Sample records for medical subject headings

  1. Conceptual mapping of user's queries to medical subject headings.

    PubMed Central

    Zieman, Y. L.; Bleich, H. L.

    1997-01-01

    This paper describes a way to map users' queries to relevant Medical Subject Headings (MeSH terms) used by the National Library of Medicine to index the biomedical literature. The method, called SENSE (SEarch with New SEmantics), transforms words and phrases in the users' queries into primary conceptual components and compares these components with those of the MeSH vocabulary. Similar to the way in which most numbers can be split into numerical factors and expressed as their product--for example, 42 can be expressed as 2*21, 6*7, 3*14, 2*3*7,--so most medical concepts can be split into "semantic factors" and expressed as their juxtaposition. Note that if we split 42 into its primary factors, the breakdown is unique: 2*3*7. Similarly, when we split medical concepts into their "primary semantic factors" the breakdown is also unique. For example, the MeSH term 'renovascular hypertension' can be split morphologically into reno, vascular, hyper, and tension--morphemes that can then be translated into their primary semantic factors--kidney, blood vessel, high, and pressure. By "factoring" each MeSH term in this way, and by similarly factoring the user's query, we can match query to MeSH term by searching for combinations of common factors. Unlike UMLS and other methods that match at the level of words or phrases, SENSE matches at the level of concepts; in this way, a wide variety of words and phrases that have the same meaning produce the same match. Now used in PaperChase, the method is surprisingly powerful in matching users' queries to Medical Subject Headings. PMID:9357680

  2. A case study: using social tagging to engage students in learning Medical Subject Headings*

    PubMed Central

    Bresnahan, Megan; Flynn, David B.; Harzbecker, Joseph; Blanchard, Mary; Ginn, David

    2009-01-01

    In exploring new ways of teaching students how to use Medical Subject Headings (MeSH), librarians at Boston University's Alumni Medical Library (AML) integrated social tagging into their instruction. These activities were incorporated into the two-credit graduate course, “GMS MS 640: Introduction to Biomedical Information,” required for all students in the graduate medical science program. Hands-on assignments and in-class exercises enabled librarians to present MeSH and the concept of a controlled vocabulary in a familiar and relevant context for the course's Generation Y student population and provided students the opportunity to actively participate in creating their education. At the conclusion of these activities, students were surveyed regarding the clarity of the presentation of the MeSH vocabulary. Analysis of survey responses indicated that 46% found the concept of MeSH to be the clearest concept presented in the in-class intervention. PMID:19404497

  3. Survey of keyword adjustment of published articles medical subject headings in journal of mazandaran university of medical sciences (2009-2010).

    PubMed

    Kabirzadeh, Azar; Siamian, Hasan; Abadi, Ebrahim Bagherian Farah; Saravi, Benyamin Mohseni

    2013-01-01

    NONE DECLARED. Keywords are the most important tools for Information retrieval. They are usually used for retrieval of articles based on contents of information reserved from printed and electronic resources. Retrieval of appropriate keywords from Medical Subject Headings (MeSH) can impact with exact, correctness and short time on information retrieval. Regarding the above mentioned matters, this study was done to compare the Latin keywords was in the articles published in the Journal of Mazandaran University of Medical Sciences. This is a descriptive study. The data were extracted from the key words of Englsih abstracts of articles published in the years 2009-2010 in the Journal of Mazandaran University of Medical Sciences by census method. Checklist of data collection is designed, based on research objectives and literature review which has face validity. Compliance rate in this study was to determine if the keywords cited in this article as a full subject of the main subject headings in a MeSH (Bold and the selected word) is a perfect adjustment. If keywords were cited in the article but the main heading is not discussed in the following main topics to be discussed with reference to See and See related it has considered has partial adjustment. Out of 148 articles published in 12 issues in proposed time of studying, 72 research papers were analyzed. The average numbers of authors in each article were 4 ± 1. Results showed that most of specialty papers 42 (58. 4%), belonging to the (Department of Clinical Sciences) School of Medicine, 11 (15.3%) Basic Science, 6(8.4%) Pharmacy, Nursing and Midwifery 5(6.9%), 4(5.5%) Health, paramedical Sciences 3(4.2%), and non medical article 1(1.3%) school of medicine. In general, results showed that 80 (30%) of key words have been used to complete the adjustment. Also, only 1(1.4%) had complete adjustment with all the MeSH key words and in 8 articles(11.4%) key words of had no adjustment with MeSH. The results showed that only

  4. Mapping of medical acronyms and initialisms to Medical Subject Headings (MeSH) across selected systems

    PubMed Central

    Shultz, Mary

    2006-01-01

    Introduction: Given the common use of acronyms and initialisms in the health sciences, searchers may be entering these abbreviated terms rather than full phrases when searching online systems. The purpose of this study is to evaluate how various MEDLINE Medical Subject Headings (MeSH) interfaces map acronyms and initialisms to the MeSH vocabulary. Methods: The interfaces used in this study were: the PubMed MeSH database, the PubMed Automatic Term Mapping feature, the NLM Gateway Term Finder, and Ovid MEDLINE. Acronyms and initialisms were randomly selected from 2 print sources. The test data set included 415 randomly selected acronyms and initialisms whose related meanings were found to be MeSH terms. Each acronym and initialism was entered into each MEDLINE MeSH interface to determine if it mapped to the corresponding MeSH term. Separately, 46 commonly used acronyms and initialisms were tested. Results: While performance differed widely, the success rates were low across all interfaces for the randomly selected terms. The common acronyms and initialisms tested at higher success rates across the interfaces, but the differences between the interfaces remained. Conclusion: Online interfaces do not always map medical acronyms and initialisms to their corresponding MeSH phrases. This may lead to inaccurate results and missed information if acronyms and initialisms are used in search strategies. PMID:17082832

  5. Accuracy of medical subject heading indexing of dental survival analyses.

    PubMed

    Layton, Danielle M; Clarke, Michael

    2014-01-01

    To assess the Medical Subject Headings (MeSH) indexing of articles that employed time-to-event analyses to report outcomes of dental treatment in patients. Articles published in 2008 in 50 dental journals with the highest impact factors were hand searched to identify articles reporting dental treatment outcomes over time in human subjects with time-to-event statistics (included, n = 95), without time-to-event statistics (active controls, n = 91), and all other articles (passive controls, n = 6,769). The search was systematic (kappa 0.92 for screening, 0.86 for eligibility). Outcome-, statistic- and time-related MeSH were identified, and differences in allocation between groups were analyzed with chi-square and Fischer exact statistics. The most frequently allocated MeSH for included and active control articles were "dental restoration failure" (77% and 52%, respectively) and "treatment outcome" (54% and 48%, respectively). Outcome MeSH was similar between these groups (86% and 77%, respectively) and significantly greater than passive controls (10%, P < .001). Significantly more statistical MeSH were allocated to the included articles than to the active or passive controls (67%, 15%, and 1%, respectively, P < .001). Sixty-nine included articles specifically used Kaplan-Meier or life table analyses, but only 42% (n = 29) were indexed as such. Significantly more time-related MeSH were allocated to the included than the active controls (92% and 79%, respectively, P = .02), or to the passive controls (22%, P < .001). MeSH allocation within MEDLINE to time-to-event dental articles was inaccurate and inconsistent. Statistical MeSH were omitted from 30% of the included articles and incorrectly allocated to 15% of active controls. Such errors adversely impact search accuracy.

  6. Vertical File Subject Headings KWIK List.

    ERIC Educational Resources Information Center

    Knowles, Em Claire; And Others

    A subject heading keyword-in-context (KWIK) list for the vertical files at the University of California, Davis, is presented. It is noted that the KWIK list was prepared to assist library users in locating more subject headings for available materials in the various pamphlet collections and that the list is computerized to enable frequent…

  7. Improving information retrieval using Medical Subject Headings Concepts: a test case on rare and chronic diseases.

    PubMed

    Darmoni, Stéfan J; Soualmia, Lina F; Letord, Catherine; Jaulent, Marie-Christine; Griffon, Nicolas; Thirion, Benoît; Névéol, Aurélie

    2012-07-01

    As more scientific work is published, it is important to improve access to the biomedical literature. Since 2000, when Medical Subject Headings (MeSH) Concepts were introduced, the MeSH Thesaurus has been concept based. Nevertheless, information retrieval is still performed at the MeSH Descriptor or Supplementary Concept level. The study assesses the benefit of using MeSH Concepts for indexing and information retrieval. Three sets of queries were built for thirty-two rare diseases and twenty-two chronic diseases: (1) using PubMed Automatic Term Mapping (ATM), (2) using Catalog and Index of French-language Health Internet (CISMeF) ATM, and (3) extrapolating the MEDLINE citations that should be indexed with a MeSH Concept. Type 3 queries retrieve significantly fewer results than type 1 or type 2 queries (about 18,000 citations versus 200,000 for rare diseases; about 300,000 citations versus 2,000,000 for chronic diseases). CISMeF ATM also provides better precision than PubMed ATM for both disease categories. Using MeSH Concept indexing instead of ATM is theoretically possible to improve retrieval performance with the current indexing policy. However, using MeSH Concept information retrieval and indexing rules would be a fundamentally better approach. These modifications have already been implemented in the CISMeF search engine.

  8. Scope Notes for LISA Subject Headings.

    ERIC Educational Resources Information Center

    Browne, Glenda

    1992-01-01

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

  9. Punctuation in Library of Congress Subject Headings

    ERIC Educational Resources Information Center

    Steinweg, Hilda

    1978-01-01

    An analysis of the punctuation of the eighth edition Library of Congress Subject Headings reveals that the hyphen, coma and parentheses are most often used. Examples of these and the use of the apostrophe, dash, and period are discussed. (Author/MBR)

  10. Subject cataloging practices in North American medical school libraries.

    PubMed Central

    Fredericksen, R B; Michael, H N

    1976-01-01

    A survey of North American medical school libraries was made to determine current trends in subject cataloging practices. First, responses from 114 of these libraries are recorded and analyzed in the following areas: subject heading authority lists employed; use of the divided versus the dictionary catalog; and the form in which local subject authority files are kept. Then, focusing on 78 libraries that use MeSH in combination with a divided catalog, a further analysis of responses is made concerning issues relating to subject cataloging practices: updating the subject catalog to conform to annual MeSH changes; use of guide cards in the catalog; use of MeSH subheadings; filing conventions; and related issues. An attempt is made to analyze the extent to which these libraries vary from NLM practices. Suggestions are offered for formulating subject cataloging practices for an individual library. Finally, while it is concluded that MeSH and the Current Catalog are useful tools, a more detailed explication of the use of MeSH and NLM cataloging practices would be beneficial. PMID:989741

  11. Head control: volitional aspects of rehabilitation training in patients with multiple sclerosis compared with healthy subjects.

    PubMed

    Cattaneo, Davide; Ferrarin, Maurizio; Frasson, William; Casiraghi, Anna

    2005-07-01

    To investigate the role of voluntary mechanisms and motor learning in head stability and the impact of longitudinal biofeedback training in head control. Crossover trial and single-subject research design. Neurorehabilitation research institute. Head stability during treadmill gait was measured in healthy subjects and patients with multiple sclerosis (MS). The experimental condition in which subjects walked on the treadmill was compared with that in which the head was voluntarily stabilized. In another experimental condition, augmented feedback of head displacement was provided by means of a laser mounted on the head that projected a laser beam on a screen. The motor learning was investigated with biofeedback training sessions. Positional feedback was represented by the laser beam, with subjects having to stabilize the beam while walking on the treadmill. Head angular oscillation in the sagittal and frontal planes. Results showed that on verbal request, healthy subjects and patients further stabilized the head during gait, especially in the sagittal plane. Short-term feedback of head displacement was no better than self-stabilization at improving head control. Conversely, the motor learning was evident in the rehabilitation protocol: after 10 to 15 training sessions, patients with MS showed a clinically relevant decrease of head angular oscillations. Voluntary mechanisms play a role in head stabilization during gait. Augmented biofeedback of head displacement may be effective in reducing head oscillations.

  12. Efficacy of the LouseBuster, a new medical device for treating head lice (Anoplura:Pediculidae).

    PubMed

    Bush, Sarah E; Rock, Alex N; Jones, Sherri L; Malenke, Jael R; Clayton, Dale H

    2011-01-01

    Human head lice (Pediculus humanus capitis De Geer) occur worldwide and infest millions of children and adults every year. Head lice infestations, which are known as pediculosis capitis, are psychologically stressful, physically irritating, and are one of the leading causes of K-6 school absence. The prevalence of head lice in many countries is increasing rapidly because of resistance to chemicals used in many head lice treatments. We tested the efficacy of an alternative method for controlling head lice, the LouseBuster, a custom-built medical device designed to kill head lice and their eggs using controlled, heated air. A total of 56 infested subjects was treated with the LouseBuster, and the efficacy of the treatment was evaluated by comparing the viability of lice and eggs on randomly assigned pre- and posttreatment sides of each subject's scalp. We evaluate treatment efficacy in the hands of novice versus experienced operators. We also evaluate treatment efficacy on different hair types and at different ambient humidities. Overall mortality of lice and eggs was 94.8% after treatment by experienced operators. Novice operators also achieved good results after a short training session; their results did not differ significantly from those of experienced operators. No adverse events were associated with the LouseBuster treatment. The LouseBuster is efficacious for killing head lice and their eggs. The use of heated air is appealing because it is a fast, safe, nonchemical treatment. Head lice are also unlikely to evolve resistance to desiccation, which is the apparent mode of action.

  13. Parent-Reported Medication Use in a Head Start Population

    ERIC Educational Resources Information Center

    Brinkman, Tara M.; Carlson, John S.

    2008-01-01

    This study investigates the prevalence of medication use within a Head Start population. Parent-reported data (N = 1,397) from initial enrollment information indicated 6.8% of children were taking 34 different types of medication. More than two thirds (69%) of those on medication were prescribed more than one medication, and more than one third…

  14. Use of Headings and Classifications by Physicians in Medical Narratives of EHRs

    PubMed Central

    Häyrinen, K.; Harno, K.; Nykänen, P.

    2011-01-01

    Objective The purpose of this study was to describe and evaluate patient care documentation by hospital physicians in EHRs and especially the use of national headings and classifications in these documentations Material and Methods The initial material consisted of a random sample of 3,481 medical narratives documented in EHRs during the period 2004-2005 in one department of a Finnish central hospital. The final material comprised a subset of 1,974 medical records with a focus on consultation requests and consultation responses by two specialist groups from 871 patients. This electronic documentation was analyzed using deductive content analyses and descriptive statistics. Results The physicians documented patient care in EHRs principally as narrative text. The medical narratives recorded by specialists were structured with headings in less than half of the patient cases. Consultation responses in general were more often structured with headings than consultation requests. The use of classifications was otherwise insignificant, but diagnoses were documented as ICD 10 codes in over 50% of consultation responses by both medical specialties. Conclusion There is an obvious need to improve the structuring of narrative text with national headings and classifications. According to the findings of this study, reason for care, patient history, health status, follow-up care plan and diagnosis are meaningful headings in physicians’ documentation. The existing list of headings needs to be analyzed within a consistent unified terminology system as a basis for further development. Adhering to headings and classifications in EHR documentation enables patient data to be shared and aggregated. The secondary use of data is expected to improve care management and quality of care. PMID:23616866

  15. Comparative effectiveness research designs: an analysis of terms and coverage in Medical Subject Headings (MeSH) and Emtree*†

    PubMed Central

    Bekhuis, Tanja; Demner-Fushman, Dina; Crowley, Rebecca S.

    2013-01-01

    Objectives: We analyzed the extent to which comparative effectiveness research (CER) organizations share terms for designs, analyzed coverage of CER designs in Medical Subject Headings (MeSH) and Emtree, and explored whether scientists use CER design terms. Methods: We developed local terminologies (LTs) and a CER design terminology by extracting terms in documents from five organizations. We defined coverage as the distribution over match type in MeSH and Emtree. We created a crosswalk by recording terms to which design terms mapped in both controlled vocabularies. We analyzed the hits for queries restricted to titles and abstracts to explore scientists' language. Results: Pairwise LT overlap ranged from 22.64% (12/53) to 75.61% (31/41). The CER design terminology (n = 78 terms) consisted of terms for primary study designs and a few terms useful for evaluating evidence, such as opinion paper and systematic review. Patterns of coverage were similar in MeSH and Emtree (gamma = 0.581, P = 0.002). Conclusions: Stakeholder terminologies vary, and terms are inconsistently covered in MeSH and Emtree. The CER design terminology and crosswalk may be useful for expert searchers. For partially mapped terms, queries could consist of free text for modifiers such as nonrandomized or interrupted added to broad or related controlled terms. PMID:23646024

  16. Head eye co-ordination and gaze stability in subjects with persistent whiplash associated disorders.

    PubMed

    Treleaven, Julia; Jull, Gwendolen; Grip, Helena

    2011-06-01

    Symptoms of dizziness, unsteadiness and visual disturbances are frequent complaints in persons with persistent whiplash associated disorders. This study investigated eye, head co-ordination and gaze stability in subjects with persistent whiplash (n = 20) and asymptomatic controls (n = 20). Wireless motion sensors and electro-oculography were used to measure: head rotation during unconstrained head movement, head rotation during gaze stability and sequential head and eye movements. Ten control subjects participated in a repeatability study (two occasions one week apart). Between-day repeatability was acceptable (ICC > 0.6) for most measures. The whiplash group had significantly less maximal eye angle to the left, range of head movement during the gaze stability task and decreased velocity of head movement in head eye co-ordination and gaze stability tasks compared to the control group (p < 0.01). There were significant correlations (r > 0.55) between both unrestrained neck movement and neck pain and head movement and velocity in the whiplash group. Deficits in gaze stability and head eye co-ordination may be related to disturbed reflex activity associated with decreased head range of motion and/or neck pain. Further research is required to explore the mechanisms behind these deficits, the nature of changes over time and the tests' ability to measure change in response to rehabilitation. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

  17. Development of a high resolution voxelised head phantom for medical physics applications.

    PubMed

    Giacometti, V; Guatelli, S; Bazalova-Carter, M; Rosenfeld, A B; Schulte, R W

    2017-01-01

    Computational anthropomorphic phantoms have become an important investigation tool for medical imaging and dosimetry for radiotherapy and radiation protection. The development of computational phantoms with realistic anatomical features contribute significantly to the development of novel methods in medical physics. For many applications, it is desirable that such computational phantoms have a real-world physical counterpart in order to verify the obtained results. In this work, we report the development of a voxelised phantom, the HIGH_RES_HEAD, modelling a paediatric head based on the commercial phantom 715-HN (CIRS). HIGH_RES_HEAD is unique for its anatomical details and high spatial resolution (0.18×0.18mm 2 pixel size). The development of such a phantom was required to investigate the performance of a new proton computed tomography (pCT) system, in terms of detector technology and image reconstruction algorithms. The HIGH_RES_HEAD was used in an ad-hoc Geant4 simulation modelling the pCT system. The simulation application was previously validated with respect to experimental results. When compared to a standard spatial resolution voxelised phantom of the same paediatric head, it was shown that in pCT reconstruction studies, the use of the HIGH_RES_HEAD translates into a reduction from 2% to 0.7% of the average relative stopping power difference between experimental and simulated results thus improving the overall quality of the head phantom simulation. The HIGH_RES_HEAD can also be used for other medical physics applications such as treatment planning studies. A second version of the voxelised phantom was created that contains a prototypic base of skull tumour and surrounding organs at risk. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. Quality of pharmacy-specific Medical Subject Headings (MeSH) assignment in pharmacy journals indexed in MEDLINE.

    PubMed

    Minguet, Fernando; Salgado, Teresa M; van den Boogerd, Lucienne; Fernandez-Llimos, Fernando

    2015-01-01

    The Medical Subject Headings (MeSH) is the National Library of Medicine (NLM) controlled vocabulary for indexing articles. Inaccuracies in the MeSH thesaurus have been reported for several areas including pharmacy. To assess the quality of pharmacy-specific MeSH assignment to articles indexed in pharmacy journals. The 10 journals containing the highest number of articles published in 2012 indexed under the MeSH 'Pharmacists' were identified. All articles published over a 5-year period (2008-2012) in the 10 previously selected journals were retrieved from PubMed. MeSH terms used to index these articles were extracted and pharmacy-specific MeSH terms were identified. The frequency of use of pharmacy-specific MeSH terms was calculated across journals. A total of 6989 articles were retrieved from the 10 pharmacy journals, of which 328 (4.7%) were articles not fully indexed and therefore did not contain any MeSH terms assigned. Among the 6661 articles fully indexed, the mean number of MeSH terms was 10.1 (SD = 4.0), being 1.0 (SD = 1.3) considered as Major MeSH. Both values significantly varied across journals. The mean number of pharmacy-specific MeSH terms per article was 0.9 (SD = 1.2). A total of 3490 (52.4%) of the 6661 articles were indexed in pharmacy journals without a single pharmacy-specific MeSH. Of the total 67193 MeSH terms assigned to articles, on average 10.5% (SD = 13.9) were pharmacy-specific MeSH. A statistically significant different pattern of pharmacy-specific MeSH assignment was identified across journals (Kruskal-Wallis P < 0.001). The quality of assignment of the existing pharmacy-specific MeSH terms to articles indexed in pharmacy journals can be improved to further enhance evidence gathering in pharmacy. Over half of the articles published in the top-10 journals publishing pharmacy literature were indexed without a single pharmacy-specific MeSH. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Distinguishing medication-free subjects with unipolar disorder from subjects with bipolar disorder: state matters.

    PubMed

    Rive, Maria M; Redlich, Ronny; Schmaal, Lianne; Marquand, André F; Dannlowski, Udo; Grotegerd, Dominik; Veltman, Dick J; Schene, Aart H; Ruhé, Henricus G

    2016-11-01

    Recent studies have indicated that pattern recognition techniques of functional magnetic resonance imaging (fMRI) data for individual classification may be valuable for distinguishing between major depressive disorder (MDD) and bipolar disorder (BD). Importantly, medication may have affected previous classification results as subjects with MDD and BD use different classes of medication. Furthermore, almost all studies have investigated only depressed subjects. Therefore, we focused on medication-free subjects. We additionally investigated whether classification would be mood state independent by including depressed and remitted subjects alike. We applied Gaussian process classifiers to investigate the discriminatory power of structural MRI (gray matter volumes of emotion regulation areas) and resting-state fMRI (resting-state networks implicated in mood disorders: default mode network [DMN], salience network [SN], and lateralized frontoparietal networks [FPNs]) in depressed (n=42) and remitted (n=49) medication-free subjects with MDD and BD. Depressed subjects with MDD and BD could be classified based on the gray matter volumes of emotion regulation areas as well as DMN functional connectivity with 69.1% prediction accuracy. Prediction accuracy using the FPNs and SN did not exceed chance level. It was not possible to discriminate between remitted subjects with MDD and BD. For the first time, we showed that medication-free subjects with MDD and BD can be differentiated based on structural MRI as well as resting-state functional connectivity. Importantly, the results indicated that research concerning diagnostic neuroimaging tools distinguishing between MDD and BD should consider mood state as only depressed subjects with MDD and BD could be correctly classified. Future studies, in larger samples are needed to investigate whether the results can be generalized to medication-naïve or first-episode subjects. © 2016 John Wiley & Sons A/S. Published by John Wiley

  20. [Medical research and vulnerable subjects: unemployed people].

    PubMed

    Niebrój, Lesław

    2006-01-01

    Although the importance of medical research for the diagnosis and treatment of human diseases is unquestionable, the use of human subjects, however, still presents a complex ethical problem. Moral difficulties occur in particular when the medical research deals with vulnerable subjects. Vulnerable individuals are defined as those who experience diminished actual autonomy. Among the groups which should be considered as being vulnerable are usually listed the following: children, pregnant women, mentally or emotionally disabled, physically disabled, homeless, and institutionalized people. This study addresses key concerns that gave rise to the question of whether unemployed people had to be recognized as vulnerable subjects. The term "vulnerability" was clarified and it was assumed that the "vulnerability" of medical research subjects' had to be understood as a form of continuum from potential, through the circumstantial, temporal, episodic, permanent to inevitable vulnerability. The conclusion was drawn that unemployed people were, at least, potentially vulnerable subjects. Research involving unemployed people presents important moral challenges to researchers and should be undertaken very carefully, following special ethical guidelines.

  1. Variations in Medical Subject Headings (MeSH) mapping: from the natural language of patron terms to the controlled vocabulary of mapped lists*

    PubMed Central

    Gault, Lora V.; Shultz, Mary; Davies, Kathy J.

    2002-01-01

    Objectives: This study compared the mapping of natural language patron terms to the Medical Subject Headings (MeSH) across six MeSH interfaces for the MEDLINE database. Methods: Test data were obtained from search requests submitted by patrons to the Library of the Health Sciences, University of Illinois at Chicago, over a nine-month period. Search request statements were parsed into separate terms or phrases. Using print sources from the National Library of Medicine, Each parsed patron term was assigned corresponding MeSH terms. Each patron term was entered into each of the selected interfaces to determine how effectively they mapped to MeSH. Data were collected for mapping success, accessibility of MeSH term within mapped list, and total number of MeSH choices within each list. Results: The selected MEDLINE interfaces do not map the same patron term in the same way, nor do they consistently lead to what is considered the appropriate MeSH term. Conclusions: If searchers utilize the MEDLINE database to its fullest potential by mapping to MeSH, the results of the mapping will vary between interfaces. This variance may ultimately impact the search results. These differences should be considered when choosing a MEDLINE interface and when instructing end users. PMID:11999175

  2. Variations in Medical Subject Headings (MeSH) mapping: from the natural language of patron terms to the controlled vocabulary of mapped lists.

    PubMed

    Gault, Lora V; Shultz, Mary; Davies, Kathy J

    2002-04-01

    This study compared the mapping of natural language patron terms to the Medical Subject Headings (MeSH) across six MeSH interfaces for the MEDLINE database. Test data were obtained from search requests submitted by patrons to the Library of the Health Sciences, University of Illinois at Chicago, over a nine-month period. Search request statements were parsed into separate terms or phrases. Using print sources from the National Library of Medicine, Each parsed patron term was assigned corresponding MeSH terms. Each patron term was entered into each of the selected interfaces to determine how effectively they mapped to MeSH. Data were collected for mapping success, accessibility of MeSH term within mapped list, and total number of MeSH choices within each list. The selected MEDLINE interfaces do not map the same patron term in the same way, nor do they consistently lead to what is considered the appropriate MeSH term. If searchers utilize the MEDLINE database to its fullest potential by mapping to MeSH, the results of the mapping will vary between interfaces. This variance may ultimately impact the search results. These differences should be considered when choosing a MEDLINE interface and when instructing end users.

  3. Critical Views of LCSH--the Library of Congress Subject Headings; A Bibliographic and Bibliometric Essay and An Analysis of Vocabulary Control in the Library of Congress List of Subject Headings (LCSH).

    ERIC Educational Resources Information Center

    Cochrane, Pauline A.; Kirtland, Monika

    A comprehensive guide to the literature published between World War II and 1979 which critically evaluates the Library of Congress list of Subject Headings (LCSH), this bibliography has been prepared for information personnel involved with subject authority files, thesauri, or vocabulary control. A brief bibliometric analysis of the literature…

  4. PROJECT HEAD START MEDICAL--A GUIDE FOR DIRECTION OF CHILD DEVELOPMENT CENTERS.

    ERIC Educational Resources Information Center

    Office of Economic Opportunity, Washington, DC.

    HEALTH SERVICES OF PROJECT HEAD START CHILD DEVELOPMENT CENTERS PROVIDE--A MEDICAL EVALUATION OF EACH CHILD INCLUDING MEDICAL HISTORY, DEVELOPMENTAL ASSESSMENT, AND PHYSICAL EXAMINATION, SCREENING TESTS FOR VISION, HEARING, SPEECH, AND TUBERCULOSIS, LABORATORY TESTS OF URINE FOR ALBUMIN AND TESTS OF SUGAR AND BLOOD FOR ANEMIA, DENTAL ASSESSMENT,…

  5. Educational Value of a Medical Student-Led Head and Neck Cancer Screening Event.

    PubMed

    Freiser, Monika E; Desai, Dipan D; Azcarate, Patrick M; Szczupak, Mikhaylo; Cohen, Erin R; Raffa, Francesca N; George, Joshua S; Lo, Kaming; Nayak, Chetan S; Weed, Donald T; Sargi, Zoukaa B

    2016-04-01

    To evaluate improvement of medical student knowledge of head and neck cancer (HNC) through participation in HNC screening fairs run by medical students. Prospective cohort study of surveys assessing medical students' knowledge of HNC before and after volunteering at screening fairs. Four screening fairs held at the University of Miami Miller School of Medicine during Oral, Head and Neck Cancer Awareness Week. Medical student screening fair volunteers. Four HNC screening fairs were organized by medical student volunteers. All students completed a preevent survey assessing baseline knowledge and participated in an otolaryngologist-led training session about HNC and the screening examination. During the screening events, students educated guests about HNC and performed physician-guided history and physical examinations. Finally, students completed identical surveys 1 week and 3 months after the event. Thirty-four (n = 34) students completed the preevent surveys. At baseline, 59%, 44%, and 24% named tobacco, alcohol, and human papilloma virus as risk factors, compared with 84%, 81%, and 69% on 3 month follow-up, respectively. Out of 6 analyzed questions, the median total number of correctly answered questions improved from 2 on pretest to 5 at 3 months (P < .0001). Volunteer participation in a HNC screening program improves medical students' knowledge of HNC risk factors and symptoms. This innovative approach to students' education via participation and organization of screening events is a useful method of improving their HNC knowledge. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  6. Comparative Study between the "Lista de Encabezamientos de Materia" by Gloria Escamilla and the "Library of Congress Subject Heading" List.

    ERIC Educational Resources Information Center

    Alvarez, Fernando

    This study shows to what extent Gloria Escamilla's "Lista de Encabezamientos de Materia," the only published Mexican subject heading list, is equivalent to the Library of Congress subject headings (LCSH). A LCSH heading sample is obtained from OCLC's Online Union Catalog. Using the EPIC search from OCLC, 1947 bibliographic records were…

  7. Statistical Analysis of the Association Between Subject Headings and Their Corresponding Class Notations in Science and Technology Monographs.

    ERIC Educational Resources Information Center

    Khosh-khui, Abolghasem

    This study investigates the degree of relationship between scientific and technical subject headings and their corresponding class notations in the Dewey Decimal (DDC) and Library of Congress Classification (LCC) systems. The degree of association between a subject heading and its corresponding class of notation or notations is measured by…

  8. Comparison of smooth pursuit and combined eye-head tracking in human subjects with deficient labyrinthine function

    NASA Technical Reports Server (NTRS)

    Leigh, R. J.; Thurston, S. E.; Sharpe, J. A.; Ranalli, P. J.; Hamid, M. A.

    1987-01-01

    The effects of deficient labyrinthine function on smooth visual tracking with the eyes and head were investigated, using ten patients with bilateral peripheral vestibular disease and ten normal controls. Active, combined eye-head tracking (EHT) was significantly better in patients than smooth pursuit with the eyes alone, whereas normal subjects pursued equally well in both cases. Compensatory eye movements during active head rotation in darkness were always less in patients than in normal subjects. These data were used to examine current hypotheses that postulate central cancellation of the vestibulo-ocular reflex (VOR) during EHT. A model that proposes summation of an integral smooth pursuit command and VOR/compensatory eye movements is consistent with the findings. Observation of passive EHT (visual fixation of a head-fixed target during en bloc rotation) appears to indicate that in this mode parametric gain changes contribute to modulation of the VOR.

  9. Otolaryngology/Head and Neck Surgery

    PubMed Central

    Trachy, R. E.; Cummings, C. W.

    1984-01-01

    The Scientific Board of the California Medical Association presents the following inventory of items of progress in otolaryngology/head and neck surgery. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, research workers or scholars to stay abreast of these items of progress in otolaryngology/head and neck surgery that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another. The items of progress listed below were selected by the Advisory Panel to the Section on Otolaryngology/Head and Neck Surgery of the California Medical Association and the summaries were prepared under its direction. PMID:18749653

  10. [Medical honey in the treatment of wound-healing disorders in the head and neck area].

    PubMed

    Knipping, S; Grünewald, B; Hirt, R

    2012-09-01

    Already in ancient times honey was used as a drug and for the treatment of wounds. In recent years the different effects of honey on wound-healing processes have been reexamined. Based on this, the antibacterial and fungicidal qualities of honey could be confirmed. Between January 2009 and July 2011 medical honey was used on 36 patients suffering from different wound-healing disorders in the head and neck area after unsuccessful conventional treatment. The healing process was registered by microbiological investigations, measurements of the wound edges and adequate photo documentation. Medical honey can be used without problems or detectable side effects on problematic wounds of the head and neck area. Constant treatment leads to fast wound lavation, granulation, reduction of putrid smells and a decrease in inflammation. In the treatment of poorly healing and infected wounds within the head and neck area, medical honey can be used successfully without problems as an effective alternative to conventional treatment options.

  11. Non-Agricultural Databases and Thesauri: Retrieval of Subject Headings and Non-Controlled Terms in Relation to Agriculture

    ERIC Educational Resources Information Center

    Bartol, Tomaz

    2012-01-01

    Purpose: The paper aims to assess the utility of non-agriculture-specific information systems, databases, and respective controlled vocabularies (thesauri) in organising and retrieving agricultural information. The purpose is to identify thesaurus-linked tree structures, controlled subject headings/terms (heading words, descriptors), and principal…

  12. A comparative study of the origin, structure, and indexing language of the Persian and English keywords of articles indexed in the IranMedex database and their compliance with the Persian medical thesaurus and Medical Subject Headings.

    PubMed

    Parsaei-Mohammadi, Parastoo; Ghasemi, Ali Hossein; Hassanzadeh-Beheshtabad, Raziyeh

    2017-01-01

    In the present era, thesauri as tools in indexing play an effective role in integrating retrieval preventing fragmentation as well as a multiplicity of terminologies and also in providing information content of documents. This study aimed to investigate the keywords of articles indexed in IranMedex in terms of origin, structure and indexing situation and their Compliance with the Persian Medical Thesaurus and Medical Subject Headings (MeSH). This study is an applied research, and a survey has been conducted. Statistical population includes 32,850 Persian articles which are indexed in the IranMedex during the years 1385-1391. 379 cases were selected as sample of the study. Data collection was done using a checklist. In analyzing the findings, the SPSS Software were used. Although there was no significant difference in terms of indexing origin between the proportion of different types of the Persian and English keywords of articles indexed in the IranMedex, the compliance rates of the Persian and English keywords with the Persian medical thesaurus and MeSH were different in different years. In the meantime, the structure of keywords is leaning more towards phrase structure, and a single word structure and the majority of keywords are selected from the titles and abstracts. The authors' familiarity with the thesauri and controlled tools causes homogeneity in assigning keywords and also provides more precise, faster, and easier retrieval of the keywords. It's suggested that a mixture of natural and control languages to be used in this database in order to reach more comprehensive results.

  13. Characterizing head motion in three planes during combined visual and base of support disturbances in healthy and visually sensitive subjects.

    PubMed

    Keshner, E A; Dhaher, Y

    2008-07-01

    Multiplanar environmental motion could generate head instability, particularly if the visual surround moves in planes orthogonal to a physical disturbance. We combined sagittal plane surface translations with visual field disturbances in 12 healthy (29-31 years) and 3 visually sensitive (27-57 years) adults. Center of pressure (COP), peak head angles, and RMS values of head motion were calculated and a three-dimensional model of joint motion was developed to examine gross head motion in three planes. We found that subjects standing quietly in front of a visual scene translating in the sagittal plane produced significantly greater (p<0.003) head motion in yaw than when on a translating platform. However, when the platform was translated in the dark or with a visual scene rotating in roll, head motion orthogonal to the plane of platform motion significantly increased (p<0.02). Visually sensitive subjects having no history of vestibular disorder produced large, delayed compensatory head motion. Orthogonal head motions were significantly greater in visually sensitive than in healthy subjects in the dark (p<0.05) and with a stationary scene (p<0.01). We concluded that motion of the visual field could modify compensatory response kinematics of a freely moving head in planes orthogonal to the direction of a physical perturbation. These results suggest that the mechanisms controlling head orientation in space are distinct from those that control trunk orientation in space. These behaviors would have been missed if only COP data were considered. Data suggest that rehabilitation training can be enhanced by combining visual and mechanical perturbation paradigms.

  14. De novo head and neck cancer arising in solid organ transplantation recipients: The Asan Medical Center experience.

    PubMed

    Park, Marn Joon; Roh, Jong-Lyel; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon; Lee, Yoon Se

    2018-08-01

    De novo cancers of head and neck area in solid organ transplantation recipients show standardized incidence ratio (SIR) of 3.8. Immunosuppression following transplantation is suggested to play as a crucial factor in pathogenesis of secondary malignancy. Prognosis of head and neck cancer arising in solid organ transplantation recipients is proven to have poor prognosis. The incidence, risk, prognosis, and survival of de novo malignancy of head and neck area in solid organ transplantation recipients in single-tertiary medical center followed up for 20 years. A retrospective medical record review of the patients who received solid organ transplantation in Asan Medical Center from 1997 to 2016 was conducted. Patients confirmed as de novo malignancy in the head and neck area after organ transplantation were included, and presented as in the case-series format. Patients with previous history of head and neck malignancy, irradiation history of head and neck area, cutaneous malignant lesion, hematopoietic malignant lesion, malignancy of thyroid and parathyroid gland and metastatic lesions newly developed in head and neck area were excluded. The incidence of head and neck malignancy in South Korea were reviewed from the National Cancer Information Center of South Korea. For the statistical analysis, standardized incidence ratio (SIR) was obtained with 95% confidence interval. Solid organ transplantation recipients show 20 times higher incidence of de novo cancer of head and neck area compared to general population. Of 13 de novo head and neck malignancy arising after solid organ transplantation, 2 (15.4%) patients were unable to withstand definitive management due to poor general condition. 2 (15.4%) patients had loco-regional recurrence, 1 (7.7%) patient with distant metastasis, and 3 (23.1%) patients died of cancer progression. Immunosuppression following solid organ transplantation gives a twenty-fold increased risk for the development of de novo head and neck cancer. A

  15. Medical students as human subjects in educational research

    PubMed Central

    Sarpel, Umut; Hopkins, Mary Ann; More, Frederick; Yavner, Steven; Pusic, Martin; Nick, Michael W.; Song, Hyuksoon; Ellaway, Rachel; Kalet, Adina L.

    2013-01-01

    Introduction Special concerns often arise when medical students are themselves the subjects of education research. A recently completed large, multi-center randomized controlled trial of computer-assisted learning modules for surgical clerks provided the opportunity to explore the perceived level of risk of studies where medical students serve as human subjects by reporting on: 1) the response of Institutional Review Boards (IRBs) at seven institutions to the same study protocol; and 2) the thoughts and feelings of students across study sites about being research subjects. Methods From July 2009 to August 2010, all third-year medical students at seven collaborating institutions were eligible to participate. Patterns of IRB review of the same protocol were compared. Participation burden was calculated in terms of the time spent interacting with the modules. Focus groups were conducted with medical students at each site. Transcripts were coded by three independent reviewers and analyzed using Atlas.ti. Results The IRBs at the seven participating institutions granted full (n=1), expedited (n=4), or exempt (n=2) review of the WISE Trial protocol. 995 (73% of those eligible) consented to participate, and 207 (20%) of these students completed all outcome measures. The average time to complete the computer modules and associated measures was 175 min. Common themes in focus groups with participant students included the desire to contribute to medical education research, the absence of coercion to consent, and the low-risk nature of the research. Discussion Our findings demonstrate that risk assessment and the extent of review utilized for medical education research vary among IRBs. Despite variability in the perception of risk implied by differing IRB requirements, students themselves felt education research was low risk and did not consider themselves to be vulnerable. The vast majority of eligible medical students were willing to participate as research subjects

  16. Characterizing Head Motion in 3 Planes during Combined Visual and Base of Support Disturbances in Healthy and Visually Sensitive Subjects

    PubMed Central

    Keshner, E.A.; Dhaher, Y.

    2008-01-01

    Multiplanar environmental motion could generate head instability, particularly if the visual surround moves in planes orthogonal to a physical disturbance. We combined sagittal plane surface translations with visual field disturbances in 12 healthy (29–31 years) and 3 visually sensitive (27–57 years) adults. Center of pressure (COP), peak head angles, and RMS values of head motion were calculated and a 3-dimensional model of joint motion11 was developed to examine gross head motion in 3 planes. We found that subjects standing quietly in front of a visual scene translating in the sagittal plane produced significantly greater (p<0.003) head motion in yaw than when on a translating platform. However, when the platform was translated in the dark or with a visual scene rotating in roll, head motion orthogonal to the plane of platform motion significantly increased (p<0.02). Visually sensitive subjects having no history of vestibular disorder produced large, delayed compensatory head motion. Orthogonal head motions were significantly greater in visually sensitive than in healthy subjects in the dark (p<0.05) and with a stationary scene (p<0.01). We concluded that motion of the visual field can modify compensatory response kinematics of a freely moving head in planes orthogonal to the direction of a physical perturbation. These results suggest that the mechanisms controlling head orientation in space are distinct from those that control trunk orientation in space. These behaviors would have been missed if only COP data were considered. Data suggest that rehabilitation training can be enhanced by combining visual and mechanical perturbation paradigms. PMID:18162402

  17. The Video Head Impulse Test (vHIT) of Semicircular Canal Function - Age-Dependent Normative Values of VOR Gain in Healthy Subjects.

    PubMed

    McGarvie, Leigh A; MacDougall, Hamish G; Halmagyi, G Michael; Burgess, Ann M; Weber, Konrad P; Curthoys, Ian S

    2015-01-01

    The video Head Impulse Test (vHIT) is now widely used to test the function of each of the six semicircular canals individually by measuring the eye rotation response to an abrupt head rotation in the plane of the canal. The main measure of canal adequacy is the ratio of the eye movement response to the head movement stimulus, i.e., the gain of the vestibulo-ocular reflex (VOR). However, there is a need for normative data about how VOR gain is affected by age and also by head velocity, to allow the response of any particular patient to be compared to the responses of healthy subjects in their age range. In this study, we determined for all six semicircular canals, normative values of VOR gain, for each canal across a range of head velocities, for healthy subjects in each decade of life. The VOR gain was measured for all canals across a range of head velocities for at least 10 healthy subjects in decade age bands: 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89. The compensatory eye movement response to a small, unpredictable, abrupt head rotation (head impulse) was measured by the ICS impulse prototype system. The same operator delivered every impulse to every subject. Vestibulo-ocular reflex gain decreased at high head velocities, but was largely unaffected by age into the 80- to 89-year age group. There were some small but systematic differences between the two directions of head rotation, which appear to be largely due to the fact that in this study only the right eye was measured. The results are considered in relation to recent evidence about the effect of age on VOR performance. These normative values allow the results of any particular patient to be compared to the values of healthy people in their age range and so allow, for example, detection of whether a patient has a bilateral vestibular loss. VOR gain, as measured directly by the eye movement response to head rotation, seems largely unaffected by aging.

  18. Relative Effectiveness of Titles, Abstracts, and Subject Headings for Machine Retrieval from the COMPENDEX Services

    ERIC Educational Resources Information Center

    Byrne, Jerry R.

    1975-01-01

    Investigated the relative merits of searching on titles, subject headings, abstracts, free-language terms, and combinations of these elements. The combination of titles and abstracts came the closest to 100 percent retrieval. (Author/PF)

  19. A comparative study of the origin, structure, and indexing language of the Persian and English keywords of articles indexed in the IranMedex database and their compliance with the Persian medical thesaurus and Medical Subject Headings

    PubMed Central

    Parsaei-Mohammadi, Parastoo; Ghasemi, Ali Hossein; Hassanzadeh-Beheshtabad, Raziyeh

    2017-01-01

    Introduction: In the present era, thesauri as tools in indexing play an effective role in integrating retrieval preventing fragmentation as well as a multiplicity of terminologies and also in providing information content of documents. Goals: This study aimed to investigate the keywords of articles indexed in IranMedex in terms of origin, structure and indexing situation and their Compliance with the Persian Medical Thesaurus and Medical Subject Headings (MeSH). Materials and Methods: This study is an applied research, and a survey has been conducted. Statistical population includes 32,850 Persian articles which are indexed in the IranMedex during the years 1385–1391. 379 cases were selected as sample of the study. Data collection was done using a checklist. In analyzing the findings, the SPSS Software were used. Findings: Although there was no significant difference in terms of indexing origin between the proportion of different types of the Persian and English keywords of articles indexed in the IranMedex, the compliance rates of the Persian and English keywords with the Persian medical thesaurus and MeSH were different in different years. In the meantime, the structure of keywords is leaning more towards phrase structure, and a single word structure and the majority of keywords are selected from the titles and abstracts. Conclusion: The authors’ familiarity with the thesauri and controlled tools causes homogeneity in assigning keywords and also provides more precise, faster, and easier retrieval of the keywords. It's suggested that a mixture of natural and control languages to be used in this database in order to reach more comprehensive results. PMID:28546967

  20. Gastrointestinal Physiology During Head Down Tilt Bedrest in Human Subjects

    NASA Technical Reports Server (NTRS)

    Vaksman, Z.; Guthienz, J.; Putcha, L.

    2008-01-01

    Introduction: Gastrointestinal (GI) motility plays a key role in the physiology and function of the GI tract. It directly affects absorption of medications and nutrients taken by mouth, in addition to indirectly altering GI physiology by way of changes in the microfloral composition and biochemistry of the GI tract. Astronauts have reported nausea, loss of appetite and constipation during space flight all of which indicate a reduction in GI motility and function similar to the one seen in chronic bed rest patients. The purpose of this study is to determine GI motility and bacterial proliferation during -6 degree head down tilt bed rest (HTD). Methods: Healthy male and female subjects between the ages of 25-40 participated in a 60 day HTD study protocol. GI transit time (GITT) was determined using lactulose breath hydrogen test and bacterial overgrowth was measured using glucose breath hydrogen test. H. Pylori colonization was determined using C13-urea breath test (UBIT#). All three tests were conducted on 9 days before HDT, and repeated on HDT days 2, 28, 58, and again on day 7 after HDT. Results: GITT increased during HTD compared to the respective ambulatory control values; GITT was significantly lower on day 7 after HTD. A concomitant increase in bacterial colonization was also noticed during HDT starting after approximately 28 days of HDT. However, H. Pylori proliferation was not recorded during HDT as indicated by UBIT#. Conclusion: GITT significantly decreased during HDT with a concomitant increase in the proliferation of GI bacterial flora but not H. pylori.

  1. Extracting Characteristics of the Study Subjects from Full-Text Articles

    PubMed Central

    Demner-Fushman, Dina; Mork, James G

    2015-01-01

    Characteristics of the subjects of biomedical research are important in determining if a publication describing the research is relevant to a search. To facilitate finding relevant publications, MEDLINE citations provide Medical Subject Headings that describe the subjects’ characteristics, such as their species, gender, and age. We seek to improve the recommendation of these headings by the Medical Text Indexer (MTI) that supports manual indexing of MEDLINE. To that end, we explore the potential of the full text of the publications. Using simple recall-oriented rule-based methods we determined that adding sentences extracted from the methods sections and captions to the abstracts prior to MTI processing significantly improved recall and F1 score with only a slight drop in precision. Improvements were also achieved in directly assigning several headings extracted from the full text. These results indicate the need for further development of automated methods capable of leveraging the full text for indexing. PMID:26958181

  2. Analysing the Role of the Subject Head of Department in Secondary Schools in England and Wales: Towards a Theoretical Framework.

    ERIC Educational Resources Information Center

    Turner, Chris; Bolam, Ray

    1998-01-01

    Argues that contingency theory offers a useful basis for considering the work of subject heads of department in (British) secondary schools, particularly if heads are actively trying to influence the quality of teaching and learning in their curriculum areas. Develops a provisional model to shed light on how department heads actually work with…

  3. The FDA's role in medical device clinical studies of human subjects

    NASA Astrophysics Data System (ADS)

    Saviola, James

    2005-03-01

    This paper provides an overview of the United States Food and Drug Administration's (FDA) role as a regulatory agency in medical device clinical studies involving human subjects. The FDA's regulations and responsibilities are explained and the device application process discussed. The specific medical device regulatory authorities are described as they apply to the development and clinical study of retinal visual prosthetic devices. The FDA medical device regulations regarding clinical studies of human subjects are intended to safeguard the rights and safety of subjects. The data gathered in pre-approval clinical studies provide a basis of valid scientific evidence in order to demonstrate the safety and effectiveness of a medical device. The importance of a working understanding of applicable medical device regulations from the beginning of the device development project is emphasized particularly for novel, complex products such as implantable visual prosthetic devices.

  4. An evaluation of flight path formats head-up and head-down

    NASA Technical Reports Server (NTRS)

    Sexton, George A.; Moody, Laura E.; Evans, Joanne; Williams, Kenneth E.

    1988-01-01

    Flight path primary flight display formats were incorporated on head-up and head-down electronic displays and integrated into an Advanced Concepts Flight Simulator. Objective and subjective data were collected while ten airline pilots evaluated the formats by flying an approach and landing task under various ceiling, visibility and wind conditions. Deviations from referenced/commanded airspeed, horizontal track, vertical track and touchdown point were smaller using the head-up display (HUD) format than the head-down display (HDD) format, but not significantly smaller. Subjectively, the pilots overwhelmingly preferred (1) flight path formats over attitude formats used in current aircraft, and (2) the head-up presentation over the head-down, primarily because it eliminated the head-down to head-up transition during low visibility landing approaches. This report describes the simulator, the flight displays, the format evaluation, and the results of the objective and subjective data.

  5. Inadequate reporting of concomitant drug treatment in cardiovascular interventional head-to-head trials.

    PubMed

    Mahfoud, Felix; Böhm, Michael; Baumhäkel, Magnus

    2012-04-01

    Optimal revascularization strategy is still under debate in patients with coronary artery disease, particularly due to the results of the Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) trial. Although medical prevention has been clearly shown to be beneficial in coronary artery disease, it has been suggested that patients were significantly undertreated with evidence-based medications for cardiovascular protection. The purpose of the study was to evaluate concomitant medical treatment in cardiovascular interventional head-to-head trials comparing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). A systematic search of the literature regarding documentation and reports of medical treatment in cardiovascular interventional head-to-head trials with more than 500 patients comparing CABG and PCI was performed. Systematic research of the literature identified 2106 articles of potential interest. After review and selection, only 3 trials reported on medical treatment. Baseline medication was reported in the RITA (Randomized Intervention Treatment of Angina), CABRI (Coronary Angioplasty versus Bypass Revascularisation Investigation), and SYNTAX trials, and follow-up data were provided by the CABRI and SYNTAX 3-year trials only. Poor reporting of medical treatment at discharge might reflect an underestimation of secondary prevention in patients undergoing cardiac surgery or interventional procedures in head-to-head interventional trials. Thus, discussion of optimal revascularization procedure has to remain open, even in terms of concomitant medical treatment of patients. © 2012 Wiley Periodicals, Inc.

  6. CINAHL list of subject headings: a nursing thesaurus revised.

    PubMed

    Fishel, C C; Graham, K E; Greer, D M; Gupta, A D; Lockwood, D K; Prime, E E

    1985-04-01

    The rationale and methods for revising the thesaurus of one of the major health sciences indexing tools are discussed. Computer production of the Cumulative Index to Nursing & Allied Health Literature and the possibility of online access mandated a revision of the list of subject headings. CINAHL has maintained a policy of responding to user needs and to changes in the nursing and allied health literature, and user input was encouraged during revision of the thesaurus. The methods of structural revision are described, and major changes in the thesaurus are detailed. Modification of the thesaurus is expected to have a far-reaching impact on the retrieval of information in nursing and allied health. Nursing and Allied Health (CINAHL) is now available online through DIALOG (file 218) and BRS (access code NAHL).

  7. CINAHL list of subject headings: a nursing thesaurus revised.

    PubMed Central

    Fishel, C C; Graham, K E; Greer, D M; Gupta, A D; Lockwood, D K; Prime, E E

    1985-01-01

    The rationale and methods for revising the thesaurus of one of the major health sciences indexing tools are discussed. Computer production of the Cumulative Index to Nursing & Allied Health Literature and the possibility of online access mandated a revision of the list of subject headings. CINAHL has maintained a policy of responding to user needs and to changes in the nursing and allied health literature, and user input was encouraged during revision of the thesaurus. The methods of structural revision are described, and major changes in the thesaurus are detailed. Modification of the thesaurus is expected to have a far-reaching impact on the retrieval of information in nursing and allied health. Nursing and Allied Health (CINAHL) is now available online through DIALOG (file 218) and BRS (access code NAHL). PMID:3995203

  8. Medical and social problems among women headed families in Baghdad.

    PubMed

    Lafta, Riyadh K; Hayawi, Ali H; Khudhairi, Jamal M

    2012-01-01

    Women-headed families tend to be the most marginalized and poverty prone in any given community. One in 10 Iraqi households is headed by woman according to International Organization for Migration, though their assessments suggest that this ratio rises to 1 in 8 in displaced families. To draw attention to the exposure and vulnerability of women headed families to key medical and social problems. This cross - sectional study was conducted from March through February 2011. Eleven non-governmental organizations (NGOs) were chosen to be the pool of data collection, in addition to 50 primary, intermediate, and secondary schools for girls. The actual participants were 720 with a response rate of (97%). Women headed families participated in the study were distributed in different areas of Baghdad and the districts around. Hypertension is the leading disease (20%) followed by arthritis (9.6%), heart disease (7.6%), and diabetes mellitus (5.2%), the least was tuberculosis (0.1%). On the other hand, the number of sons and daughters with chronic disease was 159 (6.4%). Respiratory system disease is at the top of the list at a rate of (20.6 per 1000) while the gastrointestinal disease is at the bottom at a rate of (1.6 per 1000). 7.8% of the studied household-heading women were exposed to violence that was either verbal (75%) or physical (25%), the source was the woman's parents (42.9%), husband's family (34%), neighbors (8.9%), and others (14.3%). The percentage of problematic sons (17.9%) who show different types of behavior, (30.2%) of them not obeying their mothers, (21%) hit their brothers, (9.3%) insulting the mother, (2.3%) have problems with neighbors.

  9. Differences in managerial behaviour between head nurses and medical directors in intensive care units in Europe.

    PubMed

    Pepermans, R; Mentens, C; Goedee, M; Jegers, M; van Roy, K

    2001-01-01

    We attempt to determine whether differences appear between the managerial behaviour of European intensive care head nurses on the one side and medical directors on the other. In order to come up with a managerial job and competency analysis of ICU managers, observations and interviews were performed. Additionally, focus groups consisting of ICU experts were organized. The results are discussed according to managerial behaviour taxonomies and existing competency models. There seems to be some differentiation between the two managerial positions studied. Head nurses are more involved in planning/coordinating and motivating/reinforcing activities, whereas medical directors are more involved in socializing/politicking, decision making/problem solving, interaction with others and disciplining.

  10. Dermatography (Medical Tattooing) for Scars and Skin Grafts in Head and Neck Patients to Improve Appearance and Quality of Life.

    PubMed

    Drost, Brigitte H; van de Langenberg, Rick; Manusama, Olivia R; Janssens, A Soe; Sikorska, Karolina; Zuur, C Lot; Klop, Willem M C; Lohuis, Peter J F M

    2017-01-01

    Dermatography (medical tattooing) is often overlooked as an adjuvant procedure to improve color mismatch in the head and neck area, and its effect on patient satisfaction and quality of life has not been evaluated, to our knowledge. To analyze the effect of dermatography on the subjective perception of the appearance of scars and skin grafts and the quality of life in head and neck patients. Case series of patients undergoing dermatography at the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, between July 1, 2007, and April 1, 2015. Participants were invited to respond to 2 questionnaires measuring their scar or graft appearance and their quality of life before and after dermatography as an adjuvant treatment for benign or malignant head and neck tumors. Use of dermatography. Two questionnaires evaluating a visual analog scale score (range, 0-10) and multiple questions on a 5-point scale focusing on satisfaction with the appearance and the quality of life. Among 76 patients, 56 (74%) were included in the study. The mean (SD) age of the study cohort was 56.5 (16.0) years, and 42 (75%) were female. The mean improvement in scar or skin graft perception on the visual analog scale of the modified Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty before and after dermatography was 4 points. On the modified Patient Scar Assessment Questionnaire, uniform improvement of approximately 1 point across 9 questions was observed. The answers to all patient satisfaction and quality-of-life questions on both questionnaires improved significantly after dermatography. Dermatography is an effectual adjuvant procedure to improve the subjective perception of scar and skin graft appearance and the quality of life in head and neck patients. 4.

  11. [The treatment of chronic wounds in the head and neck area after radiotherapy with medical honey].

    PubMed

    Rothmeier, N; Abu-Jawad, J; Arnolds, J; Arweiler-Harbeck, D; Dominas, N; Stein, R; Zander, S; Lang, S; Mattheis, S

    2014-09-01

    Wound healing problems and chronic wounds can be a therapeutic challenge are a frequent problem after radiotherapy. They can appear spontaneously or after further surgery. The permanently altered tissue is associated with recurrent bacterial infections with weeping wounds, which cannot be treated sufficiently by conventional conservative wound care. The topical application of medical honey seems to have a positive effect in such cases. The aim of this prospectively study is to check this effectiveness in the treatment of wound healing problems and chronic wounds in the head and neck area of irradiated patients. In the period of July 2012 until August 2013 nine patients were treated with medical honey. All pa-tients had previously radiotherapy in the head and neck area. 5 patients had protracted wound healing problems after salvage surgery. The remaining 4 cases had spontaneously dehiscenced wounds at the beginning of the study. The wound healing was confirmed by measurement of the wound edges and depth and by adequate photo documentation. In all cases, the conventional wound care was unsuccessfully. In 8 of 9 cases, the wounds could be brought to cure by the application of medical honey over 3-8 weeks. Side effects or allergic reactions to the medical honey were not seen in any -cases. Based on our clinical experience we believe that the topical application of medical honey in non-healing or recurrent wounds in the head and neck area after radiotherapy is a reason-able and successful alternative therapy. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Writing otorhinolaryngology head & neck surgery operative reports.

    PubMed

    Laccourreye, O; Rubin, F; Villeneuve, A; Bonfils, P

    2017-09-01

    Only about ten articles devoted to operative reports have been published in the medical literature, but this document is essential, both medically and legally, to ensure optimal management of operated patients. In this technical note, based on published studies on this subject, the authors describe the key features of operating reports after otorhinolaryngology head & neck surgery and emphasize the need to write this document during the minutes after the end of the operation, the importance of standardization and its teaching role during surgical training. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. Correlation between Trunk Posture and Neck Reposition Sense among Subjects with Forward Head Neck Postures

    PubMed Central

    Lee, Han Suk; Chung, Hyung Kuk; Park, Sun Wook

    2015-01-01

    Objective. To assess the correlation of abnormal trunk postures and reposition sense of subjects with forward head neck posture (FHP). Methods. In all, postures of 41 subjects were evaluated and the FHP and trunk posture including shoulder, scapular level, pelvic side, and anterior tilting degrees were analyzed. We used the head repositioning accuracy (HRA) test to evaluate neck position senses of neck flexion, neck extension, neck right and left side flexion, and neck right and left rotation and calculated the root mean square error in trials for each subject. Spearman's rank correlation coefficients and regression analysis were used to assess the degree of correlation between the trunk posture and HRA value, and a significance level of α = 0.05 was considered. Results. There were significant correlations between the HRA value of right side neck flexion and pelvic side tilt angle (p < 0.05). If pelvic side tilting angle increases by 1 degree, right side neck flexion increased by 0.76 degrees (p = 0.026). However, there were no significant correlations between other neck motions and trunk postures. Conclusion. Verifying pelvic postures should be prioritized when movement is limited due to the vitiation of the proprioceptive sense of neck caused by FHP. PMID:26583125

  14. Medical devices of the head, neck, and spine.

    PubMed

    Hunter, Tim B; Yoshino, Mark T; Dzioba, Robert B; Light, Rick A; Berger, William G

    2004-01-01

    There are many medical devices used for head, neck, and spinal diseases and injuries, and new devices are constantly being introduced. Many of the newest devices are variations on a previous theme. Knowing the specific name of a device is not important. It is important to recognize the presence of a device and to have an understanding of its function as well as to be able to recognize the complications associated with its use. The article discusses the most common and important devices of the head, neck, and spine, including cerebrospinal fluid shunts and the Codman Hakim programmable valve; subdural drainage catheters, subdural electrodes, intracranial electrodes, deep brain stimulators, and cerebellar electrodes; coils, balloons, adhesives, particles, and aneurysm clips; radiation therapy catheters, intracranial balloons for drug installation, and carmustine wafers; hearing aids, cochlear implants, and ossicular reconstruction prostheses; orbital prostheses, intraocular silicone oil, and lacrimal duct stents; anterior and posterior cervical plates, posterior cervical spine wiring, odontoid fracture fixation devices, cervical collars and halo vests; thoracic and lumbar spine implants, anterior and posterior instrumentation for the thoracic and lumbar spine, vertebroplasty, and artificial disks; spinal column stimulators, bone stimulators, intrathecal drug delivery pumps, and sacral stimulators; dental and facial implant devices; gastric and tracheal tubes; vagus nerve stimulators; lumboperitoneal shunts; and temperature- and oxygen-sensing probes. Copyright RSNA, 2004

  15. Rapid neck muscle adaptation alters the head kinematics of aware and unaware subjects undergoing multiple whiplash-like perturbations.

    PubMed

    Siegmund, Gunter P; Sanderson, David J; Myers, Barry S; Inglis, J Timothy

    2003-04-01

    To examine whether habituation confounds the study of whiplash injury using human subjects, we quantified changes in the magnitude and temporal development of the neck muscle electromyogram and peak linear and angular head/torso kinematics of subjects exposed to sequential whiplash-like perturbations. Forty-four seated subjects (23F, 21M) underwent 11 consecutive forward horizontal perturbations (peak sled acceleration=1.5 g). Electromyographic (EMG) activity was recorded over the sternocleidomastoid (SCM) and cervical paraspinal (PARA) muscles with surface electrodes, and head and torso kinematics were measured using linear and angular accelerometers and a 3D motion analysis system. EMG onset occurred at reflex latencies (67-75 ms in SCM) and did not vary with repeated perturbations. EMG amplitude was significantly attenuated by the second perturbation in PARA muscles and by the third perturbation in SCM muscles. The mean decrement in EMG amplitude between the first trial and the mean of the last five trials was between 41% and 64%. Related kinematic changes ranged from a 21% increase in head extension angle to a 29% decrease in forward acceleration at the forehead, and were also significantly different by the second exposure in some variables. Although a wider range of perturbation intensities and inter-perturbation intervals need to be studied, the significant changes observed in both muscle and kinematic variables by the second perturbation indicated that habituation was a potential confounder of whiplash injury studies using repeated perturbations of human subjects.

  16. Risk factors for COPD exacerbations in inhaled medication users: the COPDGene study biannual longitudinal follow-up prospective cohort.

    PubMed

    Busch, Robert; Han, MeiLan K; Bowler, Russell P; Dransfield, Mark T; Wells, J Michael; Regan, Elizabeth A; Hersh, Craig P

    2016-02-10

    Despite inhaled medications that decrease exacerbation risk, some COPD patients experience frequent exacerbations. We determined prospective risk factors for exacerbations among subjects in the COPDGene Study taking inhaled medications. 2113 COPD subjects were categorized into four medication use patterns: triple therapy with tiotropium (TIO) plus long-acting beta-agonist/inhaled-corticosteroid (ICS ± LABA), tiotropium alone, ICS ± LABA, and short-acting bronchodilators. Self-reported exacerbations were recorded in telephone and web-based longitudinal follow-up surveys. Associations with exacerbations were determined within each medication group using four separate logistic regression models. A head-to-head analysis compared exacerbation risk among subjects using tiotropium vs. ICS ± LABA. In separate logistic regression models, the presence of gastroesophageal reflux, female gender, and higher scores on the St. George's Respiratory Questionnaire were significant predictors of exacerbator status within multiple medication groups (reflux: OR 1.62-2.75; female gender: OR 1.53 - OR 1.90; SGRQ: OR 1.02-1.03). Subjects taking either ICS ± LABA or tiotropium had similar baseline characteristics, allowing comparison between these two groups. In the head-to-head comparison, tiotropium users showed a trend towards lower rates of exacerbations (OR = 0.69 [95 % CI 0.45, 1.06], p = 0.09) compared with ICS ± LABA users, especially in subjects without comorbid asthma (OR = 0.56 [95% CI 0.31, 1.00], p = 0.05). Each common COPD medication usage group showed unique risk factor patterns associated with increased risk of exacerbations, which may help clinicians identify subjects at risk. Compared to similar subjects using ICS ± LABA, those taking tiotropium showed a trend towards reduced exacerbation risk, especially in subjects without asthma. ClinicalTrials.gov NCT00608764, first received 1/28/2008.

  17. Subject Classification.

    ERIC Educational Resources Information Center

    Thompson, Gayle; And Others

    Three newspaper librarians described how they manage the files of newspaper clippings which are a necessary part of their collections. The development of a new subject classification system for the clippings files was outlined. The new subject headings were based on standard subject heading lists and on local need. It was decided to use a computer…

  18. Trismus following different treatment modalities for head and neck cancer: a systematic review of subjective measures.

    PubMed

    Loh, Sook Y; Mcleod, Robert W J; Elhassan, Hassan A

    2017-07-01

    The aim of this review was to compare systematically the subjective measure of trismus between different interventions to treat head and neck cancer, particularly those of the oropharynx. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Guidelines, Six databases were searched for the text using various terms which include "oropharyngeal/head and neck cancer", "trismus/mouth opening" and the various treatment modalities. Included in the review were clinical studies (> or =10 patients). Three observers independently assessed the papers identified. Among the six studies reviewed, five showed a significantly worst outcome with regard to the quality-of-life questionnaire scores for a radiotherapy or surgery and radiotherapy (RT) ± chemotherapy or chemoradiotherapy when compared to surgery alone. Only one study showed no significant difference between surgery alone and other treatment modalities. Subjective quality-of-life measures are a concurrent part of modern surgical practice. Although subjective measures were utilised to measure post operative trismus successfully, there was no consensus as to which treatment modality had overall better outcomes, with conflicting studies in keeping with the current debate in this field. Larger and higher quality studies are needed to compare all three treatment modalities.

  19. Effects of head and neck inclination on bilateral sternocleidomastoid EMG activity in healthy subjects and in patients with myogenic cranio-cervical-mandibular dysfunction.

    PubMed

    Santander, H; Miralles, R; Pérez, J; Valenzuela, S; Ravera, M J; Ormeño, G; Villegas, R

    2000-07-01

    This study was conducted in order to determine the effect of head and neck position on bilateral electromyographic (EMG) activity of the sternocleidomastoid muscles. The study was performed on 16 patients with myogenic cranio-cervical-mandibular dysfunction (CMD) and 16 healthy subjects. EMG recordings at rest and during swallowing of saliva and maximal voluntary clenching were performed by placing surface electrodes on the right and left sternocleidomastoid muscles. EMG activity was recorded in the left lateral decubitus position, in a darkened room and with the individual's eyes closed, under the following experimental conditions: 1. Head, neck, and body horizontally aligned; 2. Head and neck upwardly inclined with respect to the body, simulating the effect of a thick pillow, 3. Head and neck downwardly inclined with respect to the body, simulating the effect of a thin pillow. Variation of head and neck positions was determined by measuring the distance from the angle of neck and shoulder and the apex of the shoulder (SND = shoulder-neck distance) of each individual. Then, head and neck were forward or downwardly inclined with respect to the body at one-third of SND. A significantly higher contralateral EMG activity and a more asymmetric EMG activity were observed in the CMD group than in the healthy subjects (Kruskal-Wallis Test). These results suggest a different behavior of bilateral sternocleidomastoid EMG activity in CMD patients than in healthy subjects depending on the positioning of the head and neck.

  20. Effects of suboccipital release with craniocervical flexion exercise on craniocervical alignment and extrinsic cervical muscle activity in subjects with forward head posture.

    PubMed

    Kim, Bo-Been; Lee, Ji-Hyun; Jeong, Hyo-Jung; Cynn, Heon-Seock

    2016-10-01

    Forward head posture is a head-on-trunk malalignment, which results in musculoskeletal dysfunction and neck pain. To improve forward head posture, both the craniocervical flexion exercise and the suboccipital release technique have been used. The purpose of this study was to compare the immediate effects of craniocervical flexion exercise and suboccipital release combined with craniocervical flexion exercise on craniovertebral angle, cervical flexion and extension range of motion, and the muscle activities of the sternocleidomastoid, anterior scalene, and splenius capitis during craniocervical flexion exercise in subjects with forward head posture. In total, 19 subjects (7 males, 12 females) with forward head posture were recruited using G-power software. Each subject performed craniocervical flexion exercise and suboccipital release combined with craniocervical flexion exercise in random order. After one intervention was performed, the subject took a 20min wash out period to minimize any carry-over effect between interventions. Craniovertebral angle, cervical flexion and extension range of motion, and the muscle activities of the sternocleidomastoid, anterior scalene, and splenius capitis were measured. A one-way, repeated-measures ANOVA was used to assess differences between the effects of the craniocervical flexion exercise and suboccipital release combined with craniocervical flexion exercise interventions in the same group. Craniovertebral angle (p<0.05), cervical flexion range of motion (p<0.05), and cervical extension range of motion (p<0.001) were significantly greater after suboccipital release combined with craniocervical flexion exercise compared to craniocervical flexion exercise alone. The muscle activities of the sternocleidomastoid, anterior scalene, and splenius capitis were significantly lower during suboccipital release combined with craniocervical flexion exercise than during craniocervical flexion exercise alone across all craniocervical flexion

  1. Head repositioning accuracy in patients with neck pain and asymptomatic subjects: concurrent validity, influence of motion speed, motion direction and target distance.

    PubMed

    Dugailly, Pierre-Michel; De Santis, Roberta; Tits, Mathieu; Sobczak, Stéphane; Vigne, Anna; Feipel, Véronique

    2015-12-01

    Cervicocephalic kinesthetic deficiencies have been demonstrated in patients with chronic neck pain (NP). On the other hand, authors emphasized the use of different motion speeds for assessing functional impairment of the cervical spine. The objectives of this study were (1) to investigate the head repositioning accuracy in NP patients and control subjects and (2) to assess the influence of target distance, motion speed, motion direction and pain. Seventy-one subjects (36 healthy subjects and 35 NP patients; age 30-55 years) performed the head repositioning test (HRT) at two different speeds for horizontal and vertical movements and at two different distances. For each condition, six consecutive trials were sampled. The study showed the validity and reproducibility of the HRT, confirming a dysfunctional threshold of 4.5°. Normative values of head repositioning error up to 3.6° and 7.1° were identified for healthy and NP subjects, respectively. A distance of 180 cm from the target and a natural motion speed increased HRT accuracy. Repositioning after extension movement showed a significantly larger error in both groups. Intensity, duration of pain as well as pain level did not significantly alter head repositioning error. The assessment of proprioceptive performance in healthy and NP subjects allowed the validation of the HRT. The HRT is a simple, not expensive and fast test, easily implementable in daily practice to assess and monitor treatment and evolution of proprioceptive cervical deficits.

  2. Head lice.

    PubMed

    Devore, Cynthia D; Schutze, Gordon E

    2015-05-01

    Head lice infestation is associated with limited morbidity but causes a high level of anxiety among parents of school-aged children. Since the 2010 clinical report on head lice was published by the American Academy of Pediatrics, newer medications have been approved for the treatment of head lice. This revised clinical report clarifies current diagnosis and treatment protocols and provides guidance for the management of children with head lice in the school setting. Copyright © 2015 by the American Academy of Pediatrics.

  3. Effects of repeated snowboard exercise in virtual reality with time lags of visual scene behind body rotation on head stability and subjective slalom run performance in healthy young subjects.

    PubMed

    Wada, Yoshiro; Nishiike, Suetaka; Kitahara, Tadashi; Yamanaka, Toshiaki; Imai, Takao; Ito, Taeko; Sato, Go; Matsuda, Kazunori; Kitamura, Yoshiaki; Takeda, Noriaki

    2016-11-01

    After repeated snowboard exercises in the virtual reality (VR) world with increasing time lags in trials 3-8, it is suggested that the adaptation to repeated visual-vestibulosomatosensory conflict in the VR world improved dynamic posture control and motor performance in the real world without the development of motion sickness. The VR technology was used and the effects of repeated snowboard exercise examined in the VR world with time lags between visual scene and body rotation on the head stability and slalom run performance during exercise in healthy subjects. Forty-two healthy young subjects participated in the study. After trials 1 and 2 of snowboard exercise in the VR world without time lag, trials 3-8 were conducted with 0.1, 0.2, 0.3, 0.4, 0.5, and 0.6 s time lags of the visual scene that the computer creates behind board rotation, respectively. Finally, trial 9 was conducted without time lag. Head linear accelerations and subjective slalom run performance were evaluated. The standard deviations of head linear accelerations in inter-aural direction were significantly increased in trial 8, with a time lag of 0.6 s, but significantly decreased in trial 9 without a time lag, compared with those in trial 2 without a time lag. The subjective scores of slalom run performance were significantly decreased in trial 8, with a time lag of 0.6 s, but significantly increased in trial 9 without a time lag, compared with those in trial 2 without a time lag. Motion sickness was not induced in any subjects.

  4. Vestibulo-ocular reflex gain values in the suppression head impulse test of healthy subjects.

    PubMed

    Rey-Martinez, Jorge; Thomas-Arrizabalaga, Izaskun; Espinosa-Sanchez, Juan Manuel; Batuecas-Caletrio, Angel; Trinidad-Ruiz, Gabriel; Matiño-Soler, Eusebi; Perez-Fernandez, Nicolas

    2018-02-15

    To assess whether there are differences in vestibulo-ocular reflex (VOR) gain for suppression head impulse (SHIMP) and head impulse (HIMP) video head impulse test paradigms, and if so, what are their causes. Prospective multicenter observational double-blind nonrandomized clinical study was performed by collecting 80 healthy subjects from four reference hospitals. SHIMP data was postprocessed to eliminate impulses in which early SHIMP saccades were detected. Differences between HIMP and SHIMP VOR gain values were statistically evaluated. Head impulse maximum velocity, gender, age, direction of impulse, and hospital center were considered as possible influential factors. A small significant statistical difference between HIMP and SHIMP VOR gain values was found on repeated measures analysis of variance (-0.05 ± 0.006, P < 0.001). Optimized linear model showed a significant influence of age variable on the observed differences for HIMP and SHIMP gain values and did not find influence between gain values differences and maximum head impulse velocity. Both HIMP and SHIMP VOR gain values were significant lower (-0.09, P < 0.001) when the impulses were performed to the left side. We had observed a difference in SHIMP and HIMP gain values not adequately explained by known gain modification factors. The persistence of this slight but significant difference indicates that there are more factors causing lower SHIMP VOR gain values. This difference must to be considered in further studies as well as in the clinical SHIMP testing protocols. We hypothesized that VOR phasic response inhibition could be the underlying cause of this difference. IIb. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

  5. Head and Neck Anatomy: Effect of Focussed Near-Peer Teaching on Anatomical Confidence in Undergraduate Medical Students.

    PubMed

    Morris, Simon; Osborne, Max Sallis; Bowyer, Duncan

    2018-05-11

    To assess the effect of near-peer head and neck anatomy teaching on undergraduates and to quantify the benefit from a focussed teaching course. Near-peer teaching involves colleagues within close seniority and age proximity teaching one another on a specified topic. Small group teaching sessions were delivered to medical students on 3 key areas of ENT anatomy. Participants were given a precourse and postcourse questionnaire to determine the benefit attained from the course. An undergraduate anatomy course taking place at the University of Birmingham Medical School. A total of 30 medical students: 15 preclinical (years 1-2) and 15 clinical (years 3-5) medical students participated from a single institution. A total of 71% of students expressed inadequate teaching of head and neck anatomy in undergraduate curriculum. All students (n = 30) expressed benefit from the course, however the patterns of learning differed: preclinical students showed a significant improvement in both their ability to name anatomical structures and their application (p < 0.05). Near-peer learning provides benefit to all medical undergraduates in the context of teaching anatomy which may make it a valuable teaching tool for the future of medical education. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  6. Out of the classroom and into the community: medical students consolidate learning about health literacy through collaboration with Head Start.

    PubMed

    Milford, Emily; Morrison, Kristin; Teutsch, Carol; Nelson, Bergen B; Herman, Ariella; King, Mernell; Beucke, Nathan

    2016-04-23

    Medical schools need to teach future physicians about health literacy and patient-doctor communication, especially when working with vulnerable communities, but many fall short. In this article, we present a community-based, service learning experience over one academic year during the pre-clerkship portion of medical school as an innovative and successful model for medical students to learn about health literacy and practice effective communication strategies. "Eat Healthy, Stay Active!" (EHSA) is a 5-month pediatric obesity intervention designed for Head Start children, their parent (s), and staff. We hypothesized students' attitudes, knowledge, and skills confidence regarding healthy literacy and patient communication would improve from baseline after receiving training and serving as family mentors in the EHSA intervention. First- and second-year medical students were trained through a series of didactics and then partnered with Head Start children, parents, and staff to help educate and set goals with families during the EHSA intervention. Medical students were given a pre- and post-intervention survey designed to measure their attitudes, knowledge, and skills confidence regarding health literacy. The pre-survey was administered before the first didactic session and the post-survey was administered after the conclusion of the EHSA intervention. We compared students' pre- and post-intervention responses using paired t-tests. Throughout the project, the medical students were asked to complete a set of open-ended journal questions about their experiences. These responses were examined using qualitative, thematic analyses. Additionally, the Head Start parents and staff were asked to complete a survey about their experience working with the medical students. Participant (n=12) pre- and post-surveys revealed that medical students' attitudes about the importance of health literacy were ranked highly both pre- and post- intervention. However, knowledge and skills

  7. Mechanization of Library Procedures in the Medium-Sized Medical Library: XIV. Correlations between National Library of Medicine Classification Numbers and MeSH Headings *

    PubMed Central

    Fenske, Ruth E.

    1972-01-01

    The purpose of this study was to determine the amount of correlation between National Library of Medicine classification numbers and MeSH headings in a body of cataloging which had already been done and then to find out which of two alternative methods of utilizing the correlation would be best. There was a correlation of 44.5% between classification numbers and subject headings in the data base studied, cataloging data covering 8,137 books. The results indicate that a subject heading index showing classification numbers would be the preferred method of utilization, because it would be more accurate than the alternative considered, an arrangement by classification numbers which would be consulted to obtain subject headings. PMID:16017607

  8. Malignant fibrous histiocytoma of the head and neck: a case series.

    PubMed

    Hardison, Scott Allen; Davis, Paul Lawson; Browne, J Dale

    2013-01-01

    The study objective is to evaluate the clinical features and outcomes of patients treated for head and neck malignant fibrous histiocytoma at a tertiary care medical facility. This is a retrospective case series of 17 adult subjects with malignant fibrous histiocytoma of the head and neck who were treated between January 1, 1965, and December 31, 2010. This study was conducted using patient charts at a tertiary medical center. Subject selection was conducted using Current Procedural Terminology numbers; International Classification of Diseases, Ninth Revision, codes; and a search of the tumor registry. Chart review of the 17 identified subjects revealed an overwhelming male predominance (88%) with an overall mean age of 69 years(52-87 years). Thirteen patients (78%) underwent some form of surgical resection, 6 patients (35%) received radiation therapy, and 6 (35%) were given chemotherapy over the course of treatment. Nine tumors (53%) had a cutaneous origin, whereas 8 lesions (47.1%) were found in the soft tissue of the head and neck region. The local recurrence rate following a single resection was 46%. Overall median survival following diagnosis was found to be 65 months, with a 5-year survival rate of 52%. Median disease-free survival was 20 months, with a 5-year disease-free survival rate of 37%. Overall median and 5-year survival rates were found to increase with clear surgical margins, as was 5-year survival. Aggressive surgical management to achieve clear margins is central to the effective treatment of malignant fibrous histiocytoma of the head and neck. Metastatic disease portends a dismal prognosis. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Subject searching of monographs online in the medical literature.

    PubMed

    Brahmi, F A

    1988-01-01

    Searching by subject for monographic information online in the medical literature is a challenging task. The NLM database of choice is CATLINE. Other NLM databases of interest are BIOTHICSLINE, CANCERLIT, HEALTH, POPLINE, and TOXLINE. Ten BRS databases are also discussed. Of these, Books in Print, Bookinfo, and OCLC are explored further. The databases are compared as to number of total records and number and percentage of monographs. Three topics were searched on CROSS to compare hits on BBIP, BOOK, and OCLC. The same searches were run on CATLINE. The parameters of time coverage and language were equalized and the resulting citations were compared and analyzed for duplication and uniqueness. With the input of CATLINE tapes into OCLC, OCLC has become the database of choice for searching by subject for medical monographs.

  10. Linking the Heart and the Head: Humanism and Professionalism in Medical Education and Practice.

    PubMed

    Montgomery, Lynda; Loue, Sana; Stange, Kurt C

    2017-05-01

    This paper articulates a practical interpretive framework for understanding humanism in medicine through the lens of how it is taught and learned. Beginning with a search for key tensions and relevant insights in the literature on humanism in health professions education, we synthesized a conceptual model designed to foster reflection and action to realize humanistic principles in medical education and practice. The resulting model centers on the interaction between the heart and the head. The heart represents the emotive domains of empathy, compassion, and connectedness. The head represents the cognitive domains of knowledge, attitudes, and beliefs. The cognitive domains often are associated with professionalism, and the emotive domains with humanism, but it is the connection between the two that is vital to humanistic education and practice. The connection between the heart and the head is nurtured by critical reflection and conscious awareness. Four provinces of experience nurture humanism: (1) personal reflection, (2) action, (3) system support, and (4) collective reflection. These domains represent potential levers for developing humanism. Critical reflection and conscious awareness between the heart and head through personal reflection, individual and collective behavior, and supportive systems has potential to foster humanistic development toward healing and health.

  11. First year medical students' learning style preferences and their correlation with performance in different subjects within the medical course.

    PubMed

    Hernández-Torrano, Daniel; Ali, Syed; Chan, Chee-Kai

    2017-08-08

    Students commencing their medical training arrive with different educational backgrounds and a diverse range of learning experiences. Consequently, students would have developed preferred approaches to acquiring and processing information or learning style preferences. Understanding first-year students' learning style preferences is important to success in learning. However, little is understood about how learning styles impact learning and performance across different subjects within the medical curriculum. Greater understanding of the relationship between students' learning style preferences and academic performance in specific medical subjects would be valuable. This cross-sectional study examined the learning style preferences of first-year medical students and how they differ across gender. This research also analyzed the effect of learning styles on academic performance across different subjects within a medical education program in a Central Asian university. A total of 52 students (57.7% females) from two batches of first-year medical school completed the Index of Learning Styles Questionnaire, which measures four dimensions of learning styles: sensing-intuitive; visual-verbal; active-reflective; sequential-global. First-year medical students reported preferences for visual (80.8%) and sequential (60.5%) learning styles, suggesting that these students preferred to learn through demonstrations and diagrams and in a linear and sequential way. Our results indicate that male medical students have higher preference for visual learning style over verbal, while females seemed to have a higher preference for sequential learning style over global. Significant associations were found between sensing-intuitive learning styles and performance in Genetics [β = -0.46, B = -0.44, p < 0.01] and Anatomy [β = -0.41, B = -0.61, p < 0.05] and between sequential-global styles and performance in Genetics [β = 0.36, B = 0.43, p < 0.05]. More specifically

  12. Resources for Educators of Adults. Annotated Bibliography for the Education of Public Offenders: by Descriptive Subject Headings.

    ERIC Educational Resources Information Center

    Willis, Michael J.; And Others

    This bibliography is presented to assist educators who are engaged in research activities with inmate or ex-inmate populations. The first part contains entries under descriptive subject headings (alphabetically by author); the second part contains abstracts of the material listed in part 1 (alphabetically by title). The descriptive headings…

  13. Heading in football. Part 3: Effect of ball properties on head response

    PubMed Central

    Shewchenko, N; Withnall, C; Keown, M; Gittens, R; Dvorak, J

    2005-01-01

    Objectives: Head impacts from footballs are an essential part of the game but have been implicated in mild and acute neuropsychological impairment. Ball characteristics have been noted in literature to affect the impact response of the head; however, the biomechanics are not well understood. The present study determined whether ball mass, pressure, and construction characteristics help reduce head and neck can impact response. Methods: Head responses under ball impact (6–7 m/s) were measured with a biofidelic numerical human model and controlled human subject trials (n = 3). Three ball masses and four ball pressures were investigated for frontal heading. Further, the effect of ball construction in wet/dry conditions was studied with the numerical model. The dynamic ball characteristics were determined experimentally. Head linear and angular accelerations were measured and compared with injury assessment functions comprising peak values and head impact power. Neck responses were assessed with the numerical model. Results: Ball mass reductions up to 35% resulted in decreased head responses up to 23–35% for the numerical and subject trials. Similar decreases in neck axial and shear responses were observed. Ball pressure reductions of 50% resulted in head and neck response reductions up to 10–31% for the subject trials and numerical model. Head response reductions up to 15% were observed between different ball constructions. The wet condition generally resulted in greater head and neck responses of up to 20%. Conclusion: Ball mass, pressure, and construction can reduce the impact severity to the head and neck. It is foreseeable that the benefits can be extended to players of all ages and skill levels. PMID:16046354

  14. Abusive head trauma in Maine infants: medical, child protective, and law enforcement analysis.

    PubMed

    Ricci, Lawrence; Giantris, Amy; Merriam, Phyllis; Hodge, Sandra; Doyle, Tim

    2003-03-01

    To collect and compare the results of medical, child protective, and law enforcement evaluation of a sample of Maine children who were victims of abusive head trauma (AHT) in order to describe the clinical and evaluative characteristics as they relate to victims, families and perpetrators of such trauma and to improve the professional response to AHT in Maine. Retrospective chart review of medical, child protective, and law enforcement records of all AHT victims admitted to two tertiary care hospitals in Maine or seen by the state medical examiner from 1991 to 1994. Nineteen children (age range 2 weeks to 17 months) were identified as victims of AHT (out of a total of 94 head trauma admissions) accounting for 20 hospitalizations during the study period. There was a history of prior injury in 30%, history of prior medical evaluations for possibly abuse related problems in 65%, while, on presentation, 75% had evidence or history of prior injury. The hospitals notified child protective services (CPS) in all 20 cases and correctly identified abuse in 18 (90%). Parental risk factors for abuse identified in CPS records included substance abuse (53%), domestic violence (42%), criminal history (32%), unrealistic expectations (42%), and attachment problems (32%). However, risk factors were inadequately assessed in 53% of homes. Law enforcement identified a likely perpetrator in 79% of cases and in the majority the identified suspect was the father. In the 15 cases where a perpetrator was identified by law enforcement, that person was alone with the child at symptom onset in 14 (93%). The medical response, at least at the inpatient level, was generally well done with regard to suspicion and reporting. Cases are possibly being missed at the outpatient level. Child protective risk assessment was limited overall yet in a third of the homes where AHT occurred, few if any risk factors were present to aid in identification and prevention. Law enforcement results suggest that a

  15. Diagnostic imaging rates for head injury in the ED and states' medical malpractice tort reforms.

    PubMed

    Smith-Bindman, Rebecca; McCulloch, Charles E; Ding, Alexander; Ding, Alex; Quale, Christopher; Chu, Philip W

    2011-07-01

    Physicians' fears of being sued may lead to defensive medical practices, such as ordering nonindicated medical imaging. We investigated the association between states' medical malpractice tort reforms and neurologic imaging rates for patients seen in the emergency department with mild head trauma. We assessed neurologic imaging among a national sample of 8588 women residing in 10 US states evaluated in an emergency setting for head injury between January 1, 1992, and December 31, 2001. We assessed the odds of imaging as it varied by the enactment of medical liability reform laws. The medical liability reform laws were significantly associated with the likelihood of imaging. States with laws that limited monetary damages (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.40-0.99), mandated periodic award payments (OR, 0.64; 95% CI, 0.43-0.97), or specified collateral source offset rules (OR, 0.62; 95% CI, 0.40-0.96) had an approximately 40% lower odds of imaging, whereas states that had laws that limited attorney's contingency fees had significantly higher odds of imaging (OR, 1.5; 95% CI, 0.99-2.4), compared to states without these laws. When we used a summation of the number of laws in place, the greater the number of laws, the lower the odds of imaging. In the multivariate analysis, after adjusting for individual and community factors, the total number of laws remained significantly associated with the odds of imaging, and the effect of the individual laws was attenuated, but not eliminated. The tort reforms we examined were associated with the propensity to obtain neurologic imaging. If these results are confirmed in larger studies, tort reform might mitigate defensive medical practices. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Visualizing the Structure of Medical Informatics Using Term Co-Occurrence Analysis.

    ERIC Educational Resources Information Center

    Morris, Theodore Allan

    2000-01-01

    Examines the structure of medical informatics and the relationship between biomedicine and information science and information technology. Uses co-occurrence analysis of subject headings assigned to items indexed for MEDLINE as well as multidimensional scaling to show seven to eight broad multidisciplinary subject clusters. (Contains 28…

  17. Head-to-head randomized trials are mostly industry sponsored and almost always favor the industry sponsor.

    PubMed

    Flacco, Maria Elena; Manzoli, Lamberto; Boccia, Stefania; Capasso, Lorenzo; Aleksovska, Katina; Rosso, Annalisa; Scaioli, Giacomo; De Vito, Corrado; Siliquini, Roberta; Villari, Paolo; Ioannidis, John P A

    2015-07-01

    To map the current status of head-to-head comparative randomized evidence and to assess whether funding may impact on trial design and results. From a 50% random sample of the randomized controlled trials (RCTs) published in journals indexed in PubMed during 2011, we selected the trials with ≥ 100 participants, evaluating the efficacy and safety of drugs, biologics, and medical devices through a head-to-head comparison. We analyzed 319 trials. Overall, 238,386 of the 289,718 randomized subjects (82.3%) were included in the 182 trials funded by companies. Of the 182 industry-sponsored trials, only 23 had two industry sponsors and only three involved truly antagonistic comparisons. Industry-sponsored trials were larger, more commonly registered, used more frequently noninferiority/equivalence designs, had higher citation impact, and were more likely to have "favorable" results (superiority or noninferiority/equivalence for the experimental treatment) than nonindustry-sponsored trials. Industry funding [odds ratio (OR) 2.8; 95% confidence interval (CI): 1.6, 4.7] and noninferiority/equivalence designs (OR 3.2; 95% CI: 1.5, 6.6), but not sample size, were strongly associated with "favorable" findings. Fifty-five of the 57 (96.5%) industry-funded noninferiority/equivalence trials got desirable "favorable" results. The literature of head-to-head RCTs is dominated by the industry. Industry-sponsored comparative assessments systematically yield favorable results for the sponsors, even more so when noninferiority designs are involved. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  18. [The institutionalization of epidemiology as a subject at Rio de Janeiro Federal University Medical School].

    PubMed

    Torres, Carlos Henrique; Czeresnia, Dina

    2003-01-01

    This article aimed at studying the teaching of epidemiology in medical school undergraduate courses. Medical books have been analyzed in order to understand the constitution of epidemiology as a scientific subject, as well as its relations with medical science and secondary school teaching. The introduction and development of the subject in UFRJ Medical School were studied through the analysis of internal regulations, courses brochures and programs. Professors were interviewed. The analysis revealed that epidemiology concepts spread to health services and practice, as well as to medical research. At UFRJ Medical School, starting at the end of the 1980's, epidemiology teaching began to be emphasized and valued. That was the time when collective health began to develop. Among collective health subjects, both epidemiology and statistics developed the most.

  19. Can imaginary head tilt shorten postrotatory nystagmus?

    PubMed

    Gianna-Poulin, C C; Voelker, C C; Erickson, B; Black, F O

    2001-08-01

    In healthy subjects, head tilt upon cessation of a constant-velocity yaw head rotation shortens the duration of postrotatory nystagmus. The presumed mechanism for this effect is that the velocity storage of horizontal semicircular canal inputs is being discharged by otolith organ inputs which signal a constant yaw head position when the head longitudinal axis is no longer earth-vertical. In the present study, normal subjects were rotated head upright in the dark on a vertical-axis rotational chair at 60 degrees/s for 75 s and were required to perform a specific task as soon as the chair stopped. Horizontal position of the right eye was recorded with an infra-red video camera. The average eye velocity (AEV) was measured over a 30-s interval following chair acceleration/deceleration. The ratios (postrotatory AEV/perrotatory AEV) were 1.1 (SD 0.112) when subjects (N=10) kept their head erect, 0.414 (SD 0.083) when subjects tilted their head forward, 1.003 (SD 0.108) when subjects imagined watching a TV show, 1.012 (SD 0.074) when subjects imagined looking at a painting on a wall, and 0.995 (SD 0.074) when subjects imagined floating in a prone position on a lake. Thus, while actual head tilt reduced postrotatory nystagmus, the imagination tasks did not have a statistically significant effect on postrotatory nystagmus. Therefore, velocity storage does not appear to be under the influence of cortical neural signals when subjects imagine that they are floating in a prone orientation.

  20. CUSUM analysis of learning curves for the head-mounted microscope in phonomicrosurgery.

    PubMed

    Chen, Ting; Vamos, Andrew C; Dailey, Seth H; Jiang, Jack J

    2016-10-01

    To observe the learning curve of the head-mounted microscope in a phonomicrosurgery simulator using cumulative summation (CUSUM) analysis, which incorporates a magnetic phonomicrosurgery instrument tracking system (MPTS). Retrospective case series. Eight subjects (6 medical students and 2 surgeons inexperienced in phonomicrosurgery) operated on phonomicrosurgical simulation cutting tasks while using the head-mounted microscope for 400 minutes total. Two 20-minute sessions occurred each day for 10 total days, with operation quality (Qs ) and completion time (T) being recorded after each session. Cumulative summation analysis of Qs and T was performed by using subjects' performance data from trials completed using a traditional standing microscope as success criteria. The motion parameters from the head-mounted microscope were significantly better than the standing microscope (P < 0.01), but T was longer than that from the standing microscope (P < 0.01). No subject successfully adapted to the head-mounted microscope, as assessed by CUSUM analysis. Cumulative summation analysis can objectively monitor the learning process associated with a phonomicrosurgical simulator system, ultimately providing a tool to assess learning status. Also, motion parameters determined by our MPTS showed that, although the head-mounted microscope provides better motion control, worse Qs and longer T resulted. This decrease in Qs is likely a result of the relatively unstable visual environment that it provides. Overall, the inexperienced surgeons participating in this study failed to adapt to the head-mounted microscope in our simulated phonomicrosurgery environment. 4 Laryngoscope, 126:2295-2300, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  1. Subjective Quality of Life Measures for Evaluating Medical Intervention.

    ERIC Educational Resources Information Center

    McCauley, Clark; Bremer, Barbara A.

    1991-01-01

    Evidence indicates that subjective quality-of-life scales developed by N. M. Bradburn (1969) and by A. Campbell, P. Converse, and W. Rodgers (1976) can be as sensitive as physiological measures in distinguishing among medical treatment groups. These scales can complement more objective measures of patient status. (SLD)

  2. Changes in prevalence of subjective fatigue during 14-day 6° head-down bed rest

    NASA Astrophysics Data System (ADS)

    Hirayanagi, Kaname; Natsuno, Toyoki; Shiozawa, Tomoki; Yamaguchi, Nobuhisa; Watanabe, Yoriko; Suzuki, Satomi; Iwase, Satoshi; Mano, Tadaaki; Yajima, Kazuyoshi

    2009-06-01

    The present study examines the prevalence of subjective fatigue in young healthy males during 14 days of 6° head-down bed rest (HDBR) by using a multidimensional questionnaire. Forty-one subjects completed the Subjective Fatigue Scale questionnaire to assess the fatigue-related complaints and symptoms. The questionnaire is composed of three sections, with 10 items each. The sections measured drowsiness and dullness (Section 1), difficulty in concentration (Section 2), and the projection of physical disintegration (Section 3). The subjects answered simple questions between 1400 and 1700 on 6 measurement days before and during the HDBR period. The prevalence rate of low back pain was markedly high (80.5%) on the second day and more than 50% in the first half of the HDBR period, and any complaints related to either a lack of sleep or a deterioration in the quality of sleep continued until the end of the HDBR period. Our findings may be useful in developing preventive strategies against physical and mental fatigue associated with prolonged HDBR, horizontal bed rest, and microgravity environments.

  3. Using a Structural Equation Modelling Approach (SEM) to Examine Leadership of Heads of Subject Departments (HODs) as Perceived by Principals and Vice-Principals, Heads of Subject Departments and Teachers within "School Based Management" (SBM) Secondary Schools: Some Evidence from Hong Kong

    ERIC Educational Resources Information Center

    Au, Loretta; Wright, Nigel; Botton, Christopher

    2003-01-01

    This article reports the use of a Structural Equation Modelling (SEM) technique as a means of exploring our understanding of the leadership of Heads of Subject Departments within School Based Management (SBM) secondary schools in Hong Kong. Arguments made by Gronn (1999, 2000), Spillane et al. (2001) suggest that studies of leadership need to…

  4. A model for enhancing Internet medical document retrieval with "medical core metadata".

    PubMed

    Malet, G; Munoz, F; Appleyard, R; Hersh, W

    1999-01-01

    Finding documents on the World Wide Web relevant to a specific medical information need can be difficult. The goal of this work is to define a set of document content description tags, or metadata encodings, that can be used to promote disciplined search access to Internet medical documents. The authors based their approach on a proposed metadata standard, the Dublin Core Metadata Element Set, which has recently been submitted to the Internet Engineering Task Force. Their model also incorporates the National Library of Medicine's Medical Subject Headings (MeSH) vocabulary and MEDLINE-type content descriptions. The model defines a medical core metadata set that can be used to describe the metadata for a wide variety of Internet documents. The authors propose that their medical core metadata set be used to assign metadata to medical documents to facilitate document retrieval by Internet search engines.

  5. Reduced head-neck offset in nontraumatic osteonecrosis of the femoral head.

    PubMed

    Fraitzl, Christian R; Kappe, Thomas; Brugger, Annina; Billich, Christian; Reichel, Heiko

    2013-08-01

    Risk factors for nontraumatic osteonecrosis of the femoral head have in common that they trigger intravascular coagulation and thus lead to devascularization of the femoral head. In part of the patients, however, no risk factors seem to be evident. Mechanical reasons contributing to nontraumatic osteonecrosis have not been discussed so far. We hypothesized that recurrent traumatization of the vessels supplying the femoral head by a cam-type mechanism as in femoroacetabular impingement could add to intravascular coagulation. We, therefore, asked whether structural abnormalities at the femoral head-neck junction indicative of such a mechanism could be observed in radiographs of patients with osteonecrosis of the femoral head. The preoperative anteroposterior and lateral radiographs of 77 patients who underwent surgery because of osteonecrosis of the femoral head were retrospectively screened for a reduced head-neck offset by measuring the α-angle. For comparison, the α-angle was measured on anteroposterior and lateral radiographs of 339 control subjects without evident underlying hip pathology. The mean α-angle was 62.8° (SD 18.7°) for anteroposterior and 67.6° (SD 13.2°) for lateral radiographs in patients with nontraumatic osteonecrosis of the femoral head, whereas in control subjects, the mean α-angle was 47.2° (SD 9.6°) (p < 0.0001) and 47.6° (SD 10.3°) (p < 0.0001), respectively. A reduced head-neck offset in patients with nontraumatic osteonecrosis of the femoral head may act as a mechanical (co-)factor in developing osteonecrosis of the femoral head.

  6. An Unwilling Partnership With the Great Society Part I: Head Start and the Beginning of Change in the White Medical Community.

    PubMed

    deShazo, Richard D; Minor, Wilson F Bill; Smith, Robert; Skipworth, Leigh Baldwin

    2016-07-01

    By 1965, the policies and programs of Lyndon B. Johnson's Great Society brought optimism to black physicians and a new wave of resistance against black civil rights advocates in the American South. The largest of the first Head Start programs, Child Development Group of Mississippi (CDGM), had its roots in Freedom Summer 1964 and the Medical Committee for Human Rights. Like other proposed programs with strong medical components, CDGM was caught in a legislative Bermuda triangle created by the powerful Mississippi congressional delegation to maintain white supremacy and plantation economics. Physician-led investigations exposed the extraordinary level of poor health among Mississippi's black children, supported Head Start as a remedy, and awakened the white medical establishment to health disparities of the Jim Crow period. It was also the beginning of positive change in the previously silent white medical community in the South and their support of civil justice in health. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  7. [SPECT in diagnostic services and medical certification: a case report of depression in head injury].

    PubMed

    Banaś, Anna

    2003-01-01

    A case of severe organic affective disorder after head trauma with loss of consciousness is presented. While CT in this case was normal, SPECT brain perfusion imaging showed hipoperfusion in the right frontal lobe and the left temporal-parietal region. The psychologic tests: Benton, Bender, MMPI confirmed changes in CNS as well. These findings help to explain the severity and chronicity of disorders and medical certification.

  8. Neuromuscular control of the head in an isometric force reproduction task: comparison of whiplash subjects and healthy controls.

    PubMed

    Descarreaux, Martin; Mayrand, Nancy; Raymond, Jean

    2007-01-01

    A number of recent scientific publications suggest that patients suffering from whiplash-associated disorders (WADs) exhibit sensorimotor deficits in the control of head and neck movements. The main objective of the present study was to evaluate if subjects with WADs can produce isometric neck extension and flexion forces with precision, variability, and a mode of control similar to the values of healthy subjects. A control group study with repeated measures. Neck force production parameters and neuromuscular control were measured in 17 whiplash and 14 control subjects. The experimental group included subjects who had a history of persistent neck pain or disability after a motor vehicle accident. Pain levels were assessed on a standard 100-mm visual analog pain scale at the beginning and end of the experiment. Each whiplash subject completed the neck disability index and the short-form 36 health survey (SF-36) questionnaire before the experiment. All subjects were asked to exert flexion and extension forces against a fixed head harness. Kinetic variables included time to peak force, time to peak force variability, peak force variability, and absolute error in peak force. Surface electrodes were applied bilaterally over the sternocleidomastoideus and paraspinal muscles. Electromyography (EMG)-dependent variables included EMG burst duration and amplitude using numerical integrated techniques. The average time to peak force was significantly longer for whiplash subjects than for the healthy controls. A significant increase in peak force variability was also observed in the whiplash group, and no group differences were noted for absolute error. Heightened muscular activity was seen in both paraspinal muscles, even though it only reached statistical significance for the left paraspinal muscle. Our results show that the whiplash subjects involved in the study were able to produce isometric forces with spatial precision similar to healthy controls using a motor strategy

  9. Rate of Hanger Reflex Occurrence: Unexpected Head Rotation on Fronto-temporal Head Compression

    PubMed Central

    ASAHI, Takashi; SATO, Michi; KAJIMOTO, Hiroyuki; KOH, Masaki; KASHIWAZAKI, Daina; KURODA, Satoshi

    When the head is encircled with a wire clothes hanger and the unilateral fronto-temporal region is compressed, the head rotates unexpectedly. As the mechanism is unclear, however, we have temporarily named this phenomenon as the “hanger reflex.” We previously reported a case wherein this phenomenon was applied to treat cervical dystonia. Because little is known about this phenomenon, we determined how often this phenomenon is observed in healthy subjects. Study participants were 120 healthy Japanese adults (60 men and 60 women) aged 19–65 years. A wire clothes hanger was applied to each subject’s head. The longer side of the hanger was attached over the volunteer’s fronto-temporal regions on both sides of the head in succession (i.e., two applications per volunteer). We evaluated whether the subjects felt the sensation of head rotation by using a questionnaire. The sensation of head rotation was observed in 95.8% of subjects. There were five non-responders (4.2%). In 85.4% of the trials, head rotation was observed in the direction that coincided with the side compressed by the hanger. There were no differences in responses between genders. The incident rate of the hanger reflex was remarkably high and most likely represents a prevalent phenomenon in humans. The mechanism underlying the reflex remains unknown. Further research should be performed to elucidate the underlying causes of the hanger reflex, which represents a potential treatment for cervical dystonia. PMID:26119894

  10. Treatment outcomes of chronic post-traumatic headaches after mild head trauma in US soldiers: an observational study.

    PubMed

    Erickson, Jay C

    2011-06-01

    he effectiveness of medical therapies for chronic post-traumatic headaches (PTHs) attributable to mild head trauma in military troops has not been established. To determine the treatment outcomes of acute and prophylactic medical therapies prescribed for chronic PTHs after mild head trauma in US Army soldiers. A retrospective cohort study was conducted with 100 soldiers undergoing treatment for chronic PTH at a single US Army neurology clinic. Headache frequency and Migraine Disability Assessment (MIDAS) scores were determined at the initial clinic visit and then again by phone 3 months after starting headache prophylactic medication. Response rates of headache abortive medications were also determined. Treatment outcomes were compared between subjects with blast-related PTH and non-blast PTH. Ninety-nine of 100 subjects were male. Seventy-seven of 100 subjects had blast PTH and 23/100 subjects had non-blast PTH. Headache characteristics were similar for blast PTH and non-blast PTH with 96% and 95%, respectively, resembling migraine. Headache frequency among all PTH subjects decreased from 17.1 days/month at baseline to 14.5 days/month at follow-up (P = .009). Headache frequency decreased by 41% among non-blast PTH compared to 9% among blast PTH. Fifty-seven percent of non-blast PTH subjects had a 50% or greater decline in headache frequency compared to 29% of blast PTH subjects (P =.023). A significant decline in headache frequency occurred in subjects treated with topiramate (n = 29, -23%, P = .02) but not among those treated with a low-dose tricyclic antidepressant (n = 48, -12%, P = .23). Seventy percent of PTH subjects who used a triptan class medication experienced reliable headache relief within 2 hours compared to 42% of subjects using other headache abortive medications (P = .01). Triptan medications were effective for both blast PTH and non-blast PTH (66% response rate vs 86% response rate, respectively; P = .20). Headache-related disability, as measured

  11. MCM generator: a Java-based tool for generating medical metadata.

    PubMed

    Munoz, F; Hersh, W

    1998-01-01

    In a previous paper we introduced the need to implement a mechanism to facilitate the discovery of relevant Web medical documents. We maintained that the use of META tags, specifically ones that define the medical subject and resource type of a document, help towards this goal. We have now developed a tool to facilitate the generation of these tags for the authors of medical documents. Written entirely in Java, this tool makes use of the SAPHIRE server, and helps the author identify the Medical Subject Heading terms that most appropriately describe the subject of the document. Furthermore, it allows the author to generate metadata tags for the 15 elements that the Dublin Core considers as core elements in the description of a document. This paper describes the use of this tool in the cataloguing of Web and non-Web medical documents, such as images, movie, and sound files.

  12. Channel heads in mountain catchments subject to human impact - The Skrzyczne range in Southern Poland

    NASA Astrophysics Data System (ADS)

    Wrońska-Wałach, Dominika; Żelazny, Mirosław; Małek, Stanisław; Krakowian, Katarzyna; Dąbek, Natalia

    2018-05-01

    Channel heads in mountain catchments are increasingly influenced by human activity. The disturbance of mountain headwater areas in moderate latitudes by the clearing of trees and the associated logging, road building and hydrotechnical constructions contribute to changes in the water cycle and consequently may induce a change in channel head development. Here we examine channel heads in the Beskid Śląski Mts., one of the areas most affected by ecological disaster in the Polish Flysch Carpathians. An ecological disaster associated with the decline of spruce trees in the 1980s and 1990s caused a substantial decrease (of about 50%) in the land area occupied by spruce forest in the Beskid Śląski Mts. As a result, headwater areas were subject to multidirectional changes in the environment. The purpose of this paper is to determine the detailed characteristics of channel heads currently developing in the analyzed headwater areas, as well as to identify independent factors that affect the evolution of channel heads. Geomorphological mapping was conducted in 2012 in the vicinity of springs in the study area. One-way ANOVA was used to determine the significance of differences between mean values calculated for groups identified based on: i) geomorphologic processes (hollows with rock veneer - h, spring niches - sn, gullies - g), ii) location vs. transformation of channel heads (forested areas vs., deforested areas with road constructions). Principal component analysis (PCA) was used to determine the structure and general patterns associated with relationships between the parameters of a channel head and its contribution area, as well as to identify and interpret new (orthogonal) spaces defined using distinct factors. As far as we know, this kind of approach has been never applied before. A total of 80 channel heads surrounding 104 springs were surveyed close to the main ridge in the study area. A total of 14 morphometric parameters were taken into account in this study

  13. Testing the self-medication hypothesis of depression and aggression in cannabis-dependent subjects.

    PubMed

    Arendt, Mikkel; Rosenberg, Raben; Fjordback, Lone; Brandholdt, Jack; Foldager, Leslie; Sher, Leo; Munk-Jørgensen, Povl

    2007-07-01

    A self-medication hypothesis has been proposed to explain the association between cannabis use and psychiatric and behavioral problems. However, little is known about the reasons for use and reactions while intoxicated in cannabis users who suffer from depression or problems controlling violent behavior. We assessed 119 cannabis-dependent subjects using the Schedules of Clinical Assessment in Neuropsychiatry (SCAN), parts of the Addiction Severity Index (ASI), and questionnaires on reasons for cannabis use and reactions to cannabis use while intoxicated. Participants with lifetime depression and problems controlling violent behavior were compared to subjects without such problems. Validity of the groupings was corroborated by use of a psychiatric treatment register, previous use of psychotropic medication and convictions for violence. Subjects with lifetime depression used cannabis for the same reasons as others. While under the influence of cannabis, they more often experienced depression, sadness, anxiety and paranoia, and they were less likely to report happiness or euphoria. Participants reporting problems controlling violent behavior more often used cannabis to decrease aggression, decrease suspiciousness, and for relaxation; while intoxicated they more often reacted with aggression. Subjects with prior depression do not use cannabis as a mean of self-medication. They are more likely to experience specific increases of adverse symptoms while under the influence of cannabis, and are less likely to experience specific symptom relief. There is some evidence that cannabis is used as a means of self-medication for problems controlling aggression.

  14. The effect of vagotomy on sodium reabsorption and renin release in anaesthetized dogs subjected to 60 degrees head-up tilt.

    PubMed Central

    DiBona, G F; Johns, E J; Osborn, J L

    1981-01-01

    1. Anaesthetized dogs were subjected to two 15 min periods of 60 degrees head-up tilt. Renal perfusion pressure was regulated to minimize changes during tilting. 2. In both intact and vagotomized animals there was a fall in systemic arterial pressure and a rise in heart rate. In both intact and vagotomized animals glomerular filtration rate fell slightly during the first tilt but remained unchanged in the second tilt period. Renal blood flow was unchanged throughout. 3. Both absolute and fractional excretions of sodium were reduced in intact animals subjected to the two consecutive periods of tilt. Following vagotomy these responses were as large as those observed in intact animals. 4. Tilting caused an increase in renin secretion from the kidney in both tilting periods to which the intact animals were subjected. In the vagotomized animals the increase in renin secretion was as large as that observed in intact animals. 5. The results of the present study show that, under the experimental conditions used, vagal afferent activity had no measurable effect on the decreases in sodium excretion or increases in renin secretion mediated by the renal nerves during short periods of 60 degrees head-up tilt. PMID:7033504

  15. Impact of head models in N170 component source imaging: results in control subjects and ADHD patients

    NASA Astrophysics Data System (ADS)

    Beltrachini, L.; Blenkmann, A.; von Ellenrieder, N.; Petroni, A.; Urquina, H.; Manes, F.; Ibáñez, A.; Muravchik, C. H.

    2011-12-01

    The major goal of evoked related potential studies arise in source localization techniques to identify the loci of neural activity that give rise to a particular voltage distribution measured on the surface of the scalp. In this paper we evaluate the effect of the head model adopted in order to estimate the N170 component source in attention deficit hyperactivity disorder (ADHD) patients and control subjects, considering faces and words stimuli. The standardized low resolution brain electromagnetic tomography algorithm (sLORETA) is used to compare between the three shell spherical head model and a fully realistic model based on the ICBM-152 atlas. We compare their variance on source estimation and analyze the impact on the N170 source localization. Results show that the often used three shell spherical model may lead to erroneous solutions, specially on ADHD patients, so its use is not recommended. Our results also suggest that N170 sources are mainly located in the right occipital fusiform gyrus for faces stimuli and in the left occipital fusiform gyrus for words stimuli, for both control subjects and ADHD patients. We also found a notable decrease on the N170 estimated source amplitude on ADHD patients, resulting in a plausible marker of the disease.

  16. A Model for Enhancing Internet Medical Document Retrieval with “Medical Core Metadata”

    PubMed Central

    Malet, Gary; Munoz, Felix; Appleyard, Richard; Hersh, William

    1999-01-01

    Objective: Finding documents on the World Wide Web relevant to a specific medical information need can be difficult. The goal of this work is to define a set of document content description tags, or metadata encodings, that can be used to promote disciplined search access to Internet medical documents. Design: The authors based their approach on a proposed metadata standard, the Dublin Core Metadata Element Set, which has recently been submitted to the Internet Engineering Task Force. Their model also incorporates the National Library of Medicine's Medical Subject Headings (MeSH) vocabulary and Medline-type content descriptions. Results: The model defines a medical core metadata set that can be used to describe the metadata for a wide variety of Internet documents. Conclusions: The authors propose that their medical core metadata set be used to assign metadata to medical documents to facilitate document retrieval by Internet search engines. PMID:10094069

  17. Medication adherence and subjective weight perception in patients with first-episode psychotic disorder.

    PubMed

    Wong, Mimi M C; Chen, E Y H; Lui, Simon S Y; Tso, Steve

    2011-10-01

    Medication adherence is critical to the management of psychotic disorder. Different factors associated with medication adherence have been investigated in previous studies. However, the association with subjective weight perception, which is related to the weight gain side effect of antipsychotics, has not been thoroughly investigated. Subjective weight perception may not equal objective weight status. This study tests the hypothesis that medication adherence is related to subjective weight perception in a group of patients with first-episode psychotic disorder who have taken antipsychotics for one year. This study recruited 160 participants with one-year histories of first-episode psychotic disorder and measured their actual and perceived weights, amount of weight gain in the past year, body size satisfaction and medication adherence levels. The associations between medication adherence and both the actual and perceived weight status were analyzed controlling for other confounding factors including insight, drug attitude, illness severity and other medication side effects. Stepwise multiple regression analysis found that the participants' perceived weight status, negative attitude toward their drugs and insight were the major factors associated with poor medication adherence. Of the participants who perceived themselves as being overweight, 86% believed that antipsychotics were responsible. Among those who had such beliefs, 72% had reduced their antipsychotic dosages on their own. About half of the participants had gained more than 7% of their baseline weight and 43.1% of the participants were found to be overweight after one year of treatment with antipsychotics. The results of this study indicate that medication adherence is associated with perceived weight status. Healthcare professionals should be aware of this relationship and address this issue early in the management of patients. Apart from weight management programs, education on a correct weight

  18. Subject preferences of first- and second-year medical students for their future specialization at Chitwan Medical College and Teaching Hospital, Chitwan, Nepal - a questionnaire-based study.

    PubMed

    Jha, Rajesh K; Paudel, Keshab R; Shah, Dev K; Sah, Ajit K; Basnet, Sangharshila; Sah, Phoolgen; Adhikari, Sandeep

    2015-01-01

    The selection of a discipline for future specialization may be an important factor for the medical students' future career, and it is influenced by multiple factors. The interest of students in the early stages can be improved in subjects related to public health or of academic importance, as per need. A questionnaire-based study was conducted among 265 first- and second-year medical students of Chitwan Medical College, Nepal to find out their subject of preference for postgraduation and the factors affecting their selection along with their interesting basic science subject. Only the responses from 232 completely filled questionnaires were analyzed. The preference of the students for clinical surgical (50.9%), clinical medical (45.3%), and basic medical (3.9%) sciences for postgraduation were in descending order. The most preferred specialty among male students was clinical surgical sciences (56.3%), and among female students, it was clinical medical sciences (53.6%). Although all the students responded to their preferred specialty, only 178 students specified the subject of their interest. General surgery (23.4%), pediatrics (23.4%), and anatomy (2.4%) were the most favored subjects for postgraduation among clinical surgical, clinical medical, and basic medical sciences specialties, respectively. More common reasons for selection of specific subject for future career were found to be: personal interests, good income, intellectual challenge, and others. Many students preferred clinical surgical sciences for their future specialization. Among the reasons for the selection of the specialty for postgraduation, no significant reason could be elicited from the present study.

  19. Self-motion perception and vestibulo-ocular reflex during whole body yaw rotation in standing subjects: the role of head position and neck proprioception.

    PubMed

    Panichi, Roberto; Botti, Fabio Massimo; Ferraresi, Aldo; Faralli, Mario; Kyriakareli, Artemis; Schieppati, Marco; Pettorossi, Vito Enrico

    2011-04-01

    Self-motion perception and vestibulo-ocular reflex (VOR) were studied during whole body yaw rotation in the dark at different static head positions. Rotations consisted of four cycles of symmetric sinusoidal and asymmetric oscillations. Self-motion perception was evaluated by measuring the ability of subjects to manually track a static remembered target. VOR was recorded separately and the slow phase eye position (SPEP) was computed. Three different head static yaw deviations (active and passive) relative to the trunk (0°, 45° to right and 45° to left) were examined. Active head deviations had a significant effect during asymmetric oscillation: the movement perception was enhanced when the head was kept turned toward the side of body rotation and decreased in the opposite direction. Conversely, passive head deviations had no effect on movement perception. Further, vibration (100 Hz) of the neck muscles splenius capitis and sternocleidomastoideus remarkably influenced perceived rotation during asymmetric oscillation. On the other hand, SPEP of VOR was modulated by active head deviation, but was not influenced by neck muscle vibration. Through its effects on motion perception and reflex gain, head position improved gaze stability and enhanced self-motion perception in the direction of the head deviation. Copyright © 2010 Elsevier B.V. All rights reserved.

  20. Antidopaminergic medication in healthy subjects provokes subjective and objective mental impairments tightly correlated with perturbation of biogenic monoamine metabolism and prolactin secretion

    PubMed Central

    Veselinović, Tanja; Vernaleken, Ingo; Cumming, Paul; Henning, Uwe; Winkler, Lina; Kaleta, Peter; Paulzen, Michael; Luckhaus, Christian; Gründer, Gerhard

    2018-01-01

    Objectives Off-label prescription of antipsychotics to patients without psychotic symptoms has become a routine matter for many psychiatrists and also some general practitioners. Nonetheless, little is known about the possibly detrimental effects of antidopaminergic medications on general psychopathology, subjective mental state, or a possible association with physiological parameters in nonpsychotic individuals. Methods In this randomized, single-blinded study, groups of healthy volunteers (n=18) received low doses of reserpine, aripiprazole, haloperidol, or placebo on 7 successive days. Relevant physiological parameters (plasma prolactin, concentrations of catecholamine metabolites in plasma, and 24-hour urine) and each subject’s mental state (Positive and Negative Syndrome Scale, Hamilton Rating Scale for Depression, visual analogue scale, Beck Depression Inventory II) were assessed at the start and end of the trial. Results Of the three active treatments, only reserpine caused a significant increase in some plasma- and urine-catecholamine metabolites, but all three medications evoked objective and subjective changes in general psychopathology scores, which correlated with individual increases in plasma homovanillic acid concentrations. Both objective and subjective impairments were significantly more pronounced in the subgroup with greatest increase of plasma prolactin. Subjects experiencing the most pronounced side effects under haloperidol, which compelled them to drop out, showed significantly higher prolactin concentration increases than those who tolerated haloperidol well. Conclusion We found consistent associations between altered markers of dopamine transmission and several objective and subjective mental impairments in healthy volunteers after 1 week’s treatment with antidopaminergic medications. These findings should draw attention to a more intensive risk–benefit evaluation in cases of off-label prescription of antipsychotic medications. PMID

  1. Demographic, medical, and psychiatric factors in work and marital status after mild head injury.

    PubMed

    Vanderploeg, Rodney D; Curtiss, Glenn; Duchnick, Jennifer J; Luis, Cheryl A

    2003-01-01

    To explore factors associated with long-term outcomes of work and marital status in individuals who had experienced a mild head injury (MHI), as well as those who had not. Population-based study using logistical regression analyses to investigate the impact of preinjury characteristics on work and marital status. Two groups of Vietnam-era Army veterans: 626 who had experienced a MHI an average of 8 years before examination, and 3,896 who had not. Demographic characteristics, concurrent medical conditions, early life psychiatric problems, loss of consciousness (LOC), and interactions among these variables were used to predict current work and marital status. Multiple variables were associated with work and marital status in the sample with MHI, accounting for approximately 23% and 17% of the variance in these two outcome variables, respectively. In contrast, the same factors accounted for significantly less variance in outcome in the sample without a head injury-13.3% and 9.4% for work and marital status, respectively. These findings suggest a more potent role for and increased vulnerability to the influence of demographic, medical, and psychiatric factors on outcomes after a MHI. That is, MHI itself moderates the influence of preinjury characteristics on work and marital status. In addition, in those who had a MHI, moderator relationships were found between education and LOC for both work and marital status. Similarly, complex moderator relationships among race, region of residence, and LOC were found for both work and marital status outcomes.

  2. Subject preferences of first- and second-year medical students for their future specialization at Chitwan Medical College and Teaching Hospital, Chitwan, Nepal – a questionnaire-based study

    PubMed Central

    Jha, Rajesh K; Paudel, Keshab R; Shah, Dev K; Sah, Ajit K; Basnet, Sangharshila; Sah, Phoolgen; Adhikari, Sandeep

    2015-01-01

    Introduction The selection of a discipline for future specialization may be an important factor for the medical students’ future career, and it is influenced by multiple factors. The interest of students in the early stages can be improved in subjects related to public health or of academic importance, as per need. Methods A questionnaire-based study was conducted among 265 first- and second-year medical students of Chitwan Medical College, Nepal to find out their subject of preference for postgraduation and the factors affecting their selection along with their interesting basic science subject. Only the responses from 232 completely filled questionnaires were analyzed. Results The preference of the students for clinical surgical (50.9%), clinical medical (45.3%), and basic medical (3.9%) sciences for postgraduation were in descending order. The most preferred specialty among male students was clinical surgical sciences (56.3%), and among female students, it was clinical medical sciences (53.6%). Although all the students responded to their preferred specialty, only 178 students specified the subject of their interest. General surgery (23.4%), pediatrics (23.4%), and anatomy (2.4%) were the most favored subjects for postgraduation among clinical surgical, clinical medical, and basic medical sciences specialties, respectively. More common reasons for selection of specific subject for future career were found to be: personal interests, good income, intellectual challenge, and others. Conclusion Many students preferred clinical surgical sciences for their future specialization. Among the reasons for the selection of the specialty for postgraduation, no significant reason could be elicited from the present study. PMID:26635491

  3. Added value of integrated circuit detector in head CT: objective and subjective image quality in comparison to conventional detector design.

    PubMed

    Korn, Andreas; Bender, Benjamin; Spira, Daniel; Schabel, Christoph; Bhadelia, Rafeeque; Claussen, Claus; Ernemann, Ulrike; Brodoefel, Harald

    2014-12-01

    A new computed tomography (CT) detector with integrated electric components and shorter conducting pathways has recently been introduced to decrease system inherent electronic noise. The purpose of this study was to assess the potential benefit of such integrated circuit detector (ICD) in head CT by comparing objective and subjective image quality in low-dose examinations with a conventional detector design. Using a conventional detector, reduced-dose noncontrast head CT (255 mAs; effective dose, 1.7 mSv) was performed in 25 consecutive patients. Following transition to ICD, 25 consecutive patients were scanned using identical imaging parameters. Images in both groups were reconstructed with iterative reconstruction (IR) and filtered back projection (FBP) and assessed in terms of quantitative and qualitative image quality. Acquisition of head CT using ICD increased signal-to-noise ratio of gray and white matter by 14% (10.0 ± 1.6 vs. 11.4 ± 2.5; P = .02) and 17% (8.2 ± 0.8 vs. 9.6 ± 1.5; P = .000). The associated improvement in contrast-to-noise ratio was 12% (2.0 ± 0.5 vs. 2.2 ± 0.6; P = .121). In addition, there was a 51% increase in objective image sharpness (582 ± 85 vs. 884.5 ± 191; change in HU/Pixel; P < .000). Compared to standard acquisitions, subjective grading of noise and overall image quality scores were significantly improved with ICD (2.1 ± 0.3 vs. 1.6 ± 0.3; P < .000; 2.0 ± 0.5 vs. 1.6 ± 0.3; P = .001). Moreover, streak artifacts in the posterior fossa were substantially reduced (2.3 ± 0.7 vs. 1.7 ± 0.5; P = .004). At the same radiation level, acquisition of head CT with ICD achieves superior objective and subjective image quality and provides potential for significant dose reduction. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  4. Effect of different head-neck-jaw postures on cervicocephalic kinesthetic sense.

    PubMed

    Zafar, H; Alghadir, A H; Iqbal, Z A

    2017-12-01

    To investigate the effect of different induced head-neck-jaw postures on head-neck relocation error among healthy subjects. 30 healthy adult male subjects participated in this study. Cervicocephalic kinesthetic sense was measured while standing, habitual sitting, habitual sitting with clenched jaw and habitual sitting with forward head posture during right rotation, left rotation, flexion and extension using kinesthetic sensibility test. Head-neck relocation error was least while standing, followed by habitual sitting, habitual sitting with forward head posture and habitual sitting with jaw clenched. However, there was no significant difference in error between different tested postures during all the movements. To the best of our knowledge, this is the first study to see the effect of different induced head-neck-jaw postures on head-neck position sense among healthy subjects. Assuming a posture for a short duration of time doesn't affect head-neck relocation error in normal healthy subjects.

  5. Effects of head tilt on visual field testing with a head-mounted perimeter imo

    PubMed Central

    Matsumoto, Chota; Nomoto, Hiroki; Numata, Takuya; Eura, Mariko; Yamashita, Marika; Hashimoto, Shigeki; Okuyama, Sachiko; Kimura, Shinji; Yamanaka, Kenzo; Chiba, Yasutaka; Aihara, Makoto; Shimomura, Yoshikazu

    2017-01-01

    Purpose A newly developed head-mounted perimeter termed “imo” enables visual field (VF) testing without a fixed head position. Because the positional relationship between the subject’s head and the imo is fixed, the effects of head position changes on the test results are small compared with those obtained using a stationary perimeter. However, only ocular counter-roll (OCR) induced by head tilt might affect VF testing. To quantitatively reveal the effects of head tilt and OCR on the VF test results, we investigated the associations among the head-tilt angle, OCR amplitude and VF testing results. Subjects and methods For 20 healthy subjects, we binocularly recorded static OCR (s-OCR) while tilting the subject’s head at an arbitrary angle ranging from 0° to 60° rightward or leftward in 10° increments. By monitoring iris patterns, we evaluated the s-OCR amplitude. We also performed blind spot detection while tilting the subject’s head by an arbitrary angle ranging from 0° to 50° rightward or leftward in 10° increments to calculate the angle by which the blind spot rotates because of head tilt. Results The association between s-OCR amplitude and head-tilt angle showed a sinusoidal relationship. In blind spot detection, the blind spot rotated to the opposite direction of the head tilt, and the association between the rotation angle of the blind spot and the head-tilt angle also showed a sinusoidal relationship. The rotation angle of the blind spot was strongly correlated with the s-OCR amplitude (R2≥0.94, p<0.0001). A head tilt greater than 20° with imo causes interference between adjacent test areas. Conclusions Both the s-OCR amplitude and the rotation angle of the blind spot were correlated with the head-tilt angle by sinusoidal regression. The rotated VF was correlated with the s-OCR amplitude. During perimetry using imo, the change in the subject’s head tilt should be limited to 20°. PMID:28945777

  6. Subjective Numeracy and the Influence of Order and Amount of Audible Information on Perceived Medication Value

    PubMed Central

    Fraenkel, Liana; Stolar, Marilyn; Swift, Sarah; Street, Richard L.; Chowdhary, Harjinder; Peters, Ellen

    2016-01-01

    Background Order and amount of information influence patients’ risk perceptions, but most studies have evaluated patients’ reactions to written materials. The objective of this study was to examine the effect of four communication strategies, varying in their order and/or amount of information, on judgments related to an audible description of a new medication and among patients who varied in subjective numeracy. Methods We created five versions of a hypothetical scenario describing a new medication. The versions were composed to elucidate whether order and/or amount of the information describing benefits and adverse events influenced how subjects valued a new medication. After listening to a randomly assigned version, perceived medication value was measured by asking subjects to choose one of the following statements: the risks outweigh the benefits, the risks and benefits are equally balanced, or the benefits outweigh the risks. Results Of the 432 patients contacted, 389 participated in the study. Listening to a brief description of benefits followed by an extended description of adverse events resulted in a greater likelihood of perceiving that the medication’s benefits outweighed the risks compared to: 1) presenting the extended adverse events description before the benefits, 2) giving a greater amount of information related to benefits, and 3) sandwiching the adverse events between benefits. These associations were only observed among subjects with average or higher subjective numeracy. Conclusion If confirmed in future studies, our results suggest that, for patients with average or better subjective numeracy, perceived medication value is highest when a brief presentation of benefits is followed by an extended description of adverse events. PMID:27216580

  7. Musical auditory stimulus acutely influences heart rate dynamic responses to medication in subjects with well-controlled hypertension.

    PubMed

    Martiniano, Eli Carlos; Santana, Milana Drumond Ramos; Barros, Érico Luiz Damasceno; do Socorro da Silva, Maria; Garner, David Matthew; de Abreu, Luiz Carlos; Valenti, Vitor E

    2018-01-17

    Music can improve the efficiency of medical treatment when correctly associated with drug action, reducing risk factors involving deteriorating cardiac function. We evaluated the effect of musical auditory stimulus associated with anti-hypertensive medication on heart rate (HR) autonomic control in hypertensive subjects. We evaluated 37 well-controlled hypertensive patients designated for anti-hypertensive medication. Heart rate variability (HRV) was calculated from the HR monitor recordings of two different, randomly sorted protocols (control and music) on two separate days. Patients were examined in a resting condition 10 minutes before medication and 20 minutes, 40 minutes and 60 minutes after oral medication. Music was played throughout the 60 minutes after medication with the same intensity for all subjects in the music protocol. We noted analogous response of systolic and diastolic arterial pressure in both protocols. HR decreased 60 minutes after medication in the music protocol while it remained unchanged in the control protocol. The effects of anti-hypertensive medication on SDNN (Standard deviation of all normal RR intervals), LF (low frequency, nu), HF (high frequency, nu) and alpha-1 scale were more intense in the music protocol. In conclusion, musical auditory stimulus increased HR autonomic responses to anti-hypertensive medication in well-controlled hypertensive subjects.

  8. Effect of different head-neck-jaw postures on cervicocephalic kinesthetic sense

    PubMed Central

    Zafar, Hamayun; Alghadir, Ahmad H.; Iqbal, Zaheen A.

    2017-01-01

    Objectives: To investigate the effect of different induced head-neck-jaw postures on head-neck relocation error among healthy subjects. Methods: 30 healthy adult male subjects participated in this study. Cervicocephalic kinesthetic sense was measured while standing, habitual sitting, habitual sitting with clenched jaw and habitual sitting with forward head posture during right rotation, left rotation, flexion and extension using kinesthetic sensibility test. Results: Head-neck relocation error was least while standing, followed by habitual sitting, habitual sitting with forward head posture and habitual sitting with jaw clenched. However, there was no significant difference in error between different tested postures during all the movements. Conclusions: To the best of our knowledge, this is the first study to see the effect of different induced head-neck-jaw postures on head-neck position sense among healthy subjects. Assuming a posture for a short duration of time doesn’t affect head-neck relocation error in normal healthy subjects. PMID:29199196

  9. Repurposing the Microsoft Kinect for Windows v2 for external head motion tracking for brain PET.

    PubMed

    Noonan, P J; Howard, J; Hallett, W A; Gunn, R N

    2015-11-21

    Medical imaging systems such as those used in positron emission tomography (PET) are capable of spatial resolutions that enable the imaging of small, functionally important brain structures. However, the quality of data from PET brain studies is often limited by subject motion during acquisition. This is particularly challenging for patients with neurological disorders or with dynamic research studies that can last 90 min or more. Restraining head movement during the scan does not eliminate motion entirely and can be unpleasant for the subject. Head motion can be detected and measured using a variety of techniques that either use the PET data itself or an external tracking system. Advances in computer vision arising from the video gaming industry could offer significant benefits when re-purposed for medical applications. A method for measuring rigid body type head motion using the Microsoft Kinect v2 is described with results presenting  ⩽0.5 mm spatial accuracy. Motion data is measured in real-time at 30 Hz using the KinectFusion algorithm. Non-rigid motion is detected using the residual alignment energy data of the KinectFusion algorithm allowing for unreliable motion to be discarded. Motion data is aligned to PET listmode data using injected pulse sequences into the PET/CT gantry allowing for correction of rigid body motion. Pilot data from a clinical dynamic PET/CT examination is shown.

  10. Repurposing the Microsoft Kinect for Windows v2 for external head motion tracking for brain PET

    NASA Astrophysics Data System (ADS)

    Noonan, P. J.; Howard, J.; Hallett, W. A.; Gunn, R. N.

    2015-11-01

    Medical imaging systems such as those used in positron emission tomography (PET) are capable of spatial resolutions that enable the imaging of small, functionally important brain structures. However, the quality of data from PET brain studies is often limited by subject motion during acquisition. This is particularly challenging for patients with neurological disorders or with dynamic research studies that can last 90 min or more. Restraining head movement during the scan does not eliminate motion entirely and can be unpleasant for the subject. Head motion can be detected and measured using a variety of techniques that either use the PET data itself or an external tracking system. Advances in computer vision arising from the video gaming industry could offer significant benefits when re-purposed for medical applications. A method for measuring rigid body type head motion using the Microsoft Kinect v2 is described with results presenting  ⩽0.5 mm spatial accuracy. Motion data is measured in real-time at 30 Hz using the KinectFusion algorithm. Non-rigid motion is detected using the residual alignment energy data of the KinectFusion algorithm allowing for unreliable motion to be discarded. Motion data is aligned to PET listmode data using injected pulse sequences into the PET/CT gantry allowing for correction of rigid body motion. Pilot data from a clinical dynamic PET/CT examination is shown.

  11. [Misuse of psychotropic medications in a population of subjects held for custody in the city of Paris].

    PubMed

    Sec, Isabelle; Questel, Frank; Rey, Caroline; Pourriat, Jean-Louis

    2009-01-01

    Identify which psychotropic medications are misused and peddled in a population of subjects held for custody in the city of Paris. Subjects held for custody in the Medico-Legal Emergency Unit of the Paris Hôtel-Dieu hospital were examined and interrogated between March 2006 and March 2007 in order to assess their consumption of psychotropic medications. Sixty one of the 659 subjects (9.2%) interrogated were included in the study. Their main source of psychotropic medications was street dealers. The most frequently misused psychotropic agent was clonazepam (42.6%), followed by buprenorphine (30.65%) and methadone (21.3%). Clonazepam appears to have replaced flunitrazepam which now only comes in fifth position (11.4%). The finding that methadone is the third most misused drug should lead us to query this medication's dispensing method. Practitioners should remain vigilant regarding the potential misuse of psychotropic medications, particularly since they may induce severe undesirable events (addiction, neurological disorders, possibly lethal overdosage).

  12. Adapted head- and eye-movement responses to added-head inertia

    NASA Technical Reports Server (NTRS)

    Gauthier, G. M.; Martin, B. J.; Stark, L. W.

    1986-01-01

    Adaptation to inertia added to the head was studied in men by mounting masses on a rigidly attached helmet until two- to ten-fold increases of inertia were produced, while an overhead suspension compensated for the weights. The observed changes in the eye and head movement coordination included increased head movement latencies, as well as changes in the eye movement amplitude, and later stabilizing alternate contractions of the neck muscles. Oscillopsia, or continual displacement or instability of the visual world, which is a symptom of a breakdown of space constancy, was prominent and consistent in the perceptual reports of the subjects. Although adaptation resulting from adding inertia to the head occurred much faster than that induced by adding prisms or lenses, it has similar perceptual and motor components that may be objectively studied in detail.

  13. Health Coordination Manual. Head Start Health Services.

    ERIC Educational Resources Information Center

    Administration for Children, Youth, and Families (DHHS), Washington, DC. Head Start Bureau.

    Part 1 of this manual on coordinating health care services for Head Start children provides an overview of what Head Start health staff should do to meet the medical, mental health, nutritional, and/or dental needs of Head Start children, staff, and family members. Offering examples, lists, action steps, and charts for clarification, part 2…

  14. Does the hair influence heat extraction from the head during head cooling under heat stress?

    PubMed Central

    SHIN, Sora; PARK, Joonhee; LEE, Joo-Young

    2015-01-01

    The purpose of this study was to investigate the effects of head hair on thermoregulatory responses when cooling the head under heat stress. Eight young males participated in six experimental conditions: normal hair (100–130 mm length) and cropped hair (5 mm length) with three water inlet temperatures of 10, 15, and 20°C. The head and neck of subjects were cooled by a liquid perfused hood while immersing legs at 42°C water for 60 min in a sitting position at the air temperature of 28°C with 30% RH. The results showed that heat removal from the normal hair condition was not significantly different from the cropped hair condition. Rectal and mean skin temperatures, and sweat rate showed no significant differences between the normal and cropped hair conditions. Heat extraction from the head was significantly greater in 10°C than in 15 or 20°C cooling (p<0.05) for both normal and cropped hair, whereas subjects preferred the 15°C more than the 10 or 20°C cooling regimen. These results indicate that the selection of effective cooling temperature is more crucial than the length of workers’ hair during head cooling under heat stress, and such selection should be under the consideration of subjective perceptions with physiological responses. PMID:26165361

  15. Twenty-first Century ethics of medical research involving human subjects: achievements and challenges.

    PubMed

    Tzamaloukas, Antonios H; Konstantinov, Konstantin N; Agaba, Emmanuel I; Raj, Dominic S C; Murata, Glen H; Glew, Robert H

    2008-01-01

    The field of ethics in medical research has seen important developments in the last three decades, but it also faces great challenges in the new century. The purposes of this report are to examine the current status of ethics of medical research involving human subjects and the nature of the ethical challenges facing this research, to identify the weakness of the current system of safeguards for ethical research, and to stress the importance of the ethical character of the researcher, which is the safeguard that has the greatest potential for protecting the research subjects. Researchers appreciate the risks of human medical research that create ethical dilemmas and the need for an ethical compromise in order to proceed with the research. The main elements of the compromise, formulated primarily from experiences in the Second World War, include: (1) the dominant position of the ethical principle of autonomy; (2) the demand for a signed informed consent; (3) the likelihood of improving health with the research protocol, which must be approved by a duly appointed supervising committee; and (4) an acceptable risk/benefit ratio. The main weakness of this set of safeguards is the difficulty with obtaining a truly informed consent. The new challenges to ethical medical research stem from certain types of research, such as genetic and stem cell research, and from the increasing involvement of the industry in planning and funding the research studies. Developing medical researchers with an ethical character and knowledge about ethics in medicine may be the most effective safeguard in protecting participants of medical research experiments.

  16. The Current Practices in Injury Prevention and Safety Helmet Use in an Air Force Medical Center

    DTIC Science & Technology

    2000-05-01

    skateboarding . Findings from the DoD survey (1995) suggest that additional effort is necessary to meet Healthy People 2000 objectives in the area of...rollerblading or skateboarding . Primary care provider A family or individual goes to a primary care provider initially for medical care and the management...related head injury was considered a head injury that occurred while the subject was riding either a bicycle, motorcycle, rollerblading or skateboarding

  17. Heading assessment by "tunnel vision" patients and control subjects standing or walking in a virtual reality environment.

    PubMed

    Apfelbaum, Henry; Pelah, Adar; Peli, Eli

    2007-01-01

    Virtual reality locomotion simulators are a promising tool for evaluating the effectiveness of vision aids to mobility for people with low vision. This study examined two factors to gain insight into the verisimilitude requirements of the test environment: the effects of treadmill walking and the suitability of using controls as surrogate patients. Ten "tunnel vision" patients with retinitis pigmentosa (RP) were tasked with identifying which side of a clearly visible obstacle their heading through the virtual environment would lead them, and were scored both on accuracy and on their distance from the obstacle when they responded. They were tested both while walking on a treadmill and while standing, as they viewed a scene representing progress through a shopping mall. Control subjects, each wearing a head-mounted field restriction to simulate the vision of a paired patient, were also tested. At wide angles of approach, controls and patients performed with a comparably high degree of accuracy, and made their choices at comparable distances from the obstacle. At narrow angles of approach, patients' accuracy increased when walking, while controls' accuracy decreased. When walking, both patients and controls delayed their decisions until closer to the obstacle. We conclude that a head-mounted field restriction is not sufficient for simulating tunnel vision, but that the improved performance observed for walking compared to standing suggests that a walking interface (such as a treadmill) may be essential for eliciting natural perceptually-guided behavior in virtual reality locomotion simulators.

  18. Minor head injury: pathophysiological or iatrogenic sequelae?

    PubMed Central

    Newcombe, F; Rabbitt, P; Briggs, M

    1994-01-01

    This study addresses the possibility that cognitive sequelae--albeit of a transient or minor character--can be associated with mild head injury. Twenty men (aged 16-30 years of age), whose post-traumatic amnesia did not exceed eight hours, were examined within 48 hours of their accident and again one month later. This unselected sample had no previous history of head injury. A control group of 20 men of similar socioeconomic background, was selected from medical wards (where they had been admitted for orthopaedic treatment or a minor operation). They were also retested one month after the first examination. Neuropsychological tests were selected to measure abilities often compromised after significant head injury, namely memory and attention. The experimental component consisted of the fractionation of a complex skill (paced addition) to probe for deficits at different stages of information processing: perception and input into storage; search for and retrieval of information from working memory; and paced and unpaced addition. In general, no significant difference was found between the experimental and control groups, with the possible exception of an initial decrement on two working memory tasks: probe digits and a keeping track task (where the subject has to keep in mind and update a number of variables at the same time). The keeping track paradigm, ostensibly of ecological relevance, may well be worth further exploration in memory research, and in studies of more severely head-injured patients. It is further suggested that the appropriate management and counselling of mildly head-injured patients may help to avert symptoms that are of psychological rather than pathophysiological origin. PMID:8006652

  19. Boxing-related head injuries.

    PubMed

    Jayarao, Mayur; Chin, Lawrence S; Cantu, Robert C

    2010-10-01

    Fatalities in boxing are most often due to traumatic brain injury that occurs in the ring. In the past 30 years, significant improvements in ringside and medical equipment, safety, and regulations have resulted in a dramatic reduction in the fatality rate. Nonetheless, the rate of boxing-related head injuries, particularly concussions, remains unknown, due in large part to its variability in clinical presentation. Furthermore, the significance of repeat concussions sustained when boxing is just now being understood. In this article, we identify the clinical manifestations, pathophysiology, and management of boxing-related head injuries, and discuss preventive strategies to reduce head injuries sustained by boxers.

  20. A tailored smoking, alcohol, and depression intervention for head and neck cancer patients.

    PubMed

    Duffy, Sonia A; Ronis, David L; Valenstein, Marcia; Lambert, Michael T; Fowler, Karen E; Gregory, Lynn; Bishop, Carol; Myers, Larry L; Blow, Frederic C; Terrell, Jeffrey E

    2006-11-01

    Smoking, alcohol use, and depression are interrelated and highly prevalent in patients with head and neck cancer, adversely affecting quality of life and survival. Smoking, alcohol, and depression share common treatments, such as cognitive behavioral therapy and antidepressants. Consequently, we developed and tested a tailored smoking, alcohol, and depression intervention for patients with head and neck cancer. Patients with head and neck cancer with at least one of these disorders were recruited from the University of Michigan and three Veterans Affairs medical centers. Subjects were randomized to usual care or nurse-administered intervention consisting of cognitive behavioral therapy and medications. Data collected included smoking, alcohol use, and depressive symptoms at baseline and at 6 months. The mean age was 57 years. Most participants were male (84%) and White (90%). About half (52%) were married, 46% had a high school education or less, and 52% were recruited from Veterans Affairs sites. The sample was fairly evenly distributed across three major head and neck cancer sites and over half (61%) had stage III/IV cancers. Significant differences in 6-month smoking cessation rates were noted with 47% quitting in the intervention compared with 31% in usual care (P < 0.05). Alcohol and depression rates improved in both groups, with no significant differences in 6-month depression and alcohol outcomes. Treating comorbid smoking, problem drinking, and depression may increase smoking cessation rates above that of usual care and may be more practical than treating these disorders separately.

  1. Coordinates of Human Visual and Inertial Heading Perception.

    PubMed

    Crane, Benjamin Thomas

    2015-01-01

    Heading estimation involves both inertial and visual cues. Inertial motion is sensed by the labyrinth, somatic sensation by the body, and optic flow by the retina. Because the eye and head are mobile these stimuli are sensed relative to different reference frames and it remains unclear if a perception occurs in a common reference frame. Recent neurophysiologic evidence has suggested the reference frames remain separate even at higher levels of processing but has not addressed the resulting perception. Seven human subjects experienced a 2s, 16 cm/s translation and/or a visual stimulus corresponding with this translation. For each condition 72 stimuli (360° in 5° increments) were delivered in random order. After each stimulus the subject identified the perceived heading using a mechanical dial. Some trial blocks included interleaved conditions in which the influence of ±28° of gaze and/or head position were examined. The observations were fit using a two degree-of-freedom population vector decoder (PVD) model which considered the relative sensitivity to lateral motion and coordinate system offset. For visual stimuli gaze shifts caused shifts in perceived head estimates in the direction opposite the gaze shift in all subjects. These perceptual shifts averaged 13 ± 2° for eye only gaze shifts and 17 ± 2° for eye-head gaze shifts. This finding indicates visual headings are biased towards retina coordinates. Similar gaze and head direction shifts prior to inertial headings had no significant influence on heading direction. Thus inertial headings are perceived in body-centered coordinates. Combined visual and inertial stimuli yielded intermediate results.

  2. Coordinates of Human Visual and Inertial Heading Perception

    PubMed Central

    Crane, Benjamin Thomas

    2015-01-01

    Heading estimation involves both inertial and visual cues. Inertial motion is sensed by the labyrinth, somatic sensation by the body, and optic flow by the retina. Because the eye and head are mobile these stimuli are sensed relative to different reference frames and it remains unclear if a perception occurs in a common reference frame. Recent neurophysiologic evidence has suggested the reference frames remain separate even at higher levels of processing but has not addressed the resulting perception. Seven human subjects experienced a 2s, 16 cm/s translation and/or a visual stimulus corresponding with this translation. For each condition 72 stimuli (360° in 5° increments) were delivered in random order. After each stimulus the subject identified the perceived heading using a mechanical dial. Some trial blocks included interleaved conditions in which the influence of ±28° of gaze and/or head position were examined. The observations were fit using a two degree-of-freedom population vector decoder (PVD) model which considered the relative sensitivity to lateral motion and coordinate system offset. For visual stimuli gaze shifts caused shifts in perceived head estimates in the direction opposite the gaze shift in all subjects. These perceptual shifts averaged 13 ± 2° for eye only gaze shifts and 17 ± 2° for eye-head gaze shifts. This finding indicates visual headings are biased towards retina coordinates. Similar gaze and head direction shifts prior to inertial headings had no significant influence on heading direction. Thus inertial headings are perceived in body-centered coordinates. Combined visual and inertial stimuli yielded intermediate results. PMID:26267865

  3. Pretreatment dietary patterns, weight status, and head and neck squamous cell carcinoma prognosis.

    PubMed

    Arthur, Anna E; Peterson, Karen E; Rozek, Laura S; Taylor, Jeremy M G; Light, Emily; Chepeha, Douglas B; Hébert, James R; Terrell, Jeffrey E; Wolf, Gregory T; Duffy, Sonia A

    2013-02-01

    Few studies have evaluated the association of diet and weight status with head and neck cancer outcomes. The purpose of this study was to determine whether pretreatment dietary patterns and weight status are associated with head and neck cancer prognosis. This was a longitudinal study of 542 patients with newly diagnosed head and neck cancer who completed food-frequency questionnaires and health surveys before treatment. Clinical data were abstracted from medical records and the Social Security Death Index. Dietary patterns were identified by using principal component analysis. Cox proportional hazard models were used to examine the association of derived dietary patterns (fit by quintiles of exposure) and weight status with time to recurrence and survival, with control for covariates. During the study period, there were 229 deaths and 184 recurrences. Two dietary patterns were identified: a whole-foods pattern (characterized by high intakes of vegetables, fruit, fish, poultry, and whole grains) and a Western pattern (characterized by high intakes of red and processed meats, refined grains, potatoes, and French fries). In multivariable analyses, significantly fewer deaths were observed in subjects most adherent to the whole-foods pattern (HR: 0.56; 95% CI: 0.34, 0.92; P-trend = 0.01). Subjects classified as overweight or obese had significantly fewer deaths (HR: 0.65; 95% CI: 0.49, 0.85; P = 0.001) and recurrences (HR: 0.70; 95% CI: 0.52, 0.95; P = 0.02) than did normal-weight or underweight subjects. Consumption of a diet rich in vegetables, fruit, fish, poultry, and whole grains and being overweight before diagnosis with head and neck cancer are associated with a better prognosis.

  4. Medical Subspecialty Textbooks in the 21st Century. Essential or Headed for Extinction?

    PubMed

    Broaddus, V Courtney; Grippi, Michael A

    2015-08-01

    In recent years, the role of medical subspecialty textbooks as sources of information for students, trainees, and practicing clinicians has been challenged. Although the structure of textbooks continues to evolve from standard, printed versions to digital formats, including e-books and online texts, we maintain that the authoritative compilation of clinical and scientific material by experts in the field (i.e., a modern-day textbook) remains central to the education, training, and practice of subspecialists. Regardless of format, an effective medical subspecialty textbook is authoritative, comprehensive, and integrated in its coverage of the subject. Textbook content represents a unique synthesis of clinical and scientific material of real educational and clinical value. Incorporation of illustrations, including figures, tables, videos, and audios, bolsters the presentation and further solidifies the reader's understanding of the subject. The textbook, both printed and digital, reinforces the many widely available online resources and serves as a platform from which to evaluate other sources of information and to launch additional scientific and clinical inquiry.

  5. 21 CFR 868.5560 - Gas mask head strap.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gas mask head strap. 868.5560 Section 868.5560...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5560 Gas mask head strap. (a) Identification. A gas mask head strap is a device used to hold an anesthetic gas mask in position on a patient's...

  6. Internal Lymphedema Correlates with Subjective and Objective Measures of Dysphagia in Head and Neck Cancer Patients.

    PubMed

    Jackson, Leanne K; Ridner, Sheila H; Deng, Jie; Bartow, Carmin; Mannion, Kyle; Niermann, Ken; Gilbert, Jill; Dietrich, Mary S; Cmelak, Anthony J; Murphy, Barbara A

    2016-09-01

    Tumor/treatment-related internal lymphedema (IL) and/or external lymphedema (EL) are associated with functional deficits and increased symptom burden in head and neck cancer patients (HNCP). Previously, we noted association between EL/IL and patient-reported dysphagia using the Vanderbilt Head and Neck Symptom Survey (VHNSS) version 1.0. To determine the relationship between IL/EL and subjective and objective measures of swallowing function. Eighty-one HNCP completed: (1) VHNSS version 2.0, including 13 swallowing/nutrition-related questions grouped into three clusters: swallow solids (ss), swallow liquids (sl), and nutrition(nt); (2) physical assessment of EL using Foldi scale; (3) endoscopic assessment of IL using Patterson scale (n = 56); and (4) modified barium swallow study rated by dysphagia outcome and severity scale (DOSS) and in conjunction with a swallow evaluation by National Outcomes Measurement System (NOMS). Examinations were performed at varied time points to assess lymphedema spectrum, from baseline (n = 15, 18.1%) to 18 months post-therapy (n = 20, 24.1%). VHNSS swallow/nutrition items scores correlated with NOMS/DOSS ratings (p < 0.001). Highest correlation was with NOMS: ss (-0.73); sl (-0.61); nt (-0.56). VHNSS swallow/nutrition scores correlated with maximum grade of swelling for any single structure on Patterson scale: ss (0.43; p = 0.001); sl (0.38; p = 0.004); nt (0.41; p = 0.002). IL of aryepiglottic/pharyngoepiglottic folds, epiglottis, and pyriform sinus were most strongly correlated with VHNSS and NOMS ratings. NOMS/DOSS ratings correlated with EL (> = -0.34; p < 0.01). No meaningful correlations exist between VHNSS swallow/nutrition items and EL (< ± 0.15, p > 0.20). IL correlated with subjective and objective measures of swallow dysfunction. Longitudinal analysis of trajectory and impact of IL/EL on dysphagia is ongoing.

  7. Impact of a structured review session on medical student psychiatry subject examination performance.

    PubMed

    Siddiqi, Shan H; Black, Kevin J; Womer, Fay Y

    2015-01-01

    Introduction: The National Board of Medical Examiners (NBME) subject examinations are used as a standardized metric for performance in required clerkships for third-year medical students. While several medical schools have implemented a review session to help consolidate knowledge acquired during the clerkship, the effects of such an intervention are not yet well-established. An improvement in NBME psychiatry examination scores has previously been reported with a single end-of-clerkship review session, but this was limited by a small sample size and the fact that attendance at the review session was optional, leading to likely selection bias. Methods: A 1.5-hour structured review session was conducted for medical students in the last week of each 4-week psychiatry clerkship between September 2014 and July 2015. Students were required to attend unless excused due to scheduling conflicts. Scores on the NBME psychiatry subject exam were compared with those of students taking the examination in the corresponding time period in each of the previous two academic years. Results: 83 students took the exam during the experimental period, while 176 took the exam during the control period. Statistically significant improvements were found in mean score (p=0.03), mean for the two lowest scores in each group (p<0.0007), and percentage of students scoring 70 or less (p=0.03). Percentage of students achieving the maximum possible score (99) was higher in the experimental group, but did not reach significance (p=0.06). Conclusions: An end-of-clerkship review session led to increased mean scores on the NBME psychiatry subject examination, particularly for students at the lower end of the score range. Future research should investigate the impact of such an intervention in other specialties and other institutions.

  8. Gender differences in head-neck segment dynamic stabilization during head acceleration.

    PubMed

    Tierney, Ryan T; Sitler, Michael R; Swanik, C Buz; Swanik, Kathleen A; Higgins, Michael; Torg, Joseph

    2005-02-01

    Recent epidemiological research has revealed that gender differences exist in concussion incidence but no study has investigated why females may be at greater risk of concussion. Our purpose was to determine whether gender differences existed in head-neck segment kinematic and neuromuscular control variables responses to an external force application with and without neck muscle preactivation. Forty (20 females and 20 males) physically active volunteers participated in the study. The independent variables were gender, force application (known vs unknown), and force direction (forced flexion vs forced extension). The dependent variables were kinematic and EMG variables, head-neck segment stiffness, and head-neck segment flexor and extensor isometric strength. Statistical analyses consisted of multiple multivariate and univariate analyses of variance, follow-up univariate analyses of variance, and t-tests (P < or = 0.05). Gender differences existed in head-neck segment dynamic stabilization during head angular acceleration. Females exhibited significantly greater head-neck segment peak angular acceleration (50%) and displacement (39%) than males despite initiating muscle activity significantly earlier (SCM only) and using a greater percentage of their maximum head-neck segment muscle activity (79% peak activity and 117% muscle activity area). The head-neck segment angular acceleration differences may be because females exhibited significantly less isometric strength (49%), neck girth (30%), and head mass (43%), resulting in lower levels of head-neck segment stiffness (29%). For our subject demographic, the results revealed gender differences in head-neck segment dynamic stabilization during head acceleration in response to an external force application. Females exhibited significantly greater head-neck segment peak angular acceleration and displacement than males despite initiating muscle activity earlier (SCM only) and using a greater percentage of their maximum

  9. Pakistan Journal of Medical Sciences: A bibliometric assessment 2001-2010

    PubMed Central

    Baladi, Zameer Hussain; Umedani, Loung V.

    2017-01-01

    Objective: The aim of this study was to measure the growth of scientific research, authors’ productivity, affiliation with the institute and geographic locations published in the Pakistan Journal of Medical Sciences during the period of 2001 – 2010. Methods: This numerical analysis was conducted during mid-August 2016 to mid-October, 2016. The data for the study was downloaded from websites of e-journal of Pakistan Journal of Medical Sciences (PJMS) and Pak Medi-Net Com. Results: A total number of 1199 articled were covered by PJMS in 10 volumes and 40 issues with contribution of 3798 (3%) authors during 2001 – 2010. The average number of papers per issue is 30%. A gender wise contribution of males was higher 3050 (80%) than the females 748 (20%). A majority of articles were multi-authored 1052 (87%) as opposed to single author contribution 147 (13%). All 1199 articles were covered under four major disciplines i.e Basic medical sciences, medicine & allied, surgery & allied and radiological sciences and 39 sub-specialties according to medical subject headings (MeSH). It observed that 467 (39%) articles were published in Pakistan and 732 (61%) articles produced by other 32 countries. The Karachi city of Pakistan has produced 199 (16%) articles as highest as its national level and followed by Tehran (Iran) 77 (6%) as followed internationally. Conclusion: This study reveals that the participation of 32 countries in the PJMS publications proves it to be an internationally circulated journal to support research with the constant approach of publishing articles to each volume in basic medical sciences, biomedical, clinical and public health sciences. Abbreviations: DOAJ: Directory of Open Access Journals IMEMR: Index Medicus Eastern Mediterranean Region HEC: Higher Education Commission (Pakistan) PJMS: Pakistan Journal of Medical Sciences MeSH: Medical Subject Headings PMDC: Pakistan Medical & Dental Council SCIE: Science Citation Index Expanded PMID:28811801

  10. Pakistan Journal of Medical Sciences: A bibliometric assessment 2001-2010.

    PubMed

    Baladi, Zameer Hussain; Umedani, Loung V

    2017-01-01

    The aim of this study was to measure the growth of scientific research, authors' productivity, affiliation with the institute and geographic locations published in the Pakistan Journal of Medical Sciences during the period of 2001 - 2010. This numerical analysis was conducted during mid-August 2016 to mid-October, 2016. The data for the study was downloaded from websites of e-journal of Pakistan Journal of Medical Sciences (PJMS) and Pak Medi-Net Com. A total number of 1199 articled were covered by PJMS in 10 volumes and 40 issues with contribution of 3798 (3%) authors during 2001 - 2010. The average number of papers per issue is 30%. A gender wise contribution of males was higher 3050 (80%) than the females 748 (20%). A majority of articles were multi-authored 1052 (87%) as opposed to single author contribution 147 (13%). All 1199 articles were covered under four major disciplines i.e Basic medical sciences, medicine & allied, surgery & allied and radiological sciences and 39 sub-specialties according to medical subject headings (MeSH). It observed that 467 (39%) articles were published in Pakistan and 732 (61%) articles produced by other 32 countries. The Karachi city of Pakistan has produced 199 (16%) articles as highest as its national level and followed by Tehran (Iran) 77 (6%) as followed internationally. This study reveals that the participation of 32 countries in the PJMS publications proves it to be an internationally circulated journal to support research with the constant approach of publishing articles to each volume in basic medical sciences, biomedical, clinical and public health sciences. Abbreviations: DOAJ: Directory of Open Access Journals IMEMR: Index Medicus Eastern Mediterranean Region HEC: Higher Education Commission (Pakistan) PJMS: Pakistan Journal of Medical Sciences MeSH: Medical Subject Headings PMDC: Pakistan Medical & Dental Council SCIE: Science Citation Index Expanded.

  11. Heading perception in patients with advanced retinitis pigmentosa

    NASA Technical Reports Server (NTRS)

    Li, Li; Peli, Eli; Warren, William H.

    2002-01-01

    PURPOSE: We investigated whether retinis pigmentosa (RP) patients with residual visual field of < 100 degrees could perceive heading from optic flow. METHODS: Four RP patients and four age-matched normally sighted control subjects viewed displays simulating an observer walking over a ground. In experiment 1, subjects viewed either the entire display with free fixation (full-field condition) or through an aperture with a fixation point at the center (aperture condition). In experiment 2, patients viewed displays of different durations. RESULTS: RP patients' performance was comparable to that of the age-matched control subjects: heading judgment was better in the full-field condition than in the aperture condition. Increasing display duration from 0.5 s to 1 s improved patients' heading performance, but giving them more time (3 s) to gather more visual information did not consistently further improve their performance. CONCLUSIONS: RP patients use active scanning eye movements to compensate for their visual field loss in heading perception; they might be able to gather sufficient optic flow information for heading perception in about 1 s.

  12. Heading perception in patients with advanced retinitis pigmentosa.

    PubMed

    Li, Li; Peli, Eli; Warren, William H

    2002-09-01

    We investigated whether retinis pigmentosa (RP) patients with residual visual field of < 100 degrees could perceive heading from optic flow. Four RP patients and four age-matched normally sighted control subjects viewed displays simulating an observer walking over a ground. In experiment 1, subjects viewed either the entire display with free fixation (full-field condition) or through an aperture with a fixation point at the center (aperture condition). In experiment 2, patients viewed displays of different durations. RP patients' performance was comparable to that of the age-matched control subjects: heading judgment was better in the full-field condition than in the aperture condition. Increasing display duration from 0.5 s to 1 s improved patients' heading performance, but giving them more time (3 s) to gather more visual information did not consistently further improve their performance. RP patients use active scanning eye movements to compensate for their visual field loss in heading perception; they might be able to gather sufficient optic flow information for heading perception in about 1 s.

  13. In memory of professor Czesław Niżankowski, Head of the Department of Anatomy, Wroclaw Medical University.

    PubMed

    Kacała, Ryszard R; Wronecki, Krzysztof; Kacała, Arkadiusz; Domagała, Zygmunt; Porwolik, Michał

    2018-03-20

    Professor Czesław Niżankowski was an academic teacher and researcher at several universities; head of the Department of Anatomy at Wroclaw Medical University (1966-1982); and head of the Department of Biological Sciences at the Wrocław School of Physical Education (since 1972 University School of Physical Education in Wrocław), as well as the chancellor there. He contributed greatly to the development of morphological sciences, supervising many doctoral and post-doctoral works. He dedicated considerable time to the preparation of anatomical specimens of lungs, hearts and organs of the gastrointestinal tract. At the Museum of Anatomy, there are over 100 specimens of lungs prepared using the forced air technique improved by Professor Niżankowski, along with specimens of the bronchial tree and vascular system prepared using a corrosive technique. Professor Niżankowski was an active member of scientific societies in Wrocław and in other cities in Poland. For his accomplishments, he received a number of ministerial and state awards, including the Knight's Cross of the Order of Polonia Restituta, and was granted an honorary doctorate by Wroclaw Medical University.

  14. Differences in Optic Nerve Head, Retinal Nerve Fiber Layer, and Ganglion Cell Complex Parameters Between Caucasian and Chinese Subjects.

    PubMed

    Chansangpetch, Sunee; Huang, Guofu; Coh, Paul; Oldenburg, Catherine; Amoozgar, Behzad; He, Mingguang; Lin, Shan C

    2018-04-01

    To compare optic nerve head, peripapillary retinal nerve fiber layer (pRNFL), and ganglion cell complex (GCC) parameters between Caucasian and ethnic Chinese. Normal subjects above 40 years old and self-identified as being Caucasian and Chinese were recruited. They were evaluated with spectral-domain optical coherence tomography (RTVue-100). Parameters related to the optic nerve head, pRNFL, and GCC analysis protocols were acquired. Multivariable linear regression was performed adjusting for potential confounders. Data from 116 Caucasian and 130 Chinese subjects were available for analysis. Mean age of all participants was 66.72 (SD 10.82) years. There were statistically significant differences for disc area (DA), area cup-to-disc, vertical cup-to-disc, and cup volume (P=0.02, 0.004, 0.02, and 0.03, respectively), greater in Chinese. After adjusting for age, sex, axial length (AL), intraocular pressure (IOP), DA, and GCC thickness, Chinese subjects had significantly greater thickness in all pRNFL parameters (mean differences ranged between 4.29 and 9.93 μm; all P<0.001) except the nasal quadrant. GCC outcomes were also adjusted for DA and pRNFL; Caucasians had significantly higher average GCC and inferior GCC (mean difference 2.97 and 3.45 μm, respectively; P<0.01), whereas the Chinese group had significantly higher ganglion cell global loss volume (mean difference 2.47 %, P<0.001). This study suggests there is significantly greater pRNFL thickness in Chinese, which were independent of age, AL, IOP, and DA, and possibly greater GCC in Caucasians after adjustment for age, AL, IOP, DA, and pRNFL thickness.

  15. 21 CFR 892.1920 - Radiographic head holder.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic head holder. 892.1920 Section 892.1920 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1920 Radiographic head holder. (a...

  16. Prospective, randomized study of one, two, or three trabecular bypass stents in open-angle glaucoma subjects on topical hypotensive medication

    PubMed Central

    Katz, L Jay; Erb, Carl; Carceller, Guillamet Amadeu; Fea, Antonio M; Voskanyan, Lilit; Wells, Jeffrey M; Giamporcaro, Jane Ellen

    2015-01-01

    Purpose To assess the safety and efficacy of one, two, or three trabecular microbypass stents in eyes with primary open-angle glaucoma (OAG) not controlled on ocular hypotensive medication. A total of 119 subjects were followed for 18 months postoperatively. Materials and methods Subjects with medicated intraocular pressure (IOP) 18–30 mmHg and postmedication-washout baseline IOP 22–38 mmHg were randomized to implantation of one, two, or three stents. Ocular hypotensive medication was to be used if postoperative IOP exceeded 18 mmHg. Results A total of 38 subjects were implanted with one stent, 41 subjects with two stents, and 40 subjects with three stents. Both month 12 IOP reduction ≥20% without ocular hypotensive medication vs baseline unmedicated IOP and month 12 unmedicated IOP ≤18 mmHg were achieved by 89.2%, 90.2%, and 92.1% of one-, two-, and three-stent eyes, respectively. Furthermore, 64.9%, 85.4%, and 92.1% of the three respective groups achieved unmedicated IOP ≤15 mmHg. Over the 18-month follow-up period, medication was required in seven one-stent subjects, four two-stent subjects, and three three-stent subjects. At 18 months, mean unmedicated IOP was 15.9±0.9 mmHg in one-stent subjects, 14.1±1.0 mmHg in two-stent subjects, and 12.2±1.1 mmHg in three-stent subjects. Month 18 IOP reduction was significantly greater (P<0.001) with implantation of each additional stent, with mean differences in reduction of 1.84 mmHg (95% confidence interval 0.96–2.73) for three-stent vs two-stent groups and 1.73 mmHg (95% confidence interval 0.83–2.64) for two-stent vs one-stent groups. Adverse events through 18 months were limited to cataract progression with best-corrected visual acuity loss and subsequent cataract surgery. Conclusion In this series, implantation of each additional stent resulted in significantly greater IOP reduction with reduced medication use. Titratability of stents as a sole procedure was shown to be effective and safe, with

  17. Topiramate Responsive Exploding Head Syndrome

    PubMed Central

    Palikh, Gaurang M.; Vaughn, Bradley V.

    2010-01-01

    Exploding head syndrome is a rare phenomenon but can be a significant disruption to quality of life. We describe a 39-year-old female with symptoms of a loud bang and buzz at sleep onset for 3 years. EEG monitoring confirmed these events occurred in transition from stage 1 sleep. This patient reported improvement in intensity of events with topiramate medication. Based on these results, topiramate may be an alternative method to reduce the intensity of events in exploding head syndrome. Citation: Palikh GM; Vaughn BV. Topiramate responsive exploding head syndrome. J Clin Sleep Med 2010;6(4):382-383. PMID:20726288

  18. Catastrophic Head Injuries in High School and Collegiate Sports

    PubMed Central

    2001-01-01

    Objective: To describe the incidence of catastrophic head injuries in a variety of high school and college sports. Design and Setting: Data on catastrophic head injuries were compiled in a national surveillance system maintained by the National Center for Catastrophic Sports Injury Research. The data were compiled with the assistance of coaches, athletic trainers, athletic directors, executive officers of state and national athletic organizations, a national newspaper clipping service, professional associates of the researchers, and national sport organizations. Subjects: Data included all high school and college athletic programs in the United States. Measurements: Background information on the athlete (age, height, weight, experience, previous injury, etc), accident information, immediate and postaccident medical care, type of injury, and equipment involved. Autopsy reports were used when available. Results: A football-related fatality has occurred every year from 1945 through 1999, except for 1990. Head-related deaths accounted for 69% of football fatalities, cervical spinal injuries for 16.3%, and other injuries for 14.7%. High school football produced the greatest number of football head-related deaths. From 1984 through 1999, 69 football head-related injuries resulted in permanent disability. Sixty-three of the injuries were associated with high school football and 6 with college football. Although football has received the most attention, other sports have also been associated with head-related deaths and permanent disability injuries. From 1982 through 1999, 20 deaths and 19 permanent disability injuries occurred in a variety of sports. Track and field, baseball, and cheerleading had the highest incidence of these catastrophic injuries. Three deaths and 3 injuries resulting in permanent disability have occurred in female participants. Conclusions/Recommendations: Reliable data collection systems and continual analysis of the data can help us to reduce the

  19. Oral ivermectin for the treatment of head lice infestation.

    PubMed

    Sanchezruiz, Wendy L; Nuzum, Donald S; Kouzi, Samir A

    2018-05-22

    Published literature describing the use of oral ivermectin for the treatment of head lice infestation is reviewed. In the United States and globally, head lice infestation, or pediculosis capitis, remains a public health issue with both social and medical implications. Treatment with oral or topical medications is typically required for head lice eradication. Resistance to traditional topical therapies for head lice infestation is increasing, creating a need for consideration of additional treatment options. A growing body of data describing the potential role of oral ivermectin for the treatment or prevention of head lice infestation is available. A literature search identified 5 clinical trials that evaluated safety and/or effectiveness outcomes of oral ivermectin use as an alternative to malathion, other topical prescription medications, and traditional, nonprescription remedies; those studies were conducted in various parts of the world (e.g., Australia, Brazil, Mexico, Egypt) and likely involved varying types and degrees of lice resistance. Clinical research findings to date, while not consistently robust, suggest that oral ivermectin is comparable or superior in effectiveness to other topical treatment options for head lice infestation while being well tolerated and favorably perceived by patients and caretakers. Oral ivermectin is an option for the treatment of head lice infestation, especially in individuals who have experienced a treatment failure. Published evidence from clinical trials indicates that oral ivermectin is as effective as currently available topical treatments. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  20. Head Start.

    ERIC Educational Resources Information Center

    Greenman, Geri

    2000-01-01

    Discusses an art project in which students created drawings of mop heads. Explains that the approach of drawing was more important than the subject. States that the students used the chiaroscuro technique, used by Rembrandt and Caravaggio, in which light appears out of the darkness. (CMK)

  1. Heading assessment by “tunnel vision” patients and control subjects standing or walking in a virtual reality environment

    PubMed Central

    APFELBAUM, HENRY; PELAH, ADAR; PELI, ELI

    2007-01-01

    Virtual reality locomotion simulators are a promising tool for evaluating the effectiveness of vision aids to mobility for people with low vision. This study examined two factors to gain insight into the verisimilitude requirements of the test environment: the effects of treadmill walking and the suitability of using controls as surrogate patients. Ten “tunnel vision” patients with retinitis pigmentosa (RP) were tasked with identifying which side of a clearly visible obstacle their heading through the virtual environment would lead them, and were scored both on accuracy and on their distance from the obstacle when they responded. They were tested both while walking on a treadmill and while standing, as they viewed a scene representing progress through a shopping mall. Control subjects, each wearing a head-mounted field restriction to simulate the vision of a paired patient, were also tested. At wide angles of approach, controls and patients performed with a comparably high degree of accuracy, and made their choices at comparable distances from the obstacle. At narrow angles of approach, patients’ accuracy increased when walking, while controls’ accuracy decreased. When walking, both patients and controls delayed their decisions until closer to the obstacle. We conclude that a head-mounted field restriction is not sufficient for simulating tunnel vision, but that the improved performance observed for walking compared to standing suggests that a walking interface (such as a treadmill) may be essential for eliciting natural perceptually-guided behavior in virtual reality locomotion simulators. PMID:18167511

  2. Dietary amino acid intakes associated with a low-phenylalanine diet combined with amino acid medical foods and glycomacropeptide medical foods and neuropsychological outcomes in subjects with phenylketonuria.

    PubMed

    Stroup, Bridget M; Murali, Sangita G; Nair, Nivedita; Sawin, Emily A; Rohr, Fran; Levy, Harvey L; Ney, Denise M

    2017-08-01

    This article provides original data on median dietary intake of 18 amino acids from amino acid medical foods, glycomacropeptide medical foods, and natural foods based on 3-day food records obtained from subjects with phenylketonuria who consumed low-phenylalanine diets in combination with amino acid medical foods and glycomacropeptide medical foods for 3 weeks each in a crossover design. The sample size of 30 subjects included 20 subjects with classical phenylketonuria and 10 with a milder or variant form of phenylketonuria. Results are presented for the Delis-Kaplan Executive Function System and the Cambridge Neuropsychological Test Automated Battery; the tests were administered at the end of each 3-week dietary treatment with amino acid medical foods and glycomacropeptide medical foods. The data are supplemental to our clinical trial, entitled "Glycomacropetide for nutritional management of phenylketonuria: a randomized, controlled, crossover trial, 2016 (1) and "Metabolomic changes demonstrate reduced bioavailability of tyrosine and altered metabolism of tryptophan via the kynurenine pathway with ingestion of medical foods in phenylketonuria, 2017 (2). This data has been made public and has utility to clinicians and researchers due to the following: 1) This provides the first comprehensive report of typical intakes of 18 amino acids from natural foods, as well as amino acid and glycomacropeptide medical foods in adolescents and adults with phenylketonuria; and 2) This is the first evidence of similar standardized neuropsychological testing data in adolescents and adults with early-treated phenylketonuria who consumed amino acid and glycomacropeptide medical foods.

  3. Coherent Raman Scattering Microscopy for Evaluation of Head and Neck Carcinoma.

    PubMed

    Hoesli, Rebecca C; Orringer, Daniel A; McHugh, Jonathan B; Spector, Matthew E

    2017-09-01

    Objective We aim to describe a novel, label-free, real-time imaging technique, coherent Raman scattering (CRS) microscopy, for histopathological evaluation of head and neck cancer. We evaluated the ability of CRS microscopy to delineate between tumor and nonneoplastic tissue in tissue samples from patients with head and neck cancer. Study Design Prospective case series. Setting Tertiary care medical center. Subjects and Methods Patients eligible were surgical candidates with biopsy-proven, previously untreated head and neck carcinoma and were consented preoperatively for participation in this study. Tissue was collected from 50 patients, and after confirmation of tumor and normal specimens by hematoxylin and eosin (H&E), there were 42 tumor samples and 42 normal adjacent controls. Results There were 42 confirmed carcinoma specimens on H&E, and CRS microscopy identified 37 as carcinoma. Of the 42 normal specimens, CRS microscopy identified 40 as normal. This resulted in a sensitivity of 88.1% and specificity of 95.2% in distinguishing between neoplastic and nonneoplastic images. Conclusion CRS microscopy is a unique label-free imaging technique that can provide rapid, high-resolution images and can accurately determine the presence of head and neck carcinoma. This holds potential for implementation into standard practice, allowing frozen margin evaluation even at institutions without a histopathology laboratory.

  4. Pretreatment dietary patterns, weight status, and head and neck squamous cell carcinoma prognosis123

    PubMed Central

    Arthur, Anna E; Peterson, Karen E; Rozek, Laura S; Taylor, Jeremy MG; Light, Emily; Chepeha, Douglas B; Hébert, James R; Terrell, Jeffrey E; Wolf, Gregory T

    2013-01-01

    Background: Few studies have evaluated the association of diet and weight status with head and neck cancer outcomes. Objective: The purpose of this study was to determine whether pretreatment dietary patterns and weight status are associated with head and neck cancer prognosis. Design: This was a longitudinal study of 542 patients with newly diagnosed head and neck cancer who completed food-frequency questionnaires and health surveys before treatment. Clinical data were abstracted from medical records and the Social Security Death Index. Dietary patterns were identified by using principal component analysis. Cox proportional hazard models were used to examine the association of derived dietary patterns (fit by quintiles of exposure) and weight status with time to recurrence and survival, with control for covariates. Results: During the study period, there were 229 deaths and 184 recurrences. Two dietary patterns were identified: a whole-foods pattern (characterized by high intakes of vegetables, fruit, fish, poultry, and whole grains) and a Western pattern (characterized by high intakes of red and processed meats, refined grains, potatoes, and French fries). In multivariable analyses, significantly fewer deaths were observed in subjects most adherent to the whole-foods pattern (HR: 0.56; 95% CI: 0.34, 0.92; P-trend = 0.01). Subjects classified as overweight or obese had significantly fewer deaths (HR: 0.65; 95% CI: 0.49, 0.85; P = 0.001) and recurrences (HR: 0.70; 95% CI: 0.52, 0.95; P = 0.02) than did normal-weight or underweight subjects. Conclusion: Consumption of a diet rich in vegetables, fruit, fish, poultry, and whole grains and being overweight before diagnosis with head and neck cancer are associated with a better prognosis. PMID:23269814

  5. Countermanding eye-head gaze shifts in humans: marching orders are delivered to the head first.

    PubMed

    Corneil, Brian D; Elsley, James K

    2005-07-01

    The countermanding task requires subjects to cancel a planned movement on appearance of a stop signal, providing insights into response generation and suppression. Here, we studied human eye-head gaze shifts in a countermanding task with targets located beyond the horizontal oculomotor range. Consistent with head-restrained saccadic countermanding studies, the proportion of gaze shifts on stop trials increased the longer the stop signal was delayed after target presentation, and gaze shift stop-signal reaction times (SSRTs: a derived statistic measuring how long it takes to cancel a movement) averaged approximately 120 ms across seven subjects. We also observed a marked proportion of trials (13% of all stop trials) during which gaze remained stable but the head moved toward the target. Such head movements were more common at intermediate stop signal delays. We never observed the converse sequence wherein gaze moved while the head remained stable. SSRTs for head movements averaged approximately 190 ms or approximately 70-75 ms longer than gaze SSRTs. Although our findings are inconsistent with a single race to threshold as proposed for controlling saccadic eye movements, movement parameters on stop trials attested to interactions consistent with a race model architecture. To explain our data, we tested two extensions to the saccadic race model. The first assumed that gaze shifts and head movements are controlled by parallel but independent races. The second model assumed that gaze shifts and head movements are controlled by a single race, preceded by terminal ballistic intervals not under inhibitory control, and that the head-movement branch is activated at a lower threshold. Although simulations of both models produced acceptable fits to the empirical data, we favor the second alternative as it is more parsimonious with recent findings in the oculomotor system. Using the second model, estimates for gaze and head ballistic intervals were approximately 25 and 90 ms

  6. Subject, function, and trend in medical ethics research: a comparative study of Chinese and non-Chinese literature using bibliometrics.

    PubMed

    Jiang, Lanhui; Shen, Jiantong; Li, Youping; Deng, Shaolin; Wu, Taixiang; Chen, Baoqing; Xie, Zhiyi; Qin, Chaoyi; Yu, Zhiyuan; Qin, Chuan; Huang, Jin; Liu, Xuemei; Li, Yan; Jiang, Jie

    2012-05-01

    To perform a comparative quantitative and qualitative analysis of Chinese and non-Chinese medical ethics literature using systematic research and literature analysis in order to discern research trends in the area and provide baseline data as a reference for relevant decision making and further study. We retrieved articles using MeSH terms and keywords related to medical ethics in PubMed and CNKI, and then constructed a set of charts by applying word co-occurrence, The Pathfinder Networks algorithms, an included subject chart, a research field relationship chart, and strategy coordination charts. The total of number of papers retrieved from PubMed was six times that retrieved from CNKI. Outside China, medical ethics has been studied in eight fully shaped subject fields, including morals, ethical review, physician-patient relationships, clinical trials, euthanasia, ethics education, clinical ethics, and health policy. In contrast, medical ethics research in China is still confined to five subject fields: morals, physician-patient relations, medical ethics education, ethical review, and medical research. Medical ethics research outside China emphasizes the application of medical ethics to solve emerging problems in clinical and medical research. It is mainly centered on morals, ethical review, and physician-patient relations. By comparison, medical ethics research in China places greater emphasis on morals and medical education. In order to narrow this gap between China and other countries, we should broaden the research scope of medical ethics and add more applied research, such as ethical review and medical education. © 2012 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

  7. Use of an electronic medical record for the identification of research subjects with diabetes mellitus.

    PubMed

    Wilke, Russell A; Berg, Richard L; Peissig, Peggy; Kitchner, Terrie; Sijercic, Bozana; McCarty, Catherine A; McCarty, Daniel J

    2007-03-01

    Diabetes mellitus is a rapidly increasing and costly public health problem. Large studies are needed to understand the complex gene-environment interactions that lead to diabetes and its complications. The Marshfield Clinic Personalized Medicine Research Project (PMRP) represents one of the largest population-based DNA biobanks in the United States. As part of an effort to begin phenotyping common diseases within the PMRP, we now report on the construction of a diabetes case-finding algorithm using electronic medical record data from adult subjects aged > or =50 years living in one of the target PMRP ZIP codes. Based upon diabetic diagnostic codes alone, we observed a false positive case rate ranging from 3.0% (in subjects with the highest glycosylated hemoglobin values) to 44.4% (in subjects with the lowest glycosylated hemoglobin values). We therefore developed an improved case finding algorithm that utilizes diabetic diagnostic codes in combination with clinical laboratory data and medication history. This algorithm yielded an estimated prevalence of 24.2% for diabetes mellitus in adult subjects aged > or =50 years.

  8. Analysis of the status of informed consent in medical research involving human subjects in public hospitals in Shanghai.

    PubMed

    Jianping, Wang; Li, Lan; Xue, Di; Tang, Zhongjin; Jia, Xieyang; Wu, Rong; Xi, Yiqun; Wang, Tong; Zhou, Ping

    2010-07-01

    The objectives of the study are to understand the current practice of informed consent in medical research in public hospitals in Shanghai, and to share our views with other countries, especially developing countries. In the study, 145 consent forms (CFs) of the selected research projects in eight public hospitals with ethics committees in Shanghai were audited, and the principle investigators (PIs) of these research projects and 40 student subjects who had participated in clinical drug tests were surveyed by questionnaires. The CFs of medical researches in public hospitals with ethics committees in Shanghai were generally acceptable. However, there were some defects in the CFs. Although most of the surveyed PIs had correct recognition of informed consent, some processes of informed consent were not in accordance with generally accepted requirements. A large number of the PIs considered the greatest difficulty with informal consent was lack of correct recognition of subjects or legally authorised representatives on medical research. Informed consent in medical research should consider the research ethics, the background of potential subjects, the local resources and culture of medical research. In addition, special protection is needed for student subjects in informed consent as well as efforts for building and restoring the public's trust in biomedical research. The informed consent in Shanghai's public hospitals with ethics committees was generally acceptable and the achievement of adequate informed consent is influenced by many factors.

  9. [Biometric method for the description of the head of an unrecognized corpse for the purpose of personality individualization and identification].

    PubMed

    Zviagin, V N; Galitskaia, O I; Negasheva, M A

    2012-01-01

    We have determined absolute dimensions of the head and the relationship between the dimensions of its selected parts. The study enrolled adult subjects (mostly of Russian ethnicity) at the age from 17 to 22 years (1108 men and 1153 women). We calculated the normal values for the estimation of real dimensional characteristics and the frequency of their occurrence in the population. The proposed approach makes it possible to reliably identify the dimensional features of human appearance in terms of the quantitative verbal description (categories 1-5) and to reveal its most characteristic features. The results of this biometric study of the heads of unrecognized corpses obtained by the specially developed technology may be used in operational and search investigations, in the procedure of corpse identification, and forensic medical personality identification of a missing subject.

  10. Eye lens radiation exposure and repeated head CT scans: A problem to keep in mind.

    PubMed

    Michel, Morgane; Jacob, Sophie; Roger, Gilles; Pelosse, Béatrice; Laurier, Dominique; Le Pointe, Hubert Ducou; Bernier, Marie-Odile

    2012-08-01

    The deterministic character of radiation-induced cataract is being called into question, raising the possibility of a risk in patients, especially children, exposed to ionizing radiation in case of repeated head CT-scans. This study aims to estimate the eye lens doses of a pediatric population exposed to repeated head CTs and to assess the feasibility of an epidemiological study. Children treated for a cholesteatoma, who had had at least one CT-scan of the middle ear before their tenth birthday, were included. Radiation exposure has been assessed from medical records and telephone interviews. Out of the 39 subjects contacted, 32 accepted to participate. A total of 76 CT-scans were retrieved from medical records. At the time of the interview (mean age: 16 years), the mean number of CT per child was 3. Cumulative mean effective and eye lens doses were 1.7mSv and 168mGy, respectively. A relatively high lens radiation dose was observed in children exposed to repeated CT-scans. Due to that exposure and despite the difficulties met when trying to reach patients' families, a large scale epidemiological study should be performed in order to assess the risk of radiation-induced cataracts associated with repeated head CT. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. Reduced head steadiness in whiplash compared with non-traumatic neck pain.

    PubMed

    Woodhouse, Astrid; Liljebäck, Pål; Vasseljen, Ottar

    2010-01-01

    While sensorimotor alterations have been observed in patients with neck pain, it is uncertain whether such changes distinguish whiplash-associated disorders from chronic neck pain without trauma. The aim of this study was to investigate head steadiness during isometric neck flexion in subjects with chronic whiplash-associated disorders (WAD), those with chronic non-traumatic neck pain and healthy subjects. Associations with fatigue and effects of pain and dizziness were also investigated. Head steadiness in terms of head motion velocity was compared in subjects with whiplash (n=59), non-traumatic neck pain (n=57) and healthy controls (n=57) during 2 40-s isometric neck flexion tests; a high load test and a low load test. Increased velocity was expected to reflect decreased head steadiness. The whiplash group showed significantly decreased head steadiness in the low load task compared with the other 2 groups. The difference was explained largely by severe levels of neck pain and dizziness. No group differences in head steadiness were found in the high load task. Reduced head steadiness during an isometric holding test was observed in a group of patients with whiplash-associated disorders. Decreased head steadiness was related to severe pain and dizziness.

  12. Differences in Pre and Post Vascular Patterning Within Retinas from ISS Crew Members and Head-Down Tilt (HDT) Subjects by VESGEN Analysis

    NASA Technical Reports Server (NTRS)

    Murray, M. C.; Vizzeri, G.; Taibbi, G.; Mason, S. S.; Young, M.; Zanello, S. B.; Parsons-Wingerter, P.

    2018-01-01

    Accelerated research by NASA has investigated the significant risks incurred during long-duration missions in microgravity for Space Flight-Associated Neuro-ocular Syndrome (SANS, formerly known as Visual Impairments associated with Increased Intracranial Pressure, VIIP) [1]. For our study, NASA's VESsel GENeration Analysis (VESGEN) was used to investigate the role of retinal blood vessels in the etiology of SANS/VIIP. The response of retinal vessels to microgravity was evaluated in astronaut crew members pre and post flight to the International Space Station (ISS), and compared to the response of retinal vessels in healthy volunteers to 6deg head-down tilt during 70 days of bed rest (HDTBR). For the study, we are testing the hypothesis that long-term cephalad fluid shifts resulting in ocular and visual impairments are necessarily mediated in part by retinal blood vessels, and therefore are accompanied by structural adaptations of the vessels. METHODS: Vascular patterns in the retinas of crew members and HDTBR subjects extracted from 30deg infrared (IR) Heidelberg Spectralis images collected pre/postflight and pre/post HDTBR, respectively, were analyzed by VESGEN (patent pending). VESGEN is a mature, automated software developed as a research discovery tool for progressive vascular diseases in the retina and other tissues. The multi-parametric VESGEN analysis generates maps of branching arterial and venous trees quantified by parameters such as the fractal dimension (Df, a modern measure of vascular space-filling capacity), vessel diameters, and densities of vessel length and number classified into specific branching generations according to vascular physiological branching rules. The retrospective study approved by NASA's Institutional Review Board included the analysis of bilateral retinas in eight ISS crew members monitored by routine occupational surveillance and six HDTBR subjects (NASA FARU Campaign 11, for example). The VESGEN analysis was conducted in a

  13. Vestibular-somatosensory convergence in head movement control during locomotion after long-duration space flight.

    PubMed

    Mulavara, A P; Ruttley, T; Cohen, H S; Peters, B T; Miller, C; Brady, R; Merkle, L; Bloomberg, J J

    2012-01-01

    Space flight causes astronauts to be exposed to adaptation in both the vestibular and body load-sensing somatosensory systems. The goal of these studies was to examine the contributions of vestibular and body load-sensing somatosensory influences on vestibular mediated head movement control during locomotion after long-duration space flight. Subjects walked on a motor driven treadmill while performing a gaze stabilization task. Data were collected from three independent subject groups that included bilateral labyrinthine deficient (LD) patients, normal subjects before and after 30 minutes of 40% bodyweight unloaded treadmill walking, and astronauts before and after long-duration space flight. Motion data from the head and trunk segments were used to calculate the amplitude of angular head pitch and trunk vertical translation movement while subjects performed a gaze stabilization task, to estimate the contributions of vestibular reflexive mechanisms in head pitch movements. Exposure to unloaded locomotion caused a significant increase in head pitch movements in normal subjects, whereas the head pitch movements of LD patients were significantly decreased. This is the first evidence of adaptation of vestibular mediated head movement responses to unloaded treadmill walking. Astronaut subjects showed a heterogeneous response of both increases and decreases in the amplitude of head pitch movement. We infer that body load-sensing somatosensory input centrally modulates vestibular input and can adaptively modify vestibularly mediated head-movement control during locomotion. Thus, space flight may cause central adaptation of the converging vestibular and body load-sensing somatosensory systems leading to alterations in head movement control.

  14. Sir William Burnett (1779-1861), professional head of the Royal Naval Medical Department and entrepreneur.

    PubMed

    Penn, Christopher

    2004-08-01

    Sir William Burnett (1779-1861) had an active career as a Royal Navy surgeon in the French Revolutionary and Napoleonic Wars, including service at the battles of St Vincent, the Nile and Trafalgar. From 1822 to 1855 he was professional head of the Royal Naval Medical Department, when he provided effective leadership in a time of great change. Although his official work earned him the reputation of a "hard-working, unimaginative, somewhat harsh man", his correspondence shows a very humane centre under the official carapace. His official performance and reputation were both eroded towards the end of his career by his determined promotion of zinc chloride, for which he held lucrative patents.

  15. National Head Start Bulletin, 1993-1995.

    ERIC Educational Resources Information Center

    National Head Start Bulletin, 1995

    1995-01-01

    This document consists of the 15 issues of the "National Head Start Bulletin" published during the three-year period 1993-1995. The bulletin is devoted to subjects of concern to Head Start teachers and administrators; each issue focuses on one topic. A main article and several smaller articles discuss various aspects of the topic for…

  16. Effect of external viscous load on head movement

    NASA Technical Reports Server (NTRS)

    Nam, M.-H.; Lakshminarayanan, V.; Stark, L. W.

    1984-01-01

    Quantitative measurements of horizontal head rotation were obtained from normal human subjects intending to make 'time optimal' trajectories between targets. By mounting large, lightweight vanes on the head, viscous damping B, up to 15 times normal could be added to the usual mechanical load of the head. With the added viscosity, the head trajectory was slowed and of larger duration (as expected) since fixed and maximal (for that amplitude) muscle forces had to accelerate the added viscous load. This decreased acceleration and velocity and longer duration movement still ensued in spite of adaptive compensation; this provided evidence that quasi-'time optimal' movements do indeed employ maximal muscle forces. The adaptation to this added load was rapid. Then the 'adapted state' subjects produced changed trajectories. The adaptation depended in part on the differing detailed instructions given to the subjects. This differential adaptation provided evidence for the existence of preprogrammed controller signals, sensitive to intended criterion, and neurologically ballistic or open loop rather than modified by feedback from proprioceptors or vision.

  17. Effects of 30-Day Head-Down Bed Rest on Ocular Structures and Visual Function in a Healthy Subject

    PubMed Central

    Taibbi, Giovanni; Kaplowitz, Kevin; Cromwell, Ronita L.; Godley, Bernard F.; Zanello, Susana B.; Vizzeri, Gianmarco

    2013-01-01

    Introduction We report ocular changes occurring in a healthy human subject enrolled in a bed rest (BR) study designed to replicate the effects of a low-gravity environment. Case report A 25-year-old Caucasian male spent 30 consecutive days in a 6° head-down-tilt position at the NASA Flight Analogs Research Unit. Comprehensive ophthalmologic exams, optic disc stereo-photography, Standard Automated Perimetry (SAP) and optic disc Spectralis OCT scans were performed at baseline, immediately post-BR (BR+0) and 6 months post-BR. Main outcome measures: changes in best-corrected visual acuity, intraocular pressure (IOP), cycloplegic refraction, SAP and Spectralis OCT measures. At BR+0 IOP was 11 and 10 mmHg in the right (OD) and left eye (OS), respectively (a bilateral 4 mmHg decrease compared to baseline); SAP documented a possible bilateral symmetrical inferior scotoma; Spectralis OCT showed an average 19.4 μm (+5.2%) increase in peripapillary retinal thickness, and an average 0.03 mm3 (+5.0%) increase in peripapillary retinal volume bilaterally. However, there were no clinically detectable signs of optic disc edema. 6 months post-BR, IOP was 13 and 14 mmHg in OD and OS, respectively, and the scotoma had resolved. Spectralis OCT measurements matched the ones recorded at baseline. Discussion In this subject, a reduction in IOP associated with subtle structural and functional changes compared to baseline were documented after prolonged head-down BR. These changes may be related to cephalad fluid shifts in response to tilt. Further studies should clarify whether decreased translaminar pressure (i.e., the difference between IOP and intracranial pressure) may be responsible for these findings. PMID:23447853

  18. [Head injuries in the Bible].

    PubMed

    Feinsod, M

    1995-12-15

    3 cases of head injury are described in the Bible: the death of Sisera by the hand of Jael (Judges 4: 21; 5: 25); the skull fractures of Avimelech incurred at the tower of Tevetz, (Judges, 9: 53, 54); and the slaying of Goliath by David, (Samuel I 17: 49-51). The various attempts to understand the mechanisms of these head injuries using philology, knowledge of the art of biblical warfare and modern medical considerations are reviewed. We try to identify the site of the mortal blow to Sisera's head, to understand why Avimelech asked to be killed, and to decide whether the giant from Gath was a rugged warrior or just an endocrinological cripple.

  19. Topiramate responsive exploding head syndrome.

    PubMed

    Palikh, Gaurang M; Vaughn, Bradley V

    2010-08-15

    Exploding head syndrome is a rare phenomenon but can be a significant disruption to quality of life. We describe a 39-year-old female with symptoms of a loud bang and buzz at sleep onset for 3 years. EEG monitoring confirmed these events occurred in transition from stage 1 sleep. This patient reported improvement in intensity of events with topiramate medication. Based on these results, topiramate may be an alternative method to reduce the intensity of events in exploding head syndrome.

  20. Embodiment and Entangled Subjectivity: A Study of Robin Cook's Coma, Priscille Sibley's The Promise of Stardust and Alexander Beliaev's Professor Dowell's Head.

    PubMed

    Karmakar, Manali; Parui, Avishek

    2018-03-22

    The essay examines Robin Cook's (1977) Coma and Priscille Sibley's (2013) The Promise of Stardust that dramatize the reified and disposable status of the brain-dead patients who are classified as nonpersons. The essay argues that the man-machine entanglement as depicted in the novels constructs a deterritorialized and entangled form of subjectivity that intervenes in the dominant biomedical understanding of personhood and agency that we notionally associate with a conscious mind. The essay concludes its arguments by discussing Alexander Beliaev's (1925) Professor Dowell's Head which depicts human subjectivity as an essentially embodied and distributive phenomenon and interrogates the Cartesian mind body dualism embedded in the dominant biomedical narratives.

  1. Vacuum compatible miniature CCD camera head

    DOEpatents

    Conder, Alan D.

    2000-01-01

    A charge-coupled device (CCD) camera head which can replace film for digital imaging of visible light, ultraviolet radiation, and soft to penetrating x-rays, such as within a target chamber where laser produced plasmas are studied. The camera head is small, capable of operating both in and out of a vacuum environment, and is versatile. The CCD camera head uses PC boards with an internal heat sink connected to the chassis for heat dissipation, which allows for close(0.04" for example) stacking of the PC boards. Integration of this CCD camera head into existing instrumentation provides a substantial enhancement of diagnostic capabilities for studying high energy density plasmas, for a variety of military industrial, and medical imaging applications.

  2. Portable Wideband Microwave Imaging System for Intracranial Hemorrhage Detection Using Improved Back-projection Algorithm with Model of Effective Head Permittivity

    PubMed Central

    Mobashsher, Ahmed Toaha; Mahmoud, A.; Abbosh, A. M.

    2016-01-01

    Intracranial hemorrhage is a medical emergency that requires rapid detection and medication to restrict any brain damage to minimal. Here, an effective wideband microwave head imaging system for on-the-spot detection of intracranial hemorrhage is presented. The operation of the system relies on the dielectric contrast between healthy brain tissues and a hemorrhage that causes a strong microwave scattering. The system uses a compact sensing antenna, which has an ultra-wideband operation with directional radiation, and a portable, compact microwave transceiver for signal transmission and data acquisition. The collected data is processed to create a clear image of the brain using an improved back projection algorithm, which is based on a novel effective head permittivity model. The system is verified in realistic simulation and experimental environments using anatomically and electrically realistic human head phantoms. Quantitative and qualitative comparisons between the images from the proposed and existing algorithms demonstrate significant improvements in detection and localization accuracy. The radiation and thermal safety of the system are examined and verified. Initial human tests are conducted on healthy subjects with different head sizes. The reconstructed images are statistically analyzed and absence of false positive results indicate the efficacy of the proposed system in future preclinical trials. PMID:26842761

  3. Portable Wideband Microwave Imaging System for Intracranial Hemorrhage Detection Using Improved Back-projection Algorithm with Model of Effective Head Permittivity

    NASA Astrophysics Data System (ADS)

    Mobashsher, Ahmed Toaha; Mahmoud, A.; Abbosh, A. M.

    2016-02-01

    Intracranial hemorrhage is a medical emergency that requires rapid detection and medication to restrict any brain damage to minimal. Here, an effective wideband microwave head imaging system for on-the-spot detection of intracranial hemorrhage is presented. The operation of the system relies on the dielectric contrast between healthy brain tissues and a hemorrhage that causes a strong microwave scattering. The system uses a compact sensing antenna, which has an ultra-wideband operation with directional radiation, and a portable, compact microwave transceiver for signal transmission and data acquisition. The collected data is processed to create a clear image of the brain using an improved back projection algorithm, which is based on a novel effective head permittivity model. The system is verified in realistic simulation and experimental environments using anatomically and electrically realistic human head phantoms. Quantitative and qualitative comparisons between the images from the proposed and existing algorithms demonstrate significant improvements in detection and localization accuracy. The radiation and thermal safety of the system are examined and verified. Initial human tests are conducted on healthy subjects with different head sizes. The reconstructed images are statistically analyzed and absence of false positive results indicate the efficacy of the proposed system in future preclinical trials.

  4. Assessment of musculoskeletal impairment in head and neck cancer patients.

    PubMed

    Ghiam, Michael K; Mannion, Kyle; Dietrich, Mary S; Stevens, Kristen L; Gilbert, Jill; Murphy, Barbara A

    2017-07-01

    This study aims to describe the types of musculoskeletal impairment in head and neck cancer survivors and to evaluate objective and subjective measures of musculoskeletal impairment and identify areas of need in future studies. This is a cross-sectional pilot study of 29 head and neck cancer patients who were treated with resection and reconstruction. Subjective measures of musculoskeletal impairment (Neck Disability Index, Shoulder Pain and Disability Index, Vanderbilt Head and Neck Symptom Survey, General Symptom Survey) were collected and compared to objective measures (Cervical Range of Motion Device, Inter-incisal Distance). Digital photography was used to assess the severity of postural abnormalities. Findings were summarized using descriptive statistical and graphical methods. The majority of patients in this cohort suffered from neck disability (69%). Thirty-five percent of patients had shoulder pain and disability. Cervical range of motion deficits were observed in all directions. Inter-incisal distance averaged 33.4 mm and inversely correlated with self-reported jaw and trismus symptoms. Digital photography identified shoulder misalignment in 93% of subjects, head tilt in 89% of subjects, and postural deviation in 68% of subjects. Musculoskeletal impairment is a significant side effect in head and neck cancer survivors that results in chronic neck pain, shoulder disability, trismus, and postural deficits. Tools to describe postural deficits are needed.

  5. Grading Medical Students in a Psychiatry Clerkship: Correlation with the NBME Subject Examination Scores and Its Implications

    ERIC Educational Resources Information Center

    Ramchandani, Dilip

    2011-01-01

    Background/Objective: The author analyzed and compared various assessment methods for assessment of medical students; these methods included clinical assessment and the standardized National Board of Medical Education (NBME) subject examination. Method: Students were evaluated on their 6-week clerkship in psychiatry by both their clinical…

  6. Sensorimotor aspects of high-speed artificial gravity: II. The effect of head position on illusory self motion

    NASA Technical Reports Server (NTRS)

    Mast, F. W.; Newby, N. J.; Young, L. R.

    2002-01-01

    The effects of cross-coupled stimuli on the semicircular canals are shown to be influenced by the position of the subject's head with respect to gravity and the axis of rotation, but not by the subject's head position relative to the trunk. Seventeen healthy subjects made head yaw movements out of the horizontal plane while lying on a horizontal platform (MIT short radius centrifuge) rotating at 23 rpm about an earth-vertical axis. The subjects reported the magnitude and duration of the illusory pitch or roll sensations elicited by the cross-coupled rotational stimuli acting on the semicircular canals. The results suggest an influence of head position relative to gravity. The magnitude estimation is higher and the sensation decays more slowly when the head's final position is toward nose-up (gravity in the subject's head x-z-plane) compared to when the head is turned toward the side (gravity in the subject's head y-z-plane). The results are discussed with respect to artificial gravity in space and the possible role of pre-adaptation to cross-coupled angular accelerations on earth.

  7. Mandibular deviations in TMD and non-TMD groups related to eye dominance and head posture.

    PubMed

    Pradham, N S; White, G E; Mehta, N; Forgione, A

    2001-01-01

    This study was designed to determine whether eye-dominance affects head posture (rotation) and in turn, whether head posture is associated with mandibular frenum midline deviation, in both TMJ and control subjects. Eye dominance was determined using three tests: Porta, Hole, Point tests. Natural head posture was evaluated using the Arthrodial protractor. Mandibular frenum deviation was recorded as left, right or no deviation. Fifty female subjects were included in the study, 25 TMJ patients attending the Gelb Craniomandibular Pain Center and 25 non-TMJ control subjects. The findings indicate that eye dominance and direction of head rotation are strongly associated in both TMJ and control subjects. Further, in TMJ subjects mandibular deviation occurred in greater frequency than in controls and tends to occur in the contra lateral direction of head rotation.

  8. Medical informatics across Europe: analysis of medical informatics scientific output in 33 European countries.

    PubMed

    Polašek, Ozren; Kern, Josipa

    2012-01-01

    To investigate the medical informatics scientific output in 33 European countries. Medical Subject Heading term "medical informatics" was used to identify all relevant articles published in 1998-2007 and indexed in the Medline database. The number of articles was adjusted to the population size of each included country in order to obtain the rates per million inhabitants. A total of 28,604 articles were identified. The highest number per million inhabitants was found for Switzerland and the lowest for Albania. Overall, European Union member states had higher output than non-member states, gross domestic product was strongly associated with the scientific output in the field of medical informatics (r = 0.88, p < 0.001). While most countries had significant increase in the scientific output during the observed period, an adjustment to the European average output trend suggested that Lithuania, Portugal, Serbia and Spain had a greater increase than the rest of Europe. The results suggest large disparities across Europe. Further development of medical informatics as a profession and a clear recognition of the discipline are needed to reduce these disparities and propel further increase in research productivity.

  9. Experimental support that ocular tremor in Parkinson's disease does not originate from head movement.

    PubMed

    Gitchel, George T; Wetzel, Paul A; Qutubuddin, Abu; Baron, Mark S

    2014-07-01

    Our recent report of ocular tremor in Parkinson's disease (PD) has raised considerable controversy as to the origin of the tremor. Using an infrared based eye tracker and a magnetic head tracker, we reported that ocular tremor was recordable in PD subjects with no apparent head tremor. However, other investigators suggest that the ocular tremor may represent either transmitted appendicular tremor or subclinical head tremor inducing the vestibulo-ocular reflex (VOR). The present study aimed to further investigate the origin of ocular tremor in PD. Eye movements were recorded in 8 PD subjects both head free, and with full head restraint by means of a head holding device and a dental impression bite plate. Head movements were recorded independently using both a high sensitivity tri-axial accelerometer and a magnetic tracking system, each synchronized to the eye tracker. Ocular tremor was observed in all 8 PD subjects and was not influenced by head free and head fixed conditions. Both magnetic tracking and accelerometer recordings supported that the ocular tremor was fully independent of head position. The present study findings support our initial findings that ocular tremor is a fundamental feature of PD unrelated to head movements. Although the utility of ocular tremor for diagnostic purposes requires validation, current findings in large cohorts of PD subjects suggest its potential as a reliable clinical biomarker. Published by Elsevier Ltd.

  10. Otolaryngology--head and neck surgery in undergraduate medical education: advances and innovations.

    PubMed

    Fung, Kevin

    2015-02-01

    Medical students graduate with the knowledge and skills to be undifferentiated general physicians. Otolaryngology-head and neck surgery (OtoHNS) is an essential component of primary healthcare, but is disproportionately under-represented in undergraduate medical education (UME). Advances and innovations in educational technology may represent an exciting and creative solution to this important problem. Failure to meet this educational need will result in substantial downstream effects in primary healthcare delivery. The objectives of this study were to 1) demonstrate current deficits in OtoHNS teaching at the UME level; 2) develop, validate, and critically appraise educational innovations that may enrich OtoHNS teaching in medical school curricula; and 3) propose a process for standardization of learning objectives for OtoHNS in UME as it relates to development and deployment of such educational tools. A white paper, prepared as a Triological Society thesis, which consolidates a prospective 10-year investigation of the problem of and potential solutions for under-representation of OtoHNS in UME. Cited datasets include multicenter surveys, cohort studies, and prospective, randomized controlled trials. A series of published and unpublished data were synthesized that addresses the following: 1) the current state of OtoHNS teaching at the UME level with respect to content, volume, structure, and methods; and 2) educational innovations including e-learning and simulation with emphasis on validity and learning effectiveness. Educational innovations specific to postgraduate (residency) training were excluded. Data support the observation that there is uniformly disproportionate under-representation of OtoHNS within UME curricula. Medical school graduates, especially those pursuing primary care specialties, report poor overall comfort levels in managing OtoHNS problems. A series of novel teaching methods were developed and validated using e-learning and simulation

  11. The Effects of Providing Headings in Braille Text.

    ERIC Educational Resources Information Center

    Hartley, J.; And Others

    1987-01-01

    Twenty-four blind adults were tested to assess whether headings in braille text facilitated reading comprehension and recall. Subjects reacted positively to the use of headings, but upon being tested for recall no significant effect was found. (Author/JW)

  12. Characteristics and Intraoperative Treatments Associated with Head and Neck Free Tissue Transfer Complications and Failures

    PubMed Central

    Hand, William R.; McSwain, Julie R.; McEvoy, Matthew D.; Wolf, Bethany; Algendy, Abdalrahman A.; Parks, Matthew D.; Murray, John L.; Reeves, Scott T.

    2015-01-01

    Objective To investigate the association between perioperative patient characteristics and treatment modalities (eg, vasopressor use and volume of fluid administration) with complications and failure rates in patients undergoing head and neck free tissue transfer (FTT). Study Design A retrospective review of medical records. Setting Perioperative hospitalization for head and neck FTT at 1 tertiary care medical center between January 1, 2009, and October 31, 2011. Subjects and Methods Consecutive patients (N = 235) who underwent head and neck FTT. Demographic, patient characteristic, and intraoperative data were extracted from medical records. Complication and failure rates within the first 30 days were collected Results In a multivariate analysis controlling for age, sex, ethnicity, reason for receiving flap, and type and volume of fluid given, perioperative complication was significantly associated with surgical blood loss (P = .019; 95% confidence interval [CI], 1.01-1.16), while the rate of intraoperative fluid administration did not reach statistical significance (P = .06; 95% CI, 0.99-1.28). In a univariate analysis, FTT failure was significantly associated with reason for surgery (odds ratio, 5.40; P = .03; 95% CI, 1.69-17.3) and preoperative diagnosis of coronary artery disease (odds ratio, 3.60; P = .03; 95% CI, 1.16-11.2). Intraoperative vasopressor administration was not associated with either FTT complication or failure rate. Conclusions FTT complications were associated with surgical blood loss but not the use of vasoactive drugs. For patients undergoing FTT, judicious monitoring of blood loss may help stratify the risk of complication and failure. PMID:25550221

  13. Analysis of Retinal Vascular Branching in Human Subjects Undergoing 70-Day Head-Down Tilt by NASAs VESGEN Software

    NASA Technical Reports Server (NTRS)

    Parsons-Wingerter, Patricia; Vyas, Ruchi J.; Raghunandan, Sneha; Vu, Amanda C.; Zanello, Susana B.; Ploutz-Snyder, Rob; Taibbi, Giovanni; Vizzeri, Gianmarco

    2016-01-01

    Significant risks for visual impairment were discovered recently in astronauts following spaceflight, especially after long-duration missions. We hypothesize that microgravity-induced fluid shifts result in pathological changes within the retinal vasculature that precede visual and other ocular impairments. We therefore are analyzing retinal vessels in healthy subjects before and after head-down tilt (HDT), a ground-based microgravity analog with NASA's VESsel GENeration Analysis (VESGEN) software. Methods. Spectralis® infrared (IR) fundus images were collected from both eyes of 6 subjects before and after 70 days of bed rest at 6 degree HDT (NASA Campaign 11). For our retrospective study, branching patterns in arterial and venous trees are mapped by VESGEN into vessel branching generations (Gx) that are quantified by parameters such as densities of vessel length (Lv), area (Av), number (Nv) and fractal dimension (Df) as described previously for diabetic retinopathy (IOVS 51(1):498). Results are further assigned by VESGEN into groups of large (G1-3), medium (G4-6) and small (G=7) vessels. Results. All subjects remained asymptomatic throughout duration of HDT. To date, we have analyzed one IR image from each of the 12 eyes. Interestingly, two groups of the masked study population identified by VESGEN are distinguished by the presence or absence of small veins (G=7). For example, L=7 and Av=7 are 2.7+/-1.3 E-4 px/px2 and 7.2+/-3.6 E-4 px2/px2 in 6 retinas, but 0 in the other 6 retinas. Nonetheless, the space-filling properties of the entire venous trees were remarkably uniform by all parameters, such as Df = 1.56+/-0.02 for 6 retinas with G=7 and 1.55+/-0.02 for retinas without G=7. No small arteries (G=7) were detected. Conclusions. For our preliminary masked analysis, two groups of venous trees with and without small veins (G=7) were clearly revealed by VESGEN. Upon completing all images and unmasking the subject status of before and after HDT, we will determine

  14. Transcending Library Catalogs: A Comparative Study of Controlled Terms in Library of Congress Subject Headings and User-Generated Tags in LibraryThing for Transgender Books

    ERIC Educational Resources Information Center

    Adler, Melissa

    2009-01-01

    Perhaps the greatest power of folksonomies, especially when set against controlled vocabularies like the Library of Congress Subject Headings, lies in their capacity to empower user communities to name their own resources in their own terms. This article analyzes the potential and limitations of both folksonomies and controlled vocabularies for…

  15. The application of additive technologies in creation a medical simulator-trainer of the human head operating field

    NASA Astrophysics Data System (ADS)

    Kashapov, L. N.; Kashapov, N. F.; Kashapov, R. N.; Pashaev, B. Y.

    2016-06-01

    The aim of the work was to determine the possible application of additive manufacturing technology during the manufacturing process as close as possible to reality of medical simulator-trainers. In work were used some additive manufacturing technologies: selective laser sintering (SLS), fused deposition modeling (FDM), binder Jetting. As a result, a prototype of simulator-trainer of the human head operating field, which based on the CT real patient, was manufactured and conducted its tests. It was found that structure, which is obtained with the use of 3D-printers ProJet 160, most appropriate and closest to the real properties of the bone.

  16. An epidemiological study on the prevalence of temporomandibular disorder and associated history and problems in Nepalese subjects.

    PubMed

    Rokaya, Dinesh; Suttagul, Kanokwan; Joshi, Shraddha; Bhattarai, Bishwa Prakash; Shah, Pravin Kumar; Dixit, Shantanu

    2018-02-01

    Temporomandibular disorder (TMD) represents a subgroup of painful orofacial disorders involving pain in the temporomandibular joint (TMJ) region, fatigue of the cranio-cervico-facial muscles (especially masticatory muscles), limitation of mandible movement, and the presence of a clicking sound in the TMJ. TMD is associated with multiple factors and systemic diseases. This study aimed to assess the prevalence of TMD in Nepalese subjects for the first time. A total of 500 medical and dental students (127 men and 373 women) participated in this study from May 2016 to September 2016. The Fonseca questionnaire was used as a tool to evaluate the prevalence of TMD, and Fonseca's Anamnestic Index (FAI) was used to classify the severity of TMD. The majority of the participants with TMD had a history of head trauma, psychological stress, and dental treatment or dental problems. The prevalence of TMD in Nepalese students was mild to moderate. The prevalence of TMD in Nepalese subjects was mild to moderate. The majority of the study subjects had eyesight problems, history of head trauma, psychological stress, and drinking alcohol and had received dental treatments.

  17. Compensation for subjects of medical research: the moral rights of patients and the power of research ethics committees.

    PubMed Central

    Guest, S

    1997-01-01

    Awareness of the morally significant distinction between research and innovative therapy reveals serious gaps in the legal provision for compensation in the UK for injured subjects of medical research. Major problems are limitations inherent in negligence actions and a culture that emphasises indemnifying researchers before compensating victims. Medical research morally requires compensation on a no-fault basis even where there is proper consent on the part of the research subject. In particular, for drug research, there is insufficient provision in the current patient guidelines of the Association of the British Pharmaceutical Industry, since they make "no legal commitment" to paying compensation for injury to patient subjects. There is a need for the provision of both adequate insurance and contractual arrangements for making payments. The solution is for Local Research Ethics Committees (LRECs) to make use of their power to withhold approval of medical research where compensation is not legally enforceable. PMID:9220333

  18. Head ballistocardiogram based on wireless multi-location sensors.

    PubMed

    Onizuka, Kohei; Sodini, Charles G

    2015-08-01

    Recently a wearable BCG monitoring technique based on an accelerometer worn at the ear was demonstrated to replace a conventional bulky BCG acquisition system. In this work, a multi-location wireless vital signs monitor was developed, and at least two common acceleration vectors correlating to sitting-BCG were found in the supine position by using head PPG signal as a reference for eight healthy human subjects. The head side amplitude in the supine position is roughly proportional to the sitting amplitude that is in turn proportional to the stroke volume. Signal processing techniques to identify J-waves in a subject having small amplitude was also developed based on the two common vectors at the head side and top.

  19. Subjective and objective appearance of head and neck cancer patients following microsurgical reconstruction and associated quality of life─A cross-sectional study.

    PubMed

    Kansy, Katinka; Hoffmann, Jürgen; Alhalabi, Obada; Mistele, Nicole; Freier, Kolja; Mertens, Christian; Freudlsperger, Christian; Engel, Michael

    2018-06-01

    Depending on the site and size of head and neck cancer, the disease affects patients' appearance and subsequently their quality of life. The aim of this study was to correlate subjective and objective evaluation of facial appearance and associated quality of life following ablative tumor surgery and microsurgical reconstruction. A total of 99 patients with combined ablative and reconstructive microsurgical procedure for head and neck malignancy and seven patients with non-malignant disease were examined by three-dimensional (3D) (photogrammetry at least 6 months post-surgery and were evaluated by two-dimensional (2D) and 3D means for symmetry and facial proportions. Measurements were correlated with subjective reporting from the University of Washington Quality of Life Questionnaire and observer ratings. Of the 106 patients, three patients scored themselves as significantly disfigured (2.8%), 19 were bothered by their appearance (17.9%), 27 (25.5%) reported no change, and 57 (53.8%) reported minor changes in their appearance. On 2D evaluation, 10 patients (9.4%) showed severely abnormal facial proportions. On 3D analysis, 17 patients showed major asymmetry. There was a high correlation (0.67) between patient and observer subjective rating (p < 0.05). While 2D evaluation alone showed no significant correlation with subjective rating, 3D evaluation showed a moderate correlation (0.37; p < 0.05). The best results were achieved by combining 2D and 3D measurements (0.5; p < 0.05). Young female patients were most critical about their appearance. Following combined ablative and microsurgical reconstructive procedures, patients have a realistic perception of their appearance compared with observer ratings and a combination of 2D and 3D objective evaluation. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  20. Medical Monitoring during Short Radius Centrifugation in Bed-rested Subjects

    NASA Technical Reports Server (NTRS)

    Reinertson, Randal; Nelson, Victor; Aunon, Serena; Schlegel, Todd; Paloski, William

    2007-01-01

    The artificial gravity pilot project was designed to investigate the efficacy of daily exposure to a Gz acceleration gradient for counteracting the physiologic decrements induced by prolonged bed rest. A short radius centrifuge was used to produce a Gz gradient such that 1 g was applied at the level of the subject s heart and 2.5 g at the feet. For inclusion in the study, subjects were required to complete a 75-minute screening spin on the centrifuge. During the study, each active treatment subject was scheduled for a 60-minute spin each day for 20 consecutive days. During centrifugation, subjects were continuously monitored by a physician for signs and symptoms of pre-syncope, motion sickness, arrhythmias, joint/muscle pain and any other unanticipated problems. The physician was also present to provide emergency care in the case of a medical emergency. Cameras mounted on the centrifuge were used to provide a means of observing the subject s face and torso. Audio communication was continuously maintained. Other monitoring tools included two-lead EKG tracings, pulse oximetry, intermittent sphygmomanometer readings, lights in the peripheral visual field, and continuous blood pressure readout from a tonometry device. Thirty screening runs were attempted using twenty-seven subjects. Seven of these runs were terminated early for symptoms of pre-syncope, motion sickness, or GI distress. A total of eight subjects completed the active treatment arm of the study. Of the 160 centrifuge runs that were scheduled for these eight treatment subjects, 152 were completed, seven were terminated early, and one was not attempted. Of the seven early terminations, four were related to symptoms of pre-syncope, one to leg pain, one to GI discomfort, and one to equipment failure. Three terminations for adverse symptoms occurred on the first treatment day. Three terminations occurred on day nineteen of treatment and within 24 hours after scheduled soleus and quadriceps muscle biopsies. We

  1. Insurance status and admission to hospital for head injuries: are we part of a two-tiered medical system?

    PubMed

    Svenson, J E; Spurlock, C W

    2001-01-01

    Previous studies have shown an association between insurance status and use of resources for inpatient care. We sought to assess whether insurance status influences decisions regarding the evaluation and treatment of head injured patients in the emergency department (ED). Head injured patients were identified from ED data from 4 hospitals reporting to the Kentucky Emergency Medical Services Information System. Multiple regression analysis using admission, ED length of stay, and ED charges as outcome variables was then performed. From 216,137 ED visits there were 8,591 (4%) head injured patients identified from the database. Eliminating those with revisits, transfers to another hospital in the database, and isolated facial lacerations, there were 3,821 cases. Controlling for age, hospital, race, primary diagnosis, and indicators of severity of the injury, insurance status was significantly associated with hospital admission. Those uninsured were the least likely to be admitted (OR 0.41; 95% CI (0.31, 0.50), whereas those with public insurance had an intermediate probability (OR 0.50 95% CI (0.37, 0.68) as compared with those with private insurance. Similarly, ED charges were lower for Medicaid patients than insured patients ($880) and tended to be slightly lower for uninsured patients ($1,043) than insured patients ($1,141) (P =.001). Length of stay in the ED was shorter for publicly insured patients (179 minutes) than uninsured (186 minutes) and privately insured patients (192 minutes) (P =.001). The extent of evaluation and admission for head injured patients is associated with insurance status. This creates a dual standard of care for patients. Practitioners should work to standardize the evaluation of patients independent of paying status.

  2. Effect of head motion on MRI B0 field distribution.

    PubMed

    Liu, Jiaen; de Zwart, Jacco A; van Gelderen, Peter; Murphy-Boesch, Joseph; Duyn, Jeff H

    2018-05-16

    To identify and characterize the sources of B 0 field changes due to head motion, to reduce motion sensitivity in human brain MRI. B 0 fields were measured in 5 healthy human volunteers at various head poses. After measurement of the total field, the field originating from the subject was calculated by subtracting the external field generated by the magnet and shims. A subject-specific susceptibility model was created to quantify the contribution of the head and torso. The spatial complexity of the field changes was analyzed using spherical harmonic expansion. Minor head pose changes can cause substantial and spatially complex field changes in the brain. For rotations and translations of approximately 5 º and 5 mm, respectively, at 7 T, the field change that is associated with the subject's magnetization generates a standard deviation (SD) of about 10 Hz over the brain. The stationary torso contributes to this subject-associated field change significantly with a SD of about 5 Hz. The subject-associated change leads to image-corrupting phase errors in multi-shot T2*-weighted acquisitions. The B 0 field changes arising from head motion are problematic for multishot T2*-weighted imaging. Characterization of the underlying sources provides new insights into mitigation strategies, which may benefit from individualized predictive field models in addition to real-time field monitoring and correction strategies. © 2018 International Society for Magnetic Resonance in Medicine.

  3. Gravity and perceptual stability during translational head movement on earth and in microgravity.

    PubMed

    Jaekl, P; Zikovitz, D C; Jenkin, M R; Jenkin, H L; Zacher, J E; Harris, L R

    2005-01-01

    We measured the amount of visual movement judged consistent with translational head movement under normal and microgravity conditions. Subjects wore a virtual reality helmet in which the ratio of the movement of the world to the movement of the head (visual gain) was variable. Using the method of adjustment under normal gravity 10 subjects adjusted the visual gain until the visual world appeared stable during head movements that were either parallel or orthogonal to gravity. Using the method of constant stimuli under normal gravity, seven subjects moved their heads and judged whether the virtual world appeared to move "with" or "against" their movement for several visual gains. One subject repeated the constant stimuli judgements in microgravity during parabolic flight. The accuracy of judgements appeared unaffected by the direction or absence of gravity. Only the variability appeared affected by the absence of gravity. These results are discussed in relation to discomfort during head movements in microgravity. c2005 Elsevier Ltd. All rights reserved.

  4. Prevalence of seizures in cats after head trauma.

    PubMed

    Grohmann, Kristina S; Schmidt, Martin J; Moritz, Andreas; Kramer, Martin

    2012-12-01

    To determine the prevalence of seizures in cats after head trauma. Retrospective cross-sectional study. 52 cats with head trauma. Information was obtained from medical records of cats with head trauma and via telephone interviews of owners at least 2 years after cats had head trauma. Severity of head trauma in cats was classified with the modified Glasgow coma scale (mGCS), and the association between scores and development of seizures was determined. 9 cats had moderate head trauma (mGCS score, 9 to 14), and 43 cats had mild head trauma (mGCS score, 15 to 18). None of the cats developed seizures during the follow-up period (≥ 2 years after head injury). The calculated 95% confidence interval for prevalence of seizures in cats after head injury was 0% to 5.6%. There was no significant relationship between severity of head trauma and the risk of seizures in cats. Results indicated the probability that cats with mild to moderate head trauma would develop posttraumatic seizures was low. However, clinicians should monitor cats with a history of head trauma for development of secondary epilepsy.

  5. [Status of subjective well-being for medical staff in a tertiary hospital].

    PubMed

    Deng, Yunlong; Liu, Yan; Xu, Shaorong; Zhao, Min; Li, Junping; Xiong, Yan

    2016-06-28

    To investigate the status of subjective well-being (SWB) for medical staffs who contact with patients directly in a tertiary hospital.
 Staffs from a tertiary hospital in Hunan province were investigated the SWB Scale (SWBS-cc20) from 2012 to 2014.
 The scores of SWB for medical staffs are high (81.67±12.33). Among the 10 sub-dimensions of SWB, medical staffs performed the best in family atmosphere, personal growth, and interpersonal adaptation, while performed the worst in physical health, mental health and material contentment. Title, job nature, education and occupation significantly affected the status of SWB. Staffs who directly connected with patients have less scores of SWB than those who do not (t=-4.80, P<0.001). Moreover, they perform better in contentment (OR=0.079, 95% CI 1.278 to 2.214, P<0.001), but worse in mental health (OR=1.315, 95% CI 1.023 to 1.690, P<0.05) and physical health (OR=1.313, 95% CI 1.029 to 1.677, P<0.05).
 Medical staffs have high scores of SWB. Staffs who directly connected with patients have less scores of SWB than those who do not. Moreover, they perform better in contentment, but worse in mental health and physical health.

  6. Factors affecting the aluminium content of human femoral head and neck.

    PubMed

    Zioła-Frankowska, Anetta; Dąbrowski, Mikołaj; Kubaszewski, Łukasz; Rogala, Piotr; Frankowski, Marcin

    2015-11-01

    Tissues for the study were obtained intraoperatively during hip replacement procedures from 96 patients. In all the cases, the indication for this treatment was primary or secondary degenerative changes in the hip joint. The subject of the study was the head and neck of the femur, resected in situ. Aluminium concentrations measured in femoral head and neck samples from patients aged between 25 and 91 were varied. Statistical methods were applied to determine the variations in relation to the parameters from the background survey. Significant differences in the aluminium content of femoral head samples were observed between patients under and over 60 years of age. Based on the results, it was confirmed that the aluminium accumulates in bones over a lifetime. The study showed that the content of aluminium in the head and neck of the femur depends on the factors such as: type of medicines taken, contact with chemicals at work, differences in body anatomy and sex. The study on the levels of aluminium in bones and the factors affecting its concentration is a valuable source of information for further research on the role of aluminium in bone diseases. Based on the investigations, it was found that the GF-AAS technique is the best analytical tool for routine analysis of aluminium in complex matrix samples. The use of femoral heads in the investigations was approved by the Bioethics Committee of the University of Medical Sciences in Poznań (Poland). Copyright © 2015 Elsevier Inc. All rights reserved.

  7. 21 CFR 882.4460 - Neurosurgical head holder (skull clamp).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Neurosurgical head holder (skull clamp). 882.4460 Section 882.4460 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4460 Neurosurgical head...

  8. The development of a core syllabus for the teaching of head and neck anatomy to medical students.

    PubMed

    Tubbs, R Shane; Sorenson, Edward P; Sharma, Amit; Benninger, Brion; Norton, Neil; Loukas, Marios; Moxham, Bernard J

    2014-04-01

    The study of human anatomy has traditionally served as a fundamental component in the basic science education of medical students, yet there exists a remarkable lack of firm guidance on essential features that must be included in a gross anatomy course, which would constitute a "Core Syllabus" of absolutely mandatory structures and related clinical pathologies. While universal agreement on the details of a core syllabus is elusive, there is a general consensus that a core syllabus aims to identify the minimum level of knowledge expected of recently qualified medical graduates in order to carry out clinical procedures safely and effectively, while avoiding overloading students with unnecessary facts that have less immediate application to their future careers as clinicians. This paper aims to identify consensus standards of essential features of Head and Neck anatomy via a Delphi Panel consisting of anatomists and clinicians who evaluated syllabus content structures (greater than 1,000) as "essential", "important", "acceptable", or "not required." The goal is to provide guidance for program/course directors who intend to provide the optimal balance between establishing a comprehensive list of clinically relevant essential structures and an overwhelming litany, which would otherwise overburden trainees in their initial years of medical school with superficial rote learning, which potentially dilutes the key and enduring fundamental lessons that prepare students for training in any medical field. Copyright © 2014 Wiley Periodicals, Inc.

  9. The Effects of Training and Subject Reproducibility during Vertical Impact Acceleration

    DTIC Science & Technology

    2006-05-01

    configuration. Subjects were evaluated for reproducibility at 6, 8, and 10G with varying helmet weights. The head and sternum accelerations in the Z direction...helmet inertial properties, subject anthropometry, and the recorded head accelerations. The results from the study revealed no effect of training on the...Seat pan, seat cushion, sternum, and head accelerations were collected using an on-board data acquisition system, and neck loads were calculated to

  10. [Problems in organization of medical criminological registration and personality identification for subjects occupationally exposed to life risk].

    PubMed

    Shcherbakov, V V

    2000-01-01

    The paper discusses problems in organization of identification studies under conditions of mass deaths as exemplified by forensic medical records of medical criminological identification studies of subjects killed during war conflict in Chechnya. The evolution of the organization model of identification studies is shown transformation of organization philosophy, formation of expert algorithms, formalization and technologic realization of expert solutions.

  11. Accuracy of birth certificate head circumference measurements: Massachusetts, 2012-2013.

    PubMed

    Somerville, Nicholas J; Chen, Xiaoli; Heinke, Dominique; Stone, Sarah L; Higgins, Cathleen; Manning, Susan E; Pagnano, Sharon; Yazdy, Mahsa M; Anderka, Marlene

    2018-03-15

    Zika virus has recently emerged as a novel cause of microcephaly. CDC has asked states to rapidly ascertain and report cases of Zika-linked birth defects, including microcephaly. Massachusetts added head circumference to its birth certificate (BC) in 2011. The accuracy of head circumference measurements from state vital records data has not been reported. We sought to assess the accuracy of Massachusetts BC head circumference measurements by comparing them to measurements for 2,217 infants born during 2012-2013 captured in the Massachusetts Birth Defects Monitoring Program (BDMP) data system. BDMP contains information abstracted directly from infant medical records and served as the true head circumference value (i.e., gold standard) for analysis. We calculated the proportion of head circumference measurements in agreement between the BC and BDMP data. We assigned growth chart head circumference percentile categories to each BC and BDMP measurement, and calculated the sensitivity and specificity of BC-based categories to predict BDMP-based categories. No difference was found in head circumference measurements between the two sources in 77.9% (n = 1,727) of study infants. The sensitivity of BC-based head circumference percentile categories ranged from 85.6% (<3rd percentile) to 92.7% (≥90th percentile) and the specificity ranged from 97.6% (≥90th percentile) to 99.3% (<3rd percentile). BC head circumference measurements agreed with those abstracted from the medical chart the majority of the time. Head circumference measurements on the BC were more specific than sensitive across all standardized growth chart percentile categories. © 2017 Wiley Periodicals, Inc.

  12. [Discrimination between pain-induced head movement disturbances after whiplash injuries and their simulation].

    PubMed

    Berger, M; Lechner-Steinleitner, S; Hoffmann, F; Schönegger, J

    1998-12-09

    Neck pain after whiplash injury of the cervical spine often induces typical changes in head motion patterns (amplitude, velocity). These changes of kinematics may help to recognize malingerers. We investigated the hypothesis that malingerers are not able to reproduce their simulated head movement disturbances three times. The kinematics of head movements of 23 patients with neck pain after whiplash injury and of 22 healthy subjects trying to act as malingerers were compared. The healthy subjects were informed about the symptomatology of whiplash injury and were asked to simulate painful head movements. Two different kinds of head movements were registered and analyzed by Cervicomotography: (1) the slow free axial head rotation (yaw) and (2) the axial head rotation (yaw) tracking a moving visual target. Each experimental condition was presented three times, expecting the malingerers not to be able to produce as well as to reproduce the same head movement disturbances again and again. In patients, as a consequence of their distinct pain patterns, we expected less variance between the test repetitions. The statistical analysis showed significant differences of the calculated kinematic parameters between both groups and the inability of healthy subjects to simulate and to reproduce convincingly distinct pain patterns.

  13. Breathing pattern and head posture: changes in craniocervical angles.

    PubMed

    Sabatucci, A; Raffaeli, F; Mastrovincenzo, M; Luchetta, A; Giannone, A; Ciavarella, D

    2015-04-01

    The aim of this study was to observe the influence of oral breathing on head posture and to establish possible postural changes observing the variation of craniocervical angles NSL/OPT and NSL/CVT between oral breathing subjects and physiological breathing subjects. A cross-sectional study was conducted. The sample included 115 subject, 56 boys and 59 girls, 5-22-year-old. Among these, 80 were classified as oral breathers and 35 as physiological breathers. The diagnosis of oral breathing was carried out thanks to characteristic signs and symptoms evaluated on clinical examination, the analysis of characteristic X-ray images, ENT examination with active anterior rhinomanometric (AAR) test. The structural and postural analysis was carried out, calculating the craniofacial angles NSL/OPT and NSL/CVT. Both NSL/OPT and NSL/CVT appear to be significantly greater to those observed in physiological breathing patients. This means that patients who tend to breathe through the mouth rather than exclusively through the nose show a reduction of cervical lordosis and a proinclination of the head. Our study confirms that the oral breathing modifies head position. The significant increase of the craniocervical angles NSL/OPT and NSL/CVT in patients with this altered breathing pattern suggests an elevation of the head and a greater extension of the head compared with the cervical spine. So, to correct the breathing pattern early, either during childhood or during adolescence, can lead to a progressive normalization of craniofacial morphology and head posture.

  14. The Influence of Head Motion on Intrinsic Functional Connectivity MRI

    PubMed Central

    Van Dijk, Koene R.A.; Sabuncu, Mert R.; Buckner, Randy L.

    2011-01-01

    Functional connectivity MRI (fcMRI) has been widely applied to explore group and individual differences. A confounding factor is head motion. Children move more than adults, older adults more than younger adults, and patients more than controls. Head motion varies considerably among individuals within the same population. Here we explored the influence of head motion on fcMRI estimates. Mean head displacement, maximum head displacement, the number of micro movements (> 0.1 mm), and head rotation were estimated in 1000 healthy, young adult subjects each scanned for two resting-state runs on matched 3T scanners. The majority of fcMRI variation across subjects was not linked to estimated head motion. However, head motion had significant, systematic effects on fcMRI network measures. Head motion was associated with decreased functional coupling in the default and frontoparietal control networks – two networks characterized by coupling among distributed regions of association cortex. Other network measures increased with motion including estimates of local functional coupling and coupling between left and right motor regions – a region pair sometimes used as a control in studies to establish specificity. Comparisons between groups of individuals with subtly different levels of head motion yielded difference maps that could be mistaken for neuronal effects in other contexts. These effects are important to consider when interpreting variation between groups and across individuals. PMID:21810475

  15. Evaluation of the effectiveness of 3D vascular stereoscopic models in anatomy instruction for first year medical students.

    PubMed

    Cui, Dongmei; Wilson, Timothy D; Rockhold, Robin W; Lehman, Michael N; Lynch, James C

    2017-01-01

    The head and neck region is one of the most complex areas featured in the medical gross anatomy curriculum. The effectiveness of using three-dimensional (3D) models to teach anatomy is a topic of much discussion in medical education research. However, the use of 3D stereoscopic models of the head and neck circulation in anatomy education has not been previously studied in detail. This study investigated whether 3D stereoscopic models created from computed tomographic angiography (CTA) data were efficacious teaching tools for the head and neck vascular anatomy. The test subjects were first year medical students at the University of Mississippi Medical Center. The assessment tools included: anatomy knowledge tests (prelearning session knowledge test and postlearning session knowledge test), mental rotation tests (spatial ability; presession MRT and postsession MRT), and a satisfaction survey. Results were analyzed using a Wilcoxon rank-sum test and linear regression analysis. A total of 39 first year medical students participated in the study. The results indicated that all students who were exposed to the stereoscopic 3D vascular models in 3D learning sessions increased their ability to correctly identify the head and neck vascular anatomy. Most importantly, for students with low-spatial ability, 3D learning sessions improved postsession knowledge scores to a level comparable to that demonstrated by students with high-spatial ability indicating that the use of 3D stereoscopic models may be particularly valuable to these students with low-spatial ability. Anat Sci Educ 10: 34-45. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  16. The Subjective Visual Vertical and the Subjective Haptic Vertical Access Different Gravity Estimates

    PubMed Central

    Fraser, Lindsey E.; Makooie, Bobbak; Harris, Laurence R.

    2015-01-01

    The subjective visual vertical (SVV) and the subjective haptic vertical (SHV) both claim to probe the underlying perception of gravity. However, when the body is roll tilted these two measures evoke different patterns of errors with SVV generally becoming biased towards the body (A-effect, named for its discoverer, Hermann Rudolph Aubert) and SHV remaining accurate or becoming biased away from the body (E-effect, short for Entgegengesetzt-effect, meaning “opposite”, i.e., opposite to the A-effect). We compared the two methods in a series of five experiments and provide evidence that the two measures access two different but related estimates of gravitational vertical. Experiment 1 compared SVV and SHV across three levels of whole-body tilt and found that SVV showed an A-effect at larger tilts while SHV was accurate. Experiment 2 found that tilting either the head or the trunk independently produced an A-effect in SVV while SHV remained accurate when the head was tilted on an upright body but showed an A-effect when the body was tilted below an upright head. Experiment 3 repeated these head/body configurations in the presence of vestibular noise induced by using disruptive galvanic vestibular stimulation (dGVS). dGVS abolished both SVV and SHV A-effects while evoking a massive E-effect in the SHV head tilt condition. Experiments 4 and 5 show that SVV and SHV do not combine in an optimally statistical fashion, but when vibration is applied to the dorsal neck muscles, integration becomes optimal. Overall our results suggest that SVV and SHV access distinct underlying gravity percepts based primarily on head and body position information respectively, consistent with a model proposed by Clemens and colleagues. PMID:26716835

  17. The Subjective Visual Vertical and the Subjective Haptic Vertical Access Different Gravity Estimates.

    PubMed

    Fraser, Lindsey E; Makooie, Bobbak; Harris, Laurence R

    2015-01-01

    The subjective visual vertical (SVV) and the subjective haptic vertical (SHV) both claim to probe the underlying perception of gravity. However, when the body is roll tilted these two measures evoke different patterns of errors with SVV generally becoming biased towards the body (A-effect, named for its discoverer, Hermann Rudolph Aubert) and SHV remaining accurate or becoming biased away from the body (E-effect, short for Entgegengesetzt-effect, meaning "opposite", i.e., opposite to the A-effect). We compared the two methods in a series of five experiments and provide evidence that the two measures access two different but related estimates of gravitational vertical. Experiment 1 compared SVV and SHV across three levels of whole-body tilt and found that SVV showed an A-effect at larger tilts while SHV was accurate. Experiment 2 found that tilting either the head or the trunk independently produced an A-effect in SVV while SHV remained accurate when the head was tilted on an upright body but showed an A-effect when the body was tilted below an upright head. Experiment 3 repeated these head/body configurations in the presence of vestibular noise induced by using disruptive galvanic vestibular stimulation (dGVS). dGVS abolished both SVV and SHV A-effects while evoking a massive E-effect in the SHV head tilt condition. Experiments 4 and 5 show that SVV and SHV do not combine in an optimally statistical fashion, but when vibration is applied to the dorsal neck muscles, integration becomes optimal. Overall our results suggest that SVV and SHV access distinct underlying gravity percepts based primarily on head and body position information respectively, consistent with a model proposed by Clemens and colleagues.

  18. Head position affects the direction of occlusal force during tapping movement.

    PubMed

    Nakamura, K; Minami, I; Wada, J; Ikawa, Y; Wakabayashi, N

    2018-05-01

    Despite numerous reports describing the relationship between head position and mandibular movement in human subjects, the direction and magnitude of force at the occlusal contacts have not been investigated in relation to head position. The objective was to investigate the effect of head position on the direction of occlusal force while subjects performed a tapping movement. Twenty-three healthy adult subjects were asked to sit on a chair with their back upright and to perform 15 tapping movements in five different head positions: natural head position (control); forward; backward; and right and left rolled. The direction and magnitude of force were measured using a small triaxial force sensor. The Wilcoxon signed-rank test and Bonferroni test were used to compare head positions in each angle of the anteroposterior axis direction and the lateral axis direction with respect to the superior axis. The force element in the anteroposterior axis shifted to the forward direction in the head position pitched backward, compared with control, pitched forward and rolled left positions (P = .02, <.01 and <.01, respectively). The force direction in the lateral axis with the head position rolled to the right or left shifted to the left and right directions, respectively, compared with those in the other positions (P < .05). Results of this study suggest that the head should be maintained in a position in which a stable tapping movement can be performed in a relaxed position without anteroposterior and lateral loading. © 2018 John Wiley & Sons Ltd.

  19. [HIGH VELOCITY PENETRATING HEAD AND NECK INJURIES OF SYRIAN CIVIL WAR CASUALTIES TREATED IN THE GALILEE MEDICAL CENTER].

    PubMed

    Ronen, Ohad; Assadi, Nidal; Sela, Eyal

    2017-05-01

    For two years the State of Israel has been treating casualties from the Syrian civil war. The Galilee Medical Center in Nahariya is the main hospital for this humanitarian mission. Objectives: To evaluate the demographic and clinical characteristics of the casualties that were treated in our department. Information from medical records of all Syrian casualties evacuated to the Galilee Medical Center were evaluated. Between March 2013 and December 2014, 450 casualties were evacuated to the Galilee Medical Center. Of those, 45 were treated in the Department of Otolaryngology - Head and Neck Surgery. Of the 45 cases, 43 were male (95.5%) and the mean age was 30.4 years (range 1-79 years). There was a significant difference in terms of gender (p <0.0001). The majority of cases (42.1%) were aged 21-27 years. The most common cause of injury was a gunshot wound. Thirty five patients (77.7%) suffered from multiple trauma, and complex injuries of the maxillofacial bones and upper respiratory tract. Eight (18%) of the cases arrived at the medical center with a tracheotomy. The average length of hospital stay was 15 days (range: 1-141). Of the 450 cases, 97.3% were discharged back to Syria, and 12 died. Of all Syrian injured treated in the ENT department, the vast majority were young men. The main cause of injury was gunshot wounds. It is likely that the lack of protective gear that exist in western armies is a factor in the complex injuries treated at the Galilee Medical Center.

  20. Evaluating direct medical expenditures estimation methods of adults using the medical expenditure panel survey: an example focusing on head and neck cancer.

    PubMed

    Coughlan, Diarmuid; Yeh, Susan T; O'Neill, Ciaran; Frick, Kevin D

    2014-01-01

    To inform policymakers of the importance of evaluating various methods for estimating the direct medical expenditures for a low-incidence condition, head and neck cancer (HNC). Four methods of estimation have been identified: 1) summing all health care expenditures, 2) estimating disease-specific expenditures consistent with an attribution approach, 3) estimating disease-specific expenditures by matching, and 4) estimating disease-specific expenditures by using a regression-based approach. A literature review of studies (2005-2012) that used the Medical Expenditure Panel Survey (MEPS) was undertaken to establish the most popular expenditure estimation methods. These methods were then applied to a sample of 120 respondents with HNC, derived from pooled data (2003-2008). The literature review shows that varying expenditure estimation methods have been used with MEPS but no study compared and contrasted all four methods. Our estimates are reflective of the national treated prevalence of HNC. The upper-bound estimate of annual direct medical expenditures of adult respondents with HNC between 2003 and 2008 was $3.18 billion (in 2008 dollars). Comparable estimates arising from methods focusing on disease-specific and incremental expenditures were all lower in magnitude. Attribution yielded annual expenditures of $1.41 billion, matching method of $1.56 billion, and regression method of $1.09 billion. This research demonstrates that variation exists across and within expenditure estimation methods applied to MEPS data. Despite concerns regarding aspects of reliability and consistency, reporting a combination of the four methods offers a degree of transparency and validity to estimating the likely range of annual direct medical expenditures of a condition. © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Published by International Society for Pharmacoeconomics and Outcomes Research (ISPOR) All rights reserved.

  1. Altered sensory-motor control of the head as an etiological factor in space-motion sickness

    NASA Technical Reports Server (NTRS)

    Lackner, J. R.; DiZio, P.

    1989-01-01

    Mechanical unloading during head movements in weightlessness may be an etiological factor in space-motion sickness. We simulated altered head loading on Earth without affecting vestibular stimulation by having subjects wear a weighted helmet. Eight subjects were exposed to constant velocity rotation about a vertical axis with direction reversals every 60 sec. for eight reversals with the head loaded and eight with the head unloaded. The severity of motion sickness elicited was significantly higher when the head was loaded. This suggests that altered sensory-motor control of the head is also an etiological factor in space-motion sickness.

  2. A new head holder for reducing axial movement and repositioning errors during physiological CT imaging.

    PubMed

    Shrawder, S; Lapin, G D; Allen, C V; Vick, N A; Groothuis, D R

    1994-01-01

    We designed a new head holder for immobilization and repositioning in dynamic CT studies of the brain. A customized thermoplastic face mask and foam head rest were made to restrict movement of the head in all directions, but particularly out of the axial plane (z-movement). This design provided a rigid, detailed mold of the face and back of the head that minimized motion during lengthy CT studies and enabled accurate repositioning of the head for follow-up studies. Markers applied directly to the skin were used to quantify z-movement. When tested on 12 subjects, immobilization was limited to < 2.0 mm under worst-case conditions when the subject was asked to attempt forced movements. Repositioning was accurate to < 1.5 mm when the subject was removed from the head holder and then placed back into it.

  3. Normative data on angular vestibulo-ocular responses in the yaw axis measured using the video head impulse test.

    PubMed

    Matiño-Soler, Eusebi; Esteller-More, Eduard; Martin-Sanchez, Juan-Carlos; Martinez-Sanchez, Jose-M; Perez-Fernandez, Nicolas

    2015-03-01

    To analyze vestibulo-ocular responses using the video head impulse test in the yaw axis. Prospective. Tertiary and university hospital. Two hundred twelve healthy subjects with no history of vestibular or neurologic impairment. Video head impulse test in the lateral semicircular canal plane. Vestibulo-ocular reflex (VOR) gain and appearance of refixation saccades (RSs) considering sex, age, and head impulse velocity and direction. Mean gain was 1.06 ± 0.07, and there were no differences between sexes. For all the impulses (n = 9,654; 4,947 rightward and 4,707 leftward), VOR gain decreased as head impulse velocity increased. When gain was evaluated by age and head velocity, it was steady until age 70 years for higher-velocity impulses and until age 90 years for lower-velocity head impulses. RSs were detected in 52 subjects, occurring after impulses to both sides of the head in 22 of these subjects. The number of subjects with RSs was significantly higher after age 71 years, and velocity was correlated, not with age, but with head impulse velocity. VOR gain was stable until age 90 years and thereafter dropped. However, this decrease occurred progressively in younger subjects as head impulse velocity increased, with VOR gain for faster head impulses decreasing significantly in subjects older than 70 years. This finding, in addition to the appearance of RSs, can be explained by the effect of aging on the deterioration of the vestibular system in the semicircular canals.

  4. Psychophysical estimation of the effects of aging on direction-of-heading judgments

    NASA Astrophysics Data System (ADS)

    Raghuram, Aparna; Lakshminarayanan, Vasudevan

    2011-11-01

    We conducted psychophysical experiments on direction-of-heading judgments using old and young subjects. Subjects estimated heading directions on a translation perpendicular to the vertical plane (frontoparallel); we found that heading judgments were affected by age. Increasing the random dot density in the stimulus from 24 to 400 dots did not improve threshold significantly. Older subjects started performing worse at the highest dots condition of 400. The speed of the radial motion was important, as heading judgments with slower radial motion were difficult to judge than faster radial motion, as the focus of expansion was easier to locate owing to the larger displacement of dots. Gender differences indicated that older women had a higher threshold than older men. This was only significant for the faster simulated radial speed. A general trend of women having a higher threshold than men was noticed.

  5. Physiological responses to the Coriolis illusion: effects of head position and vision.

    PubMed

    Westmoreland, David; Krell, Robert W; Self, Brian P

    2007-10-01

    Changes in sympathetic outflow during Type II spatial disorientation are well documented. In this study we investigated the influences of head position and eye state (open or closed) on sympathetic activation. There were 11 naive subjects (6 men, 5 women) who were tested in a General Aviation Trainer that accelerated at a subthreshold rate for 60 s until a constant angular velocity of 90 degrees x s(-1) was reached. Approximately 40 s later, subjects were instructed to tilt their heads along either the pitch or roll axis, stimulating a Coriolis illusion. Subjects reported the perceived intensity and duration of disorientation. Heart rate, heart rate variability, and electrodermal responses were recorded before, during, and after the period of disorientation. Each subject completed four trials, which were crossed combinations of head position and eye state. There were significant increases in heart rate and the electrodermal response during disorientation, but no significant change in heart rate variability. Head position had no significant effect on any physiological parameters or on the perceived intensity of disorientation; subjects reported a shorter duration of disorientation when the head was tilted into the roll versus the pitch axis. Eye state had no effect on heart rate, heart rate variability, or the intensity of disorientation, but the electrodermal response was somewhat greater, and the duration of disorientation shorter when eyes were open. The results suggest that head position and eye state (open or closed) do not need to be included as factors when investigating sympathetic outflow during a mild Coriolis illusion.

  6. The video head impulse test during post-rotatory nystagmus: physiology and clinical implications.

    PubMed

    Mantokoudis, Georgios; Tehrani, Ali S Saber; Xie, Li; Eibenberger, Karin; Eibenberger, Bernhard; Roberts, Dale; Newman-Toker, David E; Zee, David S

    2016-01-01

    The aim of this study was to test the effects of a sustained nystagmus on the head impulse response of the vestibulo-ocular reflex (VOR) in healthy subjects. VOR gain (slow-phase eye velocity/head velocity) was measured using video head impulse test goggles. Acting as a surrogate for a spontaneous nystagmus (SN), a post-rotatory nystagmus (PRN) was elicited after a sustained, constant-velocity rotation, and then head impulses were applied. 'Raw' VOR gain, uncorrected for PRN, in healthy subjects in response to head impulses with peak velocities in the range of 150°/s-250°/s was significantly increased (as reflected in an increase in the slope of the gain versus head velocity relationship) after inducing PRN with slow phases of nystagmus of high intensity (>30°/s) in the same but not in the opposite direction as the slow-phase response induced by the head impulses. The values of VOR gain themselves, however, remained in the normal range with slow-phase velocities of PRN < 30°/s. Finally, quick phases of PRN were suppressed during the first 20-160 ms of a head impulse; the time frame of suppression depended on the direction of PRN but not on the duration of the head impulse. Our results in normal subjects suggest that VOR gains measured using head impulses may have to be corrected for any superimposed SN when the slow-phase velocity of nystagmus is relatively high and the peak velocity of the head movements is relatively low. The suppression of quick phases during head impulses may help to improve steady fixation during rapid head movements.

  7. A historical review of head and neck cancer in celebrities.

    PubMed

    Folz, B J; Ferlito, A; Weir, N; Pratt, L W; Rinaldo, A; Werner, J A

    2007-06-01

    The illnesses of celebrity patients always receive more attention from the general public than those of ordinary patients. With regard to cancer, this fact has helped to spread information about the four major malignancies: breast cancer, prostatic cancer, lung cancer and colorectal cancer. Head and neck cancer, on the other hand, is still not well recognised by the lay public, although the risk factors are similar to those of lung cancer. It was the objective of this analysis to identify cases of celebrity patients, the description of which could help to increase awareness of head and neck cancer, its symptoms and risk factors. The Internet and medical literature databases were searched for celebrity patients who had suffered from head and neck cancer. The search revealed numerous famous head and neck cancer patients. However, only seven cases were documented well in the medical literature. Among the identified persons were one emperor, two United States presidents, a legendary composer, a world-renowned medical doctor, an outstanding athlete and an extraordinary entertainer. In spite of their exclusive position in society, these patients did not have a better prognosis compared with ordinary patients of their time. Only two of the group experienced long term survival and only one was cured. None of these influential figures used their influence to fund research or to promote knowledge about their respective diseases. The identified cases could help increase public awareness of head and neck cancer. Similar to activities in other oncologic fields, current celebrity head and neck cancer patients should be encouraged to discuss their diseases openly, which could have a positive effect on public health.

  8. Medical support of the Sinai Multinational Force and Observers: an update, 2001.

    PubMed

    Rowe, John R

    2003-02-01

    The Multinational Force and Observers is an 11-nation coalition force with the mission of peacekeeping in the Sinai. It commenced operations in 1982 and continues today after two decades of successful enforcement of the 1979 Egyptian-Israeli Treaty of Peace. The fielding of a medical support team for this mission was the first effort of its kind for the U.S. Army Medical Department, resulting in a uniquely organized medical unit. A U.S. Army physician heads the medical team, which includes nine other physicians from six different countries. The team provides health care for the 2,500-person coalition in the remote Sinai desert. This writing compares earlier medical support with that of August 2000 through July 2001 and describes medical conditions and problems encountered during the 12-month tour of duty. This article updates two previous articles on the subject published in Military Medicine in 1983 and 1991.

  9. Subject and Citation Indexing. Part I: The Clustering Structure of Composite Representations in the Cystic Fibrosis Document Collection. Part II: The Optimal, Cluster-Based Retrieval Performance of Composite Representations.

    ERIC Educational Resources Information Center

    Shaw, W. M., Jr.

    1991-01-01

    Two articles discuss the clustering of composite representations in the Cystic Fibrosis Document Collection from the National Library of Medicine's MEDLINE file. Clustering is evaluated as a function of the exhaustivity of composite representations based on Medical Subject Headings (MeSH) and citation indexes, and evaluation of retrieval…

  10. Variability in the control of head movements in seated humans: a link with whiplash injuries?

    PubMed Central

    Vibert, N; MacDougall, H G; de Waele, C; Gilchrist, D P D; Burgess, A M; Sidis, A; Migliaccio, A; Curthoys, I S; Vidal, P P

    2001-01-01

    The aim of this study was to determine how context and on-line sensory information are combined to control posture in seated subjects submitted to high-jerk, passive linear accelerations. Subjects were seated with eyes closed on a servo-controlled linear sled. They were asked to relax and received brief accelerations either sideways or in the fore-aft direction. The stimuli had an abrupt onset, comparable to the jerk experienced during a minor car collision. Rotation and translation of the head and body were measured using an Optotrak system. In some of the subjects, surface electromyographic (EMG) responses of selected neck and/or back muscles were recorded simultaneously. For each subject, responses were highly stereotyped from the first trial, and showed little sign of habituation or sensitisation. Comparable results were obtained with sideways and fore-aft accelerations. During each impulse, the head lagged behind the trunk for several tens of milliseconds. The subjects' head movement responses were distributed as a continuum in between two extreme categories. The ‘stiff’ subjects showed little rotation or translation of the head relative to the trunk for the whole duration of the impulse. In contrast, the ‘floppy’ subjects showed a large roll or pitch of the head relative to the trunk in the direction opposite to the sled movement. This response appeared as an exaggerated ‘inertial’ response to the impulse. Surface EMG recordings showed that most of the stiff subjects were not contracting their superficial neck or back muscles. We think they relied on bilateral contractions of their deep, axial musculature to keep the head-neck ensemble in line with the trunk during the movement. About half of the floppy subjects displayed reflex activation of the neck muscles on the side opposite to the direction of acceleration, which occurred before or during the head movement and tended to exaggerate it. The other floppy subjects seemed to rely on only the

  11. Does the Integration of Haptic and Visual Cues Reduce the Effect of a Biased Visual Reference Frame on the Subjective Head Orientation?

    PubMed Central

    Gueguen, Marc; Vuillerme, Nicolas; Isableu, Brice

    2012-01-01

    Background The selection of appropriate frames of reference (FOR) is a key factor in the elaboration of spatial perception and the production of robust interaction with our environment. The extent to which we perceive the head axis orientation (subjective head orientation, SHO) with both accuracy and precision likely contributes to the efficiency of these spatial interactions. A first goal of this study was to investigate the relative contribution of both the visual and egocentric FOR (centre-of-mass) in the SHO processing. A second goal was to investigate humans' ability to process SHO in various sensory response modalities (visual, haptic and visuo-haptic), and the way they modify the reliance to either the visual or egocentric FORs. A third goal was to question whether subjects combined visual and haptic cues optimally to increase SHO certainty and to decrease the FORs disruption effect. Methodology/Principal Findings Thirteen subjects were asked to indicate their SHO while the visual and/or egocentric FORs were deviated. Four results emerged from our study. First, visual rod settings to SHO were altered by the tilted visual frame but not by the egocentric FOR alteration, whereas no haptic settings alteration was observed whether due to the egocentric FOR alteration or the tilted visual frame. These results are modulated by individual analysis. Second, visual and egocentric FOR dependency appear to be negatively correlated. Third, the response modality enrichment appears to improve SHO. Fourth, several combination rules of the visuo-haptic cues such as the Maximum Likelihood Estimation (MLE), Winner-Take-All (WTA) or Unweighted Mean (UWM) rule seem to account for SHO improvements. However, the UWM rule seems to best account for the improvement of visuo-haptic estimates, especially in situations with high FOR incongruence. Finally, the data also indicated that FOR reliance resulted from the application of UWM rule. This was observed more particularly, in the

  12. 20-Year Subject and Author Index, Volume 1, 1997-Volume 20, 1996; Subject and Author Index, Volume 21, 1997.

    ERIC Educational Resources Information Center

    Weiler, Robert M.; Pealer, Lisa N.

    1997-01-01

    This index provides readers interested in health behavior, health education, and health promotion ordered access to materials published in Health Values and the American Journal of Health Behavior, 1977-1997. The index includes 115 subject headings and 5 department headings, classifying 918 entries by 1,319 authors and coauthors. (SM)

  13. 'Goats that stare at men': dwarf goats alter their behaviour in response to human head orientation, but do not spontaneously use head direction as a cue in a food-related context.

    PubMed

    Nawroth, Christian; von Borell, Eberhard; Langbein, Jan

    2015-01-01

    Recently, comparative research on the mechanisms and species-specific adaptive values of attributing attentive states and using communicative cues has gained increased interest, particularly in non-human primates, birds, and dogs. Here, we investigate these phenomena in a farm animal species, the dwarf goat (Capra aegagrus hircus). In the first experiment, we investigated the effects of different human head and body orientations, as well as human experimenter presence/absence, on the behaviour of goats in a food-anticipating paradigm. Over a 30-s interval, the experimenter engaged in one of four different postures or behaviours (head and body towards the subject-'Control', head to the side, head and body away from the subject, or leaving the room) before delivering a reward. We found that the level of subjects' active anticipatory behaviour was highest in the control condition and decreased with a decreasing level of attention paid to the subject by the experimenter. Additionally, goats 'stared' (i.e. stood alert) at the experimental set-up for significantly more time when the experimenter was present but paid less attention to the subject ('Head' and 'Back' condition) than in the 'Control' and 'Out' conditions. In a second experiment, the experimenter provided different human-given cues that indicated the location of a hidden food reward in a two-way object choice task. Goats were able to use both 'Touch' and 'Point' cues to infer the correct location of the reward but did not perform above the level expected by chance in the 'Head only' condition. We conclude that goats are able to differentiate among different body postures of a human, including head orientation; however, despite their success at using multiple physical human cues, they fail to spontaneously use human head direction as a cue in a food-related context.

  14. Medical marijuana use in head and neck squamous cell carcinoma patients treated with radiotherapy.

    PubMed

    Elliott, David A; Nabavizadeh, Nima; Romer, Jeanna L; Chen, Yiyi; Holland, John M

    2016-08-01

    The purpose of the study was to better understand why patients with history of head and neck cancer (HNC) treated with radiotherapy are using medical marijuana (MM). Established HNC quality of life questionnaires and our own MM quality of life questionnaire were sent to 15 HNC patients treated at our institution who reported using MM. Patients are clinically disease free and currently using MM to manage long-term side effects after curative HNC treatment. There was a 100 % response rate. Median time from treatment was 45 months (21-136 months). Most patients smoked marijuana (12 patients), while others reported ingestion (4 patients), vaporizing (3 patients), and use of homemade concentrated oil (1 patient). Six patients reported prior recreational marijuana use before diagnosis. MM provided benefit in altered sense, weight maintenance, depression, pain, appetite, dysphagia, xerostomia, muscle spasm, and sticky saliva. HNC patients report MM use to help with long-term side effects of radiotherapy.

  15. Nintendo Wii remote controllers for head posture measurement: accuracy, validity, and reliability of the infrared optical head tracker.

    PubMed

    Kim, Jongshin; Nam, Kyoung Won; Jang, Ik Gyu; Yang, Hee Kyung; Kim, Kwang Gi; Hwang, Jeong-Min

    2012-03-15

    To evaluate the accuracy, validity, and reliability of a newly developed infrared optical head tracker (IOHT) using Nintendo Wii remote controllers (WiiMote; Nintendo Co. Ltd., Kyoto, Japan) for measurement of the angle of head posture. The IOHT consists of two infrared (IR) receivers (WiiMote) that are fixed to a mechanical frame and connected to a monitoring computer via a Bluetooth communication channel and an IR beacon that consists of four IR light-emitting diodes (LEDs). With the use of the Cervical Range of Motion (CROM; Performance Attainment Associates, St. Paul, MN) as a reference, one- and three-dimensional (1- and 3-D) head postures of 20 normal adult subjects (20-37 years of age; 9 women and 11 men) were recorded with the IOHT. In comparison with the data from the CROM, the IOHT-derived results showed high consistency. The measurements of 1- and 3-D positions of the human head with the IOHT were very close to those of the CROM. The correlation coefficients of 1- and 3-D positions between the IOHT and the CROM were more than 0.99 and 0.96 (P < 0.05, Pearson's correlation test), respectively. Reliability tests of the IOHT for the normal adult subjects for 1- and 3-D positions of the human head had 95% limits of agreement angles of approximately ±4.5° and ±8.0°, respectively. The IOHT showed strong concordance with the CROM and relatively good test-retest reliability, thus proving its validity and reliability as a head-posture-measuring device. Considering its high performance, ease of use, and low cost, the IOHT has the potential to be widely used as a head-posture-measuring device in clinical practice.

  16. Printed circuit board for a CCD camera head

    DOEpatents

    Conder, Alan D.

    2002-01-01

    A charge-coupled device (CCD) camera head which can replace film for digital imaging of visible light, ultraviolet radiation, and soft to penetrating x-rays, such as within a target chamber where laser produced plasmas are studied. The camera head is small, capable of operating both in and out of a vacuum environment, and is versatile. The CCD camera head uses PC boards with an internal heat sink connected to the chassis for heat dissipation, which allows for close (0.04" for example) stacking of the PC boards. Integration of this CCD camera head into existing instrumentation provides a substantial enhancement of diagnostic capabilities for studying high energy density plasmas, for a variety of military industrial, and medical imaging applications.

  17. Comprehensive head and neck trauma screening: the USS Cole experience.

    PubMed

    Helling, Eric R; Pfannenstiel, Travis J

    2005-11-01

    A prospective study was designed to determine the incidence of occult head and neck injuries after initial triage of patients following the USS Cole terrorist bombing. All 39 patients evacuated to Landstuhl Regional Medical Center underwent comprehensive head and neck examinations, regardless of known diagnoses at the time of arrival. Appropriate interventions were performed, and detailed summaries were added to the patients' records. Initial triage listed nine of 39 patients as having sustained head and neck injuries. After screening by an otolaryngology team, 23 of 39 patients were identified as having head and neck injuries requiring further care. The majority of head and neck injuries were not initially reported to the head and neck trauma service. Our conclusion is that occult head and neck injuries are common after blast injuries. Early identification and intervention by a subspecialty head and neck trauma team can aid in achieving optimal outcomes after blast injury.

  18. Developing competencies for medical librarians in Pakistan.

    PubMed

    Ullah, Midrar; Anwar, Mumtaz A

    2013-03-01

    To identify competencies for medical librarians and get these validated from head librarians and employers. The survey method was used. A structured questionnaire, listing 84 competency statements, covering eight areas, prepared after extensive literature review, expert scrutiny and pilot testing, using a 5-point Likert scale was distributed among the head librarians and chairpersons of library committees (CLC) in 115 medical libraries. Sixty seven (58%) useable responses were received from head librarians and 63 (55%) from CLC. Of the 84 competency statements 83 were validated by the head librarians, 44 receiving four or higher mean score while the other 39 statements getting mean scores in the range of 3.97 and 3.06. The CLC validated 80 statements. Only 27 statements received four or higher mean score from CLC while the other 53 got mean scores in the range of 3.97 and 3.22. Medical librarians are required to be well versed with all those competencies which are needed for general librarianship. In addition, they are expected to have adequate knowledge of health sciences environment including medical terminologies and concepts. Sound knowledge of some competencies specific for medical libraries is an additional requirement for library personnel. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

  19. Family-centered rounds and medical student performance on the NBME pediatrics subject (shelf) examination: a retrospective cohort study.

    PubMed

    Kimbrough, Tiffany N; Heh, Victor; Wijesooriya, N Romesh; Ryan, Michael S

    2016-01-01

    Objective To determine the association between family-centered rounds (FCR) and medical student knowledge acquisition as assessed by the National Board of Medical Examiners (NBME) pediatric subject (shelf) exam. Methods A retrospective cohort study was conducted of third-year medical students who graduated from Virginia Commonwealth University School of Medicine between 2009 and 2014. This timeframe represented the transition from 'traditional' rounds to FCR on the pediatric inpatient unit. Data collected included demographics, United States Medical Licensing Examination (USMLE) Step 1 and 2 scores, and NBME subject examinations in pediatrics (PSE), medicine (MSE), and surgery (SSE). Results Eight hundred and sixteen participants were included in the analysis. Student performance on the PSE could not be statistically differentiated from performance on the MSE for any year except 2011 (z-score=-0.17, p=0.02). Average scores on PSE for years 2009, 2010, 2013, and 2014 were significantly higher than for SSE, but not significantly different for all other years. The PSE was highly correlated with USMLE Step 1 and Step 2 examinations (correlation range 0.56-0.77) for all years. Conclusions Our results showed no difference in PSE performance during a time in which our institution transitioned to FCR. These findings should be reassuring for students, attending physicians, and medical educators.

  20. Family-centered rounds and medical student performance on the NBME pediatrics subject (shelf) examination: a retrospective cohort study.

    PubMed

    Kimbrough, Tiffany N; Heh, Victor; Wijesooriya, N Romesh; Ryan, Michael S

    2016-01-01

    To determine the association between family-centered rounds (FCR) and medical student knowledge acquisition as assessed by the National Board of Medical Examiners (NBME) pediatric subject (shelf) exam. A retrospective cohort study was conducted of third-year medical students who graduated from Virginia Commonwealth University School of Medicine between 2009 and 2014. This timeframe represented the transition from 'traditional' rounds to FCR on the pediatric inpatient unit. Data collected included demographics, United States Medical Licensing Examination (USMLE) Step 1 and 2 scores, and NBME subject examinations in pediatrics (PSE), medicine (MSE), and surgery (SSE). Eight hundred and sixteen participants were included in the analysis. Student performance on the PSE could not be statistically differentiated from performance on the MSE for any year except 2011 (z-score=-0.17, p=0.02). Average scores on PSE for years 2009, 2010, 2013, and 2014 were significantly higher than for SSE, but not significantly different for all other years. The PSE was highly correlated with USMLE Step 1 and Step 2 examinations (correlation range 0.56-0.77) for all years. Our results showed no difference in PSE performance during a time in which our institution transitioned to FCR. These findings should be reassuring for students, attending physicians, and medical educators.

  1. Dental needs in Brazilian patients subjected to head and neck radiotherapy.

    PubMed

    Rosales, Ana Carolina de Mesquita Netto; Esteves, Sérgio Carlos Barros; Jorge, Jacks; Almeida, Oslei Paes de; Lopes, Márcio Ajudarte

    2009-01-01

    In spite of its recognized benefits in the treatment of malignant tumors, radiation therapy have several side effects in the head and neck region. The evaluation of oral conditions by a dentist is important to prevent or minimize these problems. The aim of this retrospective review was to analyze the dental needs in 357 patients who received radiotherapy in the head and neck region and were treated at Orocentro/FOP/UNICAMP, between January 1990 and December 2004. Review of patient files showed that dental examination before radiotherapy was not performed in 148 patients (41.5%) and was done in 209 patients (58.5%). From the total of examined patients, 94 (45%) did not require dental procedures at the moment of examination, while 115 (55%) presented some sort of dental need. Following the patients after the radiotherapy, it was observed that the group of patients that was evaluated before radiation presented less need of restorations, root canal filling and dental extractions than those who were not evaluated. The results of this study confirm that the evaluation of oral conditions prior to radiotherapy is essential to minimize the dental needs, emphasizing the importance of the dentist in the multidisciplinary team that treats cancer patients.

  2. US Medical Student Performance on the NBME Subject Examination in Internal Medicine: Do Clerkship Sequence and Clerkship Length Matter?

    PubMed

    Ouyang, Wenli; Cuddy, Monica M; Swanson, David B

    2015-09-01

    Prior to graduation, US medical students are required to complete clinical clerkship rotations, most commonly in the specialty areas of family medicine, internal medicine, obstetrics and gynecology (ob/gyn), pediatrics, psychiatry, and surgery. Within a school, the sequence in which students complete these clerkships varies. In addition, the length of these rotations varies, both within a school for different clerkships and between schools for the same clerkship. The present study investigated the effects of clerkship sequence and length on performance on the National Board of Medical Examiner's subject examination in internal medicine. The study sample included 16,091 students from 67 US Liaison Committee on Medical Education (LCME)-accredited medical schools who graduated in 2012 or 2013. Student-level measures included first-attempt internal medicine subject examination scores, first-attempt USMLE Step 1 scores, and five dichotomous variables capturing whether or not students completed rotations in family medicine, ob/gyn, pediatrics, psychiatry, and surgery prior to taking the internal medicine rotation. School-level measures included clerkship length and average Step 1 score. Multilevel models with students nested in schools were estimated with internal medicine subject examination scores as the dependent measure. Step 1 scores and the five dichotomous variables were treated as student-level predictors. Internal medicine clerkship length and average Step 1 score were used to predict school-to-school variation in average internal medicine subject examination scores. Completion of rotations in surgery, pediatrics and family medicine prior to taking the internal medicine examination significantly improved scores, with the largest benefit observed for surgery (coefficient = 1.58 points; p value < 0.01); completion of rotations in ob/gyn and psychiatry were unrelated to internal medicine subject examination performance. At the school level, longer internal medicine

  3. Vestibular Dysfunction after Subconcussive Head Impact

    PubMed Central

    Ma, Lei; Kawata, Keisuke; Tierney, Ryan; Jeka, John J.

    2017-01-01

    Abstract Current thinking views mild head impact (i.e., subconcussion) as an underrecognized phenomenon that has the ability to cause significant current and future detrimental neurological effects. Repeated mild impacts to the head, however, often display no observable behavioral deficits based on standard clinical tests, which may lack sensitivity. The current study investigates the effects of subconcussive impacts from soccer heading with innovative measures of vestibular function and walking stability in a pre- 0–2 h, post- 24 h post-heading repeated measures design. The heading group (n = 10) executed 10 headers with soccer balls projected at a velocity of 25 mph (11.2 m/sec) over 10 min. Subjects were evaluated 24 h before, immediately after, and 24 h after soccer heading with: the modified Balance Error Scoring System (mBESS); a walking stability task with visual feedback of trunk movement; and galvanic vestibular stimulation (GVS) while standing with eyes closed on foam. A control group (n = 10) followed the same protocol with no heading. The results showed significant decrease in trunk angle, leg angle gain, and center of mass gain relative to GVS for the heading group compared with controls. Medial-lateral trunk orientation displacement and velocity during treadmill walking increased immediately after mild head impact for the heading group compared with controls. Controls showed an improvement in mBESS scores over time, indicating a learning effect, which was not observed with the heading group. These results suggest that mild head impact leads to a transient dysfunction in vestibular processing, which deters walking stability during task performance. PMID:26885560

  4. Vestibular Dysfunction after Subconcussive Head Impact.

    PubMed

    Hwang, Sungjae; Ma, Lei; Kawata, Keisuke; Tierney, Ryan; Jeka, John J

    2017-01-01

    Current thinking views mild head impact (i.e., subconcussion) as an underrecognized phenomenon that has the ability to cause significant current and future detrimental neurological effects. Repeated mild impacts to the head, however, often display no observable behavioral deficits based on standard clinical tests, which may lack sensitivity. The current study investigates the effects of subconcussive impacts from soccer heading with innovative measures of vestibular function and walking stability in a pre- 0-2 h, post- 24 h post-heading repeated measures design. The heading group (n = 10) executed 10 headers with soccer balls projected at a velocity of 25 mph (11.2 m/sec) over 10 min. Subjects were evaluated 24 h before, immediately after, and 24 h after soccer heading with: the modified Balance Error Scoring System (mBESS); a walking stability task with visual feedback of trunk movement; and galvanic vestibular stimulation (GVS) while standing with eyes closed on foam. A control group (n = 10) followed the same protocol with no heading. The results showed significant decrease in trunk angle, leg angle gain, and center of mass gain relative to GVS for the heading group compared with controls. Medial-lateral trunk orientation displacement and velocity during treadmill walking increased immediately after mild head impact for the heading group compared with controls. Controls showed an improvement in mBESS scores over time, indicating a learning effect, which was not observed with the heading group. These results suggest that mild head impact leads to a transient dysfunction in vestibular processing, which deters walking stability during task performance.

  5. Dynamic Parameter Identification of Subject-Specific Body Segment Parameters Using Robotics Formalism: Case Study Head Complex.

    PubMed

    Díaz-Rodríguez, Miguel; Valera, Angel; Page, Alvaro; Besa, Antonio; Mata, Vicente

    2016-05-01

    Accurate knowledge of body segment inertia parameters (BSIP) improves the assessment of dynamic analysis based on biomechanical models, which is of paramount importance in fields such as sport activities or impact crash test. Early approaches for BSIP identification rely on the experiments conducted on cadavers or through imaging techniques conducted on living subjects. Recent approaches for BSIP identification rely on inverse dynamic modeling. However, most of the approaches are focused on the entire body, and verification of BSIP for dynamic analysis for distal segment or chain of segments, which has proven to be of significant importance in impact test studies, is rarely established. Previous studies have suggested that BSIP should be obtained by using subject-specific identification techniques. To this end, our paper develops a novel approach for estimating subject-specific BSIP based on static and dynamics identification models (SIM, DIM). We test the validity of SIM and DIM by comparing the results using parameters obtained from a regression model proposed by De Leva (1996, "Adjustments to Zatsiorsky-Seluyanov's Segment Inertia Parameters," J. Biomech., 29(9), pp. 1223-1230). Both SIM and DIM are developed considering robotics formalism. First, the static model allows the mass and center of gravity (COG) to be estimated. Second, the results from the static model are included in the dynamics equation allowing us to estimate the moment of inertia (MOI). As a case study, we applied the approach to evaluate the dynamics modeling of the head complex. Findings provide some insight into the validity not only of the proposed method but also of the application proposed by De Leva (1996, "Adjustments to Zatsiorsky-Seluyanov's Segment Inertia Parameters," J. Biomech., 29(9), pp. 1223-1230) for dynamic modeling of body segments.

  6. Nano-oxide-layer specular spin valve heads with synthetic pinned layer: Head performance and reliability

    NASA Astrophysics Data System (ADS)

    Hasegawa, N.; Koike, F.; Ikarashi, K.; Ishizone, M.; Kawamura, M.; Nakazawa, Y.; Takahashi, A.; Tomita, H.; Iwasaki, H.; Sahashi, M.

    2002-05-01

    To implement the specular nano-oxide-layer (NOL) spin valve (SV) heads for use in practical applications, it is key to simultaneously achieve a good specular effect of the NOL inserted in the synthetic ferrimagnet pinned layer (i.e., high magnetoresistance MR performance) and a strong pinning field through the NOL. By using CoFe+X as a substance to be subjected to oxidation, we obtained the NOL specular SV films simultaneously achieving a high MR ratio of 17%-18% and a high pinning field of 1100-1500 Oe. Narrow track (0.12 μm) heads were fabricated and they showed a high sensitivity of 10 mV/μm. Several reliability tests were done both at the sheet film level and the actual head level. The oxygen inside NOL was found to be stable up to 350 °C, and pinned layer magnetization canting after orthogonal field annealing was found to be almost the same as today's non-NOL SV films. An electrostatic discharge test and accelerated lifetime test were also performed and NOL specular heads were demonstrated to have almost the same robustness as today's non-NOL heads.

  7. Head Circumference and Height in Autism

    PubMed Central

    Lainhart, Janet E.; Bigler, Erin D.; Bocian, Maureen; Coon, Hilary; Dinh, Elena; Dawson, Geraldine; Deutsch, Curtis K.; Dunn, Michelle; Estes, Annette; Tager-Flusberg, Helen; Folstein, Susan; Hepburn, Susan; Hyman, Susan; McMahon, William; Minshew, Nancy; Munson, Jeff; Osann, Kathy; Ozonoff, Sally; Rodier, Patricia; Rogers, Sally; Sigman, Marian; Spence, M. Anne; Stodgell, Christopher J.; Volkmar, Fred

    2016-01-01

    Data from 10 sites of the NICHD/NIDCD Collaborative Programs of Excellence in Autism were combined to study the distribution of head circumference and relationship to demographic and clinical variables. Three hundred thirty-eight probands with autism-spectrum disorder (ASD) including 208 probands with autism were studied along with 147 parents, 149 siblings, and typically developing controls. ASDs were diagnosed, and head circumference and clinical variables measured in a standardized manner across all sites. All subjects with autism met ADI-R, ADOS-G, DSM-IV, and ICD-10 criteria. The results show the distribution of standardized head circumference in autism is normal in shape, and the mean, variance, and rate of macrocephaly but not microcephaly are increased. Head circumference tends to be large relative to height in autism. No site, gender, age, SES, verbal, or non-verbal IQ effects were present in the autism sample. In addition to autism itself, standardized height and average parental head circumference were the most important factors predicting head circumference in individuals with autism. Mean standardized head circumference and rates of macrocephaly were similar in probands with autism and their parents. Increased head circumference was associated with a higher (more severe) ADI-R social algorithm score. Macrocephaly is associated with delayed onset of language. Although mean head circumference and rates of macrocephaly are increased in autism, a high degree of variability is present, underscoring the complex clinical heterogeneity of the disorder. The wide distribution of head circumference in autism has major implications for genetic, neuroimaging, and other neurobiological research. PMID:17022081

  8. Probabilistic description of infant head kinematics in abusive head trauma.

    PubMed

    Lintern, T O; Nash, M P; Kelly, P; Bloomfield, F H; Taberner, A J; Nielsen, P M F

    2017-12-01

    Abusive head trauma (AHT) is a potentially fatal result of child abuse, but the mechanisms by which injury occur are often unclear. To investigate the contention that shaking alone can elicit the injuries observed, effective computational models are necessary. The aim of this study was to develop a probabilistic model describing infant head kinematics in AHT. A deterministic model incorporating an infant's mechanical properties, subjected to different shaking motions, was developed in OpenSim. A Monte Carlo analysis was used to simulate the range of infant kinematics produced as a result of varying both the mechanical properties and the type of shaking motions. By excluding physically unrealistic shaking motions, worst-case shaking scenarios were simulated and compared to existing injury criteria for a newborn, a 4.5 month-old, and a 12 month-old infant. In none of the three cases were head kinematics observed to exceed previously-estimated subdural haemorrhage injury thresholds. The results of this study provide no biomechanical evidence to demonstrate how shaking by a human alone can cause the injuries observed in AHT, suggesting either that additional factors, such as impact, are required, or that the current estimates of injury thresholds are incorrect.

  9. Relationships between Head Circumference, Brain Volume and Cognition in Children with Prenatal Alcohol Exposure.

    PubMed

    Treit, Sarah; Zhou, Dongming; Chudley, Albert E; Andrew, Gail; Rasmussen, Carmen; Nikkel, Sarah M; Samdup, Dawa; Hanlon-Dearman, Ana; Loock, Christine; Beaulieu, Christian

    2016-01-01

    Head circumference is used together with other measures as a proxy for central nervous system damage in the diagnosis of fetal alcohol spectrum disorders, yet the relationship between head circumference and brain volume has not been investigated in this population. The objective of this study is to characterize the relationship between head circumference, brain volume and cognitive performance in a large sample of children with prenatal alcohol exposure (n = 144) and healthy controls (n = 145), aged 5-19 years. All participants underwent magnetic resonance imaging to yield brain volumes and head circumference, normalized to control for age and sex. Mean head circumference, brain volume, and cognitive scores were significantly reduced in the prenatal alcohol exposure group relative to controls, albeit with considerable overlap between groups. Males with prenatal alcohol exposure had reductions in all three measures, whereas females with prenatal alcohol exposure had reduced brain volumes and cognitive scores, but no difference in head circumference relative to controls. Microcephaly (defined here as head circumference ≤ 3rd percentile) occurred more often in prenatal alcohol exposed participants than controls, but 90% of the exposed sample had head circumferences above this clinical cutoff indicating that head circumference is not a sensitive marker of prenatal alcohol exposure. Normalized head circumference and brain volume were positively correlated in both groups, and subjects with very low head circumference typically had below-average brain volumes. Conversely, over half of the subjects with very low brain volumes had normal head circumferences, which may stem from differential effects of alcohol on the skeletal and nervous systems. There were no significant correlations between head circumference and any cognitive score. These findings confirm group-level reductions in head circumference and increased rates of microcephaly in children with prenatal alcohol

  10. Relationships between Head Circumference, Brain Volume and Cognition in Children with Prenatal Alcohol Exposure

    PubMed Central

    Treit, Sarah; Zhou, Dongming; Chudley, Albert E.; Andrew, Gail; Rasmussen, Carmen; Nikkel, Sarah M.; Samdup, Dawa; Hanlon-Dearman, Ana; Loock, Christine; Beaulieu, Christian

    2016-01-01

    Head circumference is used together with other measures as a proxy for central nervous system damage in the diagnosis of fetal alcohol spectrum disorders, yet the relationship between head circumference and brain volume has not been investigated in this population. The objective of this study is to characterize the relationship between head circumference, brain volume and cognitive performance in a large sample of children with prenatal alcohol exposure (n = 144) and healthy controls (n = 145), aged 5–19 years. All participants underwent magnetic resonance imaging to yield brain volumes and head circumference, normalized to control for age and sex. Mean head circumference, brain volume, and cognitive scores were significantly reduced in the prenatal alcohol exposure group relative to controls, albeit with considerable overlap between groups. Males with prenatal alcohol exposure had reductions in all three measures, whereas females with prenatal alcohol exposure had reduced brain volumes and cognitive scores, but no difference in head circumference relative to controls. Microcephaly (defined here as head circumference ≤ 3rd percentile) occurred more often in prenatal alcohol exposed participants than controls, but 90% of the exposed sample had head circumferences above this clinical cutoff indicating that head circumference is not a sensitive marker of prenatal alcohol exposure. Normalized head circumference and brain volume were positively correlated in both groups, and subjects with very low head circumference typically had below-average brain volumes. Conversely, over half of the subjects with very low brain volumes had normal head circumferences, which may stem from differential effects of alcohol on the skeletal and nervous systems. There were no significant correlations between head circumference and any cognitive score. These findings confirm group-level reductions in head circumference and increased rates of microcephaly in children with prenatal alcohol

  11. Assessment of Antero-Posterior Skeletal and Soft Tissue Relationships of Adult Indian Subjects in Natural Head Position and Centric Relation

    PubMed Central

    Latif, Vishnu Ben; Keshavaraj; Rai, Rohan; Hegde, Gautham; Shajahan, Shabna

    2015-01-01

    Background: The aim of this study was to verify the intra-individual reproducibility of natural head position (NHP) in centric relation (CR) position, to prove the inter-individual differences in the Frankfort horizontal plane and sella-nasion line compared with the true horizontal line, and to establish linear norms from A-point, B-point, Pog as well as soft tissue A-point, soft tissue B-point, and soft tissue Pog to nasion true vertical line (NTVL) in adult Indian subjects. Methods: Lateral cephalograms (T1) of Angle’s Class I subjects were taken in NHP and with bite in CR. A second lateral cephalogram (T2) of these subjects with ANB angle in the range 1-4° were taken after 1 week using the same wax bite and both the radiographs were analyzed based on six angular parameters using cephalometric software (Do-it, Dental studio NX version 4.1) to assess the reproducibility of NHP. Linear values of six landmarks were taken in relation to NTVL, and the mean values were calculated. A total of 116 subjects were included in this study. Results: When the cephalometric values of T1 and T2 were analyzed, it was found that, the parameters showed a P < 0.001, indicating the reproducibility of NHP in CR. Mean values for point A, point B, Pog and their soft tissue counterparts were also obtained. Conclusion: The study proved that NHP is a reproducible and accurate when recorded with the mandible in CR. Linear norms for skeletal Class I subjects in relation to NTVL were established. PMID:26124598

  12. Electro-optic voltage sensor head

    DOEpatents

    Crawford, T.M.; Davidson, J.R.; Woods, G.K.

    1999-08-17

    The invention is an electro-optic voltage sensor head designed for integration with existing types of high voltage transmission and distribution apparatus. The sensor head contains a transducer, which comprises a transducing material in which the Pockels electro-optic effect is observed. In the practice of the invention at least one beam of electromagnetic radiation is routed into the transducing material of the transducer in the sensor head. The beam undergoes an electro-optic effect in the sensor head when the transducing material is subjected to an E-field. The electro-optic effect is observed as a differential phase a shift, also called differential phase modulation, of the beam components in orthogonal planes of the electromagnetic radiation. In the preferred embodiment the beam is routed through the transducer along an initial axis and then reflected by a retro-reflector back substantially parallel to the initial axis, making a double pass through the transducer for increased measurement sensitivity. The preferred embodiment of the sensor head also includes a polarization state rotator and at least one beam splitter for orienting the beam along major and minor axes and for splitting the beam components into two signals which are independent converse amplitude-modulated signals carrying E-field magnitude and hence voltage information from the sensor head by way of optic fibers. 6 figs.

  13. Electro-optic voltage sensor head

    DOEpatents

    Crawford, Thomas M.; Davidson, James R.; Woods, Gregory K.

    1999-01-01

    The invention is an electro-optic voltage sensor head designed for integration with existing types of high voltage transmission and distribution apparatus. The sensor head contains a transducer, which comprises a transducing material in which the Pockels electro-optic effect is observed. In the practice of the invention at least one beam of electromagnetic radiation is routed into the transducing material of the transducer in the sensor head. The beam undergoes an electro-optic effect in the sensor head when the transducing material is subjected to an E-field. The electro-optic effect is observed as a differential phase a shift, also called differential phase modulation, of the beam components in orthogonal planes of the electromagnetic radiation. In the preferred embodiment the beam is routed through the transducer along an initial axis and then reflected by a retro-reflector back substantially parallel to the initial axis, making a double pass through the transducer for increased measurement sensitivity. The preferred embodiment of the sensor head also includes a polarization state rotator and at least one beam splitter for orienting the beam along major and minor axes and for splitting the beam components into two signals which are independent converse amplitude-modulated signals carrying E-field magnitude and hence voltage information from the sensor head by way of optic fibers.

  14. Effect of complete dentures on dynamic measurement of changing head position: A pilot study.

    PubMed

    Usumez, Aslihan; Usumez, Serdar; Orhan, Metin

    2003-10-01

    Complete dentures contribute significantly to the facial esthetics of edentulous patients. However, information as to the effect of complete dentures on the natural position of the head is limited. The purpose of this pilot study was to evaluate the immediate and 30-day effect of wearing complete dentures on the dynamic natural head position measured during walking. The sample consisted of a volunteer group of 16 patients, 8 women and 8 men, who received new complete dentures. The ages of the subjects ranged from 45 to 64 years (mean=52 years). Dynamic measurement of head posture was carried out by a specially constructed inclinometer device. Each subject in turn was fitted with the inclinometer system and instructed to walk in a relaxed manner for 5 minutes. The data, measured as degrees, were stored in a pocket data logger. This procedure was repeated before insertion of dentures (T1), immediately after insertion of dentures (T2), and 30 days after insertion of dentures (T3). Stored dynamic head posture data were transferred to computer for analysis. The means of the measurements were statistically compared with Friedman and following Wilcoxon tests (alpha =.05). Twelve of 16 (75%) subjects showed an average of 4.6 degrees of cranial extension immediately after insertion of dentures. Six (37.5%) subjects showed an average of 6.4 degrees of cranial flexion, and 8 (50%) subjects showed an average of 5.2 degrees of cranial extension at T3 relative to the T1 measurement. Dynamic head posture measurements of the other 2 subjects remained unchanged. There were significant differences between different measurements of dynamic head posture positions (P<.025). However, only the T1 and T2 measurements were significantly different (P<.015). The findings indicate that the statistically significant average extension 4.6 degrees in subjects immediately after insertion of complete dentures was not stable after a 30-day evaluation period and did not produce any statistically

  15. Experimental Investigation of Cavitation as a Possible Damage Mechanism in Blast-Induced Traumatic Brain Injury in Post-Mortem Human Subject Heads.

    PubMed

    Salzar, Robert S; Treichler, Derrick; Wardlaw, Andrew; Weiss, Greg; Goeller, Jacques

    2017-04-15

    The potential of blast-induced traumatic brain injury from the mechanism of localized cavitation of the cerebrospinal fluid (CSF) is investigated. While the mechanism and criteria for non-impact blast-induced traumatic brain injury is still unknown, this study demonstrates that local cavitation in the CSF layer of the cranial volume could contribute to these injuries. The cranial contents of three post-mortem human subject (PMHS) heads were replaced with both a normal saline solution and a ballistic gel mixture with a simulated CSF layer. Each were instrumented with multiple pressure transducers and placed inside identical shock tubes at two different research facilities. Sensor data indicates that cavitation may have occurred in the PMHS models at pressure levels below those for a 50% risk of blast lung injury. This study points to skull flexion, the result of the shock wave on the front of the skull leading to a negative pressure in the contrecoup, as a possible mechanism that contributes to the onset of cavitation. Based on observation of intracranial pressure transducer data from the PMHS model, cavitation onset is thought to occur from approximately a 140 kPa head-on incident blast.

  16. Identifying head-trunk and lower limb contributions to gaze stabilization during locomotion

    NASA Technical Reports Server (NTRS)

    Mulavara, Ajitkumar P.; Bloomberg, Jacob J.

    2002-01-01

    The goal of the present study was to determine how the multiple, interdependent full-body sensorimotor subsystems respond to a change in gaze stabilization task constraints during locomotion. Nine subjects performed two gaze stabilization tasks while walking at 6.4 km/hr on a motorized treadmill: 1) focusing on a central point target; 2) reading numeral characters; both presented at 2 m in front at the level of their eyes. While subjects performed the tasks we measured: temporal parameters of gait, full body sagittal plane segmental kinematics of the head, trunk, thigh, tibia and foot, accelerations along the vertical axis at the head and the tibia, and the vertical forces acting on the support surface. We tested the hypothesis that with the increased demands placed on visual acuity during the number recognition task, subjects would modify full-body segmental kinematics in order to reduce perturbations to the head in order to successfully perform the task. We found that while reading numeral characters as compared to the central point target: 1) compensatory head pitch movement was on average 22% greater despite the fact that the trunk pitch and trunk vertical translation movement control were not significantly changed; 2) coordination patterns between head and trunk as reflected by the peak cross correlation between the head pitch and trunk pitch motion as well as the peak cross correlation between the head pitch and vertical trunk translation motion were not significantly changed; 3) knee joint total movement was on average 11% greater during the period from the heel strike event to the peak knee flexion event in stance phase of the gait cycle; 4) peak acceleration measured at the head was significantly reduced by an average of 13% in four of the six subjects. This was so even when the peak acceleration at the tibia and the transmission of the shock wave at heel strike (measured by the peak acceleration ratio of the head/tibia and the time lag between the tibial

  17. Gravitoinertial force magnitude and direction influence head-centric auditory localization

    NASA Technical Reports Server (NTRS)

    DiZio, P.; Held, R.; Lackner, J. R.; Shinn-Cunningham, B.; Durlach, N.

    2001-01-01

    We measured the influence of gravitoinertial force (GIF) magnitude and direction on head-centric auditory localization to determine whether a true audiogravic illusion exists. In experiment 1, supine subjects adjusted computer-generated dichotic stimuli until they heard a fused sound straight ahead in the midsagittal plane of the head under a variety of GIF conditions generated in a slow-rotation room. The dichotic stimuli were constructed by convolving broadband noise with head-related transfer function pairs that model the acoustic filtering at the listener's ears. These stimuli give rise to the perception of externally localized sounds. When the GIF was increased from 1 to 2 g and rotated 60 degrees rightward relative to the head and body, subjects on average set an acoustic stimulus 7.3 degrees right of their head's median plane to hear it as straight ahead. When the GIF was doubled and rotated 60 degrees leftward, subjects set the sound 6.8 degrees leftward of baseline values to hear it as centered. In experiment 2, increasing the GIF in the median plane of the supine body to 2 g did not influence auditory localization. In experiment 3, tilts up to 75 degrees of the supine body relative to the normal 1 g GIF led to small shifts, 1--2 degrees, of auditory setting toward the up ear to maintain a head-centered sound localization. These results show that head-centric auditory localization is affected by azimuthal rotation and increase in magnitude of the GIF and demonstrate that an audiogravic illusion exists. Sound localization is shifted in the direction opposite GIF rotation by an amount related to the magnitude of the GIF and its angular deviation relative to the median plane.

  18. Effect of direction of head movement on motion sickness caused by Coriolis stimulation.

    PubMed

    Woodman, P D; Griffin, M J

    1997-02-01

    During constant speed rotation of the body, head rotation about an axis other than the axis of rotation of the body (i.e., Coriolis is stimulation) induces motion sickness. The position of the body relative to the center of rotation will influence the sickness caused by Coriolis stimulation; the direction of head movement will not affect the sickness caused by Coriolis stimulation. There were 24 seated subjects (12 male, 12 female) who made 30 degrees pitch motions of the head every 30 s while rotating about a vertical axis at 10 r.p.m. on a turntable at two separate locations: a) at the center of rotation; and b) 0.75 m from the center of rotation. After each head movement the subjects gave ratings of motion illness. There was no significant difference between illness 0.75 m from the center of rotation and illness at the center of rotation, or between the illness ratings from male and female subjects. Moving the head up from the horizontal caused significantly fewer increases in ratings of motion illness than moving the head back down to the horizontal. Precise location of the body at the center of rotation is not critical during Coriolis stimulation, but the direction of head movement has a large effect on nausea. An influence of somatosensory information on sickness caused by Coriolis stimulation is suggested.

  19. A Pilot Study of Horizontal Head and Eye Rotations in Baseball Batting.

    PubMed

    Fogt, Nick; Persson, Tyler W

    2017-08-01

    The purpose of the study was to measure and compare horizontal head and eye tracking movements as baseball batters "took" pitches and swung at baseball pitches. Two former college baseball players were tested in two conditions. A pitching machine was used to project tennis balls toward the subjects. In the first condition, subjects acted as if they were taking (i.e., not swinging) the pitches. In the second condition, subjects attempted to bat the pitched balls. Head movements were measured with an inertial sensor; eye movements were measured with a video eye tracker. For each condition, the relationship between the horizontal head and eye rotations was similar for the two subjects, as were the overall head-, eye-, and gaze-tracking strategies. In the "take" condition, head movements in the direction of the ball were larger than eye movements for much of the pitch trajectory. Large eye movements occurred only late in the pitch trajectory. Gaze was directed near the ball until approximately 150 milliseconds before the ball arrived at the batter, at which time gaze was directed ahead of the ball to a location near that occupied when the ball crosses the plate. In the "swing" condition, head movements in the direction of the ball were larger than eye movements throughout the pitch trajectory. Gaze was directed near the ball until approximately 50 to 60 milliseconds prior to pitch arrival at the batter. Horizontal head rotations were larger than horizontal eye rotations in both the "take" and "swing" conditions. Gaze was directed ahead of the ball late in the pitch trajectory in the "take" condition, whereas gaze was directed near the ball throughout much of the pitch trajectory in the "swing" condition.

  20. Clinical comparison of automatic, noninvasive measurements of blood pressure in the forearm and upper arm with the patient supine or with the head of the bed raised 45 degrees: a follow-up study.

    PubMed

    Schell, Kathleen; Lyons, Denise; Bradley, Elisabeth; Bucher, Linda; Seckel, Maureen; Wakai, Sandra; Carson, Elizabeth; Waterhouse, Julie; Chichester, Melanie; Bartell, Deborah; Foraker, Theresa; Simpson, E Kathleen

    2006-03-01

    Noninvasive measurement of blood pressure in the forearm is used when the upper arm is inaccessible and/or when available blood pressure cuffs do not fit a patient's arm. Evidence supporting this practice is limited. To compare noninvasive measurements of blood pressure in the forearm and upper arm of medical-surgical inpatients positioned supine and with the head of the bed raised 45 degrees . Cuff size was selected on the basis of forearm and upper arm circumference and manufacturers' recommendations. With a Welch Allyn Vital Signs 420 Series monitor, blood pressures were measured in the forearm and then in the upper arm of 221 supine patients with their arms resting at their sides. Patients were repositioned with the head of the bed elevated 45 degrees and after 2 minutes, blood pressures were measured in the upper arm and then the forearm. Starting position was alternated on subsequent subjects. Paired t tests revealed significant differences between systolic and diastolic blood pressures measured in the upper arm and forearm with patients supine and with the head of the bed elevated 45 degrees . The Bland-Altman procedure revealed that the distances between the mean values and the limits of agreement were from 15 to 33 mm Hg for individual subjects. Noninvasive measurements of blood pressure in the forearm and upper arm cannot be interchanged in medical-surgical patients who are supine or in patients with the head of the bed elevated 45 degrees .

  1. The Struggle Begins Early: Head Start and the Mississippi Freedom Movement

    ERIC Educational Resources Information Center

    Hale, Jon N.

    2012-01-01

    This article examines the history of Head Start, a federally funded program, whose conceptualization emerged in earlier phases of the Civil Rights Movement in order to provide education, nourishing meals, medical services, and a positive social environment for children about to enter the first grade. While Head Start was implemented in states…

  2. Multidisciplinary Treatment of Head and Neck Cancer

    PubMed Central

    Varkey, Prashanth; Liu, Yi-Tien; Tan, Ngian Chye

    2010-01-01

    Head and neck cancer remains a significant cause of morbidity worldwide. Multimodality treatment is often the only way to achieve improved function, quality of life, and survival, calling for a multidisciplinary team approach, particularly in view of the rapid advances being made in various fields. The roles of the head and neck surgeon and reconstructive surgeon are discussed, together with the input afforded by specialists in areas such as diagnostic imaging, radiation therapy, medical oncology, and gene therapy. Telemedicine is of importance in centers where multidisciplinary expertise is not available. PMID:22550455

  3. Knowledge and application of correct car seat head restraint usage among chiropractic college interns: a cross-sectional study.

    PubMed

    Taylor, John Am; Burke, Jeanmarie; Gavencak, John; Panwar, Pervinder

    2005-03-01

    Cervical spine injuries sustained in rear-end crashes cost at least $7 billion in insurance claims annually in the United States alone. When positioned correctly, head restraint systems have been proven effective in reducing the risk of whiplash associated disorders. Chiropractors should be knowledgeable about the correct use of head restraint systems to educate their patients and thereby prevent or minimize such injuries. The primary objective of this study was to determine the prevalence of correct positioning of car seat head restraints among the interns at our institution. The secondary objective was to determine the same chiropractic interns' knowledge of the correct positioning of car seat head restraints. It was hypothesized that 100 percent of interns would have their head restraint correctly positioned within an acceptable range and that all interns would possess the knowledge to instruct patients in the correct positioning of head restraints. Cross-sectional study of a convenient sample of 30 chiropractic interns from one institution. Interns driving into the parking lot of our health center were asked to volunteer to have measurements taken and to complete a survey. Vertical and horizontal positions of the head restraint were measured using a beam compass. A survey was administered to determine knowledge of correct head restraint position. The results were recorded, entered into a spreadsheet, and analyzed. 13.3 percent of subjects knew the recommended vertical distance and only 20 percent of subjects knew the recommended horizontal distance. Chi Square analyses substantiated that the majority of subjects were unaware of guidelines set forth by the National Highway Traffic Safety Administration (NHTSA) for the correct positioning of the head restraint (chi(2) (vertical) = 16.13, chi(2) (horizontal) = 10.80, p <.05). Only 6.7 percent of the subjects positioned their head restraint at the vertical distance of 6 cm or less (p <.05). However, 60 percent of

  4. Migraines: Simple Steps to Head Off the Pain

    MedlinePlus

    Migraines: Simple steps to head off the pain Migraines cause pain as real as the pain of ... Healthy habits and simple nonmedical remedies sometimes stop migraines before they start. By Mayo Clinic Staff Medication ...

  5. Stride-Cycle Influences on Goal-Directed Head Movements Made During Walking

    NASA Technical Reports Server (NTRS)

    Peters, Brian T.; vanEmmerik, Richard E. A.; Bloomberg, Jacob J.

    2006-01-01

    Horizontal head movements were studied in six subjects as they made rapid horizontal gaze adjustments while walking. The aim of the present research was to determine if gait-cycle events alter the head movement response to a visual target acquisition task. Gaze shifts of approximately 40deg were elicited by a step change in the position of a visual target from a central location to a second location in the left or right horizontal periphery. The timing of the target position change was constrained to occur at 25,50,75 and 100% of the stride cycle. The trials were randomly presented as the subjects walked on a treadmill at their preferred speed (range: 1.25 to 1.48 m/s, mean: 1.39 +/- 0.09 m/s ) . Analyses focused on the movement onset latencies of the head and eyes and on the peak velocity and saccade amplitude of the head movement response. A comparison of the group means indicated that the head movement onset lagged the eye onset (262 ms versus 252 ms). The head and eye movement onset latencies were not affected by either the direction of the target change nor the point in the gait cycle during which the target relocation occurred. However, the presence of an interaction between the gait cycle events and the direction of the visual target shift indicates that the peak head saccade velocity and head saccade amplitude are affected by the natural head oscillations that occur while walking.

  6. Peer-Assisted History-Taking Groups: A Subjective Assessment of their Impact Upon Medical Students' Interview Skills

    PubMed Central

    Keifenheim, Katharina Eva; Petzold, Ernst Richard; Junne, Florian; Erschens, Rebecca Sarah; Speiser, Natalie; Herrmann-Werner, Anne; Zipfel, Stephan; Teufel, Martin

    2017-01-01

    Background and Objectives: Among the clinical skills needed by all physicians, history taking is one of the most important. The teaching model for peer-assisted history-taking groups investigated in the present study consists of small-group courses in which students practice conducting medical interviews with real patients. The purpose of this pilot study was to investigate the expectations, experiences, and subjective learning progress of participants in peer-assisted history-taking groups. Methods: The 42 medical student participants completed a 4-month, peer-assisted, elective history-taking course, which both began and ended with a subjective assessment of their interview skills by way of a pseudonymized questionnaire. Measures comprised the students’ self-assessment of their interview skills, their expectations of, and their experiences with the course and especially with the peer tutors. Results: Medical students’ most important motivations in attending peer-assisted history-taking groups were becoming able to complete a structured medical interview, to mitigate difficult interviewing situations, and to address patients’ emotional demands appropriately. By the end of the course, students’ self-assessment of both their interview skills and management of emotional issues improved significantly. Students especially benefitted from individual feedback regarding interview style and relationship formation, as well as generally accepted and had their expectations met by peer tutors. Conclusions: To meet the important learning objectives of history-taking and management of emotional issues, as well as self-reflection and reflection of student–patient interactions, students in the field greatly appreciate practicing medical interviewing in small, peer-assisted groups with real patients. At the same time, peer tutors are experienced to be helpful and supportive and can help students to overcome inhibitions in making contact with patients. PMID:28890926

  7. Peer-Assisted History-Taking Groups: A Subjective Assessment of their Impact Upon Medical Students' Interview Skills.

    PubMed

    Keifenheim, Katharina Eva; Petzold, Ernst Richard; Junne, Florian; Erschens, Rebecca Sarah; Speiser, Natalie; Herrmann-Werner, Anne; Zipfel, Stephan; Teufel, Martin

    2017-01-01

    Background and Objectives: Among the clinical skills needed by all physicians, history taking is one of the most important. The teaching model for peer-assisted history-taking groups investigated in the present study consists of small-group courses in which students practice conducting medical interviews with real patients. The purpose of this pilot study was to investigate the expectations, experiences, and subjective learning progress of participants in peer-assisted history-taking groups. Methods: The 42 medical student participants completed a 4-month, peer-assisted, elective history-taking course, which both began and ended with a subjective assessment of their interview skills by way of a pseudonymized questionnaire. Measures comprised the students' self-assessment of their interview skills, their expectations of, and their experiences with the course and especially with the peer tutors. Results: Medical students' most important motivations in attending peer-assisted history-taking groups were becoming able to complete a structured medical interview, to mitigate difficult interviewing situations, and to address patients' emotional demands appropriately. By the end of the course, students' self-assessment of both their interview skills and management of emotional issues improved significantly. Students especially benefitted from individual feedback regarding interview style and relationship formation, as well as generally accepted and had their expectations met by peer tutors. Conclusions: To meet the important learning objectives of history-taking and management of emotional issues, as well as self-reflection and reflection of student-patient interactions, students in the field greatly appreciate practicing medical interviewing in small, peer-assisted groups with real patients. At the same time, peer tutors are experienced to be helpful and supportive and can help students to overcome inhibitions in making contact with patients.

  8. Heading and head injuries in soccer.

    PubMed

    Kirkendall, D T; Jordan, S E; Garrett, W E

    2001-01-01

    In the world of sports, soccer is unique because of the purposeful use of the unprotected head for controlling and advancing the ball. This skill obviously places the player at risk of head injury and the game does carry some risk. Head injury can be a result of contact of the head with another head (or other body parts), ground, goal post, other unknown objects or even the ball. Such impacts can lead to contusions, fractures, eye injuries, concussions or even, in rare cases, death. Coaches, players, parents and physicians are rightly concerned about the risk of head injury in soccer. Current research shows that selected soccer players have some degree of cognitive dysfunction. It is important to determine the reasons behind such deficits. Purposeful heading has been blamed, but a closer look at the studies that focus on heading has revealed methodological concerns that question the validity of blaming purposeful heading of the ball. The player's history and age (did they play when the ball was leather and could absorb significant amounts of water), alcohol intake, drug intake, learning disabilities, concussion definition and control group use/composition are all factors that cloud the ability to blame purposeful heading. What does seem clear is that a player's history of concussive episodes is a more likely explanation for cognitive deficits. While it is likely that the subconcussive impact of purposeful heading is a doubtful factor in the noted deficits, it is unknown whether multiple subconcussive impacts might have some lingering effects. In addition, it is unknown whether the noted deficits have any affect on daily life. Proper instruction in the technique is critical because if the ball contacts an unprepared head (as in accidental head-ball contacts), the potential for serious injury is possible. To further our understanding of the relationship of heading, head injury and cognitive deficits, we need to: learn more about the actual impact of a ball on the

  9. Optokinetic motion sickness - Attenuation of visually-induced apparent self-rotation by passive head movements

    NASA Technical Reports Server (NTRS)

    Teixeira, R. A.; Lackner, J. R.

    1979-01-01

    An experimental study was conducted on seven normal subjects to evaluate the effectiveness of passive head movements in suppressing the optokinetically-induced illusory self-rotation. Visual simulation was provided by a servo-controlled optokinetic drum. Each subject participated in two experimental sessions. In one condition, the subject's head remained stationary while he gazed passively at a moving stripe pattern. In the other, he gazed passively and relaxed his neck muscles while his head was rotated from side to side. It appears that suppression of optokinetically-induced illusory self-rotation with passive head movements results from the operation of a spatial constancy mechanism interrelating visual, vestibular, and kinesthetic information on ongoing body orientation. The results support the view that optokinetic 'motion sickness' is related, at least in part, to an oculomotor disturbance rather than a visually triggered disturbance of specifically vestibular etiology.

  10. HEAD CIRCUMFERENCE REFERENCES FOR SCHOOL AGE CHILDREN IN WESTERN ROMANIA.

    PubMed

    Chirita-Emandi, Adela; Doros, Gabriela; Simina, Iulia Jurca; Gafencu, Mihai; Puiu, Maria

    2015-01-01

    To provide head circumference references for school-aged children in western Romania, and compare them with references from other European countries. A total of 2742 children, aged 6-19 years, from Timis county, were examined by medical students, between February 2010-June 2011. Head circumference references were constructed by Cole's LMS method with LMSChartMaker software. The Romanian 3rd, 50th and 97th percentiles for head circumference were compared with recent references from Belgium and Germany. Generally, boys show significantly larger head circumference compared to girls at any age. The head circumference increments between 6 and 19 years are < 1 cm/year. Head circumference increments decrease in increasing age of the children. In girls, adult head circumference is reached at the age of 16 years, whereas head circumference growth continues, in boys, slowly until 18 years. The comparison of Romanian head percentiles with those from Belgium and Germany revealed a smaller head circumference in Romanian children (both girls and boys). Comparing head circumference references from Romania to those from Germany and Belgium, we found lower median head circumference in Romanian boys and girls, that could be explained by a taller stature of boys and girls in Germany and Belgium compared to Romania.

  11. Creating a mobile subject guide to improve access to point-of-care resources for medical students: a case study.

    PubMed

    Boruff, Jill T; Bilodeau, Edward

    2012-01-01

    Can a mobile optimized subject guide facilitate medical student access to mobile point-of-care tools? The guide was created at a library at a research-intensive university with six teaching hospital sites. The team created a guide facilitating medical student access to point-of-care tools directly on mobile devices to provide information allowing them to access and set up resources with little assistance. Two librarians designed a mobile optimized subject guide for medicine and conducted a survey to test its usefulness. Web analytics and survey results demonstrate that the guide is used and the students are satisfied. The library will continue to use the subject guide as its primary means of supporting mobile devices. It remains to be seen if the mobile guide facilitates access for those who do not need assistance and want direct access to the resources. Internet access in the hospitals remains an issue.

  12. Head restraint backset during routine automobile driving: drivers usually exceed the recommended guidelines.

    PubMed

    Shugg, Jarrod A J; Vernest, Kyle; Dickey, James P

    2011-04-01

    Although several previous studies have evaluated horizontal head restraint backset distances, few studies have evaluated them during driving. The purpose of this study was to measure this backset during routine automobile driving and to specifically evaluate the backset during individual driving tasks such as turning, stopping, starting, and lane changes. Fourteen subjects drove around a specified route through the city of Guelph, Ontario, Canada, that included residential, thruway, and highway driving; additional minor driving tasks, such as lane changes, were evaluated. The distance of head restraint to posterior aspect of the head was measured continuously throughout the drive using an ultrasonic measurement system. The timing of specific tasks was documented using a video camera. The average head-to-restraint distance throughout the driving route was 78.1 mm (standard deviation [SD] 24.8 mm); this distance did not vary significantly between the global measures during various driving areas (residential, thruway, and highway). We observed that the head restraint backsets during right turns (93.6 mm; SD 34.8 mm) were significantly larger compared to the other driving tasks (p < .001). The 7 males and 7 females showed similar backset distances: 84.52 mm (SD 12.08) and 71.68 mm (SD 5.53), respectively (p = .0785). We observed that most subjects maintain a relatively consistent head-to-restraint distance throughout their driving route; 2 subjects adopted very large head restraint backset distances throughout their drive and 2 others adopted very small head restraint backset distances-this appears to reflect driver posture. Twelve of 14 subjects had average backset distances that exceed the National Highway Traffic Safety Administration and the Federal Motor Vehicle Safety Standard guidelines, indicating that most drivers may be at risk for whiplash-like disorders if exposed to a rear impact while driving. Of the monitored driving tasks, turning, especially right

  13. Visual Acuity Using Head-fixed Displays During Passive Self and Surround Motion

    NASA Technical Reports Server (NTRS)

    Wood, Scott J.; Black, F. Owen; Stallings, Valerie; Peters, Brian

    2007-01-01

    The ability to read head-fixed displays on various motion platforms requires the suppression of vestibulo-ocular reflexes. This study examined dynamic visual acuity while viewing a head-fixed display during different self and surround rotation conditions. Twelve healthy subjects were asked to report the orientation of Landolt C optotypes presented on a micro-display fixed to a rotating chair at 50 cm distance. Acuity thresholds were determined by the lowest size at which the subjects correctly identified 3 of 5 optotype orientations at peak velocity. Visual acuity was compared across four different conditions, each tested at 0.05 and 0.4 Hz (peak amplitude of 57 deg/s). The four conditions included: subject rotated in semi-darkness (i.e., limited to background illumination of the display), subject stationary while visual scene rotated, subject rotated around a stationary visual background, and both subject and visual scene rotated together. Visual acuity performance was greatest when the subject rotated around a stationary visual background; i.e., when both vestibular and visual inputs provided concordant information about the motion. Visual acuity performance was most reduced when the subject and visual scene rotated together; i.e., when the visual scene provided discordant information about the motion. Ranges of 4-5 logMAR step sizes across the conditions indicated the acuity task was sufficient to discriminate visual performance levels. The background visual scene can influence the ability to read head-fixed displays during passive motion disturbances. Dynamic visual acuity using head-fixed displays can provide an operationally relevant screening tool for visual performance during exposure to novel acceleration environments.

  14. Variations in the axis of motion during head repositioning--a comparison of subjects with whiplash-associated disorders or non-specific neck pain and healthy controls.

    PubMed

    Grip, Helena; Sundelin, Gunnevi; Gerdle, Björn; Karlsson, J Stefan

    2007-10-01

    The ability to reproduce head position can be affected in patients after a neck injury. The repositioning error is commonly used as a measure of proprioception, but variations in the movement might provide additional information. The axis of motion and target performance were analyzed during a head repositioning task (flexion, extension and side rotations) for 24 control subjects, 22 subjects with whiplash-associated disorders and 21 with non-specific neck pain. Questionnaires regarding pain intensity and fear avoidance were collected. Head position and axis of motion parameters were calculated using a helical axis model with a moving window of 4 degrees . During flexion the whiplash group had a larger constant repositioning error than the control group (-1.8(2.9) degrees vs. 0.1(2.4) degrees , P=0.04). The axis was more inferior in both neck pain groups (12.0(1.6)cm vs. 14.5(2.0)cm, P<0.05) indicating movement at a lower level in the spine. Including pain intensity from shoulder and neck region as covariates showed an effect on the axis position (P=0.03 and 0.04). During axial rotation to the left there was more variation in axis direction for neckpain groups as compared with controls (4.0(1.7) degrees and 3.7(2.4) degrees vs. 2.3(1.9) degrees , P=0.01 and 0.05). No significant difference in fear avoidance was found between the two neck pain groups. Measuring variation in the axis of motion together with target performance gives objective measures on proprioceptive ability that are difficult to quantify by visual inspection. Repositioning errors were in general small, suggesting it is not sufficient as a single measurement variable in a clinical situation, but should be measured in combination with other tests, such as range of motion.

  15. Prevalence of head injury and medically diagnosed concussion in junior-level community-based Australian Rules Football.

    PubMed

    Hecimovich, Mark D; King, Doug

    2017-03-01

    For junior-level Australian Rules Football there is a paucity of head injury and concussion surveillance data; thus, the primary aim was to document head injury and concussion incidence in participants aged 9-17 years with a secondary aim to identify the mechanism-of-injury. A prospective cohort study in which a designated representative for each of the 41 teams recorded on a weekly basis the number of head injuries suspected of being a concussion, diagnosed concussions and the mechanism-of-injury during competition games over the course of a 12-game season. For analysis three groups were formed - number of Player-Seasons, Athlete-Exposures, head injury and concussion incidence per 1000 Athlete-Exposures - and were calculated. Narrative data was categorised. There was 13 reported head injuries resulting in seven concussions in the sample population (n = 976). The incidence rates for head injury and concussion were 1.1 (95% confidence interval: 0.5-1.7) and 0.59 (95% confidence interval: 0.2-1.0) per 1000 Athlete-Exposures. There were four head injuries resulting in two concussions in the 12-13-year-old group and nine head injuries and five concussions in the 14-17-year-old group. Two categories emerged for mechanism-of-injury: player-to-surface and player-to-player, with 9 of the 13 head injuries resulting from player-to-player contact. The incidence rates were similar in the two older groups and lower in comparison with American football and rugby. The data collected have advanced our knowledge of head injury incidence and established baseline data which to compare in future years and may assist in development of preventative measures. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  16. Mechanisms of head injuries in elite football

    PubMed Central

    Andersen, T; Arnason, A; Engebretsen, L; Bahr, R

    2004-01-01

    Objectives: The aim of this study was to describe, using video analysis, the mechanisms of head injuries and of incidents with a high risk of head injury in elite football. Methods: Videotapes and injury information were collected prospectively for 313 of the 409 matches played in the Norwegian (2000 season) and Icelandic (1999 and 2000 season) professional leagues. Video recordings of incidents where a player appeared to be hit in the head and the match was consequently interrupted by the referee were analysed and cross referenced with reports of acute time loss injuries from the team medical staff. Results: The video analysis revealed 192 incidents (18.8 per 1000 player hours). Of the 297 acute injuries reported, 17 (6%) were head injuries, which corresponds to an incidence of 1.7 per 1000 player hours (concussion incidence 0.5 per 1000 player hours). The most common playing action was a heading duel with 112 cases (58%). The body part that hit the injured player's head was the elbow/arm/hand in 79 cases (41%), the head in 62 cases (32%), and the foot in 25 cases (13%). In 67 of the elbow/arm/hand impacts, the upper arm of the player causing the incident was at or above shoulder level, and the arm use was considered to be active in 61 incidents (77%) and intentional in 16 incidents (20%). Conclusions: This study suggests that video analysis provides detailed information about the mechanisms for head injuries in football. The most frequent injury mechanism was elbow to head contact, followed by head to head contact in heading duels. In the majority of the elbow to head incidents, the elbow was used actively at or above shoulder level, and stricter rule enforcement or even changes in the laws of the game concerning elbow use should perhaps be considered, in order to reduce the risk of head injury. PMID:15562161

  17. Asthma Management Practices and Education Needs of Head Start Directors and Staff.

    ERIC Educational Resources Information Center

    Huss, Karen; Winkelstein, Marilyn; Calabrese, Barbara; Butz, Arlene; Reshef, Shoshana; Rand, Cynthia; Gilpin, Adele

    2002-01-01

    Surveyed Baltimore Head Start directors and staff participating in an asthma education intervention at 15 Head Start programs to determine their asthma management practices and education needs. Results revealed discrepancies between staff and directors regarding location of asthma medications and presence of asthma action plans in programs. Both…

  18. Qualitative Literature Review of the Prevalence of Depression in Medical Students Compared to Students in Non-medical Degrees.

    PubMed

    Bacchi, Stephen; Licinio, Julio

    2015-06-01

    The purpose of this study is to review studies published in English between 1 January 2000 and 16 June 2014, in peer-reviewed journals, that have assessed the prevalence of depression, comparing medical students and non-medical students with a single evaluation method. The databases PubMed, Medline, EMBASE, PsycINFO, and Scopus were searched for eligible articles. Searches used combinations of the Medical Subject Headings medical student and depression. Titles and abstracts were reviewed to determine eligibility before full-text articles were retrieved, which were then also reviewed. Twelve studies met eligibility criteria. Non-medical groups surveyed included dentistry, business, humanities, nursing, pharmacy, and architecture students. One study found statistically significant results suggesting that medical students had a higher prevalence of depression than groups of non-medical students; five studies found statistically significant results indicating that the prevalence of depression in medical students was less than that in groups of non-medical students; four studies found no statistically significant difference, and two studies did not report on the statistical significance of their findings. One study was longitudinal, and 11 studies were cross-sectional. While there are limitations to these comparisons, in the main, the reviewed literature suggests that medical students have similar or lower rates of depression compared to certain groups of non-medical students. A lack of longitudinal studies meant that potential common underlying causes could not be discerned, highlighting the need for further research in this area. The high rates of depression among medical students indicate the continuing need for interventions to reduce depression.

  19. Anatomic fit of six different radial head plates: comparison of precontoured low-profile radial head plates.

    PubMed

    Burkhart, Klaus Josef; Nowak, Tobias E; Kim, Yoon-Joo; Rommens, Pol M; Müller, Lars P

    2011-04-01

    Bulky implants may lead to symptomatic soft tissue irritation after open reduction and internal fixation of radial head and neck fractures. The purpose of our study was to compare the anatomic fit of precontoured radial head plates. We stripped 22 embalmed human cadaveric radiuses of soft tissues. We investigated 6 radial head plates: (1) the Medartis radial head buttress plate (MBP), (2) the Medartis radial head rim plate (MRP), (3) the Synthes radial neck plate (SNP), (4) the Synthes radial head plate (SHP), (5) the Acumed radial head plate (AHP), and (6) the Wright radial head plate (WHP). Each plate was applied to each radial head at the place of best fit within the safe zone. We tested 4 parameters of anatomic fit: (1) plate-to-bone distance, (2) plate contact judged by 3 different observers, (3) pin-subchondral zone distance, and (4) plate-to-bone contact after adjustment of the plates. The MBP and MRP showed the lowest profile by objective measurements, the SNP and AHP had a moderate profile, and the SHP and WHP demonstrated the bulkiest profile. The subjective assessments also demonstrated the best fit for the MBP, a good fit for the SNP, a moderate fit for the MRP and AHP, and a poor fit for the SHP and WHP. The MBP, MRP, and AHP could always provide pin-subchondral zone contact, unlike the SHP, SNP, and WHP. After bending, significant improvement of plate-to-bone distance could only be seen for the MBP, MRP, and WHP. The ranking among plates remained the same except for the WHP, which showed a significantly lower plate-to-bone distance than the SHP. Currently available radial head implants are heterogeneous. The MBP and MRP showed the lowest profile and best anatomic fit. Owing to the complex radial head anatomy, to date there is no one radial head plate that perfectly fits all radial heads. Conformance of existing plates to the radial head and neck is not perfect. Careful plate selection and modification, when necessary, may minimize interference of this

  20. Identifying Head-Trunk and Lower Limb Contributions to Gaze Stabilization During Locomotion

    NASA Technical Reports Server (NTRS)

    Mulavara, Ajitkumar P.; Bloomberg, Jacob J.

    2003-01-01

    The goal of the present study was to determine how the multiple, interdependent full-body sensorimotor subsystems respond to a change in gaze stabilization task constraints during locomotion. Nine subjects performed two gaze stabilization tasks while walking at 6.4 km/hr on a motorized treadmill: 1) focusing on a central point target; 2) reading numeral characters; both presented at 2m in front at the level of their eyes. While subjects performed the tasks we measured: temporal parameters of gait, full body sagittal plane segmental kinematics of the head, trunk, thigh, shank and foot, accelerations along the vertical axis at the head and the shank, and the vertical forces acting on the support surface. We tested the hypothesis that with the increased demands placed on visual acuity during the number recognition task, subjects would modify full-body segmental kinematics in order to reduce perturbations to the head in order to successfully perform the task. We found that while reading numeral characters as - compared to the central point target: 1) compensatory head pitch movement was on average 22% greater despite the fact that the trunk pitch and trunk vertical translation movement control were not significantly changed; 2) coordination patterns between head and trunk as reflected by the peak cross correlation between the head pitch and trunk pitch motion as well as the peak cross correlation between the head pitch and vertical trunk translation motion were not significantly changed; 3) knee joint total movement was on average 11% greater during the period from the heel strike event to the peak knee flexion event in stance phase of the gait cycle; 4) peak acceleration measured at the head was significantly reduced by an average of 13% in four of the six subjects. This was so even when the peak acceleration at the shank and the transmissibility of the shock wave at heel strike (measured by the peak acceleration ratio of the head/shank) remained unchanged. Taken

  1. Development and Use of Mark Sense Record Cards for Recording Medical Data on Pilots Subjected to Acceleration Stress

    NASA Technical Reports Server (NTRS)

    Smedal, Harald A.; Havill, C. Dewey

    1962-01-01

    A TIME-HONORED system of recording medical histories and the data obtained on physical and laboratory examination has been that of writing the information on record sheets that go into a folder for each patient. In order to have information which would be more readily retrieved, 'a program was initiated in 1952 by the U. S. Naval School of Aviation Medicine in connection with their "Care of the Flyer" study to place this information on machine record cards. In 1958, a machine record card method was developed for recording medical data in connection with the astronaut selection program. Machine record cards were also developed by the Aero Medical Laboratory, Wright-Patterson AFB, Ohio, and the Aviation Medical Acceleration Laboratory, Naval Air Development Center, Johnsville, Pennsylvania, for use in connection with a variety of tests including acceleration stress.1 Therefore, a variety of systems resulted in which data of a medical nature could easily be recalled. During the NASA, Ames Research Center centrifuge studies/'S the pilot subjects were interviewed after each centrifuge run, or series of runs, and subjective information was recorded in a log book by the usual history taking methods referred to above. After the methods Were reviewed, it' was recognized that a card system would be very useful in recording data from our pilots after they had been exposed to acceleration stress. Since the acceleration stress cards already developed did not meet our requirements, it was decided a different card was needed.

  2. Burnout in medical students: a systematic review of experiences in Chinese medical schools.

    PubMed

    Chunming, Wang Michael; Harrison, Reema; MacIntyre, Raina; Travaglia, Joanna; Balasooriya, Chinthaka

    2017-11-16

    To identify the: extent to which medical students in China experience burnout; factors contributing to this; potential solutions to reduce and prevent burnout in this group; and the extent to which the experiences of Chinese students reflect the international literature. Systematic review and narrative synthesis. Key words, synonyms and subject headings were used to search five electronic databases in addition to manual searching of relevant journals. Titles and abstracts of publications between 1st January 1989-31st July 2016 were screened by two reviewers and checked by a third. Full text articles were screened against the eligibility criteria. Data on design, methods and key findings were extracted and synthesised. Thirty-three studies were eligible and included in the review. Greater levels of burnout were generally identified in males, more senior medical students, and those who already experienced poorer psychological functioning. Few studies explored social or contextual factors influencing burnout, but those that did suggest that factors such as the degree of social support or the living environment surrounding a student may be a determinant of burnout. Greater understanding of the social and contextual determinants of burnout amongst medical students in China is essential towards identifying solutions to reduce and prevent burnout in this group.

  3. Medical Image Compression Using a New Subband Coding Method

    NASA Technical Reports Server (NTRS)

    Kossentini, Faouzi; Smith, Mark J. T.; Scales, Allen; Tucker, Doug

    1995-01-01

    A recently introduced iterative complexity- and entropy-constrained subband quantization design algorithm is generalized and applied to medical image compression. In particular, the corresponding subband coder is used to encode Computed Tomography (CT) axial slice head images, where statistical dependencies between neighboring image subbands are exploited. Inter-slice conditioning is also employed for further improvements in compression performance. The subband coder features many advantages such as relatively low complexity and operation over a very wide range of bit rates. Experimental results demonstrate that the performance of the new subband coder is relatively good, both objectively and subjectively.

  4. Porcine head response to blast.

    PubMed

    Shridharani, Jay K; Wood, Garrett W; Panzer, Matthew B; Capehart, Bruce P; Nyein, Michelle K; Radovitzky, Raul A; Bass, Cameron R 'dale'

    2012-01-01

    Recent studies have shown an increase in the frequency of traumatic brain injuries related to blast exposure. However, the mechanisms that cause blast neurotrauma are unknown. Blast neurotrauma research using computational models has been one method to elucidate that response of the brain in blast, and to identify possible mechanical correlates of injury. However, model validation against experimental data is required to ensure that the model output is representative of in vivo biomechanical response. This study exposes porcine subjects to primary blast overpressures generated using a compressed-gas shock tube. Shock tube blasts were directed to the unprotected head of each animal while the lungs and thorax were protected using ballistic protective vests similar to those employed in theater. The test conditions ranged from 110 to 740 kPa peak incident overpressure with scaled durations from 1.3 to 6.9 ms and correspond approximately with a 50% injury risk for brain bleeding and apnea in a ferret model scaled to porcine exposure. Instrumentation was placed on the porcine head to measure bulk acceleration, pressure at the surface of the head, and pressure inside the cranial cavity. Immediately after the blast, 5 of the 20 animals tested were apneic. Three subjects recovered without intervention within 30 s and the remaining two recovered within 8 min following respiratory assistance and administration of the respiratory stimulant doxapram. Gross examination of the brain revealed no indication of bleeding. Intracranial pressures ranged from 80 to 390 kPa as a result of the blast and were notably lower than the shock tube reflected pressures of 300-2830 kPa, indicating pressure attenuation by the skull up to a factor of 8.4. Peak head accelerations were measured from 385 to 3845 G's and were well correlated with peak incident overpressure (R(2) = 0.90). One SD corridors for the surface pressure, intracranial pressure (ICP), and head acceleration are

  5. Porcine Head Response to Blast

    PubMed Central

    Shridharani, Jay K.; Wood, Garrett W.; Panzer, Matthew B.; Capehart, Bruce P.; Nyein, Michelle K.; Radovitzky, Raul A.; Bass, Cameron R. ‘Dale’

    2012-01-01

    Recent studies have shown an increase in the frequency of traumatic brain injuries related to blast exposure. However, the mechanisms that cause blast neurotrauma are unknown. Blast neurotrauma research using computational models has been one method to elucidate that response of the brain in blast, and to identify possible mechanical correlates of injury. However, model validation against experimental data is required to ensure that the model output is representative of in vivo biomechanical response. This study exposes porcine subjects to primary blast overpressures generated using a compressed-gas shock tube. Shock tube blasts were directed to the unprotected head of each animal while the lungs and thorax were protected using ballistic protective vests similar to those employed in theater. The test conditions ranged from 110 to 740 kPa peak incident overpressure with scaled durations from 1.3 to 6.9 ms and correspond approximately with a 50% injury risk for brain bleeding and apnea in a ferret model scaled to porcine exposure. Instrumentation was placed on the porcine head to measure bulk acceleration, pressure at the surface of the head, and pressure inside the cranial cavity. Immediately after the blast, 5 of the 20 animals tested were apneic. Three subjects recovered without intervention within 30 s and the remaining two recovered within 8 min following respiratory assistance and administration of the respiratory stimulant doxapram. Gross examination of the brain revealed no indication of bleeding. Intracranial pressures ranged from 80 to 390 kPa as a result of the blast and were notably lower than the shock tube reflected pressures of 300–2830 kPa, indicating pressure attenuation by the skull up to a factor of 8.4. Peak head accelerations were measured from 385 to 3845 G’s and were well correlated with peak incident overpressure (R2 = 0.90). One SD corridors for the surface pressure, intracranial pressure (ICP), and head acceleration are

  6. Head and cervical posture in patients with temporomandibular disorders.

    PubMed

    Armijo-Olivo, Susan; Rappoport, Karen; Fuentes, Jorge; Gadotti, Inae Caroline; Major, Paul W; Warren, Sharon; Thie, Norman M R; Magee, David J

    2011-01-01

    To determine whether patients with myogenous or mixed (ie, myogeneous plus arthrogeneous) temporomandibular disorders (TMD) had different head and cervical posture measured through angles commonly used in clinical research settings when compared to healthy individuals. One hundred fifty-four persons participated in this study. Of these, 50 subjects were healthy, 55 subjects had myogenous TMD, and 49 subjects had mixed TMD (ie, arthrogenous plus myogenous TMD). A lateral photograph was taken with the head in the self-balanced position. Four angles were measured in the photographs: (1) Eye-Tragus-Horizontal, (2) Tragus-C7-Horizontal, (3) Pogonion-Tragus-C7, and (4) Tragus-C7-Shoulder. Alcimagen software specially designed to measure angles was used in this study. All of the measurements were performed by a single trained rater, a dental specialist in orthodontics, blinded to each subject's group status. The only angle that reached statistical significance among groups was the Eye-Tragus-Horizontal (F = 3.03, P = .040). Pairwise comparisons determined that a mean difference of 3.3 degrees (95% confidence intervals [CI]: 0.15, 6.41) existed when comparing subjects with myogenous TMD and healthy subjects (P = .036). Postural angles were not significantly related to neck disability, jaw disability, or pain intensity. Intrarater and interrater reliability of the measurements were excellent, with intraclass correlation coefficient (ICC) values ranging between 0.996-0.998. The only statistically significant difference in craniocervical posture between patients with myogenous TMD and healthy subjects was for the Eye-Tragus-Horizontal angle, indicating a more extended position of the head. However, the difference was very small (3.3 degrees) and was judged not to be clinically significant.

  7. Creating a mobile subject guide to improve access to point-of-care resources for medical students: a case study

    PubMed Central

    Boruff, Jill T; Bilodeau, Edward

    2012-01-01

    Question: Can a mobile optimized subject guide facilitate medical student access to mobile point-of-care tools? Setting: The guide was created at a library at a research-intensive university with six teaching hospital sites. Objectives: The team created a guide facilitating medical student access to point-of-care tools directly on mobile devices to provide information allowing them to access and set up resources with little assistance. Methods: Two librarians designed a mobile optimized subject guide for medicine and conducted a survey to test its usefulness. Results: Web analytics and survey results demonstrate that the guide is used and the students are satisfied. Conclusion: The library will continue to use the subject guide as its primary means of supporting mobile devices. It remains to be seen if the mobile guide facilitates access for those who do not need assistance and want direct access to the resources. Internet access in the hospitals remains an issue. PMID:22272160

  8. Uneasy subjects: medical students' conflicts over the pharmaceutical industry.

    PubMed

    Holloway, Kelly

    2014-08-01

    In this article I report on an investigation of the pharmaceutical industry's influence in medical education. Findings are based on fifty semi-structured interviews with medical students in the United States and Canada conducted between 2010 and 2013. Participant responses support the survey-based literature demonstrating that there is clear and pervasive influence of the pharmaceutical industry in medical education. They also challenge the theory that medical students feel entitled to industry gifts and uncritically accept industry presence. I investigate how medical students who are critical of the pharmaceutical industry negotiate its presence in the course of their medical education. Findings suggest that these participants do not simply absorb industry presence, but interpret it and respond in complex ways. Participants were uncomfortable with industry influence throughout their medical training and found multifaceted ways to resist. They struggled with power relations in medical training and the prevailing notion that industry presence is a normal part of medical education. I argue that this pervasive norm of industry presence is located in neoliberal structural transformations within and outside both education and medicine. The idea that industry presence is normal and inevitable represents a challenge for students who are critical of industry. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  9. Video analysis of head blows leading to concussion in competition Taekwondo.

    PubMed

    Koh, Jae O; Watkinson, E Jane; Yoon, Yong-Jin

    2004-12-01

    To analyse the situational and contextual factors surrounding concussions and head blows in Taekwondo. Prospective design. Direct observation, subject interview and videotape recording used. A total of 2328 competitors participated in the 2001 tournament, South Korea. All matches were recorded on videotape. All recipients of head blows were interviewed by athletic therapists and the researcher immediately after the match. The videotapes of concussions and head blows were analysed. A total of 1009 head blows including concussions were analysed. Head blows and concussions were most evident when the attacker was situated in a closed stance and received a single roundhouse kick. The most frequent anatomical site of the head impact was the temporal region. The frequency of head blows and concussions is high in Taekwondo. Development of blocking skills, safety education, rigorous enforcement of the competition rules and improvement of head-gear are recommended.

  10. The Video Head Impulse Test.

    PubMed

    Halmagyi, G M; Chen, Luke; MacDougall, Hamish G; Weber, Konrad P; McGarvie, Leigh A; Curthoys, Ian S

    2017-01-01

    In 1988, we introduced impulsive testing of semicircular canal (SCC) function measured with scleral search coils and showed that it could accurately and reliably detect impaired function even of a single lateral canal. Later we showed that it was also possible to test individual vertical canal function in peripheral and also in central vestibular disorders and proposed a physiological mechanism for why this might be so. For the next 20 years, between 1988 and 2008, impulsive testing of individual SCC function could only be accurately done by a few aficionados with the time and money to support scleral search-coil systems-an expensive, complicated and cumbersome, semi-invasive technique that never made the transition from the research lab to the dizzy clinic. Then, in 2009 and 2013, we introduced a video method of testing function of each of the six canals individually. Since 2009, the method has been taken up by most dizzy clinics around the world, with now close to 100 refereed articles in PubMed. In many dizzy clinics around the world, video Head Impulse Testing has supplanted caloric testing as the initial and in some cases the final test of choice in patients with suspected vestibular disorders. Here, we consider seven current, interesting, and controversial aspects of video Head Impulse Testing: (1) introduction to the test; (2) the progress from the head impulse protocol (HIMPs) to the new variant-suppression head impulse protocol (SHIMPs); (3) the physiological basis for head impulse testing; (4) practical aspects and potential pitfalls of video head impulse testing; (5) problems of vestibulo-ocular reflex gain calculations; (6) head impulse testing in central vestibular disorders; and (7) to stay right up-to-date-new clinical disease patterns emerging from video head impulse testing. With thanks and appreciation we dedicate this article to our friend, colleague, and mentor, Dr Bernard Cohen of Mount Sinai Medical School, New York, who since his first

  11. AHNS Series: Do you know your guidelines? Perioperative antithrombotic management in head and neck surgery.

    PubMed

    Meyer, Annika; Gross, Neil; Teng, Marita

    2018-01-01

    Head and neck surgeons are commonly faced with surgical patients who have underlying medical problems requiring antithrombotic therapy. It is difficult to achieve a balance between minimizing the risk of thromboembolism and hemorrhage in the perioperative period. Data from randomized, controlled trials are limited, and procedure-specific bleed rates are also difficult to pinpoint. The decision is made more difficult when patients with moderate-to-high risk for thromboembolic events undergo procedures that are high risk for bleeding. This is true for many head and neck oncologic surgeries. Furthermore, although elective procedures may be delayed for optimization of antithrombotic medication, emergent procedures cannot. Head and neck surgery often represents the most challenging of all these circumstances, given the potential risk of airway compromise from bleeding after head and neck surgery. © 2017 Wiley Periodicals, Inc.

  12. Destabilizing effects of visual environment motions simulating eye movements or head movements

    NASA Technical Reports Server (NTRS)

    White, Keith D.; Shuman, D.; Krantz, J. H.; Woods, C. B.; Kuntz, L. A.

    1991-01-01

    In the present paper, we explore effects on the human of exposure to a visual virtual environment which has been enslaved to simulate the human user's head movements or eye movements. Specifically, we have studied the capacity of our experimental subjects to maintain stable spatial orientation in the context of moving their entire visible surroundings by using the parameters of the subjects' natural movements. Our index of the subjects' spatial orientation was the extent of involuntary sways of the body while attempting to stand still, as measured by translations and rotations of the head. We also observed, informally, their symptoms of motion sickness.

  13. Medical waste management training for healthcare managers - a necessity?

    PubMed

    Ozder, Aclan; Teker, Bahri; Eker, Hasan Huseyin; Altındis, Selma; Kocaakman, Merve; Karabay, Oguz

    2013-07-16

    This is an interventional study, since a training has been given, performed in order to investigate whether training has significant impact on knowledge levels of healthcare managers (head-nurses, assistant head nurses, hospital managers and deputy managers) regarding bio-medical waste management. The study was conducted on 240 volunteers during June - August 2010 in 12 hospitals serving in Istanbul (private, public, university, training-research hospitals and other healthcare institutions). A survey form prepared by the project guidance team was applied to the participants through the internet before and after the training courses. The training program was composed of 40 hours of theory and 16 hours of practice sessions taught by persons known to have expertise in their fields. Methods used in the analysis of the data chi-square and t-tests in dependent groups. 67.5% (162) of participants were female. 42.5% (102) are working in private, and 21.7% in state-owned hospitals. 50.4% are head-nurses, and 18.3% are hospital managers.A statistically significant difference was found among those who had received medical waste management training (preliminary test and final test) and others who had not (p<0.01). It was observed that information levels of all healthcare managers who had received training on waste management had risen at the completion of that training session. On the subject of waste management, to have trained healthcare employees who are responsible for the safe disposal of wastes in hospitals is both a necessity for the safety of patients and important for its contribution to the economy of the country.

  14. Scientific production of medical sciences universities in north of iran.

    PubMed

    Siamian, Hasan; Firooz, Mousa Yamin; Vahedi, Mohammad; Aligolbandi, Kobra

    2013-01-01

    NONE DECLARED. The study of the scientific evidence citation production by famous databases of the world is one of the important indicators to evaluate and rank the universities. The study at investigating the scientific production of Northern Iran Medical Sciences Universities in Scopus from 2005 through 2010. This survey used scientometrics technique. The samples under studies were the scientific products of four northern Iran Medical universities. Viewpoints quantity of the Scientific Products Mazandaran University of Medical Sciences stands first and of Babol University of Medical Sciences ranks the end, but from the viewpoints of quality of scientific products of considering the H-Index and the number of cited papers the Mazandaran University of Medical Sciences is a head from the other universities under study. From the viewpoints of subject of the papers, the highest scientific products belonged to the faculty of Pharmacy affiliated to Mazandaran University of Medial Sciences, but the three other universities for the genetics and biochemistry. Results showed that the Mazandaran University of Medical Sciences as compared to the other understudies universities ranks higher for the number of articles, cited articles, number of hard work authors and H-Index of Scopus database from 2005 through 2010.

  15. Crisis in Cataloging Revisited: The Year's Work in Subject Analysis, 1990.

    ERIC Educational Resources Information Center

    Young, James Bradford

    1991-01-01

    Reviews the 1990 literature that concerns subject analysis. Issues addressed include subject cataloging, including Library of Congress Subject Headings (LCSH); classification, including Dewey Decimal Classification (DDC), Library of Congress Classification, and classification in online systems; subject access, including the online use of…

  16. A Review of Instrumented Equipment to Investigate Head Impacts in Sport

    PubMed Central

    2016-01-01

    Contact, collision, and combat sports have more head impacts as compared to noncontact sports; therefore, such sports are uniquely suited to the investigation of head impact biomechanics. Recent advances in technology have enabled the development of instrumented equipment, which can estimate the head impact kinematics of human subjects in vivo. Literature pertaining to head impact measurement devices was reviewed and usage, in terms of validation and field studies, of such devices was discussed. Over the past decade, instrumented equipment has recorded millions of impacts in the laboratory, on the field, in the ring, and on the ice. Instrumented equipment is not without limitations; however, in vivo head impact data is crucial to investigate head injury mechanisms and further the understanding of concussion. PMID:27594780

  17. Dynamic and kinematic strategies for head movement control

    NASA Technical Reports Server (NTRS)

    Peterson, B. W.; Choi, H.; Hain, T.; Keshner, E.; Peng, G. C.

    2001-01-01

    This paper describes our analysis of the complex head-neck system using a combination of experimental and modeling approaches. Dynamical analysis of head movements and EMG activation elicited by perturbation of trunk position has examined functional contributions of biomechanically and neurally generated forces in lumped systems with greatly simplified kinematics. This has revealed that visual and voluntary control of neck muscles and the dynamic and static vestibulocollic and cervicocollic reflexes preferentially govern head-neck system state in different frequency domains. It also documents redundant control, which allows the system to compensate for lesions and creates a potential for substantial variability within and between subjects. Kinematic studies have indicated the existence of reciprocal and co-contraction strategies for voluntary force generation, of a vestibulocollic strategy for stabilizing the head during body perturbations and of at least two strategies for voluntary head tracking. Each strategy appears to be executed by a specific muscle synergy that is presumably optimized to efficiently meet the demands of the task.

  18. Head Up Displays. (Latest Citations from the Aerospace Database)

    NASA Technical Reports Server (NTRS)

    1997-01-01

    The bibliography contains citations concerning the design, fabrication, and applications of head up displays (HUDs). Applications include military aircraft, helicopters, space shuttle, and commercial aircraft. Functions of the display include instrument approach, target tracking, and navigation. The head up display provides for an integrated avionics system with the pilot in the loop. (Contains 50-250 citations and includes a subject term index and title list.)

  19. Head Up Displays. (Latest citations from the Aerospace Database)

    NASA Technical Reports Server (NTRS)

    1996-01-01

    The bibliography contains citations concerning the design, fabrication, and applications of head up displays (HUDs). Applications include military aircraft, helicopters, space shuttle, and commercial aircraft. Functions of the display include instrument approach, target tracking, and navigation. The head up display provides for an integrated avionics system with the pilot in the loop. (Contains 50-250 citations and includes a subject term index and title list.)

  20. Fever in pregnancy and offspring head circumference.

    PubMed

    Dreier, Julie Werenberg; Strandberg-Larsen, Katrine; Uldall, Peter Vilhelm; Nybo Andersen, Anne-Marie

    2018-02-01

    To examine whether maternal fever during pregnancy is associated with reduced head circumference and risk of microcephaly at birth. A prospective study of 86,980 live-born singletons within the Danish National Birth Cohort was carried out. Self-reported maternal fever exposure was ascertained in two interviews during pregnancy and information on head circumference at birth was extracted from the Danish Medical Birth Registry. Fever in pregnancy was reported by 27% of the mothers, and we identified 3370 cases of microcephaly (head circumference less than or equal to third percentile for sex and gestational age) and 1140 cases of severe microcephaly (head circumference less than or equal to first percentile for sex and gestational age). In this study, maternal fever exposure was not associated with reduced head circumference (adjusted β = 0.03, 95% confidence intervals [CI]: 0.01-0.05), increased risk of microcephaly (odds ratio: 0.95, 95% CI: 0.88-1.03) nor severe microcephaly (odds ratio: 1.01, 95% CI: 0.88-1.15) in the offspring. These findings were consistent for increasing numbers of fever episodes, for increasing fever severity, and for exposure in both early pregnancy and midpregnancy. In this most comprehensive study to date, we found no indication that maternal fever in pregnancy is associated with small head size in the offspring. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. The Impact of Gross Anatomy on the Future Head and Neck Surgeon

    ERIC Educational Resources Information Center

    Archibald, David J.; Carlson, Matthew L.

    2009-01-01

    Gross anatomy is not only a rite of passage for medical students as they enter the world of practicing medicine but may also be an unrecognized fork in the road in their pursuit of choosing a medical specialty. Otolaryngology: head and neck surgery tends to be poorly represented in medical school curriculum, often only offered as an elective…

  2. Activation of biceps femoris long head reduces tibiofemoral anterior shear force and tibial internal rotation torque in healthy subjects

    PubMed Central

    Azmi, Nur Liyana; Ding, Ziyun; Xu, Rui

    2018-01-01

    The anterior cruciate ligament (ACL) provides resistance to tibial internal rotation torque and anterior shear at the knee. ACL deficiency results in knee instability. Optimisation of muscle contraction through functional electrical stimulation (FES) offers the prospect of mitigating the destabilising effects of ACL deficiency. The hypothesis of this study is that activation of the biceps femoris long head (BFLH) reduces the tibial internal rotation torque and the anterior shear force at the knee. Gait data of twelve healthy subjects were measured with and without the application of FES and taken as inputs to a computational musculoskeletal model. The model was used to investigate the optimum levels of BFLH activation during FES gait in reducing the anterior shear force to zero. This study found that FES significantly reduced the tibial internal rotation torque at the knee during the stance phase of gait (p = 0.0322) and the computational musculoskeletal modelling revealed that a mean BFLH activation of 20.8% (±8.4%) could reduce the anterior shear force to zero. At the time frame when the anterior shear force was zero, the internal rotation torque was reduced by 0.023 ± 0.0167 Nm/BW, with a mean 188% reduction across subjects (p = 0.0002). In conclusion, activation of the BFLH is able to reduce the tibial internal rotation torque and the anterior shear force at the knee in healthy control subjects. This should be tested on ACL deficient subject to consider its effect in mitigating instability due to ligament deficiency. In future clinical practice, activating the BFLH may be used to protect ACL reconstructions during post-operative rehabilitation, assist with residual instabilities post reconstruction, and reduce the need for ACL reconstruction surgery in some cases. PMID:29304102

  3. Activation of biceps femoris long head reduces tibiofemoral anterior shear force and tibial internal rotation torque in healthy subjects.

    PubMed

    Azmi, Nur Liyana; Ding, Ziyun; Xu, Rui; Bull, Anthony M J

    2018-01-01

    The anterior cruciate ligament (ACL) provides resistance to tibial internal rotation torque and anterior shear at the knee. ACL deficiency results in knee instability. Optimisation of muscle contraction through functional electrical stimulation (FES) offers the prospect of mitigating the destabilising effects of ACL deficiency. The hypothesis of this study is that activation of the biceps femoris long head (BFLH) reduces the tibial internal rotation torque and the anterior shear force at the knee. Gait data of twelve healthy subjects were measured with and without the application of FES and taken as inputs to a computational musculoskeletal model. The model was used to investigate the optimum levels of BFLH activation during FES gait in reducing the anterior shear force to zero. This study found that FES significantly reduced the tibial internal rotation torque at the knee during the stance phase of gait (p = 0.0322) and the computational musculoskeletal modelling revealed that a mean BFLH activation of 20.8% (±8.4%) could reduce the anterior shear force to zero. At the time frame when the anterior shear force was zero, the internal rotation torque was reduced by 0.023 ± 0.0167 Nm/BW, with a mean 188% reduction across subjects (p = 0.0002). In conclusion, activation of the BFLH is able to reduce the tibial internal rotation torque and the anterior shear force at the knee in healthy control subjects. This should be tested on ACL deficient subject to consider its effect in mitigating instability due to ligament deficiency. In future clinical practice, activating the BFLH may be used to protect ACL reconstructions during post-operative rehabilitation, assist with residual instabilities post reconstruction, and reduce the need for ACL reconstruction surgery in some cases.

  4. Visual perception of axes of head rotation

    PubMed Central

    Arnoldussen, D. M.; Goossens, J.; van den Berg, A. V.

    2013-01-01

    Registration of ego-motion is important to accurately navigate through space. Movements of the head and eye relative to space are registered through the vestibular system and optical flow, respectively. Here, we address three questions concerning the visual registration of self-rotation. (1) Eye-in-head movements provide a link between the motion signals received by sensors in the moving eye and sensors in the moving head. How are these signals combined into an ego-rotation percept? We combined optic flow of simulated forward and rotational motion of the eye with different levels of eye-in-head rotation for a stationary head. We dissociated simulated gaze rotation and head rotation by different levels of eye-in-head pursuit. We found that perceived rotation matches simulated head- not gaze-rotation. This rejects a model for perceived self-rotation that relies on the rotation of the gaze line. Rather, eye-in-head signals serve to transform the optic flow's rotation information, that specifies rotation of the scene relative to the eye, into a rotation relative to the head. This suggests that transformed visual self-rotation signals may combine with vestibular signals. (2) Do transformed visual self-rotation signals reflect the arrangement of the semi-circular canals (SCC)? Previously, we found sub-regions within MST and V6+ that respond to the speed of the simulated head rotation. Here, we re-analyzed those Blood oxygenated level-dependent (BOLD) signals for the presence of a spatial dissociation related to the axes of visually simulated head rotation, such as have been found in sub-cortical regions of various animals. Contrary, we found a rather uniform BOLD response to simulated rotation along the three SCC axes. (3) We investigated if subject's sensitivity to the direction of the head rotation axis shows SCC axes specifcity. We found that sensitivity to head rotation is rather uniformly distributed, suggesting that in human cortex, visuo-vestibular integration is

  5. The High School Department Head: Powerful or Powerless in Guiding Change?

    ERIC Educational Resources Information Center

    Hord, Shirley M.; Murphy, Sheila C.

    This report, one of four studies on roles of participants in high school change, presents data about activities of department heads in 30 schools throughout the nation. The report analyzes background research on the subject as well as popular perceptions, perceptions of teachers and administrators, and perceptions of department heads themselves…

  6. "It's all too subjective": scepticism about the possibility or use of philosophical medical ethics.

    PubMed

    Gillon, R

    1985-05-25

    In one of a series of articles on philosophical medical ethics, Gillon rebuts the argument that moral claims are essentially different from scientific claims because scientific claims are objective and confirmable or refutable, while moral claims are subjective, unconfirmable, irrefutable, and their differences incapable of resolution. He contends that there is widespread agreement about many moral principles, that moral disagreement may arise from the use of ambiguous terminology, and that progress toward resolution may be accomplished by analysis of the logical validity and consistency of the arguments.

  7. Changes in Head Stability Control in Response to a Lateral Perturbation while Walking in Older Adults

    NASA Technical Reports Server (NTRS)

    Buccello, Regina R.; Cromwell, Ronita L.; Bloomberg, Jacob J.

    2008-01-01

    Falling is a main contributor of injury in older adults. The decline in sensory systems associated with aging limits information needed to successfully compensate for unexpected perturbations. Therefore, sensory changes result in older adults having problems maintaining balance stability when experiencing an unexpected lateral perturbation (e.g. slip) in the environment. The goal of this study was to determine head stability movement strategies used by older adults when experiencing an unexpected lateral perturbation during walking. A total of 16 healthy adults, aged 66-81 years, walked across a foam pathway 6 times. One piece of the foam pathway covered a movable platform that translated to the left when the subject stepped on the foam. Three trials were randomized in which the platform shifted. Angular rate sensors were placed on the center of mass for the head and trunk segments to collect head and trunk movement in all three planes of motion. The predominant movement strategies for maintaining head stability were determined from the results of the cross-correlation analyses between the head and trunk segments. The Chi square test of independence was used to evaluate the movement pattern distributions of head-trunk coordination during perturbed and non-perturbed walking. When perturbed, head stabilization was significantly challenged in the yaw and roll planes of motion. Subjects demonstrated a movement pattern of the head leading the trunk in an effort to stabilize the head. The older adult subjects used this head stabilization movement pattern to compensate for sensory changes when experiencing the unexpected lateral perturbation.

  8. Vestibular-Somatosensory Convergence in Head Movement Control During Locomotion after Long-Duration Space Flight

    NASA Technical Reports Server (NTRS)

    Mulavara, Ajitkumar; Ruttley, Tara; Cohen, Helen; Peters, Brian; Miller, Chris; Brady, Rachel; Merkle, Lauren; Bloomberg, Jacob

    2010-01-01

    Exposure to the microgravity conditions of space flight induces adaptive modification in the control of vestibular-mediated reflexive head movement during locomotion after space flight. Space flight causes astronauts to be exposed to somatosensory adaptation in both the vestibular and body load-sensing (BLS) systems. The goal of these studies was to examine the contributions of vestibular and BLS-mediated somatosensory influences on head movement control during locomotion after long-duration space flight. Subjects were asked to walk on a treadmill driven at 1.8 m/s while performing a visual acuity task. Data were collected using the same testing protocol from three independent subject groups; 1) normal subjects before and after exposure to 30 minutes of 40% bodyweight unloaded treadmill walking, 2) bilateral labyrinthine deficient (LD) patients and 3) astronauts who performed the protocol before and after long duration space flight. Motion data from head and trunk segmental motion data were obtained to calculate the angular head pitch (HP) movements during walking trials while subjects performed the visual task, to estimate the contributions of vestibular reflexive mechanisms in HP movements. Results showed that exposure to unloaded locomotion caused a significant increase in HP movements, whereas in the LD patients the HP movements were significantly decreased. Astronaut subjects results showed a heterogeneous response of both increases and decreases in the amplitude of HP movement. We infer that BLS-mediated somatosensory input centrally modulates vestibular input and can adaptively modify head-movement control during locomotion. Thus, space flight may cause a central adaptation mediated by the converging vestibular and body load-sensing somatosensory systems.

  9. Bronchodilator action of inhaled fenoterol and ipratropium in normal subjects: a teaching exercise for medical students.

    PubMed Central

    Taylor, R G; Maclagan, J; Cook, D G

    1989-01-01

    1. A pharmacology practical class for preclinical medical students was designed as a placebo-controlled, double-blind trial of two bronchodilator drugs. 2. Fenoterol hydrobromide (800 micrograms), ipratropium bromide (80 micrograms) and placebo (propellant only) were given by metered dose inhaler to 79 non-asthmatic volunteers. Their effects on FEV1, heart rate and tremor (assessed by the time taken to thread five sewing needles) were compared. 3. Both drugs caused a significant increase in FEV1: the largest group mean increase was 77 ml, recorded 15 min after fenoterol, and 103 ml, recorded 60 min after ipratropium. 4. Fenoterol also caused a mean increase of 8.7 beats min-1 in heart rate, 5 min after inhalation. This effect was still apparent after 60 min. 5. Fenoterol appeared to prolong needle threading time in some individuals. 6. In subjects who inhaled fenoterol, there were no correlations between the increase in FEV1, the increase in heart rate, or the development of tremor. 7. It is concluded that inhaled fenoterol and ipratropium both cause bronchodilation in normal subjects. Systemic absorption of fenoterol is indicated by the rapid increase in heart rate. The bronchodilator effect of ipratropium suggests that resting airway calibre is governed partly by parasympathetic tone in normal subjects. 8. The bronchodilator and systemic effects of these drugs can be used to demonstrate pharmacological, therapeutic and statistical principles to medical students. PMID:2532922

  10. Analysis of Recorded Biomedical Book and Journal Use in the Yale Medical Library Part I: Date and Subject Relations*

    PubMed Central

    Stangl, Peter; Kilgour, Frederick G.

    1967-01-01

    Analysis of book and journal circulation is based on cancelled charge slips collected over a one-year period in the Yale Medical Library. About two-fifths of material circulated were monographs. Books and journals in seven subject fields provided over half of the circulation. Approximately two-thirds of both books and journals used had been published during the most recent nine years. A subject-by-subject examination of the ratio of books to journals circulating revealed that, in subjects where proportionally more journals than books were taken out of the Library, books were of more recent imprint dates than were journals, contrary to the overall pattern. Date distribution of books and journals by subject was also studied. Results are illustrated with graphs and tables. PMID:6041834

  11. The temporal dynamics of heading perception in the presence of moving objects

    PubMed Central

    Fajen, Brett R.

    2015-01-01

    Many forms of locomotion rely on the ability to accurately perceive one's direction of locomotion (i.e., heading) based on optic flow. Although accurate in rigid environments, heading judgments may be biased when independently moving objects are present. The aim of this study was to systematically investigate the conditions in which moving objects influence heading perception, with a focus on the temporal dynamics and the mechanisms underlying this bias. Subjects viewed stimuli simulating linear self-motion in the presence of a moving object and judged their direction of heading. Experiments 1 and 2 revealed that heading perception is biased when the object crosses or almost crosses the observer's future path toward the end of the trial, but not when the object crosses earlier in the trial. Nonetheless, heading perception is not based entirely on the instantaneous optic flow toward the end of the trial. This was demonstrated in Experiment 3 by varying the portion of the earlier part of the trial leading up to the last frame that was presented to subjects. When the stimulus duration was long enough to include the part of the trial before the moving object crossed the observer's path, heading judgments were less biased. The findings suggest that heading perception is affected by the temporal evolution of optic flow. The time course of dorsal medial superior temporal area (MSTd) neuron responses may play a crucial role in perceiving heading in the presence of moving objects, a property not captured by many existing models. PMID:26510765

  12. A Study of Standardized Headings for Warranties. Technical Report No. 6.

    ERIC Educational Resources Information Center

    Charrow, Veda R.; Redish, Janice C.

    A study was conducted (1) to discover whether using standardized headings on warranties would increase or decrease people's speed and accuracy in understanding the terms of warranties and (2) to determine what effect headings would have on people's attitudes toward warranties. Subjects were 48 adult consumers who read groups of four warranties for…

  13. Predictive Compensator Optimization for Head Tracking Lag in Virtual Environments

    NASA Technical Reports Server (NTRS)

    Adelstein, Barnard D.; Jung, Jae Y.; Ellis, Stephen R.

    2001-01-01

    We examined the perceptual impact of plant noise parameterization for Kalman Filter predictive compensation of time delays intrinsic to head tracked virtual environments (VEs). Subjects were tested in their ability to discriminate between the VE system's minimum latency and conditions in which artificially added latency was then predictively compensated back to the system minimum. Two head tracking predictors were parameterized off-line according to cost functions that minimized prediction errors in (1) rotation, and (2) rotation projected into translational displacement with emphasis on higher frequency human operator noise. These predictors were compared with a parameterization obtained from the VE literature for cost function (1). Results from 12 subjects showed that both parameterization type and amount of compensated latency affected discrimination. Analysis of the head motion used in the parameterizations and the subsequent discriminability results suggest that higher frequency predictor artifacts are contributory cues for discriminating the presence of predictive compensation.

  14. Medical education departments: a study of four medical schools in Sub-Saharan Africa.

    PubMed

    Kiguli-Malwadde, Elsie; Talib, Zohray M; Wohltjen, Hannah; Connors, Susan C; Gandari, Jonathan; Banda, Sekelani S; Maggio, Lauren A; van Schalkwyk, Susan C

    2015-07-01

    Many African countries are investing in medical education to address significant health care workforce shortages and ultimately improve health care. Increasingly, training institutions are establishing medical education departments as part of this investment. This article describes the status of four such departments at sub-Saharan African medical schools supported by the Medical Education Partnership Initiative (MEPI). This article will provide information about the role of these institutional structures in fostering the development of medical education within the African context and highlight factors that enable or constrain their establishment and sustainability. In-depth interviews were conducted with the heads or directors of the four medical education departments using a structured interview protocol developed by the study group. An inductive approach to analysis of the interview transcripts was adopted as the texts were subjected to thematic content analysis. Medical education departments, also known as units or centers, were established for a range of reasons including: to support curriculum review, to provide faculty development in Health Professions Education, and to improve scholarship in learning and teaching. The reporting structures of these departments differ in terms of composition and staff numbers. Though the functions of departments do vary, all focus on improving the quality of health professions education. External and internal funding, where available, as well as educational innovations were key enablers for these departments. Challenges included establishing and maintaining the legitimacy of the department, staffing the departments with qualified individuals, and navigating dependence on external funding. All departments seek to expand the scope of their services by offering higher degrees in HPE, providing assistance to other universities in this domain, and developing and maintaining a medical education research agenda. The establishment of

  15. Evaluation of emergency medicine discharge instructions in pediatric head injury.

    PubMed

    Sarsfield, Matthew J; Morley, Eric J; Callahan, James M; Grant, William D; Wojcik, Susan M

    2013-08-01

    Pediatric head trauma is a common occurrence. There is mounting evidence that even patients with minor head injury require limits on school activities and/or removal from sports and play to help speed recovery and limit morbidity. The objective of this study was to determine whether discharge instructions given to children who had sustained head injuries included information regarding activity restrictions, activity time constraints, and/or specifics of follow-up care. This was a retrospective chart review of patients aged 2 to 18 years evaluated and treated for head injury during a 4-month period at a level I trauma center (volume ∼23,000 pediatric patients per year). Included were those children seen, evaluated, and diagnosed with any of the following: mild head injury, concussion, minor head trauma, or mild traumatic brain injury (mTBI). Subjects were excluded if there was a positive acute head injury computed tomography finding (other than findings of a simple linear skull fracture) or if the subject required admission. Among the 204 patients meeting eligibility, 95.1% received instruction to follow up with a physician, 82.8% received anticipatory guidance regarding expected symptoms, 15.2% received specific restriction time from sports, and 21.5% were removed from sports. Of these patients, 113 patients were determined "likely" to have sustained an mTBI. Patients with sports-related mTBI received return-to-sports restrictions (χ2 = 11.225, P < 0.008) and to remove the child from play (χ2 = 9.781, P < 0.004) as discharge instructions significantly more than did patients with motor vehicle accident or other mechanisms of injury. Children sustaining head injury were inadequately instructed to restrict athletic activities upon discharge. This is particularly true for patients who sustain an mTBI from non-sports-related activity.

  16. Eye-head coordination during optokinetic stimulation in squirrel monkeys

    NASA Technical Reports Server (NTRS)

    Kubo, T.; Igarashi, M.; Jensen, D. W.; Homick, J. L.

    1981-01-01

    Head and eye movements in the yaw plane were recorded during and after optokinetic stimulation in squirrel monkeys. 1) Phasic or tonic head deviations to the side of the ocular quick phase occurred in 94% of total recordings (n = 50) during the perstimulus period, and in 75% of recordings (n = 49) during the poststimulus period. Magnitude of mean head deviation was significantly different between perstimulus and poststimulus periods. 2) Head nystagmus associated with eye nystagmus was consistently observed in seven of nine squirrel monkeys during optokinetic stimulation. Squirrel monkeys are thereby less prone to display head nystagmus than either guinea pigs, pigeons or chickens. 3) Slow phase speeds of coupled head and eye nystagmus were subjected to statistical analysis. A highly significant negative correlation was found between slow phase head and eye speeds. The correlation coefficient was - 0.81 at 60 degrees / sec stimulus (n = 119) and -0.72 at 100 degrees / sec stimulus (n = 131). The gaze speed, calculated by summing the head and eye speeds, was 59.1 plus or minus 6.8 / sec at 60 degrees / sec and 92.2 plus or minus 11.4 at 100 degrees / sec stimulus. There was no significant difference between the gaze speed in a free head condition and the eye speed when the head was fixed.

  17. Facial type and head posture of nasal and mouth-breathing children.

    PubMed

    Bolzan, Geovana de Paula; Souza, Juliana Alves; Boton, Luane de Moraes; Silva, Ana Maria Toniolo da; Corrêa, Eliane Castilhos Rodrigues

    2011-12-01

    To verify the facial type and the head posture of nasal and mouth-breathing children from habitual and obstructive etiologies, as well as to correlate the morphological facial index to the head angulation position in the sagittal plane. Participants were 59 children with ages between 8 years and 11 years and 10 months. All subjects were undergone to speech-language pathology screening, otorhinolaryngologic evaluation, and nasopharyngoscopy, allowing the constitution of three groups: nasal breathers--15 children; mouth breathers from obstructive etiology--22 children; and habitual mouth breathers--22 children. In order to determine facial type and morphological facial index, the height and the width of the face were measured using a digital caliper. The head posture was assessed through physical examination and computerized photogrammetry. It was verified the predominance of short face in nasal breathers, and long face in mouth breathers. There was an association among facial type and breathing mode/mouth breathing etiology: the brachyfacial type was more frequent among nasal breathers, and less frequent in subjects with obstructive nasal breathing. Head posture was similar in all three groups. No correlation was found between morphological facial index and head posture. The brachyfacial type favors the nasal-breathing mode and the head posture is not influenced by breathing mode and by the etiology of mouth breathing, as well as it is not related to facial type.

  18. Virtual head rotation reveals a process of route reconstruction from human vestibular signals

    PubMed Central

    Day, Brian L; Fitzpatrick, Richard C

    2005-01-01

    The vestibular organs can feed perceptual processes that build a picture of our route as we move about in the world. However, raw vestibular signals do not define the path taken because, during travel, the head can undergo accelerations unrelated to the route and also be orientated in any direction to vary the signal. This study investigated the computational process by which the brain transforms raw vestibular signals for the purpose of route reconstruction. We electrically stimulated the vestibular nerves of human subjects to evoke a virtual head rotation fixed in skull co-ordinates and measure its perceptual effect. The virtual head rotation caused subjects to perceive an illusory whole-body rotation that was a cyclic function of head-pitch angle. They perceived whole-body yaw rotation in one direction with the head pitched forwards, the opposite direction with the head pitched backwards, and no rotation with the head in an intermediate position. A model based on vector operations and the anatomy and firing properties of semicircular canals precisely predicted these perceptions. In effect, a neural process computes the vector dot product between the craniocentric vestibular vector of head rotation and the gravitational unit vector. This computation yields the signal of body rotation in the horizontal plane that feeds our perception of the route travelled. PMID:16002439

  19. Medical subject heading (MeSH) annotations illuminate maize genetics and evolution

    USDA-ARS?s Scientific Manuscript database

    In the modern era, high-density marker panels and/or whole-genome sequencing,coupled with advanced phenotyping pipelines and sophisticated statistical methods, have dramatically increased our ability to generate lists of candidate genes or regions that are putatively associated with phenotypes or pr...

  20. Understanding the Effects of Spaceflight on Head-trunk Coordination During Walking and Obstacle Avoidance

    NASA Technical Reports Server (NTRS)

    Madansingh, S.; Bloomberg, J. J.

    2014-01-01

    Prolonged exposure to spaceflight conditions results in a battery of physiological changes, some of which contribute to sensorimotor and neurovestibular deficits. Upon return to Earth, functional performance changes are tested using the Functional Task Test (FTT), which includes an obstacle course to observe post-flight balance and postural stability, specifically during turning. The goal of this study was to quantify changes in movement strategies during turning events by observing the latency between head-and-trunk coordinated movements. It was hypothesized that subjects experiencing neurovestibular adaptations would exhibit head-to-trunk locking ('en bloc' movement) during turning, exhibited by a decrease in latency between head and trunk movement. FTT data samples were collected from 13 ISS astronauts and 26 male 70-day head down tilt bed rest subjects, including bed rest controls (10 BRC) and bed rest exercisers (16 BRE). Samples were analyzed three times pre-exposure, immediately post-exposure (0 or 1 day post) and 2-to-3 times during recovery from the unloading environment. Two 3D inertial measurements units (XSens MTx) were attached to subjects, one on the head and one on the upper back. This study focused primarily on the yaw movements about the subject's center of rotation. Time differences (latency) between head and trunk movement were averaged across a slalom obstacle portion, consisting of three turns (approximately three 60° turns). All participants were grouped as 'decreaser' or 'increaser,' relating to their change in head-to-trunk movement latency between pre- and post- environmental adaptation measures. Space flight unloading (ISS) showed a bimodal response between the 'increaser' and 'decreaser' group, while both bed rest control (BRC) and bed rest exercise (BRE) populations showed increased preference towards a 'decreaser' categorization, displaying greater head-trunk locking. It is clear that changes in movement strategies are adopted during

  1. The implementation of game in a 20-day head-down tilting bed rest experiment upon mood status and neurotic levels of rest subjects

    NASA Astrophysics Data System (ADS)

    Ishizaki, Yuko; Fukuoka, Hideoki; Ishizaki, Tatsuro; Tanaka, Hidetaka; Ishitobi, Hiromi

    2004-12-01

    This study evaluated the effect of the implementation of game on mental health among participants in a bed rest (BR) experiment. Subjects were 12 healthy males aged 20-26, who participated in a 20-day 6-degrees head-down tilting BR experiment. The participants were asked to complete psychometrical questionnaires before, during, and after the experiment. We entrusted the participants to manage their leisure time and they intended a game in which all of them could take part over the experiment period. The general conversation and light-hearted mood among the subjects continued during the experimental period. Longitudinal data analysis showed that levels of neurosis and mood status did not deteriorate during the experiment, while our previous experiments, which were performed under the same protocol as this study except for the implementation of the game showed a distinct deterioration in psychosocial status. We consider that the implementation of game autonomously contributes to the positive effects on the mental health among the participants.

  2. Coexistence of a pectoralis quartus muscle, a supernumerary head of biceps brachii muscle and an accessory head of flexor digitorum profundus muscle.

    PubMed

    Song, Halim; Kim, Jinu; Yoon, Sang-Pil

    2018-05-26

    Although anatomical variations in the upper limb are frequent, coexistence of multiple combined variations is rare. During a routine educational dissection at Jeju National University Medical School, three muscular variations were found in a 75-year-old Korean male cadaver, in which a supraclavicular cephalic vein was also found in ipsilateral upper extremity during skinning (Go et al., 2017). Here we describe characteristics of the pectoralis quartus muscle, the supernumerary head of biceps brachii muscle and an accessory head of flexor digitorum profundus muscle, and discuss their coexistence from morphological and embryological points of view.

  3. Effect of Time Management Program on Job Satisfaction for Head Nurses

    ERIC Educational Resources Information Center

    Elsabahy, Hanan ELsayed; Sleem, Wafaa Fathi; El Atroush, Hala Gaber

    2015-01-01

    Background: Time management and job satisfaction all related to each other and greatly affect success of organization. Subjects and Methods: The study aimed to evaluate the efficacy of a designed program of time management on job satisfaction for head nurses. A Quasi-experimental design was used for a total number of head nurses participated. Two…

  4. The Video Head Impulse Test

    PubMed Central

    Halmagyi, G. M.; Chen, Luke; MacDougall, Hamish G.; Weber, Konrad P.; McGarvie, Leigh A.; Curthoys, Ian S.

    2017-01-01

    In 1988, we introduced impulsive testing of semicircular canal (SCC) function measured with scleral search coils and showed that it could accurately and reliably detect impaired function even of a single lateral canal. Later we showed that it was also possible to test individual vertical canal function in peripheral and also in central vestibular disorders and proposed a physiological mechanism for why this might be so. For the next 20 years, between 1988 and 2008, impulsive testing of individual SCC function could only be accurately done by a few aficionados with the time and money to support scleral search-coil systems—an expensive, complicated and cumbersome, semi-invasive technique that never made the transition from the research lab to the dizzy clinic. Then, in 2009 and 2013, we introduced a video method of testing function of each of the six canals individually. Since 2009, the method has been taken up by most dizzy clinics around the world, with now close to 100 refereed articles in PubMed. In many dizzy clinics around the world, video Head Impulse Testing has supplanted caloric testing as the initial and in some cases the final test of choice in patients with suspected vestibular disorders. Here, we consider seven current, interesting, and controversial aspects of video Head Impulse Testing: (1) introduction to the test; (2) the progress from the head impulse protocol (HIMPs) to the new variant—suppression head impulse protocol (SHIMPs); (3) the physiological basis for head impulse testing; (4) practical aspects and potential pitfalls of video head impulse testing; (5) problems of vestibulo-ocular reflex gain calculations; (6) head impulse testing in central vestibular disorders; and (7) to stay right up-to-date—new clinical disease patterns emerging from video head impulse testing. With thanks and appreciation we dedicate this article to our friend, colleague, and mentor, Dr Bernard Cohen of Mount Sinai Medical School, New York, who since his

  5. Effects of China's New Rural Cooperative Medical Scheme on reducing medical impoverishment in rural Yanbian: An alternative approach.

    PubMed

    Sun, Mei; Shen, Jay J; Li, Chengyue; Cochran, Christopher; Wang, Ying; Chen, Fei; Li, Pingping; Lu, Jun; Chang, Fengshui; Li, Xiaohong; Hao, Mo

    2016-08-22

    This study aimed to measure the poverty head count ratio and poverty gap of rural Yanbian in order to examine whether China's New Rural Cooperative Medical Scheme has alleviated its medical impoverishment and to compare the results of this alternative approach with those of a World Bank approach. This cross-sectional study was based on a stratified random sample survey of 1,987 households and 6,135 individuals conducted in 2008 across eight counties in Yanbian Korean Autonomous Prefecture, Jilin province, China. A new approach was developed to define and identify medical impoverishment. The poverty head count ratio, relative poverty gap, and average poverty gap were used to measure medical impoverishment. Changes in medical impoverishment after the reimbursement under the New Rural Cooperative Medical Scheme were also examined. The government-run New Rural Cooperative Medical Scheme reduced the number of medically impoverished households by 24.6 %, as well as the relative and average gaps by 37.3 % and 38.9 %, respectively. China's New Rural Cooperative Medical Scheme has certain positive but limited effects on alleviating medical impoverishment in rural Yanbian regardless of how medical impoverishment is defined and measured. More governmental and private-sector efforts should therefore be encouraged to further improve the system in terms of financing, operation, and reimbursement policy.

  6. Legal and ethical issues in neuroimaging research: human subjects protection, medical privacy, and the public communication of research results.

    PubMed

    Kulynych, Jennifer

    2002-12-01

    Humans subjects research entails significant legal and ethical obligations. Neuroimaging researchers must be familiar with the requirements of human subjects protection, including evolving standards for the protection of privacy and the disclosure of risk in "non-therapeutic" research. Techniques for creating veridical surface renderings from volumetric anatomical imaging data raise new privacy concerns, particularly under the federal medical privacy regulation. Additionally, neuroimaging researchers must consider their obligation to communicate research results responsibly. The emerging field of neuroethics should strive to raise awareness of these issues and to involve neuroimaging researchers in the legal, ethical, and policy debates that currently surround human subjects research.

  7. The Frequency of Reporting Ethical Issues in Human Subject Articles Published in Iranian Medical Journals: 2009-2013.

    PubMed

    Astaneh, Behrooz; Khani, Parisa

    2017-11-10

    Researchers should strictly consider the participants' rights. They are required to document such protections as an ethical approval of the study proposal, the obtaining "informed consent", the authors' "conflict of interests", and the source of "financial support" in the published articles. The purpose of this study was to assess the frequency of reporting ethical issues in human subject articles published in Iranian medical journals during 2009-2013. In this cross-sectional study, we randomly reviewed 1460 human subject articles published in Iranian medical journals during 2009-2013 in two Persian and English language groups. Data collection was carried out by assessing articles, focusing on the documentation "ethics committee approval", patients' "informed consent", "financial support", "confidentiality", and "conflict of interest". Of 1460 evaluated articles, 443 (30.3%) reported "ethics committee approval", 686 (47.0%) reported "informed consent", 594 (40.7%) reported "financial support", and 341 (23.4%) reported "conflict of interest". 13% of the articles referred to patients' confidentiality in their text. There was a significant association between these ethical documentations and the year of publication. Articles published in English language journals reported "ethics committee approval", "financial support", and "conflict of interest" significantly more than Persian language journals, but the frequency of "informed consent" was similar. Ethical documentation rate in Iranian medical journals is not up to the expected standards of reputable journals which might be related to a lack of awareness and the education of the authors and the journal's editors. Precise reporting of ethical considerations in medical articles by authors are recommended. It is suggested journals and policymakers pay more attention to reporting this issue while providing standard guidelines in this regard.

  8. The Effect of Soft and Rigid Cervical Collars on Head and Neck Immobilization in Healthy Subjects.

    PubMed

    Barati, Kourosh; Arazpour, Mokhtar; Vameghi, Roshanak; Abdoli, Ali; Farmani, Farzad

    2017-06-01

    Whiplash injury is a prevalent and often destructive injury of the cervical column, which can lead to serious neck pain. Many approaches have been suggested for the treatment of whiplash injury, including anti-inflammatory drugs, manipulation, supervised exercise, and cervical collars. Cervical collars are generally divided into two groups: soft and rigid collars. The present study aimed to compare the effect of soft and rigid cervical collars on immobilizing head and neck motion. Many studies have investigated the effect of collars on neck motion. Rigid collars have been shown to provide more immobilization in the sagittal and transverse planes compared with soft collars. However, according to some studies, soft and rigid collars provide the same range of motion in the frontal plane. Twenty-nine healthy subjects aged 18-26 participated in this study. Data were collected using a three-dimensional motion analysis system and six infrared cameras. Eight markers, weighing 4.4 g and thickened 2 cm 2 were used to record kinematic data. According to the normality of the data, a paired t -test was used for statistical analyses. The level of significance was set at α=0.01. All motion significantly decreased when subjects used soft collars ( p <0.01). According to the obtained data, flexion and lateral rotation experienced the maximum (39%) and minimum (11%) immobilization in all six motions using soft collars. Rigid collars caused maximum immobilization in flexion (59%) and minimum immobilization in the lateral rotation (18%) and limited all motion much more than the soft collar. This study showed that different cervical collars have different effects on neck motion. Rigid and soft cervical collars used in the present study limited the neck motion in both directions. Rigid collars contributed to significantly more immobilization in all directions.

  9. Interaction of the body, head, and eyes during walking and turning

    NASA Technical Reports Server (NTRS)

    Imai, T.; Moore, S. T.; Raphan, T.; Cohen, B.

    2001-01-01

    Body, head, and eye movements were measured in five subjects during straight walking and while turning corners. The purpose was to determine how well the head and eyes followed the linear trajectory of the body in space and whether head orientation followed changes in the gravito-inertial acceleration vector (GIA). Head and body movements were measured with a video-based motion analysis system and horizontal, vertical, and torsional eye movements with video-oculography. During straight walking, there was lateral body motion at the stride frequency, which was at half the frequency of stepping. The GIA oscillated about the direction of heading, according to the acceleration and deceleration associated with heel strike and toe flexion, and the body yawed in concert with stepping. Despite the linear and rotatory motions of the head and body, the head pointed along the forward motion of the body during straight walking. The head pitch/roll component appeared to compensate for vertical and horizontal acceleration of the head rather than orienting to the tilt of the GIA or anticipating it. When turning corners, subjects walked on a 50-cm radius over two steps or on a 200-cm radius in five to seven steps. Maximum centripetal accelerations in sharp turns were ca.0.4 g, which tilted the GIA ca.21 degrees with regard to the heading. This was anticipated by a roll tilt of the head of up to 8 degrees. The eyes rolled 1-1.5 degrees and moved down into the direction of linear acceleration during the tilts of the GIA. Yaw head deviations moved smoothly through the turn, anticipating the shift in lateral body trajectory by as much as 25 degrees. The trunk did not anticipate the change in trajectory. Thus, in contrast to straight walking, the tilt axes of the head and the GIA tended to align during turns. Gaze was stable in space during the slow phases and jumped forward in saccades along the trajectory, leading it by larger angles when the angular velocity of turning was greater

  10. Voluntary presetting of the vestibular ocular reflex permits gaze stabilization despite perturbation of fast head movements

    NASA Technical Reports Server (NTRS)

    Zangemeister, Wolfgang H.

    1989-01-01

    Normal subjects are able to change voluntarily and continuously their head-eye latency together with their compensatory eye movement gain. A continuous spectrum of intent-latency modes of the subject's coordinated gaze through verbal feedback could be demonstrated. It was also demonstrated that the intent to counteract any perturbation of head-eye movement, i.e., the mental set, permitted the subjects to manipulate consciously their vestibular ocular reflex (VOR) gain. From the data, it is inferred that the VOR is always on. It may be, however, variably suppressed by higher cortical control. With appropriate training, head-mounted displays should permit an easy VOR presetting that leads to image stabilization, perhaps together with a decrease of possible misjudgements.

  11. Severe-to-fatal head injuries in motor vehicle impacts.

    PubMed

    Yoganandan, Narayan; Baisden, Jamie L; Maiman, Dennis J; Gennarelli, Thomas A; Guan, Yabo; Pintar, Frank A; Laud, Prakash; Ridella, Stephen A

    2010-07-01

    Severe-to-fatal head injuries in motor vehicle environments were analyzed using the United States Crash Injury Research and Engineering Network database for the years 1997-2006. Medical evaluations included details and photographs of injury, and on-scene, trauma bay, emergency room, intensive care unit, radiological, operating room, in-patient, and rehabilitation records. Data were synthesized on a case-by-case basis. X-rays, computed tomography scans, and magnetic resonance images were reviewed along with field evaluations of scene and photographs for the analyses of brain injuries and skull fractures. Injuries to the parenchyma, arteries, brainstem, cerebellum, cerebrum, and loss of consciousness were included. In addition to the analyses of severe-to-fatal (AIS4+) injuries, cervical spine, face, and scalp trauma were used to determine the potential for head contact. Fatalities and survivors were compared using nonparametric tests and confidence intervals for medians. Results were categorized based on the mode of impact with a focus on head contact. Out of the 3178 medical cases and 169 occupants sustaining head injuries, 132 adults were in frontal (54), side (75), and rear (3) crashes. Head contact locations are presented for each mode. A majority of cases clustered around the mid-size anthropometry and normal body mass index (BMI). Injuries occurred at change in velocities (DeltaV) representative of US regulations. Statistically significant differences in DeltaV between fatalities and survivors were found for side but not for frontal impacts. Independent of the impact mode and survivorship, contact locations were found to be superior to the center of gravity of the head, suggesting a greater role for angular than translational head kinematics. However, contact locations were biased to the impact mode: anterior aspects of the frontal bone and face were involved in frontal impacts while temporal-parietal regions were involved in side impacts. Because head

  12. Use of Head Guards in AIBA Boxing Tournaments-A Cross-Sectional Observational Study.

    PubMed

    Loosemore, Michael P; Butler, Charles F; Khadri, Abdelhamid; McDonagh, David; Patel, Vimal A; Bailes, Julian E

    2017-01-01

    This study looks at the changes in injuries after the implementation of a new rule by the International Boxing Association (AIBA) to remove head guards from its competitions. A cross-sectional observational study performed prospectively. This brief report examines the removal of head guards in 2 different ways. The first was to examine the stoppages due to blows to the head by comparing World Series Boxing (WSB), without head guards, to other AIBA competitions with head guards. Secondly, we examined the last 3 world championships: 2009 and 2011 (with head guards) and 2013 (without head guards). World Series Boxing and AIBA world championship boxing. Boxers from WSB and AIBA world championships. The information was recorded by ringside medical physicians. Stoppages per 10 000 rounds; stoppages per 1000 hours. Both studies show that the number of stoppages due to head blows was significantly decreased without head guards. The studies also showed that there was a notable increase in cuts. Removing head guards may reduce the already small risk of acute brain injury in amateur boxing.

  13. Artificial gravity: head movements during short-radius centrifugation

    NASA Technical Reports Server (NTRS)

    Young, L. R.; Hecht, H.; Lyne, L. E.; Sienko, K. H.; Cheung, C. C.; Kavelaars, J.

    2001-01-01

    Short-radius centrifugation is a potential countermeasure to long-term weightlessness. Unfortunately, head movements in a rotating environment induce serious discomfort, non-compensatory vestibulo-ocular reflexes, and subjective illusions of body tilt. In two experiments we investigated the effects of pitch and yaw head movements in participants placed supine on a rotating bed with their head at the center of rotation, feet at the rim. The vast majority of participants experienced motion sickness, inappropriate vertical nystagmus and illusory tilt and roll as predicted by a semicircular canal model. However, a small but significant number of the 28 participants experienced tilt in the predicted plane but in the opposite direction. Heart rate was elevated following one-second duration head turns. Significant adaptation occurred following a series of head turns in the light. Vertical nystagmus, motion sickness and illusory tilt all decreased with adaptation. Consequences for artificial gravity produced by short-radius centrifuges as a countermeasure are discussed. Grant numbers: NCC 9-58. c 2001. Elsevier Science Ltd. All rights reserved.

  14. Can Predictive Modeling Identify Head and Neck Oncology Patients at Risk for Readmission?

    PubMed

    Manning, Amy M; Casper, Keith A; Peter, Kay St; Wilson, Keith M; Mark, Jonathan R; Collar, Ryan M

    2018-05-01

    Objective Unplanned readmission within 30 days is a contributor to health care costs in the United States. The use of predictive modeling during hospitalization to identify patients at risk for readmission offers a novel approach to quality improvement and cost reduction. Study Design Two-phase study including retrospective analysis of prospectively collected data followed by prospective longitudinal study. Setting Tertiary academic medical center. Subjects and Methods Prospectively collected data for patients undergoing surgical treatment for head and neck cancer from January 2013 to January 2015 were used to build predictive models for readmission within 30 days of discharge using logistic regression, classification and regression tree (CART) analysis, and random forests. One model (logistic regression) was then placed prospectively into the discharge workflow from March 2016 to May 2016 to determine the model's ability to predict which patients would be readmitted within 30 days. Results In total, 174 admissions had descriptive data. Thirty-two were excluded due to incomplete data. Logistic regression, CART, and random forest predictive models were constructed using the remaining 142 admissions. When applied to 106 consecutive prospective head and neck oncology patients at the time of discharge, the logistic regression model predicted readmissions with a specificity of 94%, a sensitivity of 47%, a negative predictive value of 90%, and a positive predictive value of 62% (odds ratio, 14.9; 95% confidence interval, 4.02-55.45). Conclusion Prospectively collected head and neck cancer databases can be used to develop predictive models that can accurately predict which patients will be readmitted. This offers valuable support for quality improvement initiatives and readmission-related cost reduction in head and neck cancer care.

  15. Destabilization of Human Balance Control by Static and Dynamic Head Tilts

    NASA Technical Reports Server (NTRS)

    Paloski, William H.; Wood, Scott J.; Feiveson, Alan H.; Black, F. Owen; Hwang, Emma Y.; Reschke, Millard F.

    2004-01-01

    To better understand the effects of varying head movement frequencies on human balance control, 12 healthy adult humans were studied during static and dynamic (0.14,0.33,0.6 Hz) head tilts of +/-30deg in the pitch and roll planes. Postural sway was measured during upright stance with eyes closed and altered somatosensory inputs provided by a computerized dynamic posturography (CDP) system. Subjects were able to maintain upright stance with static head tilts, although postural sway was increased during neck extension. Postural stability was decreased during dynamic head tilts, and the degree of destabilization varied directly with increasing frequency of head tilt. In the absence of vision and accurate foot support surface inputs, postural stability may be compromised during dynamic head tilts due to a decreased ability of the vestibular system to discern the orientation of gravity.

  16. Behavioral and Psychological Issues in Long Duration Head-down Bed Rest

    NASA Technical Reports Server (NTRS)

    Seaton, Kimberly A.; Bowie, Kendra; Sipes, Walter A.

    2008-01-01

    Behavioral health services, similar to those offered to the U.S. astronauts who complete six-month missions on board the International Space Station, were provided to 13 long-duration head-down bed rest participants. Issues in psychological screening, selection, and support are discussed as they relate to other isolated and confined environments. Psychological services offered to participants are described, and challenges in subject selection and retention are discussed. Psychological support and training provided to both subjects and study personnel have successfully improved the well-being of study participants. Behavioral health services are indispensable to long-duration head-down tilt bed rest studies.

  17. Effect of eye position during human visual-vestibular integration of heading perception.

    PubMed

    Crane, Benjamin T

    2017-09-01

    Visual and inertial stimuli provide heading discrimination cues. Integration of these multisensory stimuli has been demonstrated to depend on their relative reliability. However, the reference frame of visual stimuli is eye centered while inertia is head centered, and it remains unclear how these are reconciled with combined stimuli. Seven human subjects completed a heading discrimination task consisting of a 2-s translation with a peak velocity of 16 cm/s. Eye position was varied between 0° and ±25° left/right. Experiments were done with inertial motion, visual motion, or a combined visual-inertial motion. Visual motion coherence varied between 35% and 100%. Subjects reported whether their perceived heading was left or right of the midline in a forced-choice task. With the inertial stimulus the eye position had an effect such that the point of subjective equality (PSE) shifted 4.6 ± 2.4° in the gaze direction. With the visual stimulus the PSE shift was 10.2 ± 2.2° opposite the gaze direction, consistent with retinotopic coordinates. Thus with eccentric eye positions the perceived inertial and visual headings were offset ~15°. During the visual-inertial conditions the PSE varied consistently with the relative reliability of these stimuli such that at low visual coherence the PSE was similar to that of the inertial stimulus and at high coherence it was closer to the visual stimulus. On average, the inertial stimulus was weighted near Bayesian ideal predictions, but there was significant deviation from ideal in individual subjects. These findings support visual and inertial cue integration occurring in independent coordinate systems. NEW & NOTEWORTHY In multiple cortical areas visual heading is represented in retinotopic coordinates while inertial heading is in body coordinates. It remains unclear whether multisensory integration occurs in a common coordinate system. The experiments address this using a multisensory integration task with eccentric gaze

  18. Thermal effects of whole head submersion in cold water on nonshivering humans.

    PubMed

    Pretorius, Thea; Bristow, Gerald K; Steinman, Alan M; Giesbrecht, Gordon G

    2006-08-01

    This study isolated the effect of whole head submersion in cold water, on surface heat loss and body core cooling, when the confounding effect of shivering heat production was pharmacologically eliminated. Eight healthy male subjects were studied in 17 degrees C water under four conditions: the body was either insulated or uninsulated, with the head either above the water or completely submersed in each body-insulation subcondition. Shivering was abolished with buspirone (30 mg) and meperidine (2.5 mg/kg), and subjects breathed compressed air throughout all trials. Over the first 30 min of immersion, exposure of the head increased core cooling both in the body-insulated conditions (head out: 0.47 +/- 0.2 degrees C, head in: 0.77 +/- 0.2 degrees C; P < 0.05) and the body-exposed conditions (head out: 0.84 +/- 0.2 degrees C and head in: 1.17 +/- 0.5 degrees C; P < 0.02). Submersion of the head (7% of the body surface area) in the body-exposed conditions increased total heat loss by only 10%. In both body-exposed and body-insulated conditions, head submersion increased core cooling rate much more (average of 42%) than it increased total heat loss. This may be explained by a redistribution of blood flow in response to stimulation of thermosensitive and/or trigeminal receptors in the scalp, neck and face, where a given amount of heat loss would have a greater cooling effect on a smaller perfused body mass. In 17 degrees C water, the head does not contribute relatively more than the rest of the body to surface heat loss; however, a cold-induced reduction of perfused body mass may allow this small increase in heat loss to cause a relatively larger cooling of the body core.

  19. Head office commitment to quality-related event reporting in community pharmacy.

    PubMed

    Scobie, Andrea C; Boyle, Todd A; Mackinnon, Neil J; Mahaffey, Thomas

    2012-05-01

    This research explores how perceptions of head office commitment to quality-related event (QRE) reporting differ between pharmacy staff type and between pharmacies with high and low QRE reporting and learning performance. QREs include known, alleged or suspected medication errors that reach the patient as well as medication errors that are intercepted prior to dispensing. A survey questionnaire was mailed in the spring of 2010 to 427 pharmacy managers, pharmacists and pharmacy technicians in Nova Scotia. Nonparametric statistics were used to determine differences based on pharmacy staff type and pharmacy performance. Content analysis was used to analyze the responses to open-ended survey questions. A total of 210 surveys were returned, for a response rate of 49.2%. However, the current study used only the subgroup of pharmacy staff who self-reported working at a chain pharmacy, for a total of 124 usable questionnaires. The results showed that community pharmacies viewed head office commitment to QRE reporting as an area to improve. In general, high-performing pharmacies ranked head office commitment higher than low-performing pharmacies. One possible reason why high-performing pharmacies ranked the variables higher may be that increased levels of head office support for QRE processes have led these pharmacies to adopt and commit to QRE processes and thus increase their performance. Demonstrated commitment to QRE reporting, ongoing encouragement and targeted messages to staff could be important steps for head office to increase QRE reporting and learning in community pharmacies.

  20. Precise Head Tracking in Hearing Applications

    NASA Astrophysics Data System (ADS)

    Helle, A. M.; Pilinski, J.; Luhmann, T.

    2015-05-01

    The paper gives an overview about two research projects, both dealing with optical head tracking in hearing applications. As part of the project "Development of a real-time low-cost tracking system for medical and audiological problems (ELCoT)" a cost-effective single camera 3D tracking system has been developed which enables the detection of arm and head movements of human patients. Amongst others, the measuring system is designed for a new hearing test (based on the "Mainzer Kindertisch"), which analyzes the directional hearing capabilities of children in cooperation with the research project ERKI (Evaluation of acoustic sound source localization for children). As part of the research project framework "Hearing in everyday life (HALLO)" a stereo tracking system is being used for analyzing the head movement of human patients during complex acoustic events. Together with the consideration of biosignals like skin conductance the speech comprehension and listening effort of persons with reduced hearing ability, especially in situations with background noise, is evaluated. For both projects the system design, accuracy aspects and results of practical tests are discussed.

  1. The financial impact of head and neck cancer caregiving: a qualitative study.

    PubMed

    Balfe, Myles; Butow, Phyllis; O'Sullivan, Eleanor; Gooberman-Hill, Rachael; Timmons, Aileen; Sharp, Linda

    2016-12-01

    There is a lack of research on the financial impacts that head and neck cancer has on caregivers. To explore the overall financial impact of head and neck cancer on caregivers; to describe the factors that mitigate this impact. Interviews with 31 caregivers (mean time caring: 5.7 years). Head and neck cancer had a considerable financial impact on caregivers. It resulted in out of pocket costs and caregivers and/or their relative/friend with cancer often became under- or un-employed. Caregivers with large debts or ongoing expenses appeared to be particularly vulnerable to cancer-related financial pressures. Finance related psychological stress was prevalent, although some caregivers hid their psychological difficulties from other people. Factors which help caregivers to mitigate financial distress included having private health insurance and being able to access to medical and/or social welfare benefits. Head and neck cancer can cause caregivers substantial financial and psychological distress. Distress may be mitigated by providing caregivers and their households with access to welfare benefits. Health professionals should be aware that head and neck cancer can have short and long-term financial consequences for caregivers and their families. Health professionals should refer patients and their caregivers to medical social workers who can help them with their financial issues. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  2. 45 CFR 1307.3 - Basis for determining whether a Head Start agency will be subject to an open competition.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) Align with the Head Start Child Development and Early Learning Framework, State early learning... Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM POLICIES AND PROCEDURES FOR...

  3. 45 CFR 1307.3 - Basis for determining whether a Head Start agency will be subject to an open competition.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) Align with the Head Start Child Development and Early Learning Framework, State early learning... Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM POLICIES AND PROCEDURES FOR...

  4. 45 CFR 1307.3 - Basis for determining whether a Head Start agency will be subject to an open competition.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) Align with the Head Start Child Development and Early Learning Framework, State early learning... Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM POLICIES AND PROCEDURES FOR...

  5. Irregular head movement patterns in whiplash patients during a trajectory task.

    PubMed

    Woodhouse, Astrid; Stavdahl, Øyvind; Vasseljen, Ottar

    2010-03-01

    Patients with whiplash associated disorders (WAD) have shown less accuracy in trajectory head motion compared to asymptomatic controls, which comply with clinical observations. The aim of this study was to investigate whether a trajectory head movement task can differ between WAD patients, chronic non-traumatic neck pain (CNP) patients and asymptomatic controls. Study groups included subjects with WAD (n = 35) with persistent neck pain after a car accident, CNP (n = 45), and asymptomatic controls (n = 48). Head motion was recorded from an unsupported standing position using a 3D Fastrak device. A laser pointer was attached to the head and by moving the head the subjects were asked to trace a figure of eight displayed on the wall at three different paces (slow, moderate and fast). The motion signal was decomposed into 1 Hz frequency bands and angular velocity (deg/s) within each frequency band was calculated. Significantly higher angular RMS velocity was found in the WAD group compared to the two other groups for the slow paced test (3-4 and 4-5 Hz frequency bands) and the moderate paced test (3-4 Hz frequency band) indicating irregular and uncoordinated movements. Angular RMS velocity was associated with pain and dizziness, but only with severe symptom levels. In conclusion, irregular head movements during a complex task were found in the WAD group, indicating altered central sensorimotor processing. The irregularities were found within frequency levels observable to clinicians.

  6. Biosignal-based relaxation evaluation of head-care robot.

    PubMed

    Ando, Takeshi; Takeda, Maki; Maruyama, Tomomi; Susuki, Yuto; Hirose, Toshinori; Fujioka, Soichiro; Mizuno, Osamu; Yamada, Kenji; Ohno, Yuko; Yukio, Honda

    2013-01-01

    Such popular head care procedures as shampooing and scalp massages provide physical and mental relaxation. However, they place a big burden such as chapped hands on beauticians and other practitioners. Based on our robot hand technology, we have been developing a head care robot. In this paper, we quantitatively evaluated its relaxation effect using the following biosignals: accelerated plethymography (SDNN, HF/TP, LF/HF), heart rate (HR), blood pressure, salivary amylase (sAA) and peripheral skin temperature (PST). We compared the relaxation of our developed head care robot with the head care provided by nurses. In our experimental result with 54 subjects, the activity of the autonomic nerve system changed before and after head care procedures performed by both a human nurse and our proposed robot. Especially, in the proposed robot, we confirmed significant differences with the procedure performed by our proposed head care robot in five indexes: HF/TP, LF/HF, HR, sAA, and PST. The activity of the sympathetic nerve system decreased, because the values of its indexes significantly decreased: LF/HF, HR, and sAA. On the other hand, the activity of the parasympathetic nerve system increased, because of the increase of its indexes value: HF/TP and PST. Our developed head care robot provided satisfactory relaxation in just five minutes of use.

  7. Head-Neck Biomechanics in Simulated Rear Impact

    PubMed Central

    Yoganandan, Narayan; Pintar, Frank A.; Cusick, Joseph F.; Kleinberger, Michael

    1998-01-01

    The first objective of this study is to present an overview of the human cadaver studies aimed to determine the biomechanics of the head-neck in a simulated rear crash. The need for kinematic studies to better understand the mechanisms of load transfer to the human head-neck complex is emphasized. Based on this need, a methodology is developed to delineate the dynamic kinematics of the human head-neck complex. Intact human cadaver head-neck complexes were subjected to postero-anterior impact using a mini-sled pendulum device. The integrity of the soft tissues including the musculature and skin were maintained. The kinematic data were recorded using high-speed photography coupled with retroreflective targets placed at various regions of the human head-neck complex. The overall and segmental kinematics of the entire head-neck complex, and the localized facet joint motions were determined. During the initial stages of loading, a transient decoupling of the head occurred with respect to the neck exhibiting a lag of the cranium. The upper cervical spine-head undergoes local flexion concomitant with a lag of the head while the lower cervical spinal column is in local extension. This establishes a reverse curvature to the cervical head-neck complex. With continued loading, head motion ensues and approximately at the end of the loading phase, the entire head-neck complex is under the extension mode with a single curvature. In contrast, the lower cervical spine facet joint kinematics show varying compression and sliding. While both the anterior and posterior-most regions of the facet joint slide, the posterior-most region (mean: 2.84 mm) of the joint compresses more than the anterior-most (mean: 2.02 mm) region. These varying kinematics at the ends of the facet joint result in a pinching mechanism. These biomechanical kinematic findings may be correlated to the presence of headaches and neck pain (Lord, Bogduk et al. 1992; Barnsley, Lord et al. 1995), based on the unique

  8. Characterization of the head-to-trunk orientation with handheld optical 3D apparatus based on the fringe projection technique.

    PubMed

    Pavlovčič, Urban; Diaci, Janez; Možina, Janez; Jezeršek, Matija

    2013-09-26

    Knowing the orientation of the head is important in many fields, including medicine. Many methods and measuring systems exist, but usually they use different markers or sensors attached to the subject's head for head orientation determination. In certain applications these attachments may represent a burden or a distraction to the subject under study which may have an unfavourable impact on the measurement. We propose a non-contact optical method for head-to-trunk orientation measurement that does not require any attachments to the subject under study. An innovative handheld 3D apparatus has been developed for non-invasive and fast 3D shape measurements. It is based on the triangulation principle in combination with fringe projection. The shape of the subject's upper trunk and head is reconstructed from a single image using the Fourier transform profilometry method. Two shape measurements are required to determine the head-to-trunk orientation angles: one in the reference (neutral) position and the other one in the position of interest. The algorithm for the head-to-trunk orientation angle extraction is based on the separate alignment of the shape of the subject's upper trunk and head against the corresponding shape in the reference pose. Single factor analysis of variance (ANOVA) was used for statistical characterisation of the method precision. The method and the 3D apparatus were verified in-vitro using a mannequin and a reference orientation tracker. The uncertainty of the calculated orientation was 2°. During the in-vivo test with a human subject diagnosed with cervical dystonia (aged 60), the repeatability of the measurements was 3°. In-vitro and in-vivo comparison was done on the basis of an experiment with the mannequin and a healthy male (aged 29). These results show that only the difference between flexion/extension measured angles was statistically significant. The differences between means were less than 1° for all ranges. The new non-contact method

  9. Online and offline tools for head movement compensation in MEG.

    PubMed

    Stolk, Arjen; Todorovic, Ana; Schoffelen, Jan-Mathijs; Oostenveld, Robert

    2013-03-01

    Magnetoencephalography (MEG) is measured above the head, which makes it sensitive to variations of the head position with respect to the sensors. Head movements blur the topography of the neuronal sources of the MEG signal, increase localization errors, and reduce statistical sensitivity. Here we describe two novel and readily applicable methods that compensate for the detrimental effects of head motion on the statistical sensitivity of MEG experiments. First, we introduce an online procedure that continuously monitors head position. Second, we describe an offline analysis method that takes into account the head position time-series. We quantify the performance of these methods in the context of three different experimental settings, involving somatosensory, visual and auditory stimuli, assessing both individual and group-level statistics. The online head localization procedure allowed for optimal repositioning of the subjects over multiple sessions, resulting in a 28% reduction of the variance in dipole position and an improvement of up to 15% in statistical sensitivity. Offline incorporation of the head position time-series into the general linear model resulted in improvements of group-level statistical sensitivity between 15% and 29%. These tools can substantially reduce the influence of head movement within and between sessions, increasing the sensitivity of many cognitive neuroscience experiments. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Understanding the Effects of Spaceflight on Head-trunk Coordination during Walking and Obstacle Avoidance

    NASA Technical Reports Server (NTRS)

    Madansingh, S.; Bloomberg, J.

    2013-01-01

    Prolonged exposure to spaceflight conditions results in a battery of physiological changes, some of which contribute to sensorimotor and neurovestibular deficits. Upon return to Earth, functional performance changes are tested using the Functional Task Test (FTT), which includes an obstacle course to observe post-flight balance and postural stability, specifically during turning. Aims: To quantify changes in movement strategies during turning events by observing the latency between head-andtrunk coordinated movement. Hypothesis: It is hypothesized that subjects experiencing neurovestibular adaptations will exhibit head-to-trunk locking ('en bloc' movement) during turning, exhibited by a decrease in latency between head and trunk movement. Sample: FTT data samples were collected from Shuttle and ISS missions. Samples were analyzed three times pre exposure, immediately post-exposure (0 or 1 day post) and 2-to-3 times during recovery from the microgravity environment. Methods: Two 3D inertial measurements units (XSens MTx) were attached to subjects, one on the head and one on the upper back. This study focused primarily on the yaw movements about the subject's center of rotation. Time differences (latency) between head and trunk movement were calculated at two points: the first turn (Fturn) to enter the obstacle course (approximately 90° turn) and averaged across a slalom obstacle portion, consisting of three turns (approximately three 90° turns). Results: Preliminary analysis of the data shows a trend toward decreasing head-to-trunk movement latency during post-flight ambulation, after reintroduction to Earth gravity in Shuttle and ISS astronauts. Conclusion: It is clear that changes in movement strategies are adopted during exposure to the microgravity environment and upon reintroduction to a gravity environment. Some subjects exhibit symptoms of neurovestibular neuropathy ('en bloc movement') that may impact their ability to perform post-flight functional tasks.

  11. Head Pose Estimation on Eyeglasses Using Line Detection and Classification Approach

    NASA Astrophysics Data System (ADS)

    Setthawong, Pisal; Vannija, Vajirasak

    This paper proposes a unique approach for head pose estimation of subjects with eyeglasses by using a combination of line detection and classification approaches. Head pose estimation is considered as an important non-verbal form of communication and could also be used in the area of Human-Computer Interface. A major improvement of the proposed approach is that it allows estimation of head poses at a high yaw/pitch angle when compared with existing geometric approaches, does not require expensive data preparation and training, and is generally fast when compared with other approaches.

  12. Head sway response to optic flow: effect of age is more important than the presence of unilateral vestibular hypofunction

    PubMed Central

    Sparto, Patrick J.; Furman, Joseph M.; Redfern, Mark S.

    2014-01-01

    Background The purpose of this study was to examine how older adults with vestibular impairment use sensory feedback for postural control. Methods Nine older adult subjects with unilateral vestibular hypofunction (UVH, mean age 69 y) and 14 older (mean age 70 y) and 8 young adult controls (CON, mean age 28 y) viewed full-field optic flow scenes while standing on a fixed or sway-referenced support surface. The subjects with UVH had 100% caloric asymmetry. Optic flow consisted of sinusoidal anterior-posterior movement of the visual surround at three frequencies and three amplitudes of stimulation. The anterior-posterior head sway was measured. The number of head sway responses that were coupled to the optic flow and magnitude of head sway during optic flow relative to during quiet stance on fixed floor was quantified. Results The number of trials in which the head sway response was significantly coupled to the optic flow was significantly greater in the Older UVH and Older CON subjects compared with the Young CON subjects. Furthermore, the magnitude of head sway was two to three times greater in Older UVH and CON compared with Young CON subjects. There was no difference in coupling or magnitude of head sway between Older UVH and Older CON subjects. The amplitude of sway was also dependent on the amount of surface support, stimulus frequency, and stimulus amplitude. Conclusions Older adults with unilateral vestibular hypofunction who are able to effectively compensate show no difference in postural responses elicited by optic flow compared with age-matched controls. PMID:17312341

  13. Predictors of Pain among Head and Neck Cancer Patients

    PubMed Central

    Shuman, Andrew G.; Terrell, Jeffrey E.; Light, Emily; Wolf, Gregory T.; Bradford, Carol R.; Chepeha, Douglas; Jiang, Yunyun; McLean, Scott; Ghanem, Tamer A.; Duffy, Sonia A.

    2014-01-01

    Objective Pain is a strong contributor to cancer patients’ quality of life. The objective of this study was to determine predictors of pain 1 year after the diagnosis of head and neck cancer. Design Prospective, multi-site cohort study. Setting Three academically-affiliated medical centers. Patients Previously untreated patients with carcinoma of the upper aerodigestive tract (n=374). Main Outcome Measures Participants were surveyed pre-treatment and 1 year thereafter. Multivariate analyses were conducted to determine predictors of the SF-36 bodily pain score 1 year after diagnosis. Results The mean SF-36 bodily pain score at 1 year was 65, compared to 61 at diagnosis (p=.004), compared to 75 among population norms (lower scores indicate worse pain). Variables independently associated with pain included pre-treatment pain score (p<0.001), less education (p=0.02), neck dissection (p=0.001), feeding tube (p=0.05), xerostomia (p<0.001), depressive symptoms (p<0.001), taking more pain medication (p<0.001), less physical activity (p=.02), and poor sleep quality (p=0.006). Current smoking and problem drinking were marginally significant (p=0.07 and 0.08, respectively). Conclusions Aggressive pain management may be indicated for head and neck cancer patients who undergo neck dissections, complain of xerostomia, require feeding tubes, and have medical comorbidities. Treatment of modifiable risk factors such as depression, poor sleep quality, tobacco and alcohol abuse may also reduce pain and improve quality of life among head and neck cancer patients. PMID:23165353

  14. Historical ties between otolaryngology-head and neck surgery and aviation and space medicine.

    PubMed

    Alford, B R; Atkins, J H

    1998-03-01

    Otolaryngology-head and neck surgeons have been involved in the development of aviation and space medicine since the beginning of this century. More than 75 years ago, otolaryngologists revised the physical examination for pilots, organized "boards of medical examiners" to test pilot applicants, coined the term "flight surgeon," and helped organize the first medical research laboratories at Hazelhurst Field in New York. These laboratories were transformed in 1922 into the School of Aviation Medicine at Brooks Field, Texas, which in turn subsequently was relocated to Randolph Field, Texas. During World War II the Director of Research at the school was Colonel Paul A. Campbell, MD, an otolaryngologist. In 1959, the school moved back to Brooks Air Force Base and was renamed the Aerospace Medical Center. Since manned space flight began in the 1960s there have been many joint research efforts between principal investigators in otolaryngology-head and neck surgery and NASA. Several otolaryngology-head and neck surgeons have served or currently serve as consultants and advisors to many of NASA's standing committees. The space environment offers a new frontier for development and research in the specialty and for better understanding of vestibular function and related disorders.

  15. Comparison between two methods of hydrostatic weighing without head submersion in morbidly obese females.

    PubMed

    Israel, R G; Evans, P; Pories, W J; O'Brien, K F; Donnelly, J E

    1990-01-01

    This study compared two methods of hydrostatic weighing without head submersion to conventional hydrostatic weighting in morbidly obese females. We concluded that hydrostatic weighing without head submersion is a valid alternative to conventional hydrostatic weighing especially when subjects are apprehensive in the water. The use of anthropometric head measures (HWNS-A) did not significantly improve the accuracy of the body composition assessment; therefore, elimination of these time consuming measurements in favor of the direct correction of head above Db is recommended.

  16. Active head rotations and eye-head coordination

    NASA Technical Reports Server (NTRS)

    Zangemeister, W. H.; Stark, L.

    1981-01-01

    It is pointed out that head movements play an important role in gaze. The interaction between eye and head movements involves both their shared role in directing gaze and the compensatory vestibular ocular reflex. The dynamics of head trajectories are discussed, taking into account the use of parameterization to obtain the peak velocity, peak accelerations, the times of these extrema, and the duration of the movement. Attention is given to the main sequence, neck muscle EMG and details of the head-movement trajectory, types of head model accelerations, the latency of eye and head movement in coordinated gaze, gaze latency as a function of various factors, and coordinated gaze types. Clinical examples of gaze-plane analysis are considered along with the instantaneous change of compensatory eye movement (CEM) gain, and aspects of variability.

  17. Risk factors for closed-head injuries during military airborne operations.

    PubMed

    Knapik, Joseph J; Steelman, Ryan; Hoedebecke, Kyle; Klug, Kevin L; Rankin, Shawn; Proctor, Stanley; Graham, Bria; Jones, Bruce H

    2014-02-01

    One of the more serious adverse outcomes of military airborne operations is closed-head injuries. This investigation examined risk factors for closed-head injuries in an Army airborne infantry unit. Closed-head injuries were defined as energy exchanges in which the head contacted the ground or an object and the soldier sought medical care for external trauma, headache, loss of consciousness, or altered mental state. Injury data were obtained by investigators in the drop zone and diagnoses were confirmed by a physician. Operational data on potential injury risk factors were obtained from routine reports published by the infantry unit. Weather data were obtained using a pocket weather tracker. There were 96,132 jumps resulting in 310 closed-head injuries for a crude incidence of 3.22/1000 jumps. In 98% of known cases the injury was associated with parachute landings. Multivariate logistic regression revealed that independent risk factors for closed-head injuries included night jumps, combat loads, higher wind speeds, higher temperatures, enlisted rank, and entanglements. This study identifies the current incidence and extrinsic risk factors for closed-head injuries during military airborne operations. Although it is necessary to conduct airborne training under realistic conditions, trainers and commanders should be aware of these risks and plan airborne operations accordingly.

  18. Photographic measurement of head and cervical posture when viewing mobile phone: a pilot study.

    PubMed

    Guan, Xiaofei; Fan, Guoxin; Wu, Xinbo; Zeng, Ying; Su, Hang; Gu, Guangfei; Zhou, Qi; Gu, Xin; Zhang, Hailong; He, Shisheng

    2015-12-01

    With the dramatic growth of mobile phone usage, concerns have been raised with regard to the adverse health effects of mobile phone on spinal posture. The aim of this study was to determine the head and cervical postures by photogrammetry when viewing the mobile phone screen, compared with those in neutral standing posture. A total of 186 subjects (81 females and 105 males) aged from 17 to 31 years old participated in this study. Subjects were instructed to stand neutrally and using mobile phone as in daily life. Using a photographic method, the sagittal head and cervical postures were assessed by head tilt angle, neck tilt angle, forward head shift and gaze angle. The photographic method showed a high intra-rater and inter-rater reliability in measuring the sagittal posture of cervical spine and gaze angle (ICCs ranged from 0.80 to 0.99). When looking at mobile phone, the head tilt angle significantly increased (from 74.55° to 95.22°, p = 0.000) and the neck angle decreased (from 54.68° to 38.77°, p = 0.000). The forward head posture was also confirmed by the significantly increased head shift (from 10.90 to 13.85 cm, p = 0.000). The posture assumed in mobile phone use was significantly correlated with neutral posture (p < 0.05). Males displayed a more forward head posture than females (p < 0.05). The head tilt angle was positively correlated with the gaze angle (r = 0.616, p = 0.000), while the neck tilt angle was negatively correlated with the gaze angle (r = -0.628, p = 0.000). Photogrammetry is a reliable, quantitative method to evaluate the head and cervical posture during mobile phone use. Compared to neutral standing, subjects display a more forward head posture when viewing the mobile phone screen, which is correlated with neutral posture, gaze angle and gender. Future studies will be needed to investigate a dose-response relationship between mobile phone use and assumed posture.

  19. Effects of Flexibility and Balance on Driving Distance and Club Head Speed in Collegiate Golfers.

    PubMed

    Marshall, Kelsey J; Llewellyn, Tamra L

    2017-01-01

    Good balance, flexibility, and strength are all required to maintain a steady stance during the kinematic chain to produce successful golf shots. When the body can produce more power, more club head speed is generated. This formation of power translates into greater distance and accuracy. Athletes today are seeking exercise programs to enhance these qualities of their golf swing. The purpose of this study is to investigate the correlations between flexibility and balance with club head speed and driving distance in the golf swing of male and female collegiate golfers. Five male and five female collegiate golfers participated in the study. They completed multiple range of motion tests, the Balance Error System Test, and multiple flexibility tests. Subjects then participated in a short hitting session. Ten shots were hit with the subject's own driver. The Optishot simulator measured distance and club head speed generated. There was a significant negative correlation between the BESS test score and average distance for male subjects (r=-0.850, p=0.034). There were also a few trends between the balance, flexibility, and club head speed findings of both male and female subjects. This data shows there is a significant relationship between better balance and driving the ball farther. Other trends show better balance and flexibility will result in greater driving distance and club head speed. Balance and flexibility exercises should be incorporated into a golfer's practice or workout regiment.

  20. A 10-Year Analysis of Head and Neck Injuries Involving Nonpowder Firearms.

    PubMed

    Dandu, Kartik V; Carniol, Eric T; Sanghvi, Saurin; Baredes, Soly; Eloy, Jean Anderson

    2017-05-01

    Objectives Firearms have an enduring and visible presence within American culture. However, the public health impact of nonpowder firearms and other "toy" guns has not been fully studied. These guns-including BB guns (ie, ball bearing), paintball guns, and pellet guns-are typically marketed to a younger audience. The objective of this study is to analyze head and neck injuries related to nonpowder firearms. Study Design Cross-sectional analysis of a national database. Setting Academic medical center. Subjects and Methods The National Electronic Injury Surveillance System was queried for head and neck injuries involving nonpowder guns, including air, BB, and pellet guns, and associated ammunition. Analysis of age, sex, incidence, injury location, and diagnosis was performed. Results From 2005 to 2014, there were 1695 cases recorded, or 55,060 estimated emergency room visits, due to injuries related to nonpowder guns and fired ammunition. The majority of patients were male (80.9%). These injuries were most common in children 6 to 12 years of age (37.9%), followed by those 13 to 18 years old (27.1%) and adults (≥19 years old; 17.8%), while preschool children (0-5 years) represented 17.2%. The most common injury diagnosis was penetrating foreign body (34.9%), followed by lacerations (24.3%) and contusions/abrasions (13.7%). Conclusion Nonpowder and other nonlethal firearm-related injuries to the head and neck region are a frequent source of emergency room visits nationally. Safety measures and public education on a mainstream level are required.

  1. Head Excursion of Restrained Human Volunteers and Hybrid III Dummies in Steady State Rollover Tests

    PubMed Central

    Moffatt, Edward; Hare, Barry; Hughes, Raymond; Lewis, Lance; Iiyama, Hiroshi; Curzon, Anne; Cooper, Eddie

    2003-01-01

    Seatbelts provide substantial benefits in rollover crashes, yet occupants still receive head and neck injuries from contacting the vehicle roof interior when the roof exterior strikes the ground. Prior research has evaluated rollover restraint performance utilizing anthropomorphic test devices (dummies), but little dynamic testing has been done with human volunteers to learn how they move during rollovers. In this study, the vertical excursion of the head of restrained dummies and human subjects was measured in a vehicle being rotated about its longitudinal roll axis at roll rates from 180-to-360 deg/sec and under static inversion conditions. The vehicle’s restraint design was the commonly used 3-point seatbelt with continuous loop webbing and a sliding latch plate. This paper presents an analysis of the observed occupant motion and provides a comparison of dummy and human motion under similar test conditions. Thirty-five tests (eighteen static and seventeen dynamic) were completed using two different sizes of dummies and human subjects in both near and far-side roll directions. The research indicates that far-side rollovers cause the restrained test subjects to have greater head excursion than near-side rollovers, and that static inversion testing underestimates head excursion for far-side occupants. Human vertical head excursion of up to 200 mm was found at a roll rate of 220 deg/sec. Humans exhibit greater variability in head excursion in comparison to dummies. Transfer of seatbelt webbing through the latch plate did not correlate directly with differences in head excursion. PMID:12941241

  2. Assessing the Prevalence of Traumatic Head Injury amongst Recreational Surfers in the United States.

    PubMed

    Swinney, Christian

    2015-12-01

    Surfing is a popular recreational sport that carries a substantial risk of injury. Although head injuries are frequently documented in the surfing population, an in depth assessment of the prevalence of surfing-related head injury has not been reported. A web-based survey was conducted in May of 2015. Participants were asked a series of questions regarding surfing-related injuries and demographic characteristics. A total of 50 responses were obtained, of which 35 (70%) reported sustaining a head injury. The most common injury was laceration of the head/face (n=27), followed by concussion (n=13). Other injuries, such as skull fracture and broken nose, were also reported. Only 2 of the 50 participants reported wearing a protective helmet. Neurosurgical intervention was required in 2 instances. Increased emphasis on preventative measures by the medical community may reduce the future incidence of such injuries. Medical professionals should be aware of the most common forms of injury sustained by the surfing population in order to better recognize and treat these conditions.

  3. Assessing the Prevalence of Traumatic Head Injury amongst Recreational Surfers in the United States

    PubMed Central

    2015-01-01

    Surfing is a popular recreational sport that carries a substantial risk of injury. Although head injuries are frequently documented in the surfing population, an in depth assessment of the prevalence of surfing-related head injury has not been reported. A web-based survey was conducted in May of 2015. Participants were asked a series of questions regarding surfing-related injuries and demographic characteristics. A total of 50 responses were obtained, of which 35 (70%) reported sustaining a head injury. The most common injury was laceration of the head/face (n=27), followed by concussion (n=13). Other injuries, such as skull fracture and broken nose, were also reported. Only 2 of the 50 participants reported wearing a protective helmet. Neurosurgical intervention was required in 2 instances. Increased emphasis on preventative measures by the medical community may reduce the future incidence of such injuries. Medical professionals should be aware of the most common forms of injury sustained by the surfing population in order to better recognize and treat these conditions. PMID:26668771

  4. Biochemotherapy in patients with advanced head and neck mucosal melanoma.

    PubMed

    Bartell, Holly L; Bedikian, Agop Y; Papadopoulos, Nicholas E; Dett, Tina K; Ballo, Matthew T; Myers, Jeffrey N; Hwu, Patrick; Kim, Kevin B

    2008-12-01

    No systemic therapy regimen has been recognized as effective for metastatic mucosal melanoma of the head and neck. We retrospectively analyzed the effectiveness of biochemotherapy in patients with advanced head and neck mucosal melanoma. We evaluated the medical records of 15 patients at our institution who had received various biochemotherapy regimens for advanced head and neck mucosal melanoma. After a median follow-up duration of 13 months, 3 patients (20%) had partial response, and 4 patients (27%) had complete response. The median time to disease progression for all 15 patients was 10 months. The median overall survival duration for all patients was 22 months. Although this was a small study, our results, especially the high complete response and overall response rates, indicate that biochemotherapy for advanced head and neck mucosal melanoma should be considered as a systemic treatment option for patients with this aggressive malignancy.

  5. A comparative study of six European databases of medically oriented Web resources.

    PubMed

    Abad García, Francisca; González Teruel, Aurora; Bayo Calduch, Patricia; de Ramón Frias, Rosa; Castillo Blasco, Lourdes

    2005-10-01

    The paper describes six European medically oriented databases of Web resources, pertaining to five quality-controlled subject gateways, and compares their performance. The characteristics, coverage, procedure for selecting Web resources, record structure, searching possibilities, and existence of user assistance were described for each database. Performance indicators for each database were obtained by means of searches carried out using the key words, "myocardial infarction." Most of the databases originated in the 1990s in an academic or library context and include all types of Web resources of an international nature. Five databases use Medical Subject Headings. The number of fields per record varies between three and nineteen. The language of the search interfaces is mostly English, and some of them allow searches in other languages. In some databases, the search can be extended to Pubmed. Organizing Medical Networked Information, Catalogue et Index des Sites Médicaux Francophones, and Diseases, Disorders and Related Topics produced the best results. The usefulness of these databases as quick reference resources is clear. In addition, their lack of content overlap means that, for the user, they complement each other. Their continued survival faces three challenges: the instability of the Internet, maintenance costs, and lack of use in spite of their potential usefulness.

  6. The effect of binocular eye position and head rotation plane on the human torsional vestibuloocular reflex.

    PubMed

    Migliaccio, Americo A; Della Santina, Charles C; Carey, John P; Minor, Lloyd B; Zee, David S

    2006-08-01

    We examined how the gain of the torsional vestibulo-ocular reflex (VOR) (defined as the instantaneous eye velocity divided by inverted head velocity) in normal humans is affected by eye position, target distance, and the plane of head rotation. In six normal subjects we measured three-dimensional (3D) eye and head rotation axes using scleral search coils, and 6D head position using a magnetic angular and linear position measurement device, during low-amplitude (approximately 20 degrees ), high-velocity (approximately 200 degrees/s), high-acceleration (approximately 4000 degrees /s2) rapid head rotations or 'impulses.' Head impulses were imposed manually and delivered in five planes: yaw (horizontal canal plane), pitch, roll, left anterior-right posterior canal plane (LARP), and right anterior-left posterior canal plane (RALP). Subjects were instructed to fix on one of six targets at eye level. Targets were either straight-ahead, 20 degrees left or 20 degrees right from midline, at distance 15 or 124 cm from the subject. Two subjects also looked at more eccentric targets, 30 degrees left or 30 degrees right from midline. We found that the vertical and horizontal VOR gains increased with the proximity of the target to the subject. Previous studies suggest that the torsional VOR gain should decrease with target proximity. We found, however, that the torsional VOR gain did not change for all planes of head rotation and for both target distances. We also found a dynamic misalignment of the vertical positions of the eyes during the torsional VOR, which was greatest during near viewing with symmetric convergence. This dynamic vertical skew during the torsional VOR arises, in part, because when the eyes are converged, the optical axes are not parallel to the naso-occipital axes around which the eyes are rotating. In five of six subjects, the average skew ranged 0.9 degrees -2.9 degrees and was reduced to <0.4 degrees by a 'torsional' quick-phase (around the naso

  7. Off with your heads: isolated organs in early Soviet science and fiction.

    PubMed

    Krementsov, Nikolai

    2009-06-01

    In the summer of 1925, a debutant writer, Aleksandr Beliaev, published a 'scientific-fantastic story', which depicted the travails of a severed human head living in a laboratory, supported by special machinery. Just a few months later, a young medical researcher, Sergei Briukhonenko, succeeded in reviving the severed head of a dog, using a special apparatus he had devised to keep the head alive. This paper examines the relationship between the literary and the scientific experiments with severed heads in post-revolutionary Russia, which reflected the anxieties about death, revival, and survival in the aftermath of the 1914-1923 'reign of death' in that country. It contrasts the anguished ethical questions raised by the story with the public fascination for 'science that conquers death'.

  8. Long-duration head-down bed rest: project overview, vital signs, and fluid balance.

    PubMed

    Meck, Janice V; Dreyer, Sherlene A; Warren, L Elisabeth

    2009-05-01

    Spaceflight has profound effects on the human body. Many of these effects can be induced with head-down bed rest, which has been a useful ground-based analog. With limited resources aboard the International Space Station for human research, the bed rest analog will be a primary platform on which countermeasures will be developed and tested for lunar and Mars mission scenarios. NASA Johnson Space Center, in conjunction with the University of Texas Medical Branch (UTMB), has created the NASA Flight Analogs Project (FAP), a research program with the overall objective of using head-down bed rest to evaluate, compare, and refine candidate countermeasures to spaceflight deconditioning. This paper serves as an overview and describes the standard conditions, the standard set of subject screening criteria, and the standard set of measurements for all FAP bed rest subjects. Heart rate and diastolic pressures decreased transiently at the onset of bed rest. Fluid balance showed an early diuresis, which stabilized within 3 d. In this supplement, detailed results from multiple disciplines are presented in a series of reports. The following reports describe multi-disciplinary results from the standard measurements by which the responses to bed rest will be assessed and by which countermeasures will be evaluated. The data presented in this overview are meant to serve as a context in which to view the data presented in the discipline specific manuscripts. The dietary support and behavioral health papers provide additional information regarding those aspects of implementing bed rest studies successfully.

  9. Rotation and direction judgment from visual images head-slaved in two and three degrees-of-freedom.

    PubMed

    Adelstein, B D; Ellis, S R

    2000-03-01

    The contribution to spatial awareness of adding a roll degree-of-freedom (DOF) to telepresence camera platform yaw and pitch was examined in an experiment where subjects judged direction and rotation of stationary target markers in a remote scene. Subjects viewed the scene via head-slaved camera images in a head-mounted display. Elimination of the roll DOF affected rotation judgment, but only at extreme yaw and pitch combinations, and did not affect azimuth and elevation judgement. Systematic azimuth overshoot occurred regardless of roll condition. Observed rotation misjudgments are explained by kinematic models for eye-head direction of gaze.

  10. Smooth-pursuit eye movements without head movement disrupt the static body balance.

    PubMed

    Kim, Sang-Yeob; Moon, Byeong-Yeon; Cho, Hyun Gug

    2016-04-01

    [Purpose] To investigate the changes of body balance in static posture in smooth-pursuit eye movements (SPEMs) without head movement. [Subjects and Methods] Forty subjects (24 males, 16 females) aged 23.24 ± 2.58 years participated. SPEMs were activated in three directions (horizontal, vertical, and diagonal movements); the target speed was set at three conditions (10°/s, 20°/s, and 30°/s); and the binocular visual field was limited to 50°. To compare the body balance changes, the general stability (ST) and the fall risk index (FI) were measured with TETRAX. The subjects wore a head-neck collar and stood on a balance plate for 32 s during each measurement in three directions. SPEMs were induced to each subject with nine target speeds and directions. All measured values were compared with those in stationary fixation. [Results] The ST and FI increased significantly in all SPEMs directions, with an increased target speed than that in stationary fixation. In the same condition of the target speed, the FI had the highest value relative to diagonal SPEMs. [Conclusion] SPEMs without head movement disrupt the stability of body balance in a static posture, and diagonal SPEMs may have a more negative effect in maintaining body balance than horizontal or vertical SPEMs.

  11. The multi-modal responses of a physical head model subjected to various blast exposure conditions

    NASA Astrophysics Data System (ADS)

    Ouellet, S.; Philippens, M.

    2018-01-01

    The local and global biomechanical response of the body to a blast wave is the first step of a sequence that leads to the development of stresses and strains which can exceed the tolerance of brain tissue. These stresses and strains may then lead to neuro-physical changes in the brain and contribute to initiate a cascade of events leading to injury. The specific biomechanical pathways by which the blast energy is transmitted through the head structure are, however, not clearly understood. Multiple transmission mechanisms have been proposed to explain the generation of brain stresses following the impingement of a blast wave on the head. With the use of a physical head model, the work presented here aims at demonstrating that the proposed transmission mechanisms are not mutually exclusive. They are part of a continuum of head responses where, depending on the exposure conditions, a given mechanism may or may not dominate. This article presents the joint analysis of previous blast test results generated with the brain injury protection evaluation device (BIPED) headform under four significantly different exposure conditions. The focus of the analysis is to demonstrate how the nature of the recorded response is highly dependent on the exposure characteristics and consequently, on the method used to reproduce blast exposure in a laboratory environment. The timing and magnitude of the variations in intra-cranial pressures (ICP) were analysed relative to the external pressure field in order to better understand the wave dynamics occurring within the brain structure of the headform. ICP waveforms were also analysed in terms of their energy spectral density to better identify the energy partitioning between the different modes of response. It is shown that the BIPED response is multi-modal and that the energy partitioning between its different modes of response is greatly influenced by exposure characteristics such as external peak overpressure, impulse, blast wave

  12. Exploiting domain information for Word Sense Disambiguation of medical documents.

    PubMed

    Stevenson, Mark; Agirre, Eneko; Soroa, Aitor

    2012-01-01

    Current techniques for knowledge-based Word Sense Disambiguation (WSD) of ambiguous biomedical terms rely on relations in the Unified Medical Language System Metathesaurus but do not take into account the domain of the target documents. The authors' goal is to improve these methods by using information about the topic of the document in which the ambiguous term appears. The authors proposed and implemented several methods to extract lists of key terms associated with Medical Subject Heading terms. These key terms are used to represent the document topic in a knowledge-based WSD system. They are applied both alone and in combination with local context. A standard measure of accuracy was calculated over the set of target words in the widely used National Library of Medicine WSD dataset. The authors report a significant improvement when combining those key terms with local context, showing that domain information improves the results of a WSD system based on the Unified Medical Language System Metathesaurus alone. The best results were obtained using key terms obtained by relevance feedback and weighted by inverse document frequency.

  13. Determination of head conductivity frequency response in vivo with optimized EIT-EEG.

    PubMed

    Dabek, Juhani; Kalogianni, Konstantina; Rotgans, Edwin; van der Helm, Frans C T; Kwakkel, Gert; van Wegen, Erwin E H; Daffertshofer, Andreas; de Munck, Jan C

    2016-02-15

    Electroencephalography (EEG) benefits from accurate head models. Dipole source modelling errors can be reduced from over 1cm to a few millimetres by replacing generic head geometry and conductivity with tailored ones. When adequate head geometry is available, electrical impedance tomography (EIT) can be used to infer the conductivities of head tissues. In this study, the boundary element method (BEM) is applied with three-compartment (scalp, skull and brain) subject-specific head models. The optimal injection of small currents to the head with a modular EIT current injector, and voltage measurement by an EEG amplifier is first sought by simulations. The measurement with a 64-electrode EEG layout is studied with respect to three noise sources affecting EIT: background EEG, deviations from the fitting assumption of equal scalp and brain conductivities, and smooth model geometry deviations from the true head geometry. The noise source effects were investigated depending on the positioning of the injection and extraction electrode and the number of their combinations used sequentially. The deviation from equal scalp and brain conductivities produces rather deterministic errors in the three conductivities irrespective of the current injection locations. With a realistic measurement of around 2 min and around 8 distant distinct current injection pairs, the error from the other noise sources is reduced to around 10% or less in the skull conductivity. The analysis of subsequent real measurements, however, suggests that there could be subject-specific local thinnings in the skull, which could amplify the conductivity fitting errors. With proper analysis of multiplexed sinusoidal EIT current injections, the measurements on average yielded conductivities of 340 mS/m (scalp and brain) and 6.6 mS/m (skull) at 2 Hz. From 11 to 127 Hz, the conductivities increased by 1.6% (scalp and brain) and 6.7% (skull) on the average. The proper analysis was ensured by using recombination of

  14. Head Pose Estimation Using Multilinear Subspace Analysis for Robot Human Awareness

    NASA Technical Reports Server (NTRS)

    Ivanov, Tonislav; Matthies, Larry; Vasilescu, M. Alex O.

    2009-01-01

    Mobile robots, operating in unconstrained indoor and outdoor environments, would benefit in many ways from perception of the human awareness around them. Knowledge of people's head pose and gaze directions would enable the robot to deduce which people are aware of the its presence, and to predict future motions of the people for better path planning. To make such inferences, requires estimating head pose on facial images that are combination of multiple varying factors, such as identity, appearance, head pose, and illumination. By applying multilinear algebra, the algebra of higher-order tensors, we can separate these factors and estimate head pose regardless of subject's identity or image conditions. Furthermore, we can automatically handle uncertainty in the size of the face and its location. We demonstrate a pipeline of on-the-move detection of pedestrians with a robot stereo vision system, segmentation of the head, and head pose estimation in cluttered urban street scenes.

  15. Head office commitment to quality-related event reporting in community pharmacy

    PubMed Central

    Scobie, Andrea C.; Boyle, Todd A.; MacKinnon, Neil J.; Mahaffey, Thomas

    2012-01-01

    Background: This research explores how perceptions of head office commitment to quality-related event (QRE) reporting differ between pharmacy staff type and between pharmacies with high and low QRE reporting and learning performance. QREs include known, alleged or suspected medication errors that reach the patient as well as medication errors that are intercepted prior to dispensing. Methods: A survey questionnaire was mailed in the spring of 2010 to 427 pharmacy managers, pharmacists and pharmacy technicians in Nova Scotia. Nonparametric statistics were used to determine differences based on pharmacy staff type and pharmacy performance. Content analysis was used to analyze the responses to open-ended survey questions. Results: A total of 210 surveys were returned, for a response rate of 49.2%. However, the current study used only the subgroup of pharmacy staff who self-reported working at a chain pharmacy, for a total of 124 usable questionnaires. The results showed that community pharmacies viewed head office commitment to QRE reporting as an area to improve. In general, high-performing pharmacies ranked head office commitment higher than low-performing pharmacies. Discussion: One possible reason why high-performing pharmacies ranked the variables higher may be that increased levels of head office support for QRE processes have led these pharmacies to adopt and commit to QRE processes and thus increase their performance. Conclusion: Demonstrated commitment to QRE reporting, ongoing encouragement and targeted messages to staff could be important steps for head office to increase QRE reporting and learning in community pharmacies. PMID:23509532

  16. Analysis by NASA's VESGEN Software of Retinal Blood Vessels in Human Subjects Undergoing Head-Down Tilt During 70-Day Bed Rest

    NASA Technical Reports Server (NTRS)

    Vyas, Ruchi J.; Murray, Matthew C.; Predovic, Marina; Lim, Shiyin; Askin, Kayleigh N.; Vizzeri, Gianmarco; Taibbi, Giovanni; Mason, Sara Stroble; Zanello, Susana B.; Young, Millenia; hide

    2017-01-01

    Significant risks for visual impairment associated with increased intracranial pressure (VIIP) are incurred by microgravity spaceflight, especially long-duration missions [1]. We hypothesize that microgravity-induced fluid shifts result in pathological changes within blood vessels of the retina that precede development of visual and other ocular impairments. Potential contributions of retinal vascular remodeling to VIIP etiology are therefore being investigated for two studies in 30deg infrared (IR) Heidelberg Spectralis(Registered Trademark) images with NASA's innovative VESsel GENeration Analysis (VESGEN) software [2,3]. The retrospective studies include: (1) before, during and after (pre, mid and post) 6º head-down tilt (HDT) in human subjects during 70 days of bed rest, and (2) before and after missions to the International Space Station (ISS) by U.S. crew members. Results for both studies are almost complete. A preliminary example for HDT is described below.

  17. Functional Data Analysis of Spaceflight-Induced Changes in Coordination and Phase in Head Pitch Acceleration During Treadmill Walking

    NASA Technical Reports Server (NTRS)

    Miller, Christopher; Peters, Brian; Feiveson, Alan; Bloomberg, Jacob

    2011-01-01

    Astronauts returning from spaceflight experience neurovestibular disturbances during head movements and attempt to mitigate them by limiting head motion. Analyses to date of the head movements made during walking have concentrated on amplitude and variability measures extracted from ensemble averages of individual gait cycles. Phase shifts within each gait cycle can be determined by functional data analysis through the computation of time-warping functions. Large, localized variations in the timing of peaks in head kinematics may indicate changes in coordination. The purpose of this study was to determine timing changes in head pitch acceleration of astronauts during treadmill walking before and after flight. Six astronauts (5M/1F; age = 43.5+/-6.4yr) participated in the study. Subjects walked at 1.8 m/sec (4 mph) on a motorized treadmill while reading optotypes displayed on a computer screen 4 m in front of their eyes. Three-dimensional motion of the subject s head was recorded with an Inertial Measurement Unit (IMU) device. Data were recorded twice before flight and four times after landing. The head pitch acceleration was calculated by taking the time derivative of the pitch velocity data from the IMU. Data for each session with each subject were time-normalized into gait cycles, then registered to align significant features and create a mean curve. The mean curves of each postflight session for each subject were re-registered based on their preflight mean curve to create time-warping functions. The root mean squares (RMS) of these warping functions were calculated to assess the deviation of head pitch acceleration mean curves in each postflight session from the preflight mean curve. After landing, most crewmembers exhibited localized shifts within their head pitch acceleration regimes, with the greatest deviations in RMS occurring on landing day or 1 day after landing. These results show that the alteration of head pitch coordination due to spaceflight may be

  18. The profile of head injuries and traumatic brain injury deaths in Kashmir.

    PubMed

    Yattoo, Gh; Tabish, Amin

    2008-06-21

    This study was conducted on patients of head injury admitted through Accident & Emergency Department of Sher-i-Kashmir Institute of Medical Sciences during the year 2004 to determine the number of head injury patients, nature of head injuries, condition at presentation, treatment given in hospital and the outcome of intervention. Traumatic brain injury (TBI) deaths were also studied retrospectively for a period of eight years (1996 to 2003).The traumatic brain injury deaths showed a steady increase in number from year 1996 to 2003 except for 1999 that showed decline in TBI deaths. TBI deaths were highest in age group of 21-30 years (18.8%), followed by 11-20 years age group (17.8%) and 31-40 years (14.3%). The TBI death was more common in males. Maximum number of traumatic brain injury deaths was from rural areas as compared to urban areas.To minimize the morbidity and mortality resulting from head injury there is a need for better maintenance of roads, improvement of road visibility and lighting, proper mechanical maintenance of automobile and other vehicles, rigid enforcement of traffic rules, compulsory wearing of crash helmets by motor cyclist and scooterists and shoulder belt in cars and imparting compulsory road safety education to school children from primary education level. Moreover, appropriate medical care facilities (including trauma centres) need to be established at district level, sub-divisional and block levels to provide prompt and quality care to head injury patients.

  19. Management of post-traumatic elbow instability after failed radial head excision: A case report.

    PubMed

    Touloupakis, Georgios; Theodorakis, Emmanouil; Favetti, Fabio; Nannerini, Massimiliano

    2017-02-01

    Radial head excision has always been a safe commonly used surgical procedure with a satisfactory clinical outcome for isolated comminuted radial head fractures. However, diagnosis of elbow instability is still very challenging and often underestimated in routine orthopaedic evaluation. We present the case of a 21-years old female treated with excision after radial head fracture, resulting in elbow instability. The patient underwent revision surgery after four weeks. We believe that ligament reconstruction without radial head substitution is a safe alternative choice for Mason III radial head fractures accompanied by complex ligament lesions. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  20. Head lice

    MedlinePlus

    Pediculosis capitis - head lice ... Head lice infect hair on the head. Tiny eggs on the hair look like flakes of dandruff . However, ... flaking off the scalp, they stay in place. Head lice can live up to 30 days on a ...

  1. Growth trajectories of the human embryonic head and periconceptional maternal conditions.

    PubMed

    Koning, I V; Baken, L; Groenenberg, I A L; Husen, S C; Dudink, J; Willemsen, S P; Gijtenbeek, M; Koning, A H J; Reiss, I K M; Steegers, E A P; Steegers-Theunissen, R P M

    2016-05-01

    studied in the general population. Assessment of growth trajectories of the embryonic head may be of benefit in future early antenatal care. This study was funded by the Department of Obstetrics and Gynaecology, Erasmus MC University Medical Centre and Sophia Foundation for Medical Research, Rotterdam, The Netherlands (SSWO grant number 644). No competing interests are declared. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Femoral head epiphysis growth and development among Chinese children aged 0-5 years.

    PubMed

    Luo, Jiayou; Tang, Jin; Zhou, Libo; Zeng, Rong; Mou, Jinsong; Zhang, Lingli

    2009-05-01

    The aim of this study was to examine the pattern of femoral head epiphysis growth and development among Chinese children. Between January and December, 2007, we randomly sampled 1,450 healthy Chinese children (0-5 years old) from Hunan Provincial Children's Hospital in Changsha, Hunan, China. The diameter of femoral head epiphysis was measured by pelvic X-ray photography and processed by medical image processing software. The growth of femoral head epiphysis in girls was 2-3 months earlier than that in boys. The diameter of femoral head epiphysis increased with advancing age in both girls and boys, but the diameter of femoral head epiphysis in 2, 3, 4, 6, and 10-month-old girls was significantly larger than that in boys. Cubic regression equations between the diameter of femoral head epiphysis and age were created for boys and girls that could be used to predict the diameter of femoral head epiphysis. In conclusion, there was gender difference in femoral head epiphysis growth and development among Chinese children, and our prediction models will provide the guidance for early diagnosis of diseases related to the growth and development of the femoral head epiphysis.

  3. Biomechanical Modeling of the Human Head

    DTIC Science & Technology

    2017-10-03

    between model predictions and experimental data. This report details model calibration for all materials identified in models of a human head and...14 3 Stress-strain data for the pia mater and dura mater (human subject); experimental data orig- inally presented in [28...treated as one material) based on a hyperelastic model and experimental data from [59] ............................................... 20 5 Comparison of

  4. Quantifying Head Impacts in Collegiate Lacrosse.

    PubMed

    Reynolds, Bryson B; Patrie, James; Henry, Erich J; Goodkin, Howard P; Broshek, Donna K; Wintermark, Max; Druzgal, T Jason

    2016-11-01

    Concussion and repetitive head impact in sports has increased interest and concern for clinicians, scientists, and athletes. Lacrosse is the fastest growing sport in the United States, but the burden of head impact in lacrosse is unknown. The goal of this pilot study was to quantify head impact associated with practicing and playing collegiate lacrosse while subjects were fitted with wearable accelerometers. Descriptive epidemiology study. In a single year, a collegiate cohort of 14 women's and 15 men's lacrosse players wore mastoid-patch accelerometers to measure the frequency and severity of head impacts during official practices and games. Average impact severity, mean number of impacts, and cumulative acceleration were evaluated, stratified by sport and event type. Men's and women's collegiate lacrosse players did not significantly differ in the number of head impacts received during games (11.5 for men vs 9.2 for women) or practices (3.1 vs 3.1). Men's lacrosse players had significantly higher average head acceleration per impact during games compared with women (21.1g vs 14.7g) but not during practices (21.3g vs 18.1g). For both men and women, more impacts occurred during games than during practices (men, 11.5 vs 3.1; women, 9.2 vs 3.1), but impact severity did not significantly differ between events for either sport (men, 21.1g vs 21.3g; women, 14.7g vs 18.1g). The study data suggest a higher impact burden during games compared with practices, but this effect is driven by the quantity rather than severity of impacts. In contrast, sex-based effects in impact burden are driven by average impact severity rather than quantity. Data collected from larger multisite trials and/or different age groups could be used to inform ongoing debates, including headgear and practice regulations, that might appreciably affect the burden of head impacts in lacrosse. While most head impacts do not result in a clinical diagnosis of concussion, evidence indicates that

  5. Subjective memory and concentration deficits in medication-free, non-elderly Asians with major depressive disorder: prevalence and their correlates.

    PubMed

    Srisurapanont, Manit; Bautista, Dianne; Chen, Chia-Hui; Wang, Gang; Udomratn, Pichet; Eurviriyanukul, Kanokkwan

    2015-01-15

    Subjective cognitive impairment (SCI) in major depressive disorder (MDD) is prevalent and correlated with disability. This study aimed to examine the prevalence rates and correlates of subjective memory deficit (SMD) and subjective concentration deficit (SCD) in medication-free, non-elderly Asians with MDD. The SMD and SCD were assessed by using two items of the Symptom Checklist-90-Revised (SCL-90-R). Other measurements of interest included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale (FSS), the Sheehan Disability Scale (SDS), and the Short Form Health Survey (SF-36). Adjusted odds ratios with 95% confidence intervals were calculated. Of 515 participants from China, Korea, Malaysia, Singapore, Taiwan, and Thailand, 347 (67.4%) and 377 (73.2%) had SMD and SCD, respectively. In total, 420 participants (81.6%) had SMD alone, SCD alone, and both deficits. Severe depression and poor mental health were significant correlates of SMD. Severe depression, clinically significant disability, poor physical health, and poor mental health were significantly independent correlates of SCD. Compared with young adults (18-34 years), older adults aged 50-65 years had a significantly lower risk of SCD (OR=.33, 95% CI: .19-.57). Only two SCL-90-R items were used to assess the SMD and SCD. The exclusion of MDD patients treated with psychotropic medications eliminated many patients commonly seen in typical clinic settings. SMD and SCD are prevalent in medication-free, non-elderly Asians with MDD. Both deficits are correlated with depression and mental health status. The independent correlation between SCD and disability underscores the crucial role of SCI in MDD. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Head Start Participants, Programs, Families and Staff in 2012

    ERIC Educational Resources Information Center

    Schmit, Stephanie

    2013-01-01

    Since 1965, the Head Start program has served low-income 3- and 4-year-old children and their families with comprehensive early education and support services. Programs provide services focused on the "whole child," including early education addressing cognitive, developmental, and socio-emotional needs; medical and dental screenings and…

  7. Head Start Participants, Programs, Families, and Staff in 2006

    ERIC Educational Resources Information Center

    Center for Law and Social Policy, Inc. (CLASP), 2008

    2008-01-01

    Since 1965, the Head Start program has served low-income 3- and 4-year-old children and their families with comprehensive early education and support services. Programs provide services focused on the "whole child," including early education addressing cognitive, developmental, and socio-emotional needs; medical and dental screenings and…

  8. Head Start Participants, Programs, Families, and Staff in 2014

    ERIC Educational Resources Information Center

    Mohan, Anitha; Walker, Christina

    2016-01-01

    Since 1965, the Head Start program has served low-income 3- and 4-year-old children and their families with comprehensive early education and support services. Programs provide services focused on the "whole child," including early education addressing cognitive, developmental, and socio-emotional needs; medical and dental screenings and…

  9. Influence of history of head trauma and epilepsy on delinquents in a juvenile classification home.

    PubMed

    Miura, Hideki; Fujiki, Masumi; Shibata, Arihiro; Ishikawa, Kenji

    2005-12-01

    Juvenile delinquents often show poor impulse control and cognitive abnormalities, which may be related to disturbances in brain development due to head trauma and/or epilepsy. The aim of the present study was to examine the influence of head trauma and/or epilepsy on delinquent behavior. We examined 1,336 juvenile delinquents (1,151 males and 185 females) who had been admitted to the Nagoya Juvenile Classification Home, Aichi, Japan. Among them, 52 subjects with a history of epilepsy, convulsion or loss of consciousness, head injury requiring neurological assessment and/or treatment, or neurosurgical operation (head trauma/epilepsy group), were examined by electroencephalography and compared to subjects without these histories (control group) with respect to types of crime, history of amphetamine use, psychiatric treatment, child abuse, and family history. Among the 52 subjects, 43 (82.7%) showed abnormal findings. The head trauma/epilepsy group had significantly higher rates of psychiatric treatment (P<0.0001, OR=16.852, 95% CI=8.068-35.199) and family history of drug abuse (P<0.05, OR=2.303, 95% CI=1.003-5.290). Furthermore, the percentage of members who were sent to juvenile training school by the family court was significantly higher in the head trauma/epilepsy group (72.5%) than in the control group (38.9%, P<0.0001). The juvenile delinquents who had a history of head trauma and/or epilepsy showed a high prevalence of electroencephalograph abnormality, and higher rates of psychiatric treatment and family history of drug abuse, and were more likely to be sent to juvenile training school by the family court.

  10. Head Lice

    MedlinePlus

    What are head lice? Head lice are tiny insects that live on people's heads. Adult lice are about the size of sesame seeds. The eggs, called ... often at the neckline and behind the ears. Head lice are parasites, and they need to feed on ...

  11. Head Impact Exposure in Junior and Adult Australian Football Players

    PubMed Central

    King, Doug; Dempsey, Alasdair; Murphy, Myles

    2018-01-01

    This study measured and compared the frequency, magnitude, and distribution of head impacts sustained by junior and adult Australian football players, respectively, and between player positions over a season of games. Twelve junior and twelve adult players were tracked using a skin-mounted impact sensor. Head impact exposure, including frequency, magnitude, and location of impacts, was quantified using previously established methods. Over the collection period, there were no significant differences in the impact frequency between junior and adult players. However, there was a significant increase in the frequency of head impacts for midfielders in both grades once we accounted for player position. A comparable amount of head impacts in both junior and adult players has implications for Australian football regarding player safety and medical coverage as younger players sustained similar impact levels as adult players. The other implication of a higher impact profile within midfielders is that, by targeting education and prevention strategies, a decrease in the incidence of sports-related concussion may result. PMID:29805979

  12. Multiscale Analysis of Head Impacts in Contact Sports

    NASA Astrophysics Data System (ADS)

    Guttag, Mark; Sett, Subham; Franck, Jennifer; McNamara, Kyle; Bar-Kochba, Eyal; Crisco, Joseph; Blume, Janet; Franck, Christian

    2012-02-01

    Traumatic brain injury (TBI) is one of the world's major causes of death and disability. To aid companies in designing safer and improved protective gear and to aid the medical community in producing improved quantitative TBI diagnosis and assessment tools, a multiscale finite element model of the human brain, head and neck is being developed. Recorded impact data from football and hockey helmets instrumented with accelerometers are compared to simulated impact data in the laboratory. Using data from these carefully constructed laboratory experiments, we can quantify impact location, magnitude, and linear and angular accelerations of the head. The resultant forces and accelerations are applied to a fully meshed head-form created from MRI data by Simpleware. With appropriate material properties for each region of the head-form, the Abaqus finite element model can determine the stresses, strains, and deformations in the brain. Simultaneously, an in-vitro cellular TBI criterion is being developed to be incorporated into Abaqus models for the brain. The cell-based injury criterion functions the same way that damage criteria for metals and other materials are used to predict failure in structural materials.

  13. A 1-Diopter Vertical Prism Induces a Decrease of Head Rotation: A Pilot Investigation.

    PubMed

    Matheron, Eric; Zandi, Ava; Wang, Danping; Kapoula, Zoï

    2016-01-01

    Clinical studies in non-specific chronic arthralgia and back pain seem to indicate an association between vertical heterophoria (VH - latent vertical retinal misalignment) and asymmetrical head rotation. Such clinical observations suggest a link between VH and head rotation, but this was never tested. The purpose of this study was to simulate a VH in healthy subjects and examine its influence on the amplitude of active head rotation during 3D motion capture in upright stance. Subjects were asked to rotate their head three times from the straight ahead position and then to the right, back to straight ahead, to the left, and back to the straight ahead again. Three randomized conditions were run: normal viewing, with a 1-diopter prism base down on the dominant eye, or the non-dominant eye. The most important finding is that the experimental VH whichever the eye with the prism induces a significant decrease in the mean angle of head rotation compared to the normal viewing condition. This decrease was significant for rotation to the left. We suggest that the prism-induced VH modifies the reference posture and thereby affects head rotation; further studies are needed to confirm this effect and to extend to other types of dynamic activities.

  14. Hierarchy and Scope of Planning in Subject-Verb Agreement Production

    ERIC Educational Resources Information Center

    Gillespie, Maureen; Pearlmutter, Neal J.

    2011-01-01

    Two subject-verb agreement error elicitation studies tested the hierarchical feature-passing account of agreement computation in production and three timing-based alternatives: linear distance to the head noun, semantic integration, and a combined effect of both (a scope of planning account). In Experiment 1, participants completed subject noun…

  15. Where Is Medical Practice In India Heading?

    PubMed Central

    Pandya, Sunil K.

    2006-01-01

    Medical practice is based on teaching, learning and examples set by seniors. Past and present practices are briefly analysed. Current trends do not justify optimism. The poor patient is likely to be sidelined as doctors reach out to the rich and powerful in this country and those bringing in American dollars from abroad. While corrective steps are possible, it is unlikely that they will be implemented. PMID:22013332

  16. Effects of Soccer Heading on Brain Structure and Function

    PubMed Central

    Rodrigues, Ana Carolina; Lasmar, Rodrigo Pace; Caramelli, Paulo

    2016-01-01

    Soccer is the most popular sport in the world, with more than 265 million players worldwide, including professional and amateur ones. Soccer is unique in comparison to other sports, as it is the only sport in which participants purposely use their head to hit the ball. Heading is considered as an offensive or defensive move whereby the player’s unprotected head is used to deliberately impact the ball and direct it during play. A soccer player can be subjected to an average of 6–12 incidents of heading the ball per competitive game, where the ball reaches high velocities. Moreover, in practice sessions, heading training, which involves heading the ball repeatedly at low velocities, is common. Although the scientific community, as well as the media, has focused on the effects of concussions in contact sports, the role of subconcussive impacts, as it can occur during heading, has recently gained attention, considering that it may represent an additional mechanism of cumulative brain injury. The purpose of this study is to review the existing literature regarding the effects of soccer heading on brain structure and function. Only in the last years, some investigations have addressed the impact of heading on brain structure, by using neuroimaging techniques. Similarly, there have been some recent studies investigating biochemical markers of brain injury in soccer players. There is evidence of association between heading and abnormal brain structure, but the data are still preliminary. Also, some studies have suggested that subconcussive head impacts, as heading, could cause cognitive impairment, whereas others have not corroborated this finding. Questions persist as to whether or not heading is deleterious to cognitive functioning. Further studies, especially with longitudinal designs, are needed to clarify the clinical significance of heading as a cause of brain injury and to identify risk factors. Such investigations might contribute to the establishment of safety

  17. Off with your heads: isolated organs in early Soviet science and fiction

    PubMed Central

    Krementsov, Nikolai

    2009-01-01

    In the summer of 1925, a debutant writer, Aleksandr Beliaev, published a ‘scientific-fantastic story’, which depicted the travails of a severed human head living in a laboratory, supported by special machinery. Just a few months later, a young medical researcher, Sergei Briukhonenko, succeeded in reviving the severed head of a dog, using a special apparatus he had devised to keep the head alive. This paper examines the relationship between the literary and the scientific experiments with severed heads in post-revolutionary Russia, which reflected the anxieties about death, revival, and survival in the aftermath of the 1914–1923 ‘reign of death’ in that country. It contrasts the anguished ethical questions raised by the story with the public fascination for ‘science that conquers death’. PMID:19442924

  18. Reducing Head CT Use for Children With Head Injuries in a Community Emergency Department.

    PubMed

    Jennings, Rebecca M; Burtner, Jennifer J; Pellicer, Joseph F; Nair, Deepthi K; Bradford, Miranda C; Shaffer, Michele; Uspal, Neil G; Tieder, Joel S

    2017-04-01

    Clinical decision rules have reduced use of computed tomography (CT) to evaluate minor pediatric head injury in pediatric emergency departments (EDs). CT use remains high in community EDs, where the majority of children seek medical care. We sought to reduce the rate of CT scans used to evaluate pediatric head injury from 29% to 20% in a community ED. We evaluated a quality improvement (QI) project in a community ED aimed at decreasing the use of head CT scans in children by implementing a validated head trauma prediction rule for traumatic brain injury. A multidisciplinary team identified key drivers of CT use and implemented decision aids to improve the use of prediction rules. The team identified and mitigated barriers. An affiliated children's hospital offered Maintenance of Certification credit and QI coaching to participants. We used statistical process control charts to evaluate the effect of the intervention on monthly CT scan rates and performed a Wald test of equivalence to compare preintervention and postintervention CT scan proportions. The baseline period (February 2013-July 2014) included 695 patients with a CT scan rate of 29.2% (95% confidence interval, 25.8%-32.6%). The postintervention period (August 2014-October 2015) included 651 patients with a CT scan rate of 17.4% (95% confidence interval, 14.5%-20.2%, P < .01). Barriers included targeting providers with variable pediatric experience and parental imaging expectations. We demonstrate that a Maintenance of Certification QI project sponsored by a children's hospital can facilitate evidence-based pediatric care and decrease the rate of unnecessary CT use in a community setting. Copyright © 2017 by the American Academy of Pediatrics.

  19. Measurement of Transcranial Distance During Head-Down Tilt Using Ultrasound

    NASA Technical Reports Server (NTRS)

    Torikoshi, Shigeyo; Ballard, R. E.; Watenpaugh, D. E.; Murthy, G.; Bowley, S.; Yost, W. T.; Hargens, Alan R.

    1995-01-01

    Exposure to microgravity probably elevates blood pressure and flow in the head which may increase intracranial volume (ICV) and pressure (ICP). Due to the slightly compliant nature of the cranium, any increase of ICP will increase ICV and transcranial distance. We used a noninvasive ultrasound technique to measure transcranial distance (frontal to occipital) during head-down tilt. Seven subjects (ages 26-53) underwent the following tilt angles: 90 deg. upright, 30 deg., 0 deg., -6 deg., -10 deg., -6 deg., 0 deg., 30 deg., and 90 deg. Each angle was maintained for 1 min. Ultrasound wave frequency was collected continuously and transcranial distance was calculated (Delta(x) = x(Delta)f/f, where x is path length and f is frequency of the wave) for each tilt angle. Frequency decreased from 503.687 kHz (90 deg. upright) to 502.619 kHz (-10 deg.). These frequencies translated to an increased transcranial distance of 0.403 mm. Although our data suggest a significant increase in transcranial distance during head-down tilt, this apparent increase may result, in part, from head-down tilt-induced subcutaneous edema or cutaneous blood volume elevation. In three subjects, when the above protocol was repeated with an ace bandage wrapped around the head to minimize such edema, the increased transcranial distance from 90 deg. to -10 deg. was reduced by 0.174 mm. Further development of the technique to quantify bone-to-bone expansion unconfounded by cutaneous fluid is necessary. Therefore, this ultrasound technique may provide measurements of changes in cranial dimensions during microgravity.

  20. [Rare tumors of the head and neck; on behalf of the REFCOR, the French Network of rare head and neck tumors].

    PubMed

    Baujat, Bertrand; Thariat, Juliette; Baglin, Anne Catherine; Costes, Valérie; Testelin, Sylvie; Reyt, Emile; Janot, François

    2014-05-01

    Malignant tumors of the upper aerodigestive tract may be rare by their histology (sarcoma, variants of conventional squamous cell carcinomas) and/or location (sinuses, salivary glands, ear, of various histologies themselves). They represent less than 10% of head and neck neoplasms. The confirmation of their diagnosis often requires a medical expertise and sometimes biomolecular techniques complementary to classical histology and immunohistochemistry. Due to their location, their treatment often requires a specific surgical technique. Radiation therapy is indicated based on histoclinical characteristics common to other head and neck neoplasms but also incorporate grade. Further, the technique must often be adapted to take into account the proximity of organs at risk. For most histologies, chemotherapy is relatively inefficient but current molecular advances may allow to consider pharmaceutical developments in the coming years. The REFCOR, the French Network of head and neck cancers aims to organize and promote the optimal management of these rare and heterogeneous diseases, to promote research and clinical trials.

  1. Increased Aldosterone Release During Head-Up Tilt in Early Primary Hypertension.

    PubMed

    Reinold, Annemarie; Schneider, Andreas; Kalizki, Tatjana; Raff, Ulrike; Schneider, Markus P; Schmieder, Roland E; Schmidt, Bernhard M W

    2017-05-01

    Hyperaldosteronism is well known cause of secondary hypertension. However, the importance of aldosterone for the much larger group of patients with primary hypertension is less clear. We hypothesized that in young subjects with primary hypertension, the rise of plasma aldosterone levels in response to head-up tilt testing as a stress stimulus is exaggerated. Hemodynamics (blood pressure (BP), heart rate (HR), cardiac index (CI), and total peripheral vascular resistance index (TPRI), all by TaskForce monitor) and hormones (plasma renin activity (PRA), angiotensin II (Ang II), aldosterone) were measured before and during 30 minutes of head-up tilt in 45 young hypertensive and 45 normotensive subjects. BP, HR, CI, and TPRI all increased in response to head-up tilt, with no difference between groups. There was no difference in baseline PRA, Ang II, and aldosterone between groups. During head-up tilt, PRA, and Ang II levels increased similarly. However, aldosterone levels increased to a greater extent in the hypertensive vs. normotensive subjects (P = 0.0021). Our data suggest that an increased release of aldosterone in response to orthostatic stress is a feature of early primary hypertension. The similar increase in PRA and Ang II suggests a potential role for secretagogues of aldosterone other than Ang II in this response. In addition to its established role in secondary hypertension, dysregulation of aldosterone release might contribute to the development of primary arterial hypertension. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  2. Neonatal head injury unrelated to birth trauma in South-East Nigeria.

    PubMed

    Uche, E O; Emejulu, J K; Ekenze, S O; Okorie, E; Uche, N J

    2013-01-01

    Neonatal head trauma resulting from causes other than birth trauma has rarely been the focus of many a research theme in the literature. To highlight the occurrence of non-birth trauma related neonatal head injury, and evaluate the causes and outcome of treatment. A 3 year retrospective review of neonatal patients with head injury from two tertiary hospitals in South-East Nigeria between July 2009 and June 2012 (n-37). Data was collected from patients' birth and medical records. Data was analyzed using the SPSS version 15. Among the one hundred and seventy-six cases (11.78)% pediatric head injury cases seen, thirty seven (2.48)% occurred in neonatal patients. The most common cause of head injury was fall 22 cases [59.5%]. Children of mothers with low educational qualification were more likely to sustain falls 22 cases (59.5%). Road traffic accident (n = 15) was associated with more severe injuries and poorer outcome. Operative treatment was associated with increased mortality (two of three cases). The mortality rate in our series is 8.10%. Reduction of neonatal head trauma could be achieved through improved maternal education.

  3. Occult head injury is common in children with concern for physical abuse.

    PubMed

    Boehnke, Mitchell; Mirsky, David; Stence, Nicholas; Stanley, Rachel M; Lindberg, Daniel M

    2018-04-13

    Studies evaluating small patient cohorts have found a high, but variable, rate of occult head injury in children <2 years old with concern for physical abuse. The American College of Radiology (ACR) recommends clinicians have a low threshold to obtain neuroimaging in these patients. Our aim was to determine the prevalence of occult head injury in a large patient cohort with suspected physical abuse using similar selection criteria from previous studies. Additionally, we evaluated proposed risk factors for associations with occult head injury. This was a retrospective, secondary analysis of data collected by an observational study of 20 U.S. child abuse teams that evaluated children who underwent subspecialty evaluation for concern of abuse. We evaluated children <2 years old and excluded those with abnormal mental status, bulging fontanelle, seizure, respiratory arrest, underlying neurological condition, focal neurological deficit or scalp injury. One thousand one hundred forty-three subjects met inclusion criteria and 62.5% (714) underwent neuroimaging with either head computed tomography or magnetic resonance imaging. We found an occult head injury prevalence of 19.7% (141). Subjects with emesis (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.8-6.8), macrocephaly (OR 8.5, 95% CI 3.7-20.2), and loss of consciousness (OR 5.1, 95% CI 1.2-22.9) had higher odds of occult head injury. Our results show a high prevalence of occult head injury in patients <2 years old with suspected physical abuse. Our data support the ACR recommendation that clinicians should have a low threshold to perform neuroimaging in patients <2 years of age.

  4. The Significance of Macrocephaly or Enlarging Head Circumference in Infants With the Triad

    PubMed Central

    Miller, David; Barnes, Patrick; Miller, Marvin

    2015-01-01

    Abstract Infants with the triad (neurologic dysfunction, subdural hematoma [SDH], and retinal hemorrhage) are often diagnosed as victims of shaken baby syndrome. Medical conditions/predisposing factors to developing the triad are often dismissed: short falls, birth-related SDH that enlarges, macrocephaly, sinus/cortical vein thrombosis, and others. Six infants with the triad are described in which child abuse was diagnosed, but parents denied wrongdoing. All 6 had either macrocephaly or enlarging head circumference, which suggested medical explanations. Three infants incurred short falls, 1 had a difficult delivery in which there was likely a rebleed of a birth-related SDH, 1 had a spontaneous SDH associated with increased extra-axial fluid spaces, and 1 had a sinus thrombosis. Following legal proceedings, all 6 infants were returned to their parents, and there has been no child maltreatment in follow-up, suggesting child abuse never happened. The results indicate that alternative medical explanations for causing the triad should be considered and that macrocephaly or an enlarging head circumference raises the possibility of a medical explanation. PMID:25893912

  5. [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.

  6. A narrative review on burnout experienced by medical students and residents.

    PubMed

    Dyrbye, Liselotte; Shanafelt, Tait

    2016-01-01

    To summarise articles reporting on burnout among medical students and residents (trainees) in a narrative review. MEDLINE was searched for peer-reviewed, English language articles published between 1990 and 2015 reporting on burnout among trainees. The search used combinations of Medical Subject Heading terms medical student, resident, internship and residency, and burnout, professional. Reference lists of articles were reviewed to identify additional studies. A subset of high-quality studies was selected. Studies suggest a high prevalence of burnout among trainees, with levels higher than in the general population. Burnout can undermine trainees' professional development, place patients at risk, and contribute to a variety of personal consequences, including suicidal ideation. Factors within the learning and work environment, rather than individual attributes, are the major drivers of burnout. Limited data are available regarding how to best address trainee burnout, but multi-pronged efforts, with attention to culture, the learning and work environment and individual behaviours, are needed to promote trainees' wellness and to help those in distress. Medical training is a stressful time. Large, prospective studies are needed to identify cause-effect relationships and the best approaches for improving the trainee experience. © 2015 John Wiley & Sons Ltd.

  7. Effect of head circumference on parameters of pattern reversal visual evoked potential in healthy adults of central India.

    PubMed

    Kothari, R; Singh, R; Singh, S; Bokariya, P

    2012-06-01

    Visual evoked response testing has been one of the most exciting clinical tools to be developed from neurophysiologic research in recent years and has provided us with an objective method of identifying abnormalities of the afferent visual pathways. Investigation were carried out to see whether the head circumference influence the pattern reversal visual evoked potential (PRVEP) parameters. The study comprised of pattern reversal visual evoked potential (PRVEP) recordings in 400 eyes of 200 normal subjects. Two hundred fourty eight eyes were males and 152 eyes were from 76 female subjects recruited from the Central Indian population in the age range of 40-79 years. Visual evoked potential (VEP) recordings were performed in accordance to the standardized methodology of International Federation of Clinical Neurophysiology (IFCN) Committee Recommendations and International Society for Clinical Electrophysiology of Vision (ISCEV) Guidelines and montages were kept as per 10-20 International System of EEG Electrode placements. The stimulus configuration in this study consisted of the transient pattern reversal method in which a black and white checker board was generated (full field) and displayed on a VEP Monitor by an electronic pattern regenerator inbuilt in an Evoked Potential Recorder (RMS EMG EP MARK II). VEP latencies, duration and amplitude were measured in all subjects and the data were analyzed. The correlation of all the electrophysiological parameters with head circumference was evaluated by Pearson's correlation co-efficient (r) and its statistical significance was evaluated. The prediction equations for all the VEP parameters with respect to head circumference were derived. We found a positive correlation of P 100 latency and N 155 latency with mean head circumference, while a highly significant negative correlation were noted of P 100 amplitude with head circumference. N 70 latency was significantly correlated with head circumference. P 100 duration showed

  8. Firing properties of rat lateral mammillary single units: head direction, head pitch, and angular head velocity.

    PubMed

    Stackman, R W; Taube, J S

    1998-11-01

    Many neurons in the rat anterodorsal thalamus (ADN) and postsubiculum (PoS) fire selectively when the rat points its head in a specific direction in the horizontal plane, independent of the animal's location and ongoing behavior. The lateral mammillary nuclei (LMN) are interconnected with both the ADN and PoS and, therefore, are in a pivotal position to influence ADN/PoS neurophysiology. To further understand how the head direction (HD) cell signal is generated, we recorded single neurons from the LMN of freely moving rats. The majority of cells discharged as a function of one of three types of spatial correlates: (1) directional heading, (2) head pitch, or (3) angular head velocity (AHV). LMN HD cells exhibited higher peak firing rates and greater range of directional firing than that of ADN and PoS HD cells. LMN HD cells were modulated by angular head velocity, turning direction, and anticipated the rat's future HD by a greater amount of time (approximately 95 msec) than that previously reported for ADN HD cells (approximately 25 msec). Most head pitch cells discharged when the rostrocaudal axis of the rat's head was orthogonal to the horizontal plane. Head pitch cell firing was independent of the rat's location, directional heading, and its body orientation (i.e., the cell discharged whenever the rat pointed its head up, whether standing on all four limbs or rearing). AHV cells were categorized as fast or slow AHV cells depending on whether their firing rate increased or decreased in proportion to angular head velocity. These data demonstrate that LMN neurons code direction and angular motion of the head in both horizontal and vertical planes and support the hypothesis that the LMN play an important role in processing both egocentric and allocentric spatial information.

  9. The head-regeneration transcriptome of the planarian Schmidtea mediterranea.

    PubMed

    Sandmann, Thomas; Vogg, Matthias C; Owlarn, Suthira; Boutros, Michael; Bartscherer, Kerstin

    2011-08-16

    Planarian flatworms can regenerate their head, including a functional brain, within less than a week. Despite the enormous potential of these animals for medical research and regenerative medicine, the mechanisms of regeneration and the molecules involved remain largely unknown. To identify genes that are differentially expressed during early stages of planarian head regeneration, we generated a de novo transcriptome assembly from more than 300 million paired-end reads from planarian fragments regenerating the head at 16 different time points. The assembly yielded 26,018 putative transcripts, including very long transcripts spanning multiple genomic supercontigs, and thousands of isoforms. Using short-read data from two platforms, we analyzed dynamic gene regulation during the first three days of head regeneration. We identified at least five different temporal synexpression classes, including genes specifically induced within a few hours after injury. Furthermore, we characterized the role of a conserved Runx transcription factor, smed-runt-like1. RNA interference (RNAi) knockdown and immunofluorescence analysis of the regenerating visual system indicated that smed-runt-like1 encodes a transcriptional regulator of eye morphology and photoreceptor patterning. Transcriptome sequencing of short reads allowed for the simultaneous de novo assembly and differential expression analysis of transcripts, demonstrating highly dynamic regulation during head regeneration in planarians.

  10. The head-regeneration transcriptome of the planarian Schmidtea mediterranea

    PubMed Central

    2011-01-01

    Background Planarian flatworms can regenerate their head, including a functional brain, within less than a week. Despite the enormous potential of these animals for medical research and regenerative medicine, the mechanisms of regeneration and the molecules involved remain largely unknown. Results To identify genes that are differentially expressed during early stages of planarian head regeneration, we generated a de novo transcriptome assembly from more than 300 million paired-end reads from planarian fragments regenerating the head at 16 different time points. The assembly yielded 26,018 putative transcripts, including very long transcripts spanning multiple genomic supercontigs, and thousands of isoforms. Using short-read data from two platforms, we analyzed dynamic gene regulation during the first three days of head regeneration. We identified at least five different temporal synexpression classes, including genes specifically induced within a few hours after injury. Furthermore, we characterized the role of a conserved Runx transcription factor, smed-runt-like1. RNA interference (RNAi) knockdown and immunofluorescence analysis of the regenerating visual system indicated that smed-runt-like1 encodes a transcriptional regulator of eye morphology and photoreceptor patterning. Conclusions Transcriptome sequencing of short reads allowed for the simultaneous de novo assembly and differential expression analysis of transcripts, demonstrating highly dynamic regulation during head regeneration in planarians. PMID:21846378

  11. Surgical, ethical, and psychosocial considerations in human head transplantation

    PubMed Central

    Furr, Allen; Hardy, Mark A.; Barret, Juan P.; Barker, John H.

    2017-01-01

    Transplanting a head and brain is perhaps the final frontier of organ transplantation. The goal of body-to-head transplantation (BHT) is to sustain the life of individuals who suffer from terminal disease, but whose head and brain are healthy. Ideally BHT could provide a lifesaving treatment for several conditions where none currently exists. BHT is no ordinary experiment, to transfer a head to another body involves extraordinarily complex medical challenges as well as ethical and existential dilemmas that were previously confined to the imagination of writers of fiction. The possibility of replacing an incurably ill body with a healthy one tests not only our surgical limits, but also the social and psychological boundaries of physical life and alters what we recognize life to be. The purpose of this target article, the complementary manuscript focused on immunological issues in BHT, and the accompanying Commentaries by scholars and practitioners in medicine, immunology, and bioethics is to review major surgical and psychosocial-ethical and immunological considerations surrounding body-to-head transplantation. We hope that together these ideas will provide readers with a comprehensive overview of the possibilities and challenges associated with BHT and initiate professional discussion and debate through which this new frontier in medicine is considered and approached. PMID:28110028

  12. Consensus statement on abusive head trauma in infants and young children.

    PubMed

    Choudhary, Arabinda Kumar; Servaes, Sabah; Slovis, Thomas L; Palusci, Vincent J; Hedlund, Gary L; Narang, Sandeep K; Moreno, Joëlle Anne; Dias, Mark S; Christian, Cindy W; Nelson, Marvin D; Silvera, V Michelle; Palasis, Susan; Raissaki, Maria; Rossi, Andrea; Offiah, Amaka C

    2018-05-23

    Abusive head trauma (AHT) is the leading cause of fatal head injuries in children younger than 2 years. A multidisciplinary team bases this diagnosis on history, physical examination, imaging and laboratory findings. Because the etiology of the injury is multifactorial (shaking, shaking and impact, impact, etc.) the current best and inclusive term is AHT. There is no controversy concerning the medical validity of the existence of AHT, with multiple components including subdural hematoma, intracranial and spinal changes, complex retinal hemorrhages, and rib and other fractures that are inconsistent with the provided mechanism of trauma. The workup must exclude medical diseases that can mimic AHT. However, the courtroom has become a forum for speculative theories that cannot be reconciled with generally accepted medical literature. There is no reliable medical evidence that the following processes are causative in the constellation of injuries of AHT: cerebral sinovenous thrombosis, hypoxic-ischemic injury, lumbar puncture or dysphagic choking/vomiting. There is no substantiation, at a time remote from birth, that an asymptomatic birth-related subdural hemorrhage can result in rebleeding and sudden collapse. Further, a diagnosis of AHT is a medical conclusion, not a legal determination of the intent of the perpetrator or a diagnosis of murder. We hope that this consensus document reduces confusion by recommending to judges and jurors the tools necessary to distinguish genuine evidence-based opinions of the relevant medical community from legal arguments or etiological speculations that are unwarranted by the clinical findings, medical evidence and evidence-based literature.

  13. Segmentation of organs at risk in CT volumes of head, thorax, abdomen, and pelvis

    NASA Astrophysics Data System (ADS)

    Han, Miaofei; Ma, Jinfeng; Li, Yan; Li, Meiling; Song, Yanli; Li, Qiang

    2015-03-01

    Accurate segmentation of organs at risk (OARs) is a key step in treatment planning system (TPS) of image guided radiation therapy. We are developing three classes of methods to segment 17 organs at risk throughout the whole body, including brain, brain stem, eyes, mandible, temporomandibular joints, parotid glands, spinal cord, lungs, trachea, heart, livers, kidneys, spleen, prostate, rectum, femoral heads, and skin. The three classes of segmentation methods include (1) threshold-based methods for organs of large contrast with adjacent structures such as lungs, trachea, and skin; (2) context-driven Generalized Hough Transform-based methods combined with graph cut algorithm for robust localization and segmentation of liver, kidneys and spleen; and (3) atlas and registration-based methods for segmentation of heart and all organs in CT volumes of head and pelvis. The segmentation accuracy for the seventeen organs was subjectively evaluated by two medical experts in three levels of score: 0, poor (unusable in clinical practice); 1, acceptable (minor revision needed); and 2, good (nearly no revision needed). A database was collected from Ruijin Hospital, Huashan Hospital, and Xuhui Central Hospital in Shanghai, China, including 127 head scans, 203 thoracic scans, 154 abdominal scans, and 73 pelvic scans. The percentages of "good" segmentation results were 97.6%, 92.9%, 81.1%, 87.4%, 85.0%, 78.7%, 94.1%, 91.1%, 81.3%, 86.7%, 82.5%, 86.4%, 79.9%, 72.6%, 68.5%, 93.2%, 96.9% for brain, brain stem, eyes, mandible, temporomandibular joints, parotid glands, spinal cord, lungs, trachea, heart, livers, kidneys, spleen, prostate, rectum, femoral heads, and skin, respectively. Various organs at risk can be reliably segmented from CT scans by use of the three classes of segmentation methods.

  14. Revision of anastomotic stenosis after pancreatic head resection for chronic pancreatitis: is it futile?

    PubMed Central

    Morgan, Katherine A; Fontenot, Bennett B; Harvey, Norman R; Adams, David B

    2010-01-01

    Background: Because survival after pancreaticoduodenectomy for cancer is limited, it is difficult to assess longterm pancreaticojejunal anastomotic patency. However, in patients with benign disease, pancreaticojejunal anastomotic stenosis may become problematic. What happens when pancreaticojejunal anastomosis revision is undertaken? Methods: Patients undergoing pancreatic anastomotic revision after pancreatic head resection for benign disease between 1997 and 2007 at the Medical University of South Carolina were identified. A retrospective chart review and analysis were undertaken with the approval of the Institutional Review Board for the Evaluation of Human Subjects. Longterm follow-up was obtained by patient survey at a clinic visit or by telephone. Results: During the study period, 237 patients underwent pancreatic head resection. Of these, 27 patients (17 women; median age 42 years) underwent revision of pancreaticojejunal anastomosis. Six patients (22%) had a pancreatic leak or abscess at the time of the index pancreatic head resection. The indication for revision of anastomosis was intractable pain. All patients underwent preoperative magnetic resonance cholangiopancreatography (MRCP), which indicated anastomotic stricture in 18 patients (63%). Nine other patients underwent exploration based on clinical suspicion caused by recurrent pancreatitis and stenosis was confirmed at the time of surgery. Six patients (22%) had perioperative complications after revision. The median length of stay was 12 days. There were no perioperative deaths; however, late mortality occurred in four patients (15%). Six of 23 survivors (26%) at the time of follow-up (median 56 months) reported longterm pain relief. Conclusions: Stricture of the pancreaticojejunal anastomosis after pancreatic head resection presents with recurrent pancreatitis and pancreatic pain. MRCP has good specificity in the diagnosis of anastomotic obstruction, but lacks sensitivity. Pancreaticojejunal revision

  15. Defining Optimal Head-Tilt Position of Resuscitation in Neonates and Young Infants Using Magnetic Resonance Imaging Data

    PubMed Central

    Bhalala, Utpal S.; Hemani, Malvi; Shah, Meehir; Kim, Barbara; Gu, Brian; Cruz, Angelo; Arunachalam, Priya; Tian, Elli; Yu, Christine; Punnoose, Joshua; Chen, Steven; Petrillo, Christopher; Brown, Alisa; Munoz, Karina; Kitchen, Grant; Lam, Taylor; Bosemani, Thangamadhan; Huisman, Thierry A. G. M.; Allen, Robert H.; Acharya, Soumyadipta

    2016-01-01

    Head-tilt maneuver assists with achieving airway patency during resuscitation. However, the relationship between angle of head-tilt and airway patency has not been defined. Our objective was to define an optimal head-tilt position for airway patency in neonates (age: 0–28 days) and young infants (age: 29 days–4 months). We performed a retrospective study of head and neck magnetic resonance imaging (MRI) of neonates and infants to define the angle of head-tilt for airway patency. We excluded those with an artificial airway or an airway malformation. We defined head-tilt angle a priori as the angle between occipito-ophisthion line and ophisthion-C7 spinous process line on the sagittal MR images. We evaluated medical records for Hypoxic Ischemic Encephalopathy (HIE) and exposure to sedation during MRI. We analyzed MRI of head and neck regions of 63 children (53 neonates and 10 young infants). Of these 63 children, 17 had evidence of airway obstruction and 46 had a patent airway on MRI. Also, 16/63 had underlying HIE and 47/63 newborn infants had exposure to sedative medications during MRI. In spontaneously breathing and neurologically depressed newborn infants, the head-tilt angle (median ± SD) associated with patent airway (125.3° ± 11.9°) was significantly different from that of blocked airway (108.2° ± 17.1°) (Mann Whitney U-test, p = 0.0045). The logistic regression analysis showed that the proportion of patent airways progressively increased with an increasing head-tilt angle, with > 95% probability of a patent airway at head-tilt angle 144–150°. PMID:27003759

  16. Defining Optimal Head-Tilt Position of Resuscitation in Neonates and Young Infants Using Magnetic Resonance Imaging Data.

    PubMed

    Bhalala, Utpal S; Hemani, Malvi; Shah, Meehir; Kim, Barbara; Gu, Brian; Cruz, Angelo; Arunachalam, Priya; Tian, Elli; Yu, Christine; Punnoose, Joshua; Chen, Steven; Petrillo, Christopher; Brown, Alisa; Munoz, Karina; Kitchen, Grant; Lam, Taylor; Bosemani, Thangamadhan; Huisman, Thierry A G M; Allen, Robert H; Acharya, Soumyadipta

    2016-01-01

    Head-tilt maneuver assists with achieving airway patency during resuscitation. However, the relationship between angle of head-tilt and airway patency has not been defined. Our objective was to define an optimal head-tilt position for airway patency in neonates (age: 0-28 days) and young infants (age: 29 days-4 months). We performed a retrospective study of head and neck magnetic resonance imaging (MRI) of neonates and infants to define the angle of head-tilt for airway patency. We excluded those with an artificial airway or an airway malformation. We defined head-tilt angle a priori as the angle between occipito-ophisthion line and ophisthion-C7 spinous process line on the sagittal MR images. We evaluated medical records for Hypoxic Ischemic Encephalopathy (HIE) and exposure to sedation during MRI. We analyzed MRI of head and neck regions of 63 children (53 neonates and 10 young infants). Of these 63 children, 17 had evidence of airway obstruction and 46 had a patent airway on MRI. Also, 16/63 had underlying HIE and 47/63 newborn infants had exposure to sedative medications during MRI. In spontaneously breathing and neurologically depressed newborn infants, the head-tilt angle (median ± SD) associated with patent airway (125.3° ± 11.9°) was significantly different from that of blocked airway (108.2° ± 17.1°) (Mann Whitney U-test, p = 0.0045). The logistic regression analysis showed that the proportion of patent airways progressively increased with an increasing head-tilt angle, with > 95% probability of a patent airway at head-tilt angle 144-150°.

  17. Changes in maximum bite force related to extension of the head.

    PubMed

    Hellsing, E; Hagberg, C

    1990-05-01

    The maximum bite force and position of the hyoid bone during natural and extended head posture were studied in 15 adults. All participants had normal occlusions and full dentitions. In addition, there were no signs or symptoms of craniomandibular disorders. The bite force was measured with a bite force sensor placed between the first molars. Six registrations of gradually increasing bite force up to a maximum were made with randomized natural and extended head postures. With one exception, the mean maximum bite force value was found to be higher for every subject with extended head posture compared to natural head posture. The sample mean was 271.6 Newton in natural head posture and 321.5 Newton with 20 degrees extension. With changed head posture, the cephalometric measurements pointed towards a changed position of the hyoid bone in relation to the mandible and pharyngeal airway. The cephalometric changes in the position of the hyoid bone could be due to a changed interplay between the elevator and depressor muscle groups. This was one factor which could have influenced the registered maximum bite force.

  18. Head injury as a PTSD predictor among Oklahoma City bombing survivors.

    PubMed

    Walilko, Timothy; North, Carol; Young, Lee Ann; Lux, Warren E; Warden, Deborah L; Jaffee, Michael S; Moore, David F

    2009-12-01

    The aim of the Oklahoma City (OKC) bombing retrospective review was to investigate the relationship between physical injury, environmental contributors, and psychiatric disorders such as posttraumatic stress disorder (PTSD) in an event-based, matched design study focused on injury. The 182 selected participants were a random subset of the 1,092 direct survivors from the OKC bombing. Only 124 of these 182 cases had a full complement of medical/clinical data in the OKC database. These 124 cases were assessed to explore relationships among PTSD diagnoses, levels of blast exposure, and physical injuries. Associations among variables were statistically tested using contingency analysis and logistic regression. Comparison of the PTSD cases to symptoms/diagnoses reported in the medical records reveals a statistically significant association between PTSD and head/brain injuries associated with head acceleration. PTSD was not highly correlated with other injuries. Although blast pressure and impulse were highly correlated with head injuries, the correlation with PTSD was not statistically significant. Thus, a correlation between blast pressure and PTSD may exist, but higher fidelity pressure calculations are required to elucidate this potential relationship. This study provides clear evidence that head injury is associated with subsequent PTSD, giving caregivers' information on what physical injuries may suggest the development of psychologic disorders to aid them in developing a profile for the identification of future survivors of terrorist attacks and Warfighters with brain injuries and potential PTSD.

  19. Shaping of Looped Miniaturized Chalcogenide Fiber Sensing Heads for Mid-Infrared Sensing

    PubMed Central

    Houizot, Patrick; Anne, Marie-Laure; Boussard-Plédel, Catherine; Loréal, Olivier; Tariel, Hugues; Lucas, Jacques; Bureau, Bruno

    2014-01-01

    Chalcogenide glass fibers are promising photonic tools to develop Fiber Evanescent Wave Spectroscopy (FEWS) optical sensors working in the mid-infrared region. Numerous pioneering works have already been carried out showing their efficiency, especially for bio-medical applications. Nevertheless, this technology remains confined to academic studies at the laboratory scale because chalcogenide glass fibers are difficult to shape to produce reliable, sensitive and compact sensors. In this paper, a new method for designing and fabricating a compact and robust sensing head with a selenide glass fiber is described. Compact looped sensing heads with diameter equal to 2 mm were thus shaped. This represents an outstanding achievement considering the brittleness of such uncoated fibers. FEWS experiments were implemented using alcoholic solutions as target samples showing that the sensitivity is higher than with the routinely used classical fiber. It is also shown that the best compromise in term of sensitivity is to fabricate a sensing head including two full loops. From a mechanical point of view, the breaking loads of the loop shaped head are also much higher than with classical fiber. Finally, this achievement paves the way for the use of mid-infrared technology during in situ and even in vivo medical operations. Indeed, is is now possible to slide a chalcogenide glass fiber in the operating channel of a standard 2.8 mm diameter catheter. PMID:25264953

  20. Diversity of head shaking nystagmus in peripheral vestibular disease.

    PubMed

    Kim, Min-Beom; Huh, Se Hyung; Ban, Jae Ho

    2012-06-01

    To evaluate the characteristics of head shaking nystagmus in various peripheral vestibular diseases. Retrospective case series. Tertiary referral center. Data of 235 patients with peripheral vestibular diseases including vestibular neuritis, Ménière's disease, and benign paroxysmal positional vertigo, were retrospectively analyzed. All subjects presented between August 2009 and July 2010. Patients were tested for vestibular function including head shaking nystagmus and caloric information. Regarding vestibular neuritis, all tests were again performed during the 1-month follow-up. Head shaking nystagmus was classified as monophasic or biphasic and, according to the affected ear, was divided as ipsilesional or contralesional. Of the 235 patients, 87 patients revealed positive head shaking nystagmus. According to each disease, positive rates of head shaking nystagmus were as follows: 35 (100%) of 35 cases of vestibular neuritis, 11 (68.8%) of 16 cases of Ménière's disease, and 41 (22.2%) of 184 cases of benign paroxysmal positional vertigo. All cases of vestibular neuritis initially presented as a monophasic, contralesional beating, head shaking nystagmus. However, 1 month after first visit, the direction of nystagmus was changed to biphasic (contralesional first then ipsilesional beating) in 25 cases (72.5%) but not in 10 cases (27.5%). There was a significant correlation between the degree of initial caloric weakness and the biphasic conversion of head shaking nystagmus (p = 0.02). In 72.5% of vestibular neuritis cases, head shaking nystagmus was converted to biphasic during the subacute period. The larger the initial canal paresis was present, the more frequent the biphasic conversion of head shaking nystagmus occurred. However, Ménière's disease and benign paroxysmal positional vertigo did not have specific patterns of head shaking nystagmus.

  1. 50 CFR 300.184 - Species subject to permitting, documentation, reporting, and recordkeeping requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., documentation, reporting, and recordkeeping requirements. The following fish or fish products are subject to the....35.00.00) excluding fillets and other fish meat of HTS heading 0304. (ii) Frozen bluefin tuna (No. 0303.45.00.00), excluding fillets and other fish meat of HTS heading 0304. (2) In addition, bluefin...

  2. 50 CFR 300.184 - Species subject to permitting, documentation, reporting, and recordkeeping requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., documentation, reporting, and recordkeeping requirements. The following fish or fish products are subject to the....35.00.00) excluding fillets and other fish meat of HTS heading 0304. (ii) Frozen bluefin tuna (No. 0303.45.00.00), excluding fillets and other fish meat of HTS heading 0304. (2) In addition, bluefin...

  3. [Applications of 3D printing technology in teaching of oromaxillofacial head and neck surgical oncology].

    PubMed

    Ruan, Min; Ji, Tong; Zhang, Chen-Ping

    2016-12-01

    With the increasing maturation of 3D printing technology, as well as its application in various industries, investigation of 3D printing technology into clinic medical education becomes an important task of the current medical education. The teaching content of oromaxillofacial head and neck surgical oncology is complicated and diverse, making lower understanding/memorizing efficiency and insufficient skill training. To overcome the disadvantage of traditional teaching method, it is necessary to introduce 3D printing technique into teaching of oromaxillofacial head and neck surgical oncology, in order to improve the teaching quality and problem solving capabilities, and finally promote cultivation of skilled and innovative talents.

  4. Mining Social Tagging Data for Enhanced Subject Access for Readers and Researchers

    ERIC Educational Resources Information Center

    Lawson, Karen G.

    2009-01-01

    Social tagging enables librarians to partner with users to provide enhanced subject access. This paper quantifies and compares LC subject headings from each of 31 different subject divisions with user tags from Amazon.com and LibraryThing assigned to the same titles. The intersection and integration of these schemas is described and evaluated.…

  5. Prevalence and risk factors of depressive disorder in caregivers of patients with head and neck cancer.

    PubMed

    Lee, Yu; Lin, Pao-Yen; Chien, Chih-Yen; Fang, Fu-Min

    2015-02-01

    The purpose of this study is to examine the prevalence and risk factors of depressive disorder in caregivers of patients with head and neck cancer. Study subjects were recruited from a multidisciplinary outpatient clinic for head and neck cancer in a medical center from February to July 2012. Caregivers of patients with head and neck cancer were enrolled and assessed using the Structured Clinical Interview for the DSM-IV, Clinician Version, the Short Form 36 Health Survey, and the Family APGAR index. The main aim of the study was to examine the difference in demographic data and clinical characteristics between the caregivers with and without depressive disorders. In addition, a stepwise forward model of logistic regression was used to test the possible risk factors. One hundred and forty-three caregivers were included in the study. The most prevalent psychiatric disorder was depressive disorder (14.7%), followed by adjustment disorder (13.3%). Nearly one-third of the caregivers had a psychiatric diagnosis. By using logistic regression analysis, it was found that unemployment (odds ratio (OR) = 3.16; 95% CI, 1.04-9.68), lower social functioning (OR = 1.43; 95% CI, 1.18-1.72), and lower educational level (OR = 1.16; 95% CI, 1.01-1.34) were significant risk factors for the depressive disorder. The clinical implication of our results is the value of using the standardized structured interview for early diagnosis of depressive disorder in caregivers of head and neck cancer patients. Early screening and management of depression in these caregivers will raise their quality of life and capability to care patients. Copyright © 2014 John Wiley & Sons, Ltd.

  6. Head motion parameters in fMRI differ between patients with mild cognitive impairment and Alzheimer disease versus elderly control subjects.

    PubMed

    Haller, Sven; Monsch, Andreas U; Richiardi, Jonas; Barkhof, Frederik; Kressig, Reto W; Radue, Ernst W

    2014-11-01

    Motion artifacts are a well-known and frequent limitation during neuroimaging workup of cognitive decline. While head motion typically deteriorates image quality, we test the hypothesis that head motion differs systematically between healthy controls (HC), amnestic mild cognitive impairment (aMCI) and Alzheimer disease (AD) and consequently might contain diagnostic information. This prospective study was approved by the local ethics committee and includes 28 HC (age 71.0 ± 6.9 years, 18 females), 15 aMCI (age 67.7 ± 10.9 years, 9 females) and 20 AD (age 73.4 ± 6.8 years, 10 females). Functional magnetic resonance imaging (fMRI) at 3T included a 9 min echo-planar imaging sequence with 180 repetitions. Cumulative average head rotation and translation was estimated based on standard fMRI preprocessing and compared between groups using receiver operating characteristic statistics. Global cumulative head rotation discriminated aMCI from controls [p < 0.01, area under curve (AUC) 0.74] and AD from controls (p < 0.01, AUC 0.73). The ratio of rotation z versus y discriminated AD from controls (p < 0.05, AUC 0.71) and AD from aMCI (p < 0.05, AUC of 0.75). Head motion systematically differs between aMCI/AD and controls. Since motion is not random but convoluted with diagnosis, the higher amount of motion in aMCI and AD as compared to controls might be a potential confounding factor for fMRI group comparisons. Additionally, head motion not only deteriorates image quality, yet also contains useful discriminatory information and is available for free as a "side product" of fMRI data preprocessing.

  7. Head circumference, atrophy, and cognition: implications for brain reserve in Alzheimer disease.

    PubMed

    Perneczky, R; Wagenpfeil, S; Lunetta, K L; Cupples, L A; Green, R C; Decarli, C; Farrer, L A; Kurz, A

    2010-07-13

    Clinical and epidemiologic studies suggest that patients with Alzheimer disease (AD) with larger head circumference have better cognitive performance at the same level of brain pathology than subjects with smaller head circumference. A total of 270 patients with AD participating in the Multi-Institutional Research in Alzheimer's Genetic Epidemiology (MIRAGE) study underwent cognitive testing, APOE genotyping, and MRI of the brain in a cross-sectional study. Linear regression analysis was used to examine the association between cerebral atrophy, as a proxy for AD pathology, and level of cognitive function, adjusting for age, duration of AD symptoms, gender, head circumference, APOE genotype, diabetes mellitus, hypertension, major depression, and ethnicity. An interaction term between atrophy and head circumference was introduced to explore if head circumference modified the association between cerebral atrophy and cognition. There was a significant inverse association between atrophy and cognitive function, and a significant interaction between atrophy and head circumference. With greater levels of atrophy, cognition was higher for individuals with greater head circumference. This study suggests that larger head circumference is associated with less cognitive impairment in the face of cerebral atrophy. This finding supports the notion that head circumference (and presumably brain size) offers protection against AD symptoms through enhanced brain reserve.

  8. Head Start and Children's Nutrition, Weight, and Health Care Receipt”

    PubMed Central

    Lee, RaeHyuck; Zhai, Fuhua; Han, Wen-Jui; Brooks-Gunn, Jeanne; Waldfogel, Jane

    2013-01-01

    Using a sample of low-income children from the Early Childhood Longitudinal Study-Birth Cohort (N ≈ 4,350) and propensity-score weighted regressions, we analyzed children's nutrition, weight, and health care receipt at kindergarten entry, comparing 1) Head Start participants and all non-participants, and 2) Head Start participants and children in prekindergarten, other center-based care, other non-parental care, or only parental care. Overall, we found that compared to all non-participants, Head Start participants were more likely to receive dental checkups but showed no differences in getting medical checkups; they were also more likely to have healthy eating patterns but showed no differences in Body Mass Index (BMI), overweight, or obesity. However, these results varied depending on the comparison group—Head Start participants showed lower BMI scores and lower probability of overweight compared to those in other non-parental care, and the effects on healthy eating and dental checkups differed by comparison group. PMID:24187433

  9. The use of head/eye-centered, hand-centered and allocentric representations for visually guided hand movements and perceptual judgments.

    PubMed

    Thaler, Lore; Todd, James T

    2009-04-01

    Two experiments are reported that were designed to measure the accuracy and reliability of both visually guided hand movements (Exp. 1) and perceptual matching judgments (Exp. 2). The specific procedure for informing subjects of the required response on each trial was manipulated so that some tasks could only be performed using an allocentric representation of the visual target; others could be performed using either an allocentric or hand-centered representation; still others could be performed based on an allocentric, hand-centered or head/eye-centered representation. Both head/eye and hand centered representations are egocentric because they specify visual coordinates with respect to the subject. The results reveal that accuracy and reliability of both motor and perceptual responses are highest when subjects direct their response towards a visible target location, which allows them to rely on a representation of the target in head/eye-centered coordinates. Systematic changes in averages and standard deviations of responses are observed when subjects cannot direct their response towards a visible target location, but have to represent target distance and direction in either hand-centered or allocentric visual coordinates instead. Subjects' motor and perceptual performance agree quantitatively well. These results strongly suggest that subjects process head/eye-centered representations differently from hand-centered or allocentric representations, but that they process visual information for motor actions and perceptual judgments together.

  10. Head injury does not alter disease progression or neuropathologic outcomes in ALS.

    PubMed

    Fournier, Christina N; Gearing, Marla; Upadhyayula, Saila R; Klein, Mitch; Glass, Jonathan D

    2015-04-28

    To study the effects of head injury on disease progression and on neuropathologic outcomes in amyotrophic lateral sclerosis (ALS). Patients with ALS were surveyed to obtain head injury history, and medical records were reviewed. Linear regression was performed to determine if head injury was a predictor for mean monthly decline of Amyotrophic Lateral Sclerosis Functional Rating Scale-revised (ALSFRS-R), while controlling for confounders. Head injury history was obtained from family members of ALS autopsy cases. The frequency of tau proteinopathy, brain TDP-43 inclusions, and pathologic findings of Alzheimer disease (AD) were examined in ALS cases with head injury compared to cases without. Logistic regression was performed with each neuropathologic diagnosis as an outcome measure and head injury as a predictor variable. No difference was seen in rate of decline of the ALSFRS-R between patients with head injury (n = 24) and without (n = 76), with mean monthly decline of -0.9 for both groups (p = 0.18). Of 47 ALS autopsy cases (n = 9 with head injury, n = 38 without), no significant differences were seen in the frequency of tau proteinopathy (11% with head injury; 24% without), TDP-43 in the brain (44% with head injury; 45% without), or AD pathology (33% with head injury; 26% without). Independent logistic regression models showed head injury was not a predictor of tau pathology (p = 0.42) or TDP-43 in the brain (p = 0.99). Head injury was not associated with faster disease progression in ALS and did not result in a specific neuropathologic phenotype. The tau pathology described with chronic traumatic encephalopathy was found in ALS autopsy cases both with and without head injury. © 2015 American Academy of Neurology.

  11. Effects of External Loads on Human Head Movement Control Systems

    NASA Technical Reports Server (NTRS)

    Nam, M. H.; Choi, O. M.

    1984-01-01

    The central and reflexive control strategies underlying movements were elucidated by studying the effects of external loads on human head movement control systems. Some experimental results are presented on dynamic changes weigh the addition of aviation helmet (SPH4) and lead weights (6 kg). Intended time-optimal movements, their dynamics and electromyographic activity of neck muscles in normal movements, and also in movements made with external weights applied to the head were measured. It was observed that, when the external loads were added, the subject went through complex adapting processes and the head movement trajectory and its derivatives reached steady conditions only after transient adapting period. The steady adapted state was reached after 15 to 20 seconds (i.e., 5 to 6 movements).

  12. Head movements and postures as pain behavior

    PubMed Central

    Al-Hamadi, Ayoub; Limbrecht-Ecklundt, Kerstin; Walter, Steffen; Traue, Harald C.

    2018-01-01

    Pain assessment can benefit from observation of pain behaviors, such as guarding or facial expression, and observational pain scales are widely used in clinical practice with nonverbal patients. However, little is known about head movements and postures in the context of pain. In this regard, we analyze videos of three publically available datasets. The BioVid dataset was recorded with healthy participants subjected to painful heat stimuli. In the BP4D dataset, healthy participants performed a cold-pressor test and several other tasks (meant to elicit emotion). The UNBC dataset videos show shoulder pain patients during range-of-motion tests to their affected and unaffected limbs. In all videos, participants were sitting in an upright position. We studied head movements and postures that occurred during the painful and control trials by measuring head orientation from video over time, followed by analyzing posture and movement summary statistics and occurrence frequencies of typical postures and movements. We found significant differences between pain and control trials with analyses of variance and binomial tests. In BioVid and BP4D, pain was accompanied by head movements and postures that tend to be oriented downwards or towards the pain site. We also found differences in movement range and speed in all three datasets. The results suggest that head movements and postures should be considered for pain assessment and research. As additional pain indicators, they possibly might improve pain management whenever behavior is assessed, especially in nonverbal individuals such as infants or patients with dementia. However, in advance more research is needed to identify specific head movements and postures in pain patients. PMID:29444153

  13. Head circumference

    MedlinePlus

    ... a child's head circumference. Normal ranges for a child's sex and age (weeks, months), based on values that experts have obtained for normal growth rates of infants' and children's heads. Measurement of the head circumference is an ...

  14. Sources of information on medical geography.

    PubMed

    Mullins, L S

    1966-07-01

    Adequate research in the peripheral field of medical geography requires familiarity with the literature of medicine, geography, and other environmentally oriented fields. The pertinent literature of the two primary disciplines, as well as that of anthropology, nutrition, and human bioclimatology, is surveyed from a bibliographical point of view. A brief review of historical sources is presented, followed by a discussion of the contemporary organizations, both international and national, active in the field. Emphasis is placed on the publishing programs and projects, maps, atlases, symposia, reports, and other literature sponsored or stimulated by these organizations. Regional bibliographical surveys for East Africa, India, and the Soviet Union are also noted. Pertinent aspects of bibliographies, indexes, abstracts, library card catalogs and accession lists, and other resources are listed, with emphasis on the various subject headings and other approaches to them. Throughout, the sources of information are approached from a multidisciplinary and interdisciplinary viewpoint.

  15. Clinical medical librarian: the last unicorn?

    PubMed

    Demas, J M; Ludwig, L T

    1991-01-01

    In the information age of the 1990s, the clinical medical librarian (CML) concept, like many other personalized library services, is often criticized as being too labor-intensive and expensive; others praise its advantages. To determine the attitudes of medical school library directors and clinical department heads toward implementation and feasibility of a CML program, forty randomly selected medical schools were surveyed. A double-blind procedure was used to sample department heads in internal medicine, pediatrics, and surgery, as well as health sciences library directors identified by the Association of Academic Health Sciences Library Directors (AAHSLD) annual statistics. The survey instrument was designed to measure responses to the following attitudinal variables: acceptance and nonacceptance of a CML program; importance to patient care, education, and research; influence on information-seeking patterns of health care professionals; ethical issues; CML extension services; and costs. Seventy-nine usable questionnaires out of a total of 120 (66%) were obtained from clinical medical personnel, and 30 usable questionnaires out of a total of 40 (75%) were obtained from medical school library directors. Survey results indicated significant differences between clinical medical personnel and library personnel regarding attitudes toward CML influence on information-seeking patterns, ethics, alternative CML services, and costs. Survey results also indicated a continuing strong support for CML programs in the medical school setting; however, differences of opinion existed toward defining the role of the CML and determining responsibility for funding.

  16. 14 CFR Appendix B to Part 147 - General Curriculum Subjects

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... subject heading indicates the level of proficiency at which that item must be taught. Teaching level a... fittings. e. materials and processes (1) 14. Identify and select appropriate nondestructive testing methods...

  17. 14 CFR Appendix B to Part 147 - General Curriculum Subjects

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... subject heading indicates the level of proficiency at which that item must be taught. Teaching level a... fittings. e. materials and processes (1) 14. Identify and select appropriate nondestructive testing methods...

  18. 14 CFR Appendix B to Part 147 - General Curriculum Subjects

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... subject heading indicates the level of proficiency at which that item must be taught. Teaching level a... fittings. e. materials and processes (1) 14. Identify and select appropriate nondestructive testing methods...

  19. 14 CFR Appendix B to Part 147 - General Curriculum Subjects

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... subject heading indicates the level of proficiency at which that item must be taught. Teaching level a... fittings. e. materials and processes (1) 14. Identify and select appropriate nondestructive testing methods...

  20. 14 CFR Appendix B to Part 147 - General Curriculum Subjects

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... subject heading indicates the level of proficiency at which that item must be taught. Teaching level a... fittings. e. materials and processes (1) 14. Identify and select appropriate nondestructive testing methods...

  1. Visual Vestibular Interaction in the Dynamic Visual Acuity Test during Voluntary Head Rotation

    NASA Technical Reports Server (NTRS)

    Lee, Moo Hoon; Durnford, Simon; Crowley, John; Rupert, Angus

    1996-01-01

    Although intact vestibular function is essential in maintaining spatial orientation, no good screening tests of vestibular function are available to the aviation community. High frequency voluntary head rotation was selected as a vestibular stimulus to isolate the vestibulo-ocular reflex (VOR) from visual influence. A dynamic visual acuity test that incorporates voluntary head rotation was evaluated as a potential vestibular function screening tool. Twenty-seven normal subjects performed voluntary sinusoidal head rotation at frequencies from 0.7-4.0 Hz under three different visual conditions: visually-enhanced VOR, normal VOR, and visually suppressed VOR. Standardized Baily-Lovie chart letters were presented on a computer monitor in front of the subject, who then was asked to read the letters while rotating his head horizontally. The electro-oculogram and dynamic visual acuity score were recorded and analyzed. There were no significant differences in gain or phase shift among three visual conditions in the frequency range of 2.8 to 4.0 Hz. The dynamic visual acuity score shifted less than 0.3 logMAR at frequencies under 2.0 Hz. The dynamic visual acuity test at frequencies a round 2.0 Hz can be recommended for evaluating vestibular function.

  2. Head-Elevated Patient Positioning Decreases Complications of Emergent Tracheal Intubation in the Ward and Intensive Care Unit.

    PubMed

    Khandelwal, Nita; Khorsand, Sarah; Mitchell, Steven H; Joffe, Aaron M

    2016-04-01

    Based on the data from elective surgical patients, positioning patients in a back-up head-elevated position for preoxygenation and tracheal intubation can improve patient safety. However, data specific to the emergent setting are lacking. We hypothesized that back-up head-elevated positioning would be associated with a decrease in complications related to tracheal intubation in the emergency room environment. This retrospective study was approved by the University of Washington Human Subjects Division (Seattle, WA). Eligible patients included all adults undergoing emergent tracheal intubation outside of the operating room by the anesthesiology-based airway service at 2 university-affiliated teaching hospitals. All intubations were through direct laryngoscopy for an indication other than full cardiopulmonary arrest. Patient characteristics and details of the intubation procedure were derived from the medical record. The primary study endpoint was the occurrence of a composite of any intubation-related complication: difficult intubation, hypoxemia, esophageal intubation, or pulmonary aspiration. Multivariable logistic regression was used to estimate the odds of the primary endpoint in the supine versus back-up head-elevated positions with adjustment for a priori-defined potential confounders (body mass index and a difficult intubation prediction score [Mallampati, obstructive sleep Apnea, Cervical mobility, mouth Opening, Coma, severe Hypoxemia, and intubation by a non-Anesthesiologist score]). Five hundred twenty-eight patients were analyzed. Overall, at least 1 intubation-related complication occurred in 76 of 336 (22.6%) patients managed in the supine position compared with 18 of 192 (9.3%) patients managed in the back-up head-elevated position. After adjusting for body mass index and the Mallampati, obstructive sleep Apnea, Cervical mobility, mouth Opening, Coma, severe Hypoxemia, and intubation by a non-Anesthesiologist score, the odds of encountering the

  3. Exploiting domain information for Word Sense Disambiguation of medical documents

    PubMed Central

    Agirre, Eneko; Soroa, Aitor

    2011-01-01

    Objective Current techniques for knowledge-based Word Sense Disambiguation (WSD) of ambiguous biomedical terms rely on relations in the Unified Medical Language System Metathesaurus but do not take into account the domain of the target documents. The authors' goal is to improve these methods by using information about the topic of the document in which the ambiguous term appears. Design The authors proposed and implemented several methods to extract lists of key terms associated with Medical Subject Heading terms. These key terms are used to represent the document topic in a knowledge-based WSD system. They are applied both alone and in combination with local context. Measurements A standard measure of accuracy was calculated over the set of target words in the widely used National Library of Medicine WSD dataset. Results and discussion The authors report a significant improvement when combining those key terms with local context, showing that domain information improves the results of a WSD system based on the Unified Medical Language System Metathesaurus alone. The best results were obtained using key terms obtained by relevance feedback and weighted by inverse document frequency. PMID:21900701

  4. Surgical, ethical, and psychosocial considerations in human head transplantation.

    PubMed

    Furr, Allen; Hardy, Mark A; Barret, Juan P; Barker, John H

    2017-05-01

    Transplanting a head and brain is perhaps the final frontier of organ transplantation. The goal of body-to-head transplantation (BHT) is to sustain the life of individuals who suffer from terminal disease, but whose head and brain are healthy. Ideally BHT could provide a lifesaving treatment for several conditions where none currently exists. BHT is no ordinary experiment, to transfer a head to another body involves extraordinarily complex medical challenges as well as ethical and existential dilemmas that were previously confined to the imagination of writers of fiction. The possibility of replacing an incurably ill body with a healthy one tests not only our surgical limits, but also the social and psychological boundaries of physical life and alters what we recognize life to be. The purpose of this target article, the complementary manuscript focused on immunological issues in BHT, and the accompanying Commentaries by scholars and practitioners in medicine, immunology, and bioethics is to review major surgical and psychosocial-ethical and immunological considerations surrounding body-to-head transplantation. We hope that together these ideas will provide readers with a comprehensive overview of the possibilities and challenges associated with BHT and initiate professional discussion and debate through which this new frontier in medicine is considered and approached. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Necrosis of the femoral head after kidney transplantation.

    PubMed

    Lausten, G S; Lemser, T; Jensen, P K; Egfjord, M

    1998-12-01

    We reviewed the medical records of 750 patients (445 men, 305 women), who had received a kidney transplant during the period 1968-1995, for any sign of necrosis of the femoral head. For post-operative immunosuppression, 374 patients had received high-dose corticosteroids (average 12.5 g during the first year post-operatively), while 376 patients had received low-dose corticosteroids (average 6.5 g during the first year post-operatively) and cyclosporin A. Survival curves according to Kaplan and Meier (J Am Stat Ass 1958: 53: 457-481) were constructed. In the high-dose steroid group, 42/374 patients (11.2%) developed femoral head necrosis, at an average of 26.2 months post-transplantation. In the low-dose steroid group, only 19/376 (5.1%) patients developed this complication, at an average of 20.5 months post-transplantation. This difference in numbers of femoral head necroses was highly significant (p < 0.005). We conclude that steroid doses should be minimized whenever feasible in post-transplant immunosuppression therapy.

  6. Did René Descartes Have Exploding Head Syndrome?

    PubMed

    Otaiku, Abidemi Idowu

    2018-04-15

    René Descartes (1596-1650), "the Father of Modern Philosophy" and advocate of mind-body dualism, had three successive dreams on November 10, 1619 that changed the trajectory of his life and the trajectory of human thought. Descartes' influential dreams have been of interest to a number of commentators including the famous neurologist and psychoanalyst Sigmund Freud. Descartes' second dream in particular, in which he heard a loud noise in his head before seeing a bright flash of light upon awakening, has been discussed extensively. Commentators have employed psychoanalytic and medical explanations to account for Descartes' unusual nocturnal experience. In this tradition, I propose that Descartes' second dream was not a dream at all; rather, it was an episode of exploding head syndrome; a benign and relatively common parasomnia. I further suggest that Adrien Baillet's account of Descartes' experience constitutes the earliest description of exploding head syndrome, predating the account described by Silas Weir Mitchell in 1876 by nearly 200 years. © 2018 American Academy of Sleep Medicine.

  7. Gang warfare: the medical repercussions.

    PubMed

    Song, D H; Naude, G P; Gilmore, D A; Bongard, F

    1996-05-01

    Gang related violence in Los Angeles County has increased, with homicides increasing from 205 in 1982 to 803 in 1992. This study examines the medical and financial consequences of such violence on a level I trauma center. Of 856 gunshot injuries over a 29-month period, 272 were gang related. There were 55 pediatric and 217 adult patients. Eighty-nine percent were male and 11% were female. Trauma Score averaged 14.7 +/- 3.1, Glasgow Coma Scale average score was 13.7 +/- 3.4, and the mean Injury Severity Score was 10.8 +/- 14. Twenty-two percent of the gunshots were to the head and neck, 20% to the chest, 20% to the abdomen, 6% had a peripheral vascular injury, and 33% sustained an extremity musculoskeletal injury. Emergency surgery was performed on 43%, including laparotomy 58 (49%), craniotomy 16 (13%), laparoscopy 14 (12%), vascular procedures 10 (8%), orthopedic procedures 6 (5%), head and neck endoscopies 4 (3%), thoracotomies 2 (2%), and 10 (8%) unspecified. There were 25 deaths (9%), primarily caused by head injuries and exsanguinating hemorrhage. Eighty-six percent entered the hospital during the hours of minimal staffing that preempted the use of facilities for other emergent patients. Charges totaled $4,828,828 (emergency room, surgical procedures, intensive care, and surgical ward stay) which equated to $5,550 per patient per day. Fifty-eight percent had no third party reimbursement, 22% had Medi-Cal, and 20% had medical insurance. Because of dismal reimbursement rates, the costs of gang violence are passed on to the tax payer. The cost of gang related violence cannot be derived from hospital charges only, because death, disability, and pain are not entered into the calculation. Education, increased social programs, and strict criminal justice laws and enforcement may decrease gang related violence and the drain it has on financial and medical resources.

  8. Out of Our Heads! Four perspectives on the curation of an on-line exhibition of medically themed artwork by UK medical undergraduates

    PubMed Central

    Thompson, Trevor; van de Klee, Danny; Lamont-Robinson, Catherine; Duffin, Will

    2010-01-01

    The Medical School at Bristol University is noted for offering, and in some instances requiring, its students to work creatively with medical themes. Students, artists, educationalists and a web designer have worked to create an on-line exhibition of the resulting creative output. This can be viewed at www.outofourheads.net. This site is a themed repository of poetry, prose, drawings, paintings, cartoons, films, music, dance and rap. Most works come with commentaries that can be as illuminating as the works they describe. The site invites comment and welcomes new postings from anyone connected to medicine. As an alternative to the conventional pedagogical report, and in keeping with the subject matter, in this paper we tell the story of this unique educational enterprise through the narratives of four of its principle architects. The ‘Teacher's Tale’, the ‘Designer's Tale’, the ‘Curator's Tale’ and the ‘Artist's Tale’ offer different, personal, tellings of how the site came to be. Each tale contains hypertext links to notable works on the site some of which have become teaching resources within the institution. This paper is of relevance to anyone who seeks to explore and champion the human insights of this privileged community. PMID:21321667

  9. Heading control and the effects of display characteristics

    NASA Technical Reports Server (NTRS)

    Hinz, Stephanie J.; Bennett, C. Thomas

    1989-01-01

    The present study evaluates whether type of display (dot or wire frame) and direction of movement have an effect on a person's ability to actively maintain a specific heading angle. The questions addressed were: (1) does the magnitude of the heading angle errors differ in the two displays, (2) are some heading angles more difficult to maintain than others, and (3) does the magnitude of some errors differ as a function of display type and direction of movement. Differences between the results of this study and previous research are explained by methodological differences across the studies. Another factor that may be responsible for the difference between previous findings and those presented here is the type of graphics used to display the simulated motion. The physical characteristics of the display or the graphics engines that generate the scene have varied greatly across the studies. Analyses and diagrams are presented showing results of the study and the differences generated from previous studies on this subject.

  10. Head and neck trauma in Iraq and Afghanistan: different war, different surgery, lessons learned.

    PubMed

    Brennan, Joseph

    2013-10-01

    The objectives are to compare and contrast the head and neck trauma experience in Iraq and Afghanistan and to identify trauma lessons learned that are applicable to civilian practice. A retrospective review of one head and neck surgeon's operative experience in Iraq and Afghanistan was performed using operative logs and medical records. The surgeon's daily operative log book with patient demographic data and operative reports was reviewed. Also, patient medical records were examined to identify the preoperative and postoperative course of care. The head and neck trauma experiences in Iraq and Afghanistan were very different, with a higher percentage of emergent cases performed in Iraq. In Iraq, only 10% of patients were pretreated at a facility with surgical capabilities. In Afghanistan, 93% of patients were pretreated at such facilities. Emergent neck exploration for penetrating neck trauma and emergent airway surgery were more common in Iraq, which most likely accounted for the increased perioperative mortality also seen in Iraq (5.3% in Iraq vs. 1.3% in Afghanistan). Valuable lessons regarding soft tissue trauma repair, midface fracture repair, and mandible fracture repair were learned. The head and neck trauma experiences in Iraq and Afghanistan were very different, and the future training for mass casualty trauma events should reflect these differences. Furthermore, valuable head and neck trauma lessons learned in both war zones are applicable to the civilian practice of trauma. Level 4. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Comparison of Cyberware PX and PS 3D human head scanners

    NASA Astrophysics Data System (ADS)

    Carson, Jeremy; Corner, Brian D.; Crockett, Eric; Li, Peng; Paquette, Steven

    2008-02-01

    A common limitation of laser line three-Dimensional (3D) scanners is the inability to scan objects with surfaces that are either parallel to the laser line or that self-occlude. Filling in missing areas adds some unwanted inaccuracy to the 3D model. Capturing the human head with a Cyberware PS Head Scanner is an example of obtaining a model where the incomplete areas are difficult to fill accurately. The PS scanner uses a single vertical laser line to illuminate the head and is unable to capture data at top of the head, where the line of sight is tangent to the surface, and under the chin, an area occluded by the chin when the subject looks straight forward. The Cyberware PX Scanner was developed to obtain this missing 3D head data. The PX scanner uses two cameras offset at different angles to provide a more detailed head scan that captures surfaces missed by the PS scanner. The PX scanner cameras also use new technology to obtain color maps that are of higher resolution than the PS Scanner. The two scanners were compared in terms of amount of surface captured (surface area and volume) and the quality of head measurements when compared to direct measurements obtained through standard anthropometry methods. Relative to the PS scanner, the PX head scans were more complete and provided the full set of head measurements, but actual measurement values, when available from both scanners, were about the same.

  12. Rotational Acceleration during Head Impact Resulting from Different Judo Throwing Techniques

    PubMed Central

    MURAYAMA, Haruo; HITOSUGI, Masahito; MOTOZAWA, Yasuki; OGINO, Masahiro; KOYAMA, Katsuhiro

    2014-01-01

    Most severe head injuries in judo are reported as acute subdural hematoma. It is thus necessary to examine the rotational acceleration of the head to clarify the mechanism of head injuries. We determined the rotational acceleration of the head when the subject is thrown by judo techniques. One Japanese male judo expert threw an anthropomorphic test device using two throwing techniques, Osoto-gari and Ouchigari. Rotational and translational head accelerations were measured with and without an under-mat. For Osoto-gari, peak resultant rotational acceleration ranged from 4,284.2 rad/s2 to 5,525.9 rad/s2 and peak resultant translational acceleration ranged from 64.3 g to 87.2 g; for Ouchi-gari, the accelerations respectively ranged from 1,708.0 rad/s2 to 2,104.1 rad/s2 and from 120.2 g to 149.4 g. The resultant rotational acceleration did not decrease with installation of an under-mat for both Ouchi-gari and Osoto-gari. We found that head contact with the tatami could result in the peak values of translational and rotational accelerations, respectively. In general, because kinematics of the body strongly affects translational and rotational accelerations of the head, both accelerations should be measured to analyze the underlying mechanism of head injury. As a primary preventative measure, throwing techniques should be restricted to participants demonstrating ability in ukemi techniques to avoid head contact with the tatami. PMID:24477065

  13. Rotational acceleration during head impact resulting from different judo throwing techniques.

    PubMed

    Murayama, Haruo; Hitosugi, Masahito; Motozawa, Yasuki; Ogino, Masahiro; Koyama, Katsuhiro

    2014-01-01

    Most severe head injuries in judo are reported as acute subdural hematoma. It is thus necessary to examine the rotational acceleration of the head to clarify the mechanism of head injuries. We determined the rotational acceleration of the head when the subject is thrown by judo techniques. One Japanese male judo expert threw an anthropomorphic test device using two throwing techniques, Osoto-gari and Ouchi-gari. Rotational and translational head accelerations were measured with and without an under-mat. For Osoto-gari, peak resultant rotational acceleration ranged from 4,284.2 rad/s(2) to 5,525.9 rad/s(2) and peak resultant translational acceleration ranged from 64.3 g to 87.2 g; for Ouchi-gari, the accelerations respectively ranged from 1,708.0 rad/s(2) to 2,104.1 rad/s(2) and from 120.2 g to 149.4 g. The resultant rotational acceleration did not decrease with installation of an under-mat for both Ouchi-gari and Osoto-gari. We found that head contact with the tatami could result in the peak values of translational and rotational accelerations, respectively. In general, because kinematics of the body strongly affects translational and rotational accelerations of the head, both accelerations should be measured to analyze the underlying mechanism of head injury. As a primary preventative measure, throwing techniques should be restricted to participants demonstrating ability in ukemi techniques to avoid head contact with the tatami.

  14. The immunologic considerations in human head transplantation.

    PubMed

    Hardy, Mark A; Furr, Allen; Barret, Juan P; Barker, John H

    2017-05-01

    The idea of head transplantation appears at first as unrealistic, unethical, and futile. Here we discuss immunological considerations in human head transplantation. In a separate accompanying article we discuss surgical, ethical, and psychosocial issues concerned in body-to-head transplantation (BHT) [1]. The success of such an unusual allograft, where the donor and the recipient can reject each other, depends on prevention of complex immunologic reactions, especially rejection of the head by the body (graft-vs-host) or probably less likely, the possibility of the head rejecting the total body allograft (host-vs-graft). The technical and immunologic difficulties are enormous, especially since rapid nerve and cord connections and regeneration have not yet been possible to achieve. In this article we begin by briefly reviewing neuro-immunologic issues that may favor BHT such as the blood brain barrier (BBB) and point out its shortcomings. And we touch on the cellular and humoral elements in the brain proper that differ in some respects from those in other organs and in the periphery. Based on recent successes in vascular composite allografts (VCAs), we will elaborate on potential specific advantages and difficulties in BHT of various available immunosuppressive medications already utilized in VCAs. The risk/benefit ratio of these drugs will be emphasized in relation to direct brain toxicity such as seizure disorders, interference, or promotion of nerve regeneration, and potentiation of cerebral viral infections. The final portion of this article will focus on pre-transplant immunologic manipulation of the deceased donor body along with pretreatment of the recipient. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  15. Memory for Medication Side Effects in Younger and Older Adults: The Role of Subjective and Objective Importance

    PubMed Central

    Friedman, Michael C.; McGillivray, Shannon; Murayama, Kou; Castel, Alan D.

    2014-01-01

    Older adults often experience memory impairments, but can sometimes use selective processing and schematic support to remember important information. The current experiments investigate to what degree younger and healthy older adults remember medication side effects that were subjectively or objectively important to remember. Participants studied a list of common side effects, and rated how negative these effects were if they were to experience them, and were then given a free recall test. In Experiment 1, the severity of the side effects ranged from mild (e.g., itching) to severe (e.g., stroke), and in Experiment 2, certain side effects were indicated as critical to remember (i.e., “contact your doctor if you experience this”). There were no age differences in terms of free recall of the side effects, and older adults remembered more severe side effects relative to mild effects. However, older adults were less likely to recognize critical side effects on a later recognition test, relative to younger adults. The findings suggest that older adults can selectively remember medication side effects, but have difficulty identifying familiar but potentially critical side effects, and this has implications for monitoring medication use in older age. PMID:25331278

  16. Preference bias of head orientation in choosing between two non-durables.

    PubMed

    Funaya, Hiroyuki; Shibata, Tomohiro

    2015-01-01

    The goal of this study is to investigate how customers' gaze, head and body orientations reflect their choices. Although the relationship between human choice and gaze behavior has been well-studied, other behaviors such as head and body are unknown. We conducted a two-alternatives-forced-choice task to examine (1) whether preference bias, i.e., a positional bias in gaze, head and body toward the item that was later chosen, exists in choice, (2) when preference bias is observed and when prediction of the resulting choice becomes possible (3) whether human choice is affected when the body orientations are manipulated. We used real non-durable products (cheap snacks and clothing) on a shopping shelf. The results showed that there was a significant preference bias in head orientation at the beginning 1 s when the subjects stood straight toward the shelf, and that the head orientation was more biased toward the selected item than the gaze and the center of pressure at the ending 1 s. Manipulating body orientation did not affect the result of choice. The preference bias detected by observing the head orientation would be useful in marketing science for predicting customers' choice.

  17. The Unified Medical Language System (UMLS): integrating biomedical terminology

    PubMed Central

    Bodenreider, Olivier

    2004-01-01

    The Unified Medical Language System (http://umlsks.nlm.nih.gov) is a repository of biomedical vocabularies developed by the US National Library of Medicine. The UMLS integrates over 2 million names for some 900 000 concepts from more than 60 families of biomedical vocabularies, as well as 12 million relations among these concepts. Vocabularies integrated in the UMLS Metathesaurus include the NCBI taxonomy, Gene Ontology, the Medical Subject Headings (MeSH), OMIM and the Digital Anatomist Symbolic Knowledge Base. UMLS concepts are not only inter-related, but may also be linked to external resources such as GenBank. In addition to data, the UMLS includes tools for customizing the Metathesaurus (MetamorphoSys), for generating lexical variants of concept names (lvg) and for extracting UMLS concepts from text (MetaMap). The UMLS knowledge sources are updated quarterly. All vocabularies are available at no fee for research purposes within an institution, but UMLS users are required to sign a license agreement. The UMLS knowledge sources are distributed on CD-ROM and by FTP. PMID:14681409

  18. The Unified Medical Language System (UMLS): integrating biomedical terminology.

    PubMed

    Bodenreider, Olivier

    2004-01-01

    The Unified Medical Language System (http://umlsks.nlm.nih.gov) is a repository of biomedical vocabularies developed by the US National Library of Medicine. The UMLS integrates over 2 million names for some 900,000 concepts from more than 60 families of biomedical vocabularies, as well as 12 million relations among these concepts. Vocabularies integrated in the UMLS Metathesaurus include the NCBI taxonomy, Gene Ontology, the Medical Subject Headings (MeSH), OMIM and the Digital Anatomist Symbolic Knowledge Base. UMLS concepts are not only inter-related, but may also be linked to external resources such as GenBank. In addition to data, the UMLS includes tools for customizing the Metathesaurus (MetamorphoSys), for generating lexical variants of concept names (lvg) and for extracting UMLS concepts from text (MetaMap). The UMLS knowledge sources are updated quarterly. All vocabularies are available at no fee for research purposes within an institution, but UMLS users are required to sign a license agreement. The UMLS knowledge sources are distributed on CD-ROM and by FTP.

  19. Psychiatry, subjectivity and emotion - deepening the medical model

    PubMed Central

    Yakeley, Jessica; Hale, Rob; Johnston, James; Kirtchuk, Gabriel; Shoenberg, Peter

    2014-01-01

    Morale among psychiatrists continues to be seriously challenged in the face of recruitment difficulties, unfilled posts, diagnostic controversies, service reconfigurations and public criticism of psychiatric care, in addition to other difficulties. In this article, we argue that the positivist paradigm that continues to dominate British psychiatry has led to an undervaluing of subjectivity and of the role of emotions within psychiatric training and practice. Reintegrating the subjective perspective and promoting emotional awareness and reflection may go some way towards restoring faith in the psychiatric specialty. PMID:25237517

  20. Flight display dynamics and compensatory head movements in pilots.

    PubMed

    Beer, Jeremy; Freeman, David

    2007-06-01

    Experiments measured the optokinetic cervical reflex (OKCR), wherein the banking pilot aligns the head with the horizon. In a synthetic cockpit, the flight display was manipulated to test whether changing the visual reference frame would alter OKCR. Eight subjects (five rated pilots) flew a route in simulated visual meteorological conditions that required them to bank the aircraft frequently. Pilots' head tilt was characterized using both the conventional method of regressing against simultaneous aircraft bank, and also an event-based analysis, which identified head movements before, during, and after each turn. Three display configurations were compared to determine whether pilots' orientation would ever migrate from the horizon to the aircraft symbol. The first was a conventional "Inside-Out" condition. A "Frequency-Separated" condition combined Inside-Out horizon geometry with Outside-In dynamics for the aircraft symbol, which depicted joystick bank inputs. In the "Outside-In" condition, the aircraft symbol rolled against a static horizon. Regressions identified an interaction (p < 0.001) between display condition and aircraft bank: head tilt followed horizon tilt in Inside-Out and Frequency-Separated conditions, while remaining mostly level in the Outside-In condition. The event-based analysis identified anticipatory head movements in Inside-Out and Frequency-Separated conditions: 95% CI indicated that before each turn, head tilt favored the direction of the imminent bank. While the conventional analysis confirmed that the horizon comprises a primary spatial reference, the finer-grained event-based analysis indicated that pilots' reference can migrate at least temporarily to the vehicle, and that OKCR can be preceded by anticipatory head movements in the opposite direction.

  1. Learning mechanisms to limit medication administration errors.

    PubMed

    Drach-Zahavy, Anat; Pud, Dorit

    2010-04-01

    This paper is a report of a study conducted to identify and test the effectiveness of learning mechanisms applied by the nursing staff of hospital wards as a means of limiting medication administration errors. Since the influential report ;To Err Is Human', research has emphasized the role of team learning in reducing medication administration errors. Nevertheless, little is known about the mechanisms underlying team learning. Thirty-two hospital wards were randomly recruited. Data were collected during 2006 in Israel by a multi-method (observations, interviews and administrative data), multi-source (head nurses, bedside nurses) approach. Medication administration error was defined as any deviation from procedures, policies and/or best practices for medication administration, and was identified using semi-structured observations of nurses administering medication. Organizational learning was measured using semi-structured interviews with head nurses, and the previous year's reported medication administration errors were assessed using administrative data. The interview data revealed four learning mechanism patterns employed in an attempt to learn from medication administration errors: integrated, non-integrated, supervisory and patchy learning. Regression analysis results demonstrated that whereas the integrated pattern of learning mechanisms was associated with decreased errors, the non-integrated pattern was associated with increased errors. Supervisory and patchy learning mechanisms were not associated with errors. Superior learning mechanisms are those that represent the whole cycle of team learning, are enacted by nurses who administer medications to patients, and emphasize a system approach to data analysis instead of analysis of individual cases.

  2. Extraction of high value added gelatin biopolymer from black tilapia (Oreochromis mossambicus) head bones

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

    Sockalingam, K., E-mail: gd130106@siswa.uthm.edu.my; Abdullah, H. Z., E-mail: hasan@uthm.edu.my

    Black tilapia (Oreochromis mossambicus) fish head bones were evaluated for its possibilities in extracting gelatin. Head bones were subjected to pre-treatment with 3% of hydrochloric acid (HCl) for demineralization before undergoes thermal extraction process. The raw head bones were characterized via Scanning Electron Microscopy (SEM) in order to investigate the external and internal surface morphology. SEM images also reveal the presence of collagen fiber with 1 µm diameter in the head bone. The black tilapia fish head bones yields 5.75 % of gelatin in wet weight basis, indicating the possibility of this fish species as sources of gelatin. Further characterizations weremore » done on both raw head bones and extracted gelatin through Fourier Transform Infrared Spectroscopy (FTIR) and proximate analysis. The head bones gelatin shows high protein (10.55%) and ash (3.11 %) content with low moisture. This further proves the effectiveness of demineralization and extraction method used. The black tilapia fish head bones are found to be a prospective source of gelatin with good chemical and functional properties.« less

  3. [Current Developments of the Interdisciplinary Subject Rehabilitation, Physical Medicine, Naturopathic Treatment in the German Medical Faculties: Results of the DGRW Faculty Survey in 2015].

    PubMed

    Schmidt, S; Bergelt, C; Deck, R; Krischak, G; Morfeld, M; Michel, M; Schwarzkopf, S R; Spyra, K; Walter, S; Mau, W

    2017-02-01

    To ascertain the current development of the rehabilitation-related medical teaching in the interdisciplinary subject Rehabilitation, Physical Medicine, Naturopathic Treatment (Q12) regarding its execution, content, exams and evaluation of teaching at the Medical Faculties the German Society of Rehabilitation Science conducted another faculty survey in 2015. Representatives of all degree courses of human medicine in German Universities (n=41) received a pseudonymised standardised questionnaire in summer 2015. The response rate was 76% (n=31). Half of the faculties (48%) stated that they had a teaching and research unit for at least 1 of the 3 subjects of the interdisciplinary Q12. The Q12-teaching of faculties including these units partially differed from the other faculties. Model medical education programmes provide on average 2 semesters more for Q12-teaching in comparison to the traditional programmes. More than 3 quarters of the traditional programmes and all other courses include other medical professionals besides physicians as lecturers. Multiple choice questions still constitute the most common examination type (94%). Nearly all Medical Faculties evaluate the rehabilitation-related teaching but only half of all them have implemented a financial gratification based on the evaluation results. Even 10 years after the implementation of Q12, major variations were demonstrated regarding the execution, content and methods of medical education in rehabilitation. In the future the influence of the National Competence Based Catalogues of Learning Objectives for Undergraduate Medical Education on the Q12-development and the Q12-teaching in medical university education in Germany with foreign qualification will be of particular interest. © Georg Thieme Verlag KG Stuttgart · New York.

  4. [Medical history as an academic subject at the Bamberg University].

    PubMed

    Locher, W

    2000-01-01

    A full program of medicine was taught at the Catholic University of Bamberg (founded 1648 as the Academia Ottonia) from 1773 through 1803. Within this period of time, the History of Medicine was taught from 1790 through 1795 by Johann Baptist Dominicus Fin(c)k. This paper elucidates how in this instance protestant universities served as models for catholic universities. Interestingly, it was not the medical faculty itself which developed an interest in teaching medical history. Rather, it was Adalbert Friedrich Marcus (1753-1816), physician-in-waiting of the Prince-Bishop Franz Ludwig von Erthal and medical officer in the principality of Bamberg since June 22, 1790, who was charged by the Prince-Bishop with developing guidelines for medical education. The start of the History of Medicine lectures brought with it a heated dispute about an appropriate textbook. The discussion is evidence of a transition from historiography understood as an account of learned doctors of the past to a study of history in a modern sense.

  5. Neck Strength Imbalance Correlates With Increased Head Acceleration in Soccer Heading

    PubMed Central

    Dezman, Zachary D.W.; Ledet, Eric H.; Kerr, Hamish A.

    2013-01-01

    Background: Soccer heading is using the head to directly contact the ball, often to advance the ball down the field or score. It is a skill fundamental to the game, yet it has come under scrutiny. Repeated subclinical effects of heading may compound over time, resulting in neurologic deficits. Greater head accelerations are linked to brain injury. Developing an understanding of how the neck muscles help stabilize and reduce head acceleration during impact may help prevent brain injury. Hypothesis: Neck strength imbalance correlates to increasing head acceleration during impact while heading a soccer ball. Study Design: Observational laboratory investigation. Methods: Sixteen Division I and II collegiate soccer players headed a ball in a controlled indoor laboratory setting while player motions were recorded by a 14-camera Vicon MX motion capture system. Neck flexor and extensor strength of each player was measured using a spring-type clinical dynamometer. Results: Players were served soccer balls by hand at a mean velocity of 4.29 m/s (±0.74 m/s). Players returned the ball to the server using a heading maneuver at a mean velocity of 5.48 m/s (±1.18 m/s). Mean neck strength difference was positively correlated with angular head acceleration (rho = 0.497; P = 0.05), with a trend toward significance for linear head acceleration (rho = 0.485; P = 0.057). Conclusion: This study suggests that symmetrical strength in neck flexors and extensors reduces head acceleration experienced during low-velocity heading in experienced collegiate players. Clinical Relevance: Balanced neck strength may reduce head acceleration cumulative subclinical injury. Since neck strength is a measureable and amenable strength training intervention, this may represent a modifiable intrinsic risk factor for injury. PMID:24459547

  6. A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI.

    PubMed

    Wolff, Andy; Joshi, Revan Kumar; Ekström, Jörgen; Aframian, Doron; Pedersen, Anne Marie Lynge; Proctor, Gordon; Narayana, Nagamani; Villa, Alessandro; Sia, Ying Wai; Aliko, Ardita; McGowan, Richard; Kerr, Alexander Ross; Jensen, Siri Beier; Vissink, Arjan; Dawes, Colin

    2017-03-01

    Medication-induced salivary gland dysfunction (MISGD), xerostomia (sensation of oral dryness), and subjective sialorrhea cause significant morbidity and impair quality of life. However, no evidence-based lists of the medications that cause these disorders exist. Our objective was to compile a list of medications affecting salivary gland function and inducing xerostomia or subjective sialorrhea. Electronic databases were searched for relevant articles published until June 2013. Of 3867 screened records, 269 had an acceptable degree of relevance, quality of methodology, and strength of evidence. We found 56 chemical substances with a higher level of evidence and 50 with a moderate level of evidence of causing the above-mentioned disorders. At the first level of the Anatomical Therapeutic Chemical (ATC) classification system, 9 of 14 anatomical groups were represented, mainly the alimentary, cardiovascular, genitourinary, nervous, and respiratory systems. Management strategies include substitution or discontinuation of medications whenever possible, oral or systemic therapy with sialogogues, administration of saliva substitutes, and use of electro-stimulating devices. While xerostomia was a commonly reported outcome, objectively measured salivary flow rate was rarely reported. Moreover, xerostomia was mostly assessed as an adverse effect rather than the primary outcome of medication use. This study may not include some medications that could cause xerostomia when administered in conjunction with others or for which xerostomia as an adverse reaction has not been reported in the literature or was not detected in our search. We compiled a comprehensive list of medications with documented effects on salivary gland function or symptoms that may assist practitioners in assessing patients who complain of dry mouth while taking medications. The list may also prove useful in helping practitioners anticipate adverse effects and consider alternative medications.

  7. Vestibular and Non-vestibular Contributions to Eye Movements that Compensate for Head Rotations during Viewing of Near Targets

    NASA Technical Reports Server (NTRS)

    Han, Yanning H.

    2006-01-01

    We studied horizontal eye movements induced by en-bloc yaw rotation, over a frequency range 0.2 - 2.8 Hz, in 10 normal human subjects as they monocularly viewed a target located at their near point of focus. We measured gain and phase relationships between eye-in-head velocity and head velocity when the near target was either earth-fixed or head-fixed. During viewing of the earth-fixed near target, median gain was 1.49 (range 1.24 - 1.87) at 0.2 Hz for the group of subjects, but declined at higher frequencies, so that at 2.8 Hz median gain was 1.08 (range 0.68 - 1.67). During viewing of the head-fixed near target , median gain was 0.03 (range 0.01 - 0.10) at 0.2 Hz for the group of subjects, but increased at higher frequencies, so that at 2.8 Hz median gain was 0.71 (range 0.28 - 0.94). We estimated the vestibular contribution to these responses vestibulo-ocular reflex gain (Gvor) by applying transient head perturbations (peak acceleration> 1,000 deg/s(exp 2)) during sinusoidal rotation under the two viewing conditions. Median Gvor, estimated < 70ms after the onset of head perturbation, was 0.98 (range 0.39 - 1.42) while viewing the earth-fixed near target, and 0.97 (range 0.37 - 1.33) while viewing the head-fixed near target. For the group of subjects, 9 out of 10 subjects showed no significant difference of Gvor between the two viewing conditions ( p > 0.053 ) at all test frequencies. Since Gvor accounted for only -73% of the overall response gain during viewing of the earth-fixed target, we investigated the relative contributions of non-vestibular factors. When subjects viewed the earth-fixed target under strobe illumination, to eliminate retinal image slip information, the gain of compensatory eye movements declined compared with viewing in ambient room light. During sum-of-sine head rotations, while viewing the earth-fixed target, to Han et al./VOR during near-viewing minimize contributions from predictive mechanisms, gain also declined Nonetheless, simple

  8. Shrunken head (tsantsa): a complete forensic analysis procedure.

    PubMed

    Charlier, P; Huynh-Charlier, I; Brun, L; Hervé, C; de la Grandmaison, G Lorin

    2012-10-10

    Based on the analysis of shrunken heads referred to our forensic laboratory for anthropological expertise, and data from both anthropological and medical literature, we propose a complete forensic procedure for the analysis of such pieces. A list of 14 original morphological criteria has been developed, based on the global aspect, color, physical deformation, anatomical details, and eventual associated material (wood, vegetal fibers, sand, charcoals, etc.). Such criteria have been tested on a control sample of 20 tsantsa (i.e. shrunken heads from the Jivaro or Shuar tribes of South America). Further complementary analyses are described such as CT-scan and microscopic examination. Such expertise is more and more asked to forensic anthropologists and practitioners in a context of global repatriation of human artifacts to native communities. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Head and neck control varies with perturbation acceleration but not jerk: implications for whiplash injuries

    PubMed Central

    Siegmund, Gunter P; Blouin, Jean-Sébastien

    2009-01-01

    Recent studies have proposed that a high rate of acceleration onset, i.e. high jerk, during a low-speed vehicle collision increases the risk of whiplash injury by triggering inappropriate muscle responses and/or increasing peak head acceleration. Our goal was to test these proposed mechanisms at realistic jerk levels and then to determine how collision jerk affects the potential for whiplash injuries. Twenty-three seated volunteers (8 F, 15 M) were exposed to multiple experiments involving perturbations simulating the onset of a vehicle collision in eyes open and eyes closed conditions. In the first experiment, subjects experienced five forward and five rearward perturbations to look for the inappropriate muscle responses and ‘floppy’ head kinematics previously attributed to high jerk perturbations. In the second experiment, we independently varied the jerk (∼125 to 3 000 m s−3) and acceleration (∼0.65 to 2.6 g) of the perturbation to assess their effect on the electromyographic (EMG) responses of the sternocleidomastoid (SCM), scalene (SCAL) and cervical paraspinal (PARA) muscles and the kinematic responses of the head and neck. In the first experiment, we found neither inappropriate muscle responses nor floppy head kinematics when subjects had their eyes open, but observed two subjects with floppy head kinematics with eyes closed. In the second experiment, we found that about 70% of the variations in the SCM and SCAL responses and about 95% of the variations in head/neck kinematics were explained by changes in perturbation acceleration in both the eyes open and eyes closed conditions. Less than 2% of the variation in the muscle and kinematic responses was explained by changes in perturbation jerk and, where significant, response amplitudes diminished with increasing jerk. Based on these findings, collision jerk appears to have little or no role in the genesis of whiplash injuries in low-speed vehicle crashes. PMID:19237420

  10. Employability Competencies for Entry Level Emergency Medical Aides.

    ERIC Educational Resources Information Center

    Werner, Claire

    This document describes competencies needed by persons who complete the Los Angeles Schools' emergency medical aide competency-based program, which is designed to enhance their ability to obtain certification as an Emergency Medical Technician (EMT). The overall competency statement ("goal") of the program heads each page and is defined by one or…

  11. Journal Club: Head CT scans in the emergency department for syncope and dizziness.

    PubMed

    Mitsunaga, Myles M; Yoon, Hyo-Chun

    2015-01-01

    The purpose of this study was to determine the yield of acutely abnormal findings on head CT scans in patients presenting to the emergency department with dizziness, near-syncope, or syncope and to determine the clinical factors that potentially predicted acutely abnormal head CT findings and hospital admission. We retrospectively reviewed the electronic medical records of all patients presenting to an HMO emergency department between July 1, 2012, and December 31, 2012, who underwent head CT for a primary complaint of dizziness, syncope, or near-syncope. The primary outcomes were head CT scans with acutely abnormal findings and hospital admission. Binary logistic regression was used to assess the association between clinical variables and acute head CT findings and between clinical variables and hospital admission. Of the 253 patients who presented with dizziness, 7.1% had head CT scans with acutely abnormal findings, and 18.6% were admitted. Of the 236 patients who presented with syncope or near-syncope, 6.4% had head CT scans with acutely abnormal findings, and 39.8% were admitted. The following three clinical factors were found to be significantly correlated with acutely abnormal head CT findings: a focal neurologic deficit (p = 0.003), age greater than 60 years (p = 0.011), and acute head trauma (p = 0.026). Our results suggest that most patients presenting with syncope or dizziness to the emergency department may not benefit from head CT unless they are older, have a focal neurologic deficit, or have a history of recent head trauma.

  12. Simultaneous head tissue conductivity and EEG source location estimation.

    PubMed

    Akalin Acar, Zeynep; Acar, Can E; Makeig, Scott

    2016-01-01

    Accurate electroencephalographic (EEG) source localization requires an electrical head model incorporating accurate geometries and conductivity values for the major head tissues. While consistent conductivity values have been reported for scalp, brain, and cerebrospinal fluid, measured brain-to-skull conductivity ratio (BSCR) estimates have varied between 8 and 80, likely reflecting both inter-subject and measurement method differences. In simulations, mis-estimation of skull conductivity can produce source localization errors as large as 3cm. Here, we describe an iterative gradient-based approach to Simultaneous tissue Conductivity And source Location Estimation (SCALE). The scalp projection maps used by SCALE are obtained from near-dipolar effective EEG sources found by adequate independent component analysis (ICA) decomposition of sufficient high-density EEG data. We applied SCALE to simulated scalp projections of 15cm(2)-scale cortical patch sources in an MR image-based electrical head model with simulated BSCR of 30. Initialized either with a BSCR of 80 or 20, SCALE estimated BSCR as 32.6. In Adaptive Mixture ICA (AMICA) decompositions of (45-min, 128-channel) EEG data from two young adults we identified sets of 13 independent components having near-dipolar scalp maps compatible with a single cortical source patch. Again initialized with either BSCR 80 or 25, SCALE gave BSCR estimates of 34 and 54 for the two subjects respectively. The ability to accurately estimate skull conductivity non-invasively from any well-recorded EEG data in combination with a stable and non-invasively acquired MR imaging-derived electrical head model could remove a critical barrier to using EEG as a sub-cm(2)-scale accurate 3-D functional cortical imaging modality. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Simultaneous head tissue conductivity and EEG source location estimation

    PubMed Central

    Acar, Can E.; Makeig, Scott

    2015-01-01

    Accurate electroencephalographic (EEG) source localization requires an electrical head model incorporating accurate geometries and conductivity values for the major head tissues. While consistent conductivity values have been reported for scalp, brain, and cerebrospinal fluid, measured brain-to-skull conductivity ratio (BSCR) estimates have varied between 8 and 80, likely reflecting both inter-subject and measurement method differences. In simulations, mis-estimation of skull conductivity can produce source localization errors as large as 3 cm. Here, we describe an iterative gradient-based approach to Simultaneous tissue Conductivity And source Location Estimation (SCALE). The scalp projection maps used by SCALE are obtained from near-dipolar effective EEG sources found by adequate independent component analysis (ICA) decomposition of sufficient high-density EEG data. We applied SCALE to simulated scalp projections of 15 cm2-scale cortical patch sources in an MR image-based electrical head model with simulated BSCR of 30. Initialized either with a BSCR of 80 or 20, SCALE estimated BSCR as 32.6. In Adaptive Mixture ICA (AMICA) decompositions of (45-min, 128-channel) EEG data from two young adults we identified sets of 13 independent components having near-dipolar scalp maps compatible with a single cortical source patch. Again initialized with either BSCR 80 or 25, SCALE gave BSCR estimates of 34 and 54 for the two subjects respectively. The ability to accurately estimate skull conductivity non-invasively from any well-recorded EEG data in combination with a stable and non-invasively acquired MR imaging-derived electrical head model could remove a critical barrier to using EEG as a sub-cm2-scale accurate 3-D functional cortical imaging modality. PMID:26302675

  14. Development and Design of Next-Generation Head-Mounted Ambulatory Microdose Positron-Emission Tomography (AM-PET) System.

    PubMed

    Melroy, Samantha; Bauer, Christopher; McHugh, Matthew; Carden, Garret; Stolin, Alexander; Majewski, Stan; Brefczynski-Lewis, Julie; Wuest, Thorsten

    2017-05-19

    Several applications exist for a whole brain positron-emission tomography (PET) brain imager designed as a portable unit that can be worn on a patient's head. Enabled by improvements in detector technology, a lightweight, high performance device would allow PET brain imaging in different environments and during behavioral tasks. Such a wearable system that allows the subjects to move their heads and walk-the Ambulatory Microdose PET (AM-PET)-is currently under development. This imager will be helpful for testing subjects performing selected activities such as gestures, virtual reality activities and walking. The need for this type of lightweight mobile device has led to the construction of a proof of concept portable head-worn unit that uses twelve silicon photomultiplier (SiPM) PET module sensors built into a small ring which fits around the head. This paper is focused on the engineering design of mechanical support aspects of the AM-PET project, both of the current device as well as of the coming next-generation devices. The goal of this work is to optimize design of the scanner and its mechanics to improve comfort for the subject by reducing the effect of weight, and to enable diversification of its applications amongst different research activities.

  15. Development and Design of Next-Generation Head-Mounted Ambulatory Microdose Positron-Emission Tomography (AM-PET) System

    PubMed Central

    Melroy, Samantha; Bauer, Christopher; McHugh, Matthew; Carden, Garret; Stolin, Alexander; Majewski, Stan; Brefczynski-Lewis, Julie; Wuest, Thorsten

    2017-01-01

    Several applications exist for a whole brain positron-emission tomography (PET) brain imager designed as a portable unit that can be worn on a patient’s head. Enabled by improvements in detector technology, a lightweight, high performance device would allow PET brain imaging in different environments and during behavioral tasks. Such a wearable system that allows the subjects to move their heads and walk—the Ambulatory Microdose PET (AM-PET)—is currently under development. This imager will be helpful for testing subjects performing selected activities such as gestures, virtual reality activities and walking. The need for this type of lightweight mobile device has led to the construction of a proof of concept portable head-worn unit that uses twelve silicon photomultiplier (SiPM) PET module sensors built into a small ring which fits around the head. This paper is focused on the engineering design of mechanical support aspects of the AM-PET project, both of the current device as well as of the coming next-generation devices. The goal of this work is to optimize design of the scanner and its mechanics to improve comfort for the subject by reducing the effect of weight, and to enable diversification of its applications amongst different research activities. PMID:28534848

  16. Characteristics and intraoperative treatments associated with head and neck free tissue transfer complications and failures.

    PubMed

    Hand, William R; McSwain, Julie R; McEvoy, Matthew D; Wolf, Bethany; Algendy, Abdalrahman A; Parks, Matthew D; Murray, John L; Reeves, Scott T

    2015-03-01

    To investigate the association between perioperative patient characteristics and treatment modalities (eg, vasopressor use and volume of fluid administration) with complications and failure rates in patients undergoing head and neck free tissue transfer (FTT). A retrospective review of medical records. Perioperative hospitalization for head and neck FTT at 1 tertiary care medical center between January 1, 2009, and October 31, 2011. Consecutive patients (N=235) who underwent head and neck FTT. Demographic, patient characteristic, and intraoperative data were extracted from medical records. Complication and failure rates within the first 30 days were collected In a multivariate analysis controlling for age, sex, ethnicity, reason for receiving flap, and type and volume of fluid given, perioperative complication was significantly associated with surgical blood loss (P=.019; 95% confidence interval [CI], 1.01-1.16), while the rate of intraoperative fluid administration did not reach statistical significance (P=.06; 95% CI, 0.99-1.28). In a univariate analysis, FTT failure was significantly associated with reason for surgery (odds ratio, 5.40; P=.03; 95% CI, 1.69-17.3) and preoperative diagnosis of coronary artery disease (odds ratio, 3.60; P=.03; 95% CI, 1.16-11.2). Intraoperative vasopressor administration was not associated with either FTT complication or failure rate. FTT complications were associated with surgical blood loss but not the use of vasoactive drugs. For patients undergoing FTT, judicious monitoring of blood loss may help stratify the risk of complication and failure. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  17. Head Lice (For Parents)

    MedlinePlus

    ... Videos for Educators Search English Español First Aid: Head Lice KidsHealth / For Parents / First Aid: Head Lice Print A head louse is a tiny, wingless ... Prevention! You can help protect your kids from head lice by teaching them to: avoid head-to-head ...

  18. Validity and reliability of head posture measurement using Microsoft Kinect.

    PubMed

    Oh, Baek-Lok; Kim, Jongmin; Kim, Jongshin; Hwang, Jeong-Min; Lee, Jehee

    2014-11-01

    To investigate the validity and reliability of Microsoft Kinect-based head tracker (KHT) for measuring head posture. Considering the cervical range of motion (CROM) as a reference, one-dimensional and three-dimensional (1D and 3D) head postures of 12 normal subjects (28-58 years of age; 6 women and 6 men) were obtained using the KHT. The KHT was validated by Pearson's correlation coefficient and intraclass correlation (ICC) coefficient. Test-retest reliability of the KHT was determined by its 95% limit of agreement (LoA) with the Bland-Altman plot. Face recognition success rate was evaluated for each head posture. Measurements of 1D and 3D head posture performed using the KHT were very close to those of the CROM with correlation coefficients of 0.99 and 0.97 (p<0.05), respectively, as well as with an ICC of >0.99 and 0.98, respectively. The reliability tests of the KHT in terms of 1D and 3D head postures had 95% LoA angles of approximately ±2.5° and ±6.5°, respectively. The KHT showed good agreement with the CROM and relatively favourable test-retest reliability. Considering its high performance, convenience and low cost, KHT could be clinically used as a head posture-measuring system. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Head Trauma in Mixed Martial Arts.

    PubMed

    Hutchison, Michael G; Lawrence, David W; Cusimano, Michael D; Schweizer, Tom A

    2014-06-01

    Mixed martial arts (MMA) is a full combative sport with a recent global increase in popularity despite significant scrutiny from medical associations. To date, the empirical research of the risk of head injuries associated with this sport is limited. Youth and amateur participation is growing, warranting investigation into the burden and mechanism of injuries associated with this sport. (1) To determine the incidence, risk factors, and characteristics of knockouts (KOs) and technical knockouts (TKOs) from repetitive strikes in professional MMA; and (2) to identify the mechanisms of head trauma and the situational factors that lead to KOs and TKOs secondary to repetitive strikes through video analysis. Descriptive epidemiology study. Competition data and video records for all KOs and TKOs from numbered Ultimate Fighting Championship MMA events (n = 844) between 2006 to 2012. Analyses included (1) multivariate logistic regression to investigate factors associated with an increased risk of sustaining a KO or TKO secondary to repetitive strikes and (2) video analysis of all KOs and TKOs secondary to repetitive strikes with descriptive statistics. During the study period, the KO rate was 6.4 per 100 athlete-exposures (AEs) (12.7% of matches), and the rate of TKOs secondary to repetitive strikes was 9.5 per 100 AEs (19.1% of matches), for a combined incidence of match-ending head trauma of 15.9 per 100 AEs (31.9% of matches). Logistic regression identified that weight class, earlier time in a round, earlier round in a match, and older age were risk factors for both KOs and TKOs secondary to repetitive strikes. Match significance and previously sustained KOs or TKOs were also risk factors for KOs. Video analysis identified that all KOs were the result of direct impact to the head, most frequently a strike to the mandibular region (53.9%). The average time between the KO-strike and match stoppage was 3.5 seconds (range, 0-20 seconds), with losers sustaining an average of 2

  20. Postural Control Characteristics during Single Leg Standing of Individuals with a History of Ankle Sprain: Measurements Obtained Using a Gravicorder and Head and Foot Accelerometry.

    PubMed

    Abe, Yota; Sugaya, Tomoaki; Sakamoto, Masaaki

    2014-03-01

    [Purpose] This study aimed to validate the postural control characteristics of individuals with a history of ankle sprain during single leg standing by using a gravicorder and head and foot accelerometry. [Subjects] Twenty subjects with and 23 subjects without a history of ankle sprain (sprain and control groups, respectively) participated. [Methods] The anteroposterior, mediolateral, and total path lengths, as well as root mean square (RMS) of each length, were calculated using the gravicorder. The anteroposterior, mediolateral, and resultant acceleration of the head and foot were measured using accelerometers and were evaluated as the ratio of the acceleration of the head to the foot. [Results] There was no significant difference between the two groups in path length or RMS acceleration of the head and foot. However, the ratios of the mediolateral and resultant components were significantly higher in the sprain group than in the control group. [Conclusion] Our findings suggest that individuals with a history of ankle sprain have a higher head-to-foot acceleration ratio and different postural control characteristics than those of control subjects.

  1. Palliative surgery for head and neck cancer with extensive skin involvement.

    PubMed

    Jang, David W; Teng, Marita S; Ojo, Bukola; Genden, Eric M

    2013-05-01

    To evaluate the role of regional and free tissue transfer for the palliative management of head and neck cancer with extensive skin involvement. Case Series. A retrospective review was performed of patients treated for head and neck cancer with involvement of the skin at the Mount Sinai Medical Center over a 5-year period (2006-2010). Only patients with extensive skin involvement and unresectable tumors who underwent palliative resection and reconstruction were included in the review. Subjects were analyzed for age, gender, performance status, primary site, tumor histology, extent of invasion, type of reconstruction, hospital course, wound complications, adjuvant therapy, survival, and cause of death. Twenty-five patients met the inclusion criteria for the review. Fourteen patients (56%) underwent regional flap reconstruction, and 11 patients (44%) underwent free flap reconstruction. The average length of stay was 7 days. Twenty-four patients (96%) had a medically uncomplicated postoperative hospital course. Nineteen patients (76%) were treated with adjuvant palliative radiotherapy and/or chemotherapy. Long-term follow-up was achieved for 19 patients. The median follow up in this group was 9.5 months. Eleven of the 21 patients (52%) developed wound complications postoperatively. Eight of these were minor wound dehiscences, while three developed major wound complications. Four patients (16%) had distant metastasis at the time of surgery, and the median time to develop distant metastases after surgery was 6 months. Median survival time was 9.5 months. Twenty-two patients (88%) were discharged in the care of their families with appropriate pain management and without the need for extensive wound care. For unresectable tumors with extensive skin involvement, palliative resection and reconstruction is a reasonable treatment option. Although survival may not be affected, addressing the odor, bleeding, pain, and infection associated with skin involvement has the potential

  2. Surgical errors and risks – the head and neck cancer patient

    PubMed Central

    Harréus, Ulrich

    2013-01-01

    Head and neck surgery is one of the basic principles of head and neck cancer therapy. Surgical errors and malpractice can have fatal consequences for the treated patients. It can lead to functional impairment and has impact in future chances for disease related survival. There are many risks for head and neck surgeons that can cause errors and malpractice. To avoid surgical mistakes, thorough preoperative management of patients is mandatory. As there are ensuring operability, cautious evaluation of preoperative diagnostics and operative planning. Moreover knowledge of anatomical structures of the head and neck, of the medical studies and data as well as qualification in modern surgical techniques and the surgeons ability for critical self assessment are basic and important prerequisites for head and neck surgeons in order to make out risks and to prevent from mistakes. Additionally it is important to have profound knowledge in nutrition management of cancer patients, wound healing and to realize and to be able to deal with complications, when they occur. Despite all precaution and surgical care, errors and mistakes cannot always be avoided. For that it is important to be able to deal with mistakes and to establish an appropriate and clear communication and management for such events. The manuscript comments on recognition and prevention of risks and mistakes in the preoperative, operative and postoperative phase of head and neck cancer surgery. PMID:24403972

  3. A dictionary learning approach for human sperm heads classification.

    PubMed

    Shaker, Fariba; Monadjemi, S Amirhassan; Alirezaie, Javad; Naghsh-Nilchi, Ahmad Reza

    2017-12-01

    To diagnose infertility in men, semen analysis is conducted in which sperm morphology is one of the factors that are evaluated. Since manual assessment of sperm morphology is time-consuming and subjective, automatic classification methods are being developed. Automatic classification of sperm heads is a complicated task due to the intra-class differences and inter-class similarities of class objects. In this research, a Dictionary Learning (DL) technique is utilized to construct a dictionary of sperm head shapes. This dictionary is used to classify the sperm heads into four different classes. Square patches are extracted from the sperm head images. Columnized patches from each class of sperm are used to learn class-specific dictionaries. The patches from a test image are reconstructed using each class-specific dictionary and the overall reconstruction error for each class is used to select the best matching class. Average accuracy, precision, recall, and F-score are used to evaluate the classification method. The method is evaluated using two publicly available datasets of human sperm head shapes. The proposed DL based method achieved an average accuracy of 92.2% on the HuSHeM dataset, and an average recall of 62% on the SCIAN-MorphoSpermGS dataset. The results show a significant improvement compared to a previously published shape-feature-based method. We have achieved high-performance results. In addition, our proposed approach offers a more balanced classifier in which all four classes are recognized with high precision and recall. In this paper, we use a Dictionary Learning approach in classifying human sperm heads. It is shown that the Dictionary Learning method is far more effective in classifying human sperm heads than classifiers using shape-based features. Also, a dataset of human sperm head shapes is introduced to facilitate future research. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Potential of combining iterative reconstruction with noise efficient detector design: aggressive dose reduction in head CT

    PubMed Central

    Bender, B; Schabel, C; Fenchel, M; Ernemann, U; Korn, A

    2015-01-01

    Objective: With further increase of CT numbers and their dominant contribution to medical exposure, there is a recent quest for more effective dose control. While reintroduction of iterative reconstruction (IR) has proved its potential in many applications, a novel focus is placed on more noise efficient detectors. Our purpose was to assess the potential of IR in combination with an integrated circuit detector (ICD) for aggressive dose reduction in head CT. Methods: Non-contrast low-dose head CT [190 mAs; weighted volume CT dose index (CTDIvol), 33.2 mGy] was performed in 50 consecutive patients, using a new noise efficient detector and IR. Images were assessed in terms of quantitative and qualitative image quality and compared with standard dose acquisitions (320 mAs; CTDIvol, 59.7 mGy) using a conventional detector and filtered back projection. Results: By combining ICD and IR in low-dose examinations, the signal to noise was improved by about 13% above the baseline level in the standard-dose control group. Both, contrast-to-noise ratio (2.02 ± 0.6 vs 1.88 ± 0.4; p = 0.18) and objective measurements of image sharpness (695 ± 84 vs 705 ± 151 change in Hounsfield units per pixel; p = 0.79) were fully preserved in the low-dose group. Likewise, there was no significant difference in the grading of several subjective image quality parameters when both noise-reducing strategies were used in low-dose examinations. Conclusion: Combination of noise efficient detector with IR allows for meaningful dose reduction in head CT without compromise of standard image quality. Advances in knowledge: Our study demonstrates the feasibility of almost 50% dose reduction in head CT dose (1.1 mSv per scan) through combination of novel dose-reducing strategies. PMID:25827204

  5. Predicting variation in subject thermal response during transcranial magnetic resonance guided focused ultrasound surgery: Comparison in seventeen subject datasets.

    PubMed

    Vyas, Urvi; Ghanouni, Pejman; Halpern, Casey H; Elias, Jeff; Pauly, Kim Butts

    2016-09-01

    In transcranial magnetic resonance-guided focused ultrasound (tcMRgFUS) treatments, the acoustic and spatial heterogeneity of the skull cause reflection, absorption, and scattering of the acoustic beams. These effects depend on skull-specific parameters and can lead to patient-specific thermal responses to the same transducer power. In this work, the authors develop a simulation tool to help predict these different experimental responses using 3D heterogeneous tissue models based on the subject CT images. The authors then validate and compare the predicted skull efficiencies to an experimental metric based on the subject thermal responses during tcMRgFUS treatments in a dataset of seventeen human subjects. Seventeen human head CT scans were used to create tissue acoustic models, simulating the effects of reflection, absorption, and scattering of the acoustic beam as it propagates through a heterogeneous skull. The hybrid angular spectrum technique was used to model the acoustic beam propagation of the InSightec ExAblate 4000 head transducer for each subject, yielding maps of the specific absorption rate (SAR). The simulation assumed the transducer was geometrically focused to the thalamus of each subject, and the focal SAR at the target was used as a measure of the simulated skull efficiency. Experimental skull efficiency for each subject was calculated using the thermal temperature maps from the tcMRgFUS treatments. Axial temperature images (with no artifacts) were reconstructed with a single baseline, corrected using a referenceless algorithm. The experimental skull efficiency was calculated by dividing the reconstructed temperature rise 8.8 s after sonication by the applied acoustic power. The simulated skull efficiency using individual-specific heterogeneous models predicts well (R(2) = 0.84) the experimental energy efficiency. This paper presents a simulation model to predict the variation in thermal responses measured in clinical ctMRGFYS treatments while

  6. Predicting variation in subject thermal response during transcranial magnetic resonance guided focused ultrasound surgery: Comparison in seventeen subject datasets

    PubMed Central

    Vyas, Urvi; Ghanouni, Pejman; Halpern, Casey H.; Elias, Jeff; Pauly, Kim Butts

    2016-01-01

    Purpose: In transcranial magnetic resonance-guided focused ultrasound (tcMRgFUS) treatments, the acoustic and spatial heterogeneity of the skull cause reflection, absorption, and scattering of the acoustic beams. These effects depend on skull-specific parameters and can lead to patient-specific thermal responses to the same transducer power. In this work, the authors develop a simulation tool to help predict these different experimental responses using 3D heterogeneous tissue models based on the subject CT images. The authors then validate and compare the predicted skull efficiencies to an experimental metric based on the subject thermal responses during tcMRgFUS treatments in a dataset of seventeen human subjects. Methods: Seventeen human head CT scans were used to create tissue acoustic models, simulating the effects of reflection, absorption, and scattering of the acoustic beam as it propagates through a heterogeneous skull. The hybrid angular spectrum technique was used to model the acoustic beam propagation of the InSightec ExAblate 4000 head transducer for each subject, yielding maps of the specific absorption rate (SAR). The simulation assumed the transducer was geometrically focused to the thalamus of each subject, and the focal SAR at the target was used as a measure of the simulated skull efficiency. Experimental skull efficiency for each subject was calculated using the thermal temperature maps from the tcMRgFUS treatments. Axial temperature images (with no artifacts) were reconstructed with a single baseline, corrected using a referenceless algorithm. The experimental skull efficiency was calculated by dividing the reconstructed temperature rise 8.8 s after sonication by the applied acoustic power. Results: The simulated skull efficiency using individual-specific heterogeneous models predicts well (R2 = 0.84) the experimental energy efficiency. Conclusions: This paper presents a simulation model to predict the variation in thermal responses measured in

  7. Experimentally gained insight - based proposal apropos the treatment of osteonecrosis of the femoral head.

    PubMed

    Boss, J H; Misselevich, I; Bejar, J; Norman, D; Zinman, C; Reis, D N

    2004-01-01

    An impeded blood flow through the femoral head is incriminated in the etiopathogenesis of osteonecrosis of the femoral head. The disorder is either primary (idiopathic avascular osteonecrosis) or secondary to one condition or another, say, corticosteroid medication, fracture of the neck, coagulation defects, physical or thermal damage, storage disorders, alcoholism, and infectious, autoimmune as also marrow infiltrating diseases. In the wake of the necrosis, several mediators are released in increased amounts, prime among which is the vascular endothelial growth factor. The intermediates recruit endothelial progenitor cells, macrophages, osteoclasts, fibroblasts, and osteoblasts, which, pervading throughout the necrotic areas, initiate the reparative processes. The dead, soft and hard tissular debris is substituted by fibrous - later on by hematopoietic-fatty tissue - and bone. The newly formed, appositional and intramembranous bone is deficient in its mechanical properties. The ordinary load-carrying functions suffice to deform these weakened femoral heads so that osteoarthritic changes develop. Considering contemporary assumptions of the causes of osteonecrosis, oxygenation, revascularization, and core decompression are the realistic therapeutic interventions. Necrosis of rats' femoral heads is studied as a model of osteonecrosis in both adults and children. In view of rodents' lifelong persisting physeal cartilage, vascular deprivation-induced osteonecrosis in rats mimics children's Perthes disease. The experimental model, which is well suited to test treatment modalities, has been used to investigate the effects of exposure to hyperbaric oxygen with and without non-weight bearing, medication of enoxaparin, and creation of an intraosseous conduit on the remodeling of the avascular necrotic femoral head. Intriguingly, the shape of treated rats' femoral heads is disfigured to a greater degree than that of untreated animals. This is most likely due to the reduced

  8. Clinical predictors of quality of life in patients with head and neck cancer.

    PubMed

    Terrell, Jeffrey E; Ronis, David L; Fowler, Karen E; Bradford, Carol R; Chepeha, Douglas B; Prince, Mark E; Teknos, Theodoros N; Wolf, Gregory T; Duffy, Sonia A

    2004-04-01

    To identify clinical predictors of quality of life (QoL) in a head and neck cancer patient population. A convenience sample of 570 patients with upper aerodigestive tract cancers were surveyed at a tertiary care oncology clinic and Veterans Affairs otolaryngology clinic. A self-administered health survey was constructed to collect demographic, health, smoking, alcohol, depression symptom, and QoL information. Tumor site and tumor stage, clinical, and treatment data were abstracted from the patient medical records. Quality of life was assessed using the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36) and the Head and Neck QoL (HNQoL) instrument. Of the 570 eligible respondents, the presence of a feeding tube had the most negative impact on QoL, with significant decrements in 6 of the 8 SF-36 scales and all 4 HNQoL scales (P<.01). In descending order of severity, medical comorbid conditions, presence of a tracheotomy tube, chemotherapy, and neck dissection were also associated with significant (P<.05) decrements in QoL domains. Patients who took the survey more than 1 year after diagnosis had improved QoL in 7 of 12 domains. Hospital site, age, education level, sex, race, and marital status were also significant predictors of QoL. There are at least 13 demographic and clinical characteristics that are significant predictors of QoL in patients with head and neck cancer, which should be considered when treating patients and conducting QoL studies in the future.

  9. Sources of Information on Medical Geography

    PubMed Central

    Mullins, Lynn S.

    1966-01-01

    Adequate research in the peripheral field of medical geography requires familiarity with the literature of medicine, geography, and other environmentally oriented fields. The pertinent literature of the two primary disciplines, as well as that of anthropology, nutrition, and human bioclimatology, is surveyed from a bibliographical point of view. A brief review of historical sources is presented, followed by a discussion of the contemporary organizations, both international and national, active in the field. Emphasis is placed on the publishing programs and projects, maps, atlases, symposia, reports, and other literature sponsored or stimulated by these organizations. Regional bibliographical surveys for East Africa, India, and the Soviet Union are also noted. Pertinent aspects of bibliographies, indexes, abstracts, library card catalogs and accession lists, and other resources are listed, with emphasis on the various subject headings and other approaches to them. Throughout, the sources of information are approached from a multidisciplinary and interdisciplinary viewpoint. PMID:5329543

  10. Prevalence of Head Lice Infestation and Its Associated Factors among Primary School Students in Iran: A Systematic Review and Meta-analysis.

    PubMed

    Moosazadeh, Mahmood; Afshari, Mahdi; Keianian, Hormoz; Nezammahalleh, Asghar; Enayati, Ahmad Ali

    2015-12-01

    Head lice infestation is one of the most important health problems, generally involving children aged 5-13 years. This study aims to estimate the prevalence of head lice infestation and its associated factors among primary school children using systematic review and meta-analysis methods. Different national and international databases were searched for selecting the relevant studies using appropriate keywords, Medical Subject Heading terms, and references. Relevant studies with acceptable quality for meta-analysis were selected having excluded duplicate and irrelevant articles, quality assessment, and application of inclusion/exclusion criteria. With calculating standard errors according to binomial distribution and also considering the Cochrane's Q test as well as I-squared index for heterogeneity, pediculosis prevalence rate was estimated using Stata SE V.11 software. Forty studies met the inclusion criteria of this review and entered into the meta-analysis including 200,306 individuals. Using a random effect model, the prevalence (95% confidence interval) of head lice infestation among primary school children was estimated as 1.6% (1.2-2.05), 8.8% (7.6-9.9), and 7.4% (6.6-8.2) for boys, girls, and all the students, respectively. The infestation rate was found to be associated with low educational level of parents, long hair, family size, mother's job (housewife), father's job (worker/unemployed), using a common comb, lack of bathrooms in the house, and a low frequency of bathing. This meta-analysis revealed that the prevalence of head lice infestation among Iranian primary school children is relatively high with more prevalence among girls. We also found that economic, social, cultural, behavioral, and hygienic factors are associated with this infestation.

  11. Effects of subconcussive head trauma on the default mode network of the brain.

    PubMed

    Johnson, Brian; Neuberger, Thomas; Gay, Michael; Hallett, Mark; Slobounov, Semyon

    2014-12-01

    Although they are less severe than a full blown concussive episodes, subconcussive impacts happen much more frequently and current research has suggested this form of head trauma may have an accumulative effect and lead to neurological impairment later in life. To investigate the acute effects that subconcussive head trauma may have on the default mode network of the brain resting-state, functional magnetic resonance was performed. Twenty-four current collegiate rugby players were recruited and all subjects underwent initial scanning 24 h prior to a scheduled full contact game to provide a baseline. Follow-up scanning of the rugby players occurred within 24 h following that game to assess acute effects from subconcussive head trauma. Differences between pre-game and post-game scans showed both increased connectivity from the left supramarginal gyrus to bilateral orbitofrontal cortex and decreased connectivity from the retrosplenial cortex and dorsal posterior cingulate cortex. To assess whether or not a history of previous concussion may lead to a differential response following subconcussive impacts, subjects were further divided into two subgroups based upon history of previous concussion. Individuals with a prior history of concussion exhibited only decreased functional connectivity following exposure to subconcussive head trauma, while those with no history showed increased connectivity. Even acute exposure to subconcussive head trauma demonstrates the ability to alter functional connectivity and there is possible evidence of a differential response in the brain for those with and without a history of concussion.

  12. ADHD and growth: anthropometric changes in medicated and non-medicated ADHD boys.

    PubMed

    Ptacek, Radek; Kuzelova, Hana; Paclt, Ivo; Zukov, Ilja; Fischer, Slavomil

    2009-12-01

    ADHD children can show changes in growth and development. Many studies describe these changes as a side effect of stimulant medication. However, changes in somatic development can also appear in non-medicated children. This suggests that the changes could be a manifestation of the disorder itself and not just a side effect of the treatment. This study compared anthropometric characteristics in medicated and non-medicated ADHD boys (n=104, age 4-16 years) with the normal non-clinical population. In contrast to most previous studies, complex anthropometrical measurements were used. The results showed significant differences between children with ADHD and those without the diagnosis, the differences found to be statistically significant (p<0.01) being signs of nutrition (percentage of fat, abdominal circumference) and growth suppression (lower body height, smaller head circumference). Differences between the medicated and non-medicated groups corresponded only to a lower value of body fat in the medicated children. These results suggest that growth changes in ADHD children may be more specific to the disorder itself than to stimulant treatment.

  13. Comparison of optic area measurement using fundus photography and optical coherence tomography between optic nerve head drusen and control subjects.

    PubMed

    Flores-Rodríguez, Patricia; Gili, Pablo; Martín-Ríos, María Dolores; Grifol-Clar, Eulalia

    2013-03-01

    To compare optic disc area measurement between optic nerve head drusen (ONHD) and control subjects using fundus photography, time-domain optical coherence tomography (TD-OCT) and spectral-domain optical coherence tomography (SD-OCT). We also made a comparison between each of the three techniques. We performed our study on 66 eyes (66 patients) with ONHD and 70 healthy control subjects (70 controls) with colour ocular fundus photography at 20º (Zeiss FF 450 IR plus), TD-OCT (Stratus OCT) with the Fast Optic Disc protocol and SD-OCT (Cirrus OCT) with the Optic Disc Cube 200 × 200 protocol for measurement of the optic disc area. The measurements were made by two observers and in each measurement a correction of the image magnification factor was performed. Measurement comparison using the Student's t-test/Mann-Whitney U test, the intraclass correlation coefficient, Pearson/Spearman rank correlation coefficient and the Bland-Altman plot was performed in the statistical analysis. Mean and standard deviation (SD) of the optic disc area in ONHD and in controls was 2.38 (0.54) mm(2) and 2.54 (0.42) mm(2), respectively with fundus photography; 2.01 (0.56) mm(2) and 1.66 (0.37) mm(2), respectively with TD-OCT, and 2.03 (0.49) mm(2) and 1.75 (0.38) mm(2), respectively with SD-OCT. In ONHD and controls, repeatability of optic disc area measurement was excellent with fundus photography and optical coherence tomography (TD-OCT and SD-OCT), but with a low degree of agreement between both techniques. Optic disc area measurement is smaller in ONHD compared to healthy subjects with fundus photography, unlike time-domain and spectral-domain optical coherence tomography in which the reverse is true. Both techniques offer good repeatability, but a low degree of correlation and agreement, which means that optic disc area measurement is not interchangeable or comparable between techniques. Ophthalmic & Physiological Optics © 2013 The College of Optometrists.

  14. Prescriptions for medical research. I--Management within the Medical Research Council.

    PubMed Central

    Gillett, R; Harrow, J

    1993-01-01

    In their submission to the government in advance of the white paper on science policy in the United Kingdom the Medical Research Council commends the MRC's own approach to managing directly funded research. But a series of semi-structured interviews with the directors of some of the MRC's units suggests a gap between the MRC's model of managed research and the reality. Although such units are theoretically managed from MRC head office (and units are charged an overhead for this), in practice each unit runs its own affairs. Between major reviews average contact time with the head office contact person is seven hours a year. The first paper argues that a purchaser-provider split would recognise the benefits of decentralisation and allow units to bid for research funds from several sources, the successful ones guaranteeing their survival through a rolling series of research programmes. The second paper criticises the MRC's cumbersome peer review system. Reliance on outside experts atrophies the scientific skills of head office staff and builds delays into decision making. A purchaser-provider model would allow the head office scientific staff to act like commercial research and development managers, commissioning research, and using the outcome, rather than peer review, as a criterion for continued funding. PMID:8324441

  15. Bottom head assembly

    DOEpatents

    Fife, A.B.

    1998-09-01

    A bottom head dome assembly is described which includes, in one embodiment, a bottom head dome and a liner configured to be positioned proximate the bottom head dome. The bottom head dome has a plurality of openings extending there through. The liner also has a plurality of openings extending there through, and each liner opening aligns with a respective bottom head dome opening. A seal is formed, such as by welding, between the liner and the bottom head dome to resist entry of water between the liner and the bottom head dome at the edge of the liner. In the one embodiment, a plurality of stub tubes are secured to the liner. Each stub tube has a bore extending there through, and each stub tube bore is coaxially aligned with a respective liner opening. A seat portion is formed by each liner opening for receiving a portion of the respective stub tube. The assembly also includes a plurality of support shims positioned between the bottom head dome and the liner for supporting the liner. In one embodiment, each support shim includes a support stub having a bore there through, and each support stub bore aligns with a respective bottom head dome opening. 2 figs.

  16. Reflection as a Learning Tool in Graduate Medical Education: A Systematic Review.

    PubMed

    Winkel, Abigail Ford; Yingling, Sandra; Jones, Aubrie-Ann; Nicholson, Joey

    2017-08-01

    Graduate medical education programs employ reflection to advance a range of outcomes for physicians in training. However, the most effective applications of this tool have not been fully explored. A systematic review of the literature examined interventions reporting the use of reflection in graduate medical education. The authors searched Medline/PubMed, Embase, Cochrane CENTRAL, and ERIC for studies of reflection as a teaching tool to develop medical trainees' capacities. Key words and subject headings included reflection , narrative , residents/GME , and education / teaching / learning . No language or date limits were applied. The search yielded 1308 citations between inception for each database and June 15, 2015. A total of 16 studies, encompassing 477 residents and fellows, met eligibility criteria. Study quality was assessed using the Critical Appraisal Skills Programme Qualitative Checklist. The authors conducted a thematic analysis of the 16 articles. Outcomes studied encompassed the impact of reflection on empathy, comfort with learning in complex situations, and engagement in the learning process. Reflection increased learning of complex subjects and deepened professional values. It appears to be an effective tool for improving attitudes and comfort when exploring difficult material. Limitations include that most studies had small samples, used volunteers, and did not measure behavioral outcomes. Critical reflection is a tool that can amplify learning in residents and fellows. Added research is needed to understand how reflection can influence growth in professional capacities and patient-level outcomes in ways that can be measured.

  17. African-American and white head and neck carcinoma patients in a university medical center setting. Are treatments provided and are outcomes similar or disparate?

    PubMed

    Murdock, J M; Gluckman, J L

    2001-01-01

    Racial and ethnic disparities occur in many areas of the health care management system in the United States. These disparities include disease incidence, access to health and medical services, treatments provided, and disease outcomes. Health care delivery organizations have limited resources. Encounters between patients and providers in health care delivery organizations typically are cross-cultural. Access to care, quality of care, and equity may be affected by limited resources and cross-cultural encounters. This impacts the diagnosis, treatments provided, and outcomes, with African-American patients faring poorly compared with white patients. African Americans are 15% more likely to develop cancer than whites and are about 34% more likely to die of cancer than whites in the United States. The purpose of this study was to determine and compare the characteristics of African-American patients and white patients with carcinoma of the head and neck at the University of Cincinnati Medical Center, an equal-access facility, reporting similarities and disparities in disease stage at the time of diagnosis, treatment received, and patient outcomes. Copyright 2001 American Cancer Society.

  18. Comparison of Video Head Impulse Test (vHIT) Gains Between Two Commercially Available Devices and by Different Gain Analytical Methods.

    PubMed

    Lee, Sang Hun; Yoo, Myung Hoon; Park, Jun Woo; Kang, Byung Chul; Yang, Chan Joo; Kang, Woo Suk; Ahn, Joong Ho; Chung, Jong Woo; Park, Hong Ju

    2018-06-01

    To evaluate whether video head impulse test (vHIT) gains are dependent on the measuring device and method of analysis. Prospective study. vHIT was performed in 25 healthy subjects using two devices simultaneously. vHIT gains were compared between these instruments and using five different methods of comparing position and velocity gains during head movement intervals. The two devices produced different vHIT gain results with the same method of analysis. There were also significant differences in the vHIT gains measured using different analytical methods. The gain analytic method that compares the areas under the velocity curve (AUC) of the head and eye movements during head movements showed lower vHIT gains than a method that compared the peak velocities of the head and eye movements. The former method produced the vHIT gain with the smallest standard deviation among the five procedures tested in this study. vHIT gains differ in normal subjects depending on the device and method of analysis used, suggesting that it is advisable for each device to have its own normal values. Gain calculations that compare the AUC of the head and eye movements during the head movements show the smallest variance.

  19. Effectiveness and duration of intramuscular antimotion sickness medications

    NASA Technical Reports Server (NTRS)

    Wood, C. D.; Stewart, J. J.; Wood, M. J.; Mims, M.

    1992-01-01

    Motion sickness inhibits gastric motility, making the oral route ineffective for medications. The intramuscular route is an effective alternative. The rotating chair was used to produce the M 111 level of motion sickness on the Graybiel Symptom Scale. The intramuscular medications given 30 minutes before rotation were compared with placebo (saline, 1 mL) for effectiveness and duration in increasing the number of tolerated head movements. Average placebo number of head movements was 294. Promethazine 25 mg increased head movements by 78% (P < .05), with a duration of 12 hours. Scopolamine 0.2 mg increased head movements by 91% (P < .05), with a duration of 4 hours. The effect of caffeine 250 mg and ephedrine 25 mg was not significant. When combined with scopolamine, ephedrine produced an 32% additive effect. Scopolamine 0.08 mg, 0.1 mg, and 0.2 mg and also promethazine 12.5 mg and 25 mg were significant (P < .05). Promethazine appears to be the drug of choice for intramuscular use because of a longer duration and a high level of effectiveness. Scopolamine was of high effectiveness, but had a duration of 4 hours. It was eight times as potent by the intramuscular as by the oral route.

  20. Use of bed rest and head-down tilt to simulate spaceflight-induce immune system changes

    NASA Technical Reports Server (NTRS)

    Schmitt, D. A.; Schaffar, L.; Taylor, G. R.; Loftin, K. C.; Schneider, V. S.; Koebel, A.; Abbal, M.; Sonnenfeld, G.; Lewis, D. E.; Reuben, J. R.; hide

    1996-01-01

    Bed rest, both with and without head-down tilt, has been extensively used as an earth-bound analog to study physiologic effects mimicking those occurring in weightlessness during spaceflight. We have been able to show in six subjects that 4 weeks of head-down tilt bed rest induces a significant decrease in interleukin-2 secretion by PHA-stimulated T lymphocytes. Another study, lasting 113 days, with two subjects showed a decreased interleukin-2 receptor expression in PHA-stimulated peripheral blood mononuclear cells but a decreased interleukin-2 production in one subject only. Under the same conditions, interleukin-1 production was largely increased in both subjects. Several other immune parameters were also analyzed. Increased interleukin-1 production could contribute to bone mineral loss encountered during bed rest and decreased interleukin-2 secretion could play a role in the appearance of infectious diseases often observed during bed red.

  1. A Novel In Vivo Protocol for Molecular Study of Radiation-Induced Fibrosis in Head and Neck Cancer Patients.

    PubMed

    Krisciunas, Gintas P; Platt, Michael; Trojanowska, Maria; Grillone, Gregory A; Haines, Paul C; Langmore, Susan E

    2016-03-01

    Radiation-induced fibrosis is a common complication for patients following head and neck cancer treatment. This study presents a novel minimally invasive protocol for molecular study of fibrosis in the stromal tissues. Subjects with radiation-induced fibrosis in the head and neck who were at least 6 months post treatment received submental core needle biopsies, followed by molecular processing and quantification of gene expression for 14 select pro-inflammatory and pro-fibrotic genes. Control biopsies from the upper arm were obtained from the same subjects. Patients were followed up at 1 and 2 weeks to monitor for safety and adverse outcomes. Six subjects were enrolled and completed the study. No subjects experienced adverse outcomes or complication. An 18 gauge core biopsy needle with a 10 mm notch inserted for up to 60 seconds was needed. Subcutaneous tissue yielded 3 ng of RNA, amplified to 6 µg of cDNA, allowing for adequately sensitive quantitative polymerase chain reaction (qPCR) analysis of approximately 28 genes. This study demonstrates the safety and utility of a novel technique for the molecular study of fibrosis in head and neck cancer patients. Longitudinal studies of patients undergoing radiation therapy will allow for identification of molecular targets that contribute to the process of fibrosis in the head and neck. © The Author(s) 2015.

  2. Will New Metal Heads Restore Mechanical Integrity of Corroded Trunnions?

    PubMed

    Derasari, Aditya; Gold, Jonathan E; Ismaily, Sabir; Noble, Philip C; Incavo, Stephen J

    2017-04-01

    Metal wear and corrosion from modular junctions in total hip arthroplasty can lead to further unwanted surgery. Trunnion tribocorrosion is recognized as an important contributor to failure. This study was performed to determine if new metal heads restore mechanical integrity of the original modular junction after impaction on corroded trunnions, and assess which variables affect stability of the new interface created at revision total hip arthroplasty. Twenty-two trunnions, cobalt-chromium (CoCr) and titanium alloy (TiAIV), (CoCr, n = 12; TiAIV, n = 10) and new metal heads were used, 10 trunnions in pristine condition and 12 with corrosion damage. Test states were performed using an MTS Machine and included the following: 1, Assembly; 2, Disassembly; 3, Assembly; 4, Toggling; and 5, Disassembly. During loading, three-dimensional motion of the head-trunnion junction was measured using a custom jig. There were no statistical differences in the tested mechanical properties between corroded and pristine trunnions implanted with a new metal femoral head. Average micromotion of the head versus trunnion interface was greatest at the start of loading, stabilizing after approximately 50 loading cycles at an average of 30.6 ± 3.2 μm. Corrosion at the trunnion does not disrupt mechanical integrity of the junction when a CoCr head is replaced with a CoCr trunnion. However, increased interface motion of a new metal head on a corroded titanium trunnion requires additional study. The evaluation of ball head size on mechanical integrity of trunnions would also be a potential subject of future investigation, as increasing the ball head size at the time of revision is not uncommon in revisions today. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. The Implementation of Medical Informatics in the National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM).

    PubMed

    Behrends, Marianne; Steffens, Sandra; Marschollek, Michael

    2017-01-01

    The National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM) describes medical skills and attitudes without being ordered by subjects or organs. Thus, the NKLM enables systematic curriculum mapping and supports curricular transparency. In this paper we describe where learning objectives related to Medical Informatics (MI) in Hannover coincide with other subjects and where they are taught exclusively in MI. An instance of the web-based MERLIN-database was used for the mapping process. In total 52 learning objectives overlapping with 38 other subjects could be allocated to MI. No overlap exists for six learning objectives describing explicitly topics of information technology or data management for scientific research. Most of the overlap was found for learning objectives relating to documentation and aspects of data privacy. The identification of numerous shared learning objectives with other subjects does not mean that other subjects teach the same content as MI. Identifying common learning objectives rather opens up the possibility for teaching cooperations which could lead to an important exchange and hopefully an improvement in medical education. Mapping of a whole medical curriculum offers the opportunity to identify common ground between MI and other medical subjects. Furthermore, in regard to MI, the interaction with other medical subjects can strengthen its role in medical education.

  4. Subjective well-being and its association with peer caring and resilience among nursing vs medical students: A questionnaire study.

    PubMed

    Zhao, FangFang; Guo, Yujie; Suhonen, Riitta; Leino-Kilpi, Helena

    2016-02-01

    The subjective well-being (SWB) of nursing and medical students is a very important component in the training of future nurses and doctors, as well-being enables them to be more productive. The study examined the effects of peer caring and resilience on SWB as well as the mediating and moderating effects of resilience in the relationship between peer caring and SWB. A cross-sectional survey design was used. A university and an affiliated hospital in China. The convenience sample consisted of 426 nursing students and 336 medical students. Questionnaires comprising peer caring measurement, a resilience scale and a well-being scale were used in the spring of 2014. Students participate in the study showed low SWB. There was a significant difference between nursing students and medical students in peer caring, but not in SWB and resilience. The mediating effects of resilience on the relationship between peer caring and SWB were examined. As hypothesized, resilience mediated the relationship between peer caring and SWB partly for nursing students (SE=0.022, 95% CI=0.041-0.128) and fully for medical students (SE=0.023, 95% CI=0.067-0.161). Resilience did not statistically significantly moderate the peer caring-SWB relationship for nursing students (β=0.092, p=0.057) but did so for medical students (β=0.108, p<0.05). Peer caring and resilience improved the SWB of both nursing students and medical students. In addition, resilience improved SWB through peer caring for both nursing students and medical students, and higher resilience in medical students enhanced the positive effects of peer caring on SWB. Therefore, educators should promote peer caring and resilience in order to improve students' SWB. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Use of head circumference as a predictor of height of individual.

    PubMed

    Mansur, D I; Haque, M K; Sharma, K; Mehta, D K; Shakya, R

    2014-01-01

    Establishing personal identity is one of the main concerns in forensic investigations. In forensic anthropology, estimation of height from head circumference has a significant role in establishing personal identity. The objective of the present study was an attempt to understand the relationship between height and head circumference of an individual and to derive regression formulae to estimate the height from the head circumference. The present study consisted of 440 (258 male and 182 female) students of age group 17 to 25 years studying in Kathmandu University School of Medical Sciences, Dhulikhel, Nepal during the period from November 2012 to October 2013. Height and head circumference of an individual were measured in centimeter. Data were analyzed by using statistical software SPSS-16. The findings of the present study were significant correlation between height and head circumference (r = 0.443, p < 0.01 for male, r = 0.302, p<0.01 for female, and r = 0. 398, p < 0.01 for combined (male and female). The regression equation for height and head circumference was found to be Y = 1.734X + 70.36 (R2 = 0.196) for male, Y = 0.916X + 106.8 (R2 = 0.091) for female, and Y = 1.648 X + 71.69 (R2 = 0.158) for combined (male and female), where Y is the height of Individual and X is the Head Circumference. Head circumference showed highly significant positive correlation with individual's height. Therefore, the present study will help in medico-legal cases in establishing the identity of an individual and this would also be useful for Anatomists and Anthropologists.

  6. Head circumference and body growth in autism spectrum disorders.

    PubMed

    Fukumoto, Aya; Hashimoto, Toshiaki; Mori, Kenji; Tsuda, Yoshimi; Arisawa, Kokichi; Kagami, Shoji

    2011-08-01

    Research has shown that there is a relationship between increased head circumference and autism spectrum disorders (ASD). This study examined this relationship during the first year of life in subjects with ASD. We compared 280 children with ASD and 609 controls. In the ASD-male group, increases were observed in head circumference from 3 to 12months, in height from 3 to 9months, and in body weight from 3 to 6 and 12months. On the other hand, in the ASD-female group increases in head circumference, in body height, and in body weight were only observed at 3months. After adjusting for height, weight, and age, only the head circumference in the male ASD group was significantly increased from 6 to 9months after birth, reaching a peak at 6months after birth. No difference was found in the female ASD group. Although body overgrowth in the ASD group also started early after birth, the increase in head circumference was more marked than that in body growth. The values of physical measurements in the first year may be useful, minimally invasive parameters for the early detection of autism in combination with observing the timing of certain behaviors such as smiling, eye contact, crawling, pointing, and joint attention. Copyright © 2010 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  7. Efficacy of beta-blockade after isolated blunt head injury: does race matter?

    PubMed

    Bukur, Marko; Mohseni, Shahin; Mosheni, Shahin; Ley, Eric; Salim, Ali; Margulies, Daniel; Talving, Peep; Demetriades, Demetrios; Inaba, Kenji

    2012-04-01

    Several retrospective clinical studies and recent prospective animal models demonstrate improved outcomes with beta-blocker administration after isolated blunt head injury. However, no investigations to date have examined the influence of race on the potential therapeutic effectiveness of these medications. Our hypothesis was that mortality benefits associated with beta-blocker exposure after isolated blunt head injury varies based on ethnicity. The trauma registry and the surgical intensive care unit (ICU) databases of an academic Level I trauma center were used to identify all patients sustaining blunt head injury requiring ICU admission from July 1998 to December 2009. Patients sustaining major associated extracranial injuries (Abbreviated Injury Scale [AIS] score ≥ 3 in any body region) were excluded. Patient demographics, injury profile, Injury Severity Score, and beta-blocker exposure were abstracted. The primary outcome evaluated was in-hospital mortality stratified by ethnicity. During the 11-year study period, 3,750 patients were admitted to the Los Angeles County + University of Southern California Medical Center trauma ICU because of blunt trauma. Of these, 65% (n = 2,446) had an "isolated" head injury. When stratified by race, most patients were Hispanics (60%), followed by Whites (21%), Asians (11%), and African Americans (8%). After adjusting for confounding variables with multivariate regression, only those of Asian and Hispanic descent demonstrated significantly improved outcomes associated with beta-blocker administration. Our results indicate that beta-blockade after traumatic brain injury may not benefit all races equally. Further prospective research is necessary to assess this discrepancy in treatment benefit and explore other possible therapeutic interventions.

  8. Catastrophic head injuries in high school and college football players.

    PubMed

    Boden, Barry P; Tacchetti, Robin L; Cantu, Robert C; Knowles, Sarah B; Mueller, Frederick O

    2007-07-01

    playing with residual symptoms from a prior head injury. Coaches, athletes, athletic trainers, and medical personnel need to adhere to the guideline that an athlete with any neurologic symptoms from a head injury should be strongly discouraged from returning to play.

  9. [Ethics and laws related to human subject research].

    PubMed

    Chiu, Hui-Ju; Lee, Ya-Ling; Chang, Su-Fen

    2011-10-01

    Advances in medical technology rely on human subject research to test the effects on real patients of unproven new drugs, equipment and techniques. Illegal human subject research happens occasionally and has led to subject injury and medical disputes. Familiarity with the laws and established ethics related to human subject research can minimize both injury and disputes. History is a mirror that permits reflection today on past experience. Discussing the Nuremberg Code, the Declaration of Helsinki and Belmont Report, this article describes the laws, ethics, history and news related to human subject research as well as the current definition and characteristics of human subject research. Increasing numbers of nurses serve as research nurses and participate in human subject research. The authors hope this article can increase research nurse knowledge regarding laws and ethics in order to protect human research subjects adequately.

  10. Is a shift from research on individual medical error to research on health information technology underway? A 40-year analysis of publication trends in medical journals.

    PubMed

    Erlewein, Daniel; Bruni, Tommaso; Gadebusch Bondio, Mariacarla

    2018-06-07

    In 1983, McIntyre and Popper underscored the need for more openness in dealing with errors in medicine. Since then, much has been written on individual medical errors. Furthermore, at the beginning of the 21st century, researchers and medical practitioners increasingly approached individual medical errors through health information technology. Hence, the question arises whether the attention of biomedical researchers shifted from individual medical errors to health information technology. We ran a study to determine publication trends concerning individual medical errors and health information technology in medical journals over the last 40 years. We used the Medical Subject Headings (MeSH) taxonomy in the database MEDLINE. Each year, we analyzed the percentage of relevant publications to the total number of publications in MEDLINE. The trends identified were tested for statistical significance. Our analysis showed that the percentage of publications dealing with individual medical errors increased from 1976 until the beginning of the 21st century but began to drop in 2003. Both the upward and the downward trends were statistically significant (P < 0.001). A breakdown by country revealed that it was the weight of the US and British publications that determined the overall downward trend after 2003. On the other hand, the percentage of publications dealing with health information technology doubled between 2003 and 2015. The upward trend was statistically significant (P < 0.001). The identified trends suggest that the attention of biomedical researchers partially shifted from individual medical errors to health information technology in the USA and the UK. © 2018 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

  11. Experience of workplace violence during medical speciality training in Turkey.

    PubMed

    Acik, Yasemin; Deveci, S Erhan; Gunes, Gulsen; Gulbayrak, Canan; Dabak, Sennur; Saka, Gunay; Vural, Gulsen; Can, Gunay; Bilgin, Nursel Gamsiz; Dundar, Pinar Erbay; Erguder, Toker; Tokdemir, Mehmet

    2008-08-01

    To determine the type, extent and effects of workplace violence among residents during postgraduate speciality training in various departments of medical schools in Turkey. A cross-sectional survey was conducted in seven medical schools representing all geographical regions of Turkey. All physicians in speciality training in the selected medical schools were asked to complete a semi-structured 'violence questionnaire' addressing the type (emotional, physical and sexual) and extent of violence experienced, the perpetrators of the violence and the victim's reactions to the experience. A total of 1712 residents out of 2442 completed the questionnaire. In all, 68% indicated they had experienced some form of workplace violence, 67% had experienced verbal violence, 16% had experienced physical violence and 3% had experienced sexual violence. The victims' most prevalent reactions to violence included being deeply disturbed but feeling they had to cope with it for the sake of their career (39%), being distressed (26%) but considering that such events are common in all occupations and discounting it and being confused and bewildered and unsure how to respond (19%). The most frequently named perpetrators of verbal violence were relatives/friends of patients (36%) and academic staff (36%), followed by other residents/senior residents (21%), patients (20%), heads of department (13%) and non-medical hospital staff (6%). Physicians in speciality training in medical schools in Turkey are subject to significant verbal, physical or sexual violence. Precautions to prevent such exposure are urgently needed.

  12. Cognitive Functioning in Long Duration Head-down Bed Rest

    NASA Technical Reports Server (NTRS)

    Seaton, Kimberly A.; Slack, Kelley J.; Sipes, Walter A.; Bowie, Kendra

    2008-01-01

    The Space Flight Cognitive Assessment Tool for Windows (WinSCAT) is a self-administered battery of tests used on the International Space Station for evaluating cognitive functioning. Here, WinSCAT was used to assess cognitive functioning during extended head-down bed rest. Thirteen subjects who participated in 60 or 90 days of 6 deg head-down bed rest took WinSCAT during the pre-bed rest phase, the in-bed rest phase, and the post-bed rest (reconditioning) phase of study participation. After adjusting for individual baseline performance, 12 off-nominal scores were observed out of 351 total observations during bed rest and 7 of 180 during reconditioning. No evidence was found for systematic changes in off-nominal incidence as time in bed rest progressed, or during the reconditioning period. Cognitive functioning does not appear to be adversely affected by long duration head-down bed rest. Individual differences in underlying cognitive ability and motivation level are likely explanations for the current findings.

  13. Autism-Specific Primary Care Medical Home Intervention

    ERIC Educational Resources Information Center

    Golnik, Allison; Scal, Peter; Wey, Andrew; Gaillard, Philippe

    2012-01-01

    Forty-six subjects received primary medical care within an autism-specific medical home intervention (www.autismmedicalhome.com) and 157 controls received standard primary medical care. Subjects and controls had autism spectrum disorder diagnoses. Thirty-four subjects (74%) and 62 controls (40%) completed pre and post surveys. Controlling for…

  14. Three-dimensional head anthropometric analysis

    NASA Astrophysics Data System (ADS)

    Enciso, Reyes; Shaw, Alex M.; Neumann, Ulrich; Mah, James

    2003-05-01

    Currently, two-dimensional photographs are most commonly used to facilitate visualization, assessment and treatment of facial abnormalities in craniofacial care but are subject to errors because of perspective, projection, lack metric and 3-dimensional information. One can find in the literature a variety of methods to generate 3-dimensional facial images such as laser scans, stereo-photogrammetry, infrared imaging and even CT however each of these methods contain inherent limitations and as such no systems are in common clinical use. In this paper we will focus on development of indirect 3-dimensional landmark location and measurement of facial soft-tissue with light-based techniques. In this paper we will statistically evaluate and validate a current three-dimensional image-based face modeling technique using a plaster head model. We will also develop computer graphics tools for indirect anthropometric measurements in a three-dimensional head model (or polygonal mesh) including linear distances currently used in anthropometry. The measurements will be tested against a validated 3-dimensional digitizer (MicroScribe 3DX).

  15. Comparison of Predictable Smooth Ocular and Combined Eye-Head Tracking Behaviour in Patients with Lesions Affecting the Brainstem and Cerebellum

    NASA Technical Reports Server (NTRS)

    Grant, Michael P.; Leigh, R. John; Seidman, Scott H.; Riley, David E.; Hanna, Joseph P.

    1992-01-01

    We compared the ability of eight normal subjects and 15 patients with brainstem or cerebellar disease to follow a moving visual stimulus smoothly with either the eyes alone or with combined eye-head tracking. The visual stimulus was either a laser spot (horizontal and vertical planes) or a large rotating disc (torsional plane), which moved at one sinusoidal frequency for each subject. The visually enhanced Vestibulo-Ocular Reflex (VOR) was also measured in each plane. In the horizontal and vertical planes, we found that if tracking gain (gaze velocity/target velocity) for smooth pursuit was close to 1, the gain of combined eye-hand tracking was similar. If the tracking gain during smooth pursuit was less than about 0.7, combined eye-head tracking was usually superior. Most patients, irrespective of diagnosis, showed combined eye-head tracking that was superior to smooth pursuit; only two patients showed the converse. In the torsional plane, in which optokinetic responses were weak, combined eye-head tracking was much superior, and this was the case in both subjects and patients. We found that a linear model, in which an internal ocular tracking signal cancelled the VOR, could account for our findings in most normal subjects in the horizontal and vertical planes, but not in the torsional plane. The model failed to account for tracking behaviour in most patients in any plane, and suggested that the brain may use additional mechanisms to reduce the internal gain of the VOR during combined eye-head tracking. Our results confirm that certain patients who show impairment of smooth-pursuit eye movements preserve their ability to smoothly track a moving target with combined eye-head tracking.

  16. A Business Case Analysis: Establishment of a Sub-Acute Ward for Tripler Army Medical Center

    DTIC Science & Technology

    2007-03-31

    7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) S. PERFORMING ORGANIZATION REPORT Tripler Army Medical Center I Jarrett White Road TAMC, Hawaii ...Reichenberg, CHES Tripler Army Medical Center, Hawaii Date Complete: 31 March 2007 Date Submitted: 31 March 2007 Running Heading: Establishment of a Sub... Hawaii for his personal insight. Running Heading: Establishment of a Sub-Acute Ward 4 Abstract This business case examines the likely costs and

  17. Symposium on the evolution and development of the vertebrate head.

    PubMed

    Depew, Michael J; Olsson, Lennart

    2008-06-15

    Among the symposia held at the seminal meeting of the European Society for Evolutionary Developmental Biology was one centered on the development and evolution of the vertebrate head, an exquisitely complex anatomical system. The articles presented at this meeting have been gathered in a special issue of the Journal of Experimental Zoology, and are here reviewed by the organizers of the symposia. These articles cover a breadth of subjects, including interactions between cells derived from the different germ layers, such as those underlying neural crest cell migration and fate and cranial muscle specification, as well as placode development and the origin, development, and evolution of important evolutionary innovations such as jaws and the trabecula cranii. In this introduction, we provide a short historical overview of themes of research into the fundamental organization, structure, and development of the vertebrate head, including the search for head segmentation and the relevance of the New Head Hypothesis, and subsequently present the topics discussed in each of the articles. This overview of the past and the present of head evo-devo is then followed by a glimpse at its possible future and a brief examination of the utility of the notions of heterochrony, heterotopy, and heterofacience in describing evolutionarily important changes in developmental events. (c) 2008 Wiley-Liss, Inc.

  18. Efficacy and Safety of a Mineral Oil-Based Head Lice Shampoo: A Randomized, Controlled, Investigator-Blinded, Comparative Study

    PubMed Central

    Wolf, Luise; Eertmans, Frank; Wolf, Doerte; Rossel, Bart; Adriaens, Els

    2016-01-01

    Background Due to increased resistance and safety concerns with insecticide-based pediculicides, there is growing demand for head lice treatments with a physical mode of action. Certain mineral oils kill lice by blocking spiracles or by disrupting the epicuticular wax layer. The present study was performed to evaluate efficacy and safety of a mineral oil-based shampoo. Methods This randomized, controlled, investigator-blinded, monocentric study (EudraCT registration no. 2014-002918-23) was performed from October 2014—June 2015 in Germany. A mineral oil shampoo (Mosquito® Med Läuse Shampoo 10 in Germany, Paranix or Silcap shampoo elsewhere), registered as medical device, was compared to a conventional, locally reimbursed, pyrethroid-based pediculicide (Goldgeist® Forte solution). In total, 107 patients (>1 year) with confirmed head lice infestation were included (test arm: n = 53; control arm: n = 54). All subjects received two applications of either test or control product at day 0 and day 7, according to the instructions for use. Efficacy and safety was evaluated directly, 1h and 24h after first application, before and after second treatment, and at day 10. The main objective was demonstrating a cure rate for the test product, being superior to 70% at day 10. Results Cure rates at day 10 (corrected for re-infestation) for the test product (96.1%) and control (94%) significantly exceeded the pre-defined target (70%) (p < 0.001, 2-sided, 1-sample, chi-square test) with confirmed non-inferiority for the test product. Over all visits, cure rates were consistently higher for the test product, whereas more initially-cured subjects remained lice-free until end of study (78%; control: 60%). Both products were safe and well tolerated, offering good esthetical effects. Conclusion This study showed that substance-based medical devices (including the tested mineral oil shampoo) can be safe and effective alternatives for insecticide-based pediculicides, with less risk for

  19. Efficacy and Safety of a Mineral Oil-Based Head Lice Shampoo: A Randomized, Controlled, Investigator-Blinded, Comparative Study.

    PubMed

    Wolf, Luise; Eertmans, Frank; Wolf, Doerte; Rossel, Bart; Adriaens, Els

    2016-01-01

    Due to increased resistance and safety concerns with insecticide-based pediculicides, there is growing demand for head lice treatments with a physical mode of action. Certain mineral oils kill lice by blocking spiracles or by disrupting the epicuticular wax layer. The present study was performed to evaluate efficacy and safety of a mineral oil-based shampoo. This randomized, controlled, investigator-blinded, monocentric study (EudraCT registration no. 2014-002918-23) was performed from October 2014-June 2015 in Germany. A mineral oil shampoo (Mosquito® Med Läuse Shampoo 10 in Germany, Paranix or Silcap shampoo elsewhere), registered as medical device, was compared to a conventional, locally reimbursed, pyrethroid-based pediculicide (Goldgeist® Forte solution). In total, 107 patients (>1 year) with confirmed head lice infestation were included (test arm: n = 53; control arm: n = 54). All subjects received two applications of either test or control product at day 0 and day 7, according to the instructions for use. Efficacy and safety was evaluated directly, 1h and 24h after first application, before and after second treatment, and at day 10. The main objective was demonstrating a cure rate for the test product, being superior to 70% at day 10. Cure rates at day 10 (corrected for re-infestation) for the test product (96.1%) and control (94%) significantly exceeded the pre-defined target (70%) (p < 0.001, 2-sided, 1-sample, chi-square test) with confirmed non-inferiority for the test product. Over all visits, cure rates were consistently higher for the test product, whereas more initially-cured subjects remained lice-free until end of study (78%; control: 60%). Both products were safe and well tolerated, offering good esthetical effects. This study showed that substance-based medical devices (including the tested mineral oil shampoo) can be safe and effective alternatives for insecticide-based pediculicides, with less risk for development of resistance because of

  20. Dynamic response due to behind helmet blunt trauma measured with a human head surrogate.

    PubMed

    Freitas, Christopher J; Mathis, James T; Scott, Nikki; Bigger, Rory P; Mackiewicz, James

    2014-01-01

    A Human Head Surrogate has been developed for use in behind helmet blunt trauma experiments. This human head surrogate fills the void between Post-Mortem Human Subject testing (with biofidelity but handling restrictions) and commercial ballistic head forms (with no biofidelity but ease of use). This unique human head surrogate is based on refreshed human craniums and surrogate materials representing human head soft tissues such as the skin, dura, and brain. A methodology for refreshing the craniums is developed and verified through material testing. A test methodology utilizing these unique human head surrogates is also developed and then demonstrated in a series of experiments in which non-perforating ballistic impact of combat helmets is performed with and without supplemental ceramic appliques for protecting against larger caliber threats. Sensors embedded in the human head surrogates allow for direct measurement of intracranial pressure, cranial strain, and head and helmet acceleration. Over seventy (70) fully instrumented experiments have been executed using this unique surrogate. Examples of the data collected are presented. Based on these series of tests, the Southwest Research Institute (SwRI) Human Head Surrogate has demonstrated great potential for providing insights in to injury mechanics resulting from non-perforating ballistic impact on combat helmets, and directly supports behind helmet blunt trauma studies.