denial (A2AD) environments which limit human teleoperator decision-making and control. This research addresses the problem of decentralized vehicle re-routing and task reassignments through consensus-based UAV decision-making. An Integrated Consensus-Based Framework (ICF) is formulated as a solution to the combined single task assignment problem and vehicle routing problem. The multiple assignment and vehicle routing problem is solved with the Integrated Consensus-Based Bundle Framework (ICBF). The frameworks are hierarchically decomposed into two levels. The bottom layer utilizes the renowned Dijkstra's Algorithm. The top layer addresses task assignment with two methods. The single assignment approach is called the Caravan Auction Algorithm (CarA) Algorithm. This technique extends the Consensus-Based Auction Algorithm (CBAA) to provide awareness for task completion by agents and adopt abandoned tasks. The multiple assignment approach called the Caravan Auction Bundle Algorithm (CarAB) extends the Consensus-Based Bundle Algorithm (CBBA) by providing awareness for lost resources, prioritizing remaining tasks, and adopting abandoned tasks. Research questions are investigated regarding the novelty and performance of the proposed frameworks. Conclusions regarding the research questions will be provided through hypothesis testing. Monte Carlo simulations will provide evidence to support conclusions regarding the research hypotheses for the proposed frameworks. The approach provided in this research addresses current and future military operations for unmanned aerial vehicles. However, the general framework implied by the proposed research is adaptable to any unmanned vehicle. Civil applications that involve missions where human observability would be limited could benefit from the independent UAV task assignment, such as exploration and fire surveillance are also notable uses for this approach.

Upper-body strength gains from different modes of resistance training in women who are underweight and women who are obese.

PubMed

Mayhew, Jerry L; Smith, Abbie E; Arabas, Jana L; Roberts, B Scott

2010-10-01

The purpose of this study was to determine the degree of upper-body strength gained by college women who are underweight and those who are obese using different modes of resistance training. Women who were underweight (UWW, n = 93, weight = 49.3 ± 4.5 kg) and women who were obese (OBW, n = 73, weight = 94.0 ± 15.1 kg) were selected from a larger cohort based on body mass index (UWW ≤ 18.5 kg·m⁻²; OBW ≥ 30 kg·m⁻²). Subjects elected to train with either free weights (FW, n = 38), supine vertical bench press machine (n = 52) or seated horizontal bench press machine (n = 76) using similar linear periodization resistance training programs 3× per week for 12 weeks. Each participant was assessed for upper-body strength using FWs (general) and machine weight (specific) 1 repetition maximum bench press before and after training. Increases in general and mode-specific strength were significantly greater for OBW (5.2 ± 5.1 and 9.6 ± 5.1 kg, respectively) than for UWW (3.5 ± 4.1 and 7.2 ± 5.2 kg, respectively). General strength gains were not significantly different among the training modes. Mode-specific gains were significantly greater (p < 0.05) than general strength gains for all groups. In conclusion, various resistance training modes may produce comparable increases in general strength but will register greater gains if measured using the specific mode employed for training, regardless of the weight category of the individual.

A NSQIP Analysis of MELD and Perioperative Outcomes in General Surgery.

PubMed

Zielsdorf, Shannon M; Kubasiak, John C; Janssen, Imke; Myers, Jonathan A; Luu, Minh B

2015-08-01

It is well known that liver disease has an adverse effect on postoperative outcomes. However, what is still unknown is how to appropriately risk stratify this patient population based on the degree of liver failure. Because data are limited, specifically in general surgery practice, we analyzed the model of end-stage liver disease (MELD) in terms of predicting postoperative complications after one of three general surgery operations: inguinal hernia repair (IHR), umbilical hernia repair (UHR), and colon resection (CRXN). National Surgical Quality Improvement Program data on 17,812 total patients undergoing one of three general surgery operations from 2008 to 2012 were analyzed retrospectively. There were 7402 patients undergoing IHR; 5014 patients undergoing UHR; 5396 patients undergoing CRXN. MELD score was calculated using international normalized ratio, total bilirubin, and creatinine. The primary end point was any postoperative complication. The statistical method used was logistic regression. For IHR, UHR, and CRXN, the overall complication rates were 3.4, 6.4, and 45.9 per cent, respectively. The mean MELD scores were 8.6, 8.5, and 8.5, respectively. For every 1-point increase greater than the mean MELD score, there was a 7.8, 13.8, and 11.6 per cent increase in any postoperative complication. The overall 30-day mortality rate was 0.9 per cent. In conclusion, the MELD score continuum adequately predicts patients' increased risk of postoperative complications after IHR, UHR, and CRXN. Therefore, MELD could be used for preoperative risk stratification and guide clinical decision making for general surgery in the cirrhotic patient.

Responses to GM food content in context with food integrity issues: results from Australian population surveys.

PubMed

Mohr, Philip; Golley, Sinéad

2016-01-25

This study examined community responses to use of genetically modified (GM) content in food in the context of responses to familiar food additives by testing an empirically and theoretically derived model of the predictors of responses to both GM content and food integrity issues generally. A nationwide sample of 849 adults, selected at random from the Australian Electoral Roll, responded to a postal Food and Health Survey. Structural equation modelling analyses confirmed that ratings of general concern about food integrity (related to the presence of preservatives and other additives) strongly predicted negativity towards GM content. Concern about food integrity was, in turn, predicted by environmental concern and health engagement. In addition, both concern about food integrity generally and responses to GM content specifically were weakly predicted by attitudes to benefits of science and an intuitive (i.e., emotionally-based) reasoning style. Data from a follow-up survey conducted under the same conditions (N=1184) revealed that ratings of concern were significantly lower for use of genetic engineering in food than for four other common food integrity issues examined. Whereas the question of community responses to GM is often treated as a special issue, these findings support the conclusion that responses to the concept of GM content in food in Australia are substantially a specific instance of a general sensitivity towards the integrity of the food supply. They indicate that the origins of responses to GM content may be largely indistinguishable from those of general responses to preservatives and other common food additives. Copyright © 2015 Elsevier B.V. All rights reserved.

Does general surgery residency prepare surgeons for community practice in British Columbia?

PubMed Central

Hwang, Hamish

2009-01-01

Background Preparing surgeons for clinical practice is a challenging task for postgraduate training programs across Canada. The purpose of this study was to examine whether a single surgeon entering practice was adequately prepared by comparing the type and volume of surgical procedures experienced in the last 3 years of training with that in the first year of clinical practice. Methods During the last 3 years of general surgery training, I logged all procedures. In practice, the Medical Services Plan (MSP) of British Columbia tracks all procedures. Using MSP remittance reports, I compiled the procedures performed in my first year of practice. I totaled the number of procedures and broke them down into categories (general, colorectal, laparoscopic, endoscopic, hepatobiliary, oncologic, pediatric, thoracic, vascular and other). I then compared residency training with community practice. Results I logged a total of 1170 procedures in the last 3 years of residency. Of these, 452 were performed during community rotations. The procedures during residency could be broken down as follows: 392 general, 18 colorectal, 242 laparoscopic, 103 endoscopic, 85 hepatobiliary, 142 oncologic, 1 pediatric, 78 thoracic, 92 vascular and 17 other. I performed a total of 1440 procedures in the first year of practice. In practice the break down was 398 general, 15 colorectal, 101 laparoscopic, 654 endoscopic, 2 hepatobiliary, 77 oncologic, 10 pediatric, 0 thoracic, 70 vascular and 113 other. Conclusion On the whole, residency provided excellent preparation for clinical practice based on my experience. Areas of potential improvement included endoscopy, pediatric surgery and “other,” which comprised mostly hand surgery. PMID:19503663

Efficacy and the Strength of Evidence of U.S. Alcohol Control Policies

PubMed Central

Nelson, Toben F.; Xuan, Ziming; Babor, Thomas; Brewer, Robert D.; Chaloupka, Frank J.; Gruenewald, Paul; Holder, Harold; Klitzner, Michael; Mosher, James; Ramirez, Rebecca L.; Reynolds, Robert; Toomey, Traci L.; Naimi, Timothy S.

2013-01-01

Background Public policy can limit alcohol consumption and its associated harms, but no direct comparison of the relative efficacy of alcohol control policies exists for the U.S. Purpose To identify alcohol control policies and develop quantitative ratings of their efficacy and strength of evidence. Methods In 2010, a Delphi panel of ten U.S. alcohol policy experts identified and rated the efficacy of alcohol control policies for reducing binge drinking and alcohol-impaired driving among both the general population and youth, and the strength of evidence informing the efficacy of each policy. The policies were nominated based on scientific evidence and potential for public health impact. Analysis was conducted in 2010–2012. Results Panelists identified and rated 47 policies. Policies limiting price received the highest ratings, with alcohol taxes receiving the highest ratings for all four outcomes. Highly rated policies for reducing binge drinking and alcohol-impaired driving in the general population were also highly rated among youth, although several policies were rated more highly for youth compared with the general population. Policy efficacy ratings for the general population and youth were positively correlated for reducing both binge drinking (r = 0.50) and alcohol-impaired driving (r = 0.45). The correlation between efficacy ratings for reducing binge drinking and alcohol-impaired driving was strong for the general population (r = 0.88) and for youth (r = 0.85). Efficacy ratings were positively correlated with strength-of-evidence ratings. Conclusions Comparative policy ratings can help characterize the alcohol policy environment, inform policy discussions, and identify future research needs. PMID:23790985

Celebrity Suicides and Their Differential Influence on Suicides in the General Population: A National Population-Based Study in Korea

PubMed Central

Myung, Woojae; Won, Hong-Hee; Fava, Maurizio; Mischoulon, David; Yeung, Albert; Lee, Dongsoo; Kim, Doh Kwan

2015-01-01

Objective Although evidence suggests that there is an increase in suicide rates in the general population following celebrity suicide, the rates are heterogeneous across celebrities and countries. It is unclear which is the more vulnerable population according to the effect sizes of celebrity suicides to general population. Methods All suicide victims in the general population verified by the Korea National Statistical Office and suicides of celebrity in South Korea were included for 7 years from 2005 to 2011. Effect sizes were estimated by comparing rates of suicide in the population one month before and after each celebrity suicide. The associations between suicide victims and celebrities were examined. Results Among 94,845 suicide victims, 17,209 completed suicide within one month after 13 celebrity suicides. Multivariate logistic regression analyses revealed that suicide victims who died after celebrity suicide were significantly likely to be of age 20-39, female, and to die by hanging. These qualities were more strongly associated among those who followed celebrity suicide with intermediate and high effect sizes than lower. Younger suicide victims were significantly associated with higher effect size, female gender, white collar employment, unmarried status, higher education, death by hanging, and night-time death. Characteristics of celebrities were significantly associated with those of general population in hanging method and gender. Conclusion Individuals who commit suicide after a celebrity suicide are likely to be younger, female, and prefer hanging as method of suicide, which are more strongly associated in higher effect sizes of celebrity suicide. PMID:25866521

An Investigation of the "Jumping to Conclusions" Data-Gathering Bias and Paranoid Thoughts in Asperger Syndrome

ERIC Educational Resources Information Center

Jänsch, Claire; Hare, Dougal Julian

2014-01-01

The existence of a data-gathering bias, in the form of jumping to conclusions, and links to paranoid ideation was investigated in Asperger syndrome (AS). People with AS (N = 30) were compared to a neurotypical control group (N = 30) on the Reading the Mind in the Eyes and the Beads tasks, with self-report measures of depression, general anxiety,…

Decision-making of older patients in context of the doctor-patient relationship: a typology ranging from "self-determined" to "doctor-trusting" patients.

PubMed

Wrede-Sach, Jennifer; Voigt, Isabel; Diederichs-Egidi, Heike; Hummers-Pradier, Eva; Dierks, Marie-Luise; Junius-Walker, Ulrike

2013-01-01

Background. This qualitative study aims to gain insight into the perceptions and experiences of older patients with regard to sharing health care decisions with their general practitioners. Patients and Methods. Thirty-four general practice patients (≥70 years) were asked about their preferences and experiences concerning shared decision making with their doctors using qualitative semistructured interviews. All interviews were analysed according to principles of content analysis. The resulting categories were then arranged into a classification grid to develop a typology of preferences for participating in decision-making processes. Results. Older patients generally preferred to make decisions concerning everyday life rather than medical decisions, which they preferred to leave to their doctors. We characterised eight different patient types based on four interdependent positions (self-determination, adherence, information seeking, and trust). Experiences of a good doctor-patient relationship were associated with trust, reliance on the doctor for information and decision making, and adherence. Conclusion. Owing to the varied patient decision-making types, it is not easy for doctors to anticipate the desired level of patient involvement. However, the decision matter and the self-determination of patients provide good starting points in preparing the ground for shared decision making. A good relationship with the doctor facilitates satisfying decision-making experiences.

Electroencephalogram Signatures of Ketamine-Induced Unconsciousness

PubMed Central

Akeju, Oluwaseun; Song, Andrew H.; Hamilos, Allison E.; Pavone, Kara J.; Flores, Francisco J.; Brown, Emery N.; Purdon, Patrick L.

2016-01-01

Objectives Ketamine is an N-methyl-D-aspartate receptor antagonist commonly administered as a general anesthetic. However, circuit level mechanisms to explain ketamine-induced unconsciousness in humans are yet to be clearly defined. Disruption of frontal-parietal network connectivity has been proposed as a mechanism to explain this brain state. However, this mechanism was recently demonstrated at subanesthetic doses of ketamine in awake-patients. Therefore we investigated whether there is an electroencephalogram (EEG) marker for ketamine-induced unconsciousness. Methods We retrospectively studied the EEG in 12 patients who received ketamine for the induction of general anesthesia. We analyzed the EEG dynamics using power spectral and coherence methods. Results Following the administration of a bolus dose of ketamine to induce unconsciousness, we observed a “gamma burst” EEG pattern that consisted of alternating slow-delta (0.1-4 Hz) and gamma (~27-40 Hz) oscillations. This pattern was also associated with increased theta oscillations (~4-8 Hz) and decreased alpha/beta oscillations (~10-24 Hz). Conclusions Ketamine-induced unconsciousness is associated with a gamma burst EEG pattern. Significance We postulate that the gamma burst pattern is a thalamocortical rhythm based on insights previously obtained from cat neurophysiological experiments. This EEG signature of ketamine-induced unconsciousness may offer new insights into general anesthesia induced brain states. PMID:27178861

Generalist genes and the Internet generation: etiology of learning abilities by web testing at age 10.

PubMed

Davis, O S P; Kovas, Y; Harlaar, N; Busfield, P; McMillan, A; Frances, J; Petrill, S A; Dale, P S; Plomin, R

2008-06-01

A key translational issue for neuroscience is to understand how genes affect individual differences in brain function. Although it is reasonable to suppose that genetic effects on specific learning abilities, such as reading and mathematics, as well as general cognitive ability (g), will overlap very little, the counterintuitive finding emerging from multivariate genetic studies is that the same genes affect these diverse learning abilities: a Generalist Genes hypothesis. To conclusively test this hypothesis, we exploited the widespread access to inexpensive and fast Internet connections in the UK to assess 2541 pairs of 10-year-old twins for reading, mathematics and g, using a web-based test battery. Heritabilities were 0.38 for reading, 0.49 for mathematics and 0.44 for g. Multivariate genetic analysis showed substantial genetic correlations between learning abilities: 0.57 between reading and mathematics, 0.61 between reading and g, and 0.75 between mathematics and g, providing strong support for the Generalist Genes hypothesis. If genetic effects on cognition are so general, the effects of these genes on the brain are also likely to be general. In this way, generalist genes may prove invaluable in integrating top-down and bottom-up approaches to the systems biology of the brain.

Multivariate analysis of fears in dental phobic patients according to a reduced FSS-II scale.

PubMed

Hakeberg, M; Gustafsson, J E; Berggren, U; Carlsson, S G

1995-10-01

This study analyzed and assessed dimensions of a questionnaire developed to measure general fears and phobias. A previous factor analysis among 109 dental phobics had revealed a five-factor structure with 22 items and an explained total variance of 54%. The present study analyzed the same material using a multivariate statistical procedure (LISREL) to reveal structural latent variables. The LISREL analysis, based on the correlation matrix, yielded a chi-square of 216.6 with 195 degrees of freedom (P = 0.138) and showed a model with seven latent variables. One was a general fear factor correlated to all 22 items. The other six factors concerned "Illness & Death" (5 items), "Failures & Embarrassment" (5 items), "Social situations" (5 items), "Physical injuries" (4 items), "Animals & Natural phenomena" (4 items). One item (opposite sex) was included in both "Failures & Embarrassment" and "Social situations". The last factor, "Social interaction", combined all the items in "Failures & Embarrassment" and "Social situations" (9 items). In conclusion, this multivariate statistical analysis (LISREL) revealed and confirmed a factor structure similar to our previous study, but added two important dimensions not shown with a traditional factor analysis. This reduced FSS-II version measures general fears and phobias and may be used on a routine clinical basis as well as in dental phobia research.

Mortality and life expectancy of people with alcohol use disorder in Denmark, Finland and Sweden

PubMed Central

Westman, J; Wahlbeck, K; Laursen, T M; Gissler, M; Nordentoft, M; Hällgren, J; Arffman, M; Ösby, U

2015-01-01

Objective To analyse mortality and life expectancy in people with alcohol use disorder in Denmark, Finland and Sweden. Method A population-based register study including all patients admitted to hospital diagnosed with alcohol use disorder (1 158 486 person-years) from 1987 to 2006 in Denmark, Finland and Sweden. Results Life expectancy was 24–28 years shorter in people with alcohol use disorder than in the general population. From 1987 to 2006, the difference in life expectancy between patients with alcohol use disorder and the general population increased in men (Denmark, 1.8 years; Finland, 2.6 years; Sweden, 1.0 years); in women, the difference in life expectancy increased in Denmark (0.3 years) but decreased in Finland (−0.8 years) and Sweden (−1.8 years). People with alcohol use disorder had higher mortality from all causes of death (mortality rate ratio, 3.0–5.2), all diseases and medical conditions (2.3–4.8), and suicide (9.3–35.9). Conclusion People hospitalized with alcohol use disorder have an average life expectancy of 47–53 years (men) and 50–58 years (women) and die 24–28 years earlier than people in the general population. PMID:25243359

Definition of colorectal anastomotic leakage: A consensus survey among Dutch and Chinese colorectal surgeons

PubMed Central

van Rooijen, Stefanus J; Jongen, Audrey CHM; Wu, Zhou-Qiao; Ji, Jia-Fu; Slooter, Gerrit D; Roumen, Rudi MH; Bouvy, Nicole D

2017-01-01

AIM To determine the level of consensus on the definition of colorectal anastomotic leakage (CAL) among Dutch and Chinese colorectal surgeons. METHODS Dutch and Chinese colorectal surgeons were asked to partake in an online questionnaire. Consensus in the online questionnaire was defined as > 80% agreement between respondents on various statements regarding a general definition of CAL, and regarding clinical and radiological diagnosis of the complication. RESULTS Fifty-nine Dutch and 202 Chinese dedicated colorectal surgeons participated in the online survey. Consensus was found on only one of the proposed elements of a general definition of CAL in both countries: ‘extravasation of contrast medium after rectal enema on a CT scan’. Another two were found relevant according to Dutch surgeons: ‘necrosis of the anastomosis found during reoperation’, and ‘a radiological collection treated with percutaneous drainage’. No consensus was found for all other proposed elements that may be included in a general definition. CONCLUSION There is no universally accepted definition of CAL in the Netherlands and China. Diagnosis of CAL based on clinical manifestations remains a point of discussion in both countries. Dutch surgeons are more likely to report ‘subclinical’ leaks as CAL, which partly explains the higher reported Dutch CAL rates. PMID:28970733

Generalized epilepsy in a patient with mosaic Turner syndrome: a case report.

PubMed

Jhang, Kai-Ming; Chang, Tung-Ming; Chen, Ming; Liu, Chin-San

2014-04-02

Reports on cases of epilepsy in Turner syndrome are rare and most of them have cortical developmental malformations. We report the case of a Taiwanese patient with mosaic Turner syndrome with generalized tonic-clonic epilepsy and asymmetrical lateral ventricles but no apparent cortical anomaly. A 49-year-old Taiwanese woman without family history presented with infrequent generalized tonic-clonic epilepsy since she was 11 years old. On examination, her short stature, webbed neck, swelling of hands and feet, retrognathic face, and mild intellectual disability were noted. She had spontaneous menarche and regular menses. Brain magnetic resonance imaging showed asymmetrical lateral ventricles and diffuse subcortical white matter T2-weighted hyperintensities. Chromosome studies disclosed low aneuploid (10%) 45,X/46,XX/47,XXX mosaic Turner syndrome. There is increasing evidence that epilepsy can be an uncommon presentation of Turner syndrome. Mosaic Turner syndrome with 47, XXX probably increases the risk of epilepsy but more research is needed to reach a conclusion. This case also strengthens our knowledge that Turner syndrome can be one of the pathologic bases of asymmetrical lateral ventricles. When a patient has idiopathic/cryptogenic epilepsy or asymmetrical lateral ventricles on brain images, the presence of a mild Turner phenotype warrants further chromosome studies.

General practitioners' continuing education: a review of policies, strategies and effectiveness, and their implications for the future.

PubMed Central

Smith, F; Singleton, A; Hilton, S

1998-01-01

BACKGROUND: The accreditation and provision of continuing education for general practitioners (GPs) is set to change with new proposals from the General Medical Council, the Government, and the Chief Medical Officer. AIM: To review the theories, policies, strategies, and effectiveness in GP continuing education in the past 10 years. METHOD: A systematic review of the literature by computerized and manual searches of relevant journals and books. RESULTS: Educational theory suggests that continuing education (CE) should be work-based and use the learner's experiences. Audit can play an important role in determining performance and needs assessment, but at present is largely a separate activity. Educational and professional support, such as through mentors or co-tutors, has been successfully piloted but awaits larger scale evaluation. Most accredited educational events are still the postgraduate centre lecture, and GP Tutors have a variable role in CE management and provision. Controlled trials of CE strategies suggest effectiveness is enhanced by personal feedback and work prompts. Qualitative studies have demonstrated that education plays only a small part in influencing doctors' behavior. CONCLUSION: Maintaining good clinical practice is on many stakeholders' agendas. A variety of methods may be effective in CE, and larger scale trials or evaluations are needed. PMID:10071406

Healthy Workplaces: The Effects of Nature Contact at Work on Employee Stress and Health

PubMed Central

Largo-Wight, Erin; Chen, W. William; Dodd, Virginia; Weiler, Robert

2011-01-01

Objectives. Cultivating healthy workplaces is a critical aspect of comprehensive worksite health promotion. The influence of healthy workplace exposures on employee health outcomes warrants research attention. To date, it is unknown if nature contact in the workplace is related to employee stress and health. This study was designed to examine the effects of nature contact experienced at work on employee stress and health. Methods. Office staff at a southeastern university (n=503, 30% response rate) participated in the cross-sectional study. We used a 16-item workplace environment questionnaire, the Nature Contact Questionnaire, to comprehensively measure, for the first time, nature contact at work. The Perceived Stress Questionnaire and 13 established health and behavioral items assessed the dependent variables, general perceived stress, stress-related health behaviors, and stress-related health outcomes. Results. There was a significant, negative association between nature contact and stress and nature contact and general health complaints. The results indicate that as workday nature contact increased, perceived stress and generalized health complaints decreased. Conclusions. The findings suggest that nature contact is a healthy workplace exposure. Increasing nature contact at work may offer a simple population-based approach to enhance workplace health promotion efforts. Future researchers should test the efficacy of nature-contact workplace stress interventions. PMID:21563720

What's on Your Mind? Conversation Topics Chosen by People With Degenerative Cognitive-Linguistic Disorders for Communication Boards

PubMed Central

Daniels, Darlene; Ettinger, Olivia; Mooney, Aimee; Noethe, Glory; Rowland, Charity

2015-01-01

Purpose Conversational topics chosen by a group of adults with degenerative cognitive-linguistic disorders for personalized communication board development were examined. The patient-generated themes commonly selected are presented to guide treatment planning and communication board development. Method Communication boards were created for 109 adults as part of a larger research project. One autobiographical topic that each participant would enjoy discussing multiple times was represented on each communication board with 16 pictures and word labels. For this review, topics were collapsed into general themes through a consensus process and examined by gender and age. Results Sixty unique conversational topics were identified from 109 participants and collapsed into 9 general themes: Hobbies, Family, Travel, Work, Home/Places I've Lived, Sports/Fitness, Religion, Animals, and World War II. Age and gender produced variations in themes chosen, though no significance in rank orders was found across groups. Conclusions Topics selected by adults with degenerative cognitive-linguistic disorders for communication boards resemble common conversational adult themes and do not center around basic needs or medical issues. Differences in gender and age for topic selection tend to be based on traditional roles. These general themes should be used when creating personalized communication boards for those who benefit from conversational aids. PMID:25835511

DETERMINING THE ELEMENTAL AND ISOTOPIC COMPOSITION OF THE PRESOLAR NEBULA FROM GENESIS DATA ANALYSIS: THE CASE OF OXYGEN.

PubMed

Laming, J Martin; Heber, V S; Burnett, D S; Guan, Y; Hervig, R; Huss, G R; Jurewicz, A J G; Koeman-Shields, E C; McKeegan, K D; Nittler, L; Reisenfeld, D B; Rieck, K D; Wang, J; Wiens, R C; Woolum, D S

2017-12-10

We compare element and isotopic fractionations measured in solar wind samples collected by NASA's Genesis mission with those predicted from models incorporating both the ponderomotive force in the chromosphere and conservation of the first adiabatic invariant in the low corona. Generally good agreement is found, suggesting that these factors are consistent with the process of solar wind fractionation. Based on bulk wind measurements, we also consider in more detail the isotopic and elemental abundances of O. We find mild support for an O abundance in the range 8.75 - 8.83, with a value as low as 8.69 disfavored. A stronger conclusion must await solar wind regime specific measurements from the Genesis samples.

Revisiting syntactic development in deaf and hearing children from a dependency approach. Comment on "Dependency distance: a new perspective on syntactic patterns in natural languages" by Haitao Liu et al.

NASA Astrophysics Data System (ADS)

Yan, Jingqi

2017-07-01

Linguists are always endeavoring to discover universal rules to explain the language phenomena and interrelations [1]. Through a handful of corpus-based studies and a vast body of supporting evidence from psychological experiments, Liu, Xu and Liang [2] arrive at a conclusion on a general tendency toward dependency distance minimization (DDM) and relate this linguistic universal to the constraints of memory. Dependency distance (DD) is hereby introduced as a linguistic property, with quantitative features of frequency, and profound cognitive grounding as well. However, since the authors do not include language development, in this comment, I would like to discuss some future prospects from this perspective.

Radio interference in the near-earth environment

NASA Technical Reports Server (NTRS)

Erickson, W. C.

1988-01-01

Natural and man-made radio frequency interference (RFI) are potentially serious obstacles to the successful operation of an array of spacecraft used for low frequency (1 to 30 MHz) radio interferometry in the near-earth environment. Several satellites and planetary probes have carried radio astronomy experiments, and the moderate data base that they provide are examined to help understand the near-earth RFI environment. The general conclusion is that the region of space within 100 earth-radii of the earth is a hostile environment for any radio astronomy experiment. If a low frequency array in earth orbit is to yield useful astronomical results, severe interference problems must be anticipated and overcome. A number of recommendations are made to further examine the feasibility of such an array.

Sensitivity Analysis of Stability Problems of Steel Structures using Shell Finite Elements and Nonlinear Computation Methods

NASA Astrophysics Data System (ADS)

Kala, Zdeněk; Kala, Jiří

2011-09-01

The main focus of the paper is the analysis of the influence of residual stress on the ultimate limit state of a hot-rolled member in compression. The member was modelled using thin-walled elements of type SHELL 181 and meshed in the programme ANSYS. Geometrical and material non-linear analysis was used. The influence of residual stress was studied using variance-based sensitivity analysis. In order to obtain more general results, the non-dimensional slenderness was selected as a study parameter. Comparison of the influence of the residual stress with the influence of other dominant imperfections is illustrated in the conclusion of the paper. All input random variables were considered according to results of experimental research.

The construction and assessment of a statistical model for the prediction of protein assay data.

PubMed

Pittman, J; Sacks, J; Young, S Stanley

2002-01-01

The focus of this work is the development of a statistical model for a bioinformatics database whose distinctive structure makes model assessment an interesting and challenging problem. The key components of the statistical methodology, including a fast approximation to the singular value decomposition and the use of adaptive spline modeling and tree-based methods, are described, and preliminary results are presented. These results are shown to compare favorably to selected results achieved using comparitive methods. An attempt to determine the predictive ability of the model through the use of cross-validation experiments is discussed. In conclusion a synopsis of the results of these experiments and their implications for the analysis of bioinformatic databases in general is presented.

The ethical relevance of the unconscious.

PubMed

Farisco, Michele; Evers, Kathinka

2017-12-29

Ethical analyses of disorders of consciousness traditionally focus on residual awareness. Going one step further, this paper explores the potential ethical relevance of the unawareness retained by patients with disorders of consciousness, focusing specifically on the ethical implications of the description of the unconscious provided by recent scientific research. A conceptual methodology is used, based on the review and analysis of relevant scientific literature on the unconscious and the logical argumentation in favour of the ethical conclusions. Two conditions (experiential wellbeing and having interests) that are generally considered critical components in the ethical discussion of patients with disorders of consciousness might arguably be both conscious and unconscious. The unconscious, as well as consciousness, should be taken into account in the ethical discussions of patients with disorders of consciousness.

Environmental volunteer well-being: Managers’ perception and actual well-being of volunteers

PubMed Central

Kragh, Gitte; Stafford, Rick; Curtin, Susanna; Diaz, Anita

2016-01-01

Background: Environmental volunteering can increase well-being, but environmental volunteer well-being has rarely been compared to participant well-being associated with other types of volunteering or nature-based activities. This paper aims to use a multidimensional approach to well-being to explore the immediately experienced and later remembered well-being of environmental volunteers and to compare this to the increased well-being of participants in other types of nature-based activities and volunteering. Furthermore, it aims to compare volunteer managers’ perceptions of their volunteers’ well-being with the self-reported well-being of the volunteers. Methods: Onsite surveys were conducted of practical conservation and biodiversity monitoring volunteers, as well as their control groups (walkers and fieldwork students, respectively), to measure general well-being before their nature-based activity and activity-related well-being immediately after their activity. Online surveys of current, former and potential volunteers and volunteer managers measured remembered volunteering-related well-being and managers’ perceptions of their volunteers’ well-being. Data were analysed based on Seligman’s multidimensional PERMA (‘positive emotion’, ‘engagement’, ‘positive relationship’, ‘meaning’, ‘achievement’) model of well-being. Factor analysis recovered three of the five PERMA elements, ‘engagement’, ‘relationship’ and ‘meaning’, as well as ‘negative emotion’ and ‘health’ as factors. Results: Environmental volunteering significantly improved positive elements and significantly decreased negative elements of participants’ immediate well-being, and it did so more than walking or student fieldwork. Even remembering their volunteering up to six months later, volunteers rated their volunteering-related well-being higher than volunteers rated their well-being generally in life. However, volunteering was not found to have an effect on overall mean well-being generally in life. Volunteer managers did not perceive the significant increase in well-being that volunteers reported. Conclusions: This study showed how environmental volunteering immediately improved participants’ well-being, even more than other nature-based activities. It highlights the benefit of regarding well-being as a multidimensional construct to more systematically understand, support and enhance volunteer well-being. PMID:28184285

Teasing apart low mindfulness: differentiating deficits in mindfulness and in psychological flexibility in predicting symptoms of generalized anxiety disorder and depression.

PubMed

Curtiss, Joshua; Klemanski, David H

2014-09-01

This research investigated the differential ability of three components of low mindfulness to uniquely predict symptoms of generalized anxiety disorder (GAD) and depression, while controlling for psychological inflexibility, a construct conceptually related to low mindfulness. Also examined was the meditational role of several mindfulness facets in the relationship between psychological inflexibility and symptoms of each disorder. Using a clinical sample (n=153) containing mostly patients with GAD or depression diagnoses, we conducted hierarchical multiple regression analyses and mediation analyses to determine unique relationships. Whereas deficits in adopting a non-reactive perspective exhibited incremental validity beyond psychological inflexibility in predicting symptoms of GAD, deficits in acting with awareness did so in predicting symptoms of depression. Results of mediation analyses corroborated this pattern, as the relationships psychological inflexibility exhibited with symptoms of GAD and of depression were mediated by non-reactivity and acting with awareness, respectively. The cross-sectional design of this study precludes causal interpretations of the mediation models. Findings corroborate the following conclusions: (i) the lack of present oriented awareness experienced by individuals with symptoms of depression is not completely accounted for by psychological inflexibility nor by symptoms of GAD; (ii) the reactive approach to automatic thoughts adopted by those with symptoms of GAD is not completely accounted for by psychological inflexibility nor by symptoms of depression. These conclusions suggest that it would be profitable for mindfulness-based therapies to concentrate on these specific mindfulness deficits to ameliorate the severity of GAD and depression. Copyright © 2014 Elsevier B.V. All rights reserved.

Meta-analysis of magnitudes, differences and variation in evolutionary parameters.

PubMed

Morrissey, M B

2016-10-01

Meta-analysis is increasingly used to synthesize major patterns in the large literatures within ecology and evolution. Meta-analytic methods that do not account for the process of observing data, which we may refer to as 'informal meta-analyses', may have undesirable properties. In some cases, informal meta-analyses may produce results that are unbiased, but do not necessarily make the best possible use of available data. In other cases, unbiased statistical noise in individual reports in the literature can potentially be converted into severe systematic biases in informal meta-analyses. I first present a general description of how failure to account for noise in individual inferences should be expected to lead to biases in some kinds of meta-analysis. In particular, informal meta-analyses of quantities that reflect the dispersion of parameters in nature, for example, the mean absolute value of a quantity, are likely to be generally highly misleading. I then re-analyse three previously published informal meta-analyses, where key inferences were of aspects of the dispersion of values in nature, for example, the mean absolute value of selection gradients. Major biological conclusions in each original informal meta-analysis closely match those that could arise as artefacts due to statistical noise. I present alternative mixed-model-based analyses that are specifically tailored to each situation, but where all analyses may be implemented with widely available open-source software. In each example meta-re-analysis, major conclusions change substantially. © 2016 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2016 European Society For Evolutionary Biology.

Home care by general practitioners for cancer patients in the last 3 months of life: An epidemiological study of quality and associated factors

PubMed Central

Pivodic, Lara; Harding, Richard; Calanzani, Natalia; McCrone, Paul; Hall, Sue; Deliens, Luc; Higginson, Irene J; Gomes, Barbara

2016-01-01

Background: Stronger generalist end-of-life care at home for people with cancer is called for but the quality of end-of-life care delivered by general practitioners has been questioned. Aim: To determine the degree of and factors associated with bereaved relatives’ satisfaction with home end-of-life care delivered by general practitioners to cancer patients. Design: Population-based mortality followback survey. Setting/participants: Bereaved relatives of people who died of cancer in London, United Kingdom (identified from death registrations in 2009–2010), were invited to complete a postal questionnaire surveying the deceased’s final 3 months of life. Results: Questionnaires were completed for 596 decedents of whom 548 spent at least 1 day at home in the last 3 months of life. Of the respondents, 55% (95% confidence interval: 51%–59%) reported excellent/very good home care by general practitioners, compared with 78% (95% confidence interval: 74%–82%) for specialist palliative care providers and 68% (95% confidence interval: 64%–73%) for district/community/private nurses. The odds of high satisfaction (excellent/very good) with end-of-life care by general practitioners doubled if general practitioners made three or more compared with one or no home visits in the patient’s last 3 months of life (adjusted odds ratio: 2.54 (95% confidence interval: 1.52–4.24)) and halved if the patient died at hospital rather than at home (adjusted odds ratio: 0.55 (95% confidence interval: 0.31–0.998)). Conclusion: There is considerable room for improvement in the satisfaction with home care provided by general practitioners to terminally ill cancer patients. Ensuring an adequate offer of home visits by general practitioners may help to achieve this goal. PMID:26036688

15 CFR 904.253 - Closing of record.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Hearing and Appeal Procedures Hearings § 904.253 Closing of record. At the conclusion of the hearing, the...

15 CFR 904.253 - Closing of record.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Hearing and Appeal Procedures Hearings § 904.253 Closing of record. At the conclusion of the hearing, the...

Usage of purchased self-tests for HIV and sexually transmitted infections in Amsterdam, the Netherlands: results of population-based and serial cross-sectional studies among the general population and sexual risk groups

PubMed Central

Bil, Janneke P; Prins, Maria; Stolte, Ineke G; Dijkshoorn, Henriëtte; Heijman, Titia; Snijder, Marieke B; Davidovich, Udi; Zuure, Freke R

2017-01-01

Objectives There are limited data on the usage of commercially bought self-tests for HIV and other sexually transmitted infections (STIs). Therefore, we studied HIV/STI self-test usage and its determinants among the general population and sexual risk groups between 2007 and 2015 in Amsterdam, the Netherlands. Setting Data were collected in four different studies among the general population (S1–2) and sexual risk groups (S3–4). Participants S1–Amsterdam residents participating in representative population-based surveys (2008 and 2012; n=6044) drawn from the municipality register; S2–Participants of a population-based study stratified by ethnicity drawn from the municipality register of Amsterdam (2011–2015; n=17 603); S3–Men having sex with men (MSM) participating in an HIV observational cohort study (2008 and 2013; n=597) and S4–STI clinic clients participating in a cross-sectional survey (2007–2012; n=5655). Primary and secondary outcome measures Prevalence of HIV/STI self-test usage and its determinants. Results The prevalence of HIV/STI self-test usage in the preceding 6–12 months varied between 1% and 2% across studies. Chlamydia self-tests were most commonly used, except among MSM in S3. Chlamydia and syphilis self-test usage increased over time among the representative sample of Amsterdam residents (S1) and chlamydia self-test usage increased over time among STI clinic clients (S4). Self-test usage was associated with African Surinamese or Ghanaian ethnic origin (S2), being woman or MSM (S1 and 4) and having had a higher number of sexual partners (S1–2). Among those in the general population who tested for HIV/STI in the preceding 12 months, 5–9% used a self-test. Conclusions Despite low HIV/STI self-test usage, we observed increases over time in chlamydia and syphilis self-test usage. Furthermore, self-test usage was higher among high-risk individuals in the general population. It is important to continue monitoring self-test usage and informing the public about the unknown quality of available self-tests in the Netherlands and about the pros and cons of self-testing. PMID:28939577

Full journal publication of abstracts presented at the Nordic Congress of General Practice in 2009 and 2011

PubMed Central

Waldorff, Frans Boch; Petersen, Kristine; Vinther, Siri; Sandholdt, Håkon; Siersma, Volkert; Andersen, John Sahl

2017-01-01

Objective To determine the overall publication rates for abstracts presented at two consecutive Nordic Congresses of General Practice and to evaluate determinants for these publication rates. Design Prospective study. Setting MEDLINE (PubMed) and Google Scholar were searched for relevant publications from 1 January 2009 up until 31 August 2014. Methods Abstracts accepted for oral or poster presentation were identified from the original congress booklets from the Nordic Congresses of General Practice in 2009 and 2011. Based on PubMed and Google Scholar searches, we subsequently identified full journal publications within a 36-month follow-up from both congresses. In cases of doubt, the first author was contacted directly. Main outcome measures Full journal publication within 36 months after the congress. Results A total of 200 abstracts were analyzed. Of these, 85 (42.5%) were identified with a full publication within 36 months after the congress. More abstracts from the 2011 congress were published compared to the 2009 congress odds ratio (OR) 1.97, 95% confidence interval (CI) (1.10; 3.50). Abstracts accepted for oral presentation were more often published OR 1.94, 95% CI (1.08; 3.50) than accepted poster abstracts. In the multivariate analysis, a university affiliation for both first and last author increased the probability for publication OR 4.23, 95% CI (1.71; 10.42), as well as more than two authors. An optimal number, based on the highest OR, seems to be 3–4 authors with OR 2.43, 95% CI (1.07; 5.54). Qualitative studies were published at the same frequency as quantitative studies OR 1.36, 95% CI (0.57; 3.24). Conclusion Less than half of the abstracts accepted for oral or poster presentation at two consecutive Nordic Congresses of General Practice were published as full text articles within 36 months. Key points Congress abstracts accepted for Nordic Congress of General Practice are not indexed in international search databases. Less than half of the abstracts accepted for oral or poster presentation at two consecutive Nordic Congresses of General Practice were published as full text articles within 36 months. Future congress committees could address this aspect in order to increase the visibility of and accessibility to research within the field of general practice. PMID:28277049

Overview of Emerging Contaminants and Associated Human Health Effects

PubMed Central

Lei, Meng; Zhang, Lun; Lei, Jianjun; Zong, Liang; Li, Jiahui; Wu, Zheng; Wang, Zheng

2015-01-01

In recent decades, because of significant progress in the analysis and detection of trace pollutants, emerging contaminants have been discovered and quantified in living beings and diverse environmental substances; however, the adverse effects of environmental exposure on the general population are largely unknown. This review summarizes the conclusions of the comprehensive epidemic literature and representative case reports relevant to emerging contaminants and the human body to address concerns about potential harmful health effects in the general population. The most prevalent emerging contaminants include perfluorinated compounds, water disinfection byproducts, gasoline additives, manufactured nanomaterials, human and veterinary pharmaceuticals, and UV-filters. Rare but statistically meaningful connections have been reported for a number of contaminants and cancer and reproductive risks. Because of contradictions in the outcomes of some investigations and the limited number of articles, no significant conclusions regarding the relationship between adverse effects on humans and extents of exposure can be drawn at this time. Here, we report that the current evidence is not conclusive and comprehensive and suggest prospective cohort studies in the future to evaluate the associations between human health outcomes and emerging environmental contaminants. PMID:26713315

Helicopter roll control effectiveness criteria program summary

NASA Technical Reports Server (NTRS)

Heffley, Robert K.; Bourne, Simon M.; Mnich, Marc A.

1988-01-01

A study of helicopter roll control effectiveness is summarized for the purpose of defining military helicopter handling qualities requirements. The study is based on an analysis of pilot-in-the-loop task performance of several basic maneuvers. This is extended by a series of piloted simulations using the NASA Ames Vertical Motion Simulator and selected flight data. The main results cover roll control power and short-term response characteristics. In general the handling qualities requirements recommended are set in conjunction with desired levels of flight task and maneuver response which can be directly observed in actual flight. An important aspect of this, however, is that vehicle handling qualities need to be set with regard to some quantitative aspect of mission performance. Specific examples of how this can be accomplished include a lateral unmask/remask maneuver in the presence of a threat and an air tracking maneuver which recognizes the kill probability enhancement connected with decreasing the range to the target. Conclusions and recommendations address not only the handling qualities recommendations, but also the general use of flight simulators and the dependence of mission performance on handling qualities.

Prevalence and Socio-Demographic Determinants of Tobacco, Alcohol, Substance Use and Drug Misuse in General Population in Turkey

PubMed Central

İLHAN, Mustafa Necmi; ARIKAN, Zehra; KOTAN, Zeynep; TUNÇOĞLU, Tolga; PINARCI, Mustafa; TAŞDEMİR, Ahmet; AY, Bülent; KOÇAK, Nadir

2016-01-01

Introduction The aim of the current study is to determine prevalence ratios of tobacco, alcohol, substance use and drug misuse in a large scale sample of general population and recognize related socio-demographic factors. Methods The study was based on a cross-sectional survey conducted with a nationally representative sample of 8045 individuals with face-to-face, in-house interviews implemented by a trained team of interviewers. Results Life-time prevalences of tobacco, alcohol, substance use and drug misuse are 51.8%, 28.3%, 2.8% and 10.5% respectively. Age, gender, education level and marital status are important socio-demographic determinants for tobacco, alcohol use and drug misuse. Income level is an important determinant for alcohol and substance use. Conclusion Tobacco, alcohol, substance use and drug misuse are significant health concerns in Turkey. Socio-demographic status is an important determinant of several aspects of tobacco, alcohol, substance use and drug misuse and should therefore be evaluated carefully to develop effective protective and preventive strategies. PMID:28373796

Joint coverage probability in a simulation study on Continuous-Time Markov Chain parameter estimation.

PubMed

Benoit, Julia S; Chan, Wenyaw; Doody, Rachelle S

2015-01-01

Parameter dependency within data sets in simulation studies is common, especially in models such as Continuous-Time Markov Chains (CTMC). Additionally, the literature lacks a comprehensive examination of estimation performance for the likelihood-based general multi-state CTMC. Among studies attempting to assess the estimation, none have accounted for dependency among parameter estimates. The purpose of this research is twofold: 1) to develop a multivariate approach for assessing accuracy and precision for simulation studies 2) to add to the literature a comprehensive examination of the estimation of a general 3-state CTMC model. Simulation studies are conducted to analyze longitudinal data with a trinomial outcome using a CTMC with and without covariates. Measures of performance including bias, component-wise coverage probabilities, and joint coverage probabilities are calculated. An application is presented using Alzheimer's disease caregiver stress levels. Comparisons of joint and component-wise parameter estimates yield conflicting inferential results in simulations from models with and without covariates. In conclusion, caution should be taken when conducting simulation studies aiming to assess performance and choice of inference should properly reflect the purpose of the simulation.

Feasibility of using LANDSAT images of vegetation cover to estimate effective hydraulic properties of soils

NASA Technical Reports Server (NTRS)

Eagleson, P. S.

1985-01-01

Research activities conducted from February 1, 1985 to July 31, 1985 and preliminary conclusions regarding research objectives are summarized. The objective is to determine the feasibility of using LANDSAT data to estimate effective hydraulic properties of soils. The general approach is to apply the climatic-climax hypothesis (Ealgeson, 1982) to natural water-limited vegetation systems using canopy cover estimated from LANDSAT data. Natural water-limited systems typically consist of inhomogeneous vegetation canopies interspersed with bare soils. The ground resolution associated with one pixel from LANDSAT MSS (or TM) data is generally greater than the scale of the plant canopy or canopy clusters. Thus a method for resolving percent canopy cover at a subpixel level must be established before the Eagleson hypothesis can be tested. Two formulations are proposed which extend existing methods of analyzing mixed pixels to naturally vegetated landscapes. The first method involves use of the normalized vegetation index. The second approach is a physical model based on radiative transfer principles. Both methods are to be analyzed for their feasibility on selected sites.

Electroosmotic flow in capillary channels filled with nonconstant viscosity electrolytes: exact solution of the Navier-Stokes equation.

PubMed

Otevrel, Marek; Klepárník, Karel

2002-10-01

The partial differential equation describing unsteady velocity profile of electroosmotic flow (EOF) in a cylindrical capillary filled with a nonconstant viscosity electrolyte was derived. Analytical solution, based on the general Navier-Stokes equation, was found for constant viscosity electrolytes using the separation of variables (Fourier method). For the case of a nonconstant viscosity electrolyte, the steady-state velocity profile was calculated assuming that the viscosity decreases exponentially in the direction from the wall to the capillary center. Since the respective equations with nonconstant viscosity term are not solvable in general, the method of continuous binding conditions was used to solve this problem. In this method, an arbitrary viscosity profile can be modeled. The theoretical conclusions show that the relaxation times at which an EOF approaches the steady state are too short to have an impact on a separation process in any real systems. A viscous layer at the wall affects EOF significantly, if it is thicker than the Debye length of the electric double layer. The presented description of the EOF dynamics is applicable to any microfluidic systems.

Reverse bifurcation and fractal of the compound logistic map

NASA Astrophysics Data System (ADS)

Wang, Xingyuan; Liang, Qingyong

2008-07-01

The nature of the fixed points of the compound logistic map is researched and the boundary equation of the first bifurcation of the map in the parameter space is given out. Using the quantitative criterion and rule of chaotic system, the paper reveal the general features of the compound logistic map transforming from regularity to chaos, the following conclusions are shown: (1) chaotic patterns of the map may emerge out of double-periodic bifurcation and (2) the chaotic crisis phenomena and the reverse bifurcation are found. At the same time, we analyze the orbit of critical point of the compound logistic map and put forward the definition of Mandelbrot-Julia set of compound logistic map. We generalize the Welstead and Cromer's periodic scanning technology and using this technology construct a series of Mandelbrot-Julia sets of compound logistic map. We investigate the symmetry of Mandelbrot-Julia set and study the topological inflexibility of distributing of period region in the Mandelbrot set, and finds that Mandelbrot set contain abundant information of structure of Julia sets by founding the whole portray of Julia sets based on Mandelbrot set qualitatively.

Determination of the key parameters affecting historic communications satellite trends

NASA Technical Reports Server (NTRS)

Namkoong, D.

1984-01-01

Data representing 13 series of commercial communications satellites procured between 1968 and 1982 were analyzed to determine the factors that have contributed to the general reduction over time of the per circuit cost of communications satellites. The model by which the data were analyzed was derived from a general telecommunications application and modified to be more directly applicable for communications satellites. In this model satellite mass, bandwidth-years, and technological change were the variable parameters. A linear, least squares, multiple regression routine was used to obtain the measure of significance of the model. Correlation was measured by coefficient of determination (R super 2) and t-statistic. The results showed that no correlation could be established with satellite mass. Bandwidth-year however, did show a significant correlation. Technological change in the bandwidth-year case was a significant factor in the model. This analysis and the conclusions derived are based on mature technologies, i.e., satellite designs that are evolutions of earlier designs rather than the first of a new generation. The findings, therefore, are appropriate to future satellites only if they are a continuation of design evolution.

The influence of mood on memories of parental rearing practices.

PubMed

Gerlsma, C; Kramer, J J; Scholing, A; Emmelkamp, P M

1994-05-01

Parental rearing styles are often found to be related to adult psychological disorders. In general, conclusions are based on the data of retrospective studies, in which patients' memories of their parents' behaviour are investigated. However, it has been widely recognized that memories may be sensitive to current mood states. The possible mood sensitivity of autobiographic memories is a powerful alternative explanation of the relationship commonly found between parental rearing styles and psychopathology, with implications for the hypothesis of early parenting as a vulnerability factor in the aetiology of such disorders. The present study examined whether memories of parental rearing styles are influenced by present mood. To this aim, both mood and memories of parental rearing styles were assessed on two occasions in a sample of 315 healthy subjects from the general community (Study 1) and in a group of 46 socially phobic patients (Study 2). Results showed that memories of early parenting remained quite stable, even in the face of significant and considerable changes in anxiety, depression, and hostility. The theoretical and practical implications of these findings are discussed.

Teach Astronomy: An Online Resource for General Education and Informal Learning

NASA Astrophysics Data System (ADS)

Hardegree-Ullman, Kevin; Impey, C.; Patikkal, A.; Srinathan, A.; Collaboration of Astronomy Teaching Scholars CATS

2012-01-01

Teach Astronomy is a website developed for students and informal learners who would like to learn more general astronomy knowledge. This learning tool aggregates content from a myriad of sources, including: an introductory astronomy text book by C. D. Impey and W. K. Hartmann, astronomy related articles on Wikipedia, images from the Astronomy Picture of the Day, two to three minute video clips by C. D. Impey, podcasts from 365 Days of Astronomy, and news from Science Daily. In addition, Teach Astronomy utilizes a novel technology to cluster and display search results called a Wikimap. We present an overview of the website's features and suggestions for making the best use of Teach Astronomy in the classroom or at home. This material is based in part upon work supported by the National Science Foundation under Grant No. 0715517, a CCLI Phase III Grant for the Collaboration of Astronomy Teaching Scholars (CATS). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation.

The Impact of Re-tear on the Clinical Outcome after Rotator Cuff Repair Using Open or Arthroscopic Techniques – A Systematic Review

PubMed Central

Galanopoulos, Ilias; Ilias, Aslanidis; Karliaftis, Konstantinos; Papadopoulos, Dimitrios; Ashwood, Neil

2017-01-01

Background: It is generally accepted that rotator cuff repair gives satisfactory results in the long term, although most studies have so far shown a fairly high rate of structural failure or re-tear. The purpose of this review study is to assess whether failure of the repaired cuff to heal could negatively affect the functional outcome. Methods: This article includes an extensive Internet PubMed based research in the current English-language literature including level I to level V studies as well as systematic reviews. Results: According to this extended study research, the results are mixed; certain reports show that patients with a healed rotator cuff repair have improved function and strength compared to those with structural failure, whereas other studies support the generally perceived concept that tendon re-tear does not lead to inferior clinical outcome. Conclusion: Further high-level prospective studies with larger numbers of patients and longer follow up are needed to overcome the current debate over function between healed and failed rotator cuff repairs. PMID:28400878

Minimization of corrosion using activated sodium bromide in a medium-size cooling tower

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

Nalepa, C.J.; Moore, R.M.; Golson, G.L.

1996-07-01

The cooling tower at the Albermarle Process Development Center in Baton Rouge, Louisiana, historically used chlorine as a biocide in combination with phosphorus-based corrosion/scale inhibitors. Although this regimen provided biocontrol, sludge and iron buildup was a problem in low-velocity, small cross-sectional areas of piping. A general cleanup of the system was performed in April 1995. This cleanup was followed with a switch to a two-component corrosion inhibitor/dispersant package. Alternate biocides were evaluated at this time. Activated sodium bromide was found to be particularly effective in this tower, which operates at pH {approximately}8.4. Relative to chlorine, the use of activated sodiummore » bromide led to a decrease in general and pitting corrosion on mild steel. The reduced corrosion appears to be due to a combination of both chemical (less attack on passivated metal surfaces) and biological factors (better control of heterotrophic and sessile bacteria). These conclusions are supported by chemical analyses, corrosion meter and coupon data, dip slides, biological activity reaction tests, and visual observations of the tower sump and heat exchanger surfaces.« less

How can animal models inform on the transition to chronic symptoms in whiplash?

PubMed Central

Winkelstein, Beth A.

2011-01-01

Study Design A non-systematic review of the literature. Objective The objective was to present general schema for mechanisms of whiplash pain and review the role of animal models in understanding the development of chronic pain from whiplash injury. Summary of Background Data Extensive biomechanical and clinical studies of whiplash have been performed to understand the injury mechanisms and symptoms of whiplash injury. However, only recently have animal models of this painful disorder been developed based on other pain models in the literature. Methods A non-systematic review was performed and findings were integrated to formulate a generalized picture of mechanisms by chronic whiplash pain develops from mechanical tissue injuries. Results The development of chronic pain from tissue injuries in the neck due to whiplash involves complex interactions between the injured tissue and spinal neuroimmune circuits. A variety of animal models are beginning to define these mechanisms. Conclusion Continued work is needed in developing appropriate animal models to investigate chronic pain from whiplash injuries and care must be taken to determine whether such models aim to model the injury event or the pain symptom. PMID:22020616

Regional gray matter correlates of vocational interests

PubMed Central

2012-01-01

Background Previous studies have identified brain areas related to cognitive abilities and personality, respectively. In this exploratory study, we extend the application of modern neuroimaging techniques to another area of individual differences, vocational interests, and relate the results to an earlier study of cognitive abilities salient for vocations. Findings First, we examined the psychometric relationships between vocational interests and abilities in a large sample. The primary relationships between those domains were between Investigative (scientific) interests and general intelligence and between Realistic (“blue-collar”) interests and spatial ability. Then, using MRI and voxel-based morphometry, we investigated the relationships between regional gray matter volume and vocational interests. Specific clusters of gray matter were found to be correlated with Investigative and Realistic interests. Overlap analyses indicated some common brain areas between the correlates of Investigative interests and general intelligence and between the correlates of Realistic interests and spatial ability. Conclusions Two of six vocational-interest scales show substantial relationships with regional gray matter volume. The overlap between the brain correlates of these scales and cognitive-ability factors suggest there are relationships between individual differences in brain structure and vocations. PMID:22591829

Final Results from a Large-Scale National Study of General Education Astronomy Students' Learning Difficulties with Cosmology

NASA Astrophysics Data System (ADS)

Wallace, Colin; Prather, Edward; Duncan, Douglas

2011-10-01

We recently completed a large-scale, systematic study of general education introductory astronomy students' conceptual and reasoning difficulties related to cosmology. As part of this study, we analyzed a total of 4359 surveys (pre- and post-instruction) containing students' responses to questions about the Big Bang, the evolution and expansion of the universe, using Hubble plots to reason about the age and expansion rate of the universe, and using galaxy rotation curves to infer the presence of dark matter. We also designed, piloted, and validated a new suite of five cosmology Lecture-Tutorials. We found that students who use the new Lecture-Tutorials can achieve larger learning gains than their peers who did not. This material is based in part upon work supported by the National Science Foundation under Grant Nos. 0833364 and 0715517, a CCLI Phase III Grant for the Collaboration of Astronomy Teaching Scholars (CATS). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation.

Final Results from a Large-Scale National Study of General Education Astronomy Students’ Learning Difficulties with Cosmology

NASA Astrophysics Data System (ADS)

Wallace, Colin Scott; Prather, E. E.; Duncan, D. K.; Collaboration of Astronomy Teaching Scholars CATS

2012-01-01

We recently completed a large-scale, systematic study of general education introductory astronomy students’ conceptual and reasoning difficulties related to cosmology. As part of this study, we analyzed a total of 4359 surveys (pre- and post-instruction) containing students’ responses to questions about the Big Bang, the evolution and expansion of the universe, using Hubble plots to reason about the age and expansion rate of the universe, and using galaxy rotation curves to infer the presence of dark matter. We also designed, piloted, and validated a new suite of five cosmology Lecture-Tutorials. We found that students who use the new Lecture-Tutorials can achieve larger learning gains than their peers who did not. This material is based in part upon work supported by the National Science Foundation under Grant Nos. 0833364 and 0715517, a CCLI Phase III Grant for the Collaboration of Astronomy Teaching Scholars (CATS). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation.

Dealing with office emergencies. Stepwise approach for family physicians.

PubMed Central

Sempowski, Ian P.; Brison, Robert J.

2002-01-01

OBJECTIVE: To develop a simple stepwise approach to initial management of emergencies in family physicians' offices; to review how to prepare health care teams and equipment; and to illustrate a general approach to three of the most common office emergencies. QUALITY OF EVIDENCE: MEDLINE was searched from January 1980 to December 2001. Articles were selected based on their clinical relevance, quality of evidence, and date of publication. We reviewed American family medicine, pediatric, dental, and dermatologic articles, but found that the area has not been well studied from a Canadian family medicine perspective. Consensus statements by specialty professional groups were used to identify accepted emergency medical treatments. MAIN MESSAGE: Family medicine offices are frequently poorly equipped and inadequately prepared to deal with emergencies. Straightforward emergency response plans can be designed and tailored to an office's risk profile. A systematic team approach and effective use of skills, support staff, and equipment is important. The general approach can be modified for specific patients or conditions. CONCLUSION: Family physicians can plan ahead and use a team approach to develop a simple stepwise response to emergency situations in the office. PMID:12371305

Multiresolution generalized N dimension PCA for ultrasound image denoising

PubMed Central

2014-01-01

Background Ultrasound images are usually affected by speckle noise, which is a type of random multiplicative noise. Thus, reducing speckle and improving image visual quality are vital to obtaining better diagnosis. Method In this paper, a novel noise reduction method for medical ultrasound images, called multiresolution generalized N dimension PCA (MR-GND-PCA), is presented. In this method, the Gaussian pyramid and multiscale image stacks on each level are built first. GND-PCA as a multilinear subspace learning method is used for denoising. Each level is combined to achieve the final denoised image based on Laplacian pyramids. Results The proposed method is tested with synthetically speckled and real ultrasound images, and quality evaluation metrics, including MSE, SNR and PSNR, are used to evaluate its performance. Conclusion Experimental results show that the proposed method achieved the lowest noise interference and improved image quality by reducing noise and preserving the structure. Our method is also robust for the image with a much higher level of speckle noise. For clinical images, the results show that MR-GND-PCA can reduce speckle and preserve resolvable details. PMID:25096917

Methods development for separation of inorganic anions, organic acids and bases, and neutral organic compounds by ion chromatography and capillary electrophoresis

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

Li, Jie

1999-04-01

A novel anion-exchange resin containing three amine groups was prepared by reaction of a chloromethylated polystyrene-divinylbenzene (PS-DVB) resin with diethylenetriamine. After being protonated by contact with an aqueous acid, this resin can be used for ion chromatographic separation of anions. The charge on the resins can be varied from +1 to +3 by changing the mobile phase pH. The selectivity of the new ion exchangers for various inorganic anions was quite different from that of conventional anion exchangers. The performance of this new anion exchanger was studied by changing the pH and the concentration of the eluent, and several differentmore » eluents were used with some common anions as testing analytes. Conductivity detection and UV-visible detection were applied to detect the anions after separation. The new resin can also be used for HPLC separation of neutral organic compounds. Alkylphenols and alkylbenzenes were separated with this new polymeric resin, and excellent separations were obtained under simple conditions. This report contains Chapter 1: General introduction and Chapter 6: General conclusions.« less

Latent profile analyses of posttraumatic stress disorder, depression and generalized anxiety disorder symptoms in trauma-exposed soldiers.

PubMed

Contractor, Ateka A; Elhai, Jon D; Fine, Thomas H; Tamburrino, Marijo B; Cohen, Gregory; Shirley, Edwin; Chan, Philip K; Liberzon, Israel; Galea, Sandro; Calabrese, Joseph R

2015-09-01

Posttraumatic stress disorder (PTSD) is comorbid with major depressive disorder (MDD; Kessler et al., 1995) and generalized anxiety disorder (GAD; Brown et al., 2001). We aimed to (1) assess discrete patterns of post-trauma PTSD-depression-GAD symptoms using latent profile analyses (LPAs), and (2) assess covariates (gender, income, education, age) in defining the best fitting class solution. The PTSD Checklist (assessing PTSD symptoms), GAD-7 scale (assessing GAD symptoms), and Patient Health Questionnaire-9 (assessing depression) were administered to 1266 trauma-exposed Ohio National Guard soldiers. Results indicated three discrete subgroups based on symptom patterns with mild (class 1), moderate (class 2) and severe (class 3) levels of symptomatology. Classes differed in symptom severity rather than symptom type. Income and education significantly predicted class 1 versus class 3 membership, and class 2 versus class 3. In conclusion, there is heterogeneity regarding severity of PTSD-depression-GAD symptomatology among trauma-exposed soldiers, with income and education predictive of class membership. Copyright © 2015 Elsevier Ltd. All rights reserved.

Association between Internet gaming disorder and generalized anxiety disorder.

PubMed

Wang, Chao-Yang; Wu, Yu-Chen; Su, Chen-Hsiang; Lin, Pai-Cheng; Ko, Chih-Hung; Yen, Ju-Yu

2017-12-01

Introduction This study evaluates the association between generalized anxiety disorder (GAD) and Internet gaming disorder (IGD) and the role of behavior inhibition in young adults. Methods We recruited 87 people with IGD and a control group of 87 people without a history of IGD. All participants underwent a diagnostic interview based on the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, IGD and GAD criteria, and completed a questionnaire on behavior inhibition, depression, and anxiety. Results Logistic regression revealed that adults with GAD were more likely (odds ratio = 8.11, 95% CI = 1.78-37.09) to have IGD than those without it. The OR decreased when controlling for behavior inhibition. IGD subjects with GAD had higher depressive and anxiety score than those without GAD. Conclusions GAD was associated with IGD. Comorbid GAD can contribute to higher emotional difficulty. GAD should be well-assessed and interventions planned when treating young adults with IGD. Behavioral inhibition confounds the association between GAD and IGD. Further study is necessary to evaluate how to intervene in behavioral inhibitions to attenuate the risk of GAD and IGD comorbidity.

Evaluating the short-term and long-term effects of an internet-based aural rehabilitation programme for hearing aid users in general clinical practice: a randomised controlled trial

PubMed Central

Malmberg, Milijana; Lunner, Thomas; Kähäri, Kim; Andersson, Gerhard

2017-01-01

Objective Guided internet-based intervention beyond hearing aid (HA) fitting has been shown to be efficacious in randomised controlled trials (RCTs). However, internet interventions have rarely been applied clinically as a part of regular aural rehabilitation (AR). Our aim was to evaluate the effectiveness of internet-based AR for HA users from a clinical population. Outcome measures The Hearing Handicap Inventory for the Elderly (HHIE) was used as the primary outcome measure, and the Communication Strategies Scale (CSS) and the Hospital Anxiety and Depression Scale were used as secondary outcome measures. All questionnaires were administered before and directly after the intervention and at 6 months postintervention. Methods We used a parallel group design (RCT). The data were collected in 2013–2014 at three different clinics. Seventy-four HA users were randomly assigned to receive either full internet-based AR (intervention group, n=37) or one element of the internet-based AR (control group, n=37). Results Data were analysed following the intention-to-treat principle. Each group showed improved HHIE scores over time and did not differ significantly from each other. The intervention group showed significantly greater improvement compared with the control group for the CSS total and the non-verbal subscale scores. The intervention group and control group were also subdivided into two age groups: 20–59 years and 60–80 years. Significantly better improvement on the CSS total and non-verbal subscale scores was found in the older group compared with the younger participants. Conclusions This study indicates that participants in an internet-based intervention applied in general clinical practice showed improved self-reported communication skills compared with a control group. Receiving a full intervention was not more effective in improving self-reported hearing problems than receiving just one element of the internet-based intervention. Trial registration number This trial is registered at ClinicalTrals.gov, NCT01837550; results. PMID:28592571

SU-F-207-06: CT-Based Assessment of Tumor Volume in Malignant Pleural Mesothelioma

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

Qayyum, F; Armato, S; Straus, C

Purpose: To determine the potential utility of computed tomography (CT) scans in the assessment of physical tumor bulk in malignant pleural mesothelioma patients. Methods: Twenty-eight patients with malignant pleural mesothelioma were used for this study. A CT scan was acquired for each patient prior to surgical resection of the tumor (median time between scan and surgery: 27 days). After surgery, the ex-vivo tumor volume was measured by a pathologist using a water displacement method. Separately, a radiologist identified and outlined the tumor boundary on each CT section that demonstrated tumor. These outlines then were analyzed to determine the total volumemore » of disease present, the number of sections with outlines, and the mean volume of disease per outlined section. Subsets of the initial patient cohort were defined based on these parameters, i.e. cases with at least 30 sections of disease with a mean disease volume of at least 3mL per section. For each subset, the R- squared correlation between CT-based tumor volume and physical ex-vivo tumor volume was calculated. Results: The full cohort of 28 patients yielded a modest correlation between CT-based tumor volume and the ex-vivo tumor volume with an R-squared value of 0.66. In general, as the mean tumor volume per section increased, the correlation of CT-based volume with the physical tumor volume improved substantially. For example, when cases with at least 40 CT sections presenting a mean of at least 2mL of disease per section were evaluated (n=20) the R-squared correlation increased to 0.79. Conclusion: While image-based volumetry for mesothelioma may not generally capture physical tumor volume as accurately as one might expect, there exists a set of conditions in which CT-based volume is highly correlated with the physical tumor volume. SGA receives royalties and licensing fees through the University of Chicago for computer-aided diagnosis technology.« less

Sex Differences in Brain Volume Are Related to Specific Skills, Not to General Intelligence

ERIC Educational Resources Information Center

Burgaleta, Miguel; Head, Kevin; Alvarez-Linera, Juan; Martinez, Kenia; Escorial, Sergio; Haier, Richard; Colom, Roberto

2012-01-01

It has been proposed that males would show higher mean scores than females in general intelligence ("g") because (1) men have, on average, larger brains than women, and (2) brain volume correlates with "g." Here we report a failure to support the conclusion derived from these premises. High resolution MRIs were acquired in a sample of one hundred…

15 CFR 904.240 - Discovery generally.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) directly upon the respondent without first seeking an order from the Judge. (c) Time limits. Motions for... the materials by other means. Mental impressions, conclusions, opinions, or legal theories of an...

15 CFR 904.240 - Discovery generally.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) directly upon the respondent without first seeking an order from the Judge. (c) Time limits. Motions for... the materials by other means. Mental impressions, conclusions, opinions, or legal theories of an...

15 CFR 904.240 - Discovery generally.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) directly upon the respondent without first seeking an order from the Judge. (c) Time limits. Motions for... the materials by other means. Mental impressions, conclusions, opinions, or legal theories of an...

15 CFR 904.240 - Discovery generally.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) directly upon the respondent without first seeking an order from the Judge. (c) Time limits. Motions for... the materials by other means. Mental impressions, conclusions, opinions, or legal theories of an...