[Genetic research as a means of proof in the German penal trial after the reform of the Court Rules of Procedure of 17 March 1997 (I)].

PubMed

Etxeberria Guridi, J F

1998-01-01

The authors reviews genetic fingerprinting practice and cases in Germany following the adoption of the new specific regulatory measures in the StPO, and looks at German case law on the subject. Also examined are the way in which the issue of human rights and some doubts which have arisen among authors and the courts have been resolved. The positive aspects of the new regulations are underlined and the author concludes with some proposals for application of these, lege ferenda, in Spain.

Association between Stereotactic Radiotherapy and Death from Brain Metastases of Epithelial Ovarian Cancer: a Gliwice Data Re-Analysis with Penalization

PubMed

Tukiendorf, Andrzej; Mansournia, Mohammad Ali; Wydmański, Jerzy; Wolny-Rokicka, Edyta

2017-04-01

Background: Clinical datasets for epithelial ovarian cancer brain metastatic patients are usually small in size. When adequate case numbers are lacking, resulting estimates of regression coefficients may demonstrate bias. One of the direct approaches to reduce such sparse-data bias is based on penalized estimation. Methods: A re- analysis of formerly reported hazard ratios in diagnosed patients was performed using penalized Cox regression with a popular SAS package providing additional software codes for a statistical computational procedure. Results: It was found that the penalized approach can readily diminish sparse data artefacts and radically reduce the magnitude of estimated regression coefficients. Conclusions: It was confirmed that classical statistical approaches may exaggerate regression estimates or distort study interpretations and conclusions. The results support the thesis that penalization via weak informative priors and data augmentation are the safest approaches to shrink sparse data artefacts frequently occurring in epidemiological research. Creative Commons Attribution License

[Law No. 92-684 of 22 July 1992 reforming provisions of the Penal Code relating to the punishment of crimes and misdemeanors committed against persons].

PubMed

1992-07-23

This Law, reformulating entirely Book II of the French Penal Code, newly criminalizes the following acts: a) sexual harassment; b) subjecting a person to work conditions or lodging contrary to human dignity because that person is in a situation of vulnerability or dependence; c) incitement of minors to engage in dangerous or illegal behavior such as excessive drinking, use of narcotics, or begging; and d) using the pictures of minors for pornographic purposes. Sexual harassment is defined as the use of orders, threats, or force to gain sexual favors by a person whose responsibilities place him in a position of authority over another person. In addition, provisions relating to the punishment of procuring have been strengthened in the new Code. Acts noted in b) above were criminalized in order to combat more forcefully the use of clandestine workers.

[Harassment in the public sector].

PubMed

Puech, Paloma; Pitcho, Benjamin

2013-01-01

The French Labour Code, which provides full protection against moral and sexual harassment, is not applicable to public sector workers. The public hospital is however not exempt from such behaviour, which could go unpunished. Public sector workers are therefore protected by the French General Civil Service Regulations and the penal code.

[Euthanasia - an attempt to organize issue].

PubMed

Kirmes, Tomasz; Wilk, Mateusz; Chowaniec, Czesław

This article is an attempt to complete and holistically discuss problem of euthanasia, especially its ethical and legal aspects, comparing to Polish law. The subject of euthanasia arouse interest of the society because it touches one of the most important aspects of life, which is the death. Even bigger emotions are aroused amongst physicians. They are forced to put on the line the life as biggest value on the one side and autonomy of human being on the other. It also touches the empathy for suffering. The euthanasia was divided into three forms: active euthanasia, passive euthanasia and assisted suicide. Any form of euthanasia is illegal in Poland according to both the Penal Code and Code of Medical Ethics. Range of possible penal consequences perpetrator is very wide from waiver of punishment to life imprisonment and it comes from different penal qualification of the euthanasia. Qualification of the euthanasia is based on terms of intent of perpetrator's act, request of patient, strong empathy for suffering if the patient and decision based on up-to-date medical knowledge. It is valuable to mention "do-not-resuscitate" DNR procedure, which in case of medical futility is legally accepted in Poland, but in other form may be qualified as passive euthanasia.

Psychiatric care in the German prison system.

PubMed

Lehmann, Marc

2012-01-01

The purpose of this paper is to describe the nature of medical care within the German penal system. German prison services provide health care for all inmates, including psychiatric care. The reached level of equivalence of care and ethical problems and resource limitations are discussed and the way of legislation in this field since 2006 reform on federal law is described. The article summarizes basic data on German prison health care for mentally ill inmates. The legislation process and factors of influence are pointed out. A description of how psychiatric care is organized in German prisons follows. It focuses on the actual legal situation including European standards of prison health care and prevention of torture, psychiatric care in German prisons themselves, self harm and addiction. Associated problems such as blood born diseases and tuberculosis are included. The interactions between prison staff and health care personal and ethic aspects are discussed. The legislation process is still going on and there is still a chance to improve psychiatric care. Mental health problems are the major challenge for prison health care. Factors such as special problems of migrants, shortage of professionals and pure statistic data are considered. The paper provides a general overview on psychiatric services in prison and names weak points and strengths of the system.

Honor crimes: review and proposed definition.

PubMed

Elakkary, Sally; Franke, Barbara; Shokri, Dina; Hartwig, Sven; Tsokos, Michael; Püschel, Klaus

2014-03-01

There is every reason to believe that honor based violence is one of the forms of domestic violence that is being practiced against females all over the world. This type of violence includes a wide range of crimes, the severest of which is honor killing. Many studies have adopted different definitions for the so-called honor killing. In this paper some of these definitions are discussed and a working definition is proposed. The scope of the problem worldwide is presented. Honor killing goes beyond ethnicity, class, and religion. It is a very old phenomenon that was practiced in ancient Rome, guided by penal codes. Some of the older as well as new penal codes are discussed concerning this matter from different regions of the world. The different efforts of international governmental and nongovernmental organizations in combating this problem are also presented.

[The new Colombian criminal code and biotechnology].

PubMed

González de Cancino, Emilssen

2002-01-01

The author describes the process by which new offenses concerning biotechnology have been included in Colombia's Penal Code and discusses some of the more controversial aspects involved. She examines the various stages of the passage of the Bill through Parliament and the modifications undergone. She also provides well-argued criticism of the text, with appropriate reference to Constitutional provisions regarding the rights concerned.

A comparison of "life threatening injury" concept in the Turkish Penal Code and trauma scoring systems.

PubMed

Fedakar, Recep; Aydiner, Ahmet Hüsamettin; Ercan, Ilker

2007-07-01

To compare accuracy and to check the suitability of the Glasgow Coma Scale (GCS), the Revised Trauma Score (RTS), the Injury Severity Score (ISS), the New Injury Severity Score (NISS) and the Trauma and Injury Severity Score (TRISS), the scoring systems widely used in international trauma studies, in the evaluation of the "life threatening injury" concept established by the Turkish Penal Code. The age, sex, type of trauma, type and localizations of wounds, GCS, RTS, ISS, NISS and TRISS values, the decision of life threatening injury of 627 trauma patients admitted to Emergency Department of the Uludag University Medical School Hospital in year 2003 were examined. A life-threatening injury was present in 35.2% of the cases examined. GCS, RTS, ISS, NISS and TRISS confirmed the decision of life threatening injury with percentages of 74.8%, 76.9%, 88.7%, 86.6% and 68.6%, respectively. The best cut-off point 14 was determined in the ISS system with 79.6% sensitivity and 93.6% specificity. All of the cases with sole linear skull fracture officially decided as life threatening injury had an ISS of 5, a NISS of 6 and the best scores of GCS (15), RTS (7.8408) and TRISS (100%). ISS and NISS appeared to be the best trauma scoring systems that can be used for the decision of life threatening injury, compared with GCS, RTS and TRISS. Thus, ISS and NISS can be acceptable for using the evaluation of the life threatening injury concept established by the Turkish Penal Code.

[Treatment motivation of patients admitted for substance abuse treatment according to the section 64 StGB regulation].

PubMed

Schalast, N

2000-09-01

Describe treatment motivation in offenders with addiction problems, who enter treatment in forensic hospital departments according to section 64 of the German penal code. Consider relevance of treatment motivation with regard to course and outcome of treatment. 83 patients were interviewed within the first days of psychiatric detention and after six month of treatment. They also filled in questionnaires on treatment motivation. Hospital staff reported another six month later about course of treatment. Most patients express awareness of drug/alcohol related problems and an intention to participate in treatment. But only a minority of patients shows a very strong motivation to stay abstinent from alcohol/drugs. More than half of the patients relapse during the first year of treatment. In more than one third of the cases, psychiatric detentions are cancelled due to a negative assessment of prognosis of further treatment. Most of these patients are returned to prison. Initial treatment motivation shows some relevance with regard to course of treatment. But negative outcomes of treatment shouldn't be explained simply as effects of insufficient motivation. A conception of treatment fostering hope and social competence seems to be most effective in strengthening treatment motivation.

Recommendations for the classification of HIV associated neuromanifestations in the German DRG system.

PubMed

Evers, Stefan; Fiori, W; Brockmeyer, N; Arendt, G; Husstedt, I-W

2005-09-12

HIV associated neuromanifestations are of growing importance in the in-patient treatment of HIV infected patients. In Germany, all in-patients have to be coded according to the ICD-10 classification and the German DRG-system. We present recommendations how to code the different primary and secondary neuromanifestations of HIV infection. These recommendations are based on the commentary of the German DRG procedures and are aimed to establish uniform coding of neuromanifestations.

Penal Code (Ordinance No. 12 of 1983), 1 July 1984.

PubMed

1987-01-01

This document contains provisions of the 1984 Penal Code of Montserrat relating to sexual offenses, abortion, offenses relating to marriage, homicide and other offenses against the person, and neglect endangering life or health. Part 8 of the Code holds that a man found guilty of raping a woman is liable to life imprisonment. Rape is deemed to involve unlawful (extramarital) sexual intercourse with a woman without her consent (this is determined if the rape involved force, threats, administration of drugs, or false representation). The Code also defines offenses in cases of incest, child abuse, prostitution, abduction, controlling the actions and finances of a prostitute, and having unlawful sexual intercourse with a mentally defective woman. Part 9 of the Code outlaws abortion unless it is conducted in an approved establishment after two medical practitioners have determined that continuing the pregnancy would risk the life or physical/mental health of the pregnant woman or if a substantial risk exists that the child would have serious abnormalities. Part 10 outlaws bigamy, and part 12 holds that infanticide performed by a mother suffering postpartum imbalances can be prosecuted as manslaughter. This part also outlaws concealment of the body of a newborn, whether that child died before, at, or after birth, and aggravated assault on any child not more than 14 years old. Part 12 makes it an offense to subject any child to neglect endangering its life or health.

Act No. 62, Penal Code, 29 December 1987.

PubMed

1988-01-01

This document contains various provisions of the 1987 Cuban Penal Code. Chapter 6 of Title 8 (crimes against life and bodily integrity) outlaws abortion and sets prison terms for its performance under various circumstances. Chapter 7 sets a penalty of five to 12 years imprisonment for performing a sterilization procedure. Chapter 8 outlines the penalties for abandonment of minors and incompetent or helpless people. Under Title 9 (crimes against individual rights), Chapter 8 renders it illegal to discriminate on the grounds of sex, race, color, or national origin. Chapter 1 of Title 11 deals with crimes against the normal development of sexual relations, setting penalties for rape, pederasty with violence, and lascivious abuse. Chapter 2 covers crimes against the normal development of the family such as incest, sexual relations with a minor, bigamy, illegal marriage, and substitution of one child for another. Chapter 3 places penalties for crimes against the normal development of childhood and youth, such as the corruption of minors, the neglect of minors, and the failure to support minors.

[Multiaxial classification of stalking. Guidelines for the assessment of criminal liability and prognosis].

PubMed

Dressing, H; Kühner, C; Gass, P

2007-07-01

Stalking is a widespread phenomenon describing a pattern of intrusive and threatening behaviour that leads to the victim's perception of being harassed and of him or her being rendered fearful. Physical assault and even homicide may occur in the context of stalking. Anglo-Saxon studies have revealed a lifetime prevalence of being a victim of stalking ranging from 4-7% in men and 12-17% in women. Recently, these rates have been confirmed by the first community based study carried out in Germany. As a stalker can have a number of victims during his or her lifetime, the prevalence of stalkers may be less than this, although at present data for this are lacking. Although the phenomenology of stalking appears to be rather homogenous, fairly distinct stalker typologies and perpetrator-victim relationships have to be considered. Requests for psychiatric and forensic assessment of stalkers are increasing. According to the German penal code, psychiatrists must provide expert opinion on criminal responsibility and the placement of stalkers. So far, all typologies of stalkers refer to the Anglo-Saxon cultural background and do not consider the special needs of German forensic psychiatry. In particular, the psychopathological dimension is widely neglected in common typologies. The present paper proposes a multiaxial typology of stalking that considers the psychopathological dimension, the relationship between stalker and victim and motivational aspects. Consequences for the forensic psychiatric assessment according to section 20, 21 StGB are outlined. It should be pointed out that stalking is not a new diagnostic category, but only involves, at a descriptive level, deviation from a normal behavioural pattern. The central components of the forensic psychiatric assessment remain the known diagnostic categories, the effects of which on behaviour can be analysed.

Bayesian inference of Calibration curves: application to archaeomagnetism

NASA Astrophysics Data System (ADS)

Lanos, P.

2003-04-01

The range of errors that occur at different stages of the archaeomagnetic calibration process are modelled using a Bayesian hierarchical model. The archaeomagnetic data obtained from archaeological structures such as hearths, kilns or sets of bricks and tiles, exhibit considerable experimental errors and are typically more or less well dated by archaeological context, history or chronometric methods (14C, TL, dendrochronology, etc.). They can also be associated with stratigraphic observations which provide prior relative chronological information. The modelling we describe in this paper allows all these observations, on materials from a given period, to be linked together, and the use of penalized maximum likelihood for smoothing univariate, spherical or three-dimensional time series data allows representation of the secular variation of the geomagnetic field over time. The smooth curve we obtain (which takes the form of a penalized natural cubic spline) provides an adaptation to the effects of variability in the density of reference points over time. Since our model takes account of all the known errors in the archaeomagnetic calibration process, we are able to obtain a functional highest-posterior-density envelope on the new curve. With this new posterior estimate of the curve available to us, the Bayesian statistical framework then allows us to estimate the calendar dates of undated archaeological features (such as kilns) based on one, two or three geomagnetic parameters (inclination, declination and/or intensity). Date estimates are presented in much the same way as those that arise from radiocarbon dating. In order to illustrate the model and inference methods used, we will present results based on German archaeomagnetic data recently published by a German team.

[Orthopedic and trauma surgery in the German-DRG-System 2009].

PubMed

Franz, D; Windolf, J; Siebert, C H; Roeder, N

2009-01-01

The German DRG-System was advanced into version 2009. For orthopedic and trauma surgery significant changes concerning coding of diagnoses, medical procedures and concerning the DRG-structure were made. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2008 and 2009 based on the publications of the German DRG-institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2009 focussed on the development of DRG-structure, DRG-validation and codes for medical procedures to be used for very complex cases. The outcome of these changes for German hospitals may vary depending in the range of activities. G-DRG-System gained complexity again. High demands are made on correct and complete coding of complex orthopedic and trauma surgery cases. Quality of case-allocation within the G-DRG-System was improved. Nevertheless, further adjustments of the G-DRG-System especially for cases with severe injuries are necessary.

[Adjustment of the German DRG system in 2009].

PubMed

Wenke, A; Franz, D; Pühse, G; Volkmer, B; Roeder, N

2009-07-01

The 2009 version of the German DRG system brought significant changes for urology concerning coding of diagnoses, medical procedures and the DRG structure. In view of the political situation and considerable economic pressure, a critical analysis of the 2009 German DRG system is warranted. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2008 and 2009 based on the publications of the German DRG-institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). The relevant diagnoses, medical procedures and German DRGs in the versions 2008 and 2009 were analysed based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2009 focus on the development of the DRG structure, DRG validation and codes for medical procedures to be used for very complex cases. The outcome of these changes for German hospitals may vary depending in the range of activities. The German DRG system again gained complexity. High demands are made on correct and complete coding of complex urology cases. The quality of case allocation in the German DRG system was improved. On the one hand some of the old problems (e.g. enterostomata) still persist, while on the other hand new problems evolved out of the attempt to improve the case allocation of highly complex and expensive cases. Time will tell whether the increase in highly specialized DRG with low case numbers will continue to endure and reach acceptable rates of annual fluctuations.

Military Policy toward Homosexuals: Scientific, Historic, and Legal Perspectives

DTIC Science & Technology

1990-04-01

International Trends During the 1950s, the American Law Institute recommended that states adopt a Model Penal Code that decriminalized all non-violent...personalities. For much of our history, the military’s fear of racial tension kept black soldiers segregated from whites. Fear of sexual tensions, until

32 CFR 763.5 - Entry procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... GOVERNING PUBLIC ACCESS Entry Regulations for Kaho'olawe Island, Hawaii § 763.5 Entry procedures. (a) It is... Harbor, Hawaii 96860, at least 15 days prior to the access requested, providing therein confirmed access... proscribed by either Federal law or the State of Hawaii Penal Code, as incorporated under the Federal...

[Orthopedic and trauma surgery in the German DRG System 2007].

PubMed

Franz, D; Kaufmann, M; Siebert, C H; Windolf, J; Roeder, N

2007-03-01

The German Diagnosis-Related Groups (DRG) System was further developed into its 2007 version. For orthopedic and trauma surgery, significant changes were made in terms of the coding of diagnoses and medical procedures, as well as in the DRG structure itself. The German Societies for Trauma Surgery and for Orthopedics and Orthopedic Surgery (Deutsch Gesellschaft für Unfallchirurgie, DGU; and Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie, DGOOC) once again cooperated constructively with the German DRG Institute InEK. Among other innovations, new International Classification of Diseases (ICD) codes for second-degree burns were implemented. Procedure codes for joint operations, endoprosthetic-surgery and spine surgery were restructured. Furthermore, a specific code for septic surgery was introduced in 2007. In addition, the DRG structure was improved. Case allocation of patients with more than one significant operation was established. Further DRG subdivisions were established according to the patients age and the Patient Clinical Complexity Level (PCCL). DRG developments for 2007 have improved appropriate case allocation, but once again increased the system's complexity. Clinicians need an ever growing amount of specific coding know-how. Still, further adjustments to the German DRG system are required to allow for a correct allocation of cases and funds.

Admissibility of Evidence from Compelled Mental Examinations: MRE 302 and Beyond

DTIC Science & Technology

1988-04-01

antisocial and paranoid personality disorder. He was subsequently apprehended for possession of marihuana and another assault. He was again referred to the...acts. Mental disease or defect does not otherwise constitute a defense. Uniform Code of Military Justice art . 50a, 10 U.S.C.A. § 859a (1987 Supp...UCMJ art . 5a (bW. 4 RCM 716k (3)(A). 5 "No problem in the drafting of a penal code presents larger intrinsic difficulties than that of determining when

Bootstrap Enhanced Penalized Regression for Variable Selection with Neuroimaging Data.

PubMed

Abram, Samantha V; Helwig, Nathaniel E; Moodie, Craig A; DeYoung, Colin G; MacDonald, Angus W; Waller, Niels G

2016-01-01

Recent advances in fMRI research highlight the use of multivariate methods for examining whole-brain connectivity. Complementary data-driven methods are needed for determining the subset of predictors related to individual differences. Although commonly used for this purpose, ordinary least squares (OLS) regression may not be ideal due to multi-collinearity and over-fitting issues. Penalized regression is a promising and underutilized alternative to OLS regression. In this paper, we propose a nonparametric bootstrap quantile (QNT) approach for variable selection with neuroimaging data. We use real and simulated data, as well as annotated R code, to demonstrate the benefits of our proposed method. Our results illustrate the practical potential of our proposed bootstrap QNT approach. Our real data example demonstrates how our method can be used to relate individual differences in neural network connectivity with an externalizing personality measure. Also, our simulation results reveal that the QNT method is effective under a variety of data conditions. Penalized regression yields more stable estimates and sparser models than OLS regression in situations with large numbers of highly correlated neural predictors. Our results demonstrate that penalized regression is a promising method for examining associations between neural predictors and clinically relevant traits or behaviors. These findings have important implications for the growing field of functional connectivity research, where multivariate methods produce numerous, highly correlated brain networks.

Bootstrap Enhanced Penalized Regression for Variable Selection with Neuroimaging Data

PubMed Central

Abram, Samantha V.; Helwig, Nathaniel E.; Moodie, Craig A.; DeYoung, Colin G.; MacDonald, Angus W.; Waller, Niels G.

2016-01-01

Recent advances in fMRI research highlight the use of multivariate methods for examining whole-brain connectivity. Complementary data-driven methods are needed for determining the subset of predictors related to individual differences. Although commonly used for this purpose, ordinary least squares (OLS) regression may not be ideal due to multi-collinearity and over-fitting issues. Penalized regression is a promising and underutilized alternative to OLS regression. In this paper, we propose a nonparametric bootstrap quantile (QNT) approach for variable selection with neuroimaging data. We use real and simulated data, as well as annotated R code, to demonstrate the benefits of our proposed method. Our results illustrate the practical potential of our proposed bootstrap QNT approach. Our real data example demonstrates how our method can be used to relate individual differences in neural network connectivity with an externalizing personality measure. Also, our simulation results reveal that the QNT method is effective under a variety of data conditions. Penalized regression yields more stable estimates and sparser models than OLS regression in situations with large numbers of highly correlated neural predictors. Our results demonstrate that penalized regression is a promising method for examining associations between neural predictors and clinically relevant traits or behaviors. These findings have important implications for the growing field of functional connectivity research, where multivariate methods produce numerous, highly correlated brain networks. PMID:27516732

Route Flap Damping Made Usable

NASA Astrophysics Data System (ADS)

Pelsser, Cristel; Maennel, Olaf; Mohapatra, Pradosh; Bush, Randy; Patel, Keyur

The Border Gateway Protocol (BGP), the de facto inter-domain routing protocol of the Internet, is known to be noisy. The protocol has two main mechanisms to ameliorate this, MinRouteAdvertisementInterval (MRAI), and Route Flap Damping (RFD). MRAI deals with very short bursts on the order of a few to 30 seconds. RFD deals with longer bursts, minutes to hours. Unfortunately, RFD was found to severely penalize sites for being well-connected because topological richness amplifies the number of update messages exchanged. So most operators have disabled it. Through measurement, this paper explores the avenue of absolutely minimal change to code, and shows that a few RFD algorithmic constants and limits can be trivially modified, with the result being damping a non-trivial amount of long term churn without penalizing well-behaved prefixes' normal convergence process.

[Psychological harassment].

PubMed

Puech, Paloma; Pitcho, Benjamin

2013-04-01

Two types of harassment are distinguished: sexual and psychological. In the private sector, according to French labour laws and the penal code, psychological harassment is actionable. It is up to the employer to prove the absence of harassment. The sanctions incurred can be up to 5 years imprisonment and a 150,000 euro fine and various measures of compensation for damages can be envisaged.

[Coding in general practice-Will the ICD-11 be a step forward?

PubMed

Kühlein, Thomas; Virtanen, Martti; Claus, Christoph; Popert, Uwe; van Boven, Kees

2018-07-01

Primary care physicians in Germany don't benefit from coding diagnoses-they are coding for the needs of others. For coding, they mostly are using either the thesaurus of the German Institute of Medical Documentation and Information (DIMDI) or self-made cheat-sheets. Coding quality is low but seems to be sufficient for the main use case of the resulting data, which is the morbidity adjusted risk compensation scheme that distributes financial resources between the many German health insurance companies.Neither the International Classification of Diseases and Health Related Problems (ICD-10) nor the German thesaurus as an interface terminology are adequate for coding in primary care. The ICD-11 itself will not recognizably be a step forward from the perspective of primary care. At least the browser database format will be advantageous. An implementation into the 182 different electronic health records (EHR) on the German market would probably standardize the coding process and make code finding easier. This method of coding would still be more cumbersome than the current coding with self-made cheat-sheets.The first steps towards a useful official cheat-sheet for primary care have been taken, awaiting implementation and evaluation. The International Classification of Primary Care (ICPC-2) already provides an adequate classification standard for primary care that can also be used in combination with ICD-10. A new version of ICPC (ICPC-3) is under development. As the ICPC-2 has already been integrated into the foundation layer of ICD-11 it might easily become the future standard for coding in primary care. Improving communication between the different EHR would make taking over codes from other healthcare providers possible. Another opportunity to improve the coding quality might be creating use cases for the resulting data for the primary care physicians themselves.

Medico-legal implications of mobbing. A false accusation of psychological harassment at the workplace.

PubMed

Jarreta, Begoña Martínez; García-Campayo, Javier; Gascón, Santiago; Bolea, Miguel

2004-12-02

Mobbing, or psychological harassment at the workplace, is usually defined as a situation in which a person or a group of people engage in extreme psychological violence against another person. In Spain, the number of reports for mobbing has increased extraordinarily in the last years. The reports are increasing dramatically not only before the Labour Courts, but also before the Civil Courts, with claims for damages, and before the Penal Court for offences causing physical or moral injury, etc., since at the present time this figure is not typified as an offence in the Spanish Penal Code. The high degree of complexity of this situation has given rise to frequent misuse of the term and to a number of false accusations of mobbing. A recent European Parliament Resolution on harassment at the workplace addressed the devastating consequences of false accusations. In this paper we present a case in which the "false" victim was mentally ill (paranoia) but succeed in generating an extreme dangerous environment of great harassment against the "false" assailants that were "falsely" accused of mobbing. Forensic diagnosis of the psychiatric disorder suffered by the "false" victim was essential to clarify the issue at the Penal Court.

[Statement of the Association of Pneumological Clinics and the German Respiratory Society on the coding of invasive and non-invasive ventilation in intensity care].

PubMed

2013-07-01

Mechanical ventilation in patients with respiratory failure represents one of the most important aspects of intensity care. It can be performed invasively and non-invasively depending on the clinical situation and the underlying disease. The expenditure and consumption of resources is the basis of the compensation for each patient case in the German diagnosis related group system. For ventilated patients it is calculated based on the hours of ventilation, according to the standard coding guideline. In this statement, the German Respiratory Society and the Association of Pneumological Clinics aim to clarify some aspects of the coding of invasive and non-invasive ventilation. © Georg Thieme Verlag KG Stuttgart · New York.

[Scope of the cause of justification of the legitimate exercise of a right in the area of genetic criminality].

PubMed

Romeo Malanda, Sergio

2009-01-01

The Spanish penal Code of 1995 creates various crimes in relation to biotechnology, namely, the offence of genetic manipulation, the offence of cloning and the offence of fertilization of human eggs for purpose others than procreation. These new offences seek to protect new legal interests. But besides these interests, we must not forget that there also exist certain rights of the person that rely on reproductive and genetic technologies to be fully effective. That is why it is inevitable to bring to the discussion other interests of a different nature that may be in conflict with these new legal interests. This is the case in relation to the right to procreate and the right to scientific research. According to Article 20.7 of the Spanish penal Code, a person may justifiably engage in conduct that satisfies the elements of an offence if he has a right to do so. In this work the author analyses if certain conduct that could harm some legal interests, and therefore would be criminally punishable could be justified on the basis of the abovementioned rights to procreate and to undertake scientific research.

[Which legal consequences for those who provoke pain to infants?].

PubMed

Bellieni, C V; Gabbrielli, M; Tataranno, M L; Perrone, S; Buonocore, G

2012-02-01

The advances in perinatal care have led to a significant increase in neonatal survival rate but also to the rise of the number of invasive procedures. Several scientific studies show that newborns are able to feel pain more intensely than adults. Despite this evidence, neonatal pain and the right to an appropriate analgesia are systematically underestimated, ignoring ethical and moral principles of beneficence and non-maleficence. Infants are more susceptible to pain and the prolonged exposure to painful sensations can alter the neural development and the response to pain causing hyperalgesia. Anyone who caused pain without using any analgesic procedure due to negligence or incompetence, should be severely punished. The right to analgesia, fundamental principle, is fully incorporated in the Italian code of Medical deontology (article 3). The doctor who does not use analgesia for newborns' treatment can be indicted by the Italian penal code (art.582 and 583), aggravated by being the victim an infant, who is unable to defend himself. To avoid penal consequences, a careful education and attention are needed: "pediatric analgesia" should become a basic teaching in Universities and in specialization schools; analgesic treatments should be mandatory and annotated in the patient's file even for minor potentially painful procedures.

[Sponsoring of medical conferences, workshops and symposia by pharmaceutical companies. Physicians must be wary of this!].

PubMed

Warntjen, M

2009-12-01

The longstanding conventional forms of cooperation between medical organizations and physicians on the one hand and the pharmaceutical industry and manufacturers of medical products on the other hand nowadays hold the risk of coming into conflict with the public prosecutor. Typical circumstances which are taken up by the investigating authorities are financial supports of medical conferences, workshops and symposia. To understand the problem under criminal law it is important to become acquainted with the protective aim of the statutory offences of the acceptance of benefits according to section sign 331 of the Penal Code (Strafgesetzbuch, StGB) and of corruption according to section sign 332 of the Penal Code. The "trust of the general public in the objectivity of governmental decisions" must be protected and the "evil appearance of the corruptibility of official acts" must be counteracted. A basic differentiation is made between physicians with and without office-bearing functions. By paying attention to the recommendations and basic principles of cooperation between the medical profession and the healthcare industry presented in this article (transparency principle, equivalence principle, documentation principle and separation principle) the emergence of any suspicious factors can be effectively avoided.

How L2-Learners' Brains React to Code-Switches: An ERP Study with Russian Learners of German

ERIC Educational Resources Information Center

Ruigendijk, Esther; Hentschel, Gerd; Zeller, Jan Patrick

2016-01-01

This Event Related Potentials (ERP) study investigates auditory processing of sentences with so-called code-switches in Russian learners of German. It has often been argued that switching between two languages results in extra processing cost, although it is not completely clear yet what exactly causes these costs. ERP presents a good method to…

[Protection of unborn life by the state].

PubMed

Schell, W

1993-08-01

The German unification contract stated that up to December 31, 1992, a new legal regulation of abortion should be sought in the whole country in accordance with the basic law. Accordingly, under the pregnancy and family protection law (SFHG) of July 27, 1992, Paragraphs 218, Sections 1 and 219 of the penal code were amended stating that the termination of pregnancy by a doctor within 12 weeks of conception was not against the law in general, although the pregnant woman was obliged to be counseled at least 3 days before the procedure (term regulation with counseling requirement). However, through the ruling of May 28, 1993 (2 BvF 2/90, 2 BvF 4 and 5/92) the German Constitutional Court made a decision to the effect that Paragraphs 218, Sections 1 and 219 were unconstitutional. Thereby the reform of the abortion law faltered. The Parliament was required to conceive a law in agreement with this decision and the basic law. In the ruling there were important stipulations about the protection of human life. The newly drafted Paragraph 218, Section 1 was declared null and void, in particular because it did not consider that abortion undertaken after counseling within 12 weeks was against the law, nor were the new rules of Paragraph 219 about the content and organization of the duty to counsel. In order to guarantee the minimum requirements of protection of unborn human life by the state, the Senate replaced the nullified sections of the SFHG by a provisional regulation to be effective as of June 16, 1993, when Article 16 of the SFHG also became effective, which cancelled the term regulation valid in the new federal provinces until then. The provisional regulation stated that abortion would not be punished when performed by a doctor within 12 weeks of gestation, the pregnant woman asked for it, and proved to the doctor by an affidavit that at least 3 days before the procedure she had been counseled by an authorized counseling facility.

Tackling the Phenomenon of Elder Abuse in Italy: A Review of Existing Legislation and Policies as a Learning Resource

ERIC Educational Resources Information Center

Melchiorre, Maria Gabriella; Chiatti, Carlos; Lamura, Giovanni

2012-01-01

In Italy, data and information on prevalence and characteristics of elder abuse are very limited, and a specific legal and policy framework is lacking. Some articles of the Penal Code refer to the larger context of violence against disadvantaged groups, and some general support services not specifically dedicated to this issue are managed by local…

[Placement of children and adolescents following seclusion and restraint actions–a study on family-court approvals of minors in youth welfare, child and adolescent psychiatry and jail according to Para. 1631 German Civil Code].

PubMed

Kölch, Michael; Vogel, Harald

2016-01-01

According to German law (Para. 1631b German Civil Code), the placement of children and adolescents following seclusion and restraint actions must be approved by a family court. We analyzed the family court data of a court district in Berlin (Tempelhof-Kreuzberg) concerning cases of “placement of minors” between 2008 and 2011. A total of 474 such procedures were discovered. After data clearing and correction of cases (e. g., because of emergency interventions of the youth welfare system taking children into custody according to Para. 42, German Civil Code VIII), 376 cases remained. Of these 376 procedures in the years 2008 to 2011, 127 cases concerned children and adolescents according to Para. 1631b German Civil Code, and 249 procedures were settled either by dismissal, withdrawal or by repealing the initial decision to place the child with restrain or seclusion by means of an interim order or by filing an appeal against the final decision. Of the 127 procedures, 68 concerned girls, who were on average slightly younger than boys (14.5 years vs. 15.1 years). In two thirds of the procedures, the children and adolescents were German citizens. The majority of youths involved were living at home at the time of the procedure, but in 15 % of the case the youths were homeless. Most of the adolescents were treated with restraint in child and adolescent psychiatry. The most frequently quoted reasons for seclusion were substance abuse, suicide risk and running away from home/being homeless.

Lossless quantum data compression with exponential penalization: an operational interpretation of the quantum Rényi entropy.

PubMed

Bellomo, Guido; Bosyk, Gustavo M; Holik, Federico; Zozor, Steeve

2017-11-07

Based on the problem of quantum data compression in a lossless way, we present here an operational interpretation for the family of quantum Rényi entropies. In order to do this, we appeal to a very general quantum encoding scheme that satisfies a quantum version of the Kraft-McMillan inequality. Then, in the standard situation, where one is intended to minimize the usual average length of the quantum codewords, we recover the known results, namely that the von Neumann entropy of the source bounds the average length of the optimal codes. Otherwise, we show that by invoking an exponential average length, related to an exponential penalization over large codewords, the quantum Rényi entropies arise as the natural quantities relating the optimal encoding schemes with the source description, playing an analogous role to that of von Neumann entropy.

[Orthopedic and trauma surgery in the German DRG system. Recent developments].

PubMed

Franz, D; Schemmann, F; Selter, D D; Wirtz, D C; Roeder, N; Siebert, H; Mahlke, L

2012-07-01

Orthopedics and trauma surgery are subject to continuous medical advancement. The correct and performance-based case allocation by German diagnosis-related groups (G-DRG) is a major challenge. This article analyzes and assesses current developments in orthopedics and trauma surgery in the areas of coding of diagnoses and medical procedures and the development of the 2012 G-DRG system. The relevant diagnoses, medical procedures and G-DRGs in the versions 2011 and 2012 were analyzed based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes were made for the International Classification of Diseases (ICD) coding of complex cases with medical complications, the procedure coding for spinal surgery and for hand and foot surgery. The G-DRG structures were modified for endoprosthetic surgery on ankle, shoulder and elbow joints. The definition of modular structured endoprostheses was clarified. The G-DRG system for orthopedic and trauma surgery appears to be largely consolidated. The current phase of the evolution of the G-DRG system is primarily aimed at developing most exact descriptions and definitions of the content and mutual delimitation of operation and procedures coding (OPS). This is an essential prerequisite for a correct and performance-based case allocation in the G-DRG system.

[ENT medicine and head and neck surgery in the G-DRG system 2008].

PubMed

Franz, D; Roeder, N; Hörmann, K; Alberty, J

2008-09-01

Further developments in the German DRG system have been incorporated into the 2008 version. For ENT medicine and head and neck surgery significant changes concerning coding of diagnoses, medical procedures and concerning the DRG-structure were made. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2007 and 2008 based on the publications of the German DRG institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2008 focussed on the development of DRG structure, DRG validation and codes for medical procedures. The outcome of these changes for German hospitals may vary depending on the range of activities. The G-DRG system has gained in complexity again. High demands are made on correct and complete coding of complex ENT and head and neck surgery cases. Quality of case allocation within the G-DRG system has been improved. For standard cases quality of case allocation is adequate. Nevertheless, further adjustments of the G-DRG system especially for cases with complex neck surgery are necessary.

[Orthopedic and trauma surgery in the German DRG system 2008].

PubMed

Franz, D; Kaufmann, M; Siebert, C H; Windolf, J; Roeder, N

2008-04-01

The German DRG (diagnosis-related groups) system has been modified and updated into version 2008. For orthopedic and trauma surgery significant changes concerning coding of diagnoses, medical procedures and the DRG structure were made. The modified version has been analyzed in order to ascertain whether the DRG system is suitably qualified to fulfill the demands of the reimbursement system or whether further improvements are necessary. Analysis of the severity of relevant side-effect diagnoses, medical procedures and G-DRGs in the versions 2007 and 2008 was carried out based on the publications of the German DRG institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2008 focused on the development of DRG structure, DRG validation and codes for medical procedures. The outcome of these changes for German hospitals may vary depending on the range of activities. G-DRG system has become even more complex and the new regulations have also resulted in new problems associated with complications.. High demands are made on correct and complete coding of complex orthopedic and trauma surgery cases. Quality of case allocation within the G-DRG system has been improved. Nevertheless, further improvements of the G-DRG system are necessary, especially for cases with severe injuries.

Even Lesbian Youths or Those Presumed to Be Lesbians Are Protected by the Constitution of Uganda--But to a Limited Extent: Rules the High Court

ERIC Educational Resources Information Center

Mujuzi, Jamil Ddamulira

2009-01-01

The Ugandan Penal Code criminalizes same-sex relationships. The author analyzes the Ugandan High Court decision where the judge relied on the Constitution and international human rights instruments to hold that law enforcement officers must respect the rights to privacy and human dignity even of those people presumed to be in same-sex…

Legal issues for German-speaking cannabis growers. Results from an online survey.

PubMed

Werse, Bernd

2016-02-01

Cannabis prohibition can generally be regarded as the main driver for home growing of marijuana. In this paper, I discuss the impact of drug prohibition on cannabis cultivators from the three German-speaking countries: Germany, Austria and Switzerland. In particular, this refers to the questions; how illicitness influences motivations for growing; which precautionary measures are taken against the risk of discovery; how penal consequences differ in the three countries and how these aspects are linked to each other. The results come from a sample of 1578 respondents from the German-language online survey conducted following the International Cannabis Cultivation Questionnaire (ICCQ). The survey was carried out in late 2012 and early 2013. While most of the reasons for growing cannabis relate to avoiding negative consequences of prohibition, the illicitness of cannabis also plays a major role for concern about the cultivation activities as well as measures to avoid negative consequences. Swiss growers are less worried about their activity compared to respondents from Germany or Austria. The results confirm the notion that the illicitness of cannabis is the main drive for the private cultivation of the plant. At the same time, prohibition is the principal reason for concern regarding the growing activity. The severity of possible sentences seems to be linked to the degree of concern and precautionary measures. Copyright © 2015 Elsevier B.V. All rights reserved.

Effect of Different Teaching Techniques on the Acquisition of Grammatical Gender by Beginning German Second Language Learners

ERIC Educational Resources Information Center

Arzt, Jessica; Kost, Claudia

2016-01-01

The grammatical gender of German nouns continues to pose a challenge to second language learners. Following from a connectionist framework, this study explores the effect of two input enhancement techniques, color-coding and gendered actors, on the learning of grammatical gender by beginning learners of German during a vocabulary acquisition…

Soldier, Sailor, Rebel, Rule-Breaker: Masculinity and the Body in the German Far Right

ERIC Educational Resources Information Center

Miller-Idriss, Cynthia

2017-01-01

Drawing on a unique digital archive of thousands of images of far right symbols and commercial products in Germany, combined with 62 interviews conducted with German youth and their teachers in 2013-2014, this article examines young Germans' sense of style and their interpretation of far right-wing symbols and codes in commercial products,…

[ENT and head and neck surgery in the German DRG system 2007].

PubMed

Franz, D; Roeder, N; Hörmann, K; Alberty, J

2007-07-01

The German DRG system has been further developed into version 2007. For ENT and head and neck surgery, significant changes in the coding of diagnoses and medical operations as well as in the the DRG structure have been made. New ICD codes for sleep apnoea and acquired tracheal stenosis have been implemented. Surgery on the acoustic meatus, removal of auricle hyaline cartilage for transplantation (e. g. rhinosurgery) and tonsillotomy have been coded in the 2007 version. In addition, the DRG structure has been improved. Case allocation of more than one significant operation has been established. The G-DRG system has gained in complexity. High demands are made on the coding of complex cases, whereas standard cases require mostly only one specific diagnosis and one specific OPS code. The quality of case allocation for ENT patients within the G-DRG system has been improved. Nevertheless, further adjustments of the G-DRG system are necessary.

Prioritized LT Codes

NASA Technical Reports Server (NTRS)

Woo, Simon S.; Cheng, Michael K.

2011-01-01

The original Luby Transform (LT) coding scheme is extended to account for data transmissions where some information symbols in a message block are more important than others. Prioritized LT codes provide unequal error protection (UEP) of data on an erasure channel by modifying the original LT encoder. The prioritized algorithm improves high-priority data protection without penalizing low-priority data recovery. Moreover, low-latency decoding is also obtained for high-priority data due to fast encoding. Prioritized LT codes only require a slight change in the original encoding algorithm, and no changes at all at the decoder. Hence, with a small complexity increase in the LT encoder, an improved UEP and low-decoding latency performance for high-priority data can be achieved. LT encoding partitions a data stream into fixed-sized message blocks each with a constant number of information symbols. To generate a code symbol from the information symbols in a message, the Robust-Soliton probability distribution is first applied in order to determine the number of information symbols to be used to compute the code symbol. Then, the specific information symbols are chosen uniform randomly from the message block. Finally, the selected information symbols are XORed to form the code symbol. The Prioritized LT code construction includes an additional restriction that code symbols formed by a relatively small number of XORed information symbols select some of these information symbols from the pool of high-priority data. Once high-priority data are fully covered, encoding continues with the conventional LT approach where code symbols are generated by selecting information symbols from the entire message block including all different priorities. Therefore, if code symbols derived from high-priority data experience an unusual high number of erasures, Prioritized LT codes can still reliably recover both high- and low-priority data. This hybrid approach decides not only "how to encode" but also "what to encode" to achieve UEP. Another advantage of the priority encoding process is that the majority of high-priority data can be decoded sooner since only a small number of code symbols are required to reconstruct high-priority data. This approach increases the likelihood that high-priority data is decoded first over low-priority data. The Prioritized LT code scheme achieves an improvement in high-priority data decoding performance as well as overall information recovery without penalizing the decoding of low-priority data, assuming high-priority data is no more than half of a message block. The cost is in the additional complexity required in the encoder. If extra computation resource is available at the transmitter, image, voice, and video transmission quality in terrestrial and space communications can benefit from accurate use of redundancy in protecting data with varying priorities.

[Is preimplantation diagnosis legal?--on the need for harmonizing legislation].

PubMed

Ratzel, Rudolf

2002-07-01

Whether PGD is already legally permitted in Germany today is a moot point. A guidelines draft of the Germany's Federal General Medical Council, the Bundesärztekammer, on pre-implantation genetic diagnostics that--like the earlier findings of the ethics commission of the German federal state of the Rhineland-Palatinate--assumed that the method is admissible, if certain clearly-defined indications are present and a rigorous testing procedure has been established, has given the discussion a new impetus. The discussion is in full swing, with calls by politicians for the legislator to pass a regulation mounting. Of late, though, constitutional objections have been raised against a positive-law regulation. Such a simple legal move to regulate PGD, it is claimed, would violate the constitutionally-guaranteed right to inviolable human dignity. Critics, however, point out that such an absolute inviolability does not exist. According to them, not only the verdicts by the German Federal Constitutional Court, the Bundesverfassungsgericht, on the reform of section 218 of the German Federal Penal Code (StGB)--the paragraph that specifies the conditions under which an abortion is not punished--that relativize (in terms of the indication model) one claim to existence with respect to another, but also the approval in terms of pharmaceutical and medicine-products law of nidation-blocking agents, serve to show this. If the condition of being a human being were made to coincide with the completion of the genetic code upon the completion of the process of fertilisation, then one tended to forget, the critics noted, that this attendant dignity was not properly "infused with life" unless nidation had been successful. Without nidation everything were fragmentary, the total protection of human dignity according to Article 1 Section 1 of the Federal Republic's Basic Law, Germany's constitution, notwithstanding. During every in vitro fertilisation embryo transfer is conditional upon a variety of factors the presence of which is not noted until after fertilisation has taken place. On the part of the embryos, too, certain conditions have to be met whose presence at the moment of fertilisation is not assured. Thus an embryo with, for instance, defects that can be visually detected will not be transferred. With regard to these facts too the opponents of pre-implantation genetic diagnostics must be challenged to answer the question of why an embryo with visually-detectable defects should undoubtedly be allowed to be discarded, but the act of searching for "internal" defects be banned. Thus the fact remains that the mere acceptance of the loss of created embryos does not make artificial insemination a punishable offense, as long as the motive for the act is to bring about pregnancy. To achieve legal security for the couples and the physicians involved the law on the protection of embryos should be changed. The new regulations should determine under which conditions PGD is permissible. As is already the case for other norms that apply to reproductive medicine, but also for the practice of abortion, these regulations should contain an analogous right of refusal for the professionals involved. The laws relating to the healing professions, to the professional chambers, as well as the regulations of the various German federal states (which together constitute the Federal Republic of Germany) that apply to the professions should be amended accordingly.

[The concept of mental health deterioration in light of decisions by higher judicial bodies].

PubMed

Kaya, Ahsen; Aktaş, Ekin Özgür

2014-01-01

Important arrangements were made to protect an individuals' sexual safety in the Turkish Penal Code. During judgments of sexual crimes, the witnesses of medical experts are usually used for evidence collection and for researching whether the crimes were aggravated. Due to this, reports are frequently requested from all physicians in all fields of medicine in their daily clinical practices by judicial authorities. Following implementation of the new Turkish Penal Code, the concept of mental health deterioration was frequently discussed and is still a discussed topic in the fields of both law and medicine in terms of crimes against sexual immunity. It is believed that subjects discussed in this article will provide important information for both adult, child and adolescent mental health professionals in terms of drawing attention to the importance of the medicolegal evaluations which are frequently requested from psychiatrists in their daily clinical practice and in terms of providing an evaluation of the concept of mental health deterioration in light of judicial decisions. Regarding the process from the beginning of application to the present, prejudications reduce questions about how the concept must be evaluated and what the meaning of the concept is. In this study, the decisions of Higher Judicial Bodies were researched and situations relating to how concepts must be evaluated and the meaning of the concept of mental health deterioration today in accordance with the prejudications were presented.

Prison suicides in Germany from 2000 to 2011.

PubMed

Opitz-Welke, Annette; Bennefeld-Kersten, Katharina; Konrad, Norbert; Welke, Justus

2013-01-01

In many countries, suicide is the most frequent cause of prison deaths; moreover, the respective national penal suicide rates are consistently several times higher than the suicide rates in the general population. To assess the situation in German prisons, an assessment of all suicides in German prisons by means of a survey was carried out for the time from 2000 to 2011. The mean rate per year of prison suicides in Germany from 2000 to 2011 was 105.8 per 100,000 male inmates and 54.7 per 100,000 female inmates. Male prisoner suicide rates significantly declined during the period under investigation; no significant trend was evident for female prisoners in pre-trial detention but a noteworthy increase was apparent in the suicide rate of female sentenced prisoners. A significant positive relationship can be demonstrated between occupation density and the suicide rate for both men and women. These results should be taken as a challenge for further research on the reasons for the unexpected increase of suicide rate in female sentenced prisoners and as well on the effect of population density on prison suicide rate. Copyright © 2013. Published by Elsevier Ltd.

Genetic variation of the porcine NR5A1 is associated with meat color.

PubMed

Görres, Andreas; Ponsuksili, Siriluck; Wimmers, Klaus; Muráni, Eduard

2016-02-01

Because of the central role of Steroidogenic factor 1 in the regulation of the development and function of steroidogenic tissues, including the adrenal gland, we chose the encoding gene NR5A1 as a candidate for stress response, meat quality and carcass composition in the domestic pig. To identify polymorphisms of the porcine NR5A1 we comparatively sequenced the coding, untranslated and regulatory regions in four commercial pig lines. Single nucleotide polymorphisms could be found in the 3' UTR and in an intronic enhancer, whereas no polymorphisms were detected in the proximal promoter and coding region. A subset of the detected polymorphisms was genotyped in Piétrain x (German Large White x German Landrace) and German Landrace pigs. For the same animals, carcass composition traits, meat quality characteristics and parameters of adrenal function were recorded. Associations with meat color were found for two of the discovered SNPs in Piétrain x (German Large White x German Landrace) and German Landrace pigs but no connections to parameters of adrenal function could be established. We conclude that NR5A1 variations influence meat color in a hypothalamus-pituitary-adrenal axis independent manner and that further regulatory regions need to be analyzed for genetic variations to understand the discovered effects.

Violence In Honduras: An Analysis of the Failure in Public Security and the States Response to Criminality

DTIC Science & Technology

2014-06-01

cocaine trafficking from the Caribbean to Central America and decline of the major Colombian TCOs and the rise of Mexican TCOs, and the weak internal...34 Alison Siskin, “Immigration-Related Detention Current Legislative Issues” (CRS Report for Congress, January 12, 2012), 12. 11 2009... legislative action with the passage of the reform of article 332 of the penal code, known as Ley Antimaras. Under this anti-gang law, membership in

Consulting-Research Froblems with German and American Multinational Firms.

ERIC Educational Resources Information Center

Hildebrandt, Herbert W.

International researchers need to be aware of international problems and multinational managerial codes when they work with worldwide organizations. This paper develops the premise that consulting with German multinational companies is more complex than consulting with or researching for American firms. Discussion focuses on the following three…

Judgment, 16 June 1989.

PubMed

1989-01-01

On June 16, 1989 the following legal provisions were declared unconstitutional: 1) Articles 134 (2) and 135 of the Ecuador Civil Code, which require a wife to be obedient to her husband and to follow him to wherever he chooses to have his residence; 2) Articles 250-256 of the Civil Code, which set forth rules relating to the filiation of children whose pregnancy is declared within 30 days after the separation of the wife from the husband, which among other things, give the husband the right to provide a companion for the wife until she gives birth or to force the wife to take up residence with a family of his choice; 3) Articles 12, and 14-16 of the Commercial Code, which provide that a wife can engage in business only with the authorization of her husband; and 4) Article 27 of the Penal Code, which excuses crimes involving murder, wounding, or battery committed by a man when he surprises his daughter, granddaughter, or sister engaged in an unlawful carnal act.

Shaded seafloor relief, backscatter strength, and surficial geology; German Bank, Scotian Shelf, offshore Nova Scotia

USGS Publications Warehouse

Todd, B.J.; Valentine, Page C.

2010-01-01

This map is part of a three-map series of German Bank, located on the Scotian Shelf off southern Nova Scotia.  This map is the product of a number of surveys (1997-2003) that used a multibeam sonar system to map 5321 km2 of the seafloor.  Other surveys collected geological data for scientific interpretation.  This map sheet shows the seafloor topography of German Bank in shaded-relief view and seafloor depth (coded by colour) at a scale of 1:1000,000.  Topographic contours generated from the multibeam data are shown (in white) on the colour-coded multibeam topography at a depth interval of 20 m.  Bathymetic contours (in blue) outside the multibeam survey area, presented at a depth interval of 10 m, are from the Natural Resource Map series (Canadian Hydrographic Service, 1967, 1971a, 1971b, 1972). Sheet 2 shows coloured backscatter strength in shaded-relief view.  Sheet 3 shows seafloor topography in shaded-relief view with colour-coded surficial geological units.

Relevance of medical reports in criminal investigations of cases of suspected child abuse.

PubMed

Janßen, Katharina; Greif, Dominik; Rothschild, Markus A; Banaschak, Sibylle

2017-07-01

If a case of physical child abuse is suspected in Germany, the general feeling is often that "it does not matter whether you make a report or not" because, generally, no conviction is made anyway. This study investigates the juridical analysis of complaint cases of physical child abuse [criminal complaint parag. 225 StGB (German penal code) with filial victim]. It focuses on the doctor's role and the impact of their practice in relation to a later conviction. It is based on the analysis of 302 files of the enquiry from 2004-2009 from the department of public prosecution in Cologne, Germany. Besides general epidemiological data on the reporting person, the affected child and the presumed offender, the documents were reassessed for the relevance of medical reports for successful convictions. Only 7% (n = 21) of 302 complaints led to a conviction. In 38.1% (n = 8) of those cases, a medical report was mentioned as a piece of evidence, and just in two cases a (legal) medical report was quoted and mentioned as relevant for the conviction. 50% of the complaint cases with legal medical expertise led to a trial. In contrast, only 30.2% with a common medical report and 7.3% without a report led to a trial. The results show how a medical report existed in only a few cases. In those cases, the rate of performed trials was higher than for those without a medical report, but the report played a minor part when reasoning a verdict.

[Quality management and strategic consequences of assessing documentation and coding under the German Diagnostic Related Groups system].

PubMed

Schnabel, M; Mann, D; Efe, T; Schrappe, M; V Garrel, T; Gotzen, L; Schaeg, M

2004-10-01

The introduction of the German Diagnostic Related Groups (D-DRG) system requires redesigning administrative patient management strategies. Wrong coding leads to inaccurate grouping and endangers the reimbursement of treatment costs. This situation emphasizes the roles of documentation and coding as factors of economical success. The aims of this study were to assess the quantity and quality of initial documentation and coding (ICD-10 and OPS-301) and find operative strategies to improve efficiency and strategic means to ensure optimal documentation and coding quality. In a prospective study, documentation and coding quality were evaluated in a standardized way by weekly assessment. Clinical data from 1385 inpatients were processed for initial correctness and quality of documentation and coding. Principal diagnoses were found to be accurate in 82.7% of cases, inexact in 7.1%, and wrong in 10.1%. Effects on financial returns occurred in 16%. Based on these findings, an optimized, interdisciplinary, and multiprofessional workflow on medical documentation, coding, and data control was developed. Workflow incorporating regular assessment of documentation and coding quality is required by the DRG system to ensure efficient accounting of hospital services. Interdisciplinary and multiprofessional cooperation is recognized to be an important factor in establishing an efficient workflow in medical documentation and coding.

40 CFR 33.410 - Can a recipient be penalized for failing to meet its fair share objectives?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Can a recipient be penalized for failing to meet its fair share objectives? 33.410 Section 33.410 Protection of Environment ENVIRONMENTAL... penalized for failing to meet its fair share objectives? A recipient cannot be penalized, or treated by EPA...

40 CFR 33.410 - Can a recipient be penalized for failing to meet its fair share objectives?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Can a recipient be penalized for failing to meet its fair share objectives? 33.410 Section 33.410 Protection of Environment ENVIRONMENTAL... penalized for failing to meet its fair share objectives? A recipient cannot be penalized, or treated by EPA...

40 CFR 33.410 - Can a recipient be penalized for failing to meet its fair share objectives?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Can a recipient be penalized for failing to meet its fair share objectives? 33.410 Section 33.410 Protection of Environment ENVIRONMENTAL... penalized for failing to meet its fair share objectives? A recipient cannot be penalized, or treated by EPA...

40 CFR 33.410 - Can a recipient be penalized for failing to meet its fair share objectives?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Can a recipient be penalized for failing to meet its fair share objectives? 33.410 Section 33.410 Protection of Environment ENVIRONMENTAL... penalized for failing to meet its fair share objectives? A recipient cannot be penalized, or treated by EPA...

40 CFR 33.410 - Can a recipient be penalized for failing to meet its fair share objectives?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Can a recipient be penalized for failing to meet its fair share objectives? 33.410 Section 33.410 Protection of Environment ENVIRONMENTAL... penalized for failing to meet its fair share objectives? A recipient cannot be penalized, or treated by EPA...

Physician-assisted Suicide and Euthanasia in Indian Context: Sooner or Later the Need to Ponder!

PubMed Central

Khan, Farooq; Tadros, George

2013-01-01

Physician-assisted suicide (PAS) is a controversial subject which has recently captured the interest of media, public, politicians, and medical profession. Although active euthanasia and PAS are illegal in most parts of the world, with the exception of Switzerland and the Netherlands, there is pressure from some politicians and patient support groups to legalize this practice in and around Europe that could possibly affect many parts of the world. The legal status of PAS and euthanasia in India lies in the Indian Penal Code, which deals with the issues of euthanasia, both active and passive, and also PAS. According to Penal Code 1860, active euthanasia is an offence under Section 302 (punishment for murder) or at least under Section 304 (punishment for culpable homicide not amounting to murder). The difference between euthanasia and physician assisted death lies in who administers the lethal dose; in euthanasia, this is done by a doctor or by a third person, whereas in physician-assisted death, this is done by the patient himself. Various religions and their aspects on suicide, PAS, and euthanasia are discussed. People argue that hospitals do not pay attention to patients’ wishes, especially when they are suffering from terminally ill, crippling, and non-responding medical conditions. This is bound to change with the new laws, which might be implemented if PAS is legalized. This issue is becoming relevant to psychiatrists as they need to deal with mental capacity issues all the time. PMID:23833354

Advocating for safe abortion in Rwanda: how young people and the personal stories of young women in prison brought about change.

PubMed

Umuhoza, Chantal; Oosters, Barbara; van Reeuwijk, Miranda; Vanwesenbeeck, Ine

2013-05-01

In June 2012, a new abortion law came into effect in Rwanda as part of a larger review of Rwanda's penal code. This was a significant step in a country where it was previously taboo even to discuss abortion. This article describes some of the crucial elements in how this success was achieved in Rwanda, which began through a project launched by Rutgers WPF on "sensitive issues in young people's sexuality" in several countries. This paper describes how the Rwandan Youth Action Movement decided to work on unsafe abortion as part of this project. They gathered data on the extent of unsafe abortion and testimonies of young Rwandan women in prison for abortions; organized debates, values clarification exercises, interviews and a survey in four universities; launched a petition for law reform; produced awareness-raising materials; worked with the media; and met with representatives from government ministries, the national women's and youth councils, and parliamentarians - all of which played a significant role in the advocacy process for amendment of the law, which was revised when the penal code came up for review in June 2012. This history shows how important the role of young people can be in producing change and exposes, through personal stories, the need for a better abortion law, not only in Rwanda but also elsewhere. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Repertoires, Characters and Scenes: Sociolinguistic Difference in Turkish-German Comedy

ERIC Educational Resources Information Center

Androutsopoulos, Jannis

2012-01-01

This paper examines representations of sociolinguistic difference in a German "ethnic comedy" as a means to contribute to a framework for the sociolinguistic study of film. Three levels of analysis of sociolinguistic difference in film are distinguished: repertoire analysis reconstructs the entirety of codes used in a film and their…

A characteristic based volume penalization method for general evolution problems applied to compressible viscous flows

NASA Astrophysics Data System (ADS)

Brown-Dymkoski, Eric; Kasimov, Nurlybek; Vasilyev, Oleg V.

2014-04-01

In order to introduce solid obstacles into flows, several different methods are used, including volume penalization methods which prescribe appropriate boundary conditions by applying local forcing to the constitutive equations. One well known method is Brinkman penalization, which models solid obstacles as porous media. While it has been adapted for compressible, incompressible, viscous and inviscid flows, it is limited in the types of boundary conditions that it imposes, as are most volume penalization methods. Typically, approaches are limited to Dirichlet boundary conditions. In this paper, Brinkman penalization is extended for generalized Neumann and Robin boundary conditions by introducing hyperbolic penalization terms with characteristics pointing inward on solid obstacles. This Characteristic-Based Volume Penalization (CBVP) method is a comprehensive approach to conditions on immersed boundaries, providing for homogeneous and inhomogeneous Dirichlet, Neumann, and Robin boundary conditions on hyperbolic and parabolic equations. This CBVP method can be used to impose boundary conditions for both integrated and non-integrated variables in a systematic manner that parallels the prescription of exact boundary conditions. Furthermore, the method does not depend upon a physical model, as with porous media approach for Brinkman penalization, and is therefore flexible for various physical regimes and general evolutionary equations. Here, the method is applied to scalar diffusion and to direct numerical simulation of compressible, viscous flows. With the Navier-Stokes equations, both homogeneous and inhomogeneous Neumann boundary conditions are demonstrated through external flow around an adiabatic and heated cylinder. Theoretical and numerical examination shows that the error from penalized Neumann and Robin boundary conditions can be rigorously controlled through an a priori penalization parameter η. The error on a transient boundary is found to converge as O(η), which is more favorable than the error convergence of the already established Dirichlet boundary condition.

Error Covariance Penalized Regression: A novel multivariate model combining penalized regression with multivariate error structure.

PubMed

Allegrini, Franco; Braga, Jez W B; Moreira, Alessandro C O; Olivieri, Alejandro C

2018-06-29

A new multivariate regression model, named Error Covariance Penalized Regression (ECPR) is presented. Following a penalized regression strategy, the proposed model incorporates information about the measurement error structure of the system, using the error covariance matrix (ECM) as a penalization term. Results are reported from both simulations and experimental data based on replicate mid and near infrared (MIR and NIR) spectral measurements. The results for ECPR are better under non-iid conditions when compared with traditional first-order multivariate methods such as ridge regression (RR), principal component regression (PCR) and partial least-squares regression (PLS). Copyright © 2018 Elsevier B.V. All rights reserved.

Race Making in a Penal Institution.

PubMed

Walker, Michael L

2016-01-01

This article provides a ground-level investigation into the lives of penal inmates, linking the literature on race making and penal management to provide an understanding of racial formation processes in a modern penal institution. Drawing on 135 days of ethnographic data collected as an inmate in a Southern California county jail system, the author argues that inmates are subjected to two mutually constitutive racial projects--one institutional and the other microinteractional. Operating in symbiosis within a narrative of risk management, these racial projects increase (rather than decrease) incidents of intraracial violence and the potential for interracial violence. These findings have implications for understanding the process of racialization and evaluating the effectiveness of penal management strategies.

Use of atropine penalization to treat amblyopia in UK orthoptic practice.

PubMed

Piano, Marianne; O'Connor, Anna R; Newsham, David

2014-01-01

To compare clinical practice patterns regarding atropine penalization use by UK orthoptists to the current evidence base and identify any existing barriers against use of AP as first-line treatment. An online survey was designed to assess current practice patterns of UK orthoptists using atropine penalization. They were asked to identify issues limiting their use of atropine penalization and give opinions on its effectiveness compared to occlusion. Descriptive statistics and content analysis were applied to the results. Responses were obtained from 151 orthoptists throughout the United Kingdom. The main perceived barriers to use of atropine penalization were inability to prescribe atropine and supply difficulties. However, respondents also did not consider atropine penalization as effective as occlusion in treating amblyopia, contrary to recent research findings. Patient selection criteria and treatment administration largely follow current evidence. More orthoptists use atropine penalization as first-line treatment than previously reported. Practitioners tend to closely follow the current evidence base when using atropine penalization, but reluctance in offering it as first-line treatment or providing a choice for parents between occlusion and atropine still remains. This may result from concerns regarding atropine's general efficacy, side effects, and risk of reverse amblyopia. Alternatively, as demonstrated in other areas of medicine, it may reflect the inherent delay of research findings translating to clinical practice changes. Copyright 2014, SLACK Incorporated.

Echoic Memory Interference and Comprehension in a Foreign Language.

ERIC Educational Resources Information Center

Greenberg, Seth N.; Roscoe, Suzanne

1988-01-01

Study of echoic memory interference among students in college introductory Spanish and German courses revealed that students with weaker listening comprehension skills depended more upon vulnerable sensory codes in echoic memory, while students with stronger comprehension relied on stable higher-order codes. (Author/CB)

[Complexity level simulation in the German diagnosis-related groups system: the financial effect of coding of comorbidity diagnostics in urology].

PubMed

Wenke, A; Gaber, A; Hertle, L; Roeder, N; Pühse, G

2012-07-01

Precise and complete coding of diagnoses and procedures is of value for optimizing revenues within the German diagnosis-related groups (G-DRG) system. The implementation of effective structures for coding is cost-intensive. The aim of this study was to prove whether higher costs can be refunded by complete acquisition of comorbidities and complications. Calculations were based on DRG data of the Department of Urology, University Hospital of Münster, Germany, covering all patients treated in 2009. The data were regrouped and subjected to a process of simulation (increase and decrease of patient clinical complexity levels, PCCL) with the help of recently developed software. In urology a strong dependency of quantity and quality of coding of secondary diagnoses on PCCL and subsequent profits was found. Departmental budgetary procedures can be optimized when coding is effective. The new simulation tool can be a valuable aid to improve profits available for distribution. Nevertheless, calculation of time use and financial needs by this procedure are subject to specific departmental terms and conditions. Completeness of coding of (secondary) diagnoses must be the ultimate administrative goal of patient case documentation in urology.

[Selected legal aspects of the protection of the unborn child in the light of the draft amendment to the Polish Penal Code].

PubMed

Urbaniak, Moniak; Spaczyński, Robert Z

2015-10-01

Criminal Law Codification Commission, acting at the Ministry of Justice prepared proposals for amendments in the Polish Penal Code, related to offenses against life and health that were presented to the public in 2013. The draft provides for the protection of the child in the prenatal stage, introducing a new category of the entity to be protected, which is "unborn child" and "unborn child able to live outside the mother's body". These regulations provide for mothers criminal liability and responsibility of the medical staff (a doctor), as well as the child's father to the extent in which he is obliged to take steps aimed at rescuing the fetus. It is doctor's responsibility to show particular care for human health and life since a doctor has special medical knowledge and that is regulated by art. 30 of the act on professions of doctor and dentist. The proposed rule changes were not brought before the legislature in the current term of the Sejm (2011-2015), but due to the development of medicine, including obstetrical ultrasound, which enables visualization of a child that moves in the womb and is treated as a separate entity with distinct personal features the grounds are given for the opinion that the issue of the legal status of the unborn child, particularly in the context of causing death of a child in the last phase before birth as a result of medical malpractice or other external factors will be back in the public discussion.

Formulation of Policy for Cyber Crime in Criminal Law Revision Concept of Bill Book of Criminal Law (A New Penal Code)

NASA Astrophysics Data System (ADS)

Soponyono, Eko; Deva Bernadhi, Brav

2017-04-01

Development of national legal systems is aimed to establish the public welfare and the protection of the public. Many attempts has been carried out to renew material criminal law and those efforts results in the formulation of the concept of the draft Law Book of the Law of Criminal Law in the form of concept criminal code draft. The basic ideas in drafting rules and regulation based on the values inside the idology of Pancasila are balance among various norm and rules in society. The design concept of the New Criminal Code Act is anticipatory and proactive to formulate provisions on Crime in Cyberspace and Crime on Information and Electronic Transactions. Several issues compiled in this paper are whether the policy in formulation of cyber crime is embodied in the provisions of the current legislation and what the policies formulation of cyber crime is in the concept of the bill book of law - criminal law recently?.

Relationships and sexuality of imprisoned men in the German penal system--a survey of inmates in a Berlin prison.

PubMed

Barth, Thomas

2012-01-01

The lack of concrete scientific data on the sexual behavior of inmates in German prisons is surprising, especially given the extant international scholarship on prison culture and sexual violence. Historically, the most influential publications were Clemmer's "The Prison Community", and Sykes's "The Society of Captives", which both addressed the importance of sexual deprivation and analyzed the impact of sexual victimization on prisoners. Different forms of homosexual contact between inmates include prostitution and "protective pairing", both characterized as "dark" issues--nonconsensual sexual acts--which still have not been scientifically researched. The United States enacted the Prison Rape Elimination Act, 2003, revealing nationwide data on the prevalence of sexual assault within correctional facilities. Prison inmates suffer not only from separation from their spouses or partners, but also from sexual harassment, extortion, and the threat of rape, which has multiple implications for their mental and physical health. This article presents the first German study to record data about the relationships and sexuality of imprisoned men, and was conducted in an adult correctional facility for long-term prisoners in Berlin-Tegel. The survey, which is based on results from a questionnaire taken by voluntary study participants, had a special focus on the occurrence of consensual homoerotic contacts between heterosexual inmates. The emphasis was on the potential impact of such contact on role behavior during confinement, as well as the impact on sexual identity after release. The survey revealed the first data on the incidence and prevalence of sexual violence and coercion within correctional facilities. This article presents the results of this survey for the first time. Copyright © 2012 Elsevier Ltd. All rights reserved.

7 CFR 1484.73 - Are Cooperators penalized for failing to make required contributions?

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false Are Cooperators penalized for failing to make... Cooperators penalized for failing to make required contributions? A Cooperator's contribution requirement is specified in the Cooperator program allocation letter. If a Cooperator fails to contribute the amount...

7 CFR 1484.73 - Are Cooperators penalized for failing to make required contributions?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Are Cooperators penalized for failing to make... Cooperators penalized for failing to make required contributions? A Cooperator's contribution requirement is specified in the Cooperator program allocation letter. If a Cooperator fails to contribute the amount...

7 CFR 1484.73 - Are Cooperators penalized for failing to make required contributions?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false Are Cooperators penalized for failing to make... Cooperators penalized for failing to make required contributions? A Cooperator's contribution requirement is specified in the Cooperator program allocation letter. If a Cooperator fails to contribute the amount...

7 CFR 1484.73 - Are Cooperators penalized for failing to make required contributions?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Are Cooperators penalized for failing to make... § 1484.73 Are Cooperators penalized for failing to make required contributions? A Cooperator's contribution requirement is specified in the Cooperator program allocation letter. If a Cooperator fails to...

7 CFR 1484.73 - Are Cooperators penalized for failing to make required contributions?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Are Cooperators penalized for failing to make... § 1484.73 Are Cooperators penalized for failing to make required contributions? A Cooperator's contribution requirement is specified in the Cooperator program allocation letter. If a Cooperator fails to...

'Other Spaces' for the Dangerous Dead of Provincial England, c.1752-1832.

PubMed

Hurren, Elizabeth T

2018-01-01

The Murder Act (1752) decreed that homicide perpetrators should be hanged and sent for post-execution punishment. This article explores the event management of criminal dissections by penal surgeons in situ . It reveals that the punishment parade of the condemned did not stop at the scaffold, contrary to the impression in many standard historical accounts. Instead, ordinary people accompanied criminal corpses to many different types of dissection venues. Penal surgeons hand-picked these performance spaces that were socially produced for legal and practical reasons. They had to be able to process large numbers of people who wanted to be part of the consumption of post-mortem 'harm' in English communities. Event management on location had to have emotional and visual appeal, moral coherence, be timed appropriately, and, if successful, would enhance the deterrence value of the capital code. Yet, managing the 'dangerous dead' involved a great deal of discretionary justice with unpredictable outcomes. It often happened in 'counter-sites' of punishment in the community and involved a great deal of immersive theatre. Some events worked well, others threatened the social order. In 'Other Spaces' the 'Dangerous Dead' was hence a fascinating feature of the Murder Act outside the Metropolis from 1752 to 1832.

[Incest--forensic genetic approach].

PubMed

Raczek, Ewa

2012-01-01

The paper presents intimate relationships between biologically and legally close relatives, complicated in the social, culture and religion perspective. (art. 201 of the Penal Code), but it chiefly addresses problems associated with giving opinion on the fatherhood towards the incestuous child. The report calls for a broader interest in this issue from expert witnesses in forensic genetics, as well as encourages them to publish examples taken from their own professional experience that may unquestionably be helpful to other practitioners in this field and above all will lead to extending educational methods related to widely understood DNA analysis in giving an opinion on arguable fatherhood.

[Abortion and fetal non-viability: the Brazilian debate].

PubMed

Diniz, Debora

2005-01-01

The Case Against Non-Compliance with the Fundamental Principle concerning Anencephaly, under review by the Brazilian Supreme Court, is a milestone in the debate on abortion in Latin America. Since the currently prevailing version of the Brazilian Penal Code was enacted in 1940, there has been fierce resistance to any change in the country's abortion policy. This article discusses the arguments and political strategies used in the anencephaly suit brought before the Supreme Court, particularly the ethical and legal position that interruption of pregnancy in cases of anencephaly does not constitute abortion, but should be considered a therapeutic anticipation of delivery.

27 CFR 19.957 - Instructions to compute bond penal sum.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Instructions to compute bond penal sum. 19.957 Section 19.957 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX... Fuel Use Bonds § 19.957 Instructions to compute bond penal sum. (a) Medium plants. To find the required...

[The Patient Rights Act (PatRG)--part 1: legislative procedure, treatment contract, contracting parties and their obligations to cooperate and inform].

PubMed

Parzeller, Markus; Zedler, Barbara

2013-01-01

The article deals with the new regulations in the German Civil Code (BGB) which came into effect in Germany on 26 Feb 2013 as the Patient Rights Act (PatRG). In Part I, the legislative procedure, the treatment contract and the contracting parties (Section 630a Civil Code), the applicable regulations (Section 630b Civil Code) and the obligations to cooperate and inform (Section 630c Civil Code) are discussed and critically analysed.

Modernization of the graphics post-processors of the Hamburg German Climate Computer Center Carbon Cycle Codes

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

Stevens, E.J.; McNeilly, G.S.

The existing National Center for Atmospheric Research (NCAR) code in the Hamburg Oceanic Carbon Cycle Circulation Model and the Hamburg Large-Scale Geostrophic Ocean General Circulation Model was modernized and reduced in size while still producing an equivalent end result. A reduction in the size of the existing code from more than 50,000 lines to approximately 7,500 lines in the new code has made the new code much easier to maintain. The existing code in Hamburg model uses legacy NCAR (including even emulated CALCOMP subrountines) graphics to display graphical output. The new code uses only current (version 3.1) NCAR subrountines.

Re-Examining Bernstein: From Peer-Group Ways of Speaking to "Schriftsprache"--A Study of Turkish-German "Hauptschule" Students in Mannheim

ERIC Educational Resources Information Center

Keim, Inken

2009-01-01

This paper begins by looking at responses to Bernstein in Germany in the 1970s that criticized his notions of class difference in sociolinguistic codes. As part of a re-examination of Bernstein's ideas, the paper goes on to look at the current communicative situation in German education where urban schools have many second-generation immigrant…

[Hand surgery in the German DRG System 2007].

PubMed

Franz, D; Windolf, J; Kaufmann, M; Siebert, C H; Roeder, N

2007-05-01

Hand surgery often needs only a short length of stay in hospital. Patients' comorbidity is low. Many hand surgery procedures do not need inpatient structures. Up until 2006 special procedures of hand surgery could not be coded. The DRG structure did not separate very complex and less complex operations. Specialized hospitals needed a proper case allocation of their patients within the G-DRG system. The DRG structure concerning hand surgery increased in version 2007 of the G-DRG system. The main parameter of DRG splitting is the complexity of the operation. Furthermore additional criteria such as more than one significant OR procedure, the patients' age, or special diagnoses influence case allocation. A special OPS code for complex cases treated with hand surgery was implemented. The changes in the DRG structure and the implementation of the new OPS code for complex cases establish a strong basis for the identification of different patient costs. Different case allocation leads to different economic impacts on departments of hand surgery. Whether the new OPS code becomes a DRG splitting parameter has to be calculated by the German DRG Institute for further DRG versions.

[Prevalence of dementia of insured persons with and without German citizenship : A study based on statuatory health insurance data].

PubMed

Stock, Stephanie; Ihle, Peter; Simic, Dusan; Rupprecht, Christoph; Schubert, Ingrid; Lappe, Veronika; Kalbe, Elke; Tebest, Ralf; Lorrek, Kristina

2018-04-01

Elderly people with a non-German background are a fast growing population in Germany. Is administrative prevalence of dementia and uptake of nursing-home care similar in the German and non-German insured? Based on routine data, administrative prevalence rates for dementia were calculated for 2013 from a full census of data from one large sickness fund. Patients with dementia (PWD) were identified via ICD-10 codes (F00; F01; F03; F05; G30). Administrative prevalence of dementia was 2.67% in the study population; 3.06% in Germans, and 0.96% in non-Germans (p value <0.001). Age and sex adjusted prevalence was comparable in the insured with and without German citizenship, except in women aged 80-84 (17.2 vs. 15.4) and for men in the age groups 80-84 (16.5 vs. 14.2), 85-89 years (23.4 vs. 21.5), and above 90 years of age (32.3 vs. 26.3). Standardized to the population of all investigated insured, 31.4% of all Germans with dementia had no longterm care entitlement vs. 35.5% of all patients without German citizenship. Of German patients, 55.1% were institutionalized vs. 39.5% of all patients without German citizenship. There was a higher prevalence of dementia in the very old insured without German citizenship compared to those with German citizenship, especially in men. Non-Germans showed lower uptake of nursing home care compared to Germans. Additionally, Germans had slightly higher nursing care entitlements. It should be investigated further how much of the difference is due to underdiagnosis, cultural differences, or lack of adequate diagnostic work-up.

49 CFR 26.47 - Can recipients be penalized for failing to meet overall goals?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Can recipients be penalized for failing to meet... Goals, Good Faith Efforts, and Counting § 26.47 Can recipients be penalized for failing to meet overall... rule, because your DBE participation falls short of your overall goal, unless you have failed to...

43 CFR 4170.2-1 - Penal provisions under the Taylor Grazing Act.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Penal provisions under the Taylor Grazing Act. 4170.2-1 Section 4170.2-1 Public Lands: Interior Regulations Relating to Public Lands (Continued...-EXCLUSIVE OF ALASKA Penalties § 4170.2-1 Penal provisions under the Taylor Grazing Act. Under section 2 of...

38 CFR 14.560 - Procedure where violation of penal statutes is involved including those offenses coming within...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Procedure where violation of penal statutes is involved including those offenses coming within the purview of the Assimilative... where violation of penal statutes is involved including those offenses coming within the purview of the...

38 CFR 14.560 - Procedure where violation of penal statutes is involved including those offenses coming within...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Procedure where violation of penal statutes is involved including those offenses coming within the purview of the Assimilative... where violation of penal statutes is involved including those offenses coming within the purview of the...

38 CFR 14.560 - Procedure where violation of penal statutes is involved including those offenses coming within...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Procedure where violation of penal statutes is involved including those offenses coming within the purview of the Assimilative... where violation of penal statutes is involved including those offenses coming within the purview of the...

38 CFR 14.560 - Procedure where violation of penal statutes is involved including those offenses coming within...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Procedure where violation of penal statutes is involved including those offenses coming within the purview of the Assimilative... where violation of penal statutes is involved including those offenses coming within the purview of the...

38 CFR 14.560 - Procedure where violation of penal statutes is involved including those offenses coming within...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Procedure where violation of penal statutes is involved including those offenses coming within the purview of the Assimilative... where violation of penal statutes is involved including those offenses coming within the purview of the...

Conventional occlusion versus pharmacologic penalization for amblyopia.

PubMed

Li, Tianjing; Shotton, Kate

2009-10-07

Amblyopia is defined as defective visual acuity in one or both eyes without demonstrable abnormality of the visual pathway, and is not immediately resolved by wearing glasses. To assess the effectiveness and safety of conventional occlusion versus atropine penalization for amblyopia. We searched CENTRAL, MEDLINE, EMBASE, LILACS, the WHO International Clinical Trials Registry Platform, preference lists, science citation index and ongoing trials up to June 2009. We included randomized/quasi-randomized controlled trials comparing conventional occlusion to atropine penalization for amblyopia. Two authors independently screened abstracts and full text articles, abstracted data, and assessed the risk of bias. Three trials with a total of 525 amblyopic eyes were included. One trial was assessed as having a low risk of bias among these three trials, and one was assessed as having a high risk of bias.Evidence from three trials suggests atropine penalization is as effective as conventional occlusion. One trial found similar improvement in vision at six and 24 months. At six months, visual acuity in the amblyopic eye improved from baseline 3.16 lines in the occlusion and 2.84 lines in the atropine group (mean difference 0.034 logMAR; 95% confidence interval (CI) 0.005 to 0.064 logMAR). At 24 months, additional improvement was seen in both groups; but there continued to be no meaningful difference (mean difference 0.01 logMAR; 95% CI -0.02 to 0.04 logMAR). The second trial reported atropine to be more effective than occlusion. At six months, visual acuity improved 1.8 lines in the patching group and 3.4 lines in the atropine penalization group, and was in favor of atropine (mean difference -0.16 logMAR; 95% CI -0.23 to -0.09 logMAR). Different occlusion modalities were used in these two trials. The third trial had inherent methodological flaws and limited inference could be drawn.No difference in ocular alignment, stereo acuity and sound eye visual acuity between occlusion and atropine penalization was found. Although both treatments were well tolerated, compliance was better in atropine. Atropine penalization costs less than conventional occlusion. The results indicate that atropine penalization is as effective as conventional occlusion. Both conventional occlusion and atropine penalization produce visual acuity improvement in the amblyopic eye. Atropine penalization appears to be as effective as conventional occlusion, although the magnitude of improvement differed among the three trials. Atropine penalization can be used as first line treatment for amblyopia.

On the advancement of therapeutic penality: therapeutic authority, personality science and the therapeutic community.

PubMed

McBride, Ruari-Santiago

2017-09-01

In this article I examine the advancement of therapeutic penality in the UK, a penal philosophy that reimagines prison policy, practices and environments utilising psychological knowledge. Adopting a historical approach, I show how modern therapeutic penality is linked to the emergence of personality science in the nineteenth century and the development of the democratic therapeutic community (DTC) model in the twentieth century. I outline how at the turn of the twenty-first century a catalytic event generated a moral panic that led the British government to mobilise psychological knowledge and technologies in an attempt to manage dangerous people with severe personality disorder. Tracing subsequent developments, I argue psychological ways of talking, thinking and acting have obtained unparalleled salience in domains of penality and, in turn, radically transformed the conditions of imprisonment. © 2017 Foundation for the Sociology of Health & Illness.

Estimation of Covariance Matrix on Bi-Response Longitudinal Data Analysis with Penalized Spline Regression

NASA Astrophysics Data System (ADS)

Islamiyati, A.; Fatmawati; Chamidah, N.

2018-03-01

The correlation assumption of the longitudinal data with bi-response occurs on the measurement between the subjects of observation and the response. It causes the auto-correlation of error, and this can be overcome by using a covariance matrix. In this article, we estimate the covariance matrix based on the penalized spline regression model. Penalized spline involves knot points and smoothing parameters simultaneously in controlling the smoothness of the curve. Based on our simulation study, the estimated regression model of the weighted penalized spline with covariance matrix gives a smaller error value compared to the error of the model without covariance matrix.

Differentiating among penal states.

PubMed

Lacey, Nicola

2010-12-01

This review article assesses Loïc Wacquant's contribution to debates on penality, focusing on his most recent book, Punishing the Poor: The Neoliberal Government of Social Insecurity (Wacquant 2009), while setting its argument in the context of his earlier Prisons of Poverty (1999). In particular, it draws on both historical and comparative methods to question whether Wacquant's conception of 'the penal state' is adequately differentiated for the purposes of building the explanatory account he proposes; about whether 'neo-liberalism' has, materially, the global influence which he ascribes to it; and about whether, therefore, the process of penal Americanization which he asserts in his recent writings is credible.

Perinatal depression: a review of US legislation and law.

PubMed

Rhodes, Ann M; Segre, Lisa S

2013-08-01

Accumulating research documenting the prevalence and negative effects of perinatal depression, together with highly publicized tragic critical incidents of suicide and filicide by mothers with postpartum psychosis, have fueled a continuum of legislation. Specialists in perinatal mental health should recognize how their work influences legislative initiatives and penal codes, and take this into consideration when developing perinatal services and research. Yet, without legal expertise, the status of legislative initiatives can be confusing. To address this shortfall, we assembled an interdisciplinary team of academics specializing in law, as well as perinatal mental health, to summarize these issues. This review presents the relevant federal and state legislation and summarizes the criminal codes that governed the court decisions on cases in which a mother committed filicide because of postpartum psychosis. Moreover, the review aims to help researchers and providers who specialize in perinatal depression understand their role in this legal landscape.

Differential gene expression detection and sample classification using penalized linear regression models.

PubMed

Wu, Baolin

2006-02-15

Differential gene expression detection and sample classification using microarray data have received much research interest recently. Owing to the large number of genes p and small number of samples n (p > n), microarray data analysis poses big challenges for statistical analysis. An obvious problem owing to the 'large p small n' is over-fitting. Just by chance, we are likely to find some non-differentially expressed genes that can classify the samples very well. The idea of shrinkage is to regularize the model parameters to reduce the effects of noise and produce reliable inferences. Shrinkage has been successfully applied in the microarray data analysis. The SAM statistics proposed by Tusher et al. and the 'nearest shrunken centroid' proposed by Tibshirani et al. are ad hoc shrinkage methods. Both methods are simple, intuitive and prove to be useful in empirical studies. Recently Wu proposed the penalized t/F-statistics with shrinkage by formally using the (1) penalized linear regression models for two-class microarray data, showing good performance. In this paper we systematically discussed the use of penalized regression models for analyzing microarray data. We generalize the two-class penalized t/F-statistics proposed by Wu to multi-class microarray data. We formally derive the ad hoc shrunken centroid used by Tibshirani et al. using the (1) penalized regression models. And we show that the penalized linear regression models provide a rigorous and unified statistical framework for sample classification and differential gene expression detection.

The Rebirth of a World Power? German Unification and the Future of European Security

DTIC Science & Technology

1990-12-01

Government. 17 COSATI CODES 18 SUBJECT TERMS (Continue on reverse if necessary and identify by block number) FIELD GROUP SUB- GROUP German unification...in the balance of power system. Germany (and Prussia) was used as a territorial "shock absorber" to maintain a buffer between the great powers--a...European statecraft was not pressured by internal problems which later forced governments to take actions that aroused the suspicions and fears of the

Relationship between Training Programs being Offered in State and Federal Penal Institutions and the Unfilled Job Openings in the Major Occupations in the United States.

ERIC Educational Resources Information Center

Torrence, John Thomas

Excluding military installations, training programs in state and federal penal institutions were surveyed, through a mailed checklist, to test the hypotheses that (1) training programs in penal institutions were not related to the unfilled job openings by major occupations in the United States, and (2) that training programs reported would have a…

‘Other Spaces’ for the Dangerous Dead of Provincial England, c.1752–1832

PubMed Central

HURREN, ELIZABETH T.

2018-01-01

Abstract The Murder Act (1752) decreed that homicide perpetrators should be hanged and sent for post‐execution punishment. This article explores the event management of criminal dissections by penal surgeons in situ. It reveals that the punishment parade of the condemned did not stop at the scaffold, contrary to the impression in many standard historical accounts. Instead, ordinary people accompanied criminal corpses to many different types of dissection venues. Penal surgeons hand‐picked these performance spaces that were socially produced for legal and practical reasons. They had to be able to process large numbers of people who wanted to be part of the consumption of post‐mortem ‘harm’ in English communities. Event management on location had to have emotional and visual appeal, moral coherence, be timed appropriately, and, if successful, would enhance the deterrence value of the capital code. Yet, managing the ‘dangerous dead’ involved a great deal of discretionary justice with unpredictable outcomes. It often happened in ‘counter‐sites’ of punishment in the community and involved a great deal of immersive theatre. Some events worked well, others threatened the social order. In ‘Other Spaces’ the ‘Dangerous Dead’ was hence a fascinating feature of the Murder Act outside the Metropolis from 1752 to 1832. PMID:29491511

Sparse generalized linear model with L0 approximation for feature selection and prediction with big omics data.

PubMed

Liu, Zhenqiu; Sun, Fengzhu; McGovern, Dermot P

2017-01-01

Feature selection and prediction are the most important tasks for big data mining. The common strategies for feature selection in big data mining are L 1 , SCAD and MC+. However, none of the existing algorithms optimizes L 0 , which penalizes the number of nonzero features directly. In this paper, we develop a novel sparse generalized linear model (GLM) with L 0 approximation for feature selection and prediction with big omics data. The proposed approach approximate the L 0 optimization directly. Even though the original L 0 problem is non-convex, the problem is approximated by sequential convex optimizations with the proposed algorithm. The proposed method is easy to implement with only several lines of code. Novel adaptive ridge algorithms ( L 0 ADRIDGE) for L 0 penalized GLM with ultra high dimensional big data are developed. The proposed approach outperforms the other cutting edge regularization methods including SCAD and MC+ in simulations. When it is applied to integrated analysis of mRNA, microRNA, and methylation data from TCGA ovarian cancer, multilevel gene signatures associated with suboptimal debulking are identified simultaneously. The biological significance and potential clinical importance of those genes are further explored. The developed Software L 0 ADRIDGE in MATLAB is available at https://github.com/liuzqx/L0adridge.

IPF-LASSO: Integrative L 1-Penalized Regression with Penalty Factors for Prediction Based on Multi-Omics Data

PubMed Central

Jiang, Xiaoyu; Fuchs, Mathias

2017-01-01

As modern biotechnologies advance, it has become increasingly frequent that different modalities of high-dimensional molecular data (termed “omics” data in this paper), such as gene expression, methylation, and copy number, are collected from the same patient cohort to predict the clinical outcome. While prediction based on omics data has been widely studied in the last fifteen years, little has been done in the statistical literature on the integration of multiple omics modalities to select a subset of variables for prediction, which is a critical task in personalized medicine. In this paper, we propose a simple penalized regression method to address this problem by assigning different penalty factors to different data modalities for feature selection and prediction. The penalty factors can be chosen in a fully data-driven fashion by cross-validation or by taking practical considerations into account. In simulation studies, we compare the prediction performance of our approach, called IPF-LASSO (Integrative LASSO with Penalty Factors) and implemented in the R package ipflasso, with the standard LASSO and sparse group LASSO. The use of IPF-LASSO is also illustrated through applications to two real-life cancer datasets. All data and codes are available on the companion website to ensure reproducibility. PMID:28546826

"You Can Speak German, Sir": On the Complexity of Teachers' L1 Use in CLIL

ERIC Educational Resources Information Center

Gierlinger, Erwin

2015-01-01

Classroom code switching in foreign language teaching is still a controversial issue whose status as a tool of both despair and desire continues to be hotly debated. As the teaching of content and language integrated learning (CLIL) is, by definition, concerned with the learning of a foreign language, one would expect the value of code switching…

Dog breed stereotype and exposure to negative behavior: effects on perceptions of adoptability.

PubMed

Wright, John C; Smith, Alison; Daniel, Katie; Adkins, Karen

2007-01-01

The purpose of the study was to determine if brief exposure to a dog behaving badly or in a friendly manner affects subsequent perceptions of the target dog's and other dogs' adoptability. Participants viewed a videotape of an adoptable German shepherd behaving either aggressively or prosocially and were then asked to rate the characteristics and adoptability of the same and different dogs. The results showed that people who saw the aggressive behavioral schema perceived only the target dog and a dog of the same breed to be significantly less adoptable than dogs of other breeds (p<.01). Results of a principal components analysis showed participants perceived the adoptability of dogs to be related to "sociability": Adoptable dogs were more approachable, friendly, intelligent, and less dangerous and aggressive (p<.01). Brief exposure to a misbehaving dog prior to making a decision to adopt may unfairly penalize other dogs perceived to be similar to the misbehaving dog.

45 CFR 261.15 - Can a family be penalized if a parent refuses to work because he or she cannot find child care?

Code of Federal Regulations, 2011 CFR

2011-10-01

... Provisions Addressing Individual Responsibility? § 261.15 Can a family be penalized if a parent refuses to... parent caring for a child under age six who has a demonstrated inability to obtain needed child care, as... 45 Public Welfare 2 2011-10-01 2011-10-01 false Can a family be penalized if a parent refuses to...

45 CFR 261.15 - Can a family be penalized if a parent refuses to work because he or she cannot find child care?

Code of Federal Regulations, 2013 CFR

2013-10-01

... Provisions Addressing Individual Responsibility? § 261.15 Can a family be penalized if a parent refuses to... parent caring for a child under age six who has a demonstrated inability to obtain needed child care, as... 45 Public Welfare 2 2013-10-01 2012-10-01 true Can a family be penalized if a parent refuses to...

45 CFR 261.15 - Can a family be penalized if a parent refuses to work because he or she cannot find child care?

Code of Federal Regulations, 2012 CFR

2012-10-01

... Provisions Addressing Individual Responsibility? § 261.15 Can a family be penalized if a parent refuses to... parent caring for a child under age six who has a demonstrated inability to obtain needed child care, as... 45 Public Welfare 2 2012-10-01 2012-10-01 false Can a family be penalized if a parent refuses to...

45 CFR 261.15 - Can a family be penalized if a parent refuses to work because he or she cannot find child care?

Code of Federal Regulations, 2010 CFR

2010-10-01

... Provisions Addressing Individual Responsibility? § 261.15 Can a family be penalized if a parent refuses to... parent caring for a child under age six who has a demonstrated inability to obtain needed child care, as... 45 Public Welfare 2 2010-10-01 2010-10-01 false Can a family be penalized if a parent refuses to...

45 CFR 261.15 - Can a family be penalized if a parent refuses to work because he or she cannot find child care?

Code of Federal Regulations, 2014 CFR

2014-10-01

... Provisions Addressing Individual Responsibility? § 261.15 Can a family be penalized if a parent refuses to... parent caring for a child under age six who has a demonstrated inability to obtain needed child care, as... 45 Public Welfare 2 2014-10-01 2012-10-01 true Can a family be penalized if a parent refuses to...

Integrative Analysis of “-Omics” Data Using Penalty Functions

PubMed Central

Zhao, Qing; Shi, Xingjie; Huang, Jian; Liu, Jin; Li, Yang; Ma, Shuangge

2014-01-01

In the analysis of omics data, integrative analysis provides an effective way of pooling information across multiple datasets or multiple correlated responses, and can be more effective than single-dataset (response) analysis. Multiple families of integrative analysis methods have been proposed in the literature. The current review focuses on the penalization methods. Special attention is paid to sparse meta-analysis methods that pool summary statistics across datasets, and integrative analysis methods that pool raw data across datasets. We discuss their formulation and rationale. Beyond “standard” penalized selection, we also review contrasted penalization and Laplacian penalization which accommodate finer data structures. The computational aspects, including computational algorithms and tuning parameter selection, are examined. This review concludes with possible limitations and extensions. PMID:25691921

Hospital Characteristics Associated With Penalties in the Centers for Medicare & Medicaid Services Hospital-Acquired Condition Reduction Program.

PubMed

Rajaram, Ravi; Chung, Jeanette W; Kinnier, Christine V; Barnard, Cynthia; Mohanty, Sanjay; Pavey, Emily S; McHugh, Megan C; Bilimoria, Karl Y

2015-07-28

In fiscal year (FY) 2015, the Centers for Medicare & Medicaid Services (CMS) instituted the Hospital-Acquired Condition (HAC) Reduction Program, which reduces payments to the lowest-performing hospitals. However, it is uncertain whether this program accurately measures quality and fairly penalizes hospitals. To examine the characteristics of hospitals penalized by the HAC Reduction Program and to evaluate the association of a summary score of hospital characteristics related to quality with penalization in the HAC program. Data for hospitals participating in the FY2015 HAC Reduction Program were obtained from CMS' Hospital Compare and merged with the 2014 American Hospital Association Annual Survey and FY2015 Medicare Impact File. Logistic regression models were developed to examine the association between hospital characteristics and HAC program penalization. An 8-point hospital quality summary score was created using hospital characteristics related to volume, accreditations, and offering of advanced care services. The relationship between the hospital quality summary score and HAC program penalization was examined. Publicly reported process-of-care and outcome measures were examined from 4 clinical areas (surgery, acute myocardial infarction, heart failure, pneumonia), and their association with the hospital quality summary score was evaluated. Penalization in the HAC Reduction Program. Hospital characteristics associated with penalization. Of the 3284 hospitals participating in the HAC program, 721 (22.0%) were penalized. Hospitals were more likely to be penalized if they were accredited by the Joint Commission (24.0% accredited, 14.4% not accredited; odds ratio [OR], 1.33; 95% CI, 1.04-1.70); they were major teaching hospitals (42.3%; OR, 1.58; 95% CI, 1.09-2.29) or very major teaching hospitals (62.2%; OR, 2.61; 95% CI, 1.55-4.39; vs nonteaching hospitals, 17.0%); they cared for more complex patient populations based on case mix index (quartile 4 vs quartile 1: 32.8% vs 12.1%; OR, 1.98; 95% CI, 1.44-2.71); or they were safety-net hospitals vs non-safety-net hospitals (28.3% vs 19.9%; OR, 1.36; 95% CI, 1.11-1.68). Hospitals with higher hospital quality summary scores had significantly better performance on 9 of 10 publicly reported process and outcomes measures compared with hospitals that had lower quality scores (all P ≤ .01 for trend). However, hospitals with the highest quality score of 8 were penalized significantly more frequently than hospitals with the lowest quality score of 0 (67.3% [37/55] vs 12.6% [53/422]; P < .001 for trend). Among hospitals participating in the HAC Reduction Program, hospitals that were penalized more frequently had more quality accreditations, offered advanced services, were major teaching institutions, and had better performance on other process and outcome measures. These paradoxical findings suggest that the approach for assessing hospital penalties in the HAC Reduction Program merits reconsideration to ensure it is achieving the intended goals.

Enforcing the International Code of Marketing of Breast-milk Substitutes for Better Promotion of Exclusive Breastfeeding: Can Lessons Be Learned?

PubMed

Barennes, Hubert; Slesak, Guenther; Goyet, Sophie; Aaron, Percy; Srour, Leila M

2016-02-01

Exclusive breastfeeding, one of the best natural resources, needs protection and promotion. The International Code of Marketing of Breast-milk Substitutes (the Code), which aims to prevent the undermining of breastfeeding by formula advertising, faces implementation challenges. We reviewed frequently overlooked challenges and obstacles that the Code is facing worldwide, but particularly in Southeast Asia. Drawing lessons from various countries where we work, and following the example of successful public health interventions, we discussed legislation, enforcement, and experiences that are needed to successfully implement the Code. Successful holistic approaches that have strengthened the Code need to be scaled up. Community-based actions and peer-to-peer promotions have proved successful. Legislation without stringent enforcement and sufficient penalties is ineffective. The public needs education about the benefits and ways and means to support breastfeeding. It is crucial to combine strong political commitment and leadership with strict national regulations, definitions, and enforcement. National breastfeeding committees, with the authority to improve regulations, investigate violations, and enforce the laws, must be established. Systematic monitoring and reporting are needed to identify companies, individuals, intermediaries, and practices that infringe on the Code. Penalizing violators is crucial. Managers of multinational companies must be held accountable for international violations, and international legislative enforcement needs to be established. Further measures should include improved regulations to protect the breastfeeding mother: large-scale education campaigns; strong penalties for Code violators; exclusion of the formula industry from nutrition, education, and policy roles; supportive legal networks; and independent research of interventions supporting breastfeeding. © The Author(s) 2015.

Performance and robustness of penalized and unpenalized methods for genetic prediction of complex human disease.

PubMed

Abraham, Gad; Kowalczyk, Adam; Zobel, Justin; Inouye, Michael

2013-02-01

A central goal of medical genetics is to accurately predict complex disease from genotypes. Here, we present a comprehensive analysis of simulated and real data using lasso and elastic-net penalized support-vector machine models, a mixed-effects linear model, a polygenic score, and unpenalized logistic regression. In simulation, the sparse penalized models achieved lower false-positive rates and higher precision than the other methods for detecting causal SNPs. The common practice of prefiltering SNP lists for subsequent penalized modeling was examined and shown to substantially reduce the ability to recover the causal SNPs. Using genome-wide SNP profiles across eight complex diseases within cross-validation, lasso and elastic-net models achieved substantially better predictive ability in celiac disease, type 1 diabetes, and Crohn's disease, and had equivalent predictive ability in the rest, with the results in celiac disease strongly replicating between independent datasets. We investigated the effect of linkage disequilibrium on the predictive models, showing that the penalized methods leverage this information to their advantage, compared with methods that assume SNP independence. Our findings show that sparse penalized approaches are robust across different disease architectures, producing as good as or better phenotype predictions and variance explained. This has fundamental ramifications for the selection and future development of methods to genetically predict human disease. © 2012 WILEY PERIODICALS, INC.

[Incidence and Costs of 1:1 Care in Psychiatric Hospitals in Germany - A Descriptive Analysis Based on the VIPP Project Data Set].

PubMed

Nienaber, André; Schulz, Michael; Noelle, Rüdiger; Wiegand, Hauke Felix; Wolff-Menzler, Claus; Häfner, Sibylle; Seemüller, Florian; Godemann, Frank; Löhr, Michael

2016-05-01

1:1 care is applied for patients requiring close psychiatric monitoring and care like patients with acute suicidality. The article describes the frequency of 1:1 care across different diagnoses and age groups in German psychiatric hospitals. The analysis was based on the VIPP Project from the years 2011 and 2012. A total of 47 hospitals with more than 120,000 cases were included. Object of the analysis was the OPS code 9-640.0 1:1 care. The evaluation was performed on case level. Data of 47 hospitals were included. Of the 121,454 cases evaluated in 2011 3.8 % documented a 1:1 care within the meaning of OPS 9-640.0 additional code. Of the 66 245 male cases a 1:1 care was documented in 3.5 % and the 55 207 female cases was 4.1 %. Compared to 2011, the proportion of 1:1 care in 2012 rose to 4.8 %. The results show that 1:1 care is frequently applied in German psychiatric hospitals. The Data of the VIPP project have proven to be a useful tool to gain information on the frequency of cost-intensive interventions in German psychiatric hospitals. Further analyses should create the possibility of evaluation at the level of the individual codes. © Georg Thieme Verlag KG Stuttgart · New York.

Analyzing Association Mapping in Pedigree-Based GWAS Using a Penalized Multitrait Mixed Model

PubMed Central

Liu, Jin; Yang, Can; Shi, Xingjie; Li, Cong; Huang, Jian; Zhao, Hongyu; Ma, Shuangge

2017-01-01

Genome-wide association studies (GWAS) have led to the identification of many genetic variants associated with complex diseases in the past 10 years. Penalization methods, with significant numerical and statistical advantages, have been extensively adopted in analyzing GWAS. This study has been partly motivated by the analysis of Genetic Analysis Workshop (GAW) 18 data, which have two notable characteristics. First, the subjects are from a small number of pedigrees and hence related. Second, for each subject, multiple correlated traits have been measured. Most of the existing penalization methods assume independence between subjects and traits and can be suboptimal. There are a few methods in the literature based on mixed modeling that can accommodate correlations. However, they cannot fully accommodate the two types of correlations while conducting effective marker selection. In this study, we develop a penalized multitrait mixed modeling approach. It accommodates the two different types of correlations and includes several existing methods as special cases. Effective penalization is adopted for marker selection. Simulation demonstrates its satisfactory performance. The GAW 18 data are analyzed using the proposed method. PMID:27247027

Instruction No. 3/1988, 1 June 1988.

PubMed

1988-01-01

This Instruction contains provisions relating to the injury and maltreatment of children and women and the enforcement of support payments to women and children. With respect to the maltreatment of children, it provides that the Spanish Office of the Public Prosecutor shall a) curb child abuse; b) take decisive action to protect minors who have been abused or are helpless and to execute the new responsibilities imposed by Law 21/1987 of November 11, which modifies the Civil Code with respect to adoption; and c) collect the necessary data with regard to felonies or misdemeanors that involve child abuse so as to allow for the compilation of annual statistics which may identify the magnitude of this problem; With respect to the maltreatment of women, the prosecutor shall a) curb the abuse of women, investigating those cases where a lack of evidence exists because women are afraid; and b) collect the necessary data with regard to felonies or misdemeanors that involve the abuse of women so as to allow for the compilation of annual statistics which may identify the social reality of this problem. With respect to support payments, the Instruction urges all prosecutors to monitor the execution of support payments using all judicial means authorized, including penal actions when applicable, or enforcement mechanisms which have been mentioned in this memo, that is, conditioning visitation rights on timely payment of the support established for food and education of the children. In Circular No. 32 of 15 April 1988, the National Directorate of Police is called on to provide all necessary police assistance to women who have been the object of illegitimate acts of force so that they can report such acts and to inform women of laws designed to help them and the means of availing themselves of these laws. See Anuario de Derecho Penal y Ciencias Penales, Vol. 41, No. 3, September-December 1988, p. 978. full text

Principles of Product Quality Control of German Radioactive Waste Forms from the Reprocessing of Spent Fuel: Vitrification, Compaction and Numerical Simulation - 12529

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

Tietze-Jaensch, Holger; Schneider, Stephan; Aksyutina, Yuliya

2012-07-01

The German product quality control is inter alia responsible for control of two radioactive waste forms of heat generating waste: a) homogeneous vitrified HLW and b) heterogeneous compacted hulls, end-pieces and technological metallic waste. In either case, significantly different metrology is employed at the site of the conditioning plant for the obligatory nuclide inventory declaration. To facilitate an independent evaluation and checking of the accompanying documentation numerical simulations are carried out. The physical and chemical properties of radioactive waste residues are used to assess the data consistency and uncertainty margins, as well as to predict the long-term behavior of themore » radioactive waste. This is relevant for repository acceptance and safety considerations. Our new numerical approach follows a bottom-up simulation starting from the burn-up behavior of the fuel elements in the reactor core. The output of these burn-up calculations is then coupled with a program that simulates the material separation in the subsequent dissolution and extraction processes normalized to the mass balance. Follow-up simulations of the separated reprocessing lines of a) the vitrification of highly-active liquid and b) the compaction of residual intermediate-active metallic hulls remaining after fuel pellets dissolution, end-pieces and technological waste, allows calculating expectation values for the various repository relevant properties of either waste stream. The principles of the German product quality control of radioactive waste residues from the spent fuel reprocessing have been introduced and explained. Namely, heat generating homogeneous vitrified HLW and heterogeneous compacted metallic MLW have been discussed. The advantages of a complementary numerical property simulation have been made clear and examples of benefits are presented. We have compiled a new program suite to calculate the physical and radio-chemical properties of common nuclear waste residues. The immediate benefit is the independent assessment of radio-active inventory declarations and much facilitated product quality control of waste residues that need to be returned to Germany and submitted to a German HLW-repository requirements. Wherever possible, internationally accepted standard programs are used and embedded. The innovative coupling of burn-up calculations (SCALE) with neutron and gamma transport codes (MCPN-X) allows an application in the world of virtual waste properties. If-then-else scenarios of hypothetical waste material compositions and distributions provide valuable information of long term nuclide property propagation under repository conditions over a very long time span. Benchmarking the program with real residue data demonstrates the power and remarkable accuracy of this numerical approach, boosting the reliability of the confidence aforementioned numerous applications, namely the proof tool set for on-the-spot production quality checking and data evaluation and independent verification. Moreover, using the numerical bottom-up approach helps to avoid the accumulation of fake activities that may gradually build up in a repository from the so-called conservative or penalizing nuclide inventory declarations. The radioactive waste properties and the hydrolytic and chemical stability can be predicted. The interaction with invasive chemicals can be assessed and propagation scenarios can be developed from reliable and sound data and HLW properties. Hence, the appropriate design of a future HLW repository can be based upon predictable and quality assured waste characteristics. (authors)« less

Smoking in contemporary German television programming.

PubMed

Hanewinkel, Reiner; Wiborg, Gudrun

2007-01-01

To study the prevalence of smoking in German television in 2005. Content analysis of all programmes of the four main national channels Das Erste, ZDF RTL and Pro7 over one week between 3 pm and 12 pm. A total of 395 programmes were analysed (252 h of programming). Each programme was coded regarding whether there was one or more smoking occurrence, defined as active smoking or handling with tobacco products by a character. Smoking was portrayed in 176 (45%) of the programmes. Smoking occurrences were frequent in movies (77%), and in TV magazines (69%). Movies, films, and serials produced in Germany showed more often smoking (65%) compared with productions from abroad (48%; p = 0.051). Smoking is frequently portrayed in German TV.

No grammatical gender effect on affective ratings: evidence from Italian and German languages.

PubMed

Montefinese, Maria; Ambrosini, Ettore; Roivainen, Eka

2018-06-06

In this study, we tested the linguistic relativity hypothesis by studying the effect of grammatical gender (feminine vs. masculine) on affective judgments of conceptual representation in Italian and German. In particular, we examined the within- and cross-language grammatical gender effect and its interaction with participants' demographic characteristics (such as, the raters' age and sex) on semantic differential scales (affective ratings of valence, arousal and dominance) in Italian and German speakers. We selected the stimuli and the relative affective measures from Italian and German adaptations of the ANEW (Affective Norms for English Words). Bayesian and frequentist analyses yielded evidence for the absence of within- and cross-languages effects of grammatical gender and sex- and age-dependent interactions. These results suggest that grammatical gender does not affect judgments of affective features of semantic representation in Italian and German speakers, since an overt coding of word grammar is not required. Although further research is recommended to refine the impact of the grammatical gender on properties of semantic representation, these results have implications for any strong view of the linguistic relativity hypothesis.

An adjoint-based framework for maximizing mixing in binary fluids

NASA Astrophysics Data System (ADS)

Eggl, Maximilian; Schmid, Peter

2017-11-01

Mixing in the inertial, but laminar parameter regime is a common application in a wide range of industries. Enhancing the efficiency of mixing processes thus has a fundamental effect on product quality, material homogeneity and, last but not least, production costs. In this project, we address mixing efficiency in the above mentioned regime (Reynolds number Re = 1000 , Peclet number Pe = 1000) by developing and demonstrating an algorithm based on nonlinear adjoint looping that minimizes the variance of a passive scalar field which models our binary Newtonian fluids. The numerical method is based on the FLUSI code (Engels et al. 2016), a Fourier pseudo-spectral code, which we modified and augmented by scalar transport and adjoint equations. Mixing is accomplished by moving stirrers which are numerically modeled using a penalization approach. In our two-dimensional simulations we consider rotating circular and elliptic stirrers and extract optimal mixing strategies from the iterative scheme. The case of optimizing shape and rotational speed of the stirrers will be demonstrated.

[Mentally ill and dangerous: civil commitment or internment? The Belgian judicial framework].

PubMed

Smets, H; Verelst, R; Vandenberghe, J

2009-01-01

There are two important Belgian laws referring to psychiatric disturbances that may prove dangerous. The Civil Code includes the law relating to the protection of the mentally ill person, dated 26th June 1990, better known as the law of civil commitment of the mentally ill. Since April, 2007, the Penal Code has contained a new law on the internment of people with a psychiatric disorder; this new law replaces the old law of the 1st July, 1964, meant to protect the society. Although the two laws apply to different fields, in clinical practice there are sometimes 'grey areas' where it is not immediately evident which legal framework is applicable. Starting from a case study in which the civil judge ordered the civil commitment of a detainee, we explore these 'grey areas' and compare the two legal frameworks. We base our study on the new law on internment, clarify it and sketch the legal history of internment in Belgium.

[Patient information in urology: current legal situation with particular emphasis on the codification of the contract governing medical treatment in the German Civil Code (BGB)].

PubMed

Fischer, C; Petersilie, F

2014-12-01

The extent and specification of patient information have so far been defined by case law. Henceforth, the rules of patient information are included in a new type of contract, a contract governing medical treatment (Behandlungsvertrag), codified in §§630a-630e of the German Civil Code (BGB). The main conclusions of the case law are now governed by law; however, some new requirements, such as the obligation to inform patients about treatment errors or the stipulation to deliver copies of undersigned documents have been added. This article gives an overview of the codification of patient information, explains how to inform patients, particularly in urology and illustrates where it is still likely that law courts will be concerned with questions of interpretation. Correct patient information is crucial for declarations of informed consent.

Majorization Minimization by Coordinate Descent for Concave Penalized Generalized Linear Models

PubMed Central

Jiang, Dingfeng; Huang, Jian

2013-01-01

Recent studies have demonstrated theoretical attractiveness of a class of concave penalties in variable selection, including the smoothly clipped absolute deviation and minimax concave penalties. The computation of the concave penalized solutions in high-dimensional models, however, is a difficult task. We propose a majorization minimization by coordinate descent (MMCD) algorithm for computing the concave penalized solutions in generalized linear models. In contrast to the existing algorithms that use local quadratic or local linear approximation to the penalty function, the MMCD seeks to majorize the negative log-likelihood by a quadratic loss, but does not use any approximation to the penalty. This strategy makes it possible to avoid the computation of a scaling factor in each update of the solutions, which improves the efficiency of coordinate descent. Under certain regularity conditions, we establish theoretical convergence property of the MMCD. We implement this algorithm for a penalized logistic regression model using the SCAD and MCP penalties. Simulation studies and a data example demonstrate that the MMCD works sufficiently fast for the penalized logistic regression in high-dimensional settings where the number of covariates is much larger than the sample size. PMID:25309048

Comparison of the efficacies of patching and penalization therapies for the treatment of amblyopia patients

PubMed Central

Cabi, Cemalettin; Sayman Muslubas, Isil Bahar; Aydin Oral, Ayse Yesim; Dastan, Metin

2014-01-01

AIM To compare the efficacies of patching and penalization therapies for the treatment of amblyopia patients. METHODS The records of 64 eyes of 50 patients 7 to 16y of age who had presented to our clinics with a diagnosis of amblyopia, were evaluated retrospectively. Forty eyes of 26 patients who had received patching therapy and 24 eyes of 24 patients who had received penalization therapy included in this study. The latencies and amplitudes of visual evoked potential (VEP) records and best corrected visual acuities (BCVA) of these two groups were compared before and six months after the treatment. RESULTS In both patching and the penalization groups, the visual acuities increased significantly following the treatments (P<0.05). The latency measurements of the P100 wave obtained at 1.0°, 15 arc min. Patterns of both groups significantly decreased following the 6-months-treatment. However, the amplitude measurements increased (P<0.05). CONCLUSION The patching and the penalization methods, which are the main methods used in the treatment of amblyopia, were also effective over the age of 7y, which has been accepted as the critical age for the treatment of amblyopia. PMID:24967195

[open quotes]Sonya[close quotes] explains

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

Moss, N.

This article describes observations of Ruth Werner from when she was an agent of the Soviet espionage service (code name [open quotes]Sonya[close quotes]) as related in her interview with the author. The main topics covered in the interview include her opinion and relationship with Klaus Fuchs, the German-born British physicist who passed the secrets of the first atomic bomb to the Russians, and her views on German reunification. Ruth focuses her discussion on her dedication to making the world a better place and the disillusionment she has felt as she reminisces about her past.

[Chronic pain disorder with somatic and psychological factors (F45.41) : Validation criteria on operationalization of the ICD-10-GM diagnosis].

PubMed

Arnold, B; Lutz, J; Nilges, P; Pfingsten, M; Rief, Winfried; Böger, A; Brinkschmidt, T; Casser, H-R; Irnich, D; Kaiser, U; Klimczyk, K; Sabatowski, R; Schiltenwolf, M; Söllner, W

2017-12-01

In 2009 the diagnosis chronic pain disorder with somatic and psychological factors (F45.41) was integrated into the German version of the International Classification of Diseases, version 10 (ICD-10-GM). In 2010 Paul Nilges and Winfried Rief published operationalization criteria for this diagnosis. In the present publication the ad hoc commission on multimodal interdisciplinary pain therapy of the German Pain Society now presents a formula for a clear validation of these operationalization criteria of the ICD code F45.41.

Regularized rare variant enrichment analysis for case-control exome sequencing data.

PubMed

Larson, Nicholas B; Schaid, Daniel J

2014-02-01

Rare variants have recently garnered an immense amount of attention in genetic association analysis. However, unlike methods traditionally used for single marker analysis in GWAS, rare variant analysis often requires some method of aggregation, since single marker approaches are poorly powered for typical sequencing study sample sizes. Advancements in sequencing technologies have rendered next-generation sequencing platforms a realistic alternative to traditional genotyping arrays. Exome sequencing in particular not only provides base-level resolution of genetic coding regions, but also a natural paradigm for aggregation via genes and exons. Here, we propose the use of penalized regression in combination with variant aggregation measures to identify rare variant enrichment in exome sequencing data. In contrast to marginal gene-level testing, we simultaneously evaluate the effects of rare variants in multiple genes, focusing on gene-based least absolute shrinkage and selection operator (LASSO) and exon-based sparse group LASSO models. By using gene membership as a grouping variable, the sparse group LASSO can be used as a gene-centric analysis of rare variants while also providing a penalized approach toward identifying specific regions of interest. We apply extensive simulations to evaluate the performance of these approaches with respect to specificity and sensitivity, comparing these results to multiple competing marginal testing methods. Finally, we discuss our findings and outline future research. © 2013 WILEY PERIODICALS, INC.

Competitive repetition suppression (CoRe) clustering: a biologically inspired learning model with application to robust clustering.

PubMed

Bacciu, Davide; Starita, Antonina

2008-11-01

Determining a compact neural coding for a set of input stimuli is an issue that encompasses several biological memory mechanisms as well as various artificial neural network models. In particular, establishing the optimal network structure is still an open problem when dealing with unsupervised learning models. In this paper, we introduce a novel learning algorithm, named competitive repetition-suppression (CoRe) learning, inspired by a cortical memory mechanism called repetition suppression (RS). We show how such a mechanism is used, at various levels of the cerebral cortex, to generate compact neural representations of the visual stimuli. From the general CoRe learning model, we derive a clustering algorithm, named CoRe clustering, that can automatically estimate the unknown cluster number from the data without using a priori information concerning the input distribution. We illustrate how CoRe clustering, besides its biological plausibility, posses strong theoretical properties in terms of robustness to noise and outliers, and we provide an error function describing CoRe learning dynamics. Such a description is used to analyze CoRe relationships with the state-of-the art clustering models and to highlight CoRe similitude with rival penalized competitive learning (RPCL), showing how CoRe extends such a model by strengthening the rival penalization estimation by means of loss functions from robust statistics.

[Euthanasia: legal comparison in selected European countries].

PubMed

Doležal, Adam

2018-01-01

This article deals with the subject of euthanasia (all its forms) and other end-of-life decisions, such as assisted suicide, withdrawing and whithholding life-sustaining treatments. Among other things, the article will also deal with the issue of the offense of Homicide by the Victims Request. Based on an empirical historical method, the article compares the various selected legal orders. From this analysis, it draws some conclusions that have an impact on ethical discourse. First of all, the terminology is defined in the article, which is very important in this area. Further, German law is being analysed, with emphasis on Nazi Germany. On that basis, the so-called reductio ad Hitlerum argument is rejected. Research continues and is followed by another states, the Netherlands, Belgium and Switzerland. By analysing them, the following ethical arguments used in euthanasia debates are examined: the argument of a slippery slope and the argument of respect for autonomy. Finally, the judgment of the European Court of Human Rights in the Pretty case is also analysed. On this case, we can demonstrate, how insufficient is argument of human dignity. The last part is dedicated to the Czech Republic and its legal order. Firstly, it focuses on the history of the legal regulation of euthanasia, but the main part deals with the current legal situation. In addition to the recent state of affairs, the bill of Death with dignity act is also being examined. At the end of the article it is pointed out that the Czech regulation is insufficient and changes are necessary. However, the proposed bill of Death with dignity act is not the right way to follow. Rather, it may be wise to adopt an amendment to the Penal Code that would introduce the offense of Homicide by the Victims Request.Key words: assisted suicide - euthanasia - Homicide by the Victims Request - medical futility - withdrawing and whithholding life-sustaining treatment.

Analysis of Genome-Wide Association Studies with Multiple Outcomes Using Penalization

PubMed Central

Liu, Jin; Huang, Jian; Ma, Shuangge

2012-01-01

Genome-wide association studies have been extensively conducted, searching for markers for biologically meaningful outcomes and phenotypes. Penalization methods have been adopted in the analysis of the joint effects of a large number of SNPs (single nucleotide polymorphisms) and marker identification. This study is partly motivated by the analysis of heterogeneous stock mice dataset, in which multiple correlated phenotypes and a large number of SNPs are available. Existing penalization methods designed to analyze a single response variable cannot accommodate the correlation among multiple response variables. With multiple response variables sharing the same set of markers, joint modeling is first employed to accommodate the correlation. The group Lasso approach is adopted to select markers associated with all the outcome variables. An efficient computational algorithm is developed. Simulation study and analysis of the heterogeneous stock mice dataset show that the proposed method can outperform existing penalization methods. PMID:23272092

Penalized Ordinal Regression Methods for Predicting Stage of Cancer in High-Dimensional Covariate Spaces.

PubMed

Gentry, Amanda Elswick; Jackson-Cook, Colleen K; Lyon, Debra E; Archer, Kellie J

2015-01-01

The pathological description of the stage of a tumor is an important clinical designation and is considered, like many other forms of biomedical data, an ordinal outcome. Currently, statistical methods for predicting an ordinal outcome using clinical, demographic, and high-dimensional correlated features are lacking. In this paper, we propose a method that fits an ordinal response model to predict an ordinal outcome for high-dimensional covariate spaces. Our method penalizes some covariates (high-throughput genomic features) without penalizing others (such as demographic and/or clinical covariates). We demonstrate the application of our method to predict the stage of breast cancer. In our model, breast cancer subtype is a nonpenalized predictor, and CpG site methylation values from the Illumina Human Methylation 450K assay are penalized predictors. The method has been made available in the ordinalgmifs package in the R programming environment.

Regional and temporal variations in coding of hospital diagnoses referring to upper gastrointestinal and oesophageal bleeding in Germany.

PubMed

Langner, Ingo; Mikolajczyk, Rafael; Garbe, Edeltraut

2011-08-17

Health insurance claims data are increasingly used for health services research in Germany. Hospital diagnoses in these data are coded according to the International Classification of Diseases, German modification (ICD-10-GM). Due to the historical division into West and East Germany, different coding practices might persist in both former parts. Additionally, the introduction of Diagnosis Related Groups (DRGs) in Germany in 2003/2004 might have changed the coding. The aim of this study was to investigate regional and temporal variations in coding of hospitalisation diagnoses in Germany. We analysed hospitalisation diagnoses for oesophageal bleeding (OB) and upper gastrointestinal bleeding (UGIB) from the official German Hospital Statistics provided by the Federal Statistical Office. Bleeding diagnoses were classified as "specific" (origin of bleeding provided) or "unspecific" (origin of bleeding not provided) coding. We studied regional (former East versus West Germany) differences in incidence of hospitalisations with specific or unspecific coding for OB and UGIB and temporal variations between 2000 and 2005. For each year, incidence ratios of hospitalisations for former East versus West Germany were estimated with log-linear regression models adjusting for age, gender and population density. Significant differences in specific and unspecific coding between East and West Germany and over time were found for both, OB and UGIB hospitalisation diagnoses, respectively. For example in 2002, incidence ratios of hospitalisations for East versus West Germany were 1.24 (95% CI 1.16-1.32) for specific and 0.67 (95% CI 0.60-0.74) for unspecific OB diagnoses and 1.43 (95% CI 1.36-1.51) for specific and 0.83 (95% CI 0.80-0.87) for unspecific UGIB. Regional differences nearly disappeared and time trends were less marked when using combined specific and unspecific diagnoses of OB or UGIB, respectively. During the study period, there were substantial regional and temporal variations in the coding of OB and UGIB diagnoses in hospitalised patients. Possible explanations for the observed regional variations are different coding preferences, further influenced by changes in coding and reimbursement rules. Analysing groups of diagnoses including specific and unspecific codes reduces the influence of varying coding practices.

Cryptanalysis in World War II--and Mathematics Education.

ERIC Educational Resources Information Center

Hilton, Peter

1984-01-01

Hilton describes the team of cryptanalysts who tried to decipher German and Japanese codes during the Second World War. The work of Turing, essentially developing the computer, is reported, as well as inferences about pure and applied mathematics. (MNS)

Key populations and human rights in the context of HIV services rendition in Ghana.

PubMed

Laar, Amos; DeBruin, Debra

2017-08-02

In line with its half century old penal code, Ghana currently criminalizes and penalizes behaviors of some key populations - populations deemed to be at higher risk of acquiring or transmitting Human Immunodeficiency Virus (HIV). Men who have sex with men (MSM), and sex workers (SWs) fit into this categorization. This paper provides an analysis of how enactment and implementation of rights-limiting laws not only limit rights, but also amplify risk and vulnerability to HIV in key and general populations. The paper derives from a project that assessed the ethics sensitivity of key documents guiding Ghana's response to its HIV epidemic. Assessment was guided by leading frameworks from public health ethics, and relevant articles from the international bill of rights. Ghana's response to her HIV epidemic does not adequately address the rights and needs of key populations. Even though the national response has achieved some public health successes, palpable efforts to address rights issues remain nascent. Ghana's guiding documents for HIV response include no advocacy for decriminalization, depenalization or harm reduction approaches for these key populations. The impact of rights-restricting codes on the nation's HIV epidemic is real: criminalization impedes key populations' access to HIV prevention and treatment services. Given that they are bridging populations, whatever affects the Ghanaian key populations directly, affects the general population indirectly. The right to the highest attainable standard of health, without qualification, is generally acknowledged as a fundamental human right. Unfortunately, this right currently eludes the Ghanaian SW and MSM. The paper endorses decriminalization as a means of promoting this right. In the face of opposition to decriminalization, the paper proposes specific harm reduction strategies as approaches to promote health and uplift the diminished rights of key populations. Thus the authors call on Ghana to remove impediments to public health services provision to these populations. Doing so will require political will and sufficient planning toward prioritizing HIV prevention, care and treatment programming for key populations.

The Mediterranean Crucible, 1942-1943: Did Technology or Tenets Achieve Air Superiority

DTIC Science & Technology

2012-06-01

messages of critical Luftwaffe communications. The decryption, analysis, and dissemination of messages from the German Enigma coding machine, facilitated...the ability to “read the Luftwaffe [Enigma] keys in North Africa from the first day of their introduction” in the theater.5 This system, code ...IRIS no. 118168, in USAF Collection, AFHRA, Part IV, 1. 21 AWPD-42, Part IV, 1. superiority which enables its possessor to conduct air

Advanced colorectal neoplasia risk stratification by penalized logistic regression.

PubMed

Lin, Yunzhi; Yu, Menggang; Wang, Sijian; Chappell, Richard; Imperiale, Thomas F

2016-08-01

Colorectal cancer is the second leading cause of death from cancer in the United States. To facilitate the efficiency of colorectal cancer screening, there is a need to stratify risk for colorectal cancer among the 90% of US residents who are considered "average risk." In this article, we investigate such risk stratification rules for advanced colorectal neoplasia (colorectal cancer and advanced, precancerous polyps). We use a recently completed large cohort study of subjects who underwent a first screening colonoscopy. Logistic regression models have been used in the literature to estimate the risk of advanced colorectal neoplasia based on quantifiable risk factors. However, logistic regression may be prone to overfitting and instability in variable selection. Since most of the risk factors in our study have several categories, it was tempting to collapse these categories into fewer risk groups. We propose a penalized logistic regression method that automatically and simultaneously selects variables, groups categories, and estimates their coefficients by penalizing the [Formula: see text]-norm of both the coefficients and their differences. Hence, it encourages sparsity in the categories, i.e. grouping of the categories, and sparsity in the variables, i.e. variable selection. We apply the penalized logistic regression method to our data. The important variables are selected, with close categories simultaneously grouped, by penalized regression models with and without the interactions terms. The models are validated with 10-fold cross-validation. The receiver operating characteristic curves of the penalized regression models dominate the receiver operating characteristic curve of naive logistic regressions, indicating a superior discriminative performance. © The Author(s) 2013.

Current challenges and problems in the field of new psychoactive substances in Germany from a law enforcement perspective.

PubMed

Duffert, Anna

2014-01-01

Over the last few years, a range of so-called new psychoactive substances (NPS) have established themselves on the German recreational drug scene, causing increased concern. At the same time, a great number of Internet shops have come into existence offering these substances for sale online, ensuring a high level of availability. A number of these substances derived from pharmaceutical research which did not result in marketing authorization, presumably due to unfavourable properties. There are hardly any reliable data on long-term health damage, addictive potential, and other aspects of these scientifically unexplored substances. A number of fatal intoxications have also become known. As a rule, the mostly young consumers do not know what substance they are taking and in what concentration, thus exposing themselves to incalculable health risks and consequences. The punishability of the handling of NPS depends on the actual content: the Narcotic Drugs Act (BtMG) is applicable if a product contains narcotic drugs. If similarly effective substances are contained, which are not classified as narcotic drugs, the (penal) provisions of the Medicinal Products Act might be applicable, if the product has a pharmaceutical effect. Experience gained so far has shown that manufacturers of these intoxicating substances react immediately to inclusions in the German BtMG and put new substances on the market which are chemically similar to the known substances thus circumventing legislation. In view of the immense variety of NPS and the enormous profits derived from their sale, an end to this development is not in sight. Copyright © 2014 John Wiley & Sons, Ltd.

Case mix measures and diagnosis-related groups: opportunities and threats for inpatient dermatology.

PubMed

Hensen, P; Fürstenberg, T; Luger, T A; Steinhoff, M; Roeder, N

2005-09-01

The changing healthcare environment world-wide is leading to extensive use of per case payment systems based on diagnosis-related groups (DRG). The aim of this study was to examine the impact of application of different DRG systems used in the German healthcare system. We retrospectively analysed 2334 clinical data sets of inpatients discharged from an academic dermatological inpatient unit in 2003. Data were regarded as providing high coding quality in compliance with the diagnosis and procedure classifications as well as coding standards. The application of the Australian AR-DRG version 4.1, the German G-DRG version 1.0, and the German G-DRG version 2004 was considered in detail. To evaluate more specific aspects, data were broken down into 11 groups based on the principle diagnosis. DRG cost weights and case mix index were used to compare coverage of inpatient dermatological services. Economic impacts were illustrated by case mix volumes and calculation of DRG payments. Case mix index results and the pending prospective revenues vary tremendously from the application of one or another of the DRG systems. The G-DRG version 2004 provides increased levels of case mix index that encourages, in particular, medical dermatology. The AR-DRG version 4.1 and the first German DRG version 1.0 appear to be less suitable to adequately cover inpatient dermatology. The G-DRG version 2004 has been greatly improved, probably due to proceeding calculation standards and DRG adjustments. The future of inpatient dermatology is subject to appropriate depiction of well-established treatment standards.

Prospects for research in haemophilia with real-world data-An analysis of German registry and secondary data.

PubMed

Schopohl, D; Bidlingmaier, C; Herzig, D; Klamroth, R; Kurnik, K; Rublee, D; Schramm, W; Schwarzkopf, L; Berger, K

2018-02-28

Open questions in haemophilia, such as effectiveness of innovative therapies, clinical and patient-reported outcomes (PROs), epidemiology and cost, await answers. The aim was to identify data attributes required and investigate the availability, appropriateness and accessibility of real-world data (RWD) from German registries and secondary databases to answer the aforementioned questions. Systematic searches were conducted in BIOSIS, EMBASE and MEDLINE to identify non-commercial secondary healthcare databases and registries of patients with haemophilia (PWH). Inclusion of German patients, type of patients, data elements-stratified by use in epidemiology, safety, outcomes and health economics research-and accessibility were investigated by desk research. Screening of 676 hits, identification of four registries [national PWH (DHR), national/international paediatric (GEPARD, PEDNET), international safety monitoring (EUHASS)] and seven national secondary databases. Access was limited to participants in three registries and to employees in one secondary database. One registry asks for PROs. Limitations of secondary databases originate from the ICD-coding system (missing: severity of haemophilia, presence of inhibitory antibodies), data protection laws and need to monitor reliability. Rigorous observational analysis of German haemophilia RWD shows that there is potential to supplement current knowledge and begin to address selected policy goals. To improve the value of existing RWD, the following efforts are proposed: ethical, legal and methodological discussions on data linkage across different sources, formulation of transparent governance rules for data access, redefinition of the ICD-coding, standardized collection of outcome data and implementation of incentives for treatment centres to improve data collection. © 2018 John Wiley & Sons Ltd.

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

Burke, J.V.

The published work on exact penalization is indeed vast. Recently this work has indicated an intimate relationship between exact penalization, Lagrange multipliers, and problem stability or calmness. In the present work we chronicle this development within a simple idealized problem framework, wherein we unify, extend, and refine much of the known theory. In particular, most of the foundations for constrained optimization are developed with the aid of exact penalization techniques. Our approach is highly geometric and is based upon the elementary subdifferential theory for distance functions. It is assumed that the reader is familiar with the theory of convex setsmore » and functions. 54 refs.« less

[Educational objectives in the new interdisciplinary subject "Rehabilitation, Physical Medicine, Naturopathic Techniques" under the 9th Revision of the Licensing Regulations for Doctors--consensus recommendations of the German Society for Rehabilitative Sciences and the German Society for Physical Medicine and Rehabilitation].

PubMed

Mau, W; Gülich, M; Gutenbrunner, C; Lampe, B; Morfeld, M; Schwarzkopf, S R; Smolenski, U C

2004-12-01

In October 2003 the 9 (th) revision of the Federal Medical Training Regulations (Approbationsordnung) came into effect. The new compulsory interdisciplinary subject "Rehabilitation, Physical Medicine, Naturopathic Treatment" offers the opportunity to teach all students in comprehensive concepts of Rehabilitation such as the International Classification of Functioning, Disability and Health (ICF) of the WHO and the new book 9 of the German Social Code (SGB 9), as well as Physical Medicine and Naturopathic Treatment. Since the content of this new subject has not been defined up to date a joint task force of the German Society of Rehabilitation Science and the German Society of Physical Medicine and Rehabilitation was founded in order to recommend teaching standards. As part of these teaching standards educational objectives are introduced in this article. They should guide the persons in charge of teaching the subject in the medical faculties. In some areas the students should acquire profound abilities and skills in addition to knowledge. The medical faculties may focus on different educational targets according to their individual teaching profile.

[Legal aspects of reuse and re-sterilization of disposable products in the hospital].

PubMed

Bohle, T

2000-06-01

What consequences may follow if the hospital administration decides to introduce recycling and resterilisation of disposable medical products? While some consider the chief executive administrators and doctors to be seriously endangered by the legal implications of the German Medical Products Act (MPG), others consider recycling and resterilisation to be clearly admissible. A closer look at what constitutes an offence as described in sec. 43, para 1 No. 1 of the MPG reveals that mere presumptions do not suffice to incur the respective penalties; rather, a concrete, scientifically sound basis for assuming an endangerment of safety or health are required for penal measures to be justified. The manufacturer's designation "for once-only use" may not be considered "intended purpose" as stipulated in sec. 4, para 1 No. 1 of the MPG. If recycling or resterilisation be confined to self-made disposables, there is no necessity for CE marking. Information of the patient and individual documentation must be extended to cover the use of recycled or resterilised disposable products only if the use of the latter may constitute a significant additional danger to the patient.

[Transparency as a prerequisite of innovation in health services research: deficits in the reporting of model projects concerning managed care].

PubMed

Wiethege, J; Ommen, O; Ernstmann, N; Pfaff, H

2010-10-01

Currently, elements of managed care are being implemented in the German health-care system. The legal basis for these innovations are § 140, § 73, § 137, and §§ 63 et seq. of the German Social Code - Part 5 (SGB V). For the model projects according to §§ 63 et seq. of the German Social Code a scientific evaluation and publication of the evaluation results is mandatory. The present study examines the status of evaluation of German model projects. The present study has a mixed method design: A mail and telephone survey with the German Federal Social Insurance Authority, the health insurance funds, and the regional Associations of Statutory Health Insurance Physicians has been conducted. Furthermore, an internet research on "Medpilot" and "Google" has been accomplished to search for model projects and their evaluation reports. 34 model projects met the inclusion criteria. 13 of these projects had been terminated up to 30/9/2008. 6 of them have published an evaluation report. 4 model projects have published substantial documents. One model project in progress has published a meaningful interim report. 12 model projects failed to give information concerning the evaluator or the duration of the model projects. The results show a significant deficit in the mandatory reporting of the evaluation of model projects in Germany. There is a need for action for the legislator and the health insurance funds in terms of promoting the evaluation and the publication of the results. The institutions evaluating the model projects should obligate themselves to publish the evaluation results. The publication is an essential precondition for the development of managed care structures in the health-care system and in the development of scientific evaluation methods. © Georg Thieme Verlag KG Stuttgart · New York.

Rights versus morality: online debate about decriminalization of gay sex in Singapore.

PubMed

Detenber, Benjamin H; Cenite, Mark; Zhou, Shuhua; Malik, Shelly; Neo, Rachel L

2014-01-01

This article presents a quantitative content analysis of 10,473 comments from two opposing online petitions related to the legal status of a section of the penal code in Singapore used to ban sex between men. Results indicate numerous significant differences in how the two sides discussed the law and its significance. In particular, they used different types of arguments to support their views and expressed different kinds of concerns over the potential impact of changing or maintaining the law. The patterns of language use seem to reflect distinctly different approaches to the debate and suggest the difficulty of finding common ground amid this contentious social issue, but they also reveal similarities to how Western cultures have framed the debate.

India's homosexual discrimination and health consequences.

PubMed

Agoramoorthy, Govindasamy; Minna, J Hsu

2007-08-01

A large number of countries worldwide have legalized homosexual rights. But for 147 years, since when India was a British colony, Section 377 of the Indian Penal Code defines homosexuality as a crime, punishable by imprisonment. This outdated law violates the fundamental rights of homosexuals in India. Despite the fact that literature drawn from Hindu, Buddhist, Muslim, and modern fiction testify to the presence of same-sex love in various forms, homosexuality is still considered a taboo subject in India, by both the society and the government. In the present article, the continuation of the outdated colonial-era homosexuality law and its impact on the underprivileged homosexual society in India is discussed, as well as consequences to this group's health in relation to HIV infection.

A Penalized Likelihood Framework For High-Dimensional Phylogenetic Comparative Methods And An Application To New-World Monkeys Brain Evolution.

PubMed

Julien, Clavel; Leandro, Aristide; Hélène, Morlon

2018-06-19

Working with high-dimensional phylogenetic comparative datasets is challenging because likelihood-based multivariate methods suffer from low statistical performances as the number of traits p approaches the number of species n and because some computational complications occur when p exceeds n. Alternative phylogenetic comparative methods have recently been proposed to deal with the large p small n scenario but their use and performances are limited. Here we develop a penalized likelihood framework to deal with high-dimensional comparative datasets. We propose various penalizations and methods for selecting the intensity of the penalties. We apply this general framework to the estimation of parameters (the evolutionary trait covariance matrix and parameters of the evolutionary model) and model comparison for the high-dimensional multivariate Brownian (BM), Early-burst (EB), Ornstein-Uhlenbeck (OU) and Pagel's lambda models. We show using simulations that our penalized likelihood approach dramatically improves the estimation of evolutionary trait covariance matrices and model parameters when p approaches n, and allows for their accurate estimation when p equals or exceeds n. In addition, we show that penalized likelihood models can be efficiently compared using Generalized Information Criterion (GIC). We implement these methods, as well as the related estimation of ancestral states and the computation of phylogenetic PCA in the R package RPANDA and mvMORPH. Finally, we illustrate the utility of the new proposed framework by evaluating evolutionary models fit, analyzing integration patterns, and reconstructing evolutionary trajectories for a high-dimensional 3-D dataset of brain shape in the New World monkeys. We find a clear support for an Early-burst model suggesting an early diversification of brain morphology during the ecological radiation of the clade. Penalized likelihood offers an efficient way to deal with high-dimensional multivariate comparative data.

Variable selection in semiparametric cure models based on penalized likelihood, with application to breast cancer clinical trials.

PubMed

Liu, Xiang; Peng, Yingwei; Tu, Dongsheng; Liang, Hua

2012-10-30

Survival data with a sizable cure fraction are commonly encountered in cancer research. The semiparametric proportional hazards cure model has been recently used to analyze such data. As seen in the analysis of data from a breast cancer study, a variable selection approach is needed to identify important factors in predicting the cure status and risk of breast cancer recurrence. However, no specific variable selection method for the cure model is available. In this paper, we present a variable selection approach with penalized likelihood for the cure model. The estimation can be implemented easily by combining the computational methods for penalized logistic regression and the penalized Cox proportional hazards models with the expectation-maximization algorithm. We illustrate the proposed approach on data from a breast cancer study. We conducted Monte Carlo simulations to evaluate the performance of the proposed method. We used and compared different penalty functions in the simulation studies. Copyright © 2012 John Wiley & Sons, Ltd.

A Solution to Separation and Multicollinearity in Multiple Logistic Regression

PubMed Central

Shen, Jianzhao; Gao, Sujuan

2010-01-01

In dementia screening tests, item selection for shortening an existing screening test can be achieved using multiple logistic regression. However, maximum likelihood estimates for such logistic regression models often experience serious bias or even non-existence because of separation and multicollinearity problems resulting from a large number of highly correlated items. Firth (1993, Biometrika, 80(1), 27–38) proposed a penalized likelihood estimator for generalized linear models and it was shown to reduce bias and the non-existence problems. The ridge regression has been used in logistic regression to stabilize the estimates in cases of multicollinearity. However, neither solves the problems for each other. In this paper, we propose a double penalized maximum likelihood estimator combining Firth’s penalized likelihood equation with a ridge parameter. We present a simulation study evaluating the empirical performance of the double penalized likelihood estimator in small to moderate sample sizes. We demonstrate the proposed approach using a current screening data from a community-based dementia study. PMID:20376286

A Solution to Separation and Multicollinearity in Multiple Logistic Regression.

PubMed

Shen, Jianzhao; Gao, Sujuan

2008-10-01

In dementia screening tests, item selection for shortening an existing screening test can be achieved using multiple logistic regression. However, maximum likelihood estimates for such logistic regression models often experience serious bias or even non-existence because of separation and multicollinearity problems resulting from a large number of highly correlated items. Firth (1993, Biometrika, 80(1), 27-38) proposed a penalized likelihood estimator for generalized linear models and it was shown to reduce bias and the non-existence problems. The ridge regression has been used in logistic regression to stabilize the estimates in cases of multicollinearity. However, neither solves the problems for each other. In this paper, we propose a double penalized maximum likelihood estimator combining Firth's penalized likelihood equation with a ridge parameter. We present a simulation study evaluating the empirical performance of the double penalized likelihood estimator in small to moderate sample sizes. We demonstrate the proposed approach using a current screening data from a community-based dementia study.

Evaluation of Penalized and Nonpenalized Methods for Disease Prediction with Large-Scale Genetic Data.

PubMed

Won, Sungho; Choi, Hosik; Park, Suyeon; Lee, Juyoung; Park, Changyi; Kwon, Sunghoon

2015-01-01

Owing to recent improvement of genotyping technology, large-scale genetic data can be utilized to identify disease susceptibility loci and this successful finding has substantially improved our understanding of complex diseases. However, in spite of these successes, most of the genetic effects for many complex diseases were found to be very small, which have been a big hurdle to build disease prediction model. Recently, many statistical methods based on penalized regressions have been proposed to tackle the so-called "large P and small N" problem. Penalized regressions including least absolute selection and shrinkage operator (LASSO) and ridge regression limit the space of parameters, and this constraint enables the estimation of effects for very large number of SNPs. Various extensions have been suggested, and, in this report, we compare their accuracy by applying them to several complex diseases. Our results show that penalized regressions are usually robust and provide better accuracy than the existing methods for at least diseases under consideration.

A penalized framework for distributed lag non-linear models.

PubMed

Gasparrini, Antonio; Scheipl, Fabian; Armstrong, Ben; Kenward, Michael G

2017-09-01

Distributed lag non-linear models (DLNMs) are a modelling tool for describing potentially non-linear and delayed dependencies. Here, we illustrate an extension of the DLNM framework through the use of penalized splines within generalized additive models (GAM). This extension offers built-in model selection procedures and the possibility of accommodating assumptions on the shape of the lag structure through specific penalties. In addition, this framework includes, as special cases, simpler models previously proposed for linear relationships (DLMs). Alternative versions of penalized DLNMs are compared with each other and with the standard unpenalized version in a simulation study. Results show that this penalized extension to the DLNM class provides greater flexibility and improved inferential properties. The framework exploits recent theoretical developments of GAMs and is implemented using efficient routines within freely available software. Real-data applications are illustrated through two reproducible examples in time series and survival analysis. © 2017 The Authors Biometrics published by Wiley Periodicals, Inc. on behalf of International Biometric Society.

Compound Identification Using Penalized Linear Regression on Metabolomics

PubMed Central

Liu, Ruiqi; Wu, Dongfeng; Zhang, Xiang; Kim, Seongho

2014-01-01

Compound identification is often achieved by matching the experimental mass spectra to the mass spectra stored in a reference library based on mass spectral similarity. Because the number of compounds in the reference library is much larger than the range of mass-to-charge ratio (m/z) values so that the data become high dimensional data suffering from singularity. For this reason, penalized linear regressions such as ridge regression and the lasso are used instead of the ordinary least squares regression. Furthermore, two-step approaches using the dot product and Pearson’s correlation along with the penalized linear regression are proposed in this study. PMID:27212894

[Development of the 2014 G-DRG system. Departure from coding of secondary diagnoses?].

PubMed

Volkmer, B G; Kahlmeyer, A; Petervari, M; Pechoel, M

2014-01-01

The objective of the German DRG (diagnosis-related groups) system is to adequately reimburse hospital costs using flat rate payments. The goal is to thereby achieve the most adequate representation of hospital costs in flat rate payments. The DRG for 2014 is based on the actual number of cases treated and the costs determined from 2012. For 2014, the current changes of the DRG system for the specialty urology concerning the coding and recording of secondary diagnoses are presented and discussed.

RNA meets disease in paradise.

PubMed

Winter, Julia; Roth, Anna; Diederichs, Sven

2011-01-01

Getting off the train in Jena-Paradies, 60 participants joined for the 12 (th) Young Scientist Meeting of the German Society for Cell Biology (DGZ) entitled "RNA & Disease". Excellent speakers from around the world, graduate students, postdocs and young group leaders enjoyed a meeting in a familiar atmosphere to exchange inspiring new data and vibrant scientific discussions about the fascinating history and exciting future of non-coding RNA research including microRNA, piRNA and long non-coding RNA as well as their function in cancer, diabetes and neurodegenerative diseases.

NCAA Penalizes Fewer Teams than Expected

ERIC Educational Resources Information Center

Sander, Libby

2008-01-01

This article reports that the National Collegiate Athletic Association (NCAA) has penalized fewer teams than it expected this year over athletes' poor academic performance. For years, officials with the NCAA have predicted that strikingly high numbers of college sports teams could be at risk of losing scholarships this year because of their…

The Role of the Environmental Health Specialist in the Penal and Correctional System

ERIC Educational Resources Information Center

Walker, Bailus, Jr.; Gordon, Theodore J.

1976-01-01

Implementing a health and hygiene program in penal systems necessitates coordinating the entire staff. Health specialists could participate in facility planning and management, policy formation, and evaluation of medical care, housekeeping, and food services. They could also serve as liaisons between correctional staff and governmental or…

The Change Grid and the Active Client: Challenging the Assumptions of Change Agentry in the Penal Process.

ERIC Educational Resources Information Center

Klofas, John; Duffee, David E.

1981-01-01

Reexamines the assumptions of the change grid regarding the channeling of masses of clients into change strategies programs. Penal organizations specifically select and place clients so that programs remain stable, rather than sequence programs to meet the needs of clients. (Author)

27 CFR 19.246 - Strengthening bonds.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Strengthening bonds. 19... Strengthening bonds. In all cases when the penal sum of any bond becomes insufficient, the principal shall either give a strengthening bond with the same surety to attain a sufficient penal sum, or give a new...

SkyFACT: high-dimensional modeling of gamma-ray emission with adaptive templates and penalized likelihoods

NASA Astrophysics Data System (ADS)

Storm, Emma; Weniger, Christoph; Calore, Francesca

2017-08-01

We present SkyFACT (Sky Factorization with Adaptive Constrained Templates), a new approach for studying, modeling and decomposing diffuse gamma-ray emission. Like most previous analyses, the approach relies on predictions from cosmic-ray propagation codes like GALPROP and DRAGON. However, in contrast to previous approaches, we account for the fact that models are not perfect and allow for a very large number (gtrsim 105) of nuisance parameters to parameterize these imperfections. We combine methods of image reconstruction and adaptive spatio-spectral template regression in one coherent hybrid approach. To this end, we use penalized Poisson likelihood regression, with regularization functions that are motivated by the maximum entropy method. We introduce methods to efficiently handle the high dimensionality of the convex optimization problem as well as the associated semi-sparse covariance matrix, using the L-BFGS-B algorithm and Cholesky factorization. We test the method both on synthetic data as well as on gamma-ray emission from the inner Galaxy, |l|<90o and |b|<20o, as observed by the Fermi Large Area Telescope. We finally define a simple reference model that removes most of the residual emission from the inner Galaxy, based on conventional diffuse emission components as well as components for the Fermi bubbles, the Fermi Galactic center excess, and extended sources along the Galactic disk. Variants of this reference model can serve as basis for future studies of diffuse emission in and outside the Galactic disk.

Elder abuse in Europe's "most elderly" city: an assessment of the phenomenon and an analysis of the data from the Penal Court of Genoa from 2010 to 2015.

PubMed

Molinelli, Andrea; Ventura, Francesco; Pinto, Sara Lo; Drommi, Martina; De Stefano, Francesco

2017-12-01

In Italy, 5% of the elderly are estimated to have suffered abuse. While the Penal Code refers to generic types of abuse, such as physical and psychological maltreatment, abandonment and financial fraud, it does not specifically protect the elderly as a category. To assess the frequency and modalities of elder abuse in Genoa and its Province, and to compare these data with those reported in the literature, in order to provide a picture of the current situation that can be used by the authorities to combat this phenomenon. We analysed the first-degree verdicts issued by the Court of Genoa regarding accusations of physical, psychological and moral abuse and maltreatment of elderly subjects (over 65 years) in the period 2010-2015. Only 85 of the 4028 court verdicts analysed involved elderly persons: 19 cases of domestic maltreatment, 3 of abuse of the means of correction or discipline, 18 of personal injury, 5 of abandonment and 40 of circumvention (deceiving someone, especially an elderly or mentally impaired person, to obtain a profit). A gap was observed between the number of crimes reported to the judicial authorities (tip of the iceberg) and the estimated prevalence of the phenomenon in the literature. There is a need both to create a network of protection for the elderly involving medical and judicial specialists and to train healthcare professionals to better recognise and report cases of maltreatment.

Methodology for the nuclear design validation of an Alternate Emergency Management Centre (CAGE)

NASA Astrophysics Data System (ADS)

Hueso, César; Fabbri, Marco; de la Fuente, Cristina; Janés, Albert; Massuet, Joan; Zamora, Imanol; Gasca, Cristina; Hernández, Héctor; Vega, J. Ángel

2017-09-01

The methodology is devised by coupling different codes. The study of weather conditions as part of the data of the site will determine the relative concentrations of radionuclides in the air using ARCON96. The activity in the air is characterized depending on the source and release sequence specified in NUREG-1465 by RADTRAD code, which provides results of the inner cloud source term contribution. Known activities, energy spectra are inferred using ORIGEN-S, which are used as input for the models of the outer cloud, filters and containment generated with MCNP5. The sum of the different contributions must meet the conditions of habitability specified by the CSN (Spanish Nuclear Regulatory Body) (TEDE <50 mSv and equivalent dose to the thyroid <500 mSv within 30 days following the accident doses) so that the dose is optimized by varying parameters such as CAGE location, flow filtering need for recirculation, thicknesses and compositions of the walls, etc. The results for the most penalizing area meet the established criteria, and therefore the CAGE building design based on the methodology presented is radiologically validated.

Historical HIV incidence modelling in regional subgroups: use of flexible discrete models with penalized splines based on prior curves.

PubMed

Greenland, S

1996-03-15

This paper presents an approach to back-projection (back-calculation) of human immunodeficiency virus (HIV) person-year infection rates in regional subgroups based on combining a log-linear model for subgroup differences with a penalized spline model for trends. The penalized spline approach allows flexible trend estimation but requires far fewer parameters than fully non-parametric smoothers, thus saving parameters that can be used in estimating subgroup effects. Use of reasonable prior curve to construct the penalty function minimizes the degree of smoothing needed beyond model specification. The approach is illustrated in application to acquired immunodeficiency syndrome (AIDS) surveillance data from Los Angeles County.

In comparative perspective: The effects of incarceration abroad on penal subjectivity among prisoners in Lithuania

PubMed Central

Slade, Gavin; Vaičiūnienė, Rūta

2017-01-01

This article looks at how global flows of people and policies affect penal subjectivity among prisoners in Lithuania. Those who had previously been incarcerated abroad perceive their punishment in Lithuania’s reforming penal system in comparative terms. We find that international prison experience may either diminish or increase the sense of the severity of the current punishment. Respondents often felt more comfortable in a familiar culture of punishment in Lithuania that emphasizes autonomy and communality. Moreover, internationalized prisoners perceive prison reform emulating West European models as a threat to this culture and are able to articulate comparative critiques of this reform and contest its effects. PMID:29568238

Setting the Standard. International Forum on Education in Penal Systems Conference Proceedings (Adelaide, Australia, April 5-7, 1998).

ERIC Educational Resources Information Center

Semmens, Bob, Ed.; Cook, Sandy, Ed.

This document contains 19 papers presented at an international forum on education in penal systems. The following papers are included: "Burning" (Craig W.J. Minogue); "The Acquisition of Cognitive Skills as a Means of Recidivism Reduction: A Former Prisoner's Perspective" (Trevor Darryl Doherty); "CEA (Correctional…

27 CFR 24.153 - Strengthening bonds.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Strengthening bonds. 24... Strengthening bonds. In any instance where the penal sum of the bond on file becomes insufficient, the principal shall either give a strengthening bond with the same surety to attain a sufficient penal sum or give a...

27 CFR 24.153 - Strengthening bonds.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Strengthening bonds. 24... Strengthening bonds. In any instance where the penal sum of the bond on file becomes insufficient, the principal shall either give a strengthening bond with the same surety to attain a sufficient penal sum or give a...

27 CFR 24.153 - Strengthening bonds.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Strengthening bonds. 24... Strengthening bonds. In any instance where the penal sum of the bond on file becomes insufficient, the principal shall either give a strengthening bond with the same surety to attain a sufficient penal sum or give a...

27 CFR 24.153 - Strengthening bonds.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Strengthening bonds. 24... Strengthening bonds. In any instance where the penal sum of the bond on file becomes insufficient, the principal shall either give a strengthening bond with the same surety to attain a sufficient penal sum or give a...

27 CFR 24.153 - Strengthening bonds.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Strengthening bonds. 24... Strengthening bonds. In any instance where the penal sum of the bond on file becomes insufficient, the principal shall either give a strengthening bond with the same surety to attain a sufficient penal sum or give a...

Crime and Punishment: Are Copyright Violators Ever Penalized?

ERIC Educational Resources Information Center

Russell, Carrie

2004-01-01

Is there a Web site that keeps track of copyright Infringers and fines? Some colleagues don't believe that copyright violators are ever penalized. This question was asked by a reader in a question and answer column of "School Library Journal". Carrie Russell is the American Library Association's copyright specialist, and she will answer selected…

Estimation and Selection via Absolute Penalized Convex Minimization And Its Multistage Adaptive Applications

PubMed Central

Huang, Jian; Zhang, Cun-Hui

2013-01-01

The ℓ1-penalized method, or the Lasso, has emerged as an important tool for the analysis of large data sets. Many important results have been obtained for the Lasso in linear regression which have led to a deeper understanding of high-dimensional statistical problems. In this article, we consider a class of weighted ℓ1-penalized estimators for convex loss functions of a general form, including the generalized linear models. We study the estimation, prediction, selection and sparsity properties of the weighted ℓ1-penalized estimator in sparse, high-dimensional settings where the number of predictors p can be much larger than the sample size n. Adaptive Lasso is considered as a special case. A multistage method is developed to approximate concave regularized estimation by applying an adaptive Lasso recursively. We provide prediction and estimation oracle inequalities for single- and multi-stage estimators, a general selection consistency theorem, and an upper bound for the dimension of the Lasso estimator. Important models including the linear regression, logistic regression and log-linear models are used throughout to illustrate the applications of the general results. PMID:24348100

STRONG ORACLE OPTIMALITY OF FOLDED CONCAVE PENALIZED ESTIMATION.

PubMed

Fan, Jianqing; Xue, Lingzhou; Zou, Hui

2014-06-01

Folded concave penalization methods have been shown to enjoy the strong oracle property for high-dimensional sparse estimation. However, a folded concave penalization problem usually has multiple local solutions and the oracle property is established only for one of the unknown local solutions. A challenging fundamental issue still remains that it is not clear whether the local optimum computed by a given optimization algorithm possesses those nice theoretical properties. To close this important theoretical gap in over a decade, we provide a unified theory to show explicitly how to obtain the oracle solution via the local linear approximation algorithm. For a folded concave penalized estimation problem, we show that as long as the problem is localizable and the oracle estimator is well behaved, we can obtain the oracle estimator by using the one-step local linear approximation. In addition, once the oracle estimator is obtained, the local linear approximation algorithm converges, namely it produces the same estimator in the next iteration. The general theory is demonstrated by using four classical sparse estimation problems, i.e., sparse linear regression, sparse logistic regression, sparse precision matrix estimation and sparse quantile regression.

STRONG ORACLE OPTIMALITY OF FOLDED CONCAVE PENALIZED ESTIMATION

PubMed Central

Fan, Jianqing; Xue, Lingzhou; Zou, Hui

2014-01-01

Folded concave penalization methods have been shown to enjoy the strong oracle property for high-dimensional sparse estimation. However, a folded concave penalization problem usually has multiple local solutions and the oracle property is established only for one of the unknown local solutions. A challenging fundamental issue still remains that it is not clear whether the local optimum computed by a given optimization algorithm possesses those nice theoretical properties. To close this important theoretical gap in over a decade, we provide a unified theory to show explicitly how to obtain the oracle solution via the local linear approximation algorithm. For a folded concave penalized estimation problem, we show that as long as the problem is localizable and the oracle estimator is well behaved, we can obtain the oracle estimator by using the one-step local linear approximation. In addition, once the oracle estimator is obtained, the local linear approximation algorithm converges, namely it produces the same estimator in the next iteration. The general theory is demonstrated by using four classical sparse estimation problems, i.e., sparse linear regression, sparse logistic regression, sparse precision matrix estimation and sparse quantile regression. PMID:25598560

Unmet care needs of the oldest old with late-life depression: A comparison of patient, caring relative and general practitioner perceptions - Results of the AgeMooDe study.

PubMed

Stein, Janine; Pabst, Alexander; Weyerer, Siegfried; Werle, Jochen; Maier, Wolfgang; Miebach, Lisa; Scherer, Martin; Stark, Anne; Kaduszkiewicz, Hanna; Wiese, Birgitt; Moor, Lilia; Bock, Jens-Oliver; König, Hans-Helmut; Riedel-Heller, Steffi G

2016-11-15

Research showed that the perception of unmet needs may differ between patients, caregivers and professionals. Lacking agreement with regard to unmet needs between raters involved may have a negative impact on treatment of late-life depression. As part of the multicenter German study "Late-life depression in primary care: needs, health care utilization and costs" (AgeMooDe), n=1188 primary care patients aged 75-98 with and without depression, relatives (n=366) and general practitioners (GPs, n=1152) were assessed using the German version of the Camberwell Assessment of Need for the Elderly (CANE) in order to identify patients' unmet needs from different perspectives. Kappa coefficients were computed to determine level of agreement between perspectives. Penalized likelihood logistic regression models were run in order to assess the association between depression severity and disagreement between perspectives with regard to unmet needs. The prevalence of unmet needs was higher in depressive patients. Kappa coefficients were on average higher for depressive patients ranging from poor to substantial. Severity of depression was significantly associated with disagreement regarding unmet needs between perspectives. The cross-sectional design of the study limits the results. Only a part of caring relatives was able to participate. Perceptions of unmet needs in the oldest old primary care patients suffering from depression strongly differ between raters. Severity of depression seems to exacerbate the discrepancy between involved perspectives. The negative impact that depression severity may have on the perception and assessment of unmet needs requires greater attention by GPs. Copyright © 2016 Elsevier B.V. All rights reserved.

[Demands for death (suicide assistance and euthanasia) in palliative medicine].

PubMed

Moynier-Vantieghem, Karine; Weber, Catherine; Espolio, Desbaillet Yolanda; Pautex, Sophie; Zulian, Gilbert

2010-02-03

During a prospective open survey over 12 months of hospitalized patients, 44 death demands were registered for 39 patients (25 cancer, 6 cardiovascular disorder, 2 Parkinson's disease, 3 arthritis, 1 COPD, 1 dementia and 1 severe depression). 14 patients were also depressed. 28 requested euthanasia, 16 suicide assistance. At 1 month, 3 persisted, 16 had abandoned, 16 had died and 4 were not questioned. At 6 months, 7 were alive but had abandoned and 2 had committed suicide at their home. The majority of death demands correspond to euthanasia which is a murder according to the penal code. In front of such demand, realistic short-term objectives must be established. Many patients give up their project. This indicates great uncertainty in front of care and greatest ambivalence in front of life.

Experiencing abortion rights in India through issues of autonomy and legality: A few controversies.

PubMed

Patel, Tulsi

2018-06-01

Abortion laws in India, like other laws, are premised on the 1861 British Penal Code. The Medical Termination of Pregnancy Act was passed in 1971 to circumvent the criminality clause around abortion. Yet the law continues to render invisible women's right to choose. Legal procedures have often hindered in permitting abortion, resulting in the death of a mother or the foetus. Despite the latest techno-medical advances, the laws have remained stagnant or rather restrictive, complicated further by selective female foetus abortions. Legal resistance to abortion-seeking after 20 weeks gestation adversely affects women, depriving them of autonomy of choice. In this paper, raising important gender, health and ethical issues are illustrated through a recent legal case in India. Feminist campaigns against the legal mindset in India are emerging.

Investigating L2 Performance in Text Chat

ERIC Educational Resources Information Center

Sauro, Shannon; Smith, Bryan

2010-01-01

This study examines the linguistic complexity and lexical diversity of both overt and covert L2 output produced during synchronous written computer-mediated communication, also referred to as chat. Video enhanced chatscripts produced by university learners of German (N = 23) engaged in dyadic task-based chat interaction were coded and analyzed for…

36 CFR 1200.16 - Will I be penalized for misusing the official seals and logos?

Code of Federal Regulations, 2010 CFR

2010-07-01

... misusing the official seals and logos? 1200.16 Section 1200.16 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION GENERAL RULES OFFICIAL SEALS Penalties for Misuse of NARA Seals and Logos § 1200.16 Will I be penalized for misusing the official seals and logos? (a) Seals. (1) If you...

36 CFR 1200.16 - Will I be penalized for misusing the official seals and logos?

Code of Federal Regulations, 2011 CFR

2011-07-01

... misusing the official seals and logos? 1200.16 Section 1200.16 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION GENERAL RULES OFFICIAL SEALS Penalties for Misuse of NARA Seals and Logos § 1200.16 Will I be penalized for misusing the official seals and logos? (a) Seals. (1) If you...

27 CFR 24.148 - Penal sums of bonds.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Penal sums of bonds. 24.148 Section 24.148 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU... Vinegar Plant Bond, TTB F 5510.2 Not less than the tax on all wine on hand, in transit, or unaccounted for...

Madness and crime: Zefinha, the longest confined woman in Brazil.

PubMed

Diniz, Debora; Brito, Luciana

2016-01-01

Living in a forensic hospital for the last 38 years, Josefa da Silva is the longest female inhabitant surviving the penal and psychiatric regime in Brazil. This paper analyses dossier, judicial proceedings, interviews and photographs about her. The psychiatric report is the key component of the medical and penal doubling of criminal insanity. Twelve psychiatric reports illustrate three time frames of the court files: abnormality, danger, and abandonment. The psychiatric authority over confinement has moved from discipline to security, and from disciplinary security to social assistance. In the arrangement between the penal and psychiatric powers, the judge recognizes the medical authority over the truth of insanity. It is the medicine of the reasons for Zefinha's internment that altered over the decades.

[Mental Health Stigma: An Influencing Factor in Healthcare Utilization by Veterans of the German Armed Forces].

PubMed

Schuy, Katrin; Brants, Loni M; Dors, Simone; Ströhle, Andreas; Zimmermann, Peter Lutz; Willmund, Gerd Dieter; Rau, Heinrich; Siegel, Stefan

2018-05-14

 Mental illness stigma is a barrier to healthcare utilization. This study is the first to research the connection between mental illness stigma and the use of healthcare by veterans of the German Armed Forces. An overview of perceived stigma components in this sample is provided that should help understand how these factors influence healthcare utilization.  43 interviews with veterans of the German Armed Forces were conducted. The resulting data were analyzed in several coding steps. It was investigated whether the stigma experience of veterans of the German Armed Forces could be well illustrated by the theory-based stigmatization model of Link and Phelan. A set of hypotheses on stigma and healthcare utilization based on the data were developed.  All stigma components according to the model of Link and Phelan were found in the sample. Internalized stigma, perceived public stigmatization, vocational disadvantage and social exclusion as well as feared misunderstanding of the military past in the civilian sector were reported as main stigma-relevant barriers to the use of healthcare.  Recommendations for interventions are given to decrease mental illness stigma in this specific group of former soldiers. © Georg Thieme Verlag KG Stuttgart · New York.

Coping with the DVD Dilemma: Region Codes and Copy Protection

ERIC Educational Resources Information Center

Ecke, Peter

2005-01-01

German teachers' use of DVDs, purchased abroad, has become increasingly difficult through restrictions imposed by the motion pictures industry on DVDs, DVD-playing equipment and software. In addition, the law, in particular through the Digital Millennium Copyright Act (DMCA), has imposed restrictions that negatively affect the fair use of digital…

Negotiation of Meaning and Codeswitching in Online Tandems.

ERIC Educational Resources Information Center

Kotter, Markus

2003-01-01

Analyzes negotiation of meaning and code switching in discourse between 29 language students from classes at a German and a North American university, who teamed up with their peers to collaborate on projects whose results hey had to present to the other groups in the MOO during the final weeks of the project. (VWL)

[Changes for rheumatology in the G-DRG system 2005].

PubMed

Fiori, W; Roeder, N; Lakomek, H-J; Liman, W; Köneke, N; Hülsemann, J L; Lehmann, H; Wenke, A

2005-02-01

The German prospective payment system G-DRG has been recently adapted and recalculated. Apart from the adjustments of the G-DRG classification system itself changes in the legal framework like the extension of the "convergence period" or the limitation of budget loss due to DRG introduction have to be considered. Especially the introduction of new procedure codes (OPS) describing the specialized and complex rheumatologic treatment of inpatients might be of significant importance. Even though these procedures will not yet develop influence on the grouping process in 2005, it will enable a more accurate description of the efforts of acute-rheumatologic treatment which can be used for further adaptations of the DRG algorithm. Numerous newly introduced additive payment components (ZE) result in a more adequate description of the "DRG-products". Although not increasing the individual hospital budget, these additive payments contribute to more transparency of high cost services and can be addressed separately from the DRG-budget. Furthermore a lot of other relevant changes to the G-DRG catalogue, the classification systems ICD-10-GM and OPS-301 and the German Coding Standards (DKR) are presented.

[The right to medical rehabilitation according to the 2007 act to strengthen health insurance competition, GKV-WSG].

PubMed

Liebold, D

2008-02-01

Since April 1, 2007 medical rehabilitation is a standard insurance benefit of the statutory health insurance scheme (covered by the SGB V, book 5 of the German social code), with the right of the beneficiary to comply especially with the intentions, the principles and the preconditions of the benefits as stipulated in the SGB IX (book 9 of the German social code covering rehabilitation and participation of persons with disabilities). In claiming benefits the applicable rules primarily are those of the SGB IX, as long as the SGB V does not contain different rules. In light of the demands of the SGB IX, the prevailing case law of the Federal Social Court concerning technical aids and assistive devices cannot persist any longer. The so-called "basic-compensation" is contradictory to the specifications of the SGB IX. Medical rehabilitation does not only consist of complex benefits, but every single benefit pursuant to section sign 26 Abs. 2, Abs. 3 SGB IX is a medical rehabilitation benefit if its priority intention is to achieve the beneficiary's participation in society.

[Projection of prisoner numbers].

PubMed

Metz, Rainer; Sohn, Werner

2015-01-01

The past and future development of occupancy rates in prisons is of crucial importance for the judicial administration of every country. Basic factors for planning the required penal facilities are seasonal fluctuations, minimum, maximum and average occupancy as well as the present situation and potential development of certain imprisonment categories. As the prisoner number of a country is determined by a complex set of interdependent conditions, it has turned out to be difficult to provide any theoretical explanations. The idea accepted in criminology for a long time that prisoner numbers are interdependent with criminal policy must be regarded as having failed. Statistical and time series analyses may help, however, to identify the factors having influenced the development of prisoner numbers in the past. The analyses presented here, first describe such influencing factors from a criminological perspective and then deal with their statistical identification and modelling. Using the development of prisoner numbers in Hesse as an example, it has been found that modelling methods in which the independent variables predict the dependent variable with a time lag are particularly helpful. A potential complication is, however, that for predicting the number of prisoners the different dynamics in German and foreign prisoners require the development of further models.

“Patient trade” in Germany: an ethical issue at the practitioner-clinician interface in 1909 and 2009

PubMed Central

Maehle, Andreas-Holger

2013-01-01

In 2009 the German media featured the so-called “patient trade” scandal. Offending against the rules of the professional code for German doctors, some medical practitioners had accepted bonus payments from specific hospitals for referring patients to them. This article discusses a historical precedent for this scandal, the patient trade affair of 1909, in which several medical professors of the Berlin university clinics were accused of having paid agents for bringing them lucrative private patients. Although the historical contexts were different, then, as in 2009, a commercial attitude towards medical practice clashed with the ethical ideal of the economically disinterested doctor. PMID:21393288

SkyFACT: high-dimensional modeling of gamma-ray emission with adaptive templates and penalized likelihoods

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

Storm, Emma; Weniger, Christoph; Calore, Francesca, E-mail: e.m.storm@uva.nl, E-mail: c.weniger@uva.nl, E-mail: francesca.calore@lapth.cnrs.fr

We present SkyFACT (Sky Factorization with Adaptive Constrained Templates), a new approach for studying, modeling and decomposing diffuse gamma-ray emission. Like most previous analyses, the approach relies on predictions from cosmic-ray propagation codes like GALPROP and DRAGON. However, in contrast to previous approaches, we account for the fact that models are not perfect and allow for a very large number (∼> 10{sup 5}) of nuisance parameters to parameterize these imperfections. We combine methods of image reconstruction and adaptive spatio-spectral template regression in one coherent hybrid approach. To this end, we use penalized Poisson likelihood regression, with regularization functions that aremore » motivated by the maximum entropy method. We introduce methods to efficiently handle the high dimensionality of the convex optimization problem as well as the associated semi-sparse covariance matrix, using the L-BFGS-B algorithm and Cholesky factorization. We test the method both on synthetic data as well as on gamma-ray emission from the inner Galaxy, |ℓ|<90{sup o} and | b |<20{sup o}, as observed by the Fermi Large Area Telescope. We finally define a simple reference model that removes most of the residual emission from the inner Galaxy, based on conventional diffuse emission components as well as components for the Fermi bubbles, the Fermi Galactic center excess, and extended sources along the Galactic disk. Variants of this reference model can serve as basis for future studies of diffuse emission in and outside the Galactic disk.« less

Reduced rank regression via adaptive nuclear norm penalization

PubMed Central

Chen, Kun; Dong, Hongbo; Chan, Kung-Sik

2014-01-01

Summary We propose an adaptive nuclear norm penalization approach for low-rank matrix approximation, and use it to develop a new reduced rank estimation method for high-dimensional multivariate regression. The adaptive nuclear norm is defined as the weighted sum of the singular values of the matrix, and it is generally non-convex under the natural restriction that the weight decreases with the singular value. However, we show that the proposed non-convex penalized regression method has a global optimal solution obtained from an adaptively soft-thresholded singular value decomposition. The method is computationally efficient, and the resulting solution path is continuous. The rank consistency of and prediction/estimation performance bounds for the estimator are established for a high-dimensional asymptotic regime. Simulation studies and an application in genetics demonstrate its efficacy. PMID:25045172

[Consistency and Reliability of MDK Expertise Examining the Encoding in the German DRG System].

PubMed

Gaertner, T; Lehr, F; Blum, B; van Essen, J

2015-09-01

Hospital inpatient stays are reimbursed on the basis of German diagnosis-related groups (G-DRG). The G-DRG classification system is based on complex coding guidelines. The Medical Review Board of the Statutory Health Insurance Funds (MDK) examines the encoding by hospitals and delivers individual expertises on behalf of the German statutory health insurance companies in cases in which irregularities are suspected. A study was conducted on the inter-rater reliability of the MDK expertises regarding the scope of the assessment. A representative sample of 212 MDK expertises was taken from a selected pool of 1 392 MDK expertises in May 2013. This representative sample underwent a double-examination by 2 independent MDK experts using a special software based on the 3MTM G-DRG Grouper 2013 of 3M Medica, Germany. The following items encoded by the hospitals were examined: DRG, principal diagnosis, secondary diagnoses, procedures and additional payments. It was analysed whether the results of MDK expertises were consistent, reliable and correct. 202 expertises were eligible for evaluation, containing a total of 254 questions regarding one or more of the 5 items encoded by hospitals. The double-examination by 2 independent MDK experts showed matching results in 187 questions (73.6%) meaning they had been examined consistently and correctly. 59 questions (23.2%) did not show matching results, nevertheless they had been examined correctly regarding the scope of the assessment. None of the principal diagnoses was significantly affected by inconsistent or wrong judgment. A representative sample of MDK expertises examining the DRG encoding by hospitals showed a very high percentage of correct examination by the MDK experts. Identical MDK expertises cannot be achieved in all cases due to the scope of the assessment. Further improvement and simplification of codes and coding guidelines are required to reduce the scope of assessment with regard to correct DRG encoding and its examination. © Georg Thieme Verlag KG Stuttgart · New York.

[Geriatric rehabilitation from the perspective of Book 9 of the German social code, SGB IX].

PubMed

Fuchs, H

2007-10-01

The legal foundations for provision and realization of geriatric rehabilitation benefits are contained in particular in Book 9 of the German social code, SGB IX (covering rehabilitation and participation of people with disabilities). This paper discusses claims foundations and benefit prerequisites of geriatric rehabilitation taking into consideration the relations between Book 5 (on health insurance) and Book 9 of the social code. The article includes a definition of "geriatric rehabilitation" in light of the SGB IX, describes the benefit carriers' obligations as well as the procedure in place for determining geriatric rehab need, in this context appraising the designation as "geriatric patient" in terms of its appropriateness as an identifying criterion in determining need. Provision of geriatric rehab benefits is contingent on a potential for attaining rehab goals as specified by SGB IX as well as on fulfillment of the benefit prerequisites. Responsibility for the content, extent and quality of geriatric rehabilitation lies with the benefit carriers, as is the case for the obligation to secure availability of the required numbers and quality of rehabilitation facilities and services. The article specifies the legal foundations of the various benefit types (ambulatory, mobile rehab, under a Personal Budget, integrated benefit provision, or early rehab), and discusses geriatric rehabilitation in the framework of an insurance-based medical care system as well as of activating care.

The costs of hazardous alcohol consumption in Germany.

PubMed

Effertz, Tobias; Verheyen, Frank; Linder, Roland

2017-07-01

Hazardous alcohol consumption in Germany is a main threat to health. By using insurance claim data from the German Statutory Health Insurance and a classification strategy based on ICD10 diagnoses-codes we analyzed a sample of 146,000 subjects with more than 19,000 hazardous alcohol consumers. Employing different regression models with a control function approach, we calculate life years lost due to alcohol consumption, annual direct and indirect health costs, and the burden of pain and suffering measured by the Charlson-Index and assessed pain diagnoses. Additionally, we simulate the net accumulated premium payments over expenses in the German Statutory Health Insurance and the Statutory Pension Fund for hazardous alcohol consumers from a lifecycle perspective. In total, €39.3 billion each year result from hazardous alcohol consumption with an average loss of 7 years in life expectancy. Hazardous alcohol consumers clearly do not "pay their way" in the two main German social security systems and also display a higher intangible burden according to our definitions of pain and suffering.

A psychiatrist's role in “coming out” process: Context and controversies post-377

PubMed Central

Kalra, Gurvinder

2012-01-01

After the Delhi High Court judgment on reading down Section 377 Indian penal code, many individuals of alternate sexuality are wanting to come out to themselves and significant others in their lives. In this process, they often turn to psychiatrists seeking help. However the past of this specialty wherein homosexuality and other sexualities were considered a disease still haunts it with anecdotal reports of reorienting treatments continuing in certain parts of the country. While it is important to not continue with this unethical practice, at the same time, it is also important to be supportive to the issues that this and various other marginalized sexualities in our country face. This viewpoint is an attempt to reiterate certain steps that are to be followed by psychiatrists who find themselves in such clinical consultations. PMID:22556443

Advocacy for legal reform for safe abortion.

PubMed

Ashenafi, Meaza

2004-04-01

In Ethiopia, violation of women's reproductive rights is both a cause and a manifestation of women's disempowerment. Obstacles to full realisation of Ethiopian women's reproductive health and rights include the persistence of harmful traditional practices such as female genital mutilation, early marriage and abduction, as well as the disturbing prevalence of rape and HIV/AIDS. Unsafe abortion represents a particularly serious threat to women's health and lives. Ethiopia's status as a signatory to the Convention to Eliminate all Forms of Discrimination Against Women (CEDAW) and its constitutional guarantee of women's equality demand more aggressive action to eradicate such practices and inequities. After years of lobbying by women's organisations, parliamentarians are now reviewing a draft of the 1957 penal code, which includes numerous provisions addressing some of these practices and other conditions that underlie women's poor social and health status.

Abortion and politics in Mexico: 'context is all'.

PubMed

Lamas, M; Bissell, S

2000-11-01

A strong collective pro-choice mentality was recently manifested in Mexico when a legislative initiative to revoke the legal right of rape survivor to abortion in the state of Guanajuato awakened national indignation. Pro-choice values were expressed in public opinion with such force that it sparked off the passage of liberalising law reforms in Mexico City and the state of Morelos. In this paper we trace the development of these manifestations of pro-choice views, beginning with the Democratic Revolution Party's (PRD) refusal in 1999 to modify abortion legislation within the context of penal code reform, and moving through the events surrounding the Guanajuato reform, and the pro-choice response of Mexico City and Morelos legislators. This analysis allows us to recognise the emergence of a pro-choice consciousness and to understand that, when it comes to abortion, 'context is all'.

Fungible Correlation Matrices: A Method for Generating Nonsingular, Singular, and Improper Correlation Matrices for Monte Carlo Research.

PubMed

Waller, Niels G

2016-01-01

For a fixed set of standardized regression coefficients and a fixed coefficient of determination (R-squared), an infinite number of predictor correlation matrices will satisfy the implied quadratic form. I call such matrices fungible correlation matrices. In this article, I describe an algorithm for generating positive definite (PD), positive semidefinite (PSD), or indefinite (ID) fungible correlation matrices that have a random or fixed smallest eigenvalue. The underlying equations of this algorithm are reviewed from both algebraic and geometric perspectives. Two simulation studies illustrate that fungible correlation matrices can be profitably used in Monte Carlo research. The first study uses PD fungible correlation matrices to compare penalized regression algorithms. The second study uses ID fungible correlation matrices to compare matrix-smoothing algorithms. R code for generating fungible correlation matrices is presented in the supplemental materials.

["Is there a doctor on board?" - legal aspects of medical care in emergency situations during spare time].

PubMed

Lindner, Christina; Lindner, Gregor; Exadaktylos, Aristomenis K

2013-12-11

Medical emergencies on international flights are not uncommon. In these situations the question often arises whether physicians are obliged to render first aid and whether omission leads to legal consequences. The general obligation to aid those in need applies to everyone, not only to physicians. Evading this duty makes liable to prosecution for omittance of defence of a third person in line with Art. 128 of the Swiss Penal Code, punishable by custodial sentence up to three years or an equivalent punitive fine. Vocational and professional law extend the duty to aid for physicians to urgent cases. Although resulting from the performance of a legal obligation, malpractice occurred in the course of first aid can lead to claims for compensation - even from foreign patients, and that according to their own domestic law.

Robust Variable Selection with Exponential Squared Loss.

PubMed

Wang, Xueqin; Jiang, Yunlu; Huang, Mian; Zhang, Heping

2013-04-01

Robust variable selection procedures through penalized regression have been gaining increased attention in the literature. They can be used to perform variable selection and are expected to yield robust estimates. However, to the best of our knowledge, the robustness of those penalized regression procedures has not been well characterized. In this paper, we propose a class of penalized robust regression estimators based on exponential squared loss. The motivation for this new procedure is that it enables us to characterize its robustness that has not been done for the existing procedures, while its performance is near optimal and superior to some recently developed methods. Specifically, under defined regularity conditions, our estimators are [Formula: see text] and possess the oracle property. Importantly, we show that our estimators can achieve the highest asymptotic breakdown point of 1/2 and that their influence functions are bounded with respect to the outliers in either the response or the covariate domain. We performed simulation studies to compare our proposed method with some recent methods, using the oracle method as the benchmark. We consider common sources of influential points. Our simulation studies reveal that our proposed method performs similarly to the oracle method in terms of the model error and the positive selection rate even in the presence of influential points. In contrast, other existing procedures have a much lower non-causal selection rate. Furthermore, we re-analyze the Boston Housing Price Dataset and the Plasma Beta-Carotene Level Dataset that are commonly used examples for regression diagnostics of influential points. Our analysis unravels the discrepancies of using our robust method versus the other penalized regression method, underscoring the importance of developing and applying robust penalized regression methods.

Robust Variable Selection with Exponential Squared Loss

PubMed Central

Wang, Xueqin; Jiang, Yunlu; Huang, Mian; Zhang, Heping

2013-01-01

Robust variable selection procedures through penalized regression have been gaining increased attention in the literature. They can be used to perform variable selection and are expected to yield robust estimates. However, to the best of our knowledge, the robustness of those penalized regression procedures has not been well characterized. In this paper, we propose a class of penalized robust regression estimators based on exponential squared loss. The motivation for this new procedure is that it enables us to characterize its robustness that has not been done for the existing procedures, while its performance is near optimal and superior to some recently developed methods. Specifically, under defined regularity conditions, our estimators are n-consistent and possess the oracle property. Importantly, we show that our estimators can achieve the highest asymptotic breakdown point of 1/2 and that their influence functions are bounded with respect to the outliers in either the response or the covariate domain. We performed simulation studies to compare our proposed method with some recent methods, using the oracle method as the benchmark. We consider common sources of influential points. Our simulation studies reveal that our proposed method performs similarly to the oracle method in terms of the model error and the positive selection rate even in the presence of influential points. In contrast, other existing procedures have a much lower non-causal selection rate. Furthermore, we re-analyze the Boston Housing Price Dataset and the Plasma Beta-Carotene Level Dataset that are commonly used examples for regression diagnostics of influential points. Our analysis unravels the discrepancies of using our robust method versus the other penalized regression method, underscoring the importance of developing and applying robust penalized regression methods. PMID:23913996

AucPR: an AUC-based approach using penalized regression for disease prediction with high-dimensional omics data.

PubMed

Yu, Wenbao; Park, Taesung

2014-01-01

It is common to get an optimal combination of markers for disease classification and prediction when multiple markers are available. Many approaches based on the area under the receiver operating characteristic curve (AUC) have been proposed. Existing works based on AUC in a high-dimensional context depend mainly on a non-parametric, smooth approximation of AUC, with no work using a parametric AUC-based approach, for high-dimensional data. We propose an AUC-based approach using penalized regression (AucPR), which is a parametric method used for obtaining a linear combination for maximizing the AUC. To obtain the AUC maximizer in a high-dimensional context, we transform a classical parametric AUC maximizer, which is used in a low-dimensional context, into a regression framework and thus, apply the penalization regression approach directly. Two kinds of penalization, lasso and elastic net, are considered. The parametric approach can avoid some of the difficulties of a conventional non-parametric AUC-based approach, such as the lack of an appropriate concave objective function and a prudent choice of the smoothing parameter. We apply the proposed AucPR for gene selection and classification using four real microarray and synthetic data. Through numerical studies, AucPR is shown to perform better than the penalized logistic regression and the nonparametric AUC-based method, in the sense of AUC and sensitivity for a given specificity, particularly when there are many correlated genes. We propose a powerful parametric and easily-implementable linear classifier AucPR, for gene selection and disease prediction for high-dimensional data. AucPR is recommended for its good prediction performance. Beside gene expression microarray data, AucPR can be applied to other types of high-dimensional omics data, such as miRNA and protein data.

Analytical determination of propeller performance degradation due to ice accretion

NASA Technical Reports Server (NTRS)

Miller, T. L.

1986-01-01

A computer code has been developed which is capable of computing propeller performance for clean, glaze, or rime iced propeller configurations, thereby providing a mechanism for determining the degree of performance degradation which results from a given icing encounter. The inviscid, incompressible flow field at each specified propeller radial location is first computed using the Theodorsen transformation method of conformal mapping. A droplet trajectory computation then calculates droplet impingement points and airfoil collection efficiency for each radial location, at which point several user-selectable empirical correlations are available for determining the aerodynamic penalities which arise due to the ice accretion. Propeller performance is finally computed using strip analysis for either the clean or iced propeller. In the iced mode, the differential thrust and torque coefficient equations are modified by the drag and lift coefficient increments due to ice to obtain the appropriate iced values. Comparison with available experimental propeller icing data shows good agreement in several cases. The code's capability to properly predict iced thrust coefficient, power coefficient, and propeller efficiency is shown to be dependent on the choice of empirical correlation employed as well as proper specification of radial icing extent.

Does Distance Determine Who Attends a University in Germany?

ERIC Educational Resources Information Center

Spiess, C. Katharina; Wrohlich, Katharina

2010-01-01

We analyze the role of distance to the nearest university in the demand for higher education in Germany. Distance could matter due to transaction costs or due to neighborhood effects. We use data from the German Socio-Economic Panel (SOEP) combined with a database on university postal codes to estimate a discrete choice model of the demand for…

Phonological Working Memory in German Children with Poor Reading and Spelling Abilities

ERIC Educational Resources Information Center

Steinbrink, Claudia; Klatte, Maria

2008-01-01

Deficits in verbal short-term memory have been identified as one factor underlying reading and spelling disorders. However, the nature of this deficit is still unclear. It has been proposed that poor readers make less use of phonological coding, especially if the task can be solved through visual strategies. In the framework of Baddeley's…

The Intercultural and Non-Formal Learning Processes of Children in Primary School Exchange Programmes in France and Germany

ERIC Educational Resources Information Center

Melin, Valérie; Wagner, Bernd

2015-01-01

This paper is based on educational anthropology, and presents the initial findings of a three-year international comparative study of primary school children's learning-processes during travel and cross-cultural encounters. A French-German research team investigated and here reports on primary school exchange programmes. Open coding of the…

Penalized regression procedures for variable selection in the potential outcomes framework

PubMed Central

Ghosh, Debashis; Zhu, Yeying; Coffman, Donna L.

2015-01-01

A recent topic of much interest in causal inference is model selection. In this article, we describe a framework in which to consider penalized regression approaches to variable selection for causal effects. The framework leads to a simple ‘impute, then select’ class of procedures that is agnostic to the type of imputation algorithm as well as penalized regression used. It also clarifies how model selection involves a multivariate regression model for causal inference problems, and that these methods can be applied for identifying subgroups in which treatment effects are homogeneous. Analogies and links with the literature on machine learning methods, missing data and imputation are drawn. A difference LASSO algorithm is defined, along with its multiple imputation analogues. The procedures are illustrated using a well-known right heart catheterization dataset. PMID:25628185

A displacement-based finite element formulation for incompressible and nearly-incompressible cardiac mechanics

PubMed Central

Hadjicharalambous, Myrianthi; Lee, Jack; Smith, Nicolas P.; Nordsletten, David A.

2014-01-01

The Lagrange Multiplier (LM) and penalty methods are commonly used to enforce incompressibility and compressibility in models of cardiac mechanics. In this paper we show how both formulations may be equivalently thought of as a weakly penalized system derived from the statically condensed Perturbed Lagrangian formulation, which may be directly discretized maintaining the simplicity of penalty formulations with the convergence characteristics of LM techniques. A modified Shamanskii–Newton–Raphson scheme is introduced to enhance the nonlinear convergence of the weakly penalized system and, exploiting its equivalence, modifications are developed for the penalty form. Focusing on accuracy, we proceed to study the convergence behavior of these approaches using different interpolation schemes for both a simple test problem and more complex models of cardiac mechanics. Our results illustrate the well-known influence of locking phenomena on the penalty approach (particularly for lower order schemes) and its effect on accuracy for whole-cycle mechanics. Additionally, we verify that direct discretization of the weakly penalized form produces similar convergence behavior to mixed formulations while avoiding the use of an additional variable. Combining a simple structure which allows the solution of computationally challenging problems with good convergence characteristics, the weakly penalized form provides an accurate and efficient alternative to incompressibility and compressibility in cardiac mechanics. PMID:25187672

A displacement-based finite element formulation for incompressible and nearly-incompressible cardiac mechanics.

PubMed

Hadjicharalambous, Myrianthi; Lee, Jack; Smith, Nicolas P; Nordsletten, David A

2014-06-01

The Lagrange Multiplier (LM) and penalty methods are commonly used to enforce incompressibility and compressibility in models of cardiac mechanics. In this paper we show how both formulations may be equivalently thought of as a weakly penalized system derived from the statically condensed Perturbed Lagrangian formulation, which may be directly discretized maintaining the simplicity of penalty formulations with the convergence characteristics of LM techniques. A modified Shamanskii-Newton-Raphson scheme is introduced to enhance the nonlinear convergence of the weakly penalized system and, exploiting its equivalence, modifications are developed for the penalty form. Focusing on accuracy, we proceed to study the convergence behavior of these approaches using different interpolation schemes for both a simple test problem and more complex models of cardiac mechanics. Our results illustrate the well-known influence of locking phenomena on the penalty approach (particularly for lower order schemes) and its effect on accuracy for whole-cycle mechanics. Additionally, we verify that direct discretization of the weakly penalized form produces similar convergence behavior to mixed formulations while avoiding the use of an additional variable. Combining a simple structure which allows the solution of computationally challenging problems with good convergence characteristics, the weakly penalized form provides an accurate and efficient alternative to incompressibility and compressibility in cardiac mechanics.

Lungworm Infections in German Dairy Cattle Herds — Seroprevalence and GIS-Supported Risk Factor Analysis

PubMed Central

Schunn, Anne-Marie; Conraths, Franz J.; Staubach, Christoph; Fröhlich, Andreas; Forbes, Andrew; Strube, Christina

2013-01-01

In November 2008, a total of 19,910 bulk tank milk (BTM) samples were obtained from dairy farms from all over Germany, corresponding to about 20% of all German dairy herds, and analysed for antibodies against the bovine lungworm Dictyocaulus viviparus by use of the recombinant MSP-ELISA. A total number of 3,397 (17.1%; n = 19,910) BTM samples tested seropositive. The prevalences in individual German federal states varied between 0.0% and 31.2% positive herds. A geospatial map was drawn to show the distribution of seropositive and seronegative herds per postal code area. ELISA results were further analysed for associations with land-use and climate data. Bivariate statistical analysis was used to identify potential spatial risk factors for dictyocaulosis. Statistically significant positive associations were found between lungworm seropositive herds and the proportion of water bodies and grassed area per postal code area. Variables that showed a statistically significant association with a positive BTM test were included in a logistic regression model, which was further refined by controlled stepwise selection of variables. The low Pseudo R2 values (0.08 for the full model and 0.06 for the final model) and further evaluation of the model by ROC analysis indicate that additional, unrecorded factors (e.g. management factors) or random effects may substantially contribute to lungworm infections in dairy cows. Veterinarians should include lungworms in the differential diagnosis of respiratory disease in dairy cattle, particularly those at pasture. Monitoring of herds through BTM screening for antibodies can help farmers and veterinarians plan and implement appropriate control measures. PMID:24040243

[Implementation of interdisciplinary multimodal pain therapy according to OPS 8‑918 : Recommendations of the ad hoc commission for interdisciplinary multimodal pain therapy of the German Pain Association].

PubMed

Arnold, B; Böger, A; Brinkschmidt, T; Casser, H-R; Irnich, D; Kaiser, U; Klimczyk, K; Lutz, J; Pfingsten, M; Sabatowski, R; Schiltenwolf, M; Söllner, W

2018-02-01

With the implementation of the German diagnosis-related groups (DRG) reimbursement system in hospitals, interdisciplinary multimodal pain therapy was incorporated into the associated catalogue of procedures (OPS 8‑918). Yet, the presented criteria describing the procedure of interdisciplinary multimodal pain therapy are neither precise nor unambiguous. This has led to discrepancies in the interpretation regarding the handling of the procedure-making it difficult for medical services of health insurance companies to evaluate the accordance between the delivered therapy and the required criteria. Since the number of pain units has increased in recent years, the number of examinations by the medical service of health insurance companies has increased. This article, published by the ad hoc commission for interdisciplinary multimodal pain therapy of the German Pain Association, provides specific recommendations for correct implementation of interdisciplinary multimodal pain therapy in routine care. The aim is to achieve a maximum level of accordance between health care providers and the requirements of the medical examiners from health insurance companies. More extensive criteria regarding interdisciplinary multimodal pain treatment in an in-patient setting, especially for patients with chronic and complex pain, are obviously needed. Thus, the authors further discuss specific aspects towards further development of the OPS-code. However, the application of the OPS-code still leaves room regarding treatment intensity and process quality. Therefore, the delivery of pain management in sufficient quantity and quality still remains the responsibility of each health care provider.

Covert Operation ``Sun God'' - History of German Solar Research in the Third Reich and Under Allied Occupation (German Title: Kommandosache ``Sonnengott'' - Geschichte der deutschen Sonnenforschung im Dritten Reich und unter alliierter Besatzung)

NASA Astrophysics Data System (ADS)

Seiler, Michael P.

Between 1939 and 1945 the Luftwaffe of the Third Reich invested large sums in solar research and the establishment of a chain of solar observatories under the code word “Sun God”. Observations of the different phenomena of solar activity were intended to allow a dependable daily prediction of the best frequency bands for long-range military radio. For the development of these research activities the Luftwaffe used a young astrophysicist, who - being the son of a well-known leftist publisher of the Weimar Republic - did appear not well suited to perform “war decisive research” for the Nazi regime: Karl-Otto Kiepenheuer (1910-1975). Circumventing the usual academic tenure, Hitler's war turned the barely thirty-year-old and up to then rather unsuccessful Kiepenheuer into an influential director of a research institution, which he was to remain for the next three decades as well. This book recounts the history of German solar research in the period 1939-1949, her entanglement with the crimes of the Nazi regime as well as her use by the Western Allies until the founding of the German Federal Republic.

The cultural dimension of uncertainty avoidance impacts police-civilian interaction.

PubMed

Giebels, Ellen; Oostinga, Miriam S D; Taylor, Paul J; Curtis, Joanna L

2017-02-01

This research examines how the cultural dimension of uncertainty avoidance-a person's (in)tolerance for uncertain or unknown situations-impacts communication alignment in crisis negotiations. We hypothesized that perpetrators high on uncertainty avoidance would respond better to negotiators who use formal language and legitimize their position with reference to law, procedures, and moral codes. Data were transcriptions of 53 negotiations from a Dutch-German police training initiative, where police negotiators interacted with a high (German) and low (Dutch) uncertainty-avoidant mock perpetrator. Consistent with accounts of cross-cultural interaction, negotiators tended to achieve more alignment in within-culture interactions compared to cross-cultural interactions. Moreover, German negotiators, who scored higher on uncertainty avoidance than the Dutch negotiators, were found to use more legitimizing messages and more formal language than their Dutch counterparts. Critically, irrespective of the negotiators cultural background, the use of these behaviors was a significant moderator of the degree to which negotiator and perpetrator aligned their communicative frames: Using legitimizing and formal language helped with German perpetrators but had no effect on Dutch perpetrators. Our findings show the effects of cultural background on communication alignment and demonstrate the benefits of using more formal language and messages that emphasize law and regulations when interacting with perpetrators high on uncertainty avoidance. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Is it necessary to assume an apartheid-like social structure in Early Anglo-Saxon England?

PubMed

Pattison, John E

2008-11-07

It has recently been argued that there was an apartheid-like social structure operating in Early Anglo-Saxon England. This was proposed in order to explain the relatively high degree of similarity between Germanic-speaking areas of northwest Europe and England. Opinions vary as to whether there was a substantial Germanic invasion or only a relatively small number arrived in Britain during this period. Contrary to the assumption of limited intermarriage made in the apartheid simulation, there is evidence that significant mixing of the British and Germanic peoples occurred, and that the early law codes, such as that of King Ine of Wessex, could have deliberately encouraged such mixing. More importantly, the simulation did not take into account any northwest European immigration that arrived both before and after the Early Anglo-Saxon period. In view of the uncertainty of the places of origin of the various Germanic peoples, and their numbers and dates of arrival, the present study adopts an alternative approach to estimate the percentage of indigenous Britons in the current British population. It was found unnecessary to introduce any special social structure among the diverse Anglo-Saxon people in order to account for the estimates of northwest European intrusion into the British population.

Is it necessary to assume an apartheid-like social structure in Early Anglo-Saxon England?

PubMed Central

Pattison, John E

2008-01-01

It has recently been argued that there was an apartheid-like social structure operating in Early Anglo-Saxon England. This was proposed in order to explain the relatively high degree of similarity between Germanic-speaking areas of northwest Europe and England. Opinions vary as to whether there was a substantial Germanic invasion or only a relatively small number arrived in Britain during this period. Contrary to the assumption of limited intermarriage made in the apartheid simulation, there is evidence that significant mixing of the British and Germanic peoples occurred, and that the early law codes, such as that of King Ine of Wessex, could have deliberately encouraged such mixing. More importantly, the simulation did not take into account any northwest European immigration that arrived both before and after the Early Anglo-Saxon period. In view of the uncertainty of the places of origin of the various Germanic peoples, and their numbers and dates of arrival, the present study adopts an alternative approach to estimate the percentage of indigenous Britons in the current British population. It was found unnecessary to introduce any special social structure among the diverse Anglo-Saxon people in order to account for the estimates of northwest European intrusion into the British population. PMID:18430641

45 CFR 286.150 - Can a family, with a child under age 6, be penalized because a parent refuses to work because (s...

Code of Federal Regulations, 2010 CFR

2010-10-01

... penalized because a parent refuses to work because (s)he cannot find child care? 286.150 Section 286.150... a parent refuses to work because (s)he cannot find child care? (a) If the individual is a single custodial parent caring for a child under age six, the Tribe may not reduce or terminate assistance based on...

45 CFR 286.150 - Can a family, with a child under age 6, be penalized because a parent refuses to work because (s...

Code of Federal Regulations, 2013 CFR

2013-10-01

... penalized because a parent refuses to work because (s)he cannot find child care? 286.150 Section 286.150... a parent refuses to work because (s)he cannot find child care? (a) If the individual is a single custodial parent caring for a child under age six, the Tribe may not reduce or terminate assistance based on...

45 CFR 286.150 - Can a family, with a child under age 6, be penalized because a parent refuses to work because (s...

Code of Federal Regulations, 2011 CFR

2011-10-01

... penalized because a parent refuses to work because (s)he cannot find child care? 286.150 Section 286.150... a parent refuses to work because (s)he cannot find child care? (a) If the individual is a single custodial parent caring for a child under age six, the Tribe may not reduce or terminate assistance based on...

45 CFR 286.150 - Can a family, with a child under age 6, be penalized because a parent refuses to work because (s...

Code of Federal Regulations, 2014 CFR

2014-10-01

... penalized because a parent refuses to work because (s)he cannot find child care? 286.150 Section 286.150... a parent refuses to work because (s)he cannot find child care? (a) If the individual is a single custodial parent caring for a child under age six, the Tribe may not reduce or terminate assistance based on...

45 CFR 286.150 - Can a family, with a child under age 6, be penalized because a parent refuses to work because (s...

Code of Federal Regulations, 2012 CFR

2012-10-01

... penalized because a parent refuses to work because (s)he cannot find child care? 286.150 Section 286.150... a parent refuses to work because (s)he cannot find child care? (a) If the individual is a single custodial parent caring for a child under age six, the Tribe may not reduce or terminate assistance based on...

Postcolonial penality: Liberty and repression in the shadow of independence, India c. 1947

PubMed Central

Brown, Mark

2016-01-01

This article reports primary archival data on the colonial penal history of British India and its reconfiguration into the postcolonial Indian state. It introduces criminologists to frameworks through which postcolonial scholars have sought to make sense of the continuities and discontinuities of rule across the colonial/postcolonial divide. The article examines the postcolonial life of one example of colonial penal power, known as the criminal tribes policy, under which more than three million Indian subjects of British rule were restricted in their movements, subject to a host of administrative rules and sometimes severe punishments, sequestered in settlements and limited in access to legal redress. It illustrates how at the birth of the postcolonial Indian state, encompassing visions of a liberal, unfettered and free life guaranteed in a new Constitution and charter of Fundamental Rights, freedom for some was to prove as elusive as citizens as it had been as subjects. PMID:28503082

Postcolonial penality: Liberty and repression in the shadow of independence, India c. 1947.

PubMed

Brown, Mark

2017-05-01

This article reports primary archival data on the colonial penal history of British India and its reconfiguration into the postcolonial Indian state. It introduces criminologists to frameworks through which postcolonial scholars have sought to make sense of the continuities and discontinuities of rule across the colonial/postcolonial divide. The article examines the postcolonial life of one example of colonial penal power, known as the criminal tribes policy, under which more than three million Indian subjects of British rule were restricted in their movements, subject to a host of administrative rules and sometimes severe punishments, sequestered in settlements and limited in access to legal redress. It illustrates how at the birth of the postcolonial Indian state, encompassing visions of a liberal, unfettered and free life guaranteed in a new Constitution and charter of Fundamental Rights, freedom for some was to prove as elusive as citizens as it had been as subjects.

[Follow-up Care in the Field of Medical Rehabilitation Concerning Psychosomatic Indications Based on the New Conceptual Framework of the German Pension Insurance].

PubMed

Boes, N

2016-12-01

Mental disorders rank first amongst all causes for disability pensions and second in the field of medical rehabilitation. Especially alarming is the significantly lower age of entry of the mentally ill disability pensioners, compared to those with other indications. Mentally ill people often look back at a long history of diseases before getting in contact with the German pension insurance. In this regard the German pension insurance, which is obligated to effectively support people in order to keep them in working life until reaching the regular retirement age, is facing a big challenge, which stands right next to further demands, due to the demographic change, the increase of chronic diseases, multimorbidity, retirement age of 67 and changes in the working environment.With their activities in the field of medical rehabilitation the German pension insurance is aiming at the reintegration of people whose working capacity is endangered or reduced into the labor force or to prevent them from leaving it early. One of the main challenges notably in the field of mental diseases is to keep the success of the medical rehabilitation long-lasting. In this regard the post-rehabilitation provisions of the German pension insurances offer support according to § 31 I 1 Nr. 1 Social Insurance Code VI, if so required.On January 1st, 2016 the German pension insurance has adopted a new conceptual framework in the field of post rehabilitation which is presented in the following article, covering the range of psychosomatic indications. The aim of the new conceptual framework, which has to be implemented within the next three years, is to establish a nationwide, uniformed and preferably comprehensive follow-up care concept, which can be referred to by everyone, regardless which agency of the German pension insurance is in charge. © Georg Thieme Verlag KG Stuttgart · New York.

[Forensic medicine and the overlap with pathology].

PubMed

Riepert, T

2010-07-01

Forensic medicine incorporates research, teaching and professional service. In the routine practice this encompasses interdisciplinary cooperation with physicians, natural scientists and the legal profession. Lectures in forensic medicine include the correct performance of an external examination of corpses, which every physician must be capable of, just as medical questions and the evidential documentation of injuries. Clinical forensic medicine encompasses the examination and documentation of living victims of physical and/or sexual violence. For further training to become a specialist for forensic medicine it is mandatory to undertake a 6-month training period in pathology. Fatalities with an unclear or unnatural manner of death must be registered with the police. On suspicion of third party involvement the public prosecutor will request a legal autopsy, which is carried out and documented by two physicians in accordance with the penal code. Imaging procedures are standard for an autopsy. Extensive samples are taken for additional testing, such as toxicological and molecular biological investigations.

Access to safe legal abortion in Malaysia: women's insights and health sector response.

PubMed

Low, Wah-Yun; Tong, Wen-Ting; Wong, Yut-Lin; Jegasothy, Ravindran; Choong, Sim-Poey

2015-01-01

Malaysia has an abortion law, which permits termination of pregnancy to save a woman's life and to preserve her physical and mental health (Penal Code Section 312, amended in 1989). However, lack of clear interpretation and understanding of the law results in women facing difficulties in accessing abortion information and services. Some health care providers were unaware of the legalities of abortion in Malaysia and influenced by their personal beliefs with regard to provision of abortion services. Accessibility to safer abortion techniques is also an issue. The development of the 2012 Guidelines on Termination of Pregnancy and Guidelines for Management of Sexual and Reproductive Health among Adolescents in Health Clinics by the Ministry of Health, Malaysia, is a step forward toward increasing women's accessibility to safe abortion services in Malaysia. This article provides an account of women's accessibility to abortion in Malaysia and the health sector response in addressing the barriers. © 2014 APJPH.

Sexual Abuse in Cameroon: A Four-Year-Old Girl Victim of Rape in Buea Case Study.

PubMed

Chishugi, John; Franke, Trixy

2016-01-01

A young girl was brought to the emergency unit after suffering sexual abuse by an older male. Additional abuses against women and girls include physical beating, forced marriage, female genital mutilation, breast ironing, widow's rites, psychological abuse, and discrimination in education, finance, employment, and legal access. Cameroon has adopted strategies aimed at eliminating violence against women, including ratification of international policies, penal codes, and support of local and international efforts that promote women; however, many of the laws remain in name only and are rarely enforced, given women's lack of financial access to quality lawyers and an unsympathetic male-dominated police force. Underreporting and culturally accepted abuses remain a challenge, too, as the country seeks to understand the extent of abuses and how to effectively fight against them. A complete paradigm shift in cultural attitude toward the female gender is required for abuses to cease.

In Mexico, abortion rights strictly for the books.

PubMed

Farmer, A

2000-06-01

This paper characterizes the Mexican abortion laws using the case of a girl aged 14 years, Paulina Ramirez Jacinta, who was raped, became pregnant, and chose to terminate the unwanted pregnancy, yet was denied an abortion. This case clearly showed that Mexican abortion law, despite its legality, is highly restrictive in nature and, in a way, violated the human rights of Paulina. Even though it permits first-trimester abortion procedures for rape victims or women whose lives are endangered by the pregnancy, many pregnant women still resort to illegal abortion. To further aggravate the restrictive nature of the law, Baja California state Rep. Martin Dominguez Rocha made a proposal to eliminate the rape exception in the state's penal code. The case of Paulina will be handled by the lawyers at the Center for Reproductive Law and Policy in order to arrive at a settlement favorable to Paulina.

[Freedom of conscience. Biojuridical conflicts at multicultural societies].

PubMed

Albert Márquez, Marta

2010-01-01

The paper analyzes the right of healthcare professionals to conscientious objection at multicultural societies. the ethical relativism, characteristic of these societies, lives together with an apparently paradoxical reduction of the exercise of freedom of conscience. It is wrote "Apparently" because, at the end, the ethical relativism tends to the adoption of dogmatic attitudes. Special attention is paid to the situation of Spanish healthcare in relation with euthanasia and abortion. With regard to euthanasia, the "dignified dead" draft bill of Andalucía is considered. With regard to abortion, we will pay attention to the reform of the Penal Code in the context of a new regulation about "reproductive health" of women, which means the adoption of a system of time limits, and the characterization of abortion as a women's right. It is concluded that the freedom of conscience of healthcare professionals would be probably at risk if proposed legal policies doesn't change.

[Right of the adolescent to health protection according to Italian legislation].

PubMed

Schwarzenberg, T L

1983-04-30

A comprehensive study on the rights of the adolescent to the protection of his health according to existing Italian legislation is carried out. After a full examination of international law, the author carefully evaluates all specific articles of the Italian Constitution and all the civil and penal code articles regarding rights and duties of minors. The juridical figure of the adolescent in labor legislation is also examined together with regulations for the healthcare of drug-addicted adolescents and regulations allowing abortion or use of contraception in minor adolescents. After the general overview of the existing legislation, the author discusses the possibility of a proper management in Italy of the Centers for Clinical Adolescentology, as has already been done in other countries. This, however, implies a pressing demand for appropriate modifications of existing legislation to fill all the existing gaps and remove the more obvious contradictions. (author's modified)

Changes in attitudes towards war and violence after September 11, 2001.

PubMed

Carnagey, Nicholas L; Anderson, Craig A

2007-01-01

Two inter-related studies examined the effect of the September 11, 2001, terrorist attacks on attitudes towards war and violence. A three-wave between-subjects analysis revealed that attitudes towards war became more positive after September 11, 2001 and remained high over a year afterwards. Self-reported trait physical aggression also rose after September 11. Attitudes towards penal code violence (PCV) became more positive immediately after September 11, but were somewhat reduced a year afterward. A two-wave within subjects study revealed that war attitudes became even more positive at 2 months post-September 11. Attitudes towards PCV became less positive during this time period, but only for women. Other aggression-related attitudes were not affected in either study. These studies demonstrate that a large-scale event can change attitudes, but those attitudes must be directly relevant to the event. Copyright 2006 Wiley-Liss; Inc.

Special investigative actions in the criminal procedural law of Bosnia and Herzegovina, and their purposefulness in law

NASA Astrophysics Data System (ADS)

Rodic, V.

2017-05-01

Special investigative actions are a novelty in the criminal procedure legislation BiH. In our legislation this has been introduced only in 2003. These are actions that need to assist prosecutors to effectively reveal the perpetrators and the evidence of serious and complex crimes, especially organized crime. There are criminal offenses in whose execution included a larger number of people in different locations and which are carried out with the help of new communication technologies, so that it is not possible to prove the classic means of evidence (documents, physical evidence, witnesses). Unfortunately, criminals are often better organized than the state and in their criminal activities are introduced various technological developments. Therefore, the legislator extended the powers of the prosecutor and gave them into the hands of more effective mechanisms for discovering the perpetrators of these crimes. Special investigative measures are listed in the Penal Code.

(De-) criminalization of attempted suicide in India: A review

PubMed Central

Ranjan, Rajeev; Kumar, Saurabh; Pattanayak, Raman Deep; Dhawan, Anju; Sagar, Rajesh

2014-01-01

Attempted suicide is a serious problem requiring mental health interventions, but it continues to be treated as a criminal offence under the section 309 of Indian Penal Code. The article reviews the international legal perspective across various regions of the world, discusses the unintended consequences of section 309 IPC and highlights the need for decriminalization of attempted suicide in India. The Mental Health Care Bill, 2013, still under consideration in the Rajya Sabha (upper house), has proposed that attempted suicide should not be criminally prosecuted. Decriminalization of suicidal attempt will serve to cut down the undue stigma and avoid punishment in the aftermath of incident, and lead to a more accurate collection of suicide-related statistics. From a policy perspective, it will further emphasize the urgent need to develop a framework to deliver mental health services to all those who attempt suicide. PMID:25535437

A constitution for AIDS.

PubMed

Koshy, L M

1996-01-15

The Indian Health Organization projected the number of deaths per day due to AIDS by the year 2000 at 10,000. An interdisciplinary international conference was held in New Delhi to draft an international law governing the issues related to AIDS. Human freedom and public health policies are the most affected by this disease. In the absence of an international AIDS law, judicial verdicts set precedents and could have serious ramifications. A participant from the John Marshall Law School, Chicago, suggested that instead of making new laws, the existing ones from the colonial past should be repealed. This includes Section 377 of the Indian Penal Code, which provides criminal sanctions against those who indulge in unnatural relations with man, woman, or animal. Penalizing homosexuality will only perpetuate clandestine relations and spread the virus into their families. Another participant seconded this motion stating that even a sex worker must be protected from abuse and indignity. The National AIDS Control Organization responded to the criticism that the government had not utilized all the World Bank funds allocated for anti-AIDS projects. The trends of the epidemic were the most important indicators not just the numbers. In Manipur and Mizoram, infection was almost entirely due to injecting drug use. The Saheli project undertaken in the red-light areas of Bombay encompassed brothel owners and prostitutes, which could be replicated in other areas. Because existing government policies were focusing on prevention, there was no protection of an HIV-infected individual's privacy, one participant from Madras stated. The confidentiality issue was also echoed by a US participant. The New Delhi Declaration and Action Plan on HIV/AIDS was also discussed. It forbids discrimination in employment, education, housing, health care, social security, travel, and marital and reproductive rights. Providing sterile needles and ensuring the safety of the blood supply were other concerns mentioned.

Integrated analysis of DNA-methylation and gene expression using high-dimensional penalized regression: a cohort study on bone mineral density in postmenopausal women.

PubMed

Lien, Tonje G; Borgan, Ørnulf; Reppe, Sjur; Gautvik, Kaare; Glad, Ingrid Kristine

2018-03-07

Using high-dimensional penalized regression we studied genome-wide DNA-methylation in bone biopsies of 80 postmenopausal women in relation to their bone mineral density (BMD). The women showed BMD varying from severely osteoporotic to normal. Global gene expression data from the same individuals was available, and since DNA-methylation often affects gene expression, the overall aim of this paper was to include both of these omics data sets into an integrated analysis. The classical penalized regression uses one penalty, but we incorporated individual penalties for each of the DNA-methylation sites. These individual penalties were guided by the strength of association between DNA-methylations and gene transcript levels. DNA-methylations that were highly associated to one or more transcripts got lower penalties and were therefore favored compared to DNA-methylations showing less association to expression. Because of the complex pathways and interactions among genes, we investigated both the association between DNA-methylations and their corresponding cis gene, as well as the association between DNA-methylations and trans-located genes. Two integrating penalized methods were used: first, an adaptive group-regularized ridge regression, and secondly, variable selection was performed through a modified version of the weighted lasso. When information from gene expressions was integrated, predictive performance was considerably improved, in terms of predictive mean square error, compared to classical penalized regression without data integration. We found a 14.7% improvement in the ridge regression case and a 17% improvement for the lasso case. Our version of the weighted lasso with data integration found a list of 22 interesting methylation sites. Several corresponded to genes that are known to be important in bone formation. Using BMD as response and these 22 methylation sites as covariates, least square regression analyses resulted in R 2 =0.726, comparable to an average R 2 =0.438 for 10000 randomly selected groups of DNA-methylations with group size 22. Two recent types of penalized regression methods were adapted to integrate DNA-methylation and their association to gene expression in the analysis of bone mineral density. In both cases predictions clearly benefit from including the additional information on gene expressions.

Tracking Multiple Video Targets with an Improved GM-PHD Tracker

PubMed Central

Zhou, Xiaolong; Yu, Hui; Liu, Honghai; Li, Youfu

2015-01-01

Tracking multiple moving targets from a video plays an important role in many vision-based robotic applications. In this paper, we propose an improved Gaussian mixture probability hypothesis density (GM-PHD) tracker with weight penalization to effectively and accurately track multiple moving targets from a video. First, an entropy-based birth intensity estimation method is incorporated to eliminate the false positives caused by noisy video data. Then, a weight-penalized method with multi-feature fusion is proposed to accurately track the targets in close movement. For targets without occlusion, a weight matrix that contains all updated weights between the predicted target states and the measurements is constructed, and a simple, but effective method based on total weight and predicted target state is proposed to search the ambiguous weights in the weight matrix. The ambiguous weights are then penalized according to the fused target features that include spatial-colour appearance, histogram of oriented gradient and target area and further re-normalized to form a new weight matrix. With this new weight matrix, the tracker can correctly track the targets in close movement without occlusion. For targets with occlusion, a robust game-theoretical method is used. Finally, the experiments conducted on various video scenarios validate the effectiveness of the proposed penalization method and show the superior performance of our tracker over the state of the art. PMID:26633422

Penalized likelihood and multi-objective spatial scans for the detection and inference of irregular clusters

PubMed Central

2010-01-01

Background Irregularly shaped spatial clusters are difficult to delineate. A cluster found by an algorithm often spreads through large portions of the map, impacting its geographical meaning. Penalized likelihood methods for Kulldorff's spatial scan statistics have been used to control the excessive freedom of the shape of clusters. Penalty functions based on cluster geometry and non-connectivity have been proposed recently. Another approach involves the use of a multi-objective algorithm to maximize two objectives: the spatial scan statistics and the geometric penalty function. Results & Discussion We present a novel scan statistic algorithm employing a function based on the graph topology to penalize the presence of under-populated disconnection nodes in candidate clusters, the disconnection nodes cohesion function. A disconnection node is defined as a region within a cluster, such that its removal disconnects the cluster. By applying this function, the most geographically meaningful clusters are sifted through the immense set of possible irregularly shaped candidate cluster solutions. To evaluate the statistical significance of solutions for multi-objective scans, a statistical approach based on the concept of attainment function is used. In this paper we compared different penalized likelihoods employing the geometric and non-connectivity regularity functions and the novel disconnection nodes cohesion function. We also build multi-objective scans using those three functions and compare them with the previous penalized likelihood scans. An application is presented using comprehensive state-wide data for Chagas' disease in puerperal women in Minas Gerais state, Brazil. Conclusions We show that, compared to the other single-objective algorithms, multi-objective scans present better performance, regarding power, sensitivity and positive predicted value. The multi-objective non-connectivity scan is faster and better suited for the detection of moderately irregularly shaped clusters. The multi-objective cohesion scan is most effective for the detection of highly irregularly shaped clusters. PMID:21034451

dPIRPLE: a joint estimation framework for deformable registration and penalized-likelihood CT image reconstruction using prior images

NASA Astrophysics Data System (ADS)

Dang, H.; Wang, A. S.; Sussman, Marc S.; Siewerdsen, J. H.; Stayman, J. W.

2014-09-01

Sequential imaging studies are conducted in many clinical scenarios. Prior images from previous studies contain a great deal of patient-specific anatomical information and can be used in conjunction with subsequent imaging acquisitions to maintain image quality while enabling radiation dose reduction (e.g., through sparse angular sampling, reduction in fluence, etc). However, patient motion between images in such sequences results in misregistration between the prior image and current anatomy. Existing prior-image-based approaches often include only a simple rigid registration step that can be insufficient for capturing complex anatomical motion, introducing detrimental effects in subsequent image reconstruction. In this work, we propose a joint framework that estimates the 3D deformation between an unregistered prior image and the current anatomy (based on a subsequent data acquisition) and reconstructs the current anatomical image using a model-based reconstruction approach that includes regularization based on the deformed prior image. This framework is referred to as deformable prior image registration, penalized-likelihood estimation (dPIRPLE). Central to this framework is the inclusion of a 3D B-spline-based free-form-deformation model into the joint registration-reconstruction objective function. The proposed framework is solved using a maximization strategy whereby alternating updates to the registration parameters and image estimates are applied allowing for improvements in both the registration and reconstruction throughout the optimization process. Cadaver experiments were conducted on a cone-beam CT testbench emulating a lung nodule surveillance scenario. Superior reconstruction accuracy and image quality were demonstrated using the dPIRPLE algorithm as compared to more traditional reconstruction methods including filtered backprojection, penalized-likelihood estimation (PLE), prior image penalized-likelihood estimation (PIPLE) without registration, and prior image penalized-likelihood estimation with rigid registration of a prior image (PIRPLE) over a wide range of sampling sparsity and exposure levels.

[Study of efficiancy of teleconsultation: the Telepathology Consultation Service of the Professional Assoziation of German Pathologists for the screening program of breast carcinoma].

PubMed

Schrader, T; Hufnagl, P; Schlake, W; Dietel, M

2005-01-01

In the autumn a German screening program was started for detecting breast cancer in the population of women fifty and above. For the first time in this program, quality assurance rules were established: All statements of the radiologists and pathologists have to be confirmed by a second opinion. This improvement in quality is combined with a delay in time and additional expence. A new Telepathology Consultation Service was developed based on the experiences of the Telepathology Consultation Center of the UICC to speed up the second opinion process. The complete web-based service is operated under MS Windows 2003 Server, as web server the Internet Information Server, and the SQL-Server (both Microsoft) as the database. The websites, forms and control mechanism have been coded in by ASP scripts and JavaScript. A study to evaluate the effectiveness of telepathological consultation in comparison to conventional consultation has been carried out. Pathologists of the Professional Association of German Pathologists took part as well as requesting pathologists and as consultants for other participants. The quality of telepathological diagnosis was comparable to the conventional diagnosis. Telepathology allows a faster respond of 1 to 2 day (conventional postal delay). The time to prepare a telepathology request is about twice as conventional. This ratio may be inverted by an interface between the Pathology Information System and the Telepathology Server and the use of virtual microscopy. The Telepathology Consultation Service of the Professional Association of German Pathologists is a fast and effective German-language, internet-based service for obtaining a second opinion.

Boosting structured additive quantile regression for longitudinal childhood obesity data.

PubMed

Fenske, Nora; Fahrmeir, Ludwig; Hothorn, Torsten; Rzehak, Peter; Höhle, Michael

2013-07-25

Childhood obesity and the investigation of its risk factors has become an important public health issue. Our work is based on and motivated by a German longitudinal study including 2,226 children with up to ten measurements on their body mass index (BMI) and risk factors from birth to the age of 10 years. We introduce boosting of structured additive quantile regression as a novel distribution-free approach for longitudinal quantile regression. The quantile-specific predictors of our model include conventional linear population effects, smooth nonlinear functional effects, varying-coefficient terms, and individual-specific effects, such as intercepts and slopes. Estimation is based on boosting, a computer intensive inference method for highly complex models. We propose a component-wise functional gradient descent boosting algorithm that allows for penalized estimation of the large variety of different effects, particularly leading to individual-specific effects shrunken toward zero. This concept allows us to flexibly estimate the nonlinear age curves of upper quantiles of the BMI distribution, both on population and on individual-specific level, adjusted for further risk factors and to detect age-varying effects of categorical risk factors. Our model approach can be regarded as the quantile regression analog of Gaussian additive mixed models (or structured additive mean regression models), and we compare both model classes with respect to our obesity data.

The Case of Pharmacological Neuroenhancement: Medical, Judicial and Ethical Aspects from a German Perspective.

PubMed

Franke, A G; Northoff, R; Hildt, E

2015-11-01

Pharmacological neuroenhancement (PN) describes the use of psychoactive drugs for the purpose of enhancing cognition (e. g., fatigue, concentration, memory etc.) by healthy subjects without medical need. Drugs used for this purpose can be divided into freely available, over-the-counter drugs (e. g., methylxanthines such as caffeine), prescription drugs (e. g., antidementia drugs, methylphenidate) and illicit drugs (e. g., illicit amphetamines). Clinical studies have shown that the aforementioned substances only have limited pro-cognitive effects and have considerable safety risks and side effects.The German judicial perspective shows legal differences between substances (drugs, food, food supplements, fortified food) that can be bought in a supermarket, drugs that can be bought in a pharmacy as over-the-counter- (OTC-) drugs, drugs with or without the need for a prescription and illicit drugs. Supermarket drugs and fortified food can be sold freely and follow the general rules of civil and penal law; regarding acquisition, parents are responsible for their children. OTC drugs require special information about therapy. Regarding prescription drugs, there are legal problems caused by an off-label use and the non-medical purposes of PN drugs. Furthermore, prescription stimulants for PN are governed by the specialized law for narcotics, and their use might be punished. Beyond the general lack of rules for regulation for PN drug use there are specific needs for prevention (e. g., control of the black market, etc.).Possible future policy will depend, among others, on the probability with which effective PN drugs with an acceptable risk-benefit ratio will be available, on individual and societal implications, and on public opinion towards PN. While 4 different general policy scenarios can be identified, it is important to advance a broad societal debate on PN to collect relevant empirical data and to address enhancement-related conceptual issues. © Georg Thieme Verlag KG Stuttgart · New York.

Awareness of female students attending higher educational institutions toward legalization of safe abortion and associated factors, Harari Region, Eastern Ethiopia: a cross sectional study.

PubMed

Geleto, Ayele; Markos, Jote

2015-03-17

Unsafe abortion has been recognized as an important public health problem in the world. It accounts for 14% of all maternal deaths in sub-Saharan African countries. In Ethiopia, 32% of all maternal deaths are accounted to unsafe abortion. Taking the problem of unsafe abortion into consideration, the penal code of Ethiopia was amended in 2005, to permit safe abortion under a set of circumstances. However, lack of awareness on the revised penal code is a major barrier that hinders women to seek safe abortion. The aim of this study is to assess awareness of female students attending higher educational institutions toward legalization of safe abortion and associated factors in Harari region, eastern Ethiopia. Institution-based descriptive cross sectional study was conducted among 762 female students who are attending five higher educational institutions in Harari Region. Systematic sampling method was used to identify study participants from randomly selected colleges. Self administered structured questionnaire was used to collect data. Data were entered in to Epi Info version 6.04 and analyzed by SPSS version 17.0 statistical packages. Frequency, percentage and ratio were used to describe variables. Multivariable logistic regression analysis was done to control confounders and odds ratio with 95% confidence interval was used to identify factors associated with awareness of female students to legalization of abortion. 762 study participants completed the survey questionnaire making the response rate 90.2%. Only 272 (35.7%) of the respondents reported that they have good awareness about legalization of safe abortion. Studying other fields than health and medicine [AOR 0.48; 95%CI (0.23, 0.85)], being the only child for their family [AOR 0.28; 95%CI (0.13, 0.86)], having no boy friend [AOR 0.34; 95%CI (0.12, 0.74)], using family planning [AOR 0.50; 95%CI (0.13 and 0.86)], being 25 years or older [AOR 1.64; 95%CI (1.33, 2.80)] were significantly associated with awareness of female students to legalization of safe abortion. Only slightly more than a third of the study participants, 35.7% have good awareness of legalization of safe abortion. Strengthening information dissemination regarding legalization of safe abortion is required for female reproductive age group in general and higher institution female students in particular.

Intelligence Secrecy and Transparency: Finding the Proper Balance from the War of Independence to the War on Terror (Strategic Insights, Volume 6, Issue 3, May 2007)

DTIC Science & Technology

2007-05-01

NIE), requested by Congress, prior to the House and Senate vote to authorize the President to use force against Iraq. Secretary of State Colin ... Bamford , The Puzzle Palace (London: Penguin Books, 1982), and David Kahn, Seizing the Enigma: The Race to Break the German U-Boat Codes 1939-1943

’Offsets’ for NATO Procurement of the Airborne Warning and Control System: Opportunities and Implications

DTIC Science & Technology

1976-02-01

the Anglo-French ; azel ’, the German B9715, and the Italian Ag129--all appear responsi- e to a U.S. need for an Advanced Scout -32- Helicopter (ASH...currencies by OECD using IMF parity rates, or average of annual range of flexible rates. -86- code (individual chemicals, such as sulphuric acid , etc.), it is

One? "Dos" Drei. A Study of Code Switching in Child Trilingualism

ERIC Educational Resources Information Center

Davidiak, Elena

2010-01-01

This longitudinal study focuses on the language production of two siblings, aged 6 and 9 at the beginning of the data collection period, who have been brought up in a bilingual family in New York. The parents of the two girls are native speakers of German and Spanish, respectively, and English for them is the language of education and the larger…

Fremdsprachenerwerb in einer individualisierten Lernsituation. Eine Beschreibung von Lernverhalten (Foreign Language Acquisition in an Individualized Learning Situation. A Description of Learning Behavior)

ERIC Educational Resources Information Center

Extra, G.

1974-01-01

The introduction reviews and compares the audiolingual and cognitive code-learning methods. An experiment was conducted using audiolingual methods to show that learning behavior diverges considerably from the expectations set up by that method. Several charts and diagrams present the analyzed results. (Text is in German.) See FL 507 969 for…

Multiparticipant Chat Analysis: A Survey

DTIC Science & Technology

2013-02-26

language variation (e.g., regional speech in Germany [6]; code-switching in German-speaking regions of Switzerland [84] and Indian IRC channels [77]), and...messages which may be missed in high- tempo situations [19], and automated analysis of chat messages [13]. Finally, the high number of chat messages can...Androutsopoulos, E. Ziegler, Exploring language variation on the internet: Regional speech in a chat community, in: Proceedings of the Second International

Sparse High Dimensional Models in Economics

PubMed Central

Fan, Jianqing; Lv, Jinchi; Qi, Lei

2010-01-01

This paper reviews the literature on sparse high dimensional models and discusses some applications in economics and finance. Recent developments of theory, methods, and implementations in penalized least squares and penalized likelihood methods are highlighted. These variable selection methods are proved to be effective in high dimensional sparse modeling. The limits of dimensionality that regularization methods can handle, the role of penalty functions, and their statistical properties are detailed. Some recent advances in ultra-high dimensional sparse modeling are also briefly discussed. PMID:22022635

["Integrity" in the healthcare system : Recognize and avoid risks: on dealing with the Association of Statutory Health Insurance Physicians and the public prosecutors office].

PubMed

Wohlgemuth, Martin; Heinrich, Julia

2018-05-24

This article describes the introduction of the law to combat corruption in the healthcare system. The effects of the introduced penal regulations on the delivery of medical services is critically scrutinized and the associated procedures as well as indications for the course of action are presented. Knowledge of the relevant regulations and types of procedure is decisive for the penal, social legislative and professional conduct risk minimization.

To Amend Certain Federal Statutes to Enhance the Effectiveness of Job Training Programs in Penal Institutions. Hearing before the Subcommittee on Labor Standards of the Committee on Education and Labor, House of Representatives, Ninety-Fourth Congress, Second Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Education and Labor.

A hearing before the subcommittee on labor standards was held to receive testimony on a bill, H.R. 2715, to amend Federal statutes to improve the effectiveness of job training programs in penal institutions. H.R. 2715, sponsored by Congressman Albert H. Quie of Minnesota, would permit the distribution in interstate commerce of goods produced by…

Religious counseling in the penal context: strategies of trust and establishment of trusting relationships in a context of distrust.

PubMed

Brandner, Tobias

2013-06-01

The paper describes how distrust shapes the network of relationships between the different agents in the penal context, among inmates, between inmates and their family, between inmates and staff, between counselors and staff, and between inmates and counselors, and discusses how counseling strategies need to be adjusted to counter the effects of the institutional and biographical context of distrust. The paper is based on many years of participation and observation in the context of Hong Kong.

[Standards for treatment in forensic committment according to § 63 and § 64 of the German criminal code : Interdisciplinary task force of the DGPPN].

PubMed

Müller, J L; Saimeh, N; Briken, P; Eucker, S; Hoffmann, K; Koller, M; Wolf, T; Dudeck, M; Hartl, C; Jakovljevic, A-K; Klein, V; Knecht, G; Müller-Isberner, R; Muysers, J; Schiltz, K; Seifert, D; Simon, A; Steinböck, H; Stuckmann, W; Weissbeck, W; Wiesemann, C; Zeidler, R

2017-08-01

People who have been convicted of a crime due to a severe mental disorder and continue to be dangerous as a result of this disorder may be placed in a forensic psychiatric facility for improvement and safeguarding according to § 63 and § 64 of the German Criminal Code (StGB). In Germany, approximately 9000 patients are treated in clinics for forensic psychiatry and psychotherapy on the basis of § 63 of the StGB and in withdrawal centers on the basis of § 64 StGB. The laws for treatment of patients in forensic commitment are passed by the individual States, with the result that even the basic conditions differ in the individual States. While minimum requirements have already been published for the preparation of expert opinions on liability and legal prognosis, consensus standards for the treatment in forensic psychiatry have not yet been published. Against this background, in 2014 the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) commissioned an interdisciplinary task force to develop professional standards for treatment in forensic psychiatry. Legal, ethical, structural, therapeutic and prognostic standards for forensic psychiatric treatment should be described according to the current state of science. After 3 years of work the results of the interdisciplinary working group were presented in early 2017 and approved by the board of the DGPPN. The standards for the treatment in the forensic psychiatric commitment aim to initiate a discussion in order to standardize the treatment conditions and to establish evidence-based recommendations.

De Novo Transcriptome of the Hemimetabolous German Cockroach (Blattella germanica)

PubMed Central

Zhou, Xiaojie; Qian, Kun; Tong, Ying; Zhu, Junwei Jerry; Qiu, Xinghui; Zeng, Xiaopeng

2014-01-01

Background The German cockroach, Blattella germanica, is an important insect pest that transmits various pathogens mechanically and causes severe allergic diseases. This insect has long served as a model system for studies of insect biology, physiology and ecology. However, the lack of genome or transcriptome information heavily hinder our further understanding about the German cockroach in every aspect at a molecular level and on a genome-wide scale. To explore the transcriptome and identify unique sequences of interest, we subjected the B. germanica transcriptome to massively parallel pyrosequencing and generated the first reference transcriptome for B. germanica. Methodology/Principal Findings A total of 1,365,609 raw reads with an average length of 529 bp were generated via pyrosequencing the mixed cDNA library from different life stages of German cockroach including maturing oothecae, nymphs, adult females and males. The raw reads were de novo assembled to 48,800 contigs and 3,961 singletons with high-quality unique sequences. These sequences were annotated and classified functionally in terms of BLAST, GO and KEGG, and the genes putatively coding detoxification enzyme systems, insecticide targets, key components in systematic RNA interference, immunity and chemoreception pathways were identified. A total of 3,601 SSRs (Simple Sequence Repeats) loci were also predicted. Conclusions/Significance The whole transcriptome pyrosequencing data from this study provides a usable genetic resource for future identification of potential functional genes involved in various biological processes. PMID:25265537

Fast function-on-scalar regression with penalized basis expansions.

PubMed

Reiss, Philip T; Huang, Lei; Mennes, Maarten

2010-01-01

Regression models for functional responses and scalar predictors are often fitted by means of basis functions, with quadratic roughness penalties applied to avoid overfitting. The fitting approach described by Ramsay and Silverman in the 1990 s amounts to a penalized ordinary least squares (P-OLS) estimator of the coefficient functions. We recast this estimator as a generalized ridge regression estimator, and present a penalized generalized least squares (P-GLS) alternative. We describe algorithms by which both estimators can be implemented, with automatic selection of optimal smoothing parameters, in a more computationally efficient manner than has heretofore been available. We discuss pointwise confidence intervals for the coefficient functions, simultaneous inference by permutation tests, and model selection, including a novel notion of pointwise model selection. P-OLS and P-GLS are compared in a simulation study. Our methods are illustrated with an analysis of age effects in a functional magnetic resonance imaging data set, as well as a reanalysis of a now-classic Canadian weather data set. An R package implementing the methods is publicly available.

Hospitals with higher nurse staffing had lower odds of readmissions penalties than hospitals with lower staffing.

PubMed

McHugh, Matthew D; Berez, Julie; Small, Dylan S

2013-10-01

The Affordable Care Act's Hospital Readmissions Reduction Program (HRRP) penalizes hospitals based on excess readmission rates among Medicare beneficiaries. The aim of the program is to reduce readmissions while aligning hospitals' financial incentives with payers' and patients' quality goals. Many evidence-based interventions that reduce readmissions, such as discharge preparation, care coordination, and patient education, are grounded in the fundamentals of basic nursing care. Yet inadequate staffing can hinder nurses' efforts to carry out these processes of care. We estimated the effect that nurse staffing had on the likelihood that a hospital was penalized under the HRRP. Hospitals with higher nurse staffing had 25 percent lower odds of being penalized compared to otherwise similar hospitals with lower staffing. Investment in nursing is a potential system-level intervention to reduce readmissions that policy makers and hospital administrators should consider in the new regulatory environment as they examine the quality of care delivered to US hospital patients.

Penalized Nonlinear Least Squares Estimation of Time-Varying Parameters in Ordinary Differential Equations

PubMed Central

Cao, Jiguo; Huang, Jianhua Z.; Wu, Hulin

2012-01-01

Ordinary differential equations (ODEs) are widely used in biomedical research and other scientific areas to model complex dynamic systems. It is an important statistical problem to estimate parameters in ODEs from noisy observations. In this article we propose a method for estimating the time-varying coefficients in an ODE. Our method is a variation of the nonlinear least squares where penalized splines are used to model the functional parameters and the ODE solutions are approximated also using splines. We resort to the implicit function theorem to deal with the nonlinear least squares objective function that is only defined implicitly. The proposed penalized nonlinear least squares method is applied to estimate a HIV dynamic model from a real dataset. Monte Carlo simulations show that the new method can provide much more accurate estimates of functional parameters than the existing two-step local polynomial method which relies on estimation of the derivatives of the state function. Supplemental materials for the article are available online. PMID:23155351

Integrative Analysis of Cancer Diagnosis Studies with Composite Penalization

PubMed Central

Liu, Jin; Huang, Jian; Ma, Shuangge

2013-01-01

Summary In cancer diagnosis studies, high-throughput gene profiling has been extensively conducted, searching for genes whose expressions may serve as markers. Data generated from such studies have the “large d, small n” feature, with the number of genes profiled much larger than the sample size. Penalization has been extensively adopted for simultaneous estimation and marker selection. Because of small sample sizes, markers identified from the analysis of single datasets can be unsatisfactory. A cost-effective remedy is to conduct integrative analysis of multiple heterogeneous datasets. In this article, we investigate composite penalization methods for estimation and marker selection in integrative analysis. The proposed methods use the minimax concave penalty (MCP) as the outer penalty. Under the homogeneity model, the ridge penalty is adopted as the inner penalty. Under the heterogeneity model, the Lasso penalty and MCP are adopted as the inner penalty. Effective computational algorithms based on coordinate descent are developed. Numerical studies, including simulation and analysis of practical cancer datasets, show satisfactory performance of the proposed methods. PMID:24578589

This is SPIRAL-TAP: Sparse Poisson Intensity Reconstruction ALgorithms--theory and practice.

PubMed

Harmany, Zachary T; Marcia, Roummel F; Willett, Rebecca M

2012-03-01

Observations in many applications consist of counts of discrete events, such as photons hitting a detector, which cannot be effectively modeled using an additive bounded or Gaussian noise model, and instead require a Poisson noise model. As a result, accurate reconstruction of a spatially or temporally distributed phenomenon (f*) from Poisson data (y) cannot be effectively accomplished by minimizing a conventional penalized least-squares objective function. The problem addressed in this paper is the estimation of f* from y in an inverse problem setting, where the number of unknowns may potentially be larger than the number of observations and f* admits sparse approximation. The optimization formulation considered in this paper uses a penalized negative Poisson log-likelihood objective function with nonnegativity constraints (since Poisson intensities are naturally nonnegative). In particular, the proposed approach incorporates key ideas of using separable quadratic approximations to the objective function at each iteration and penalization terms related to l1 norms of coefficient vectors, total variation seminorms, and partition-based multiscale estimation methods.

Orthogonalizing EM: A design-based least squares algorithm.

PubMed

Xiong, Shifeng; Dai, Bin; Huling, Jared; Qian, Peter Z G

We introduce an efficient iterative algorithm, intended for various least squares problems, based on a design of experiments perspective. The algorithm, called orthogonalizing EM (OEM), works for ordinary least squares and can be easily extended to penalized least squares. The main idea of the procedure is to orthogonalize a design matrix by adding new rows and then solve the original problem by embedding the augmented design in a missing data framework. We establish several attractive theoretical properties concerning OEM. For the ordinary least squares with a singular regression matrix, an OEM sequence converges to the Moore-Penrose generalized inverse-based least squares estimator. For ordinary and penalized least squares with various penalties, it converges to a point having grouping coherence for fully aliased regression matrices. Convergence and the convergence rate of the algorithm are examined. Finally, we demonstrate that OEM is highly efficient for large-scale least squares and penalized least squares problems, and is considerably faster than competing methods when n is much larger than p . Supplementary materials for this article are available online.

Hospitals With Higher Nurse Staffing Had Lower Odds Of Readmissions Penalties Than Hospitals With Lower Staffing

PubMed Central

McHugh, Matthew D.; Berez, Julie; Small, Dylan S.

2015-01-01

The Affordable Care Act’s Hospital Readmissions Reduction Program (HRRP) penalizes hospitals based on excess readmission rates among Medicare beneficiaries. The aim of the program is to reduce readmissions while aligning hospitals’ financial incentives with payers’ and patients’ quality goals. Many evidence-based interventions that reduce readmissions, such as discharge preparation, care coordination, and patient education, are grounded in the fundamentals of basic nursing care. Yet inadequate staffing can hinder nurses’ efforts to carry out these processes of care. We estimated the effect that nurse staffing had on the likelihood that a hospital was penalized under the HRRP. Hospitals with higher nurse staffing had 25 percent lower odds of being penalized compared to otherwise similar hospitals with lower staffing. Investment in nursing is a potential system-level intervention to reduce readmissions that policy makers and hospital administrators should consider in the new regulatory environment as they examine the quality of care delivered to US hospital patients. PMID:24101063

Labor union members play an OLG repeated game

PubMed Central

Kandori, Michihiro; Obayashi, Shinya

2014-01-01

Humans are capable of cooperating with one another even when it is costly and a deviation provides an immediate gain. An important reason is that cooperation is reciprocated or rewarded and deviations are penalized in later stages. For cooperation to be sustainable, not only must rewards and penalties be strong enough but individuals should also have the right incentives to provide rewards and punishments. Codes of conduct with such properties have been studied extensively in game theory (as repeated game equilibria), and the literature on the evolution of cooperation shows how equilibrium behavior might emerge and proliferate in society. We found that community unions, a subclass of labor unions that admits individual affiliations, are ideal to corroborate these theories with reality, because (i) their activities are simple and (ii) they have a structure that closely resembles a theoretical model, the overlapping generations repeated game. A detailed case study of a community union revealed a possible equilibrium that can function under the very limited observability in the union. The equilibrium code of conduct appears to be a natural focal point based on simple heuristic reasoning. The union we studied was created out of necessity for cooperation, without knowing or anticipating how cooperation might be sustained. The union has successfully resolved about 3,000 labor disputes and created a number of offspring. PMID:25024211

Report: Hospital waste management--awareness and practices: a study of three states in India.

PubMed

Rao, P Hanumantha

2008-06-01

The study was conducted in Andhra Pradesh, Maharashtra and Uttar Pradesh in India. Hospitals/nursing homes and private medical practitioners in urban as well as rural areas and those from the private as well as the government sector were covered. Information on (a) awareness of bio-medical waste management rules, (b) training undertaken and (c) practices with respect to segregation, use of colour coding, sharps management, access to common waste management facilities and disposal was collected. Awareness of Bio-medical Waste Management Rules was better among hospital staff in comparison with private medical practitioners and awareness was marginally higher among those in urban areas in comparison with those in rural areas. Training gained momentum only after the dead-line for compliance was over. Segregation and use of colour codes revealed gaps, which need correction. About 70% of the healthcare facilities used a needle cutter/destroyer for sharps management. Access to Common Waste Management facilities was low at about 35%. Dumping biomedical waste on the roads outside the hospital is still prevalent and access to Common Waste facilities is still limited. Surveillance, monitoring and penal machinery was found to be deficient and these require strengthening to improve compliance with the Bio-medical Waste Management Rules and to safeguard the health of employees, patients and communities.

[Ethical and legal duty of anesthesiologists regarding Jehovah's Witness patient: care protocol].

PubMed

Takaschima, Augusto Key Karazawa; Sakae, Thiago Mamôru; Takaschima, Alexandre Karazawa; Takaschima, Renata Dos Santos Teodoro; de Lima, Breno José Santiago Bezerra; Benedetti, Roberto Henrique

Jehovah's Witnesses patients refuse blood transfusions for religious reasons. Anesthesiologists must master specific legal knowledge to provide care to these patients. Understanding how the Law and the Federal Council of Medicine treat this issue is critical to know how to act in this context. The aim of this paper was to establish a treatment protocol for the Jehovah's Witness patient with emphasis on ethical and legal duty of the anesthesiologist. The article analyzes the Constitution, Criminal Code, resolutions of the Federal Council of Medicine (FCM), opinions, and jurisprudence to understand the limits of the conflict between the autonomy of will of Jehovah's Witnesses to refuse transfusion and the physician's duty to provide the transfusion. Based on this evidence, a care protocol is suggested. The FCM resolution 1021/1980, the penal code Article 135, which classifies denial of care as a crime and the Supreme Court decision on the HC 268,459/SP process imposes on the physician the obligation of blood transfusion when life is threatened. The patient's or guardian's consent is not necessary, as the autonomy of will manifestation of the Jehovah's Witness patient refusing blood transfusion for himself and relatives, even in emergencies, is no not forbidden. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Ethical and legal duty of anesthesiologists regarding Jehovah's Witness patient: care protocol.

PubMed

Takaschima, Augusto Key Karazawa; Sakae, Thiago Mamôru; Takaschima, Alexandre Karazawa; Takaschima, Renata Dos Santos Teodoro; Lima, Breno José Santiago Bezerra de; Benedetti, Roberto Henrique

Jehovah's Witnesses patients refuse blood transfusions for religious reasons. Anesthesiologists must master specific legal knowledge to provide care to these patients. Understanding how the Law and the Federal Council of Medicine treat this issue is critical to know how to act in this context. The aim of this paper was to establish a treatment protocol for the Jehovah's Witness patient with emphasis on ethical and legal duty of the anesthesiologist. The article analyzes the Constitution, Criminal Code, resolutions of the Federal Council of Medicine, opinions, and jurisprudence to understand the limits of the conflict between the autonomy of will of Jehovah's Witnesses to refuse transfusion and the physician's duty to provide the transfusion. Based on this evidence, a care protocol is suggested. The Federal Council of Medicine resolution 1021/1980, the penal code Article 135, which classifies denial of care as a crime and the Supreme Court decision on the HC 268,459/SP process imposes on the physician the obligation of blood transfusion when life is threatened. The patient's or guardian's consent is not necessary, as the autonomy of will manifestation of the Jehovah's Witness patient refusing blood transfusion for himself and relatives, even in emergencies, is no not forbidden. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

Penalized discriminant analysis for the detection of wild-grown and cultivated Ganoderma lucidum using Fourier transform infrared spectroscopy

NASA Astrophysics Data System (ADS)

Zhu, Ying; Tan, Tuck Lee

2016-04-01

An effective and simple analytical method using Fourier transform infrared (FTIR) spectroscopy to distinguish wild-grown high-quality Ganoderma lucidum (G. lucidum) from cultivated one is of essential importance for its quality assurance and medicinal value estimation. Commonly used chemical and analytical methods using full spectrum are not so effective for the detection and interpretation due to the complex system of the herbal medicine. In this study, two penalized discriminant analysis models, penalized linear discriminant analysis (PLDA) and elastic net (Elnet),using FTIR spectroscopy have been explored for the purpose of discrimination and interpretation. The classification performances of the two penalized models have been compared with two widely used multivariate methods, principal component discriminant analysis (PCDA) and partial least squares discriminant analysis (PLSDA). The Elnet model involving a combination of L1 and L2 norm penalties enabled an automatic selection of a small number of informative spectral absorption bands and gave an excellent classification accuracy of 99% for discrimination between spectra of wild-grown and cultivated G. lucidum. Its classification performance was superior to that of the PLDA model in a pure L1 setting and outperformed the PCDA and PLSDA models using full wavelength. The well-performed selection of informative spectral features leads to substantial reduction in model complexity and improvement of classification accuracy, and it is particularly helpful for the quantitative interpretations of the major chemical constituents of G. lucidum regarding its anti-cancer effects.

The "other" side of labor reform: accounts of incarceration and resistance in the Straits Settlements penal system, 1825-1873.

PubMed

Pieris, Anoma

2011-01-01

The rhetoric surrounding the transportation of prisoners to the Straits Settlements and the reformative capacity of the penal labor regime assumed a uniform subject, an impoverished criminal, who could be disciplined and accordingly civilized through labor. Stamford Raffles, as lieutenant governor of Benkulen, believed that upon realizing the advantages of the new colony, criminals would willingly become settlers. These two colonial prerogatives of labor and population categorized transportees into laboring classes where their exploitation supposedly brought mutual benefit. The colonized was collectively homogenized as a class of laborers and evidence to the contrary, of politically challenging and resistant individuals was suppressed. This paper focuses on two prisoners who were incriminated during the anti-colonial rebellions of the mid-nineteenth century and were transported to the Straits Settlements. Nihal Singh, a political prisoner from Lahore, was incarcerated in isolation to prevent his martyrdom and denied the supposed benefits of labor reform. Conversely, Tikiri Banda Dunuwille, a lawyer from Ceylon was sent to labor in Melaka as a form of humiliation. Tikiri’s many schemes to evade labor damned him in the eyes of the authorities. The personal histories of these two individuals expose how colonial penal policy recognized and manipulated individual differences during a time of rising anti-colonial sentiment. The experiences of these prisoners, the response of their communities and the voices of their descendents offer us a very different entry point into colonial penal history.

[Medical legal aspects of the requirement to report noise-induced hearing loss notified to INAIL to the judicial authorities].

PubMed

Salatin, Giuseppina; Mattia, C F; Morganti, M; Motta, Laura

2006-01-01

Law 689/81 redefined how personal lesions could be prosecuted by means of explicit mention of occupational diseases among the type of offences subject to mandatory reporting. The high prevalence of noise-induced hearing loss (NIHL) among occupational diseases has monopolized attention towards identification of a method that can define the penal limits of this occupational disease; however, up to now no single univocal approach exists. For this reason operators in this field are perplexed as to the requirement of reporting judicial authorities (J.A.). On the other hand, the great changes that have occurred in compensation of occupational diseases by INAIL (sentence 179/88 of the Constitutional Court) and the evaluation of the same in terms of biological impairment (Law D.Lgs. 38/00 and Law D.M. 12.7.00) have led to an ample and accurately assessed protection against, work-related hearing loss. From this perspective the authors analysed 52 cases of NIHL reported to INAIL. They compared the assessments made according to Law D.M. 12.7.00 and the guidelines for reporting to the J.A. according to four different methods generally used in the criminal field: Benciolini, Merluzzi, SIMLII guide lines and SIO guidelines. By stressing the need for a preliminary qualitative evaluation of NIHL in the penal report, the authors. restricted the analysis to the quantitative aspect with technically compatible graphs. Processing the data resulting from application of the different methods, led to the assumption that audiometric graphs that showed a percentage of biological impairment according to Law D.M. 12.7.00 higher than 2.40% must always be reported to the JA. For audiometric graphs that show impairment of less than 0.5% recommendations to report tare rather sporadic. For the graphs with intermediate values recommendations to report to the J.A, which are always present in at least one of the methods, are not constant, and in particular there is no linear correlation between the percent grading of biological impairment and the recommendation to report; this is probably due to a difference in concept of the various methods which reflects on the respective scale of values. On the basis of these results the authors suggest that reporting to the judicial authority can be recommended for all those cases whose quantification, according Marello's schedule, is higher than 0.5%, as these cases can, according to the penal code, supplement assessment of impairment.

The Pacification Campaign of Madagascar: 1896-1905

DTIC Science & Technology

2002-01-01

and 1940s. This was no improvised brutality. My German colleague, Rudolf Scharping revealed on 9 April details of a covert Serbian plan, code-named...administrator arrived to begin attempts to transfer authority to local institutions and to work to improve security and boost the economy. Steiner , a...Yugoslav President Slobodan Milosevic’s crackdown on ethnic Albanians in the province. Steiner also said he would focus on creating jobs in the province

Reichsrundschreiben 1931: pre-Nuremberg German regulations concerning new therapy and human experimentation.

PubMed

Sass, H M

1983-05-01

This is the first re-publication and first English translation of regulations concerning Human Experimentation which were binding law prior to and during the Third Reich, 1931 to 1945. The introduction briefly describes the duties of the Reichsgesundheitsamt, which formulated these regulations. It then outlines the basic concept of the Richtlinien for protecting subjects and patients on the one hand and for encouraging New Therapy and Human Experimentation on the other hand. Major issues, like personal responsibility of the physician or researcher, teaching of ethics of research and therapy, and research and therapy on vulnerable populations, are compared with the regulations in the Nuremberg Code and subsequent regulations influenced by the Nuremberg Code.

Operational Tsunami Modelling with TsunAWI for the German-Indonesian Tsunami Early Warning System: Recent Developments

NASA Astrophysics Data System (ADS)

Rakowsky, N.; Harig, S.; Androsov, A.; Fuchs, A.; Immerz, A.; Schröter, J.; Hiller, W.

2012-04-01

Starting in 2005, the GITEWS project (German-Indonesian Tsunami Early Warning System) established from scratch a fully operational tsunami warning system at BMKG in Jakarta. Numerical simulations of prototypic tsunami scenarios play a decisive role in a priori risk assessment for coastal regions and in the early warning process itself. Repositories with currently 3470 regional tsunami scenarios for GITEWS and 1780 Indian Ocean wide scenarios in support of Indonesia as a Regional Tsunami Service Provider (RTSP) were computed with the non-linear shallow water modell TsunAWI. It is based on a finite element discretisation, employs unstructured grids with high resolution along the coast and includes inundation. This contribution gives an overview on the model itself, the enhancement of the model physics, and the experiences gained during the process of establishing an operational code suited for thousands of model runs. Technical aspects like computation time, disk space needed for each scenario in the repository, or post processing techniques have a much larger impact than they had in the beginning when TsunAWI started as a research code. Of course, careful testing on artificial benchmarks and real events remains essential, but furthermore, quality control for the large number of scenarios becomes an important issue.

Phonological working memory in German children with poor reading and spelling abilities.

PubMed

Steinbrink, Claudia; Klatte, Maria

2008-11-01

Deficits in verbal short-term memory have been identified as one factor underlying reading and spelling disorders. However, the nature of this deficit is still unclear. It has been proposed that poor readers make less use of phonological coding, especially if the task can be solved through visual strategies. In the framework of Baddeley's phonological loop model, this study examined serial recall performance in German second-grade children with poor vs good reading and spelling abilities. Children were presented with four-item lists of common nouns for immediate serial recall. Word length and phonological similarity as well as presentation modality (visual vs auditory) and type of recall (visual vs verbal) were varied as within-subject factors in a mixed design. Word length and phonological similarity effects did not differ between groups, thus indicating equal use of phonological coding and rehearsal in poor and good readers. However, in all conditions, except the one that combined visual presentation and visual recall, overall performance was significantly lower in poor readers. The results suggest that the poor readers' difficulties do not arise from an avoidance of the phonological loop, but from its inefficient use. An alternative account referring to unstable phonological representations in long-term memory is discussed. Copyright (c) 2007 John Wiley & Sons, Ltd.

[Penal and non-penal legislative policy in relation to human biotechnology].

PubMed

Romeo Casabona, Carlos María

2007-01-01

The Spanish legislator has introduced a set of legislative novelties in the field of human biotechnology or is about to do so. This will be done either through the reform of some laws or through the approval of new laws, that is, without previous regulatory references available. The greater part of these novelties turn on research with cells or cell lines of human origin, specifically those from human embryos and through the use of diverse techniques, such as reproductive cloning and non-reproductive ('therapeutic') cloning.

Qualitative Data Analysis for Health Services Research: Developing Taxonomy, Themes, and Theory

PubMed Central

Bradley, Elizabeth H; Curry, Leslie A; Devers, Kelly J

2007-01-01

Objective To provide practical strategies for conducting and evaluating analyses of qualitative data applicable for health services researchers. Data Sources and Design We draw on extant qualitative methodological literature to describe practical approaches to qualitative data analysis. Approaches to data analysis vary by discipline and analytic tradition; however, we focus on qualitative data analysis that has as a goal the generation of taxonomy, themes, and theory germane to health services research. Principle Findings We describe an approach to qualitative data analysis that applies the principles of inductive reasoning while also employing predetermined code types to guide data analysis and interpretation. These code types (conceptual, relationship, perspective, participant characteristics, and setting codes) define a structure that is appropriate for generation of taxonomy, themes, and theory. Conceptual codes and subcodes facilitate the development of taxonomies. Relationship and perspective codes facilitate the development of themes and theory. Intersectional analyses with data coded for participant characteristics and setting codes can facilitate comparative analyses. Conclusions Qualitative inquiry can improve the description and explanation of complex, real-world phenomena pertinent to health services research. Greater understanding of the processes of qualitative data analysis can be helpful for health services researchers as they use these methods themselves or collaborate with qualitative researchers from a wide range of disciplines. PMID:17286625

Qualitative data analysis for health services research: developing taxonomy, themes, and theory.

PubMed

Bradley, Elizabeth H; Curry, Leslie A; Devers, Kelly J

2007-08-01

To provide practical strategies for conducting and evaluating analyses of qualitative data applicable for health services researchers. DATA SOURCES AND DESIGN: We draw on extant qualitative methodological literature to describe practical approaches to qualitative data analysis. Approaches to data analysis vary by discipline and analytic tradition; however, we focus on qualitative data analysis that has as a goal the generation of taxonomy, themes, and theory germane to health services research. We describe an approach to qualitative data analysis that applies the principles of inductive reasoning while also employing predetermined code types to guide data analysis and interpretation. These code types (conceptual, relationship, perspective, participant characteristics, and setting codes) define a structure that is appropriate for generation of taxonomy, themes, and theory. Conceptual codes and subcodes facilitate the development of taxonomies. Relationship and perspective codes facilitate the development of themes and theory. Intersectional analyses with data coded for participant characteristics and setting codes can facilitate comparative analyses. Qualitative inquiry can improve the description and explanation of complex, real-world phenomena pertinent to health services research. Greater understanding of the processes of qualitative data analysis can be helpful for health services researchers as they use these methods themselves or collaborate with qualitative researchers from a wide range of disciplines.

Genetic drift. Overview of German, Nazi, and Holocaust medicine.

PubMed

Cohen, M Michael

2010-03-01

An overview of German, Nazi, and Holocaust medicine brings together a group of subjects discussed separately elsewhere. Topics considered include German medicine before and during the Nazi era, such as advanced concepts in epidemiology, preventive medicine, public health policy, screening programs, occupational health laws, compensation for certain medical conditions, and two remarkable guidelines for informed consent for medical procedures; also considered are the Nuremberg Code; American models for early Nazi programs, including compulsory sterilization, abusive medical experiments on prison inmates, and discrimination against black people; two ironies in US and Nazi laws; social Darwinism and racial hygiene; complicity of Nazi physicians, including the acts of sterilization, human experimentation, and genocide; Nazi persecution of Jewish physicians; eponyms of unethical German physicians with particular emphasis on Reiter, Hallervorden, and Pernkopf; eponyms of famous physicians who were Nazi victims, including Pick and van Creveld; and finally, a recommendation for convening an international committee of physicians and ethicists to deal with five issues: (a) to propose alternative names for eponyms of physicians who exhibited complicity during the Nazi era; (b) to honor the eponyms and stories of physicians who were victims of Nazi atrocities and genocide; (c) to apply vigorous pressure to those German and Austrian Institutes that have not yet undertaken investigations to determine if the bodies of Nazi victims remain in their collections; (d) to recommend holding annual commemorations in medical schools and research institutes worldwide to remember and to reflect on the victims of compromised medical practice, particularly, but not exclusively, during the Nazi era because atrocities and acts of genocide have occurred elsewhere; and (e) to examine the influence of any political ideology that compromises the practice of medicine. (c) 2010 Wiley-Liss, Inc

[New forms of medical profession--advertising].

PubMed

Wolter, Udo

2005-04-01

Particularly in the last two years, the legislation of Part V of the German Social Code has challenged the time-honoured system of the physician's own medical practice as the panel doctor's registered office. New forms of outpatient care, for example the health centres, "Heilkunde-GmbHs", and the recently-developed medical care centres, are intended to impact on patients' ambulatory healthcare. Due to the partial employee status of practice owners, and thus the relinquishing of the independent entrepreneurial structuring of their own practices, the construct of the traditional professional code of conduct for physicians is beginning to totter. It remains to be seen whether liberalisation of the model code of conduct will provide a remedy. The principle should, however, be adhered to that advertising in the physician sector must not be unethical, if we understand this to mean not strident, not confusing, and not comparative.

Intercoder Reliability of Mapping Between Pharmaceutical Dose Forms in the German Medication Plan and EDQM Standard Terms.

PubMed

Sass, Julian; Becker, Kim; Ludmann, Dominik; Pantazoglou, Elisabeth; Dewenter, Heike; Thun, Sylvia

2018-01-01

A nationally uniform medication plan has recently been part of German legislation. The specification for the German medication plan was developed in cooperation between various stakeholders of the healthcare system. Its' goal is to enhance usability and interoperability while also providing patients and physicians with the necessary information they require for a safe and high-quality therapy. Within the research and development project named Medication Plan PLUS, the specification of the medication plan was tested and reviewed for semantic interoperability in particular. In this study, the list of pharmaceutical dose forms provided in the specification was mapped to the standard terms of the European Directorate for the Quality of Medicines & HealthCare by different coders. The level of agreement between coders was calculated using Cohen's Kappa (κ). Results show that less than half of the dose forms could be coded with EDQM standard terms. In addition to that Kappa was found to be moderate, which means rather unconvincing agreement among coders. In conclusion, there is still vast room for improvement in utilization of standardized international vocabulary and unused potential considering cross-border eHealth implementations in the future.

[Medicolegal aspects of doping in sports].

PubMed

Pruvost, J; Depiesse, F

2004-08-01

To investigate the medico-legal aspects of national and international procedures for monitoring prescription drug use by competing athletes. We studied the French law No. 99-223 of March 23, 1999, relating to the protection of the health of athletes? We also studied annual statistics from the Ministry of Sports concerning anti-doping controls, substances detected by the National Doping Control Laboratory and penalties applied since 2000, as well as the World Anti-Doping Code, which came into effect on January 1, 2004, and should be universally applied by 2006. Athletes registered with a federation or unregistered athletes taking part in competitions approved by sporting federations can use prescription drugs but must follow strict rules. Athletes under investigation for drug use must declare all drugs or products recently taken. The use of prescription drugs not on the list of the prohibited substances is allowed, but evidence of the use of such drugs is the responsibility of the prescriber. A medical practitioner in France who considers it essential to prescribe prohibited drugs or drugs under certain restrictions must systematically inform the athlete about the regulations by providing various certificates and forms. For international athletes, a form authorizing therapeutic use must be submitted to the validation committee of the applicable international federation. Disciplinary, ordinal and penal sanctions are also described. Prescription drug use by an athlete is never a light matter and always engages the responsibility of the doctor. Anti-doping controls and sanctions encourage physicians to comply scrupulously with the medico-legal rules set forth by the public health code and the world anti-doping code.

Elastic SCAD as a novel penalization method for SVM classification tasks in high-dimensional data.

PubMed

Becker, Natalia; Toedt, Grischa; Lichter, Peter; Benner, Axel

2011-05-09

Classification and variable selection play an important role in knowledge discovery in high-dimensional data. Although Support Vector Machine (SVM) algorithms are among the most powerful classification and prediction methods with a wide range of scientific applications, the SVM does not include automatic feature selection and therefore a number of feature selection procedures have been developed. Regularisation approaches extend SVM to a feature selection method in a flexible way using penalty functions like LASSO, SCAD and Elastic Net.We propose a novel penalty function for SVM classification tasks, Elastic SCAD, a combination of SCAD and ridge penalties which overcomes the limitations of each penalty alone.Since SVM models are extremely sensitive to the choice of tuning parameters, we adopted an interval search algorithm, which in comparison to a fixed grid search finds rapidly and more precisely a global optimal solution. Feature selection methods with combined penalties (Elastic Net and Elastic SCAD SVMs) are more robust to a change of the model complexity than methods using single penalties. Our simulation study showed that Elastic SCAD SVM outperformed LASSO (L1) and SCAD SVMs. Moreover, Elastic SCAD SVM provided sparser classifiers in terms of median number of features selected than Elastic Net SVM and often better predicted than Elastic Net in terms of misclassification error.Finally, we applied the penalization methods described above on four publicly available breast cancer data sets. Elastic SCAD SVM was the only method providing robust classifiers in sparse and non-sparse situations. The proposed Elastic SCAD SVM algorithm provides the advantages of the SCAD penalty and at the same time avoids sparsity limitations for non-sparse data. We were first to demonstrate that the integration of the interval search algorithm and penalized SVM classification techniques provides fast solutions on the optimization of tuning parameters.The penalized SVM classification algorithms as well as fixed grid and interval search for finding appropriate tuning parameters were implemented in our freely available R package 'penalizedSVM'.We conclude that the Elastic SCAD SVM is a flexible and robust tool for classification and feature selection tasks for high-dimensional data such as microarray data sets.

Elastic SCAD as a novel penalization method for SVM classification tasks in high-dimensional data

PubMed Central

2011-01-01

Background Classification and variable selection play an important role in knowledge discovery in high-dimensional data. Although Support Vector Machine (SVM) algorithms are among the most powerful classification and prediction methods with a wide range of scientific applications, the SVM does not include automatic feature selection and therefore a number of feature selection procedures have been developed. Regularisation approaches extend SVM to a feature selection method in a flexible way using penalty functions like LASSO, SCAD and Elastic Net. We propose a novel penalty function for SVM classification tasks, Elastic SCAD, a combination of SCAD and ridge penalties which overcomes the limitations of each penalty alone. Since SVM models are extremely sensitive to the choice of tuning parameters, we adopted an interval search algorithm, which in comparison to a fixed grid search finds rapidly and more precisely a global optimal solution. Results Feature selection methods with combined penalties (Elastic Net and Elastic SCAD SVMs) are more robust to a change of the model complexity than methods using single penalties. Our simulation study showed that Elastic SCAD SVM outperformed LASSO (L1) and SCAD SVMs. Moreover, Elastic SCAD SVM provided sparser classifiers in terms of median number of features selected than Elastic Net SVM and often better predicted than Elastic Net in terms of misclassification error. Finally, we applied the penalization methods described above on four publicly available breast cancer data sets. Elastic SCAD SVM was the only method providing robust classifiers in sparse and non-sparse situations. Conclusions The proposed Elastic SCAD SVM algorithm provides the advantages of the SCAD penalty and at the same time avoids sparsity limitations for non-sparse data. We were first to demonstrate that the integration of the interval search algorithm and penalized SVM classification techniques provides fast solutions on the optimization of tuning parameters. The penalized SVM classification algorithms as well as fixed grid and interval search for finding appropriate tuning parameters were implemented in our freely available R package 'penalizedSVM'. We conclude that the Elastic SCAD SVM is a flexible and robust tool for classification and feature selection tasks for high-dimensional data such as microarray data sets. PMID:21554689

Should Lifestyles Be a Criterion for Healthcare Rationing? Evidence from a Portuguese Survey.

PubMed

Borges, Ana Pinto; Pinho, Micaela

2017-11-18

We evaluated whether different personal responsibilities should influence the allocation healthcare resources and whether attitudes toward the penalization of risk behaviours vary among individual's sociodemographic characteristics and health related habits. A cross-sectional study. We developed an online survey and made it available on various social networks for six months, during 2015. The sample covered the population aged 18 yr and older living in Portugal and we got 296 valid answers. Respondents faced four lifestyle choices: smoking, consumption of alcoholic beverages, unhealthy diet and illegal drug use, and should decide whether each one is relevant when establishing healthcare priorities. Logistic regressions were used to explore the relation of respondents' sociodemographic characteristics and health related behaviours in the likelihood of agreeing with the patients engaged in risky behaviour deserve a lower priority. Using illegal drugs was the behaviour most penalized (65.5%) followed by heavy drinkers (61.5%) and smoking (51.0%). The slight penalization was the unhealthy dieting (29.7%). The sociodemographic characteristics had different impact in penalization of the risks' behaviours. Moreover, the respondents who support the idea that unhealthy lifestyles should have a lower priority, all strongly agreed that the smoking habit (OR=36.05; 95% CI: 8.72, 149.12), the unhealthy diets (OR=12.87; 95% CI: 3.21, 51.53), drink alcohol in excess (OR=20.51; 95% CI: 12.09, 85.46) and illegal drug use (OR=73.21; 95% CI: 9.78, 97.83) must have a lower priority in the access to healthcare. The respondents accept the notion of rationing healthcare based on lifestyles.

Penalized discriminant analysis for the detection of wild-grown and cultivated Ganoderma lucidum using Fourier transform infrared spectroscopy.

PubMed

Zhu, Ying; Tan, Tuck Lee

2016-04-15

An effective and simple analytical method using Fourier transform infrared (FTIR) spectroscopy to distinguish wild-grown high-quality Ganoderma lucidum (G. lucidum) from cultivated one is of essential importance for its quality assurance and medicinal value estimation. Commonly used chemical and analytical methods using full spectrum are not so effective for the detection and interpretation due to the complex system of the herbal medicine. In this study, two penalized discriminant analysis models, penalized linear discriminant analysis (PLDA) and elastic net (Elnet),using FTIR spectroscopy have been explored for the purpose of discrimination and interpretation. The classification performances of the two penalized models have been compared with two widely used multivariate methods, principal component discriminant analysis (PCDA) and partial least squares discriminant analysis (PLSDA). The Elnet model involving a combination of L1 and L2 norm penalties enabled an automatic selection of a small number of informative spectral absorption bands and gave an excellent classification accuracy of 99% for discrimination between spectra of wild-grown and cultivated G. lucidum. Its classification performance was superior to that of the PLDA model in a pure L1 setting and outperformed the PCDA and PLSDA models using full wavelength. The well-performed selection of informative spectral features leads to substantial reduction in model complexity and improvement of classification accuracy, and it is particularly helpful for the quantitative interpretations of the major chemical constituents of G. lucidum regarding its anti-cancer effects. Copyright © 2016 Elsevier B.V. All rights reserved.

Folded concave penalized learning in identifying multimodal MRI marker for Parkinson’s disease

PubMed Central

Liu, Hongcheng; Du, Guangwei; Zhang, Lijun; Lewis, Mechelle M.; Wang, Xue; Yao, Tao; Li, Runze; Huang, Xuemei

2016-01-01

Background Brain MRI holds promise to gauge different aspects of Parkinson’s disease (PD)-related pathological changes. Its analysis, however, is hindered by the high-dimensional nature of the data. New method This study introduces folded concave penalized (FCP) sparse logistic regression to identify biomarkers for PD from a large number of potential factors. The proposed statistical procedures target the challenges of high-dimensionality with limited data samples acquired. The maximization problem associated with the sparse logistic regression model is solved by local linear approximation. The proposed procedures then are applied to the empirical analysis of multimodal MRI data. Results From 45 features, the proposed approach identified 15 MRI markers and the UPSIT, which are known to be clinically relevant to PD. By combining the MRI and clinical markers, we can enhance substantially the specificity and sensitivity of the model, as indicated by the ROC curves. Comparison to existing methods We compare the folded concave penalized learning scheme with both the Lasso penalized scheme and the principle component analysis-based feature selection (PCA) in the Parkinson’s biomarker identification problem that takes into account both the clinical features and MRI markers. The folded concave penalty method demonstrates a substantially better clinical potential than both the Lasso and PCA in terms of specificity and sensitivity. Conclusions For the first time, we applied the FCP learning method to MRI biomarker discovery in PD. The proposed approach successfully identified MRI markers that are clinically relevant. Combining these biomarkers with clinical features can substantially enhance performance. PMID:27102045

Evaluating penalized logistic regression models to predict Heat-Related Electric grid stress days

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

Bramer, L. M.; Rounds, J.; Burleyson, C. D.

Understanding the conditions associated with stress on the electricity grid is important in the development of contingency plans for maintaining reliability during periods when the grid is stressed. In this paper, heat-related grid stress and the relationship with weather conditions is examined using data from the eastern United States. Penalized logistic regression models were developed and applied to predict stress on the electric grid using weather data. The inclusion of other weather variables, such as precipitation, in addition to temperature improved model performance. Several candidate models and datasets were examined. A penalized logistic regression model fit at the operation-zone levelmore » was found to provide predictive value and interpretability. Additionally, the importance of different weather variables observed at different time scales were examined. Maximum temperature and precipitation were identified as important across all zones while the importance of other weather variables was zone specific. The methods presented in this work are extensible to other regions and can be used to aid in planning and development of the electrical grid.« less

Evaluating penalized logistic regression models to predict Heat-Related Electric grid stress days

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

Bramer, Lisa M.; Rounds, J.; Burleyson, C. D.

Understanding the conditions associated with stress on the electricity grid is important in the development of contingency plans for maintaining reliability during periods when the grid is stressed. In this paper, heat-related grid stress and the relationship with weather conditions were examined using data from the eastern United States. Penalized logistic regression models were developed and applied to predict stress on the electric grid using weather data. The inclusion of other weather variables, such as precipitation, in addition to temperature improved model performance. Several candidate models and combinations of predictive variables were examined. A penalized logistic regression model which wasmore » fit at the operation-zone level was found to provide predictive value and interpretability. Additionally, the importance of different weather variables observed at various time scales were examined. Maximum temperature and precipitation were identified as important across all zones while the importance of other weather variables was zone specific. In conclusion, the methods presented in this work are extensible to other regions and can be used to aid in planning and development of the electrical grid.« less

A Selective Overview of Variable Selection in High Dimensional Feature Space

PubMed Central

Fan, Jianqing

2010-01-01

High dimensional statistical problems arise from diverse fields of scientific research and technological development. Variable selection plays a pivotal role in contemporary statistical learning and scientific discoveries. The traditional idea of best subset selection methods, which can be regarded as a specific form of penalized likelihood, is computationally too expensive for many modern statistical applications. Other forms of penalized likelihood methods have been successfully developed over the last decade to cope with high dimensionality. They have been widely applied for simultaneously selecting important variables and estimating their effects in high dimensional statistical inference. In this article, we present a brief account of the recent developments of theory, methods, and implementations for high dimensional variable selection. What limits of the dimensionality such methods can handle, what the role of penalty functions is, and what the statistical properties are rapidly drive the advances of the field. The properties of non-concave penalized likelihood and its roles in high dimensional statistical modeling are emphasized. We also review some recent advances in ultra-high dimensional variable selection, with emphasis on independence screening and two-scale methods. PMID:21572976

Orthogonalizing EM: A design-based least squares algorithm

PubMed Central

Xiong, Shifeng; Dai, Bin; Huling, Jared; Qian, Peter Z. G.

2016-01-01

We introduce an efficient iterative algorithm, intended for various least squares problems, based on a design of experiments perspective. The algorithm, called orthogonalizing EM (OEM), works for ordinary least squares and can be easily extended to penalized least squares. The main idea of the procedure is to orthogonalize a design matrix by adding new rows and then solve the original problem by embedding the augmented design in a missing data framework. We establish several attractive theoretical properties concerning OEM. For the ordinary least squares with a singular regression matrix, an OEM sequence converges to the Moore-Penrose generalized inverse-based least squares estimator. For ordinary and penalized least squares with various penalties, it converges to a point having grouping coherence for fully aliased regression matrices. Convergence and the convergence rate of the algorithm are examined. Finally, we demonstrate that OEM is highly efficient for large-scale least squares and penalized least squares problems, and is considerably faster than competing methods when n is much larger than p. Supplementary materials for this article are available online. PMID:27499558

Evaluating penalized logistic regression models to predict Heat-Related Electric grid stress days

DOE PAGES

Bramer, Lisa M.; Rounds, J.; Burleyson, C. D.; ...

2017-09-22

Understanding the conditions associated with stress on the electricity grid is important in the development of contingency plans for maintaining reliability during periods when the grid is stressed. In this paper, heat-related grid stress and the relationship with weather conditions were examined using data from the eastern United States. Penalized logistic regression models were developed and applied to predict stress on the electric grid using weather data. The inclusion of other weather variables, such as precipitation, in addition to temperature improved model performance. Several candidate models and combinations of predictive variables were examined. A penalized logistic regression model which wasmore » fit at the operation-zone level was found to provide predictive value and interpretability. Additionally, the importance of different weather variables observed at various time scales were examined. Maximum temperature and precipitation were identified as important across all zones while the importance of other weather variables was zone specific. In conclusion, the methods presented in this work are extensible to other regions and can be used to aid in planning and development of the electrical grid.« less

Debating Sex: Education Films and Sexual Morality for the Young in Post-War Germany, 1945-1955.

PubMed

Winkler, Anita

2015-01-01

After 1945 rapidly climbing figures of venereal disease infections menaced the health of the war-ridden German population. Physicians sought to gain control over this epidemic and initiated large-scale sex education campaigns to inform people about identification, causes and treatment of VD and advised them on appropriate moral sexual behaviour as a prophylactic measure. Film played a crucial role in these campaigns. As mass medium it was believed film could reach out to large parts of society and quickly disseminate sexual knowledge and moral codes of conduct amongst the population. This essay discusses the transition of the initial central role of sex education films in the fight against venereal disease in the immediate post-war years towards a more critical stance as to the effects of cinematographic education of the young in an East and West German context.

Sozialindex für Grundschulen in Mülheim an der Ruhr. Ansatz einer datengestützten bedarfsgerechten Ressourcenverteilung

NASA Astrophysics Data System (ADS)

Groos, Thomas

2016-12-01

The German school system is socially highly unequal, as educational research criticized for a long time. While in some schools socially privileged pupils are the majority, other schools are composed by mostly poor pupils. The combination of socio-geographic and educational geographic considerations leads to a social school index, which clearly shows how strong schools are socially privileged or disadvantaged. The paper presents a practical example of building a social school index for cities and compares the results. The residence-based density index on grid data from German Social Code (book 2) is preferred because it is unproblematic in terms of data protection law and can be extended at the level of 100 × 100 m grids. Calculating detailed and differentiated social school indices with school enrollment data leads to very good results, but is much more work.

Debating Sex: Education Films and Sexual Morality for the Young in post-War Germany, 1945-55

PubMed Central

Winkler, Anita

2015-01-01

Summary After 1945 rapidly climbing figures of venereal disease infections menaced the health of the war-ridden German population. Physicians sought to gain control over this epidemic and initiated large-scale sex education campaigns to inform people about identification, causes and treatment of VD and advised them on appropriate moral sexual behaviour as a prophylactic measure. Film played a crucial role in these campaigns. As mass medium it was believed film could reach out to large parts of society and quickly disseminate sexual knowledge and moral codes of conduct amongst the population. This essay discusses the transition of the initial central role of sex education films in the fight against venereal disease in the immediate post-war years towards a more critical stance as to the effects of cinematographic education of the young in an East and West German context. PMID:26403056

Simulation of German PKL refill/reflood experiment K9A using RELAP4/MOD7. [PWR

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

Hsu, M.T.; Davis, C.B.; Behling, S.R.

This paper describes a RELAP4/MOD7 simulation of West Germany's Kraftwerk Union (KWU) Primary Coolant Loop (PKL) refill/reflood experiment K9A. RELAP4/MOD7, a best-estimate computer program for the calculation of thermal and hydraulic phenomena in a nuclear reactor or related system, is the latest version in the RELAP4 code development series. This study was the first major simulation using RELAP4/MOD7 since its release by the Idaho National Engineering Laboratory (INEL). The PKL facility is a reduced scale (1:134) representation of a typical West German four-loop 1300 MW pressurized water reactor (PWR). A prototypical scale of the total volume to power ratio wasmore » maintained. The test facility was designed specifically for an experiment simulating the refill/reflood phase of a Loss-of-Coolant Accident (LOCA).« less

State-of-the-art in biosafety and biosecurity in European countries.

PubMed

Bielecka, Anna; Mohammadi, Ali Akbar

2014-06-01

The terms biosafety and biosecurity are widely used in different concepts and refer not only to protection of human beings and their surrounding environment against hazardous biological agent, but also to global disarmament of weapons of mass destruction. As a result, the biosafety and biosecurity issues should be considered interdisciplinary based on multilateral agreements against proliferation of biological weapons, public health and environmental protection. This publication presents information on both, international and national biosafety and biosecurity legislation. Status of national implementation of the Biological and Toxin Weapons Convention, penalization issues and measures to account for and secure production, use, storage of particularly dangerous pathogens or activities involving humans, plants and animals where infection may pose a risk have been analyzed. Safety and security measures in laboratories have been studied. Moreover, dual-use technology and measures of secure transport of biohazard materials have been also taken into account. In addition, genetic engineering regulations, biosecurity activities in laboratories and code of conducts have been investigated, as well.

[Possibilities of medical opinionating in cases associated with "exposure to direct danger of death or serious health damage"].

PubMed

Konopka, Tomasz; Skupień, Elzbieta

2008-01-01

In the opinion of some forensic medicine experts, assessment of potential consequences in keeping with Article 160 of the Polish Penal code, which refers to the crime of "exposure to direct danger of death or severe health damage", lies within the competence of medicolegal specialists. This view is accepted by courts and prosecution offices. However, the knowledge of physicians in the field of predicting consequences which did not occur is only somewhat better than that of lawyers. In simple cases, e.g. in trauma involving a sensitive area of the body, passing an opinion confirming a serious danger is not associated with any major problems. Similarly, no problems arise when passing an opinion on the lack of such a danger e.g. in the case of traumawithout any injuries. In complex cases, however, which include the majority of medical error cases, passing an opinion on exposure to direct danger of death or severe health damage may be not feasible.

[The discussion on induced abortion in the Brazilian Congress: the role of the women's movement

PubMed

Hardy; Rebello

1996-04-01

Induced abortion has been discussed in Brazil for many years without producing changes in the Penal Code in force since 1940 and according to which it is illegal and a crime against life. There are only two circumstances in which induced abortion is allowed: when there is no other recourse for saving the pregnant woman' life, and when the pregnancy resulted from rape and the abortion is preceded by the woman's informed consent. The purpose of this article is to show how the abortion problem has been dealt with under executive and legislative policies, focusing especially on discussion in Congress considering the role of organized women's groups. The study focuses on the legislative debate on induced abortion and how it was preceded, accompanied, and followed by actions by the women's groups. Other political and social actors involved in the debate, such as the Catholic Church, sectors of the medical community, and protestant religions are mentioned.

Brief notes on the portuguese criminal regime of homicide upon request of the victim and physician assisted suicide.

PubMed

Moreira, Sara Leitão

2013-12-01

Society is changing at an unprecedented rate. Several areas of knowledge are evolving on a daily basis, namely medicine and connected sciences. Hence it is needed that the legislator walks at least right behind this evolution, in order not to be considered retrograde. One of the areas that need the constant attention of the legislator is medicine, as far as prolonging life is considered. We have witnessed several cases along the decades of people who are not living a long and healthy life, but rather just a long life, with little quality in it. Therefore, it is also known that issues such as euthanasia have been discussed at several levels. Criminal law, in most countries, namely in Portugal, does not admit any type of euthanasia. We will briefly analyse the two Articles in the Portuguese Penal Code concerning this matter, in order to come to the conclusion of its pertinence and adequacy to today's society.

Old age as an "alternative" to illness: gerontological and medico-legal aspects.

PubMed

Molinelli, Andrea; Viale, Laura; Landolfa, Maria Celeste; De Stefano, Francesco

2011-04-01

The current trend toward an ever increasing aging population forces society to face the problem of how to care for elderly people who are exposed to the risk of so-called "elder abuse," a phenomenon becoming increasingly widespread in Italy, as legislation does not provide a precise juridical definition of "elderly" nor does it provide for their specific protection. From a geriatric and medico-legal point of view, it is difficult to assess the cognitive performance of elderly individuals due to a number of factors, including the lack of evaluation tools with well-defined reference parameters for assessing decision-making capacities. Nonetheless, according to Italian penal code, abandoning a person incapable of self-support due to old age is considered a violation of the obligation of family assistance. Just as in the USA, which has instituted the Adult Protective Services, the Authors propose that the local health authorities provide help desks for the victims of elder abuse in Italy.

Intervention of the hospital midwife in the case of a pregnant women who had undergone female genital mutilation. A case study.

PubMed

Díaz-Jiménez, Désirée; Rodríguez-Villalón, Marta; Moreno-Dueñas, María Begoña

Female genital mutilation, condemned by all UN member countries has spread throughout the world as a result of migratory flows and is practiced under the guise of a custom, tradition or culture. In Spain, it is punishable as a personal injury offence under the current penal code. A clinical case study reviewedthe main actions of the midwife in this kind of injury in a pregnant woman during labour. The data collected from the physical examination and the midwife's assessment according to the Virginia Henderson model are presented and a complete care plan developed. From the case it can be concluded that in the hospital area, midwives can and should reinforce and complete the work with these women and their families, of informing, educating and reinforcing the decision not to mutilate. This work should have been started in, the health centre. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

[Bioethics in Peru].

PubMed

Zuloaga, R L

1990-01-01

Bioethics has still not acquired an identity of its own in Peru. The Ethics Committee of the Peruvian Medical School and the National AIDS Commission are review committees that deal with ethical problems arising in practice. Doubts regarding quality control of the drugs being tested have been raised in research on human subjects. Questions related to reproduction are very important. There is a high incidence of adolescent pregnancies, and illegal abortions result in many deaths and hospitalizations of women in serious condition. Birth control methods, such as vasectomy, conflict with attitudes about manhood in Peruvian society. Euthanasia is prohibited by the Ethical Code of the Peruvian Medical School, and legislation penalizes assisted suicide. Organ transplantation is hindered by concerns over early declaration of death. Handicapped children are often rejected by society owing to an absurd belief in the possibility that disorders such as Down's syndrome are contagious. The Ministry of Health requires state hospitals to accept AIDS patients, but instances of rejection are still reported.

Regulation of sexuality in Indonesian discourse: normative gender, criminal law and shifting strategies of control.

PubMed

Blackwood, Evelyn

2007-01-01

This paper examines changes in the regulation of sexuality in Indonesia in the period since 1980 as seen through state, religious and lesbian and gay activist discourses on sexuality. Three different eras during that period of Indonesian history are compared. Under the New Order regime of Suharto, the Indonesian state sought to control sexuality through a deployment of gender. During the 1990s, state Islamic discourses of sexuality shifted in response to international pressures to support same-sex marriage and sexual rights. During the third period following the end of the Suharto regime in 1998, a conservative Islamic minority pushed for more restrictive laws in the State Penal Code, initiating intense public debate on the role of the state in questions of sexuality and morality. Over this time period, the dominant discourse on sexuality moved from strategically linking normative gender with heterosexuality and marriage to direct attempts to legislate heterosexual marriage by criminalizing a wide range of sexual practices.

Limited utility of residue masking for positive-selection inference.

PubMed

Spielman, Stephanie J; Dawson, Eric T; Wilke, Claus O

2014-09-01

Errors in multiple sequence alignments (MSAs) can reduce accuracy in positive-selection inference. Therefore, it has been suggested to filter MSAs before conducting further analyses. One widely used filter, Guidance, allows users to remove MSA positions aligned with low confidence. However, Guidance's utility in positive-selection inference has been disputed in the literature. We have conducted an extensive simulation-based study to characterize fully how Guidance impacts positive-selection inference, specifically for protein-coding sequences of realistic divergence levels. We also investigated whether novel scoring algorithms, which phylogenetically corrected confidence scores, and a new gap-penalization score-normalization scheme improved Guidance's performance. We found that no filter, including original Guidance, consistently benefitted positive-selection inferences. Moreover, all improvements detected were exceedingly minimal, and in certain circumstances, Guidance-based filters worsened inferences. © The Author 2014. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

THE DiskMass SURVEY. III. STELLAR KINEMATICS VIA CROSS-CORRELATION

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

Westfall, Kyle B.; Bershady, Matthew A.; Verheijen, Marc A. W., E-mail: westfall@astro.rug.nl, E-mail: mab@astro.wisc.edu, E-mail: verheyen@astro.rug.nl

2011-03-15

We describe a new cross-correlation (CC) approach used by our survey to derive stellar kinematics from galaxy-continuum spectroscopy. This approach adopts the formal error analysis derived by Statler, but properly handles spectral masks. Thus, we address the primary concerns regarding application of the CC method to censored data, while maintaining its primary advantage by consolidating kinematic and template-mismatch information toward different regions of the CC function. We identify a systematic error in the nominal CC method of approximately 10% in velocity dispersion incurred by a mistreatment of detector-censored data, which is eliminated by our new method. We derive our approachmore » from first principles, and we use Monte Carlo simulations to demonstrate its efficacy. An identical set of Monte Carlo simulations performed using the well-established penalized-pixel-fitting code of Cappellari and Emsellem compares favorably with the results from our newly implemented software. Finally, we provide a practical demonstration of this software by extracting stellar kinematics from SparsePak spectra of UGC 6918.« less

A 2-step penalized regression method for family-based next-generation sequencing association studies.

PubMed

Ding, Xiuhua; Su, Shaoyong; Nandakumar, Kannabiran; Wang, Xiaoling; Fardo, David W

2014-01-01

Large-scale genetic studies are often composed of related participants, and utilizing familial relationships can be cumbersome and computationally challenging. We present an approach to efficiently handle sequencing data from complex pedigrees that incorporates information from rare variants as well as common variants. Our method employs a 2-step procedure that sequentially regresses out correlation from familial relatedness and then uses the resulting phenotypic residuals in a penalized regression framework to test for associations with variants within genetic units. The operating characteristics of this approach are detailed using simulation data based on a large, multigenerational cohort.

Disease-Specific Trends of Comorbidity Coding and Implications for Risk Adjustment in Hospital Administrative Data.

PubMed

Nimptsch, Ulrike

2016-06-01

To investigate changes in comorbidity coding after the introduction of diagnosis related groups (DRGs) based prospective payment and whether trends differ regarding specific comorbidities. Nationwide administrative data (DRG statistics) from German acute care hospitals from 2005 to 2012. Observational study to analyze trends in comorbidity coding in patients hospitalized for common primary diseases and the effects on comorbidity-related risk of in-hospital death. Comorbidity coding was operationalized by Elixhauser diagnosis groups. The analyses focused on adult patients hospitalized for the primary diseases of heart failure, stroke, and pneumonia, as well as hip fracture. When focusing the total frequency of diagnosis groups per record, an increase in depth of coding was observed. Between-hospital variations in depth of coding were present throughout the observation period. Specific comorbidity increases were observed in 15 of the 31 diagnosis groups, and decreases in comorbidity were observed for 11 groups. In patients hospitalized for heart failure, shifts of comorbidity-related risk of in-hospital death occurred in nine diagnosis groups, in which eight groups were directed toward the null. Comorbidity-adjusted outcomes in longitudinal administrative data analyses may be biased by nonconstant risk over time, changes in completeness of coding, and between-hospital variations in coding. Accounting for such issues is important when the respective observation period coincides with changes in the reimbursement system or other conditions that are likely to alter clinical coding practice. © Health Research and Educational Trust.

[New legal regulations for palliative care with implications for politics and practice].

PubMed

Melching, Heiner

2017-01-01

In December 2015 two different laws were adopted. Both are of importance for palliative care. One of the laws criminalizes commercial, "business-like" assisted suicide (§ 217 German Criminal Code), the other one aims to improve hospice and palliative care in Germany. Through the latter far-reaching changes in Social Code Books V and XI, as well as of the Hospital Finance Act have been made. This new Act to Improve Hospice and Palliative Care (HPG) focuses, amongst others, on: (a) Better funding of hospice services, by raising the minimum grant for patients in inpatient hospices paid per day by the health insurance funds by about 28.5%, and for outpatient hospice services by about 18%; (b) further development of general outpatient nursing and medical palliative care, and the networking of different service providers; (c) introduction of an arbitration procedure for service provider agreements to be concluded between the health insurance funds and the teams providing specialized home palliative care (SAPV); (d) the right to individual advice and support by the health insurance funds; (e) care homes may offer their residents advance care planning programs to be funded by the statutory health insurers; (f) palliative care units in hospitals can be remunerated outside the DRG system by per diem rates; (g) separate funding and criteria for multi-professional palliative care services within a hospital.While little concrete impact on hospice and palliative care can be expected following the new § 217 German Criminal Code, the HPG provides a good basis to improve care. For this purpose, however, which complementary and more concrete agreements are made to put the new legal regulations into practice will be crucial.

Towards a Certified Lightweight Array Bound Checker for Java Bytecode

NASA Technical Reports Server (NTRS)

Pichardie, David

2009-01-01

Dynamic array bound checks are crucial elements for the security of a Java Virtual Machines. These dynamic checks are however expensive and several static analysis techniques have been proposed to eliminate explicit bounds checks. Such analyses require advanced numerical and symbolic manipulations that 1) penalize bytecode loading or dynamic compilation, 2) complexify the trusted computing base. Following the Foundational Proof Carrying Code methodology, our goal is to provide a lightweight bytecode verifier for eliminating array bound checks that is both efficient and trustable. In this work, we define a generic relational program analysis for an imperative, stackoriented byte code language with procedures, arrays and global variables and instantiate it with a relational abstract domain as polyhedra. The analysis has automatic inference of loop invariants and method pre-/post-conditions, and efficient checking of analysis results by a simple checker. Invariants, which can be large, can be specialized for proving a safety policy using an automatic pruning technique which reduces their size. The result of the analysis can be checked efficiently by annotating the program with parts of the invariant together with certificates of polyhedral inclusions. The resulting checker is sufficiently simple to be entirely certified within the Coq proof assistant for a simple fragment of the Java bytecode language. During the talk, we will also report on our ongoing effort to scale this approach for the full sequential JVM.

Comparison of Turkish Injury Scale (TIS) with the Abbreviated Injury Scale (AIS).

PubMed

Günay, Yasemin; Yavuz, M Fatih; Eşiyok, Burcu

2003-03-12

According to the Turkish Penal Code, Section 456, an assailant is punished in a correlation to the severity of the victim's injury. In this study, the injury scale used in Turkey in the basis code 456 is compared with Abbreviated Injury Scale (AIS). For this aim, a total of 984 cases out of the total amount reported at the Traumatology Section of the Turkish Council for Forensic Medicine were randomly selected and evaluated retrospectively. In all, 40.7% of injuries were caused by blunt trauma, whereas 59.3% were caused by a penetrating trauma. According to the Turkish Injury Scale (TIS), 40.3% of the cases were scored to be of a first degree of injury, 15.6% as second degree and 44.1% as third degree. When compared, the score points 3, 4 and 5 in the AIS were seen to be nearly equivalent to the TIS of third degree. From this point of view, in the modified AIS 91.1% of first degree of injury, 51.2% of second degree and 97.2% of third degree of injury are harmonious with TIS. Generally, 83.2% of the cases are harmonious with the AIS system. The purpose of this study is to determine what was the source of differences and to focus on particular traumatic lesions in order to determine a possible rearrangement of the Turkish Injury Scale.

[An assessment tool for analysing the early vocal development of young children with cochlear implant].

PubMed

Lang, S; Leistner, S; Sandrieser, P; Kröger, B J

2009-05-01

Early vocal development of German-speaking cochlear implant recipients has rarely been assessed so far. There-fore the purpose of this study was to describe the early vocal development following successful implantation. A case study was designed to assess the temporal progression of early vocal development in a young cochlear implant recipient who was bilaterally implanted at the age of 8;3 months. Data were collected during one year by recording parent-child interactions on a monthly basis. The first recording was made before the onset of the signal-processors, the 12 following recordings were made during the first year of implant use. The child's vocalizations were classified according to the vocalization categories and developmental levels from the Stark Assessment of Early Vocal Development--Revised (SAEVD-R). This assessment tool was translated into German in this study and used with German-speaking children for the first time. It allows a coding of prelinguistic utterances via auditory perceptual analysis. The results show an overall decrease of early vocalizations and an increase of speech-like vowels and consonants. In the first six months no apparent progress took place; The child produced almost exclusively vocalizations from Levels 1-3. In the second half of the year an increase of canonical utterances (Level 4) and advanced forms (Level 5) was observed. However, vocalizations beyond the canonical babbling phase, especially vocants and closants as well as their combinations, continued to be dominant throughout the first year of implant use. The progress of development of the child investigated in this study is comparable to other children implanted at young age who had also been assessed with the SAEVD-R. In comparison to normal-hearing children, the implanted child's development seemed to progress slightly faster. Interrater- and intrarater-reliability using the SAEVD-R were measured for two independent observers and for a first and second coding procedure and revealed to be acceptable to good. The use of SAEVD-R for an implanted German-speaking child allowed the investigation of prelinguistic vocal development before the onset of words. The fact that early vocalizations remain the dominant form throughout the first year of hearing experience emphasizes the importance of documenting and analysing prelinguistic vocal development in order to monitor progression of speech acquisition.

Texas Studies in Bilingualism. Spanish, French, German, Czech, Polish, Sorbian, and Norwegian in the Southwest. (With a Concluding Chapter on Code-Switching and Modes of Speaking in American Swedish.) Studia Linguistica Germanica.

ERIC Educational Resources Information Center

Gilbert, Glenn G., Ed.

This book contains studies of seven non-English languages spoken in Texas, Oklahoma and Louisiana, as well as a final chapter based on data obtained from Swedish-English bilinguals in Massachusetts, Illinois, and Minnesota. The individual studies are: Lurline H. Coltharp, "Invitation to the Dance: Spanish in the El Paso Underworld"; Janet B.…

[Multiple homicides--forensic and criminologic aspects].

PubMed

Padosch, Stephan A; Schmidt, Peter H; Rothschild, Markus A; Madea, Burkhard

2004-01-01

The interpretation of medicolegal findings in homicide is an important tool of case profiling (so-called "operative case analysis"). In 17 cases of "multiple homicides" involving 22 offenders (21 males, 1 female; mean age 33 years) and 45 victims (21 males, 24 females; mean age 35 years; 41 fatalities, 4 survivors), the autopsy reports and the prosecution authorities' files were retrospectively analysed with regard to individual characteristics of perpetrators and victims, circumstances, and mode of commitment in order to comprehensively characterise relevant forensic and criminologic aspects. 31 victims were found to belong to the close social environment of the perpetrator, and 32 killings were committed in the victim's, perpetrator's or the joint flat. The main motives included greed (n = 7), personal conflicts (n = 5) and concealing of a crime (n = 9). The relevant injuries were attributable to gunshot wounds (n = 13), sharp force (n = 11), blunt force (n = 3), ligature strangulation (n = 3), smothering (n = 6), fire/carbon monoxide (n = 2) and combined impacts (n = 7). In 12 victims, defense injuries were found. The blood alcohol concentration exceeded 1.5 g/l in 5 victims. In 5 offenders, a psychiatric impairment of juridical responsibility was assessed (and 20 German criminal code, n = 1, psychosis; and 21 German criminal code, n = 4; acute alcohol intoxication). As far as data were available, 16 crimes were judged as murder, 12 as manslaughter and one as physical injury with fatal outcome.

Investigating How German Biology Teachers Use Three-Dimensional Physical Models in Classroom Instruction: a Video Study

NASA Astrophysics Data System (ADS)

Werner, Sonja; Förtsch, Christian; Boone, William; von Kotzebue, Lena; Neuhaus, Birgit J.

2017-07-01

To obtain a general understanding of science, model use as part of National Education Standards is important for instruction. Model use can be characterized by three aspects: (1) the characteristics of the model, (2) the integration of the model into instruction, and (3) the use of models to foster scientific reasoning. However, there were no empirical results describing the implementation of National Education Standards in science instruction concerning the use of models. Therefore, the present study investigated the implementation of different aspects of model use in German biology instruction. Two biology lessons on the topic neurobiology in grade nine of 32 biology teachers were videotaped (N = 64 videos). These lessons were analysed using an event-based coding manual according to three aspects of model described above. Rasch analysis of the coded categories was conducted and showed reliable measurement. In the first analysis, we identified 68 lessons where a total of 112 different models were used. The in-depth analysis showed that special aspects of an elaborate model use according to several categories of scientific reasoning were rarely implemented in biology instruction. A critical reflection of the used model (N = 25 models; 22.3%) and models to demonstrate scientific reasoning (N = 26 models; 23.2%) were seldom observed. Our findings suggest that pre-service biology teacher education and professional development initiatives in Germany have to focus on both aspects.

Need For Long-Term Care in Children is Increasingly Caused by Disorders of Psychological Development. Changes in the Care Causing Diagnoses According to German Social Code (SGB XI) Between 2009-2014.

PubMed

Beck-Ripp, Julia Christiane; Dressel, Holger

2018-05-22

There is an ongoing discussion on the increasing number of children with mental and developmental disorders, with some even needing long-term care according to the German Social Code XI. This study was performed to identify the main diagnoses justifying such care in children and to analyse their prevalence over time. The diagnoses justifying long-term care were evaluated using care assessments of Bavarian children and adolescents between 2009 to 2014 by the medical service of statutory health insurance. Over the years investigated, the percentage of assessments due to a mental and behavioural disorder rose significantly from 36.2 to 42.2%. Since 2012, the most common diagnose changed from Down's syndrome to pervasive developmental disorders with marked increase of also mixed specific developmental disorders. In new applications for nursing insurance services the proportion of pervasive developmental disorders rose gradually from 151 in 2010 to 254 in 2014. During the whole period of time, the overall care dependency in children seemed to be stable. These observations might rather be influenced by altered awareness of health and illness, increasing readiness to seek help with psychological or developmental impairments as well as changed diagnostic criteria than by a steady increase in affected individuals. © Georg Thieme Verlag KG Stuttgart · New York.

The geology of the Penal/Barrackpore field, onshore Trinidad

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

Dyer, B.L.

1991-03-01

The Penal/Barrackpore field was discovered in 1938 and is located in the southern subbasin of onshore Trinidad. It is one of a series of northeast-southwest trending en echelon middle Miocene anticlinal structures that was later accentuated by late Pliocene transpressional folding. The middle Miocene Herrera and Karamat turbiditic sandstones are the primary reservoir rock in the subsurface anticline of the Penal/Barrackpore field. These turbidites were sourced from the north and deposited within the marls and clays of the Cipero Formation. The Karamat sandstones are followed in vertical stratigraphic succession by the shales and boulder beds of the Lengua formation, themore » turbidites and deltaics of the lower and middle Cruse, and the deltaics of the upper Cruse, the Forest, and the Morne L'Enfer formations. Relative movement of the South American and Caribbean plates climaxed in the middle Miocene compressive tectonic event and produced an imbricate pattern of southward-facing basement-involved thrusts. The Pliocene deltaics were sourced by erosion of Miocene highs to the north and the South American landmass to the south. These deltaics exhibit onlap onto the preexisting Miocene highs. The late Pliocene transpression also coincides with the onset of oil migration along faults, diapirs, and unconformities from the Cretaceous Naparima Hill source. The Lengua Formation and the upper Forest clays are considered effect seals. Hydrocarbon trapping is structurally and stratigraphically controlled, with structure being the dominant trapping mechanism. Ultimate recoverable reserves for the Penal/Barrackpore field are estimated at 127.9 MMBO and 628.8 bcf. The field is presently owned and operated by the Trinidad and Tobago Oil Company Limited (TRINTOC).« less

Differences in the implementation of diagnosis-related groups across clinical departments: a German hospital case study.

PubMed

Ridder, Hans-Gerd; Doege, Vanessa; Martini, Susanne

2007-12-01

This article aims to examine the implementation process of diagnosis-related groups (DRGs) in the clinical departments of a German hospital group and to explain why some gain competitive advantage while others do not. To investigate this research question, we conducted a qualitative study based on primary data obtained in six clinical departments in a German hospital group between 2003 and 2005. We chose the case study method in order to gain deep insights into the process dynamics of the implementation of DRGs in the six clinical departments. The dynamic capability approach is used as a theoretical foundation. Employing theory-driven categories we focused on idiosyncratic and common patterns of "successful coders" and "unsuccessful coders." To observe the implementation process of DRGs, we conducted 43 semistructured interviews with key persons, carried out direct observations of the monthly meetings of the DRG project group, and sampled written materials. "Successful coders" invest into change resources, demonstrate a high level of acceptance of innovations, and organize effective processes of coordination and learning. All clinical departments only put an emphasis on the coding aspects of the DRGs. There is a lack of vision regarding the optimization of patient treatment processes and specialization. Physicians are the most important key actors, rather than the main barriers.

[The "modernization" of health education in both German states between 1949 and 1975. The example of smoking].

PubMed

Sammer, Christian

2015-01-01

Using the example of smoking, this article scrutinizes the notions of order, educational conduct and images of subjects in the health education of both German states between 1949 and the mid 70s. Drawing on archival sources, publications and educational media from both health ministries, the Deutsches Hygiene-Museum and the Bundeszentrale für gesundheitliche Aufklärung I reconstruct the organizational, conceptual and medial shift of health education from "citizenship" to a technology of communication and public relation, needing "scientification" in the 1960s. New epidemiological evidence fostered the belief in an efficacious prevention of manly coded and with smoking associated cardio-vascular diseases by forming healthy behavior. This went hand in hand with the increase of state responsibility for the health of its citizens and the import of new knowledge stemming from social research and new methodological expertise from advertising. At the same time the ideal of a comprehensible citizen shifted into a "socialist personality" that was to be shaped by a hierarchical and consistent education in the German Democratic Republic. In the Federal Republic of Germany the general principle of the self-determined citizen unfolded the antagonism of health education between individual emancipation and imposition.

[A debate of the legal regulation of organ transplantation in West and East Germany (1960 - 1989). A comparative study].

PubMed

Lohmeier, Jens; Gross, Dominik

2013-01-01

The debate on the legal frameworks of organ transplantation in Germany began in the 1960s with the upcoming of new medical treatments. Since there were two German States at that time, the Federal Republic of Germany (FRG) and the German Democratic Republic (GDR), the process of the discussion on the way to legislation took place under two very different circumstances. In 1975 the GDR implemented a decree regarding the legal aspects of organ transplantation. Meanwhile the discussion in the FRG proceeded with no result until 1997. The analysis of articles in German medical and juridical journals in the period 1960-1989 showed that the discussion in the GDR was less intensive than in the FRG and nearly stopped after the decree from 1975. The majority of the East-German authors preferred an arrangement that will keep the next of kin of a deceased person out of the process of organ transplantation. They argued for the so-called "Widerspruchslösung" (dissent solution): During his lifetime, the donor must have denied organ removal after his death; otherwise organ explantation will be performed. The law of 1975 was consistent with this preference. In West-Germany the motifs concerning the legal aspects of organ transplantation changed over the time. The discussion started with the same arguments that were used in East-Germany. The physicians wished some kind of "Widerspruchslösung" manifested by a draft law, but their requests changed over time. In the early 1980s, most of the West-German authors pleaded for what had become the code of practice because no bill was passed by the politicians: the "Zustimmungslösung" (consent solution). The physician was obliged to ask the next of kin if there was any statement of the potential donor towards organ donation. Some authors even considered a bill unnecessary, as the system organ transplantation in West-Germany was working well without it. A massive change in the West-German medical society from fighting for a "Widerspruchslösung" to acceptance of a "Zustimmungslösung" or even no legal frame at all was observed.

[The clinical predictors of heteroaggressive behaviour of the women serving sentence in penitentiary].

PubMed

Shaklein, K N; Bardenshtein, L M; Demcheva, N K

To identify clinical predictors of heteroaggressive behavior. Three hundreds and three women serving sentence in a penal colony were examined using clinical, neurologic and statistical methods. The main group consisted of 225 women with heteroaggressive behavior, the control group included 78 women without aggressive behavior. Differences between the main and control groups in the structure of mental disorders and key syndromes were revealed. The authors conclude that the states with elements of dysphoria, dysthymia, decompensation of personality disorders, which are defined in the various forms of mental pathology, are the most significant predictors of heteroaggressive behavior in women in the penal colony.

HIV counselling in prisons.

PubMed

Curran, L; McHugh, M; Nooney, K

1989-01-01

HIV presents particular problem in penal establishments: the nature of the population; conditions in prison; media attention and misinformation; the possibility of transmission within and beyond the prison population; the extra issues that apply to female prisoners. These are discussed in the context of prison policy regarding HIV and the broad strategic approach which is being adopted to manage the problem of HIV within penal institutions. Counselling has a key role in the overall strategy. Pre- and post-test counselling with prisoners is described and the particular problems presented by inmates are discussed and illustrated by reference to case histories. Developments in counselling provision for inmates are outlined.

Gender Norms in Portuguese College Students' Judgments in Familial Homicides: Bad Men and Mad Women.

PubMed

Saavedra, Luísa; Cameira, Miguel; Rebelo, Ana Sofia; Sebastião, Cátia

2015-05-08

The gender of the offender has been proved to be an important factor in judicial sentencing. In this study, we analyze the judgments of College students regarding perpetrators of familial homicides to evaluate the presence of these gender norms and biases in the larger society. The sample included 303 college students (54.8% female) enrolled in several social sciences and engineering courses. Participants were asked to read 12 vignettes based on real crimes taken from Portuguese newspapers. Half were related to infanticide, and half were related to intimate partner homicide. The sex of the offender was orthogonally manipulated to the type of crime. The results show that gender had an important impact on sentences, with males being more harshly penalized by reasons of perversity and women less penalized by reason of mental disorders. In addition, filicide was more heavily penalized than was intimate partner homicide. The results also revealed a tendency toward a retributive conception of punishment. We discuss how gender norms in justice seem to be embedded in society as well as the need for intervention against the punitive tendency of this population. © The Author(s) 2015.

Estimating the variance for heterogeneity in arm-based network meta-analysis.

PubMed

Piepho, Hans-Peter; Madden, Laurence V; Roger, James; Payne, Roger; Williams, Emlyn R

2018-04-19

Network meta-analysis can be implemented by using arm-based or contrast-based models. Here we focus on arm-based models and fit them using generalized linear mixed model procedures. Full maximum likelihood (ML) estimation leads to biased trial-by-treatment interaction variance estimates for heterogeneity. Thus, our objective is to investigate alternative approaches to variance estimation that reduce bias compared with full ML. Specifically, we use penalized quasi-likelihood/pseudo-likelihood and hierarchical (h) likelihood approaches. In addition, we consider a novel model modification that yields estimators akin to the residual maximum likelihood estimator for linear mixed models. The proposed methods are compared by simulation, and 2 real datasets are used for illustration. Simulations show that penalized quasi-likelihood/pseudo-likelihood and h-likelihood reduce bias and yield satisfactory coverage rates. Sum-to-zero restriction and baseline contrasts for random trial-by-treatment interaction effects, as well as a residual ML-like adjustment, also reduce bias compared with an unconstrained model when ML is used, but coverage rates are not quite as good. Penalized quasi-likelihood/pseudo-likelihood and h-likelihood are therefore recommended. Copyright © 2018 John Wiley & Sons, Ltd.

Simulation of confined magnetohydrodynamic flows with Dirichlet boundary conditions using a pseudo-spectral method with volume penalization

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

Morales, Jorge A.; Leroy, Matthieu; Bos, Wouter J.T.

A volume penalization approach to simulate magnetohydrodynamic (MHD) flows in confined domains is presented. Here the incompressible visco-resistive MHD equations are solved using parallel pseudo-spectral solvers in Cartesian geometries. The volume penalization technique is an immersed boundary method which is characterized by a high flexibility for the geometry of the considered flow. In the present case, it allows to use other than periodic boundary conditions in a Fourier pseudo-spectral approach. The numerical method is validated and its convergence is assessed for two- and three-dimensional hydrodynamic (HD) and MHD flows, by comparing the numerical results with results from literature and analyticalmore » solutions. The test cases considered are two-dimensional Taylor–Couette flow, the z-pinch configuration, three dimensional Orszag–Tang flow, Ohmic-decay in a periodic cylinder, three-dimensional Taylor–Couette flow with and without axial magnetic field and three-dimensional Hartmann-instabilities in a cylinder with an imposed helical magnetic field. Finally, we present a magnetohydrodynamic flow simulation in toroidal geometry with non-symmetric cross section and imposing a helical magnetic field to illustrate the potential of the method.« less

Mental health/illness and prisons as place: frontline clinicians׳ perspectives of mental health work in a penal setting.

PubMed

Wright, Nicola; Jordan, Melanie; Kane, Eddie

2014-09-01

This article takes mental health and prisons as its two foci. It explores the links between social and structural aspects of the penal setting, the provision of mental healthcare in prisons, and mental health work in this environment. This analysis utilises qualitative interview data from prison-based fieldwork undertaken in Her Majesty׳s Prison Service, England. Two themes are discussed: (1) the desire and practicalities of doing mental health work and (2) prison staff as mental health work allies. Concepts covered include equivalence, training, ownership, informal communication, mental health knowledge, service gatekeepers, case identification, and unmet need. Implications for practice are (1) the mental health knowledge and understanding of prison wing staff could be appraised and developed to improve mental healthcare and address unmet need. Their role as observers and gatekeepers could be considered. (2) The realities of frontline mental health work for clinicians in the penal environment should be embraced and used to produce and implement improved policy and practice guidance, which is in better accord with the actuality of the context - both socially and structurally. Copyright © 2014 Elsevier Ltd. All rights reserved.

Posttest analysis of international standard problem 10 using RELAP4/MOD7. [PWR

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

Hsu, M.; Davis, C.B.; Peterson, A.C. Jr.

RELAP4/MOD7, a best estimate computer code for the calculation of thermal and hydraulic phenomena in a nuclear reactor or related system, is the latest version in the RELAP4 code development series. This paper evaluates the capability of RELAP4/MOD7 to calculate refill/reflood phenomena. This evaluation uses the data of International Standard Problem 10, which is based on West Germany's KWU PKL refill/reflood experiment K9A. The PKL test facility represents a typical West German four-loop, 1300 MW pressurized water reactor (PWR) in reduced scale while maintaining prototypical volume-to-power ratio. The PKL facility was designed to specifically simulate the refill/reflood phase of amore » hypothetical loss-of-coolant accident (LOCA).« less

Mass, Mobility, and the Red Army’s Road to Operational Art, 1918-1936

DTIC Science & Technology

1987-07-01

Combined Arms Center CAC 8c. ADDRESS (City, State, and ZIP Code) 10. SOURCE OF FUNDING NUMBERS C AC PROGRAM IPROJECT ITASK WORK UNIT -~ Ft. Leavenworth...tsarist government’s adoption of the Grand Program for rearmament in 1912 thus threatened to change the military balance on the continent.’ Those forces...for which the "Great Program of 1912" provided did create a window of vulnerability which German officers assumed would open around 1917. This in its

[Representation of cystectomy and urinary diversion in the G-DRG system 2010: an example for the complexity of the reimbursement system].

PubMed

Volkmer, B; Petervari, M; de Geeter, P

2011-01-01

Cystectomy and urinary diversion is an excellent example for the growing complexity of the G-DRG (German diagnosis-related groups) system. Based on different diagnoses (malignant tumor of the urinary tract, benign disease of the urinary tract, malignant tumor of the female genital tract, or malignant tumor of the male genital tract), identical cases may lead to very different codes, resulting in even more differences in reimbursement.

The U.S. Navy in Operation Overlord Under the Command of Rear Admiral Alan G. Kirk

DTIC Science & Technology

1994-05-19

assault on the beaches. 14. SUBJECT TERMS 15. NUMBER OF PAGES Operation Overlord, COSSAC, Admiral Alan G. Kirk, U.S. Navy 16. PRICE CODE 17. SECUriLY ...Allies’ smal2 but growing forces. 5 Although reluctant to confront the German Army in France, Brooke admitted that reasons existed to take the Qamble; the...After Kirk took command of TF122, the pace of American landing craft and personnel arrival into Britain rapidly increased. Kirk told Stark that the

Reference Dosimetry according to the New German Protocol DIN 6800-2 and Comparison with IAEA TRS 398 and AAPM TG 51*

PubMed Central

Zakaria, A; Schuette, W; Younan, C

2011-01-01

The preceding DIN 6800-2 (1997) protocol has been revised by a German task group and its latest version was published in March 2008 as the national standard dosimetry protocol DIN 6800-2 (2008 March). Since then, in Germany the determination of absorbed dose to water for high-energy photon and electron beams has to be performed according to this new German dosimetry protocol. The IAEA Code of Practice TRS 398 (2000) and the AAPM TG-51 are the two main protocols applied internationally. The new German version has widely adapted the methodology and dosimetric data of TRS-398. This paper investigates systematically the DIN 6800-2 protocol and compares it with the procedures and results obtained by using the international protocols. The investigation was performed with 6 MV and 18 MV photon beams as well as with electron beams from 5 MeV to 21 MeV. While only cylindrical chambers were used for photon beams, the measurements of electron beams were performed by using cylindrical and plane-parallel chambers. It was found that the discrepancies in the determination of absorbed dose to water among the three protocols were 0.23% for photon beams and 1.2% for electron beams. The determination of water absorbed dose was also checked by a national audit procedure using TLDs. The comparison between the measurements following the DIN 6800-2 protocol and the TLD audit-procedure confirmed a difference of less than 2%. The advantage of the new German protocol DIN 6800-2 lies in the renouncement on the cross calibration procedure as well as its clear presentation of formulas and parameters. In the past, the different protocols evoluted differently from time to time. Fortunately today, a good convergence has been obtained in concepts and methods. PMID:22287987

Reference Dosimetry according to the New German Protocol DIN 6800-2 and Comparison with IAEA TRS 398 and AAPM TG 51.

PubMed

Zakaria, A; Schuette, W; Younan, C

2011-04-01

The preceding DIN 6800-2 (1997) protocol has been revised by a German task group and its latest version was published in March 2008 as the national standard dosimetry protocol DIN 6800-2 (2008 March). Since then, in Germany the determination of absorbed dose to water for high-energy photon and electron beams has to be performed according to this new German dosimetry protocol. The IAEA Code of Practice TRS 398 (2000) and the AAPM TG-51 are the two main protocols applied internationally. The new German version has widely adapted the methodology and dosimetric data of TRS-398. This paper investigates systematically the DIN 6800-2 protocol and compares it with the procedures and results obtained by using the international protocols. The investigation was performed with 6 MV and 18 MV photon beams as well as with electron beams from 5 MeV to 21 MeV. While only cylindrical chambers were used for photon beams, the measurements of electron beams were performed by using cylindrical and plane-parallel chambers. It was found that the discrepancies in the determination of absorbed dose to water among the three protocols were 0.23% for photon beams and 1.2% for electron beams. The determination of water absorbed dose was also checked by a national audit procedure using TLDs. The comparison between the measurements following the DIN 6800-2 protocol and the TLD audit-procedure confirmed a difference of less than 2%. The advantage of the new German protocol DIN 6800-2 lies in the renouncement on the cross calibration procedure as well as its clear presentation of formulas and parameters. In the past, the different protocols evoluted differently from time to time. Fortunately today, a good convergence has been obtained in concepts and methods.

ELSID-Diabetes study-evaluation of a large scale implementation of disease management programmes for patients with type 2 diabetes. Rationale, design and conduct--a study protocol [ISRCTN08471887].

PubMed

Joos, Stefanie; Rosemann, Thomas; Heiderhoff, Marc; Wensing, Michel; Ludt, Sabine; Gensichen, Jochen; Kaufmann-Kolle, Petra; Szecsenyi, Joachim

2005-10-04

Diabetes model projects in different regions of Germany including interventions such as quality circles, patient education and documentation of medical findings have shown improvements of HbA1c levels, blood pressure and occurrence of hypoglycaemia in before-after studies (without control group). In 2002 the German Ministry of Health defined legal regulations for the introduction of nationwide disease management programs (DMP) to improve the quality of care in chronically ill patients. In April 2003 the first DMP for patients with type 2 diabetes was accredited. The evaluation of the DMP is essential and has been made obligatory in Germany by the Fifth Book of Social Code. The aim of the study is to assess the effectiveness of DMP by example of type 2 diabetes in the primary care setting of two German federal states (Rheinland-Pfalz and Sachsen-Anhalt). The study is three-armed: a prospective cluster-randomized comparison of two interventions (DMP 1 and DMP 2) against routine care without DMP as control group. In the DMP group 1 the patients are treated according to the current situation within the German-Diabetes-DMP. The DMP group 2 represents diabetic care within ideally implemented DMP providing additional interventions (e.g. quality circles, outreach visits). According to a sample size calculation a sample size of 200 GPs (each GP including 20 patients) will be required for the comparison of DMP 1 and DMP 2 considering possible drop-outs. For the comparison with routine care 4000 patients identified by diabetic tracer medication and age (> 50 years) will be analyzed. This study will evaluate the effectiveness of the German Diabetes-DMP compared to a Diabetes-DMP providing additional interventions and routine care in the primary care setting of two different German federal states.

ELSID-Diabetes study-evaluation of a large scale implementation of disease management programmes for patients with type 2 diabetes. Rationale, design and conduct – a study protocol [ISRCTN08471887

PubMed Central

Joos, Stefanie; Rosemann, Thomas; Heiderhoff, Marc; Wensing, Michel; Ludt, Sabine; Gensichen, Jochen; Kaufmann-Kolle, Petra; Szecsenyi, Joachim

2005-01-01

Background Diabetes model projects in different regions of Germany including interventions such as quality circles, patient education and documentation of medical findings have shown improvements of HbA1c levels, blood pressure and occurrence of hypoglycaemia in before-after studies (without control group). In 2002 the German Ministry of Health defined legal regulations for the introduction of nationwide disease management programs (DMP) to improve the quality of care in chronically ill patients. In April 2003 the first DMP for patients with type 2 diabetes was accredited. The evaluation of the DMP is essential and has been made obligatory in Germany by the Fifth Book of Social Code. The aim of the study is to assess the effectiveness of DMP by example of type 2 diabetes in the primary care setting of two German federal states (Rheinland-Pfalz and Sachsen-Anhalt). Methods/Design The study is three-armed: a prospective cluster-randomized comparison of two interventions (DMP 1 and DMP 2) against routine care without DMP as control group. In the DMP group 1 the patients are treated according to the current situation within the German-Diabetes-DMP. The DMP group 2 represents diabetic care within ideally implemented DMP providing additional interventions (e.g. quality circles, outreach visits). According to a sample size calculation a sample size of 200 GPs (each GP including 20 patients) will be required for the comparison of DMP 1 and DMP 2 considering possible drop-outs. For the comparison with routine care 4000 patients identified by diabetic tracer medication and age (> 50 years) will be analyzed. Discussion This study will evaluate the effectiveness of the German Diabetes-DMP compared to a Diabetes-DMP providing additional interventions and routine care in the primary care setting of two different German federal states. PMID:16202151

LOINC, a universal standard for identifying laboratory observations: a 5-year update.

PubMed

McDonald, Clement J; Huff, Stanley M; Suico, Jeffrey G; Hill, Gilbert; Leavelle, Dennis; Aller, Raymond; Forrey, Arden; Mercer, Kathy; DeMoor, Georges; Hook, John; Williams, Warren; Case, James; Maloney, Pat

2003-04-01

The Logical Observation Identifier Names and Codes (LOINC) database provides a universal code system for reporting laboratory and other clinical observations. Its purpose is to identify observations in electronic messages such as Health Level Seven (HL7) observation messages, so that when hospitals, health maintenance organizations, pharmaceutical manufacturers, researchers, and public health departments receive such messages from multiple sources, they can automatically file the results in the right slots of their medical records, research, and/or public health systems. For each observation, the database includes a code (of which 25 000 are laboratory test observations), a long formal name, a "short" 30-character name, and synonyms. The database comes with a mapping program called Regenstrief LOINC Mapping Assistant (RELMA(TM)) to assist the mapping of local test codes to LOINC codes and to facilitate browsing of the LOINC results. Both LOINC and RELMA are available at no cost from http://www.regenstrief.org/loinc/. The LOINC medical database carries records for >30 000 different observations. LOINC codes are being used by large reference laboratories and federal agencies, e.g., the CDC and the Department of Veterans Affairs, and are part of the Health Insurance Portability and Accountability Act (HIPAA) attachment proposal. Internationally, they have been adopted in Switzerland, Hong Kong, Australia, and Canada, and by the German national standards organization, the Deutsches Instituts für Normung. Laboratories should include LOINC codes in their outbound HL7 messages so that clinical and research clients can easily integrate these results into their clinical and research repositories. Laboratories should also encourage instrument vendors to deliver LOINC codes in their instrument outputs and demand LOINC codes in HL7 messages they get from reference laboratories to avoid the need to lump so many referral tests under the "send out lab" code.

Examination of influential observations in penalized spline regression

NASA Astrophysics Data System (ADS)

Türkan, Semra

2013-10-01

In parametric or nonparametric regression models, the results of regression analysis are affected by some anomalous observations in the data set. Thus, detection of these observations is one of the major steps in regression analysis. These observations are precisely detected by well-known influence measures. Pena's statistic is one of them. In this study, Pena's approach is formulated for penalized spline regression in terms of ordinary residuals and leverages. The real data and artificial data are used to see illustrate the effectiveness of Pena's statistic as to Cook's distance on detecting influential observations. The results of the study clearly reveal that the proposed measure is superior to Cook's Distance to detect these observations in large data set.

[Guideline compliance in hip fracture: results of an external quality-assurance program in North Rhine Westphalia: 2003-2005].

PubMed

Schulze Raestrup, U; Grams, A; Smektala, R

2008-02-01

Whereas the Scottish guidelines are audited annually, nobody evaluates guideline compliance in Germany. Thus, can external quality assurance data pursuant to section 137 of the German Social Code Book V be suitable for auditing guideline compliance? From North Rhine Westphalia, a total of 48,831 cases of femoral fractures near the hip joint were evaluated. Compliance with the guidelines was determined based on preoperative hospital stay, thrombosis, and antibiotic prophylaxis. Guideline rationale was reviewed in terms of mortality and thromboembolism rate. Sixty-four percent of the interventions were performed in a timely manner. Thrombosis prophylaxis was given in 99% of cases. Antibiotics were given as a single shot. There was no connection between mortality and thromboembolism rates or time to surgery. Guideline compliance is similar in German and Scotland. The external quality assurance data are suitable for evaluating guideline compliance. The literature recommends a short time to surgery. Given the short observation period, it was not possible to demonstrate any improvement in outcomes.

5HT-2C receptor polymorphism in suicide victims. Association studies in German and Slavic populations.

PubMed

Stefulj, Jasminka; Büttner, Andreas; Kubat, Milovan; Zill, Peter; Balija, Melita; Eisenmenger, Wolfgang; Bondy, Brigitta; Jernej, Branimir

2004-08-01

Sustainable observations suggest that suicidal behaviour by itself may have biological correlates, among which those related to the serotonergic synapse hold the key position. Based on the association of suicide and serotonergic dysfunction, it was proposed that genetic mechanisms affecting suicidal behaviour could be related to the alterations of the genes encoding the elements of 5HT synapse. The present study tested the association of the polymorphism in the serotonin 2C (5HT-2C) receptor coding region (Cys23Ser) with suicide commitment. Study was based on two independent samples, one of German (284 suicide victims versus 297 controls) and other of Slavic/Croatian (118 suicide victims versus 275 controls) ethnicity. No significant differences in allele or genotype frequencies between victims and controls were demonstrated. Results did not provide supporting evidence for the potential involvement of the investigated variants of 5HT-2C receptor in the susceptibility to suicide.

[What is the value of pain therapy in the German refined diagnosis-related-groups system?].

PubMed

Meissner, W; Thoma, R; Bauer, M

2006-03-01

The German refined diagnosis-related-groups (G-DRG) system was introduced on 1st January 2003, initially on a voluntary basis and on 1st January 2004 the use of a G-DRG costing for stationary hospital treatment became obligatory. The possibility of a description of acute and chronic pain therapy in the G-DRG system was initially rudimentary and not logically planned and also a fair allotment of proceeds according to resources was not possible. By further development of the G-DRG system, pain therapeutic treatment could be improved in some areas, but in others it still remains unsatisfactory. This article offers a summary of the underlying systematics of the G-DRG system and consideration of chronic and current pain therapy in the G-DRG system 2006. In addition to information on currently available possibilities of a pain therapeutical coding in conformation with the G-DRG system, the tasks which are still outstanding will be outlined.

[Economisation of research -- or: what price deception?].

PubMed

Fischer, K

2005-06-01

According to the accepted credo of German science policy the organization of research has to be reshaped to fit the needs of the national economy better than it did so in the past. This is seen as a conditio sine qua non to help German corporations to prevail in the global competition as well as to protect national welfare. The author argues that reorganizing research on a strictly mission-oriented line under economic imperatives will partly suspend the code of science in favor of the code of economy. The focal aim of science, which is to reach at the most reliable information in a methodical and impartial way, will be partly replaced by the aim to reach at the best sellable information in any way which is cheap and profitable. The probability that any information which might endanger the market performance of a product is clandestinely kept under cover by the selling corporation will be greatly enlarged. Expert knowledge necessary to uncover the truth will be mainly interest bound and no longer be freely available. Knowledge perceived to be irrelevant for economy, although possibly being of great intrinsic interest, and even knowledge which might become an essential part of a culture's identity, will be lost on its search for an investor. The great danger is that this applies also to important parts of basic science potentially providing the foundations for future technologies. Externalities such as these could be called the costs of economization, or: the costs of untruth.

Stellar parameters for the central star of the planetary nebula PRTM 1 using the German Astrophysical Virtual Observatory service TheoSSA

NASA Astrophysics Data System (ADS)

Rauch, T.; Demleitner, M.; Hoyer, D.; Werner, K.

2018-04-01

The German Astrophysical Virtual Observatory (GAVO) developed the registered service TheoSSA (theoretical stellar spectra access) and the supporting registered VO tool TMAW (Tübingen Model-Atmosphere WWW interface). These allow individual spectral analyses of hot, compact stars with state-of-the-art non-local thermodynamical equilibrium (NLTE) stellar-atmosphere models that presently consider opacities of the elements H, He, C, N, O, Ne, Na, and Mg, without requiring detailed knowledge about the involved background codes and procedures. Presently, TheoSSA provides easy access to about 150 000 pre-calculated stellar spectral energy distributions (SEDs) and is intended to ingest SEDs calculated by any model-atmosphere code. In the case of the exciting star of PN PRTM 1, we demonstrate the easy way to calculate individual NLTE stellar model-atmospheres to reproduce an observed optical spectrum. We measured T_eff = 98 000± 5 000 K, log (g / cm/s^2) = 5.0^{+0.3}_{-0.2}, and photospheric mass fractions of H =7.5 × 10-1 (1.02 times solar), He =2.4 × 10-1 (0.96), C =2.0 × 10-3 (0.84), N =3.2 × 10-4 (0.46), and O =8.5 × 10-3 (1.48) with uncertainties of ±0.2 dex. We determined the stellar mass and luminosity of 0.73^{+0.16}_{-0.15} M_{⊙} and log (L/L⊙) = 4.2 ± 0.4, respectively.

A multilingual assessment of melanoma information quality on the Internet.

PubMed

Bari, Lilla; Kemeny, Lajos; Bari, Ferenc

2014-06-01

This study aims to assess and compare melanoma information quality in Hungarian, Czech, and German languages on the Internet. We used country-specific Google search engines to retrieve the first 25 uniform resource locators (URLs) by searching the word "melanoma" in the given language. Using the automated toolbar of Health On the Net Foundation (HON), we assessed each Web site for HON certification based on the Health On the Net Foundation Code of Conduct (HONcode). Information quality was determined using a 35-point checklist created by Bichakjian et al. (J Clin Oncol 20:134-141, 2002), with the NCCN melanoma guideline as control. After excluding duplicate and link-only pages, a total of 24 Hungarian, 18 Czech, and 21 German melanoma Web sites were evaluated and rated. The amount of HON certified Web sites was the highest among the German Web pages (19%). One of the retrieved Hungarian and none of the Czech Web sites were HON certified. We found the highest number of Web sites containing comprehensive, correct melanoma information in German language, followed by Czech and Hungarian pages. Although the majority of the Web sites lacked data about incidence, risk factors, prevention, treatment, work-up, and follow-up, at least one comprehensive, high-quality Web site was found in each language. Several Web sites contained incorrect information in each language. While a small amount of comprehensive, quality melanoma-related Web sites was found, most of the retrieved Web content lacked basic disease information, such as risk factors, prevention, and treatment. A significant number of Web sites contained malinformation. In case of melanoma, primary and secondary preventions are of especially high importance; therefore, the improvement of disease information quality available on the Internet is necessary.

Present situation and prospect of medical knowledge based systems in German-speaking countries: results of an online survey.

PubMed

Spreckelsen, Cord; Spitzer, K; Honekamp, W

2012-01-01

After a decrease of interest in classical medical expert systems, the publication activity concerning the medical application of Artificial Intelligence and the interest in medical decision support have markedly increased. Nonetheless, no systematic exploratory study has yet been carried out, which directly considers the actual fields of applications, exemplary approaches, obstacles, challenges, and future prospect as seen by pioneering users and developers in a given region. This paper reports the results of an online survey designed to fill this gap with the "Knowledge Based Systems" working group of the German Society for Medical Informatics, Biometry and Epidemiology (GMDS) in 2010. The survey was based on an online questionnaire (5 single and multiple choice questions, 8 Likert-scaled items, 7 free text questions) consented to by the working group. The answers were analyzed by descriptive statistics and a qualitative analysis (bottom-up coding). All academic institutions of Medical Informatics in the German-speaking countries and contributors reporting KBS-related projects at the relevant scientific conferences and in a journal specialized in the field were invited to participate. The survey reached a response rate of 33.4%. The results show a gap between the reported obstacles of medical KBS (mainly low acceptance and rare use in clinical practice) and their future prospect as stated by the participants. Problems previously discussed in the literature like low acceptance, integration, and sustainability of KBS projects were confirmed. The current situation was characterized by naming exemplary existing systems and specifying promising fields of application. The field of KBS in medicine is more diversified and has evolved beyond expectations in the German-speaking countries.

Comprehensive analysis of the mutation spectrum in 301 German ALS families.

PubMed

Müller, Kathrin; Brenner, David; Weydt, Patrick; Meyer, Thomas; Grehl, Torsten; Petri, Susanne; Grosskreutz, Julian; Schuster, Joachim; Volk, Alexander E; Borck, Guntram; Kubisch, Christian; Klopstock, Thomas; Zeller, Daniel; Jablonka, Sibylle; Sendtner, Michael; Klebe, Stephan; Knehr, Antje; Günther, Kornelia; Weis, Joachim; Claeys, Kristl G; Schrank, Berthold; Sperfeld, Anne-Dorte; Hübers, Annemarie; Otto, Markus; Dorst, Johannes; Meitinger, Thomas; Strom, Tim M; Andersen, Peter M; Ludolph, Albert C; Weishaupt, Jochen H

2018-04-12

Recent advances in amyotrophic lateral sclerosis (ALS) genetics have revealed that mutations in any of more than 25 genes can cause ALS, mostly as an autosomal-dominant Mendelian trait. Detailed knowledge about the genetic architecture of ALS in a specific population will be important for genetic counselling but also for genotype-specific therapeutic interventions. Here we combined fragment length analysis, repeat-primed PCR, Southern blotting, Sanger sequencing and whole exome sequencing to obtain a comprehensive profile of genetic variants in ALS disease genes in 301 German pedigrees with familial ALS. We report C9orf72 mutations as well as variants in consensus splice sites and non-synonymous variants in protein-coding regions of ALS genes. We furthermore estimate their pathogenicity by taking into account type and frequency of the respective variant as well as segregation within the families. 49% of our German ALS families carried a likely pathogenic variant in at least one of the earlier identified ALS genes. In 45% of the ALS families, likely pathogenic variants were detected in C9orf72, SOD1, FUS, TARDBP or TBK1 , whereas the relative contribution of the other ALS genes in this familial ALS cohort was 4%. We identified several previously unreported rare variants and demonstrated the absence of likely pathogenic variants in some of the recently described ALS disease genes. We here present a comprehensive genetic characterisation of German familial ALS. The present findings are of importance for genetic counselling in clinical practice, for molecular research and for the design of diagnostic gene panels or genotype-specific therapeutic interventions in Europe. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Assessing health-related quality of life in urology - a survey of 4500 German urologists.

PubMed

Schmick, A; Juergensen, M; Rohde, V; Katalinic, A; Waldmann, A

2017-06-19

Urological diseases and their treatment may negatively influence continence, potency, and health-related quality of life (HRQOL). Although current guidelines recommend HRQOL assessment in clinical urology, specific guidance on how to assess HRQOL is frequently absent. We evaluated whether and how urologists assess HRQOL and how they determine its practicality. A random sample of 4500 (from 5200 identified German urologists) was drawn and invited to participate in a postal survey (an initial letter followed by one reminder after six weeks). The questionnaire included questions on whether and how HRQOL is assessed, general attitudes towards the concept of HRQOL, and socio-demographics. Due to the exploratory character of the study we produced mainly descriptive statistics. Chi 2 -tests and logistic regression were used for subgroup-analysis. 1557 urologists (85% male, with a mean age of 49 yrs.) participated. Most of them (87%) considered HRQOL assessment as 'important' in daily work, while only 7% reported not assessing HRQOL. Patients with prostate carcinoma, incontinence, pain, and benign prostate hyperplasia were the main target groups for HRQOL assessment. The primary aim of HRQOL assessment was to support treatment decisions, monitor patients, and produce a 'baseline measurement'. Two-thirds of urologists used questionnaires and interviews to evaluate HRQOL and one-quarter assessed HRQOL by asking: 'How are you?'. The main barriers to HRQOL assessment were anticipated questionnaire costs (77%), extensive questionnaire length (52%), and complex analysis (51%). The majority of German urologists assess HRQOL as part of their clinical routine. However, knowledge of HRQOL assessment, analysis, and interpretation seems to be limited in this group. Therefore, urologists may benefit from a targeted education program. The clinical trial was registered with the code VfD_13_003629 at the German Healthcare Research Registry ( www.versorgungsforschung-deutschland.de ).

Integrative Analysis of High-throughput Cancer Studies with Contrasted Penalization

PubMed Central

Shi, Xingjie; Liu, Jin; Huang, Jian; Zhou, Yong; Shia, BenChang; Ma, Shuangge

2015-01-01

In cancer studies with high-throughput genetic and genomic measurements, integrative analysis provides a way to effectively pool and analyze heterogeneous raw data from multiple independent studies and outperforms “classic” meta-analysis and single-dataset analysis. When marker selection is of interest, the genetic basis of multiple datasets can be described using the homogeneity model or the heterogeneity model. In this study, we consider marker selection under the heterogeneity model, which includes the homogeneity model as a special case and can be more flexible. Penalization methods have been developed in the literature for marker selection. This study advances from the published ones by introducing the contrast penalties, which can accommodate the within- and across-dataset structures of covariates/regression coefficients and, by doing so, further improve marker selection performance. Specifically, we develop a penalization method that accommodates the across-dataset structures by smoothing over regression coefficients. An effective iterative algorithm, which calls an inner coordinate descent iteration, is developed. Simulation shows that the proposed method outperforms the benchmark with more accurate marker identification. The analysis of breast cancer and lung cancer prognosis studies with gene expression measurements shows that the proposed method identifies genes different from those using the benchmark and has better prediction performance. PMID:24395534

Neutron Tomography of a Fuel Cell: Statistical Learning Implementation of a Penalized Likelihood Method

NASA Astrophysics Data System (ADS)

Coakley, Kevin J.; Vecchia, Dominic F.; Hussey, Daniel S.; Jacobson, David L.

2013-10-01

At the NIST Neutron Imaging Facility, we collect neutron projection data for both the dry and wet states of a Proton-Exchange-Membrane (PEM) fuel cell. Transmitted thermal neutrons captured in a scintillator doped with lithium-6 produce scintillation light that is detected by an amorphous silicon detector. Based on joint analysis of the dry and wet state projection data, we reconstruct a residual neutron attenuation image with a Penalized Likelihood method with an edge-preserving Huber penalty function that has two parameters that control how well jumps in the reconstruction are preserved and how well noisy fluctuations are smoothed out. The choice of these parameters greatly influences the resulting reconstruction. We present a data-driven method that objectively selects these parameters, and study its performance for both simulated and experimental data. Before reconstruction, we transform the projection data so that the variance-to-mean ratio is approximately one. For both simulated and measured projection data, the Penalized Likelihood method reconstruction is visually sharper than a reconstruction yielded by a standard Filtered Back Projection method. In an idealized simulation experiment, we demonstrate that the cross validation procedure selects regularization parameters that yield a reconstruction that is nearly optimal according to a root-mean-square prediction error criterion.

A powerful and flexible approach to the analysis of RNA sequence count data.

PubMed

Zhou, Yi-Hui; Xia, Kai; Wright, Fred A

2011-10-01

A number of penalization and shrinkage approaches have been proposed for the analysis of microarray gene expression data. Similar techniques are now routinely applied to RNA sequence transcriptional count data, although the value of such shrinkage has not been conclusively established. If penalization is desired, the explicit modeling of mean-variance relationships provides a flexible testing regimen that 'borrows' information across genes, while easily incorporating design effects and additional covariates. We describe BBSeq, which incorporates two approaches: (i) a simple beta-binomial generalized linear model, which has not been extensively tested for RNA-Seq data and (ii) an extension of an expression mean-variance modeling approach to RNA-Seq data, involving modeling of the overdispersion as a function of the mean. Our approaches are flexible, allowing for general handling of discrete experimental factors and continuous covariates. We report comparisons with other alternate methods to handle RNA-Seq data. Although penalized methods have advantages for very small sample sizes, the beta-binomial generalized linear model, combined with simple outlier detection and testing approaches, appears to have favorable characteristics in power and flexibility. An R package containing examples and sample datasets is available at http://www.bios.unc.edu/research/genomic_software/BBSeq yzhou@bios.unc.edu; fwright@bios.unc.edu Supplementary data are available at Bioinformatics online.

Across-Platform Imputation of DNA Methylation Levels Incorporating Nonlocal Information Using Penalized Functional Regression.

PubMed

Zhang, Guosheng; Huang, Kuan-Chieh; Xu, Zheng; Tzeng, Jung-Ying; Conneely, Karen N; Guan, Weihua; Kang, Jian; Li, Yun

2016-05-01

DNA methylation is a key epigenetic mark involved in both normal development and disease progression. Recent advances in high-throughput technologies have enabled genome-wide profiling of DNA methylation. However, DNA methylation profiling often employs different designs and platforms with varying resolution, which hinders joint analysis of methylation data from multiple platforms. In this study, we propose a penalized functional regression model to impute missing methylation data. By incorporating functional predictors, our model utilizes information from nonlocal probes to improve imputation quality. Here, we compared the performance of our functional model to linear regression and the best single probe surrogate in real data and via simulations. Specifically, we applied different imputation approaches to an acute myeloid leukemia dataset consisting of 194 samples and our method showed higher imputation accuracy, manifested, for example, by a 94% relative increase in information content and up to 86% more CpG sites passing post-imputation filtering. Our simulated association study further demonstrated that our method substantially improves the statistical power to identify trait-associated methylation loci. These findings indicate that the penalized functional regression model is a convenient and valuable imputation tool for methylation data, and it can boost statistical power in downstream epigenome-wide association study (EWAS). © 2016 WILEY PERIODICALS, INC.

Penalized spline estimation for functional coefficient regression models.

PubMed

Cao, Yanrong; Lin, Haiqun; Wu, Tracy Z; Yu, Yan

2010-04-01

The functional coefficient regression models assume that the regression coefficients vary with some "threshold" variable, providing appreciable flexibility in capturing the underlying dynamics in data and avoiding the so-called "curse of dimensionality" in multivariate nonparametric estimation. We first investigate the estimation, inference, and forecasting for the functional coefficient regression models with dependent observations via penalized splines. The P-spline approach, as a direct ridge regression shrinkage type global smoothing method, is computationally efficient and stable. With established fixed-knot asymptotics, inference is readily available. Exact inference can be obtained for fixed smoothing parameter λ, which is most appealing for finite samples. Our penalized spline approach gives an explicit model expression, which also enables multi-step-ahead forecasting via simulations. Furthermore, we examine different methods of choosing the important smoothing parameter λ: modified multi-fold cross-validation (MCV), generalized cross-validation (GCV), and an extension of empirical bias bandwidth selection (EBBS) to P-splines. In addition, we implement smoothing parameter selection using mixed model framework through restricted maximum likelihood (REML) for P-spline functional coefficient regression models with independent observations. The P-spline approach also easily allows different smoothness for different functional coefficients, which is enabled by assigning different penalty λ accordingly. We demonstrate the proposed approach by both simulation examples and a real data application.

Psychic trauma as cause of death.

PubMed

Terranova, C; Snenghi, R; Thiene, G; Ferrara, S D

2011-01-01

of study Psychic trauma is described as the action of 'an emotionally overwhelming factor' capable of causing neurovegetative alterations leading to transitory or persisting bodily changes. The medico-legal concept of psychic trauma and its definition as a cause in penal cases is debated. The authors present three cases of death after psychic trauma, and discuss the definition of cause within the penal ambit of identified 'emotionally overwhelming factors'. The methodological approach to ascertainment and criterion-based assessment in each case involved the following phases: (1) examination of circumstantial evidence, clinical records and documentation; (2) autopsy; (3) ascertainment of cause of death; and (4) ascertainment of psychic trauma, and its coexisting relationship with the cause of death. The results and assessment of each of the three cases are discussed from the viewpoint of the causal connotation of psychic trauma. In the cases presented, psychic trauma caused death, as deduced from assessment of the type of externally caused emotional insult, the subjects' personal characteristics and the circumstances of the event causing death. In cases of death due to psychic trauma, careful methodological ascertainment is essential, with the double aim of defining 'emotionally overwhelming factors' as a significant cause of death from the penal point of view, and of identifying the responsibility of third parties involved in the death event and associated dynamics of homicide.

Penalized weighted least-squares approach for multienergy computed tomography image reconstruction via structure tensor total variation regularization.

PubMed

Zeng, Dong; Gao, Yuanyuan; Huang, Jing; Bian, Zhaoying; Zhang, Hua; Lu, Lijun; Ma, Jianhua

2016-10-01

Multienergy computed tomography (MECT) allows identifying and differentiating different materials through simultaneous capture of multiple sets of energy-selective data belonging to specific energy windows. However, because sufficient photon counts are not available in each energy window compared with that in the whole energy window, the MECT images reconstructed by the analytical approach often suffer from poor signal-to-noise and strong streak artifacts. To address the particular challenge, this work presents a penalized weighted least-squares (PWLS) scheme by incorporating the new concept of structure tensor total variation (STV) regularization, which is henceforth referred to as 'PWLS-STV' for simplicity. Specifically, the STV regularization is derived by penalizing higher-order derivatives of the desired MECT images. Thus it could provide more robust measures of image variation, which can eliminate the patchy artifacts often observed in total variation (TV) regularization. Subsequently, an alternating optimization algorithm was adopted to minimize the objective function. Extensive experiments with a digital XCAT phantom and meat specimen clearly demonstrate that the present PWLS-STV algorithm can achieve more gains than the existing TV-based algorithms and the conventional filtered backpeojection (FBP) algorithm in terms of both quantitative and visual quality evaluations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Detection of Protein Complexes Based on Penalized Matrix Decomposition in a Sparse Protein⁻Protein Interaction Network.

PubMed

Cao, Buwen; Deng, Shuguang; Qin, Hua; Ding, Pingjian; Chen, Shaopeng; Li, Guanghui

2018-06-15

High-throughput technology has generated large-scale protein interaction data, which is crucial in our understanding of biological organisms. Many complex identification algorithms have been developed to determine protein complexes. However, these methods are only suitable for dense protein interaction networks, because their capabilities decrease rapidly when applied to sparse protein⁻protein interaction (PPI) networks. In this study, based on penalized matrix decomposition ( PMD ), a novel method of penalized matrix decomposition for the identification of protein complexes (i.e., PMD pc ) was developed to detect protein complexes in the human protein interaction network. This method mainly consists of three steps. First, the adjacent matrix of the protein interaction network is normalized. Second, the normalized matrix is decomposed into three factor matrices. The PMD pc method can detect protein complexes in sparse PPI networks by imposing appropriate constraints on factor matrices. Finally, the results of our method are compared with those of other methods in human PPI network. Experimental results show that our method can not only outperform classical algorithms, such as CFinder, ClusterONE, RRW, HC-PIN, and PCE-FR, but can also achieve an ideal overall performance in terms of a composite score consisting of F-measure, accuracy (ACC), and the maximum matching ratio (MMR).

[Structured quality report of urologic clinics according to section 137 SGB V. Useful information for the patient, marketing tool of the hospitals, leverage wielded by the health insurance companies, or junk data?].

PubMed

Volkmer, B; Petschl, S; Härtel, M; Bopp, G; Herkommer, K; Gschwend, J

2006-04-01

In 2005, German hospitals were legally obliged to publish a structured quality report on their data of 2004 including the top 10 diagnosis-related groups, top 10 diagnoses, and top 10 procedures for every specialty. The aim was to increase the transparency for patients, doctors, and health insurance companies. Comparing the quality reports of 248 departments of urology revealed very uniform distributions of diagnoses and diagnosis-related groups. There was a large variety of top 10 procedures, resulting from different interpretations of the coding system, leading to diminished accuracy. The quality reports provide coding specialists with important data, but for patients and nonspecialized doctors, this system is not helpful in improving transparency.

Are implicit motives revealed in mere words? Testing the marker-word hypothesis with computer-based text analysis

PubMed Central

Schultheiss, Oliver C.

2013-01-01

Traditionally, implicit motives (i.e., non-conscious preferences for specific classes of incentives) are assessed through semantic coding of imaginative stories. The present research tested the marker-word hypothesis, which states that implicit motives are reflected in the frequencies of specific words. Using Linguistic Inquiry and Word Count (LIWC; Pennebaker et al., 2001), Study 1 identified word categories that converged with a content-coding measure of the implicit motives for power, achievement, and affiliation in picture stories collected in German and US student samples, showed discriminant validity with self-reported motives, and predicted well-validated criteria of implicit motives (gender difference for the affiliation motive; in interaction with personal-goal progress: emotional well-being). Study 2 demonstrated LIWC-based motive scores' causal validity by documenting their sensitivity to motive arousal. PMID:24137149

Republic Act No. 6725, 12 May 1989.

PubMed

1989-01-01

This Philippines Act is designed to strengthen the prohibition on discrimination against women with respect to the terms and conditions of employment. It amends Article 135 of the Labor Code to read as follows: "Art. 135. Discrimination prohibited. It shall be unlawful for any employer to discriminate against any woman employee with respect to terms and conditions of employment solely on the grounds of sex. The following are acts of discrimination: (a) Payment of a lesser compensation, including wage, salary or other form of remuneration and fringe benefits, to a female employee as against a male employee, for work of equal value; and (b) Favoring a male employee over a female employee with respect to promotion, training opportunities, study and scholarship grants solely on account of their sexes. Criminal liability for the willful commission of any unlawful act as provided in this article or any violation of the rules and regulations issued pursuant to Section 2 hereof shall be penalized as provided in Articles 288 and 289 of this Code: provided, that the institution of any criminal action under this provision shall not bar the aggrieved employee from filing an entirely separate and distinct action for money claims, which may include claims for damages and other affirmative reliefs. The actions hereby authorized shall proceed independently of each other. SEC. 2. The Secretary of Labor and Employment is hereby authorized to promulgate the necessary guidelines to implement this Article in accordance with the generally accepted practices and standards here and abroad."

Differences in the Implementation of Diagnosis-Related Groups across Clinical Departments: A German Hospital Case Study

PubMed Central

Ridder, Hans-Gerd; Doege, Vanessa; Martini, Susanne

2007-01-01

Objective This article aims to examine the implementation process of diagnosis-related groups (DRGs) in the clinical departments of a German hospital group and to explain why some gain competitive advantage while others do not. Study Setting To investigate this research question, we conducted a qualitative study based on primary data obtained in six clinical departments in a German hospital group between 2003 and 2005. Study Design We chose the case study method in order to gain deep insights into the process dynamics of the implementation of DRGs in the six clinical departments. The dynamic capability approach is used as a theoretical foundation. Employing theory-driven categories we focused on idiosyncratic and common patterns of “successful coders” and “unsuccessful coders.” Data Collection To observe the implementation process of DRGs, we conducted 43 semistructured interviews with key persons, carried out direct observations of the monthly meetings of the DRG project group, and sampled written materials. Principal Findings “Successful coders” invest into change resources, demonstrate a high level of acceptance of innovations, and organize effective processes of coordination and learning. Conclusions All clinical departments only put an emphasis on the coding aspects of the DRGs. There is a lack of vision regarding the optimization of patient treatment processes and specialization. Physicians are the most important key actors, rather than the main barriers. PMID:17995556

[Financing of inpatient orthopaedics and trauma surgery in the 2011 G-DRG System].

PubMed

Franz, D; Schemmann, F; Roeder, N; Siebert, H; Mahlke, L

2011-09-01

The German DRG system forms the basis for billing inpatient hospital services. It includes not only the case groups (G-DRGs), but also copayments. This paper analyses and evaluates the relevant developments of the 2011 G-DRG system for orthopaedics and traumatology from the medical and classificatory perspective. An analysis was performed of relevant diagnoses, medical procedures and G-DRGs in the 2010 and 2011 versions based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). A number of codes for surgical measures have been newly established or modified - above all in foot surgery, arthroscopic surgery and wound surgery. Here, the identification and the correct and performance-based mapping of complex and elaborate scenarios was again the focus of the restructuring of the G-DRG system. The G-DRG structure in orthopaedics and traumatology is changed, especially for polytraumata. The allocation of common cases with a standardized treatment pattern appears to be appropriate and the reimbursement adequate. For the less common and more complex cases the 2011 G-DRG system still shows need for further modification (e.g. polytraumata, joint replacement, spine surgery). The proper integration of the modified OPS classification for foot surgery to the appropriate G-DRGs will be essential to maintain the high quality of the reimbursement structure for the future.

Transcription Factor Binding Site Polymorphism in the Motilin Gene Associated with Left-Sided Displacement of the Abomasum in German Holstein Cattle

PubMed Central

Mömke, Stefanie; Sickinger, Marlene; Rehage, Jürgen; Doll, Klaus; Distl, Ottmar

2012-01-01

Left-sided displacement of the abomasum (LDA) is a common disease in many dairy cattle breeds. A genome-wide screen for QTL for LDA in German Holstein (GH) cows indicated motilin (MLN) as a candidate gene on bovine chromosome 23. Genomic DNA sequence analysis of MLN revealed a total of 32 polymorphisms. All informative polymorphisms used for association analyses in a random sample of 1,136 GH cows confirmed MLN as a candidate for LDA. A single nucleotide polymorphism (FN298674:g.90T>C) located within the first non-coding exon of bovine MLN affects a NKX2-5 transcription factor binding site and showed significant associations (ORallele = 0.64; −log10Pallele = 6.8, −log10Pgenotype = 7.0) with LDA. An expression study gave evidence of a significantly decreased MLN expression in cows carrying the mutant allele (C). In individuals heterozygous or homozygous for the mutation, MLN expression was decreased by 89% relative to the wildtype. FN298674:g.90T>C may therefore play a role in bovine LDA via the motility of the abomasum. This MLN SNP appears useful to reduce the incidence of LDA in German Holstein cattle and provides a first step towards a deeper understanding of the genetics of LDA. PMID:22536407

Police in an intensive care unit: what can happen?

PubMed Central

Lynøe, Niels; Leijonhufvud, Madeleine

2013-01-01

During spring 2009 a Swedish senior paediatric intensivist and associate professor was detained and later prosecuted for mercy-killing a child with severe brain damage. The intensivist was accused of having used high doses of thiopental after having withdrawn life-sustaining treatment when the child was imminently dying. After more than 2.5 years of investigation the physician was acquitted by the Stockholm City Court. The court additionally stated that the physician had provided good end-of-life care. Since the trial it has become evident that the accusation was based on a problematic medicolegal report. Nevertheless, the event has had severe negative consequences for the physician personally and professionally, and probably also, in general, for patients in the final stage of life. This case illustrates, together with other cases, that there is a lack of correspondence between ethical soft law/healthcare law and the Penal Code. To optimise medical practice we suggest that the criminal law be carefully examined and if possible changed. Furthermore, we suggest a peer-review system for assessing medicolegal reports in cases of suspected homicide. PMID:23900291

Piano Transcription with Convolutional Sparse Lateral Inhibition

DOE PAGES

Cogliati, Andrea; Duan, Zhiyao; Wohlberg, Brendt Egon

2017-02-08

This paper extends our prior work on contextdependent piano transcription to estimate the length of the notes in addition to their pitch and onset. This approach employs convolutional sparse coding along with lateral inhibition constraints to approximate a musical signal as the sum of piano note waveforms (dictionary elements) convolved with their temporal activations. The waveforms are pre-recorded for the specific piano to be transcribed in the specific environment. A dictionary containing multiple waveforms per pitch is generated by truncating a long waveform for each pitch to different lengths. During transcription, the dictionary elements are fixed and their temporal activationsmore » are estimated and post-processed to obtain the pitch, onset and note length estimation. A sparsity penalty promotes globally sparse activations of the dictionary elements, and a lateral inhibition term penalizes concurrent activations of different waveforms corresponding to the same pitch within a temporal neighborhood, to achieve note length estimation. Experiments on the MAPS dataset show that the proposed approach significantly outperforms a state-of-the-art music transcription method trained in the same context-dependent setting in transcription accuracy.« less

[Medical end-of-life decisions and assisted suicide].

PubMed

Bosshard, Georg

2008-07-01

Medical end-of-life decisions that potentially shorten life (Sterbehilfe) are normally divided into four categories: Passive Sterbehilfe refers to withholding or withdrawing life-prolonging measures, indirect Sterbehilfe refers to the use of agents such as opioids or sedatives to alleviate symptoms of a terminally ill patient, assisted suicide (Suizidbeihilfe or Beihilfe zum Suizid) refers to prescribing and/or supplying a lethal drug in order to help someone to end his own life, and active euthanasia - which is illegal in any circumstances - means a doctor actively ending a patients life. In passive and indirect euthanasia, the will of a competent patient, or the presumed will of an incompetent patient respectively, is crucial. Assisted suicide is not illegal according to the Swiss Penal Code as long as there are no motives of self-interest of the individual assisting, and the individual assisted has decisional capacity. However, for doctors participating in assisted suicide, specific requirements of medical due care have to be met. What this means in the context of assisted suicide has recently been elaborated by the Swiss Federal Court of Justice.

Piano Transcription with Convolutional Sparse Lateral Inhibition

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

Cogliati, Andrea; Duan, Zhiyao; Wohlberg, Brendt Egon

This paper extends our prior work on contextdependent piano transcription to estimate the length of the notes in addition to their pitch and onset. This approach employs convolutional sparse coding along with lateral inhibition constraints to approximate a musical signal as the sum of piano note waveforms (dictionary elements) convolved with their temporal activations. The waveforms are pre-recorded for the specific piano to be transcribed in the specific environment. A dictionary containing multiple waveforms per pitch is generated by truncating a long waveform for each pitch to different lengths. During transcription, the dictionary elements are fixed and their temporal activationsmore » are estimated and post-processed to obtain the pitch, onset and note length estimation. A sparsity penalty promotes globally sparse activations of the dictionary elements, and a lateral inhibition term penalizes concurrent activations of different waveforms corresponding to the same pitch within a temporal neighborhood, to achieve note length estimation. Experiments on the MAPS dataset show that the proposed approach significantly outperforms a state-of-the-art music transcription method trained in the same context-dependent setting in transcription accuracy.« less

Political intersections between HIV/AIDS, sexuality and human rights: a history of resistance to the anti-sodomy law in India.

PubMed

Ramasubban, R

2008-01-01

The HIV/AIDS epidemic in India has posed unprecedented challenges to both state and society, to question prevailing constructions of patriarchal gender relations and heteronormativity. Response to the challenge has come not from the political and social mainstream but from the criminalised "margins": people of alternative sexualities, who have launched a struggle for reform of the anti-sodomy law, Section 377 of the Indian Penal Code. This article documents the history of this movement, and identifies the multiple national and global-level cultural, political, and economic strands, shaping it. The legal reform movement has been invaluable as a tool to mobilise disparate alternative sexualities groups around a common strategy, thereby forging them into a tenuous national-level "community". Going beyond legal reform in the direction of sexual rights, however, requires a broader coalition of groups, and a broad-based political agenda of sexual rights for all. This agenda must critique patriarchy, dominant masculinity, and sexual violence; forces that together govern both the subordination of women and repression of alternative sexualities.

Law on consent and confidentiality in India: a need for clarity.

PubMed

Mathiharan, Karunakaran

2014-01-01

The concept of informed consent specific to medical research and treatment is still alien to many medical researchers and practitioners and to millions of Indians. The doctor-patient relationship in India is governed more by trust where the doctor is the authoritative person. Therefore, the benefit of informed consent does not reach all patients in day-to-day medical practice. To complicate the issue, the Indian law is not specific about the age at which a person can give valid consent. The Indian Penal Code is silent about the legal validity of consent given by persons between 12 and 18 years of age. Similarly, the age at which the 'Right to Confidentiality' begins is yet to be defined either by the statute or by the courts. Hence, there is a need for a clear statutory provision to remove the anomalies and ambiguities regarding the age of consent to undergo invasive therapeutic or investigative procedures, participate in clinical trials, as well as define the age at which a person's right to medical confidentiality begins.

Knowledge of healthcare professionals about rights of patient’s images

PubMed Central

Caires, Bianca Rodrigues; Lopes, Maria Carolina Barbosa Teixeira; Okuno, Meiry Fernanda Pinto; Vancini-Campanharo, Cássia Regina; Batista, Ruth Ester Assayag

2015-01-01

Objective To assess knowledge of healthcare professionals about capture and reproduction of images of patients in a hospital setting. Methods A cross-sectional and observational study among 360 healthcare professionals (nursing staff, physical therapists, and physicians), working at a teaching hospital in the city of São Paulo (SP). A questionnaire with sociodemographic information was distributed and data were correlated to capture and reproduction of images at hospitals. Results Of the 360 respondents, 142 had captured images of patients in the last year, and 312 reported seeing other professionals taking photographs of patients. Of the participants who captured images, 61 said they used them for studies and presentation of clinical cases, and 168 professionals reported not knowing of any legislation in the Brazilian Penal Code regarding collection and use of images. Conclusion There is a gap in the training of healthcare professionals regarding the use of patient´s images. It is necessary to include subjects that address this theme in the syllabus of undergraduate courses, and the healthcare organizations should regulate this issue. PMID:26267838

Bayesian dynamic mediation analysis.

PubMed

Huang, Jing; Yuan, Ying

2017-12-01

Most existing methods for mediation analysis assume that mediation is a stationary, time-invariant process, which overlooks the inherently dynamic nature of many human psychological processes and behavioral activities. In this article, we consider mediation as a dynamic process that continuously changes over time. We propose Bayesian multilevel time-varying coefficient models to describe and estimate such dynamic mediation effects. By taking the nonparametric penalized spline approach, the proposed method is flexible and able to accommodate any shape of the relationship between time and mediation effects. Simulation studies show that the proposed method works well and faithfully reflects the true nature of the mediation process. By modeling mediation effect nonparametrically as a continuous function of time, our method provides a valuable tool to help researchers obtain a more complete understanding of the dynamic nature of the mediation process underlying psychological and behavioral phenomena. We also briefly discuss an alternative approach of using dynamic autoregressive mediation model to estimate the dynamic mediation effect. The computer code is provided to implement the proposed Bayesian dynamic mediation analysis. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Comparing implementations of penalized weighted least-squares sinogram restoration.

PubMed

Forthmann, Peter; Koehler, Thomas; Defrise, Michel; La Riviere, Patrick

2010-11-01

A CT scanner measures the energy that is deposited in each channel of a detector array by x rays that have been partially absorbed on their way through the object. The measurement process is complex and quantitative measurements are always and inevitably associated with errors, so CT data must be preprocessed prior to reconstruction. In recent years, the authors have formulated CT sinogram preprocessing as a statistical restoration problem in which the goal is to obtain the best estimate of the line integrals needed for reconstruction from the set of noisy, degraded measurements. The authors have explored both penalized Poisson likelihood (PL) and penalized weighted least-squares (PWLS) objective functions. At low doses, the authors found that the PL approach outperforms PWLS in terms of resolution-noise tradeoffs, but at standard doses they perform similarly. The PWLS objective function, being quadratic, is more amenable to computational acceleration than the PL objective. In this work, the authors develop and compare two different methods for implementing PWLS sinogram restoration with the hope of improving computational performance relative to PL in the standard-dose regime. Sinogram restoration is still significant in the standard-dose regime since it can still outperform standard approaches and it allows for correction of effects that are not usually modeled in standard CT preprocessing. The authors have explored and compared two implementation strategies for PWLS sinogram restoration: (1) A direct matrix-inversion strategy based on the closed-form solution to the PWLS optimization problem and (2) an iterative approach based on the conjugate-gradient algorithm. Obtaining optimal performance from each strategy required modifying the naive off-the-shelf implementations of the algorithms to exploit the particular symmetry and sparseness of the sinogram-restoration problem. For the closed-form approach, the authors subdivided the large matrix inversion into smaller coupled problems and exploited sparseness to minimize matrix operations. For the conjugate-gradient approach, the authors exploited sparseness and preconditioned the problem to speed up convergence. All methods produced qualitatively and quantitatively similar images as measured by resolution-variance tradeoffs and difference images. Despite the acceleration strategies, the direct matrix-inversion approach was found to be uncompetitive with iterative approaches, with a computational burden higher by an order of magnitude or more. The iterative conjugate-gradient approach, however, does appear promising, with computation times half that of the authors' previous penalized-likelihood implementation. Iterative conjugate-gradient based PWLS sinogram restoration with careful matrix optimizations has computational advantages over direct matrix PWLS inversion and over penalized-likelihood sinogram restoration and can be considered a good alternative in standard-dose regimes.

Effects of malnutrition on complication rates, length of hospital stay, and revenue in elective surgical patients in the G-DRG-system.

PubMed

Thomas, Michael N; Kufeldt, Johannes; Kisser, Ulrich; Hornung, Hans-Martin; Hoffmann, Jessica; Andraschko, Monika; Werner, Jens; Rittler, Peter

2016-02-01

Malnutrition is known to independently affect patient outcomes. The aim of this study was to investigate the prevalence of patients at risk for malnutrition in an elective surgery patient cohort and to analyze the effects of malnutrition on morbidity, mortality, and hospital length of hospital (LOS). Furthermore, we aimed to evaluate the economic effect of a diligent coding of malnutrition, as a side diagnosis, in a simulation of the German Diagnosis-Related Group system. The nutritional status of 1244 patients undergoing elective surgery was standardized on the day of admission by the Nutritional Risk Screening (NRS) 2002. To quantify the influence of malnutrition on revenue, the real DRGs of all patients were grouped. In simulation, an appropriate International Classification of Diseases code was used as a secondary diagnosis for all malnourished patients based on the NRS rating. A multivariate logistic regression analysis and a Cox regression were performed to identify potential confounders and to determine the adjusted effect of nutritional status on the occurrence of complications and hospital LOS. The prevalence of patients at risk for malnutrition (NRS ≥3) was 24.1% (300 of 1244). These patients showed a significant increase in hospital LOS (13 versus 7 d). Additionally, postoperative complications were significantly higher in this group (7.23% versus 6.91%). Including malnutrition in the Diagnosis-Related Group coding system resulted in a reimbursement of €1979.67 per patient at risk for malnutrition and a total reimbursement of €79,186.73 for all patients at risk for malnutrition in the present study. Establishment of a structured, comprehensive assessment of the nutritional status of hospitalized patients can repetitiously identify patients at risk for malnutrition. Additionally, the diligent codification of malnutrition can lead to cost compensation in the German Diagnosis-Related Group system. Copyright © 2016 Elsevier Inc. All rights reserved.

VizieR Online Data Catalog: NLTE spectral analysis of white dwarf G191-B2B (Rauch+, 2013)

NASA Astrophysics Data System (ADS)

Rauch, T.; Werner, K.; Bohlin, R.; Kruk, J. W.

2013-08-01

In the framework of the Virtual Observatory, the German Astrophysical Virtual Observatory developed the registered service TheoSSA. It provides easy access to stellar spectral energy distributions (SEDs) and is intended to ingest SEDs calculated by any model-atmosphere code. In case of the DA white dwarf G191-B2B, we demonstrate that the model reproduces not only its overall continuum shape but also the numerous metal lines exhibited in its ultraviolet spectrum. (3 data files).

Western Europe: Battery forecast report - status 1995 and outlook. Summary

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

Kellinghusen, G.

1996-09-01

This presentation will cover the following main topics: (1) The market situation and the market players; (2) The Western European starter battery market in 1995 and outlook and 3. New European starter battery coding system: European Type Number (ETN). The current situation in the Western Europe lead battery market has the following features: (a) Market globalization; (b) a dramatic erosion of prices; (c) the acceleration of technological change; (d) {open_quotes}time to market{close_quotes} as a new competitive dimension and, (e) a strong German currency in the foreseeable future.

Penalized Multi-Way Partial Least Squares for Smooth Trajectory Decoding from Electrocorticographic (ECoG) Recording

PubMed Central

Eliseyev, Andrey; Aksenova, Tetiana

2016-01-01

In the current paper the decoding algorithms for motor-related BCI systems for continuous upper limb trajectory prediction are considered. Two methods for the smooth prediction, namely Sobolev and Polynomial Penalized Multi-Way Partial Least Squares (PLS) regressions, are proposed. The methods are compared to the Multi-Way Partial Least Squares and Kalman Filter approaches. The comparison demonstrated that the proposed methods combined the prediction accuracy of the algorithms of the PLS family and trajectory smoothness of the Kalman Filter. In addition, the prediction delay is significantly lower for the proposed algorithms than for the Kalman Filter approach. The proposed methods could be applied in a wide range of applications beyond neuroscience. PMID:27196417

Cox Regression Models with Functional Covariates for Survival Data.

PubMed

Gellar, Jonathan E; Colantuoni, Elizabeth; Needham, Dale M; Crainiceanu, Ciprian M

2015-06-01

We extend the Cox proportional hazards model to cases when the exposure is a densely sampled functional process, measured at baseline. The fundamental idea is to combine penalized signal regression with methods developed for mixed effects proportional hazards models. The model is fit by maximizing the penalized partial likelihood, with smoothing parameters estimated by a likelihood-based criterion such as AIC or EPIC. The model may be extended to allow for multiple functional predictors, time varying coefficients, and missing or unequally-spaced data. Methods were inspired by and applied to a study of the association between time to death after hospital discharge and daily measures of disease severity collected in the intensive care unit, among survivors of acute respiratory distress syndrome.

A Permutation Approach for Selecting the Penalty Parameter in Penalized Model Selection

PubMed Central

Sabourin, Jeremy A; Valdar, William; Nobel, Andrew B

2015-01-01

Summary We describe a simple, computationally effcient, permutation-based procedure for selecting the penalty parameter in LASSO penalized regression. The procedure, permutation selection, is intended for applications where variable selection is the primary focus, and can be applied in a variety of structural settings, including that of generalized linear models. We briefly discuss connections between permutation selection and existing theory for the LASSO. In addition, we present a simulation study and an analysis of real biomedical data sets in which permutation selection is compared with selection based on the following: cross-validation (CV), the Bayesian information criterion (BIC), Scaled Sparse Linear Regression, and a selection method based on recently developed testing procedures for the LASSO. PMID:26243050

Functional Generalized Structured Component Analysis.

PubMed

Suk, Hye Won; Hwang, Heungsun

2016-12-01

An extension of Generalized Structured Component Analysis (GSCA), called Functional GSCA, is proposed to analyze functional data that are considered to arise from an underlying smooth curve varying over time or other continua. GSCA has been geared for the analysis of multivariate data. Accordingly, it cannot deal with functional data that often involve different measurement occasions across participants and a large number of measurement occasions that exceed the number of participants. Functional GSCA addresses these issues by integrating GSCA with spline basis function expansions that represent infinite-dimensional curves onto a finite-dimensional space. For parameter estimation, functional GSCA minimizes a penalized least squares criterion by using an alternating penalized least squares estimation algorithm. The usefulness of functional GSCA is illustrated with gait data.

Objective speech quality assessment and the RPE-LTP coding algorithm in different noise and language conditions.

PubMed

Hansen, J H; Nandkumar, S

1995-01-01

The formulation of reliable signal processing algorithms for speech coding and synthesis require the selection of a prior criterion of performance. Though coding efficiency (bits/second) or computational requirements can be used, a final performance measure must always include speech quality. In this paper, three objective speech quality measures are considered with respect to quality assessment for American English, noisy American English, and noise-free versions of seven languages. The purpose is to determine whether objective quality measures can be used to quantify changes in quality for a given voice coding method, with a known subjective performance level, as background noise or language conditions are changed. The speech coding algorithm chosen is regular-pulse excitation with long-term prediction (RPE-LTP), which has been chosen as the standard voice compression algorithm for the European Digital Mobile Radio system. Three areas are considered for objective quality assessment which include: (i) vocoder performance for American English in a noise-free environment, (ii) speech quality variation for three additive background noise sources, and (iii) noise-free performance for seven languages which include English, Japanese, Finnish, German, Hindi, Spanish, and French. It is suggested that although existing objective quality measures will never replace subjective testing, they can be a useful means of assessing changes in performance, identifying areas for improvement in algorithm design, and augmenting subjective quality tests for voice coding/compression algorithms in noise-free, noisy, and/or non-English applications.

Methodology, status and plans for development and assessment of the code ATHLET

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

Teschendorff, V.; Austregesilo, H.; Lerchl, G.

1997-07-01

The thermal-hydraulic computer code ATHLET (Analysis of THermal-hydraulics of LEaks and Transients) is being developed by the Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS) for the analysis of anticipated and abnormal plant transients, small and intermediate leaks as well as large breaks in light water reactors. The aim of the code development is to cover the whole spectrum of design basis and beyond design basis accidents (without core degradation) for PWRs and BWRs with only one code. The main code features are: advanced thermal-hydraulics; modular code architecture; separation between physical models and numerical methods; pre- and post-processing tools; portability. The codemore » has features that are of special interest for applications to small leaks and transients with accident management, e.g. initialization by a steady-state calculation, full-range drift-flux model, dynamic mixture level tracking. The General Control Simulation Module of ATHLET is a flexible tool for the simulation of the balance-of-plant and control systems including the various operator actions in the course of accident sequences with AM measures. The code development is accompained by a systematic and comprehensive validation program. A large number of integral experiments and separate effect tests, including the major International Standard Problems, have been calculated by GRS and by independent organizations. The ATHLET validation matrix is a well balanced set of integral and separate effects tests derived from the CSNI proposal emphasizing, however, the German combined ECC injection system which was investigated in the UPTF, PKL and LOBI test facilities.« less

Difficulties experienced by migrant physicians working in German hospitals: a qualitative interview study.

PubMed

Klingler, Corinna; Marckmann, Georg

2016-09-23

With Germany facing a shortage of doctors, hospitals have been increasingly recruiting physicians from abroad. Studies in other countries have shown that migrant physicians experience various difficulties in their work, which might impact the quality of patient care, physician job satisfaction, and, accordingly, retention. The experiences of migrant doctors in Germany have not been systematically studied so far and will likely differ from experiences migrant physicians make in other contexts. A thorough understanding of challenges faced by this group, however, is needed to develop adequate support structures-as required by the WHO Global Code of Practice on the International Recruitment of Health Personnel. A qualitative study was conducted to give an overview of the multifaceted difficulties migrant physicians might face in German hospitals. Twenty semi-structured interviews with foreign-born and foreign-trained physicians were conducted in German. Participants were recruited via the State Chambers of Physicians and snowballing based on a maximum variation sampling strategy varying purposefully by source country and medical specialty. The interviews were recorded, transcribed verbatim, and analysed using qualitative content analysis. Participants described difficulties relating to healthcare institutions, own competencies, and interpersonal interactions. Participants experienced certain legal norms, the regulation of licensure and application for work, and the organization of the hospital environment as inadequate. Most struggled with their lack of setting-specific (language, cultural, clinical, and system) knowledge. Furthermore, behaviour of patients and co-workers was perceived as discriminating or inadequate for other reasons. This is the first study to describe the broad range of issues migrant physicians experience in Germany. Based on this information, institutional actors should devise support structures to ensure quality of care, physician wellbeing, and retention. For example, training opportunities should be offered where needed to support acquisition of setting-specific knowledge. Discrimination experienced by participants calls for better diversity management as a leadership task in healthcare institutions. Misinformation practices in recruitment could be managed by a voluntary code of ethical conduct. Further research is necessary to identify strategies that adequately address diverging normative positions between migrant health personnel and their patients and colleagues.

Patent and product piracy

NASA Astrophysics Data System (ADS)

Ignat, V.

2016-08-01

Advanced industrial countries are affected by technology theft. German industry annually loses more than 50 billion euros. The main causes are industrial espionage and fraudulent copying patents and industrial products. Many Asian countries are profiteering saving up to 65% of production costs. Most affected are small medium enterprises, who do not have sufficient economic power to assert themselves against some powerful countries. International organizations, such as Interpol and World Customs Organization - WCO - work together to combat international economic crime. Several methods of protection can be achieved by registering patents or specific technical methods for recognition of product originality. They have developed more suitable protection, like Hologram, magnetic stripe, barcode, CE marking, digital watermarks, DNA or Nano-technologies, security labels, radio frequency identification, micro color codes, matrix code, cryptographic encodings. The automotive industry has developed the method “Manufactures against Product Piracy”. A sticker on the package features original products and it uses a Data Matrix verifiable barcode. The code can be recorded with a smartphone camera. The smartphone is connected via Internet to a database, where the identification numbers of the original parts are stored.

[Quality of case allocation of orthopedics and trauma surgery in the 2004 and 2014 versions of the German DRG system. An interim assessment of the development process].

PubMed

Franz, D; Schemmann, F; Selter, D D; Auhuber, T; Gehweiler, D; Roeder, N; Siebert, H; Mahlke, L

2014-10-01

Since 2004 the German diagnosis-related groups (DRG) system has been applied nationwide in all German somatic hospitals. The G-DRG system is updated annually in order to increase the quality of case allocation. What developments have occurred since 2004 from the perspective of orthopedics and trauma surgery? This article takes stock of the developments between 2004 and 2014. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2004 and 2014 based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). The number of G-DRGs in the whole system increased by 45.1 % between 2004 and 2014. The number of G-DRGs in the major diagnostic category (MDC) 08 that contains the majority of orthopedic and trauma surgery categories increased in the same period by 61.6 %. The reduction of variance of inlier costs in the MDC 08 category, a statistical measure of the performance of the G-DRG system, was below the corresponding value of the total system in 2004 as well in 2014. However, the reduction of variance of inlier costs in MDC 08 (+ 30.0 %) rose more from 2004 to 2014 than the corresponding value of the overall system (+ 21.5 %). Many modifications of the classification systems of diagnoses (ICD-10-GM) and medical procedures (OPS) and the structures of the G-DRG system could significantly improve the quality of case allocation from the perspective of orthopedics and trauma surgery between 2004 and 2014. Th assignment of cases could be differentiated so that complex cases with more utilization of resources were allocated to higher rated G-DRGs and vice versa. However, further improvements of the G-DRG system are necessary. Only correct and complete documentation and coding can provide a high quality of calculation of costs as a basis for a correct case allocation in future G-DRG systems.

A powerful and flexible approach to the analysis of RNA sequence count data

PubMed Central

Zhou, Yi-Hui; Xia, Kai; Wright, Fred A.

2011-01-01

Motivation: A number of penalization and shrinkage approaches have been proposed for the analysis of microarray gene expression data. Similar techniques are now routinely applied to RNA sequence transcriptional count data, although the value of such shrinkage has not been conclusively established. If penalization is desired, the explicit modeling of mean–variance relationships provides a flexible testing regimen that ‘borrows’ information across genes, while easily incorporating design effects and additional covariates. Results: We describe BBSeq, which incorporates two approaches: (i) a simple beta-binomial generalized linear model, which has not been extensively tested for RNA-Seq data and (ii) an extension of an expression mean–variance modeling approach to RNA-Seq data, involving modeling of the overdispersion as a function of the mean. Our approaches are flexible, allowing for general handling of discrete experimental factors and continuous covariates. We report comparisons with other alternate methods to handle RNA-Seq data. Although penalized methods have advantages for very small sample sizes, the beta-binomial generalized linear model, combined with simple outlier detection and testing approaches, appears to have favorable characteristics in power and flexibility. Availability: An R package containing examples and sample datasets is available at http://www.bios.unc.edu/research/genomic_software/BBSeq Contact: yzhou@bios.unc.edu; fwright@bios.unc.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:21810900

Flexible and structured survival model for a simultaneous estimation of non-linear and non-proportional effects and complex interactions between continuous variables: Performance of this multidimensional penalized spline approach in net survival trend analysis.

PubMed

Remontet, Laurent; Uhry, Zoé; Bossard, Nadine; Iwaz, Jean; Belot, Aurélien; Danieli, Coraline; Charvat, Hadrien; Roche, Laurent

2018-01-01

Cancer survival trend analyses are essential to describe accurately the way medical practices impact patients' survival according to the year of diagnosis. To this end, survival models should be able to account simultaneously for non-linear and non-proportional effects and for complex interactions between continuous variables. However, in the statistical literature, there is no consensus yet on how to build such models that should be flexible but still provide smooth estimates of survival. In this article, we tackle this challenge by smoothing the complex hypersurface (time since diagnosis, age at diagnosis, year of diagnosis, and mortality hazard) using a multidimensional penalized spline built from the tensor product of the marginal bases of time, age, and year. Considering this penalized survival model as a Poisson model, we assess the performance of this approach in estimating the net survival with a comprehensive simulation study that reflects simple and complex realistic survival trends. The bias was generally small and the root mean squared error was good and often similar to that of the true model that generated the data. This parametric approach offers many advantages and interesting prospects (such as forecasting) that make it an attractive and efficient tool for survival trend analyses.

Robust Gaussian Graphical Modeling via l1 Penalization

PubMed Central

Sun, Hokeun; Li, Hongzhe

2012-01-01

Summary Gaussian graphical models have been widely used as an effective method for studying the conditional independency structure among genes and for constructing genetic networks. However, gene expression data typically have heavier tails or more outlying observations than the standard Gaussian distribution. Such outliers in gene expression data can lead to wrong inference on the dependency structure among the genes. We propose a l1 penalized estimation procedure for the sparse Gaussian graphical models that is robustified against possible outliers. The likelihood function is weighted according to how the observation is deviated, where the deviation of the observation is measured based on its own likelihood. An efficient computational algorithm based on the coordinate gradient descent method is developed to obtain the minimizer of the negative penalized robustified-likelihood, where nonzero elements of the concentration matrix represents the graphical links among the genes. After the graphical structure is obtained, we re-estimate the positive definite concentration matrix using an iterative proportional fitting algorithm. Through simulations, we demonstrate that the proposed robust method performs much better than the graphical Lasso for the Gaussian graphical models in terms of both graph structure selection and estimation when outliers are present. We apply the robust estimation procedure to an analysis of yeast gene expression data and show that the resulting graph has better biological interpretation than that obtained from the graphical Lasso. PMID:23020775

Do perceived context pictures automatically activate their phonological code?

PubMed

Jescheniak, Jörg D; Oppermann, Frank; Hantsch, Ansgar; Wagner, Valentin; Mädebach, Andreas; Schriefers, Herbert

2009-01-01

Morsella and Miozzo (Morsella, E., & Miozzo, M. (2002). Evidence for a cascade model of lexical access in speech production. Journal of Experimental Psychology: Learning, Memory, and Cognition, 28, 555-563) have reported that the to-be-ignored context pictures become phonologically activated when participants name a target picture, and took this finding as support for cascaded models of lexical retrieval in speech production. In a replication and extension of their experiment in German, we failed to obtain priming effects from context pictures phonologically related to a to-be-named target picture. By contrast, corresponding context words (i.e., the names of the respective pictures) and the same context pictures, when used in an identity condition, did reliably facilitate the naming process. This pattern calls into question the generality of the claim advanced by Morsella and Miozzo that perceptual processing of pictures in the context of a naming task automatically leads to the activation of corresponding lexical-phonological codes.

UV-induced occupational skin cancer: possibilities of secondary individual prevention in the "Dermatologist's Procedure".

PubMed

Elsner, Peter; Blome, Otto; Diepgen, Thomas Ludwig

2013-07-01

Invasive squamous cell carcinoma (SCC) as a "quasi occupational disease" according to §9 Section 2 of the German Social Code Book (SGB) VII typically develops on chronically UV-damaged skin from actinic keratoses. After the Medical Scientific Committee of the Federal Ministry of Labor and Social Affairs has confirmed the legal criteria for acknowledging UV-induced SCC as an occupational disease, it is expected that the condition will be added to the official list of occupational diseases issued by the Federal Government in the near future. The Social Accident Insurance is required by law (§3 Occupational Disease Regulation) to prevent these tumors by "all appropriate means". There are excellent therapeutic and preventive measures for the management of actinic keratoses to avoid the development of SCC. The "Dermatologist's Procedure" according to §§ 41-43 of the agreement between the Social Accident Insurance and the Federal Medical Association was established in Germany in 1972 to take preventive measures in insured persons with skin lesions possibly developing into an occupational disease, or worsening it, or leading to a recurrence of it This procedure proved to be very successful in the prevention of severe and/or recurring skin diseases forcing a worker to leave his job. On the basis of this agreement, the Social Accident Insurance has the instruments to independently provide preventive measures for the new occupational skin disease SCC induced by natural UV light according to §9 Section 2 of the German Social Code Book (SGB) VII. © The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.

[Changes in clinical standards and the need for adjusting legal standards of care from the point of view of civil law].

PubMed

Rosenberger, Rainer

2007-01-01

The legal standard of medical care is laid down in Sect. 276 of the German Civil Code (principle of due diligence). It applies to both contractual and tortious liability and likewise to the treatment of patients insured under the statutory health insurance scheme and self-payers. The legal standard of care conforms to the clinical standards because medical liability means medical professional liability. Liability law does not distinguish between different standards of care in the treatment of patients insured under the statutory health insurance scheme on the one hand and privately insured patients on the other. Changes in clinical standards immediately affect liability law without the need for formal adaptation of the legal standard of care. Liability law cannot claim more diligence than that owed from a medical point of view. Legislative changes that result in a lowering of medical standards (reduction in the quality of treatment) will have to be accepted by liability law, even if these are regulations pertaining to Social Law (SGB V, Book 5 of the German Social Code). In this respect, the principle of legal unity applies. In consideration of this kind of changes the due diligence requirements for the treatment of patients insured under the statutory health insurance scheme and privately insured patients remain basically equal. If these changes lead to an increase of risk for the patient, the resulting liabilities are not to be attributed to the therapist. What remains to be seen is whether there will be an increased attempt to minimise risk by "additionally purchasing health care services".

Side-information-dependent correlation channel estimation in hash-based distributed video coding.

PubMed

Deligiannis, Nikos; Barbarien, Joeri; Jacobs, Marc; Munteanu, Adrian; Skodras, Athanassios; Schelkens, Peter

2012-04-01

In the context of low-cost video encoding, distributed video coding (DVC) has recently emerged as a potential candidate for uplink-oriented applications. This paper builds on a concept of correlation channel (CC) modeling, which expresses the correlation noise as being statistically dependent on the side information (SI). Compared with classical side-information-independent (SII) noise modeling adopted in current DVC solutions, it is theoretically proven that side-information-dependent (SID) modeling improves the Wyner-Ziv coding performance. Anchored in this finding, this paper proposes a novel algorithm for online estimation of the SID CC parameters based on already decoded information. The proposed algorithm enables bit-plane-by-bit-plane successive refinement of the channel estimation leading to progressively improved accuracy. Additionally, the proposed algorithm is included in a novel DVC architecture that employs a competitive hash-based motion estimation technique to generate high-quality SI at the decoder. Experimental results corroborate our theoretical gains and validate the accuracy of the channel estimation algorithm. The performance assessment of the proposed architecture shows remarkable and consistent coding gains over a germane group of state-of-the-art distributed and standard video codecs, even under strenuous conditions, i.e., large groups of pictures and highly irregular motion content.

29 CFR 1975.5 - States and political subdivisions thereof.

Code of Federal Regulations, 2010 CFR

2010-07-01

... penal institutions; State, county, and municipal judicial bodies; State University Boards of Trustees; State, county, and municipal public school boards and commissions; and public libraries. (2) Depending...

Analyzing Test-Taking Behavior: Decision Theory Meets Psychometric Theory.

PubMed

Budescu, David V; Bo, Yuanchao

2015-12-01

We investigate the implications of penalizing incorrect answers to multiple-choice tests, from the perspective of both test-takers and test-makers. To do so, we use a model that combines a well-known item response theory model with prospect theory (Kahneman and Tversky, Prospect theory: An analysis of decision under risk, Econometrica 47:263-91, 1979). Our results reveal that when test-takers are fully informed of the scoring rule, the use of any penalty has detrimental effects for both test-takers (they are always penalized in excess, particularly those who are risk averse and loss averse) and test-makers (the bias of the estimated scores, as well as the variance and skewness of their distribution, increase as a function of the severity of the penalty).

Fisher's method of scoring in statistical image reconstruction: comparison of Jacobi and Gauss-Seidel iterative schemes.

PubMed

Hudson, H M; Ma, J; Green, P

1994-01-01

Many algorithms for medical image reconstruction adopt versions of the expectation-maximization (EM) algorithm. In this approach, parameter estimates are obtained which maximize a complete data likelihood or penalized likelihood, in each iteration. Implicitly (and sometimes explicitly) penalized algorithms require smoothing of the current reconstruction in the image domain as part of their iteration scheme. In this paper, we discuss alternatives to EM which adapt Fisher's method of scoring (FS) and other methods for direct maximization of the incomplete data likelihood. Jacobi and Gauss-Seidel methods for non-linear optimization provide efficient algorithms applying FS in tomography. One approach uses smoothed projection data in its iterations. We investigate the convergence of Jacobi and Gauss-Seidel algorithms with clinical tomographic projection data.

Stationary wavelet transform for under-sampled MRI reconstruction.

PubMed

Kayvanrad, Mohammad H; McLeod, A Jonathan; Baxter, John S H; McKenzie, Charles A; Peters, Terry M

2014-12-01

In addition to coil sensitivity data (parallel imaging), sparsity constraints are often used as an additional lp-penalty for under-sampled MRI reconstruction (compressed sensing). Penalizing the traditional decimated wavelet transform (DWT) coefficients, however, results in visual pseudo-Gibbs artifacts, some of which are attributed to the lack of translation invariance of the wavelet basis. We show that these artifacts can be greatly reduced by penalizing the translation-invariant stationary wavelet transform (SWT) coefficients. This holds with various additional reconstruction constraints, including coil sensitivity profiles and total variation. Additionally, SWT reconstructions result in lower error values and faster convergence compared to DWT. These concepts are illustrated with extensive experiments on in vivo MRI data with particular emphasis on multiple-channel acquisitions. Copyright © 2014 Elsevier Inc. All rights reserved.

[The German DRG system 2003-2010 from the perspective of intensive care medicine].

PubMed

Franz, Dominik; Bunzemeier, Holger; Roeder, Norbert; Reinecke, Holger

2010-01-01

Intensive care medicine is extremely heterogeneous, expensive and can only be partially planned and controlled. A correct and fair representation of intensive care medicine in the G-DRG system is an essential requirement for the use as a pricing system. From the perspective of intensive care medicine, pertinent changes of the DRG structure and differentiation of relevant parameters have been established within the G-DRG systems 2003-2010. Analysis of relevant diagnoses, medical procedures, co-payment structures and G-DRGs in the versions 2003-2010 based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Since the first G-DRG system version 2003, numerous measures improved quality of case allocation of intensive care medicine. Highly relevant to the system version 2010 are duration of mechanical ventilation, the intensive care treatment complex and complicating constellations. The number of G-DRGs relevant to intensive medical care increased from n = 3 (2003) to n = 58 (2010). For standard cases, quality of case allocation and G-DRG reimbursement are adequate in 2010. The G-DRG system gained complexity again. High demands are made on correct and complete coding of complex cases. Nevertheless, further adjustments of the G-DRG system especially for cases with extremely high costs are necessary. Where the G-DRG system is unable to cover extremely high-cost cases, reimbursement solutions beyond the G-DRG structure should be taken into account.

Integrated image data and medical record management for rare disease registries. A general framework and its instantiation to theGerman Calciphylaxis Registry.

PubMed

Deserno, Thomas M; Haak, Daniel; Brandenburg, Vincent; Deserno, Verena; Classen, Christoph; Specht, Paula

2014-12-01

Especially for investigator-initiated research at universities and academic institutions, Internet-based rare disease registries (RDR) are required that integrate electronic data capture (EDC) with automatic image analysis or manual image annotation. We propose a modular framework merging alpha-numerical and binary data capture. In concordance with the Office of Rare Diseases Research recommendations, a requirement analysis was performed based on several RDR databases currently hosted at Uniklinik RWTH Aachen, Germany. With respect to the study management tool that is already successfully operating at the Clinical Trial Center Aachen, the Google Web Toolkit was chosen with Hibernate and Gilead connecting a MySQL database management system. Image and signal data integration and processing is supported by Apache Commons FileUpload-Library and ImageJ-based Java code, respectively. As a proof of concept, the framework is instantiated to the German Calciphylaxis Registry. The framework is composed of five mandatory core modules: (1) Data Core, (2) EDC, (3) Access Control, (4) Audit Trail, and (5) Terminology as well as six optional modules: (6) Binary Large Object (BLOB), (7) BLOB Analysis, (8) Standard Operation Procedure, (9) Communication, (10) Pseudonymization, and (11) Biorepository. Modules 1-7 are implemented in the German Calciphylaxis Registry. The proposed RDR framework is easily instantiated and directly integrates image management and analysis. As open source software, it may assist improved data collection and analysis of rare diseases in near future.

Polymorphisms of methylenetetrahydrofolate reductase (MTHFR) and susceptibility to pediatric acute lymphoblastic leukemia in a German study population.

PubMed

Schnakenberg, Eckart; Mehles, Andrea; Cario, Gunnar; Rehe, Klaus; Seidemann, Kathrin; Schlegelberger, Brigitte; Elsner, Holger A; Welte, Karl H; Schrappe, Martin; Stanulla, Martin

2005-05-27

Methylenetetrahydrofolate reductase (MTHFR) has a major impact on the regulation of the folic acid pathway due to conversion of 5,10-methylenetetrahydrofolate (methylene-THF) to 5-methyl-THF. Two common polymorphisms (677C>T and 1298A>C) in the gene coding for MTHFR have been shown to reduce MTHFR enzyme activity and were associated with the susceptibility to different disorders, including vascular disease, neural tube defects and lymphoid malignancies. Studies on the role of these polymorphisms in the susceptibility to acute lymphoblastic leukemia (ALL) led to discrepant results. We retrospectively evaluated the association of the MTHFR 677C>T and 1298A>C polymorphisms with pediatric ALL by genotyping a study sample of 443 ALL patients consecutively enrolled onto the German multicenter trial ALL-BFM 2000 and 379 healthy controls. We calculated odds ratios of MTHFR genotypes based on the MTHFR 677C>T and 1298A>C polymorphisms to examine if one or both of these polymorphisms are associated with pediatric ALL. No significant associations between specific MTHFR variants or combinations of variants and risk of ALL were observed neither in the total patient group nor in analyses stratified by gender, age at diagnosis, DNA index, immunophenotype, or TEL/AML1 rearrangement. Our findings suggest that the MTHFR 677C>T and 1298A>C gene variants do not have a major influence on the susceptibility to pediatric ALL in the German population.

Polymorphisms of methylenetetrahydrofolate reductase (MTHFR) and susceptibility to pediatric acute lymphoblastic leukemia in a German study population

PubMed Central

Schnakenberg, Eckart; Mehles, Andrea; Cario, Gunnar; Rehe, Klaus; Seidemann, Kathrin; Schlegelberger, Brigitte; Elsner, Holger A; Welte, Karl H; Schrappe, Martin; Stanulla, Martin

2005-01-01

Background Methylenetetrahydrofolate reductase (MTHFR) has a major impact on the regulation of the folic acid pathway due to conversion of 5,10-methylenetetrahydrofolate (methylene-THF) to 5-methyl-THF. Two common polymorphisms (677C>T and 1298A>C) in the gene coding for MTHFR have been shown to reduce MTHFR enzyme activity and were associated with the susceptibility to different disorders, including vascular disease, neural tube defects and lymphoid malignancies. Studies on the role of these polymorphisms in the susceptibility to acute lymphoblastic leukemia (ALL) led to discrepant results. Methods We retrospectively evaluated the association of the MTHFR 677C>T and 1298A>C polymorphisms with pediatric ALL by genotyping a study sample of 443 ALL patients consecutively enrolled onto the German multicenter trial ALL-BFM 2000 and 379 healthy controls. We calculated odds ratios of MTHFR genotypes based on the MTHFR 677C>T and 1298A>C polymorphisms to examine if one or both of these polymorphisms are associated with pediatric ALL. Results No significant associations between specific MTHFR variants or combinations of variants and risk of ALL were observed neither in the total patient group nor in analyses stratified by gender, age at diagnosis, DNA index, immunophenotype, or TEL/AML1 rearrangement. Conclusion Our findings suggest that the MTHFR 677C>T and 1298A>C gene variants do not have a major influence on the susceptibility to pediatric ALL in the German population. PMID:15921520

Comparing implementations of penalized weighted least-squares sinogram restoration

PubMed Central

Forthmann, Peter; Koehler, Thomas; Defrise, Michel; La Riviere, Patrick

2010-01-01

Purpose: A CT scanner measures the energy that is deposited in each channel of a detector array by x rays that have been partially absorbed on their way through the object. The measurement process is complex and quantitative measurements are always and inevitably associated with errors, so CT data must be preprocessed prior to reconstruction. In recent years, the authors have formulated CT sinogram preprocessing as a statistical restoration problem in which the goal is to obtain the best estimate of the line integrals needed for reconstruction from the set of noisy, degraded measurements. The authors have explored both penalized Poisson likelihood (PL) and penalized weighted least-squares (PWLS) objective functions. At low doses, the authors found that the PL approach outperforms PWLS in terms of resolution-noise tradeoffs, but at standard doses they perform similarly. The PWLS objective function, being quadratic, is more amenable to computational acceleration than the PL objective. In this work, the authors develop and compare two different methods for implementing PWLS sinogram restoration with the hope of improving computational performance relative to PL in the standard-dose regime. Sinogram restoration is still significant in the standard-dose regime since it can still outperform standard approaches and it allows for correction of effects that are not usually modeled in standard CT preprocessing. Methods: The authors have explored and compared two implementation strategies for PWLS sinogram restoration: (1) A direct matrix-inversion strategy based on the closed-form solution to the PWLS optimization problem and (2) an iterative approach based on the conjugate-gradient algorithm. Obtaining optimal performance from each strategy required modifying the naive off-the-shelf implementations of the algorithms to exploit the particular symmetry and sparseness of the sinogram-restoration problem. For the closed-form approach, the authors subdivided the large matrix inversion into smaller coupled problems and exploited sparseness to minimize matrix operations. For the conjugate-gradient approach, the authors exploited sparseness and preconditioned the problem to speed up convergence. Results: All methods produced qualitatively and quantitatively similar images as measured by resolution-variance tradeoffs and difference images. Despite the acceleration strategies, the direct matrix-inversion approach was found to be uncompetitive with iterative approaches, with a computational burden higher by an order of magnitude or more. The iterative conjugate-gradient approach, however, does appear promising, with computation times half that of the authors’ previous penalized-likelihood implementation. Conclusions: Iterative conjugate-gradient based PWLS sinogram restoration with careful matrix optimizations has computational advantages over direct matrix PWLS inversion and over penalized-likelihood sinogram restoration and can be considered a good alternative in standard-dose regimes. PMID:21158306

[Epidemiology of occupational skin cancer due to UV-irradiation].

PubMed

Diepgen, T L; Drexler, H; Schmitt, J

2012-10-01

Skin cancer induced by occupational UV-irradiation is not an official occupational disease number in the appendix of the German ordinance on occupational diseases (Berufskrankheitenverordnung (BKV) but can be recognized as a "virtually" occupational disease according to § 9 (2) of the 7th book of the German Social Code (SGB VII). Epidemiological studies have demonstrated a positive, statistically significant and relevant association between occupational UV-irradiation and the risk of squamous cell carcinoma (SCC) and actinic keratoses (AK). Outdoor workers have on average a 100% higher risk to develop SCC compared to the general population. Therefore, the prerequisites for a new occupational disease are fulfilled and SCC and AK should be reported as an occupational disease if an additional 40% occupationally-related UV-irradiation is documented and the clinical criteria are typical for work- related skin cancer. Epidemiologic evidence also indicates a significant association between work-related UV-irradiation and basal cell carcinoma (BCC) risk: however the results are less consistent and the association is weaker than with SCC. There is an urgent need for further studies in outdoor workers on BCC and lentigo maligna melanoma.

MO-DE-207A-10: One-Step CT Reconstruction for Metal Artifact Reduction by a Modification of Penalized Weighted Least-Squares (PWLS)

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

Kim, H; Chen, J

Purpose: Metal objects create severe artifacts in kilo-voltage (kV) CT image reconstructions due to the high attenuation coefficients of high atomic number objects. Most of the techniques devised to reduce this artifact utilize a two-step approach, which do not reliably yield the qualified reconstructed images. Thus, for accuracy and simplicity, this work presents a one-step reconstruction method based on a modified penalized weighted least-squares (PWLS) technique. Methods: Existing techniques for metal artifact reduction mostly adopt a two-step approach, which conduct additional reconstruction with the modified projection data from the initial reconstruction. This procedure does not consistently perform well due tomore » the uncertainties in manipulating the metal-contaminated projection data by thresholding and linear interpolation. This study proposes a one-step reconstruction process using a new PWLS operation with total-variation (TV) minimization, while not manipulating the projection. The PWLS for CT reconstruction has been investigated using a pre-defined weight, based on the variance of the projection datum at each detector bin. It works well when reconstructing CT images from metal-free projection data, which does not appropriately penalize metal-contaminated projection data. The proposed work defines the weight at each projection element under the assumption of a Poisson random variable. This small modification using element-wise penalization has a large impact in reducing metal artifacts. For evaluation, the proposed technique was assessed with two noisy, metal-contaminated digital phantoms, against the existing PWLS with TV minimization and the two-step approach. Result: The proposed PWLS with TV minimization greatly improved the metal artifact reduction, relative to the other techniques, by watching the results. Numerically, the new approach lowered the normalized root-mean-square error about 30 and 60% for the two cases, respectively, compared to the two-step method. Conclusion: A new PWLS operation shows promise for improving metal artifact reduction in CT imaging, as well as simplifying the reconstructing procedure.« less

Women in Portugal.

PubMed

Barbosa, M

1981-01-01

Prior to 1974, women in Portugal were restricted by the Penal Code and had little organizational power. Women's groups were formed within the Catholic Church to teach women about cooking, child care, and home economics. There was no contact with international women's groups. The press only reported events such as bra burning. 80% of all illiterates in Portugal are women. The conditions of Portuguese women are described after the revolution of April 25, 1974. Present roles are discussed for work, health, education, religion, trade unions and political parties, and women's organizations. The Women's Liberation Movement (WLM) appeared in May 1974 among a heterogenous group of women in Lisbon who were concerned about the oppression of women. WLM made feminist issues public amid ridicule and promoted the declaration of equal rights for women in the 1976 Republic Constitution and in the Family Code. Wage discrimination became illegal in 1979. Women represent 32.8% of the labor force. Unemployment is particularly high among women and is increasing. Women's wages and levels of skill are the lowest. The Christian Democratic government is actively engaged in a campaign to keep women at home and has formed the special Ministry of Family Affairs, which encourages large families and women's home activity in order to save jobs for men. There is a crisis in education: large class sizes and limited number of schools. Child care for the working mother is expensive when available and rarely available. An obstacle to women's rights has been the role of the Catholic Church, which fought equal rights legislation, condemned the Family Code and divorce laws, forbade the practice of contraception, and supported the movement against abortion. Only 1 member of government is a women, and she is considered a token. Trade unions have a women's section, but little attention is given to the problems of women. Women's groups within larger organizations have little autonomy. Those with autonomy are restricted and organized around specific causes, such as abortion. The liberation of women is evolving slowly.

Medical-legal issues in headache: penal and civil Italian legislation, working claims, social security, off-label prescription.

PubMed

Aguggia, M; Cavallini, M; Varetto, L

2006-05-01

Primary headaches can be considered simultaneously as symptom and disease itself, while secondary headaches are expressions of a pathological process that can be systemic or locoregional. Because of its subjective features, headache is often difficult to assess and quantify by severity, frequency and invalidity rate, and for these reasons it has often been implicated in legal controversies. Headache has seldom been considered in the criminal law, except when it represents a typical symptom of a disease whose existence can be objectively assessed (i. e. raised intracranial pressure). Therefore, in civil legislation it is not yet coded to start claiming for invalidity compensation. In particular, one of the most debated medical-legal questions is represented by headaches occurring after head injury. Headache is often the principal symptom at the beginning of several toxic chronic syndromes, with many implications, especially in working claims, and, more recently, it may be referred to as one of the most frequent symptoms by victims of mobbing (i. e. psychological harassment in the workplace). The National Institute for Industrial Accident Insurance (INAIL) scales (instituted by the law 38/2000) mention the "Subjective cranial trauma syndrome" and give an invalidity rate evaluation. With reference to other headache forms, no legislation really exists at the present time, and headache is only considered as a symptom of a certain coded disease. Requests for invalidity social pension and the question of off-label prescriptions (drug prescription for a disease, without formal indication for it) are other controversial matters.

[Benefit assessment of medical services in German health service - legal framework, historical and international perspective].

PubMed

Windeler, Jürgen; Lange, Stefan

2015-03-01

The term benefit describes the (positive) causal, patient-relevant consequences of medical interventions, whether diagnostic or therapeutic. Benefit assessments form the basis of rational decision-making within a health care system. They are based on clinical trials that are able to provide valid answers to the question regarding the relevant benefit or harm that can be caused by an intervention. In Germany, evidence-based benefit assessments are fixed by law, i.e., the Social Code Book V. The application and the practical impact of these assessments could be improved.

[Assessment of Coding in German Diagnosis Related Groups System in Otorhinolaryngology].

PubMed

Ellies, Maik; Anders, Berit; Seger, Wolfgang

2018-05-14

Prospective analysis of assessment reports in otorhinolaryngology for the period 01-03-2011 to 31-03-2017 by the Health Advisory Boards in Lower Saxony and Bremen, Germany in relation to coding in the G-DRG-System. The assessment reports were documented using a standardized database system developed on the basis of the electronic data exchange (DTA) by the Health Advisory Board in Lower Saxony. In addition, the documentation of the assessment reports according to the G-DRG system was used for assessment. Furthermore, the assessment of a case was evaluated once again on the basis of the present assessment documents and presented as an example in detail. During the period from 01-03-2011 to 31-03-2017, a total of 27,424 cases of inpatient assessments of DRGs according to the G-DRG system were collected in the field of otorhinolaryngology. In 7,259 cases, the DRG was changed, and in 20,175 cases, the suspicion of a DRG-relevant coding error was not justified in the review; thus, a DRG change rate of 26% of the assessments was identified over the time period investigated. There were different kinds of coding errors. In order to improve the coding quality in otorhinolaryngology, in addition to the special consideration of the presented "hit list" by the otorhinolaryngology departments, there should be more intensive cooperation between hospitals and the Health Advisory Boards of the federal states. © Georg Thieme Verlag KG Stuttgart · New York.

Consent Agreement and Consent Order

EPA Pesticide Factsheets

Contains legal consent agreement and consent order for the assessment of a civil penality pursuant to Section 14(1) of the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA), BioLab Inc., Conyers, GA, September 14, 1998.

A penalized linear and nonlinear combined conjugate gradient method for the reconstruction of fluorescence molecular tomography.

PubMed

Shang, Shang; Bai, Jing; Song, Xiaolei; Wang, Hongkai; Lau, Jaclyn

2007-01-01

Conjugate gradient method is verified to be efficient for nonlinear optimization problems of large-dimension data. In this paper, a penalized linear and nonlinear combined conjugate gradient method for the reconstruction of fluorescence molecular tomography (FMT) is presented. The algorithm combines the linear conjugate gradient method and the nonlinear conjugate gradient method together based on a restart strategy, in order to take advantage of the two kinds of conjugate gradient methods and compensate for the disadvantages. A quadratic penalty method is adopted to gain a nonnegative constraint and reduce the illposedness of the problem. Simulation studies show that the presented algorithm is accurate, stable, and fast. It has a better performance than the conventional conjugate gradient-based reconstruction algorithms. It offers an effective approach to reconstruct fluorochrome information for FMT.

Penalized nonparametric scalar-on-function regression via principal coordinates

PubMed Central

Reiss, Philip T.; Miller, David L.; Wu, Pei-Shien; Hua, Wen-Yu

2016-01-01

A number of classical approaches to nonparametric regression have recently been extended to the case of functional predictors. This paper introduces a new method of this type, which extends intermediate-rank penalized smoothing to scalar-on-function regression. In the proposed method, which we call principal coordinate ridge regression, one regresses the response on leading principal coordinates defined by a relevant distance among the functional predictors, while applying a ridge penalty. Our publicly available implementation, based on generalized additive modeling software, allows for fast optimal tuning parameter selection and for extensions to multiple functional predictors, exponential family-valued responses, and mixed-effects models. In an application to signature verification data, principal coordinate ridge regression, with dynamic time warping distance used to define the principal coordinates, is shown to outperform a functional generalized linear model. PMID:29217963

Estimation of Noise Properties for TV-regularized Image Reconstruction in Computed Tomography

PubMed Central

Sánchez, Adrian A.

2016-01-01

A method for predicting the image covariance resulting from total-variation-penalized iterative image reconstruction (TV-penalized IIR) is presented and demonstrated in a variety of contexts. The method is validated against the sample covariance from statistical noise realizations for a small image using a variety of comparison metrics. Potential applications for the covariance approximation include investigation of image properties such as object- and signal-dependence of noise, and noise stationarity. These applications are demonstrated, along with the construction of image pixel variance maps for two-dimensional 128 × 128 pixel images. Methods for extending the proposed covariance approximation to larger images and improving computational efficiency are discussed. Future work will apply the developed methodology to the construction of task-based image quality metrics such as the Hotelling observer detectability for TV-based IIR. PMID:26308968

Estimation of noise properties for TV-regularized image reconstruction in computed tomography.

PubMed

Sánchez, Adrian A

2015-09-21

A method for predicting the image covariance resulting from total-variation-penalized iterative image reconstruction (TV-penalized IIR) is presented and demonstrated in a variety of contexts. The method is validated against the sample covariance from statistical noise realizations for a small image using a variety of comparison metrics. Potential applications for the covariance approximation include investigation of image properties such as object- and signal-dependence of noise, and noise stationarity. These applications are demonstrated, along with the construction of image pixel variance maps for two-dimensional 128 × 128 pixel images. Methods for extending the proposed covariance approximation to larger images and improving computational efficiency are discussed. Future work will apply the developed methodology to the construction of task-based image quality metrics such as the Hotelling observer detectability for TV-based IIR.

Estimation of noise properties for TV-regularized image reconstruction in computed tomography

NASA Astrophysics Data System (ADS)

Sánchez, Adrian A.

2015-09-01

A method for predicting the image covariance resulting from total-variation-penalized iterative image reconstruction (TV-penalized IIR) is presented and demonstrated in a variety of contexts. The method is validated against the sample covariance from statistical noise realizations for a small image using a variety of comparison metrics. Potential applications for the covariance approximation include investigation of image properties such as object- and signal-dependence of noise, and noise stationarity. These applications are demonstrated, along with the construction of image pixel variance maps for two-dimensional 128× 128 pixel images. Methods for extending the proposed covariance approximation to larger images and improving computational efficiency are discussed. Future work will apply the developed methodology to the construction of task-based image quality metrics such as the Hotelling observer detectability for TV-based IIR.

Middle Micoene sandstone reservoirs of the Penal/Barrackpore field

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

Dyer, B.L.

1991-03-01

The Penal/Barrackpore field was discovered in 1938 and is located in the southern subbasin of onshore Trinidad. The accumulation is one of a series of northeast-southwest trending en echelon middle Miocene anticlinal structures that was later accentuated by late Pliocene transpressional folding. Relative movement of the South American and Caribbean plates climaxed in the middle Miocene compressive tectonic event and produced an imbricate pattern of southward-facing basement-involved thrusts. Further compressive interaction between the plates in the late Pliocene produced a transpressive tectonic episode forming northwest-southeast oriented transcurrent faults, tear faults, basement thrust faults, lystric normal faults, and detached simple foldsmore » with infrequent diapiric cores. The middle Miocene Herrera and Karamat turbiditic sandstones are the primary reservoir rock in the subsurface anticline of the Penal/Barrackpore field. These turbidites were sourced from the north and deposited within the marls and clays of the Cipero Formation. Miocene and Pliocene deltaics and turbidites succeed the Cipero Formation vertically, lapping into preexisting Miocene highs. The late Pliocene transpression also coincides with the onset of oil migration along faults, diapirs, and unconformities from the Cretaceous Naparima Hill source. The Lengua Formation and the upper Forest clays are considered effective seals. Hydrocarbon trapping is structurally and stratigraphically controlled, with structure being the dominant trapping mechanism. Ultimate recoverable reserves for the field are estimated at 127.9 MMBo and 628.8 bcf. The field is presently owned and operated by the Trinidad and Tobago Oil Company Limited (TRINTOC).« less

Improving multisensor estimation of heavy-to-extreme precipitation via conditional bias-penalized optimal estimation

NASA Astrophysics Data System (ADS)

Kim, Beomgeun; Seo, Dong-Jun; Noh, Seong Jin; Prat, Olivier P.; Nelson, Brian R.

2018-01-01

A new technique for merging radar precipitation estimates and rain gauge data is developed and evaluated to improve multisensor quantitative precipitation estimation (QPE), in particular, of heavy-to-extreme precipitation. Unlike the conventional cokriging methods which are susceptible to conditional bias (CB), the proposed technique, referred to herein as conditional bias-penalized cokriging (CBPCK), explicitly minimizes Type-II CB for improved quantitative estimation of heavy-to-extreme precipitation. CBPCK is a bivariate version of extended conditional bias-penalized kriging (ECBPK) developed for gauge-only analysis. To evaluate CBPCK, cross validation and visual examination are carried out using multi-year hourly radar and gauge data in the North Central Texas region in which CBPCK is compared with the variant of the ordinary cokriging (OCK) algorithm used operationally in the National Weather Service Multisensor Precipitation Estimator. The results show that CBPCK significantly reduces Type-II CB for estimation of heavy-to-extreme precipitation, and that the margin of improvement over OCK is larger in areas of higher fractional coverage (FC) of precipitation. When FC > 0.9 and hourly gauge precipitation is > 60 mm, the reduction in root mean squared error (RMSE) by CBPCK over radar-only (RO) is about 12 mm while the reduction in RMSE by OCK over RO is about 7 mm. CBPCK may be used in real-time analysis or in reanalysis of multisensor precipitation for which accurate estimation of heavy-to-extreme precipitation is of particular importance.

Treating substance abuse is not enough: comorbidities in consecutively admitted female prisoners.

PubMed

Mir, Jan; Kastner, Sinja; Priebe, Stefan; Konrad, Norbert; Ströhle, Andreas; Mundt, Adrian P

2015-07-01

Several studies have pointed to high rates of substance use disorders among female prisoners. The present study aimed to assess comorbidities of substance use disorders with other mental disorders in female prisoners at admission to a penal justice system. A sample of 150 female prisoners, consecutively admitted to the penal justice system of Berlin, Germany, was interviewed using the Mini-International Neuropsychiatric Interview (MINI). The presence of borderline personality disorder was assessed using the Structured Clinical Interview II for DSM-IV. Prevalence rates and comorbidities were calculated as percentage values and 95% confidence intervals (CIs). Ninety-three prisoners (62%; 95% CI: 54-70) had substance use disorders; n=49 (33%; 95% CI: 24-42) had alcohol abuse/dependence; n=76 (51%; 95% CI: 43-59) had illicit drug abuse/dependence; and n=53 (35%; 95% CI: 28-44) had opiate use disorders. In the group of inmates with substance use disorders, 84 (90%) had at least one other mental disorder; n=63 (68%) had comorbid affective disorders; n=45 (49%) had borderline or antisocial personality disorders; and n=41 (44%) had comorbid anxiety disorders. Female prisoners with addiction have high rates of comorbid mental disorders at admission to the penal justice system, ranging from affective to personality and anxiety disorders. Generic and robust interventions that can address different comorbid mental health problems in a flexible manner may be required to tackle widespread addiction and improve mental health of female prisoners. Copyright © 2015 Elsevier Ltd. All rights reserved.

Working through mass incarceration: gender and the politics of prison labor from east to west.

PubMed

Haney, Lynne A

2010-01-01

This article explores the politics and practices of labor in two penal institutions for women: a maximum security facility for women in Hungary and a community‐based facility for women in California. Diverging from other accounts of imprisonment that tend to operate at either the individual or macroeconomic level, this article analyzes the concrete institutional relations of prison and complicates the assumption that they simply reflect the logic of the prison‐industrial complex. Based on years of ethnographic work in two very different penal systems, I describe variation in how prisons institute labor within and across institutions and cultures: the Hungarian facility positioned wage labor as a right and an obligation that formed the basis of women’s social relationships and ties to others, while the U.S. prison excluded wage labor from women’s lives so they could get on with the work of self‐improvement and personal healing. From the comparison, I reveal how prisons can both draw on and subvert broader social meanings assigned to women’s work, making it difficult to view prison labor as wholly exploitative or abusive. I also argue that refusing to allow female inmates to engage in wage labor can be a more profound form of punishment than requiring it of them. By juxtaposing the discourses and practices of work in two very different penal contexts, this article offers a critical reflection on the political economy of prison labor from the ground up.

Adaptive low-rank subspace learning with online optimization for robust visual tracking.

PubMed

Liu, Risheng; Wang, Di; Han, Yuzhuo; Fan, Xin; Luo, Zhongxuan

2017-04-01

In recent years, sparse and low-rank models have been widely used to formulate appearance subspace for visual tracking. However, most existing methods only consider the sparsity or low-rankness of the coefficients, which is not sufficient enough for appearance subspace learning on complex video sequences. Moreover, as both the low-rank and the column sparse measures are tightly related to all the samples in the sequences, it is challenging to incrementally solve optimization problems with both nuclear norm and column sparse norm on sequentially obtained video data. To address above limitations, this paper develops a novel low-rank subspace learning with adaptive penalization (LSAP) framework for subspace based robust visual tracking. Different from previous work, which often simply decomposes observations as low-rank features and sparse errors, LSAP simultaneously learns the subspace basis, low-rank coefficients and column sparse errors to formulate appearance subspace. Within LSAP framework, we introduce a Hadamard production based regularization to incorporate rich generative/discriminative structure constraints to adaptively penalize the coefficients for subspace learning. It is shown that such adaptive penalization can significantly improve the robustness of LSAP on severely corrupted dataset. To utilize LSAP for online visual tracking, we also develop an efficient incremental optimization scheme for nuclear norm and column sparse norm minimizations. Experiments on 50 challenging video sequences demonstrate that our tracker outperforms other state-of-the-art methods. Copyright © 2017 Elsevier Ltd. All rights reserved.

Occlusion properties of prosthetic contact lenses for the treatment of amblyopia.

PubMed

Collins, Randall S; McChesney, Megan E; McCluer, Craig A; Schatz, Martha P

2008-12-01

The efficacy of opaque contact lenses as occlusion therapy for amblyopia has been established in the literature. Prosthetic contact lenses use similar tints to improve cosmesis in scarred or deformed eyes and may be an alternative in occlusion therapy. To test this idea, we determined the degree of vision penalization elicited by prosthetic contact lenses and their effect on peripheral fusion. We tested 19 CIBA Vision DuraSoft 3 Prosthetic soft contact lenses with varying iris prints, underprints, and opaque pupil sizes in 10 volunteers with best-corrected Snellen distance visual acuity of 20/20 or better in each eye. Snellen visual acuity and peripheral fusion using the Worth 4-Dot test at near were measured on each subject wearing each of the 19 lenses. Results were analyzed with 3-factor analysis of variance. Mean visual acuity through the various lenses ranged from 20/79 to 20/620. Eight lenses allowed preservation of peripheral fusion in 50% or more of the subjects tested. Iris print pattern and opaque pupil size were significant factors in determining visual acuity (p < 0.05). Sufficient vision penalization can be achieved to make occlusion with prosthetic contact lenses a viable therapy for amblyopia. The degree of penalization can be varied and different iris print patterns and pupil sizes, using peripheral fusion, can be preserved with some lenses. Prosthetic contact lenses can be more cosmetically appealing and more tolerable than other amblyopia treatment modalities. These factors may improve compliance in occlusion therapy.

mPLR-Loc: an adaptive decision multi-label classifier based on penalized logistic regression for protein subcellular localization prediction.

PubMed

Wan, Shibiao; Mak, Man-Wai; Kung, Sun-Yuan

2015-03-15

Proteins located in appropriate cellular compartments are of paramount importance to exert their biological functions. Prediction of protein subcellular localization by computational methods is required in the post-genomic era. Recent studies have been focusing on predicting not only single-location proteins but also multi-location proteins. However, most of the existing predictors are far from effective for tackling the challenges of multi-label proteins. This article proposes an efficient multi-label predictor, namely mPLR-Loc, based on penalized logistic regression and adaptive decisions for predicting both single- and multi-location proteins. Specifically, for each query protein, mPLR-Loc exploits the information from the Gene Ontology (GO) database by using its accession number (AC) or the ACs of its homologs obtained via BLAST. The frequencies of GO occurrences are used to construct feature vectors, which are then classified by an adaptive decision-based multi-label penalized logistic regression classifier. Experimental results based on two recent stringent benchmark datasets (virus and plant) show that mPLR-Loc remarkably outperforms existing state-of-the-art multi-label predictors. In addition to being able to rapidly and accurately predict subcellular localization of single- and multi-label proteins, mPLR-Loc can also provide probabilistic confidence scores for the prediction decisions. For readers' convenience, the mPLR-Loc server is available online (http://bioinfo.eie.polyu.edu.hk/mPLRLocServer). Copyright © 2014 Elsevier Inc. All rights reserved.

"Vehicular homicide", a new Italian offence: law provisions and comparison with some other European countries.

PubMed

Marinelli, E; Pichini, S; Zaami, S; Giorgetti, R; Busardò, F P; Pacifici, R

2016-07-01

According to the most recent World Health Organization report, road accidents represent a very serious public health issue, claiming each year more than 1.2 million lives worldwide and being the leading cause of death among young people aged between 15 and 29 years. Up to now, the policies to reduce this issue are different, unbalanced and often inadequate not only in Italy, but also in the other European Countries. Specifically, the Italian Parliament has recently introduced a new law (n. 41 of March 23rd, 2016), making vehicular homicide together with road traffic injuries a criminal offense, both to be punished as a result of negligence. The measure came into force on March 25th, 2016. In this paper, the provisions of the above-reported law have been assessed, taking into account the modifications introduced in the Penal Code by this law and the impact it is having and will have on drivers on a day-to-day basis. Similarities and differences with legislative framework of some other European countries were also examined. Finally, some open questions to be solved are named as an open eye for future considerations.

Human rights protections and HIV prevalence among MSM who sell sex: Cross-country comparisons from a systematic review and meta-analysis.

PubMed

Oldenburg, Catherine E; Perez-Brumer, Amaya G; Reisner, Sari L; Mayer, Kenneth H; Mimiaga, Matthew J; Hatzenbuehler, Mark L; Bärnighausen, Till

2018-04-01

Laws and policies can affect the HIV risk of key populations through a number of direct and indirect pathways. We investigated the association between HIV prevalence among men who engage in transactional sex and language in the penal code protecting sexual minorities, including men who have sex with men (MSM), and sex workers. HIV prevalence among men who engage in transactional sex was assessed through meta-analysis of published literature and country surveillance reports. Meta-regression was used to determine the association between HIV prevalence and protective laws for sexual minorities and sex workers. Sixty-six reports representing 28 countries and 31,924 individuals were included in the meta-analysis. Controlling for multiple study- and country-level variables, legal protection for sexual minorities was associated with a 10.9% (95% CI: 3.8-18.0%) and sex workers associated with a 7.0% (95% CI: 1.3-12.8%) decrease in country-level HIV prevalence among men who engage in transactional sex. Laws that seek to actively protect sex workers and MSM may be necessary to decrease HIV risk for this key population.

Decriminalising homosexuality in India.

PubMed

Misra, Geetanjali

2009-11-01

This paper examines the successful fight against the provision in Section 377 of the Penal Code of India that criminalised private consensual sex between adults of the same sex. This law had led to serious discrimination against people engaging in homosexual acts, who were subjected to frequent beatings and blackmail attempts by police, who used the threat of prosecution against them. NGOs working with sexual minorities have also been harassed and sometimes charged under Section 377. By stigmatising homosexuality and threatening gay men with prison, the law is also likely to have impeded the battle against HIV. The provision was read down in July 2009 after an innovative, sustained, mass media campaign by activists. The Voices Against 377 coalition brought together sexuality and lesbian, gay, bisexual and transgender (LGBT) organisations, who were previously marginalised, with groups working in areas such as children's rights and feminist groups, showing that support for non-discrimination towards sexual minorities was broad-based. Further legal and social changes are needed for LGBT individuals to gain full acceptance and equality within Indian society. However, the judgement transcended the LGBT issue with the implication of protection for all minorities and introduced for the first time in South Asia the idea of sexual citizenship.

Ethical and legal aspects in medically assisted human reproduction in Romania.

PubMed

Ioan, Beatrice; Astarastoae, Vasile

2008-01-01

Up to the present, there have not been any specific norms regarding medically assisted human reproduction in Romanian legislation. Due to this situation the general legislation regarding medical assistance (law no. 95/2006, regarding the Reform in Health Care System), the Penal and Civil law and the provisions of the Code of Deontology of the Romanian College of Physicians are applied to the field of medically assisted human reproduction. By analysing the ethical and legal conflicts regarding medically assisted human reproduction in Romania, some characteristics cannot be set apart because they derive from religious, cultural and socio-economic aspects. In this article the authors identify the development stages of medically assisted human reproduction in Romania, beginning from these characteristics and insisting upon the failure of the legal system in this specific field. The authors consider that the law regarding medically assisted human reproduction cannot be effective because it did not take into account the ethical and cultural aspects that might appear. Furthermore, in this framework of the legal process, no public debate involving the representatives of civil society was undertaken although the Council of Europe Oviedo Convention approved by our country according to law no. 17/2001 stipulated exactly this working method.

A Machine Learning Framework for Plan Payment Risk Adjustment.

PubMed

Rose, Sherri

2016-12-01

To introduce cross-validation and a nonparametric machine learning framework for plan payment risk adjustment and then assess whether they have the potential to improve risk adjustment. 2011-2012 Truven MarketScan database. We compare the performance of multiple statistical approaches within a broad machine learning framework for estimation of risk adjustment formulas. Total annual expenditure was predicted using age, sex, geography, inpatient diagnoses, and hierarchical condition category variables. The methods included regression, penalized regression, decision trees, neural networks, and an ensemble super learner, all in concert with screening algorithms that reduce the set of variables considered. The performance of these methods was compared based on cross-validated R 2 . Our results indicate that a simplified risk adjustment formula selected via this nonparametric framework maintains much of the efficiency of a traditional larger formula. The ensemble approach also outperformed classical regression and all other algorithms studied. The implementation of cross-validated machine learning techniques provides novel insight into risk adjustment estimation, possibly allowing for a simplified formula, thereby reducing incentives for increased coding intensity as well as the ability of insurers to "game" the system with aggressive diagnostic upcoding. © Health Research and Educational Trust.

Deciphering the associations between gene expression and copy number alteration using a sparse double Laplacian shrinkage approach

PubMed Central

Shi, Xingjie; Zhao, Qing; Huang, Jian; Xie, Yang; Ma, Shuangge

2015-01-01

Motivation: Both gene expression levels (GEs) and copy number alterations (CNAs) have important biological implications. GEs are partly regulated by CNAs, and much effort has been devoted to understanding their relations. The regulation analysis is challenging with one gene expression possibly regulated by multiple CNAs and one CNA potentially regulating the expressions of multiple genes. The correlations among GEs and among CNAs make the analysis even more complicated. The existing methods have limitations and cannot comprehensively describe the regulation. Results: A sparse double Laplacian shrinkage method is developed. It jointly models the effects of multiple CNAs on multiple GEs. Penalization is adopted to achieve sparsity and identify the regulation relationships. Network adjacency is computed to describe the interconnections among GEs and among CNAs. Two Laplacian shrinkage penalties are imposed to accommodate the network adjacency measures. Simulation shows that the proposed method outperforms the competing alternatives with more accurate marker identification. The Cancer Genome Atlas data are analysed to further demonstrate advantages of the proposed method. Availability and implementation: R code is available at http://works.bepress.com/shuangge/49/ Contact: shuangge.ma@yale.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:26342102

Awareness of Forensic Odontology among Legal Professionals, Chennai, India

PubMed Central

Selvajothi, Packiaraj; Lavanya, Chandra; Joshua, Elizabeth; Rao, Umadevi K.; Ranganathan, Kannan

2014-01-01

Background: The forensic discipline of law is a multidisciplinary team comprising of specialists in forensic medicine, forensic odontology, security and law. Aim: The study was to find the awareness level of scope and utility of forensic odontology among lawyers in Chennai, South India. Materials and Methods: A cross-sectional study using a self administered structured questionnaire was conducted in 200 lawyers between August and September of 2013. The data was analyzed depending on age, gender, type and years of practice. Results: Lawyers above 40 years of experience were more aware of palatal rugae analysis (P = 0.02), and those with more than 20 years were aware of lip print (P = 0.001) and bite mark analysis (P = 0.001). Males were more aware of forensic odontology with respect to criminal identification (P = 0.001). The knowledge of bite mark analysis was higher among male lawyers (P = 0.001), civil and criminal practicing lawyers (P = 0.004). All participants were aware that loss or fracture of tooth constitutes a grievous injury under Indian Penal Code (IPC) 320 clause 7(5). Conclusion: This study highlighted the knowledge of forensic odontology among legal professionals and also identified the areas in which they need further appraisal. PMID:25535602

Encoding Dissimilarity Data for Statistical Model Building.

PubMed

Wahba, Grace

2010-12-01

We summarize, review and comment upon three papers which discuss the use of discrete, noisy, incomplete, scattered pairwise dissimilarity data in statistical model building. Convex cone optimization codes are used to embed the objects into a Euclidean space which respects the dissimilarity information while controlling the dimension of the space. A "newbie" algorithm is provided for embedding new objects into this space. This allows the dissimilarity information to be incorporated into a Smoothing Spline ANOVA penalized likelihood model, a Support Vector Machine, or any model that will admit Reproducing Kernel Hilbert Space components, for nonparametric regression, supervised learning, or semi-supervised learning. Future work and open questions are discussed. The papers are: F. Lu, S. Keles, S. Wright and G. Wahba 2005. A framework for kernel regularization with application to protein clustering. Proceedings of the National Academy of Sciences 102, 12332-1233.G. Corrada Bravo, G. Wahba, K. Lee, B. Klein, R. Klein and S. Iyengar 2009. Examining the relative influence of familial, genetic and environmental covariate information in flexible risk models. Proceedings of the National Academy of Sciences 106, 8128-8133F. Lu, Y. Lin and G. Wahba. Robust manifold unfolding with kernel regularization. TR 1008, Department of Statistics, University of Wisconsin-Madison.

Sequential Dictionary Learning From Correlated Data: Application to fMRI Data Analysis.

PubMed

Seghouane, Abd-Krim; Iqbal, Asif

2017-03-22

Sequential dictionary learning via the K-SVD algorithm has been revealed as a successful alternative to conventional data driven methods such as independent component analysis (ICA) for functional magnetic resonance imaging (fMRI) data analysis. fMRI datasets are however structured data matrices with notions of spatio-temporal correlation and temporal smoothness. This prior information has not been included in the K-SVD algorithm when applied to fMRI data analysis. In this paper we propose three variants of the K-SVD algorithm dedicated to fMRI data analysis by accounting for this prior information. The proposed algorithms differ from the K-SVD in their sparse coding and dictionary update stages. The first two algorithms account for the known correlation structure in the fMRI data by using the squared Q, R-norm instead of the Frobenius norm for matrix approximation. The third and last algorithm account for both the known correlation structure in the fMRI data and the temporal smoothness. The temporal smoothness is incorporated in the dictionary update stage via regularization of the dictionary atoms obtained with penalization. The performance of the proposed dictionary learning algorithms are illustrated through simulations and applications on real fMRI data.

Addison's disease with polyglandular autoimmunity carries a more than 2·5-fold risk for adrenal crises: German Health insurance data 2010-2013.

PubMed

Meyer, Gesine; Badenhoop, Klaus; Linder, Roland

2016-09-01

Adrenal crises are potentially life-threatening complications in patients with adrenal insufficiency (AI). Our objective was to investigate the frequency of adrenal crises in different forms of AI. The Statutory Health Insurance (SHI) database of the Techniker Krankenkasse - covering more than 12% of the German population - was analysed for diagnostic codes from 1 January 2010 to 31 December 2013. By analysis of routine data from a large healthcare provider. Diagnoses of AI were recorded and classified in primary AI, secondary AI and autoimmune polyglandular syndrome (APS). The ICD-code E27·2 (AC) was retrieved in all cohorts. We found a prevalence of 222/million for secondary and 126/million for primary AI. AC was documented with a frequency of 4·8/100 patient years. Crises were significantly more frequent in patients with primary (7·6/100 patient years) compared to those with secondary AI (3·2/100 patient years; P < 0·0001). Prevalence of crises was higher in individuals with APS (10·9/100 patient years) and highest in patients with primary AI and type 1 diabetes (12·5/100 patient years). Applying a SHI database comprising more than 9 million individuals, we identified robust data about the risk of AC in different groups of patients with AI. Our data confirm and extend the clinical observation that patients with APS are at highest risk for AC. Approximately 1 of 8 patients with primary AI and type 1 diabetes suffers from an AC each year. Specific targeting of efforts aiming at the prevention of AC is necessary. © 2016 John Wiley & Sons Ltd.

[The quality of patient care under the German DRG system using as example the inguinal hernia repair].

PubMed

Rudroff, C; Schweins, M; Heiss, M M

2008-02-01

The DRG system in Germany was introduced to improve and at the same time simplify the reimbursement of costs in German hospitals. Cost effectiveness and economic efficiency were the declared goals. Structural changes and increased competition among different hospitals were the consequences. The effect on the qualitiy of patient care has been discussed with some concern. Furthermore, doubts have been expressed about the correct representation of the various diagnoses and treatments in the coding system and the financial revenue. Inguinal hernia repair serves as an example to illustrate some common problems with the reimbursement in the DRG system. Virtual patients were grouped using a "Web Grouper" and analysed using the cost accounting from the G-DRG-Browser of the InEK. Additionally, the reimbursement for ambulant hernia repair was estimated. The DRG coding did not differentiate the various operative procedures for inguinal hernia repair. They all generated the same revenues. For example, the increased costs for bilateral inguinal hernia repair are not represented in the payment. Furthermore, no difference is made between primary and recurrent inguinal hernia. In the case of a short-term hospital stay, part of the revenue is retained. In the case of ambulatory treatment of inguinal hernia, the reimbursement is by far not a real compensation for the actual costs. The ideal patient in the DRG system suffers from a primary inguinal hernia, undergoes an open hernia repair without mesh, and remains for 2-3 days in hospital. Minimally invasive procedures, repair of bilateral inguinal hernia and ambulant operation are by far less profitable--if at all. The current revenues for inguinal hernia repair require improvement and adjustment to reality in order to accomplish the goals which the DRG system in Germany aims at.

Forensic case profiling aspects on multiple homicides from the Cologne-Bonn metropolitan area 1985-2000.

PubMed

Schmidt, Peter H; Padosch, Stephan A; Rothschild, Markus A; Madea, Burkhard

2005-10-29

The medicolegal and subsequent criminologic interpretation of forensic and pathological findings in cases of homicide makes up an important tool of case profiling. In a retrospective study of 26 cases of "multiple homicides" involving 31 perpetrators (30 males, 1 female, mean age 33.5 years) and 73 victims (33 males, 40 females, mean age 36 years, 68 fatalities, 5 survivors), autopsy reports and prosecution authorities' files were investigated with regard to individual characteristics of victims and offenders, circumstances as well as mode of commitment. The major aim of this study was to comprehensively elucidate and characterise relevant forensic and criminologic features, which may gain importance for forensic case profiling. Forty-six victims were found in the close social environment of the perpetrator and 45 homicides were committed either in the victim's, the perpetrator's or the shared domicile. The main motives included concealment of a crime (n=13), personal conflicts/domestic arguments (n=7) and greed (n=12). The relevant injuries with regard to the cause of death were attributable to sharp force (n=13), blunt force (n=7), gunshot wounds (n=24), ligature strangulation (n=3), smothering (n=5), fire/carbon monoxide (n=4) and combined impacts (n=11). In 15 cases, so called defence injuries were found. In 5 victims a post-mortem blood alcohol concentration >1.5 g/l was determined. In six perpetrators, a severe psychiatric impairment of juridical responsibility was ascertained (Section 20 German criminal code, n=2, psychosis; Section 21 German criminal code, n=4, acute alcohol intoxication). As far as conviction data were available, 27 crimes were juridically assessed as murder, 12 as manslaughter and one as bodily harm with fatal consequences.

Dominance and parent-of-origin effects of coding and non-coding alleles at the acylCoA-diacylglycerol-acyltransferase (DGAT1) gene on milk production traits in German Holstein cows

PubMed Central

Kuehn, Christa; Edel, Christian; Weikard, Rosemarie; Thaller, Georg

2007-01-01

Background Substantial gene substitution effects on milk production traits have formerly been reported for alleles at the K232A and the promoter VNTR loci in the bovine acylCoA-diacylglycerol-acyltransferase 1 (DGAT1) gene by using data sets including sires with accumulated phenotypic observations of daughters (breeding values, daughter yield deviations). However, these data sets prevented analyses with respect to dominance or parent-of-origin effects, although an increasing number of reports in the literature outlined the relevance of non-additive gene effects on quantitative traits. Results Based on a data set comprising German Holstein cows with direct trait measurements, we first confirmed the previously reported association of DGAT1 promoter VNTR alleles with milk production traits. We detected a dominant mode of effects for the DGAT1 K232A and promoter VNTR alleles. Namely, the contrasts between the effects of heterozygous individuals at the DGAT1 loci differed significantly from the midpoint between the effects for the two homozygous genotypes for several milk production traits, thus indicating the presence of dominance. Furthermore, we identified differences in the magnitude of effects between paternally and maternally inherited DGAT1 promoter VNTR – K232A haplotypes indicating parent-of-origin effects on milk production traits. Conclusion Non-additive effects like those identified at the bovine DGAT1 locus have to be accounted for in more specific QTL detection models as well as in marker assisted selection schemes. The DGAT1 alleles in cattle will be a useful model for further investigations on the biological background of non-additive effects in mammals due to the magnitude and consistency of their effects on milk production traits. PMID:17892573

[Problems of implementing integration management at company level in small and medium-sized enterprises].

PubMed

Hetzel, C; Flach, T; Weber, A; Schian, H-M

2006-05-01

At company level responsibility increases for the employment of workers with health-related problems or disabilities, but realisation in small and medium-sized enterprises (SME) is lacking. Therefore a model is developed based on theory and a survey. Minimum requirements for "betriebliches Eingliederungsmanagement" (integration management at company level) according to section 84 (2) SGB IX Book 9 of the German Social Code, the main products of the international movement "disability management", a description of roles for realisation and the main sources of employers' support are described. Although external supporting of SMEs is unquestioned, it is expensive and retards own initiative and own activity counting solely on this. Only by developing a minimum of SME's awareness, acceptance and competence, this will open up to (currently suboptimal) external support. Goal is identifying SME managers' attitudes, activities, proposals and expectations referring integration management at company level to derive concepts of SME's support. 13 interviews are analysed by qualitative content analysis identifying the following barriers: information deficit, absence of priority, limited possibilities for transitional work, cost, partially limited workers' self-responsibility, illness as a "tabes" subject. Possibilities overcoming these barriers are delineated. On that basis a model is presented: pragmatically for realisation, a company contact person with minimum competence, uniform external support, institutional partners' integration and quality assurance according to disability management. Interlocking SME world and social insurance world means first to support SME's awareness, acceptance and competence, second to create for SME a central contact in the "rehabilitation jungle" and third to develop SME-suitable premiums according to section 84 (3) SGB IX, Book 9 of the German social code.

[Standard of integration management at company level and its auditing].

PubMed

Flach, T; Hetzel, C; Mozdzanowski, M; Schian, H-M

2006-10-01

Responsibility at company level for the employment of workers with health-related problems or disabilities has increased, inter alia because of integration management at company level according to section 84 (2) of the German Social Code Book IX. Although several recommendations exist, no standard is available for auditing and certification. Such a standard could be a basis for granting premiums according to section 84 (3) of Book IX of the German Social Code. AUDIT AND CERTIFICATION: One product of the international "disability management" movement is the "Consensus Based Disability Management Audit" (CBDMA). The Audit is a systematic and independent measurement of the effectiveness of integration management at company level. CBDMA goals are to give evidence of the quality of the integration management implemented, to identify opportunities for improvement and recommend appropriate corrective and preventive action. In May 2006, the integration management of Ford-Werke GmbH Germany with about 23 900 employees was audited and certified as the first company in Europe. STANDARD OF INTEGRATION MANAGEMENT AT COMPANY LEVEL: In dialogue with corporate practitioners, the international standard of CBDMA has been adapted, completed and verified concerning its practicability. Process orientation is the key approach, and the structure is similar to DIN EN ISO 9001:2000. Its structure is as follows: (1) management-labour responsibility (goals and objectives, program planning, management-labour review), (2) management of resources (disability manager and DM team, employees' participation, cooperation with external partners, infrastructure), (3) communication (internal and external public relations), (4) case management (identifying cases, contact, situation analysis, planning actions, implementing actions and monitoring, process and outcome evaluation), (5) analysis and improvement (analysis and program evaluation), (6) documentation (manual, records).

[Standardized CT/HRCT-classification of the German Federal Republic for work and environmental related thoracic diseases].

PubMed

Hering, K G; Tuengerthal, S; Kraus, T

2004-05-01

High resolution computed tomography (HRCT) plays an indispensable role in the diagnosis of pneumoconiosis and other lung damage arising from inhalation. Till now, however, there has been no agreed standardized convention for the use of the technique, or for documenting results uniformly. A task-group on Diagnostic Radiology in Occupational and Environmental Diseases of the German Radiological Society has produced a coding sheet based on experience gained in production of consultants' clinical reports, experts' examinations of patients seeking compensation for occupational lung disease, and physicians' professional development courses. The coding sheet has been used in a national multicenter study. It has been further developed and tested by an international working group comprising experts from Belgium (P.A. Gevenois), Germany (K.G. Hering, T. Kraus, S. Tuengerthal), Finland (L. Kivisaari, T. Vehmas), France (M. Letourneux), Great Britain (M.D. Crane), Japan (H. Arikawa, Y. Kusaka, N. Suganuma), and the USA (J. Parker). The intention is to standardize documentation of computertomographic findings in occupationally and environmentally related lung and pleural changes, and to facilitate international comparisons of results. Such comparisons were found to be achievable reproducibly with the help of CT/HRCT reference films. The classification scheme is purely descriptive (rather than diagnostic), so that all aspects of occupationally and environmentally related parenchymal and pleural abnormalities may be recorded. Although some of the descriptive terms used are associated with pneumoconiosis (e.g., rounded opacities in silicosis, or, in asbestosis, interlobular septal and intralobular non-septal lines, as well as honeycombing) many overlapping patterns that need to be considered for differential diagnosis are also included in the scheme.

27 CFR 26.69 - Strengthening bonds.

Code of Federal Regulations, 2012 CFR

2012-04-01

... OF THE TREASURY LIQUORS LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Taxpayment of Liquors and Articles in Puerto Rico Bonds § 26.69 Strengthening bonds. In all cases where the penal sum of...

Senegal: Background and U.S. Relations

DTIC Science & Technology

2010-08-16

boys, often separated from their families, receive religious instruction.33 The 1999 Penal Law outlawed domestic violence and female genital ... mutilation ; however, implementation has reportedly been uneven, and both are widespread.34 Human rights organizations have criticized

Vaccine mandates, public trust, and vaccine confidence: understanding perceptions is important.

PubMed

Widdus, Roy; Larson, Heidi

2018-05-01

The experience in Australia with penalizing parents who refuse to have their children vaccinated demonstrates the need to study and understand resistance to vaccination as a global phenomenon with particular local manifestations.

49 CFR 26.47 - Can recipients be penalized for failing to meet overall goals?

Code of Federal Regulations, 2011 CFR

2011-10-01

... BY DISADVANTAGED BUSINESS ENTERPRISES IN DEPARTMENT OF TRANSPORTATION FINANCIAL ASSISTANCE PROGRAMS... attention of FTA, FHWA, or FAA, demonstrates that current trends make it unlikely that you will achieve DBE...

Differentiation of Populus species using chloroplast single nucleotide polymorphism (SNP) markers--essential for comprehensible and reliable poplar breeding.

PubMed

Schroeder, H; Hoeltken, A M; Fladung, M

2012-03-01

Within the genus Populus several species belonging to different sections are cross-compatible. Hence, high numbers of interspecies hybrids occur naturally and, additionally, have been artificially produced in huge breeding programmes during the last 100 years. Therefore, determination of a single poplar species, used for the production of 'multi-species hybrids' is often difficult, and represents a great challenge for the use of molecular markers in species identification. Within this study, over 20 chloroplast regions, both intergenic spacers and coding regions, have been tested for their ability to differentiate different poplar species using 23 already published barcoding primer combinations and 17 newly designed primer combinations. About half of the published barcoding primers yielded amplification products, whereas the new primers designed on the basis of the total sequenced cpDNA genome of Populus trichocarpa Torr. & Gray yielded much higher amplification success. Intergenic spacers were found to be more variable than coding regions within the genus Populus. The highest discrimination power of Populus species was found in the combination of two intergenic spacers (trnG-psbK, psbK-psbl) and the coding region rpoC. In barcoding projects, the coding regions matK and rbcL are often recommended, but within the genus Populus they only show moderate variability and are not efficient in species discrimination. © 2011 German Botanical Society and The Royal Botanical Society of the Netherlands.

[The challenge of adequate reimbursement for the seriously injured patient in the German DRG system].

PubMed

Franz, D; Lefering, R; Siebert, H; Windolf, J; Roeder, N; Mahlke, L

2013-02-01

Critically injured patients are a very heterogeneous group, medically and economically. Their treatment is a major challenge for both the medical care and the appropriate financial reimbursement. Systematic underfunding can have a significant impact on the quality of patient care. In 2009 the German Trauma Society and the DRG-Research Group of the University Hospital Muenster initialised a DRG evaluation project to analyse the validity of case allocation of critically injured patients within the German DRG system versions 2008 and 2011 with additional consideration of clinical data from the trauma registry of the German Trauma Society. Severe deficits within the G-DRG structure were identified and specific solutions were designed and realised. A retrospective analysis was undertaken of standardised G-DRG data (§ 21 KHEntgG) including case-related cost data from 3 362 critically injured patients in the periods 2007 and 2008 from 10 university hospitals and 7 large municipal hospitals. For 1 241 cases of the sample, complementary detailed information was available from the trauma registry of the German Trauma Society to monitor the case allocation of critically injured patients within the G-DRG system. Analyses of coding and grouping, performance of case allocation, and the homogeneity of costs in the G-DRG versions 2008 and 2011 were done. The following situations were found: (i) systematic underfunding of trauma patients in the G-DRG-Version 2008, especially trauma patients with acute paraplegia; (ii) participation in the official G-DRG development for 2011 with 13 proposals which were largely realised; (ii) the majority of cases with cost-covering in the G-DRG version 2011; (iv) significant improvements in the quality of statistical criteria; (v) overfunded trauma patients with high intensive care costs; (vi) underfunding for clinically relevant critically injured patients not identified in the G-DRG system. The quality of the G-DRG system is measured by the ability to obtain adequate case allocations for highly complex and heterogeneous cases. Specific modifications of the G-DRG structures could increase the appropriateness of case allocation of critically injured patients. Additional consideration of the ISS clinical data must be further evaluated. Data-based analysis is an essential prerequisite for a constructive development of the G-DRG system and a necessary tool for the active participation of medical societies in this process. © Georg Thieme Verlag KG Stuttgart · New York.

$L^1$ penalization of volumetric dose objectives in optimal control of PDEs

DOE PAGES

Barnard, Richard C.; Clason, Christian

2017-02-11

This work is concerned with a class of PDE-constrained optimization problems that are motivated by an application in radiotherapy treatment planning. Here the primary design objective is to minimize the volume where a functional of the state violates a prescribed level, but prescribing these levels in the form of pointwise state constraints leads to infeasible problems. We therefore propose an alternative approach based on L 1 penalization of the violation that is also applicable when state constraints are infeasible. We establish well-posedness of the corresponding optimal control problem, derive first-order optimality conditions, discuss convergence of minimizers as the penalty parametermore » tends to infinity, and present a semismooth Newton method for their efficient numerical solution. Finally, the performance of this method for a model problem is illustrated and contrasted with an alternative approach based on (regularized) state constraints.« less

Flight evaluation of an advanced technology light twin-engine airplane (ATLIT)

NASA Technical Reports Server (NTRS)

Holmes, B. J.

1977-01-01

Project organization and execution, airplane description and performance predictions, and the results of the flight evaluation of an advanced technology light twin engine airplane (ATLIT) are presented. The ATLIT is a Piper PA-34-200 Seneca I modified by the installation of new wings incorporating the GA(W)-1 (Whitcomb) airfoil, reduced wing area, roll control spoilers, and full span Fowler flaps. The conclusions for the ATLIT evaluation are based on complete stall and roll flight test results and partial performance test results. The Stalling and rolling characteristics met design expectations. Climb performance was penalized by extensive flow separation in the region of the wing body juncture. Cruise performance was found to be penalized by a large value of zero lift drag. Calculations showed that, with proper attention to construction details, the improvements in span efficiency and zero lift drag would permit the realization of the predicted increases in cruising and maximum rate of climb performance.

GLOBAL SOLUTIONS TO FOLDED CONCAVE PENALIZED NONCONVEX LEARNING

PubMed Central

Liu, Hongcheng; Yao, Tao; Li, Runze

2015-01-01

This paper is concerned with solving nonconvex learning problems with folded concave penalty. Despite that their global solutions entail desirable statistical properties, there lack optimization techniques that guarantee global optimality in a general setting. In this paper, we show that a class of nonconvex learning problems are equivalent to general quadratic programs. This equivalence facilitates us in developing mixed integer linear programming reformulations, which admit finite algorithms that find a provably global optimal solution. We refer to this reformulation-based technique as the mixed integer programming-based global optimization (MIPGO). To our knowledge, this is the first global optimization scheme with a theoretical guarantee for folded concave penalized nonconvex learning with the SCAD penalty (Fan and Li, 2001) and the MCP penalty (Zhang, 2010). Numerical results indicate a significant outperformance of MIPGO over the state-of-the-art solution scheme, local linear approximation, and other alternative solution techniques in literature in terms of solution quality. PMID:27141126

Adaptive rival penalized competitive learning and combined linear predictor model for financial forecast and investment.

PubMed

Cheung, Y M; Leung, W M; Xu, L

1997-01-01

We propose a prediction model called Rival Penalized Competitive Learning (RPCL) and Combined Linear Predictor method (CLP), which involves a set of local linear predictors such that a prediction is made by the combination of some activated predictors through a gating network (Xu et al., 1994). Furthermore, we present its improved variant named Adaptive RPCL-CLP that includes an adaptive learning mechanism as well as a data pre-and-post processing scheme. We compare them with some existing models by demonstrating their performance on two real-world financial time series--a China stock price and an exchange-rate series of US Dollar (USD) versus Deutschmark (DEM). Experiments have shown that Adaptive RPCL-CLP not only outperforms the other approaches with the smallest prediction error and training costs, but also brings in considerable high profits in the trading simulation of foreign exchange market.

Interquantile Shrinkage in Regression Models

PubMed Central

Jiang, Liewen; Wang, Huixia Judy; Bondell, Howard D.

2012-01-01

Conventional analysis using quantile regression typically focuses on fitting the regression model at different quantiles separately. However, in situations where the quantile coefficients share some common feature, joint modeling of multiple quantiles to accommodate the commonality often leads to more efficient estimation. One example of common features is that a predictor may have a constant effect over one region of quantile levels but varying effects in other regions. To automatically perform estimation and detection of the interquantile commonality, we develop two penalization methods. When the quantile slope coefficients indeed do not change across quantile levels, the proposed methods will shrink the slopes towards constant and thus improve the estimation efficiency. We establish the oracle properties of the two proposed penalization methods. Through numerical investigations, we demonstrate that the proposed methods lead to estimations with competitive or higher efficiency than the standard quantile regression estimation in finite samples. Supplemental materials for the article are available online. PMID:24363546

Penalizing hospitals for chronic obstructive pulmonary disease readmissions.

PubMed

Feemster, Laura C; Au, David H

2014-03-15

In October 2014, the U.S. Centers for Medicare and Medicaid Services (CMS) will expand its Hospital Readmission Reduction Program (HRRP) to include chronic obstructive pulmonary disease (COPD). Under the new policy, hospitals with high risk-adjusted, 30-day all-cause unplanned readmission rates after an index hospitalization for a COPD exacerbation will be penalized with reduced reimbursement for the treatment of Medicare beneficiaries. In this perspective, we review the history of the HRRP, including the recent addition of COPD to the policy. We critically assess the use of 30-day all-cause COPD readmissions as an accountability measure, discussing potential benefits and then highlighting the substantial drawbacks and potential unintended consequences of the measure that could adversely affect providers, hospitals, and patients with COPD. We conclude by emphasizing the need to place the 30-day COPD readmission measure in the context of a reconceived model for postdischarge quality and review several frameworks that could help guide this process.

A model for nocturnal frost formation on a wing section: Aircraft takeoff performance penalties

NASA Technical Reports Server (NTRS)

Dietenberger, M. A.

1983-01-01

The nocturnal frost formation on a wing section, to explain the hazard associated with frost during takeoff was investigated. A model of nocturnal frost formation on a wing section which predicts when the nocturnal frost will form and also its thickness and density as a function of time was developed. The aerodynamic penalities as related to the nocturnal frost formation properties were analyzed to determine how much the takeoff performance would be degraded by a specific frost layer. With an aircraft takeoff assuming equations representing a steady climbing flight, it is determined that a reduction in the maximum gross weight or a partial frost clearance and a reduction in the takeoff angle of attack is needed to neutralize drag and life penalities which are due to frost. Atmospheric conditions which produce the most hazardous frost buildup are determined.

Assessment of Blood Glucose Control in the Pediatric Intensive Care Unit: Extension of the Glycemic Penalty Index toward Children and Infants

PubMed Central

Van Herpe, Tom; Gielen, Marijke; Vanhonsebrouck, Koen; Wouters, Pieter J; Van den Berghe, Greet; De Moor, Bart; Mesotten, Dieter

2011-01-01

Background: The glycemic penalty index (GPI) is a measure to assess blood glucose (BG) control in critically ill adult patients but needs to be adapted for children and infants. Method: The squared differences between a clinical expertise penalty function and the corresponding polynomial function are minimized for optimization purposes. The average of all penalties (individually assigned to all BG readings) represents the patient-specific GPI. Results: Penalization in the hypoglycemic range is more severe than in the hyperglycemic range as the developing brains of infants and children may be more vulnerable to hypoglycemia. Similarly, hypoglycemia is also more heavily penalized in infants than in children. Conclusions: Extending the adult GPI toward the age-specific GPI is an important methodological step. Long-term clinical studies are needed to determine the clinically acceptable GPI cut-off level. PMID:21527105

Theoretical White Dwarf Spectra on Demand: TheoSSA

NASA Astrophysics Data System (ADS)

Ringat, E.; Rauch, T.

2010-11-01

In the last decades, a lot of progress was made in spectral analysis. The quality (e.g. resolution, S/N ratio) of observed spectra has improved much and several model-atmosphere codes were developed. One of these is the ``Tübingen NLTE Model-Atmosphere Package'' (TMAP), that is a highly developed program for the calculation of model atmospheres of hot, compact objects. In the framework of the German Astrophysical Virtual Observatory (GAVO), theoretical spectral energy distributions (SEDs) can be downloaded via TheoSSA. In a pilot phase, TheoSSA is based on TMAP model atmospheres. We present the current state of this VO service.

Development, dissemination, and applications of a new terminological resource, the Q-Code taxonomy for professional aspects of general practice/family medicine.

PubMed

Jamoulle, Marc; Resnick, Melissa; Grosjean, Julien; Ittoo, Ashwin; Cardillo, Elena; Vander Stichele, Robert; Darmoni, Stefan; Vanmeerbeek, Marc

2018-12-01

While documentation of clinical aspects of General Practice/Family Medicine (GP/FM) is assured by the International Classification of Primary Care (ICPC), there is no taxonomy for the professional aspects (context and management) of GP/FM. To present the development, dissemination, applications, and resulting face validity of the Q-Codes taxonomy specifically designed to describe contextual features of GP/FM, proposed as an extension to the ICPC. The Q-Codes taxonomy was developed from Lamberts' seminal idea for indexing contextual content (1987) by a multi-disciplinary team of knowledge engineers, linguists and general practitioners, through a qualitative and iterative analysis of 1702 abstracts from six GP/FM conferences using Atlas.ti software. A total of 182 concepts, called Q-Codes, representing professional aspects of GP/FM were identified and organized in a taxonomy. Dissemination: The taxonomy is published as an online terminological resource, using semantic web techniques and web ontology language (OWL) ( http://www.hetop.eu/Q ). Each Q-Code is identified with a unique resource identifier (URI), and provided with preferred terms, and scope notes in ten languages (Portuguese, Spanish, English, French, Dutch, Korean, Vietnamese, Turkish, Georgian, German) and search filters for MEDLINE and web searches. This taxonomy has already been used to support queries in bibliographic databases (e.g., MEDLINE), to facilitate indexing of grey literature in GP/FM as congress abstracts, master theses, websites and as an educational tool in vocational teaching, Conclusions: The rapidly growing list of practical applications provides face-validity for the usefulness of this freely available new terminological resource.

LBP-based penalized weighted least-squares approach to low-dose cone-beam computed tomography reconstruction

NASA Astrophysics Data System (ADS)

Ma, Ming; Wang, Huafeng; Liu, Yan; Zhang, Hao; Gu, Xianfeng; Liang, Zhengrong

2014-03-01

Cone-beam computed tomography (CBCT) has attracted growing interest of researchers in image reconstruction. The mAs level of the X-ray tube current, in practical application of CBCT, is mitigated in order to reduce the CBCT dose. The lowering of the X-ray tube current, however, results in the degradation of image quality. Thus, low-dose CBCT image reconstruction is in effect a noise problem. To acquire clinically acceptable quality of image, and keep the X-ray tube current as low as achievable in the meanwhile, some penalized weighted least-squares (PWLS)-based image reconstruction algorithms have been developed. One representative strategy in previous work is to model the prior information for solution regularization using an anisotropic penalty term. To enhance the edge preserving and noise suppressing in a finer scale, a novel algorithm combining the local binary pattern (LBP) with penalized weighted leastsquares (PWLS), called LBP-PWLS-based image reconstruction algorithm, is proposed in this work. The proposed LBP-PWLS-based algorithm adaptively encourages strong diffusion on the local spot/flat region around a voxel and less diffusion on edge/corner ones by adjusting the penalty for cost function, after the LBP is utilized to detect the region around the voxel as spot, flat and edge ones. The LBP-PWLS-based reconstruction algorithm was evaluated using the sinogram data acquired by a clinical CT scanner from the CatPhan® 600 phantom. Experimental results on the noiseresolution tradeoff measurement and other quantitative measurements demonstrated its feasibility and effectiveness in edge preserving and noise suppressing in comparison with a previous PWLS reconstruction algorithm.

A penalized quantitative structure-property relationship study on melting point of energetic carbocyclic nitroaromatic compounds using adaptive bridge penalty.

PubMed

Al-Fakih, A M; Algamal, Z Y; Lee, M H; Aziz, M

2018-05-01

A penalized quantitative structure-property relationship (QSPR) model with adaptive bridge penalty for predicting the melting points of 92 energetic carbocyclic nitroaromatic compounds is proposed. To ensure the consistency of the descriptor selection of the proposed penalized adaptive bridge (PBridge), we proposed a ridge estimator ([Formula: see text]) as an initial weight in the adaptive bridge penalty. The Bayesian information criterion was applied to ensure the accurate selection of the tuning parameter ([Formula: see text]). The PBridge based model was internally and externally validated based on [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], the Y-randomization test, [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text] and the applicability domain. The validation results indicate that the model is robust and not due to chance correlation. The descriptor selection and prediction performance of PBridge for the training dataset outperforms the other methods used. PBridge shows the highest [Formula: see text] of 0.959, [Formula: see text] of 0.953, [Formula: see text] of 0.949 and [Formula: see text] of 0.959, and the lowest [Formula: see text] and [Formula: see text]. For the test dataset, PBridge shows a higher [Formula: see text] of 0.945 and [Formula: see text] of 0.948, and a lower [Formula: see text] and [Formula: see text], indicating its better prediction performance. The results clearly reveal that the proposed PBridge is useful for constructing reliable and robust QSPRs for predicting melting points prior to synthesizing new organic compounds.

A TVSCAD approach for image deblurring with impulsive noise

NASA Astrophysics Data System (ADS)

Gu, Guoyong; Jiang, Suhong; Yang, Junfeng

2017-12-01

We consider image deblurring problem in the presence of impulsive noise. It is known that total variation (TV) regularization with L1-norm penalized data fitting (TVL1 for short) works reasonably well only when the level of impulsive noise is relatively low. For high level impulsive noise, TVL1 works poorly. The reason is that all data, both corrupted and noise free, are equally penalized in data fitting, leading to insurmountable difficulty in balancing regularization and data fitting. In this paper, we propose to combine TV regularization with nonconvex smoothly clipped absolute deviation (SCAD) penalty for data fitting (TVSCAD for short). Our motivation is simply that data fitting should be enforced only when an observed data is not severely corrupted, while for those data more likely to be severely corrupted, less or even null penalization should be enforced. A difference of convex functions algorithm is adopted to solve the nonconvex TVSCAD model, resulting in solving a sequence of TVL1-equivalent problems, each of which can then be solved efficiently by the alternating direction method of multipliers. Theoretically, we establish global convergence to a critical point of the nonconvex objective function. The R-linear and at-least-sublinear convergence rate results are derived for the cases of anisotropic and isotropic TV, respectively. Numerically, experimental results are given to show that the TVSCAD approach improves those of the TVL1 significantly, especially for cases with high level impulsive noise, and is comparable with the recently proposed iteratively corrected TVL1 method (Bai et al 2016 Inverse Problems 32 085004).

German politics of genetic engineering and its deconstruction.

PubMed

Gottweis, H

1995-05-01

Policy-making, as exemplified by biotechnology policy, can be understood as an attempt to manage a field of discursivity, to construct regularity in a dispersed multitude of combinable elements. Following this perspective of politics as a textual process, the paper interprets the politicization of genetic engineering in Germany as a defence of the political as a regime of heterogeneity, as a field of 'dissensus' rather than 'consensus', and a rejection of the idea that the framing of technological transformation is an autonomous process. From its beginning in the early 1970s, genetic engineering was symbolically entrenched as a key technology of the future, and as an integral element of the German politics of modernization. Attempts by new social movements and the Green Party to displace the egalitarian imaginary of democratic discourse into the politics of genetic engineering were construed by the political élites as an attack on the political order of post-World War II Germany. The 1990 Genetic Engineering Law attempted a closure of this controversy. But it is precisely the homogenizing idiom of this 'settlement' which continues to nourish the social movements and their radical challenge to the definitions and codings of the politics of genetic engineering.

Evaluating Galactic Cosmic Ray Environment Models Using RaD-X Flight Data

NASA Technical Reports Server (NTRS)

Norman, R. B.; Mertens, C. J.; Slaba, T. C.

2016-01-01

Galactic cosmic rays enter Earth's atmosphere after interacting with the geomagnetic field. The primary galactic cosmic rays spectrum is fundamentally changed as it interacts with Earth's atmosphere through nuclear and atomic interactions. At points deeper in the atmosphere, such as at airline altitudes, the radiation environment is a combination of the primary galactic cosmic rays and the secondary particles produced through nuclear interactions. The RaD-X balloon experiment measured the atmospheric radiation environment above 20 km during 2 days in September 2015. These experimental measurements were used to validate and quantify uncertainty in physics-based models used to calculate exposure levels for commercial aviation. In this paper, the Badhwar-O'Neill 2014, the International Organization for Standardization 15390, and the German Aerospace Company galactic cosmic ray environment models are used as input into the same radiation transport code to predict and compare dosimetric quantities to RaD-X measurements. In general, the various model results match the measured tissue equivalent dose well, with results generated by the German Aerospace Center galactic cosmic ray environment model providing the best comparison. For dose equivalent and dose measured in silicon, however, the models were compared less favorably to the measurements.

[Comparison of pedicle and free tissue transfers in the German DRG system].

PubMed

Lotter, O; Stahl, S; Hohenstein, C; Schaller, H-E; Jaminet, P

2011-12-01

Diagnosis-Related Groups (DRGs) are a patient classification system grouping related types of patients to the resources they have consumed. In this analysis, we compared pedicle and free flaps in plastic and reconstructive surgery in the actual German DRG system. After grouping common flaps while systematically modifying the diagnosis, the operative procedure(s), and the receptor site, reimbursement and thresholds of length of stay were identified. The mean value of the average length of stay was higher in free flaps as compared to pedicle flaps (15 vs. 9 days) and the mean reimbursement in free flaps was almost twice as high as in pedicle flaps (8 936 € vs. 4 582 €). Regarding the diagnosis, third-grade open fractures in pedicle flaps and full-thickness burns in free flaps are in the vanguard of reimbursement. Higher DRG conformity is generally found with free flaps. Different possibilities in coding the procedures and the strong dependence on the underlying diagnosis lead to variations of remuneration and length of stay, which are not explainable and sometimes even seem paradoxical. Furthermore, mixed calculation creates DRGs that lose the ability to describe the real effort. © Georg Thieme Verlag KG Stuttgart · New York.

The influence of ignoring secondary structure on divergence time estimates from ribosomal RNA genes.

PubMed

Dohrmann, Martin

2014-02-01

Genes coding for ribosomal RNA molecules (rDNA) are among the most popular markers in molecular phylogenetics and evolution. However, coevolution of sites that code for pairing regions (stems) in the RNA secondary structure can make it challenging to obtain accurate results from such loci. While the influence of ignoring secondary structure on multiple sequence alignment and tree topology has been investigated in numerous studies, its effect on molecular divergence time estimates is still poorly known. Here, I investigate this issue in Bayesian Markov Chain Monte Carlo (BMCMC) and penalized likelihood (PL) frameworks, using empirical datasets from dragonflies (Odonata: Anisoptera) and glass sponges (Porifera: Hexactinellida). My results indicate that highly biased inferences under substitution models that ignore secondary structure only occur if maximum-likelihood estimates of branch lengths are used as input to PL dating, whereas in a BMCMC framework and in PL dating based on Bayesian consensus branch lengths, the effect is far less severe. I conclude that accounting for coevolution of paired sites in molecular dating studies is not as important as previously suggested, as long as the estimates are based on Bayesian consensus branch lengths instead of ML point estimates. This finding is especially relevant for studies where computational limitations do not allow the use of secondary-structure specific substitution models, or where accurate consensus structures cannot be predicted. I also found that the magnitude and direction (over- vs. underestimating node ages) of bias in age estimates when secondary structure is ignored was not distributed randomly across the nodes of the phylogenies, a phenomenon that requires further investigation. Copyright © 2013 Elsevier Inc. All rights reserved.

Non-consensual sex in Benin.

PubMed

Gharoro, E P; Enabudoso, E J; Sodje, D K J

2011-01-01

The objective of the study is to investigate the prevalence and risk factors of non-consensual sex/rape in Benin. We surveyed 580 females in the University Community of Benin, 414 questionnaires were sufficiently completed for analysis. Seventy-six (18.4%) respondents reported that they had been victims of non-consensual sex (NCS), 36 in their current relationship. The unmarried single respondents had the lowest mean age at NCS experience of 18 years, while the divorced victims had the highest mean age of 32.5 ( P = 0.000). There was a major exposure peak age at 19 years with a smaller peak at 25. The majority of sex offenders were their present partners and next the husbands (22.2%). The father was the perpetrator on one (2.78%) occasion, while armed robbers raped two of the victims. Eighteen of the seventy-six respondents made a formal report. Cumulatively, 95.4% of the respondents felt it was futile reporting, four (5.3%) felt it was not all a bad experience. The risk of being infected with the HIV/AIDS virus was the worst fear. Ninety-five of four hundred and fourteen respondents want the public and parents to be educated, 64 would like the penal code to be tougher and better implemented, while 64 (14.0%) crave for a dress code for the University community. The self-reported incidence of NCS is high, majority were not formally reported as most of the sex offenders were the (ex)partners of the victims. There was a major exposure peak age at 19 with a smaller peak at 25 years. There was a condoned sense of futility and frustration in reporting.

Marlene Dietrich in the German Classroom: A German Film Project--Humanities through the Golden Age of German Cinema.

ERIC Educational Resources Information Center

Flippo, Hyde

1993-01-01

Marlene Dietrich and other classic performers of German cinema can serve to open up a whole new realm for students of German, at secondary and postsecondary levels. By researching and viewing German and American film classics, students have opportunity to learn more about German language and an important element of German culture that has had…

Participatory Practices in Adult Education.

ERIC Educational Resources Information Center

Campbell, Pat, Ed.; Burnaby, Barbara, Ed.

Participatory education is a collective effort in which the participants are committed to building a just society through individual and socieoeconomic transformation and to ending domination through changing power relations. This book describes participatory practices in many environments, including educational and penal institutions,…

Office Skills: Measuring Typewriting Output.

ERIC Educational Resources Information Center

Petersen, Lois E.; Kruk, Leonard B.

1978-01-01

The advent of word processing centers has provided typewriting teachers with an alternative measurement system that, instead of penalizing errors, grades students according to Usable Lines Produced (ULP). The ULP system is job-oriented and promotes realistic office standards in typewriting productivity. (MF)

Senegal: Background and U.S. Relations

DTIC Science & Technology

2012-02-20

press, and assembly; corruption and impunity; rape, domestic violence, sexual harassment of and discrimination against women; female genital mutilation ...Senegal’s Budget Process is Transparent [UNCLASSIFIED],” May 4, 2010. 23 The 1999 Penal Law outlawed domestic violence and female genital mutilation , and

Validation of CESAR Thermal-hydraulic Module of ASTEC V1.2 Code on BETHSY Experiments

NASA Astrophysics Data System (ADS)

Tregoures, Nicolas; Bandini, Giacomino; Foucher, Laurent; Fleurot, Joëlle; Meloni, Paride

The ASTEC V1 system code is being jointly developed by the French Institut de Radioprotection et Sûreté Nucléaire (IRSN) and the German Gesellschaft für Anlagen und ReaktorSicherheit (GRS) to address severe accident sequences in a nuclear power plant. Thermal-hydraulics in primary and secondary system is addressed by the CESAR module. The aim of this paper is to present the validation of the CESAR module, from the ASTEC V1.2 version, on the basis of well instrumented and qualified integral experiments carried out in the BETHSY facility (CEA, France), which simulates a French 900 MWe PWR reactor. Three tests have been thoroughly investigated with CESAR: the loss of coolant 9.1b test (OECD ISP N° 27), the loss of feedwater 5.2e test, and the multiple steam generator tube rupture 4.3b test. In the present paper, the results of the code for the three analyzed tests are presented in comparison with the experimental data. The thermal-hydraulic behavior of the BETHSY facility during the transient phase is well reproduced by CESAR: the occurrence of major events and the time evolution of main thermal-hydraulic parameters of both primary and secondary circuits are well predicted.

Association Between Hospital Penalty Status Under the Hospital Readmission Reduction Program and Readmission Rates for Target and Non-Target Conditions

PubMed Central

Desai, Nihar R.; Ross, Joseph S.; Kwon, Ji Young; Herrin, Jeph; Dharmarajan, Kumar; Bernheim, Susannah M.; Krumholz, Harlan M.; Horwitz, Leora I.

2017-01-01

Importance Readmission rates declined after announcement of the Hospital Readmission Reduction Program (HRRP), which penalizes hospitals for excess readmissions for acute myocardial infarction (AMI), heart failure (HF), and pneumonia. Objective To compare trends in readmission rates for target and non-target conditions, stratified by hospital penalty status. Design, Setting, Participants Retrospective cohort study of 48,137,102 hospitalizations of 20,351,161 Medicare fee-for-service beneficiaries over 64 years discharged between January 1, 2008 and June 30, 2015 from 3,497 hospitals. Difference interrupted time series models were used to compare trends in readmission rates by condition and penalty status. Exposure Hospital penalty status or target condition under the HRRP. Outcome 30-day risk adjusted, all-cause unplanned readmission rates for target and non-target conditions. Results In January 2008, the mean readmission rates for AMI, HF, pneumonia and non-target conditions were 21.9%, 27.5%, 20.1%, and 18.4% respectively at hospitals later subject to financial penalties (n=2,189) and 18.7%, 24.2%, 17.4%, and 15.7% at hospitals not subject to penalties (n=1,283). Between January 2008 and March 2010, prior to HRRP announcement, readmission rates were stable across hospitals (except AMI at non-penalty hospitals). Following announcement of HRRP (March 2010), readmission rates for both target and non-target conditions declined significantly faster for patients at hospitals later subject to financial penalties compared with those at non-penalized hospitals (AMI, additional decrease of −1.24 (95% CI, −1.84, −0.65) percentage points per year relative to non-penalty discharges; HF, −1.25 (−1.64, −0.65); pneumonia, −1.37 (−0.95, −1.80); non-target, −0.27 (−0.38, −0.17); p<0.001 for all). For penalty hospitals, readmission rates for target conditions declined significantly faster compared with non-target conditions (AMI: additional decline of −0.49 (−0.81, −0.16) percentage points per year relative to non-target conditions, p=0.004; HF: −0.90 (−1.18, −0.62), p<0.001; pneumonia: −0.57 (−0.92,−0.23), p<0.001). By contrast, among non-penalty hospitals, readmissions for target conditions declined similarly or more slowly compared with non-target conditions (AMI: additional increase of 0.48 (0.01, 0.95) percentage points per year, p=0.05; HF: 0.08 (−0.30, 0.46), p=0.67; pneumonia: 0.53 (0.13, 0.93), p=0.01). After HRRP implementation in October 2012, the rate of change for readmission rates plateaued (p<0.05 for all except pneumonia at non-penalty hospitals) with the greatest relative change observed among hospitals subject to financial penalty. Conclusions Patients at hospitals subject to penalties had greater reductions in readmission rates compared with those at non-penalized hospitals. Changes were greater for target conditions at penalized hospitals, but not at non-penalized hospitals. PMID:28027367

Constructing Understandings of End-of-Life Care in Europe: A Qualitative Study Involving Cognitive Interviewing with Implications for Cross-National Surveys

PubMed Central

Bechinger-English, Dorothee; Bausewein, Claudia; Simon, Steffan T.; Harding, Richard; Higginson, Irene J.; Gomes, Barbara

2011-01-01

Abstract Background Although national findings regarding people's end-of-life care (EoLC) preferences and priorities are available within Europe, a lack of research coordination between countries has meant that cross-national understandings of EoLC remain unknown. Purpose To (1) identify English and German understandings of EoLC within the context of an EoLC survey, and (2) to synthesise these understandings to aid interpretation of results from a cross-national survey. Methods An inductive and interpretive two-phased sequential design involving (1) qualitative analysis of cognitive interview data from 15 English and 15 German respondents to develop country-related categories, and (2) qualitative synthesis to identify a conceptually coherent understanding of EoLC. Results Open and axial coding resulted in six English and six German categories. Commonalities included (a) the importance of social and relational dimensions, (b) dynamic decision making comprising uncertainty, (c) a valuing of life's quality and quantity, and (d) expectations for holistic care involving autonomy, choice, and timely information from trusted professionals. Differences involved attention to practical matters, and thoughts about prolongation of life, preferred place of death, and the role of media and context. Synthesis resulted in four concepts with underlying coherence: expectations of a high standard of EoLC involving autonomy, choice, and context; evolving decision making amid anticipated change; thoughts about living and existing; and worldviews shaping EoLC preferences in real and hypothetical scenarios. Conclusion Individual and country-related diversity must be remembered when quantifying EoLC understandings. Inductive-interpretive analysis of cognitive interview data aids interpretation of survey findings. Cross-national research coordination and qualitative synthesis assists EoLC in Europe. PMID:21306232

Sharing the knowledge gained from occupational cohort studies: a call for action.

PubMed

Behrens, Thomas; Mester, Birte; Fritschi, Lin

2012-06-01

An immense body of knowledge has been created by establishing various job-exposure matrices (JEMs) to assess occupational exposures in community- and industry-based cohort studies. These JEMs could be made available to occupational epidemiologists using knowledge-sharing technologies, thereby saving considerable amounts of time and money for researchers investigating occupation-related research questions. In this paper, the authors give an example of how a detailed JEM can be easily transformed into a job-specific module (JSM) for use in community-based studies. OccIDEAS is operationalised as a web-based software, combining the use of JSMs with an individual expert exposure assessment to assess occupational exposures in various industries according to a set of predefined rules. The authors used a JEM focusing on endocrine-disrupting chemicals from a German study on testicular cancer in the automobile industry to create a JSM in OccIDEAS. The JEM was easily translated into OccIDEAS requiring about 50 h of work by an epidemiologist familiar with the German JEM to learn about the OccIDEAS structure, establish the required set of exposure rules and to translate the JEM into OccIDEAS. Language did not represent an obstacle for translation either. To make the data available in an international context, an interpreter had to translate the German tasks and exposures after they were coded into OccIDEAS. JEMs which are constructed based on identifying tasks that determine exposure can be easily transformed into a JSM. Occupational epidemiologists are invited to contribute to the international scope of OccIDEAS by providing their previously established JEMs to make existing data on occupational exposures widely available to the epidemiological community.

[Financing of inpatient orthopedics and trauma surgery in the G-DRG system 2010].

PubMed

Franz, D; Schemmann, F; Roeder, N; Mahlke, L

2010-08-01

The German DRG (diagnosis-related groups) system forms the basis for billing inpatient hospital services. It includes not only the case groups (G-DRGs), but also additional and innovation payments. This paper analyzes and evaluates the relevant developments of the G-DRG System 2010 for orthopedics and traumatology from the medical and classification perspectives. Analyses of relevant diagnoses, medical procedures and G-DRGs in the versions 2009 and 2010 based on the publications of the German DRG institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI) were carried out. The DRG catalog is has grown from 8 to 1,200 G-DRGs. A number of codes for surgical measures have been newly established or modified. Here, the identification and the correct and performance-based mapping of complex and elaborate scenarios was again the focus of the restructuring of the G-DRG system. The G-DRG structure in orthopedics and traumatology has been changed, especially in the areas of spinal surgery and surgery of the upper and lower extremities. The actual impact of the changes may vary depending on the individual hospital services. For the first time since the introduction of the G-DRG system, the pure numerical changes at the level of DRGs themselves are so marginal that only part of the DRG users in the hospitals will register them. The changes implemented not only a high selectivity between complex and less complex scenarios, but partly also unintended and unjustified revaluation of less complex measures. The G-DRG system has gained complexity again. Especially the G-DRG allocation of spinal surgery and multiple surgical interventions of the upper and/or lower extremities have reached such a complexity that only a few DRG users can follow them.

[Data protection, radiation protection and copyright: Problems of transferring results in assessment practice].

PubMed

Klemm, H-T

2015-06-01

In Germany, the medical assessor is subject to the law on contracts for work and services ("Werksvertragsrecht"). When a medical expert assesses a subject on behalf of a third party, there is no contractual relationship between them. In the field of private insurance law and in social insurance law, the medical expert is faced with various procedural requirements. Failing to meet these legal requirements often makes the assessment difficult or even impossible. The transfer of radiographs to the medical assessor is dealt with in the German X-ray regulations ("Röntgenverordnung"). The assessor, who is without doubt an examining doctor, has the right to have the radiographs temporarily made available (§ 28 et al.). Passing on the radiographs is all the more appropriate if by doing so additional X-ray examinations can be avoided. The right of access to medical data in the social security law, apart from X-ray regulations, is regulated by German Civil Code (BGB) § 810 and German Basic Law section 1 paragraph 1 in connection with section 2 paragraph 1 ("§ 810 BGB; Art. 1 Abs. 1, Art. 2 Abs. 1 GG"). In the absence of third party interest worthy of protection, the right of access to assessment records has to be granted to the subject, who will then authorize the examining medical expert to exercise this right. In private insurance law, only the private health insurance has its regulation concerning obtaining information about treatment or the access to medical assessments. In other types of insurance the medical assessor's right of access to medical examination data and/or the basis for medical findings can only be derived from secondary obligations as part of the insurance contract or directly from general constitutional personal rights.

[Cause-of-death statistics and ICD, quo vadis?

PubMed

Eckert, Olaf; Vogel, Ulrich

2018-07-01

The International Statistical Classification of Diseases and Related Health Problems (ICD) is the worldwide binding standard for generating underlying cause-of-death statistics. What are the effects of former revisions of the ICD on underlying cause-of-death statistics and which opportunities and challenges are becoming apparent in a possible transition process from ICD-10 to ICD-11?This article presents the calculation of the exploitation grade of ICD-9 and ICD-10 in the German cause-of-death statistics and quality of documentation. Approximately 67,000 anonymized German death certificates are processed by Iris/MUSE and official German cause-of-death statistics are analyzed.In addition to substantial changes in the exploitation grade in the transition from ICD-9 to ICD-10, regional effects become visible. The rate of so-called "ill-defined" conditions exceeds 10%.Despite substantial improvement of ICD revisions there are long-known deficits in the coroner's inquest, filling death certificates and quality of coding. To make better use of the ICD as a methodological framework for mortality statistics and health reporting in Germany, the following measures are necessary: 1. General use of Iris/MUSE, 2. Establishing multiple underlying cause-of-death statistics, 3. Introduction of an electronic death certificate, 4. Improvement of the medical assessment of cause of death.Within short time the WHO will release the 11th revision of the ICD that will provide additional opportunities for the development of underlying cause-of-death statistics and their use in science, public health and politics. A coordinated effort including participants in the process and users is necessary to meet the related challenges.

Evaluating the Visually Impaired: Neuropsychological Techniques.

ERIC Educational Resources Information Center

Price, J. R.; And Others

1987-01-01

Assessment of nonvisual neuropsychological impairments in visually impaired persons can be achieved through modification of existing intelligence, memory, sensory-motor, personality, language, and achievement tests so that they do not require vision or penalize visually impaired persons. The Halstead-Reitan and Luria-Nebraska neuropsychological…

Improving Cluster Analysis with Automatic Variable Selection Based on Trees

DTIC Science & Technology

2014-12-01

regression trees Daisy DISsimilAritY PAM partitioning around medoids PMA penalized multivariate analysis SPC sparse principal components UPGMA unweighted...unweighted pair-group average method ( UPGMA ). This method measures dissimilarities between all objects in two clusters and takes the average value

Golden Handcuffs

ERIC Educational Resources Information Center

Costrell, Robert M.; Podgursky, Michael

2010-01-01

Teacher pensions consume a substantial portion of school budgets. If relatively generous pensions help attract effective teachers, the expense might be justified. But new evidence suggests that current pension systems, by concentrating benefits on teachers who spend their entire careers in a single state and penalizing mobile teachers, may…

24 CFR 882.401 - Eligible properties.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Ineligible properties. (1) Nursing homes, units within the grounds of penal, reformatory, medical, mental and similar public or private institutions, and facilities providing continual psychiatric, medical or nursing... State or unit of general local government is not eligible for assistance under this program. (3) High...

24 CFR 882.401 - Eligible properties.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Ineligible properties. (1) Nursing homes, units within the grounds of penal, reformatory, medical, mental and similar public or private institutions, and facilities providing continual psychiatric, medical or nursing... State or unit of general local government is not eligible for assistance under this program. (3) High...

24 CFR 882.401 - Eligible properties.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Ineligible properties. (1) Nursing homes, units within the grounds of penal, reformatory, medical, mental and similar public or private institutions, and facilities providing continual psychiatric, medical or nursing... State or unit of general local government is not eligible for assistance under this program. (3) High...

24 CFR 882.401 - Eligible properties.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Ineligible properties. (1) Nursing homes, units within the grounds of penal, reformatory, medical, mental and similar public or private institutions, and facilities providing continual psychiatric, medical or nursing... State or unit of general local government is not eligible for assistance under this program. (3) High...

… but You Are Not German." -- Afro-German Culture and Literature in the German Language Classroom

ERIC Educational Resources Information Center

Schenker, Theresa; Munro, Robert

2016-01-01

Units and classes dedicated to multiculturalism in Germany have predominantly focused on Turkish-German literature and culture. Afro-Germans have been a minority whose culture and literature have only marginally been included in German classes, even though Afro-Germans have been a part of Germany for centuries and have undergone efforts at…

[Social medicine in medical faculties: realisation of the topic in the specialty "social medicine, occupational health"].

PubMed

Behmann, M; Bisson, S; Walter, U

2011-12-01

The 9 (th) Revision of German Medical Licensing Regulations for Physicians has come into effect on October 1 (st) 2003. Social medicine was separated into the fields "occupational health, social medicine" and the various cross-sectional modules: epidemiology, biometry, medical computer science; health economics, health-care system, public health; prevention, health promotion; rehabilitation, physical medicine, naturopathic treatment. This paper studies the realisation of teaching in the field social medicine at German medical faculties. The survey was conducted in collaboration with the German Association for Social Medicine and Prevention (DGSMP). A survey was conducted at 38 institutes of 36 German medical faculties. The written questionnaire contained mostly selection items in which chances and barriers of the field were queried with supply items. Information about time scale, general conditions and resources was aked for. On the basis of the guidelines of the DGSMP, the topics to be taught were evaluated concerning their relevance and integration into education. The response rate was 68% (n=26). Social insurance, basic principles, responsibility in the Social Security Code and the different providers were judged as the most important topics. There was a strong demand for lecturing material. 82% (n=18) of the faculties wished to have specific material, for example e-learning, examples, lesson plans, curricula and also textbooks. 91% (n=19) of the faculties requested an exchange of information between the faculties concerning educational contents, motivation of students and e-learning. The realisation of teaching is different between the faculties concerning the number of hours, teaching methods and number of students per year. The motivation of the students is one of the problems, but also the lack of acceptance within the clinic. Specific resources and exchange between the faculties are necessary concerning e-learning, which is offered at only few faculties so far, but interest for a more intensive usage exists. Potentials of social medicine are the promotion of awareness among the students and the "identification of basics for medical acts in the social security system". Social medicine offers the possibility to connect the theoretical institutes with the clinic. © Georg Thieme Verlag KG Stuttgart · New York.

The 2-D magnetotelluric inverse problem solved with optimization

NASA Astrophysics Data System (ADS)

van Beusekom, Ashley E.; Parker, Robert L.; Bank, Randolph E.; Gill, Philip E.; Constable, Steven

2011-02-01

The practical 2-D magnetotelluric inverse problem seeks to determine the shallow-Earth conductivity structure using finite and uncertain data collected on the ground surface. We present an approach based on using PLTMG (Piecewise Linear Triangular MultiGrid), a special-purpose code for optimization with second-order partial differential equation (PDE) constraints. At each frequency, the electromagnetic field and conductivity are treated as unknowns in an optimization problem in which the data misfit is minimized subject to constraints that include Maxwell's equations and the boundary conditions. Within this framework it is straightforward to accommodate upper and lower bounds or other conditions on the conductivity. In addition, as the underlying inverse problem is ill-posed, constraints may be used to apply various kinds of regularization. We discuss some of the advantages and difficulties associated with using PDE-constrained optimization as the basis for solving large-scale nonlinear geophysical inverse problems. Combined transverse electric and transverse magnetic complex admittances from the COPROD2 data are inverted. First, we invert penalizing size and roughness giving solutions that are similar to those found previously. In a second example, conventional regularization is replaced by a technique that imposes upper and lower bounds on the model. In both examples the data misfit is better than that obtained previously, without any increase in model complexity.

Legal terrorism in domestic violence -- an Indian outlook.

PubMed

Shetty, B Suresh Kumar; Rao, P P Jagadish; Shetty, Aditi Suresh

2012-01-01

Marriage in India is a voluntary union for life of one man and one woman to the exclusion of all others. It is a social association where the husband has the responsibility to take care of and maintain his wife and not to neglect his duties. But in relation to this great institution, the problem of the "dowry" still persists. Women are ill-treated, harassed, killed or divorced for the simple reason that they do not get a dowry or do not get a sufficiently large one. To safeguard the interest of women against the cruelty they face within the four walls of their matrimonial home, the Indian Penal Code 1860 was amended in 1983 and section 498A was added. This deals with "Matrimonial Cruelty" to a woman. Matrimonial Cruelty in India is a cognizable, non-bailable and non-compoundable offence. Notwithstanding that the practice of demanding dowries was made illegal in India over 50 years ago, the (London) Times on 18 January 2012 reported that a study in 2007 concluded that "there is a dowry-related death in India every four hours". Official statistics in India show there were 8,391 dowry-related deaths in 2010, and there may well have been more. Why has leglislation that criminalises these appalling practices failed to stop them?

Mens Rea and Methamphetamine: High Time for a Modern Doctrine Acknowledging the Neuroscience of Addiction.

PubMed

Cusick, Meredith

2017-04-01

In American criminal law, actus non facit reum, nisi mens sit rea, "an act does not make one guilty, without a guilty mind." Both actus reus and mens rea are required to justify criminal liability. The Model Penal Code's (MPC) section on culpability has been especially influential on mens rea analysis. An issue of increasing importance in this realm arises when an offensive act is committed while the actor is under the influence of drugs. Several legal doctrines address the effect of intoxication on mental state, including the MPC, limiting or eliminating its relevance to the mens rea analysis. Yet these doctrines do not differentiate between intoxication and addiction. Neuroscience research reveals that drug addiction results in catastrophic damage to the brain resulting in cognitive and behavioral deficits. Methamphetamine addiction is of particular interest to criminal law because it causes extensive neural destruction and is associated with impulsive behavior, violent crime, and psychosis. Furthermore, research has revealed important distinctions between the effects of acute intoxication and addiction. These findings have implications for the broader doctrine of mens rea and, specifically, the intoxication doctrines. This Note argues for the adoption of an addiction doctrine that acknowledges the effect of addiction on mens rea that is distinct from doctrines of intoxication.

Highly Parallel Alternating Directions Algorithm for Time Dependent Problems

NASA Astrophysics Data System (ADS)

Ganzha, M.; Georgiev, K.; Lirkov, I.; Margenov, S.; Paprzycki, M.

2011-11-01

In our work, we consider the time dependent Stokes equation on a finite time interval and on a uniform rectangular mesh, written in terms of velocity and pressure. For this problem, a parallel algorithm based on a novel direction splitting approach is developed. Here, the pressure equation is derived from a perturbed form of the continuity equation, in which the incompressibility constraint is penalized in a negative norm induced by the direction splitting. The scheme used in the algorithm is composed of two parts: (i) velocity prediction, and (ii) pressure correction. This is a Crank-Nicolson-type two-stage time integration scheme for two and three dimensional parabolic problems in which the second-order derivative, with respect to each space variable, is treated implicitly while the other variable is made explicit at each time sub-step. In order to achieve a good parallel performance the solution of the Poison problem for the pressure correction is replaced by solving a sequence of one-dimensional second order elliptic boundary value problems in each spatial direction. The parallel code is implemented using the standard MPI functions and tested on two modern parallel computer systems. The performed numerical tests demonstrate good level of parallel efficiency and scalability of the studied direction-splitting-based algorithm.

ToTem: a tool for variant calling pipeline optimization.

PubMed

Tom, Nikola; Tom, Ondrej; Malcikova, Jitka; Pavlova, Sarka; Kubesova, Blanka; Rausch, Tobias; Kolarik, Miroslav; Benes, Vladimir; Bystry, Vojtech; Pospisilova, Sarka

2018-06-26

High-throughput bioinformatics analyses of next generation sequencing (NGS) data often require challenging pipeline optimization. The key problem is choosing appropriate tools and selecting the best parameters for optimal precision and recall. Here we introduce ToTem, a tool for automated pipeline optimization. ToTem is a stand-alone web application with a comprehensive graphical user interface (GUI). ToTem is written in Java and PHP with an underlying connection to a MySQL database. Its primary role is to automatically generate, execute and benchmark different variant calling pipeline settings. Our tool allows an analysis to be started from any level of the process and with the possibility of plugging almost any tool or code. To prevent an over-fitting of pipeline parameters, ToTem ensures the reproducibility of these by using cross validation techniques that penalize the final precision, recall and F-measure. The results are interpreted as interactive graphs and tables allowing an optimal pipeline to be selected, based on the user's priorities. Using ToTem, we were able to optimize somatic variant calling from ultra-deep targeted gene sequencing (TGS) data and germline variant detection in whole genome sequencing (WGS) data. ToTem is a tool for automated pipeline optimization which is freely available as a web application at  https://totem.software .

[Unconscious resistance to contraception].

PubMed

Gloor, P A

1978-12-01

The Swiss penal code of 1942 requires the presence of a psychiatrist in all decisions about termination of pregnancy and of sterilization. The so called sexual revolution of the last 20 years has brought about a dissociation of the traditional psychosexual behavior, where eroticism, affection, and desire of a child do not integrate as harmoniously as before. Narcissistic libido, inherent in all of us, can make an individual want a baby for reasons other than normal, but as a reflection of a parent, as a toy for an infantile mother, as a termination to free, sexual life, felt as sin, for a young couple, as a hope for the future, as the rival of one of the parents, as a remedy for something lost. These are just some of the reasons why contraception, completely accepted on a conscious level, can be rejected on an unconscious one, leading to unwanted pregnancies. Family planning, through a better and deeper psychological preparation of its personnel, should better identify patients more at risk of contraceptive failure, and the unconscious resistances of individuals and couples. This very important task can be started in schools with sex education, and in family planning centers with sexual therapy for the couple. This new approach would imply an increased interest for psychology on the part of doctors assisting young couples.

MATRIX DISCRIMINANT ANALYSIS WITH APPLICATION TO COLORIMETRIC SENSOR ARRAY DATA

PubMed Central

Suslick, Kenneth S.

2014-01-01

With the rapid development of nano-technology, a “colorimetric sensor array” (CSA) which is referred to as an optical electronic nose has been developed for the identification of toxicants. Unlike traditional sensors which rely on a single chemical interaction, CSA can measure multiple chemical interactions by using chemo-responsive dyes. The color changes of the chemo-responsive dyes are recorded before and after exposure to toxicants and serve as a template for classification. The color changes are digitalized in the form of a matrix with rows representing dye effects and columns representing the spectrum of colors. Thus, matrix-classification methods are highly desirable. In this article, we develop a novel classification method, matrix discriminant analysis (MDA), which is a generalization of linear discriminant analysis (LDA) for the data in matrix form. By incorporating the intrinsic matrix-structure of the data in discriminant analysis, the proposed method can improve CSA’s sensitivity and more importantly, specificity. A penalized MDA method, PMDA, is also introduced to further incorporate sparsity structure in discriminant function. Numerical studies suggest that the proposed MDA and PMDA methods outperform LDA and other competing discriminant methods for matrix predictors. The asymptotic consistency of MDA is also established. R code and data are available online as supplementary material. PMID:26783371

[Bipolar disorder and criminality: a comparative study by gender].

PubMed

Bram, N; Rafrafi, R; Ben Romdhane, I; Ridha, R

2013-12-01

Unlike schizophrenia, the impact of gender on the criminality of patients with bipolar disorder has received little attention. To estimate the sex ratio in relation to acts committed by forensic bipolar patients and evaluate the impact of gender on the characteristics of this crime. A comparative study by gender, conducted at the psychiatric hospital Razi has included all patients with bipolar disorder hospitalized between 1990 and 2010 after being relaxed for mental illness, owing to the Tunisian penal code. The total number of patients was 36 and the sex ratio of 3.5.A suicide history was four times more common in women. Alcohol abuse was found only in men. Relapses were more frequent in women (3.06 I year against 1.14 I year, p = 0.02). Rapid cycling and comorbid anxiety were noted only in female patients. Filicide and prostitution were committed exclusively by women, economic crimes and sexual assaults were the preserve of men. The male offenses were more impulsive and unpremeditated (p = 0.04). Although sex ratio is in favor of men, women's representation in the violence induced by bipolar disorder is significant, resulting, particularly during depressive phases, by serious and deadly acts. Preventive measures of acting out in bipolar patients must be supported and especially adapted to the genre

[68% of Brazilians want abortion prohibited].

PubMed

1991-09-25

According to a survey, 68% of the Brazilian population want the continuation of the law banning abortion. Only 24% favor liberalization. The penal code stipulates a jail term of 2-8 years for abortion. The survey was carried out in 1991 involving 7018 persons aged 16 in 15 municipalities. 71% who approved the ban lived in the northeast north, and central-east regions. 68% in the south and 65% in the southeast were in favor of the prohibition. 74% in the small towns endorsed this law. 73% with up to 5 times the minimum monthly salary were against abortion, 65% of those with incomes between 5-10 times the minimum salary and 57% of those earning more than 10 times the minimum salary condemned abortion. 72% of women and 64% of men were against it. 73% of young people aged 16-25 wanted the continuation of the ban, compared to 66% of those aged 26-40 and 65% of people 41 or over. 72% of those with up to primary school education, 65% with secondary school education, and 48% with higher education approved the ban. Among those who favored liberalization, 27% lived in the southwest region, 31% were inhabitants of large cities, 36% earned more than 10 times the minimum income monthly, and 39% had obtained higher education.