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Sample records for objective structured clinical

  1. Objective structured clinical examination in radiology

    PubMed Central

    Agarwal, Anurag; Batra, Bipin; Sood, AK; Ramakantan, Ravi; Bhargava, Satish K; Chidambaranathan, N; Indrajit, IK

    2010-01-01

    There is a growing need for introducing objective structured clinical examination (OSCE) as a part of radiology practical examinations in India. OSCE is an established, reliable, and effective multistation test for the assessment of practical professional skills in an objective and a transparent manner. In India, it has been successfully initiated and implemented in specialties like pediatrics, ophthalmology, and otolaryngology. Each OSCE station needs to have a pre-agreed “key-list” that contains a list of objective steps prepared for uniformly assessing the tasks given to students. Broadly, OSCE stations are classified as “manned” or “unmanned” stations. These stations may include procedure or pictorial or theory stations with clinical oriented contents. This article is one of a series of measures to initiate OSCE in radiology; it analyzes the attributes of OSCE stations and outlines the steps for implementing OSCE. Furthermore, important issues like the advantages of OSCE, its limitations, a strengths, weaknesses, opportunities, and threats (SWOT) analysis, and the timing of introduction of OSCE in radiology are also covered. The OSCE format in radiology and its stations needs to be validated, certified, and finalized before its use in examinations. This will need active participation and contribution from the academic radiology fraternity and inputs from faculty members of leading teaching institutions. Many workshops/meetings need to be conducted. Indeed, these collaborative measures will effectively sensitize universities, examiners, organizers, faculty, and students across India to OSCE and help successfully usher in this new format in radiology practical examinations. PMID:20607015

  2. Objective structured clinical examination in radiology.

    PubMed

    Agarwal, Anurag; Batra, Bipin; Sood, Ak; Ramakantan, Ravi; Bhargava, Satish K; Chidambaranathan, N; Indrajit, Ik

    2010-05-01

    There is a growing need for introducing objective structured clinical examination (OSCE) as a part of radiology practical examinations in India. OSCE is an established, reliable, and effective multistation test for the assessment of practical professional skills in an objective and a transparent manner. In India, it has been successfully initiated and implemented in specialties like pediatrics, ophthalmology, and otolaryngology. Each OSCE station needs to have a pre-agreed "key-list" that contains a list of objective steps prepared for uniformly assessing the tasks given to students. Broadly, OSCE stations are classified as "manned" or "unmanned" stations. These stations may include procedure or pictorial or theory stations with clinical oriented contents. This article is one of a series of measures to initiate OSCE in radiology; it analyzes the attributes of OSCE stations and outlines the steps for implementing OSCE. Furthermore, important issues like the advantages of OSCE, its limitations, a strengths, weaknesses, opportunities, and threats (SWOT) analysis, and the timing of introduction of OSCE in radiology are also covered. The OSCE format in radiology and its stations needs to be validated, certified, and finalized before its use in examinations. This will need active participation and contribution from the academic radiology fraternity and inputs from faculty members of leading teaching institutions. Many workshops/meetings need to be conducted. Indeed, these collaborative measures will effectively sensitize universities, examiners, organizers, faculty, and students across India to OSCE and help successfully usher in this new format in radiology practical examinations.

  3. Objective structured clinical exams: a critical review.

    PubMed

    Turner, John L; Dankoski, Mary E

    2008-09-01

    Since their inception in the 1970s, objective structured clinical examinations (OSCEs) have become popular and now are part of the US Medical Licensing Examination for all US medical graduates. Despite general acceptance of this method, there is debate over the value of OSCE testing compared to more traditional methods. A review of reliability and validity research does not clearly show superiority of OSCE testing. To use OSCEs in a valid and reliable way, attention must be paid to test content, test design, and implementation factors, especially when the results will be used for high-stakes decision making. While questions remain around the application of OSCE testing, there are also both known and hidden benefits to students, faculty, and organizations that use OSCEs. This paper reviews the pros and cons of the OSCE method and outlines important issues for medical educators to consider when planning to use OSCEs in their programs. PMID:18988044

  4. Item Dependency in an Objective Structured Clinical Examination

    ERIC Educational Resources Information Center

    Iramaneerat, Cherdsak; Myford, Carol M.; Yudkowsky, Rachel

    2006-01-01

    An Objective Structured Clinical Examination (OSCE) is an assessment approach employed in medical education, in which residents rotate through multiple stations of standardized clinical tasks to evaluate their clinical competence. Because items used to evaluate residents' performance in each OSCE station are linked to the same task and are rated…

  5. Effects of test stress during an objective structured clinical examination

    PubMed Central

    Zhang, Niu; Rabatsky, Ali

    2015-01-01

    Objective The existence of test stress has been widely reported among professional students. To our knowledge, no studies exist that explore student stress response to objective structured clinical examinations. The aim of this study was to evaluate possible correlations between stress and objective structured clinical examination performance in a sample of chiropractic students. Methods A total of 116 students completed a 2-part questionnaire to assess test stress and the physiological symptoms and signs of stress. Heart rate, systolic blood pressure, and diastolic were measured during the physical examination laboratory class within the first 3 weeks and then again just prior to their objective structured clinical examination in week 5. Statistical tests were then performed for questionnaire data, heart rate and blood pressure differences, and correlation between the objective structured clinical examination grade and symptoms and signs. Results Questionnaire results showed that 5.1%–22.4% of students sometimes or often felt a certain degree of stress. More than 50% had 1 or more physiological symptoms and signs of stress. The objective structured clinical examination heart rate (75.23 ± 11.20 vs 68.16 ± 8.82, p < .001), systolic blood pressure (120.43 ± 9.59 vs 114.97 ± 11.83, p < .001), and diastolic blood pressure (73.00 ± 7.93 vs 69.32 ± 7.76, p < .001) were significantly higher than baseline. There were also negative linear correlations between objective structured clinical examination grades and physiological symptoms and signs and between objective structured clinical examination grades and feeling statement score. Conclusion The results support our hypothesis that chiropractic students experience stress when performing the objective structured clinical examination and that high levels of stress had a negative impact on performance. PMID:25806413

  6. Objective structured clinical examination (OSCE) in pharmacy education - a trend.

    PubMed

    Shirwaikar, Annie

    2015-01-01

    Pharmacy education has undergone a radical change as it evolves towards becoming a more patient oriented profession. With a greater emphasis on problem based teaching and competency, the Objective Structured Clinical Examination (OSCE), supported by its reliability and validity became the gold standard for the evaluation of clinical skills of undergraduate students of medicine and pharmacy worldwide. Core competency evaluation has become a mandatory and critical norm for accountability of educational objectives as the traditional testing tools cannot evaluate clinical competence. Interpersonal and communication skills, professional judgment, skills of resolution etc., may be best assessed through a well- structured OSCE in comparison to oral examinations, multiple choice tests and other methods of assessment. Though OSCEs as an objective method of evaluation offer several advantages to both students and teachers, it also has disadvantages and pitfalls in implementation. This article reviews the OSCE as a trend in pharmacy education. PMID:26759616

  7. Designing and implementing the objective structured clinical examination in anesthesiology.

    PubMed

    Hastie, Maya Jalbout; Spellman, Jessica L; Pagano, Parwane P; Hastie, Jonathan; Egan, Brian J

    2014-01-01

    Since its description in 1974, the Objective Structured Clinical Examination (OSCE) has gained popularity as an objective assessment tool of medical students, residents, and trainees. With the development of the anesthesiology residents' milestones and the preparation for the Next Accreditation System, there is an increased interest in OSCE as an evaluation tool of the six core competencies and the corresponding milestones proposed by the Accreditation Council for Graduate Medical Education.In this article the authors review the history of OSCE and its current application in medical education and in different medical and surgical specialties. They also review the use of OSCE by anesthesiology programs and certification boards in the United States and internationally. In addition, they discuss the psychometrics of test design and implementation with emphasis on reliability and validity measures as they relate to OSCE.

  8. Psychometric Structure of a Comprehensive Objective Structured Clinical Examination: A Factor Analytic Approach

    ERIC Educational Resources Information Center

    Volkan, Kevin; Simon, Steven R.; Baker, Harley; Todres, I. David

    2004-01-01

    Problem Statement and Background: While the psychometric properties of Objective Structured Clinical Examinations (OSCEs) have been studied, their latent structures have not been well characterized. This study examines a factor analytic model of a comprehensive OSCE and addresses implications for measurement of clinical performance. Methods: An…

  9. [HOLDING OBJECTIVE STRUCTURED CLINICAL EXAMINATIONS FOR ANESTHESIOLOGY AND INTENSIVE CARE CLINICAL RESIDENCY IN STATE GRADUATES CERTIFICATION].

    PubMed

    Schegolev, A V; Andreenko, A A; Ershov, E N; Lahin, R E; Makarenko, E P

    2016-01-01

    The modern system of medical education requires objective methods to assess clinical competence of medical specialists. Application of objective structured clinical examination (OSCE) during the final certification of graduates of clinical residency allows to evaluate the theoretical knowledge, manual skills. Enabling simulation scenarios in the program makes it possible to objectively evaluate the important non-technical skills of anesthesiologists, identify gaps in the system of training and modify it. The experience of the objective structured clinical examination as part of the state certification of graduates of clinical residency of the Department ofAnesthesiology and Intensive Care, Military MedicalAcademy after C M Kirov allows us to consider this technique in an objective way a comprehensive assessment of the competence of health professionals. Students confirmed its highly realistic, they have revealed the presence of emotional stress during the simulation sessions, the majority agreed that the simulation session increased the level of their readiness to address these situations in clinical practice. Staff of the department is planning to testing and introduction rating scales into a system of assessment, to improved exam program, increasing the number of clinical scenarios for simulation sessions. PMID:27192861

  10. Does Objective Structured Clinical Examinations Score Reflect the Clinical Reasoning Ability of Medical Students?

    PubMed Central

    Park, Wan Beom; Kang, Seok Hoon; Lee, Yoon-Seong

    2015-01-01

    Abstract: Background: Clinical reasoning ability is an important factor in a physician's competence and thus should be taught and tested in medical schools. Medical schools generally use objective structured clinical examinations (OSCE) to measure the clinical competency of medical students. However, it is unknown whether OSCE can also evaluate clinical reasoning ability. In this study, the authors investigated whether OSCE scores reflected students' clinical reasoning abilities. Methods: Sixty-five fourth-year medical students participated in this study. Medical students completed the OSCE with 4 cases using standardized patients. For assessment of clinical reasoning, students were asked to list differential diagnoses and the findings that were compatible or not compatible with each diagnosis. The OSCE score (score of patient encounter), diagnostic accuracy score, clinical reasoning score, clinical knowledge score and grade point average (GPA) were obtained for each student, and correlation analysis was performed. Results: Clinical reasoning score was significantly correlated with diagnostic accuracy and GPA (correlation coefficient = 0.258 and 0.380; P = 0.038 and 0.002, respectively) but not with OSCE score or clinical knowledge score (correlation coefficient = 0.137 and 0.242; P = 0.276 and 0.052, respectively). Total OSCE score was not significantly correlated with clinical knowledge test score, clinical reasoning score, diagnostic accuracy score or GPA. Conclusions: OSCE score from patient encounters did not reflect the clinical reasoning abilities of the medical students in this study. The evaluation of medical students' clinical reasoning abilities through OSCE should be strengthened. PMID:25647834

  11. Construct Validity of an Objective Structured Clinical Examination (OSCE) in Psychiatry: Associations with the Clinical Skills Examination and Other Indicators

    ERIC Educational Resources Information Center

    Park, Robin S.; Chibnall, John T.; Blaskiewicz, Robert J.; Furman, Gail E.; Powell, Jill K.; Mohr, Clinton J.

    2004-01-01

    Objective: The construct validity of checklist and global process scores for an objective structured clinical examination (OSCE) in psychiatry was assessed. Multiple regression analysis was used to predict psychiatry OSCE scores from the clinical skills examination, an obstetrics/gynecology (OB/GYN) OSCE, and the National Board of Medical…

  12. Assessment of first-year veterinary students' clinical skills using objective structured clinical examinations.

    PubMed

    Hecker, Kent; Read, Emma K; Vallevand, Andrea; Krebs, Gord; Donszelmann, Darlene; Muelling, Christoph K W; Freeman, Sarah L

    2010-01-01

    The DVM program at the University of Calgary offers a Clinical Skills course each year for the first three years. The course is designed to teach students the procedural skills required for entry-level general veterinary practice. Objective Structured Clinical Examinations (OSCEs) were used to assess students' performance on these procedural skills. A series of three OSCEs were developed for the first year. Content was determined by an exam blueprint, exam scoring sheets were created, rater training was provided, a mock OSCE was performed with faculty and staff, and the criterion-referencing Ebel method was used to set cut scores for each station using two content experts. Each station and the overall exam were graded as pass or fail. Thirty first-year DVM students were assessed. Content validity was ensured by the exam blueprint and expert review. Reliability (coefficient α) of the stations from the three OSCE exams ranged from 0.0 to 0.71. The three exam reliabilities (Generalizability Theory) were, for OSCE 1, G=0.56; OSCE 2, G=0.37; and OSCE 3, G=0.32. Preliminary analysis has suggested that the OSCEs demonstrate face and content validity, and certain stations demonstrated adequate reliability. Overall exam reliability was low, which reflects issues with first-time exam delivery. Because this year was the first that this course was taught and this exam format was used, work continues in the program on the teaching of the procedural skills and the development and revision of OSCE stations and scoring checklists.

  13. Geriatric Medicine Fellows' Experiences and Attitudes toward an Objective Structured Clinical Examination (OSCE)

    ERIC Educational Resources Information Center

    Bagri, Anita S.; Zaw, Khin M.; Milanez, Marcos N.; Palacios, Juan J.; Qadri, Syeda S.; Bliss, Linda A.; Roos, Bernard A.; Ruiz, Jorge G.

    2009-01-01

    A total of 8 geriatric medicine fellows participated in an objective structured clinical examination (OSCE) assessing communication skills and clinical reasoning in common geriatric syndromes. To determine their perceptions about the experience, we conducted surveys and semistructured interviews. We analyzed the survey data using descriptive…

  14. Sharing of information by students in an objective structured clinical examination.

    PubMed

    Rutala, P J; Witzke, D B; Leko, E O; Fulginiti, J V; Taylor, P J

    1991-03-01

    Increasing numbers of medical schools are using Objective Structured Clinical Examinations (OSCEs) to evaluate students. An Objective Structured Clinical Examination employs a multiple-station format and standardized patients to document students' clinical skills. A lengthy format is necessary; testing an entire class often necessitates multiple repetitions of the same examination. This dictates a need to minimize sharing of information among students. We studied six administrations of an Objective Structured Clinical Examination designed to measure skills. Analyses were conducted to detect changes in scores over the administrations as well as over the 8.5 hours of each day of testing. An increase in either might indicate information sharing had occurred. No significant increase occurred. If information was shared, it had no significant effect on scores. Skills a student uses to approach a patient should not change even if the patient's complaints are known.

  15. Introducing the Objective Structured Clinical Examination (OSCE) in the Undergraduate Psychiatric Curriculum: Evaluation after One Year

    ERIC Educational Resources Information Center

    Zahid, Muhammad Ajmal; Al-Zayed, Adel; Ohaeri, Jude; Varghese, Ramani

    2011-01-01

    Objective: The Objective Structured Clinical Examination (OSCE) was introduced in undergraduate psychiatry clerkship in 2008. The authors studied the effect of OSCE on the students' performance. Methods: The "short case" (SC) and "oral examination" (OE), two of the five components of the previous assessment format, were replaced with the OSCE.…

  16. Nurse practitioner education: enhancing performance through the use of the Objective Structured Clinical Assessment.

    PubMed

    Bramble, K

    1994-02-01

    An Objective Structured Clinical Assessment (OSCA) was implemented in a graduate nurse practitioner (NP) program to determine the effect that participation in this type of clinical simulation would have on the cognitive and clinical competency of students. Based on the analysis of data, participation in the OSCA simulations did not lead to significantly better cognitive or clinical performance. Support for the OSCA was shown, however, by NP students when subjectively evaluating their experiences. All students agreed or strongly agreed that OSCA participation was a valuable learning experience and that the feedback provided was beneficial to their clinical and cognitive performance.

  17. Factors shaping e-feedback utilization following electronic Objective Structured Clinical Examinations.

    PubMed

    Ashby, Samantha E; Snodgrass, Suzanne H; Rivett, Darren A; Russell, Trevor

    2016-09-01

    The development of student-practitioners' practical clinical skills is essential in health professional education. Objective Structured Clinical Examinations are central to the assessment of students performing clinical procedures on simulated patients (actors). While feedback is considered core to learning providing timely, individualised student OSCE feedback is difficult. This study explored the perceptions of students about the multiple factors which shape the utility of e-feedback following an electronic Objective Structured Clinical Examinations, which utilized iPad and specialised software. The e-feedback was trialled in four courses within occupational therapy and physiotherapy pre-professional programs with a cohort of 204 students. Evaluation of student perceptions about feedback was collected using two surveys and eight focus groups. This data showed three factors shaped perceptions of the utility of e- Objective Structured Clinical Examinations feedback: 1) timely accessibility within one day of the assessment, 2) feedback demonstrating examiners' academic literacy and 3) feedback orientated to ways of improving future performance of clinical skills. The study found training in the provision of feedback using IPads and software is needed for examiners to ensure e-feedback meets students' needs for specific, future-oriented e-feedback and institutional requirements for justification of grades. PMID:27029015

  18. Competency-Based Training: Objective Structured Clinical Exercises (OSCE) in Marriage and Family Therapy

    ERIC Educational Resources Information Center

    Miller, John K.

    2010-01-01

    The field of marriage and family therapy (MFT) has recently engaged in the process of defining core competencies for the profession. Many MFT training programs are adapting their curriculum to develop more competency-based training strategies. The Objective Structured Clinical "Examination" (OSCE) is widely used in the medical profession to assess…

  19. Evaluation of Clinical and Communication Skills of Pharmacy Students and Pharmacists with an Objective Structured Clinical Examination.

    PubMed

    Urteaga, Elizabeth M; Attridge, Rebecca L; Tovar, John M; Witte, Amy P

    2015-10-25

    Objective. To evaluate how effectively pharmacy students and practicing pharmacists communicate and apply knowledge to simulations of commonly encountered patient scenarios using an objective structured clinical examination (OSCE). Design. Second-, third-, and fourth-year pharmacy students completed an OSCE as part of their required courses in 2012 and 2013. All students in both years completed identical OSCE cases. Licensed pharmacists were recruited to complete the OSCE and serve as controls in 2012. A survey assessed student perception and acceptance of the OSCE as well as student confidence in performance. Assessment. Licensed pharmacists had significantly higher clinical and communication skills scores than did pharmacy students. Student progression in communication and clinical skills improved significantly over time. Survey results indicated that students felt the OSCE was well-structured and assessed clinical skills taught in pharmacy school; 86% of students felt confident they could provide these skills. Conclusion. Objective structured clinical examinations can evaluate clinical competence and communication skills among professional students. Implementation of OSCEs may be an effective tool for assessment of the Center for the Advancement of Pharmacy Education domains.

  20. Evaluation of Clinical and Communication Skills of Pharmacy Students and Pharmacists with an Objective Structured Clinical Examination

    PubMed Central

    Attridge, Rebecca L.; Tovar, John M.; Witte, Amy P.

    2015-01-01

    Objective. To evaluate how effectively pharmacy students and practicing pharmacists communicate and apply knowledge to simulations of commonly encountered patient scenarios using an objective structured clinical examination (OSCE). Design. Second-, third-, and fourth-year pharmacy students completed an OSCE as part of their required courses in 2012 and 2013. All students in both years completed identical OSCE cases. Licensed pharmacists were recruited to complete the OSCE and serve as controls in 2012. A survey assessed student perception and acceptance of the OSCE as well as student confidence in performance. Assessment. Licensed pharmacists had significantly higher clinical and communication skills scores than did pharmacy students. Student progression in communication and clinical skills improved significantly over time. Survey results indicated that students felt the OSCE was well-structured and assessed clinical skills taught in pharmacy school; 86% of students felt confident they could provide these skills. Conclusion. Objective structured clinical examinations can evaluate clinical competence and communication skills among professional students. Implementation of OSCEs may be an effective tool for assessment of the Center for the Advancement of Pharmacy Education domains. PMID:26690286

  1. An exploration of student midwives' experiences of the Objective Structured Clinical Examination assessment process.

    PubMed

    Barry, Maebh; Noonan, Maria; Bradshaw, Carmel; Murphy-Tighe, Sylvia

    2012-08-01

    This paper reports on a qualitative descriptive study that explored student midwives' experiences of the Objective Structured Clinical Examination assessment process for obstetric emergencies within a university setting. The development of fundamental clinical skills is an important component in preparing students to meet the responsibilities of a midwife. There is an international concern that the transfer of midwifery education into universities may impact on the development of midwifery clinical skills. Objective Structured Clinical Examinations (OSCEs) have the potential to promote integration and consolidation of skills prior to clinical placement. Twenty six students (n=36) from two midwifery programmes (BSc and Higher Diploma) participated in four focus groups and Burnard's (2006) framework was used for data analysis. Three main themes emerged following analysis: preparation for the OSCE assessment, the OSCE process and learning through simulating practice. Preparation for the OSCE's which included lectures, demonstrations, and practice of OSCE's facilitated by lecturers and by the students themselves, was considered central to the process. Learning via OSCEs was perceived to be more effective in comparison to other forms of assessment and prepared students for clinical practice. Positive aspects of the process and areas for improvement were identified. Using OSCE's increased the depth of learning for the students with the steps taken in preparation for the OSCE's proving to be a valuable learning tool. This study adds to the evidence on the use of OSCE's in midwifery education. PMID:21999901

  2. The experience of an objective, structured clinical examination at Kaohsiung Medical University.

    PubMed

    Lee, Kun-Tai; Liu, Wei-Ting; Yen, Jeng-Hsien; Liu, Ching-Kuan; Liu, Keh-Min; Lai, Chung-Sheng

    2008-12-01

    The objective, structured clinical examination (OSCE) is a method to assess clinical competency based on objective testing, through direct observation in a formal setting. The Kaohsiung Medical University (KMU) has pioneered OSCEs in Taiwan. In KMU, three groups of examinees---medical students in years 3 and 4, medical students in years 5 and 6, and medical students in year 7---were assessed using different OSCEs. Each OSCE was set up using the following five steps: (1) create cases; (2) decide on the items or clinical skills to be evaluated; (3) train standardized patients; (4) run the OSCE and (5) review videos to improve the curriculum. We expect that KMU will become the premier OSCE center in Taiwan.

  3. The reliability, validity, and usefulness of the Objective Structured Clinical Examination (OSCE) in dental education

    NASA Astrophysics Data System (ADS)

    Graham, Roseanna

    This study evaluated the reliability, validity, and educational usefulness of a comprehensive, multidisciplinary Objective Structured Clinical Examination (OSCE) in dental education. The OSCE was administered to dental students at the Columbia University College of Dental Medicine (CDM) before they entered clinical training. Participants in this study included CDM's class of 2010 which consisted of 78 students. The overall reliability of the examination was measured via calculation of Cronbach's alpha. Content validity was examined through evaluation of the OSCE by three experienced clinical faculty members. Predictive validity was evaluated by correlating student grades on the OSCE to future clinical performance as measured by number of clinical points achieved during the third year of training. Student perceptions regarding the educational usefulness of the examination were evaluated through a 12-question Liken-type survey and focus group interviews analyzed using a phenomenological approach. Findings of the study indicated the OSCE was a highly reliable examination (alpha=0.86) with high content validity and a moderately high correlation to future clinical performance (r=.614, p<.0001). Overall, student perceptions of the educational usefulness of the OSCE were positive as based on their responses to a 5-point Likert scale (1=strongly disagree and 5=strongly agree). They reported that the exam required the ability to think critically and problem-solve (4.0 +/- 0.85), assessed clinically relevant skills (4.59 +/- 0.69), helped identify clinical weaknesses (4.16 +/- 0.90), and was a learning experience (4.58 +/- 0.84). Findings from the qualitative portion of the study identified four main themes including the student perception that the OSCE is a unique assessment experience that required integration and application of knowledge. Recommendations for the use of the OSCE to improve clinical teaching and the implications of this study relating to the expanded use of

  4. The cost of the objective structured clinical examination on an Italian nursing bachelor's degree course.

    PubMed

    Palese, A; Bulfone, G; Venturato, E; Urli, N; Bulfone, T; Zanini, A; Fabris, S; Tomietto, M; Comisso, I; Tosolini, C; Zuliani, S; Dante, A

    2012-05-01

    The OSCE (Objective Structured Clinical Examination) is considered the most valid and reliable method for assessing the clinical skills of students training for health professions, but its use is limited by the related high costs. We analyzed the cost retrospectively of using an OSCE designed for second-year students (2009) in our degree course, adopting the Reznick et al. guidelines (1993), which recommend assessing both high-end costs and low-end costs. The high-end costs adopting the OSCE amounted to € 145.23 per student, while the low-end costs were € 31.51 per student. Considering the economic crisis and the cost-containment measures applied also in nursing education, strategies for further reducing costs are discussed. PMID:21470724

  5. The opinion of post graduate students on objective structured clinical examination in Anaesthesiology: A preliminary report

    PubMed Central

    Jindal, Parul; Khurana, Gurjeet

    2016-01-01

    Background and Aims: The scenario in medical education is changing with objective structured clinical examination (OSCE) being introduced as an assessment tool. Its successful implementation in anaesthesiology postgraduate evaluation process is still limited. We decided to to evaluate the effectiveness of OSCE and compare it to conventional examinations as formative assessment tools in anaesthesiology. Methods: We conducted a cross-sectional comparative study in defined population of anaesthesiology postgraduate students to evaluate the effectiveness of OSCE as compared to conventional examination as formative assessment tool in anaesthesiology. Thirty-five students appeared for the conventional examination on the 1st day and viva voce on the 2nd day and OSCE on the last day. At the conclusion of the assessment, all the students were asked to respond to the perception evaluation questionnaire. We analysed the perception of OSCE among the students. Results: Results showed a positive perception of the objective structured physical examination (OSCE) as well as structured 9 (25.7%), fair 19 (54.2%) and unbiased 13 (37.1%) with more standardised scoring 9 (25.7%). The students perceived OSCE to be less stressful than other examination. Thirty-one (88.5%) students agreed that OSCE is easier to pass than conventional method and 29 (82.5%) commented that the degree of emotional stress is less in OSCE than traditional methods. Conclusion: OSCE is better evaluation tool when compared to conventional examination. PMID:27053779

  6. Reliability analysis of the objective structured clinical examination using generalizability theory

    PubMed Central

    Trejo-Mejía, Juan Andrés; Sánchez-Mendiola, Melchor; Méndez-Ramírez, Ignacio; Martínez-González, Adrián

    2016-01-01

    Background The objective structured clinical examination (OSCE) is a widely used method for assessing clinical competence in health sciences education. Studies using this method have shown evidence of validity and reliability. There are no published studies of OSCE reliability measurement with generalizability theory (G-theory) in Latin America. The aims of this study were to assess the reliability of an OSCE in medical students using G-theory and explore its usefulness for quality improvement. Methods An observational cross-sectional study was conducted at National Autonomous University of Mexico (UNAM) Faculty of Medicine in Mexico City. A total of 278 fifth-year medical students were assessed with an 18-station OSCE in a summative end-of-career final examination. There were four exam versions. G-theory with a crossover random effects design was used to identify the main sources of variance. Examiners, standardized patients, and cases were considered as a single facet of analysis. Results The exam was applied to 278 medical students. The OSCE had a generalizability coefficient of 0.93. The major components of variance were stations, students, and residual error. The sites and the versions of the tests had minimum variance. Conclusions Our study achieved a G coefficient similar to that found in other reports, which is acceptable for summative tests. G-theory allows the estimation of the magnitude of multiple sources of error and helps decision makers to determine the number of stations, test versions, and examiners needed to obtain reliable measurements. PMID:27543188

  7. Measuring Professional Behaviour in Canadian Physical Therapy Students' Objective Structured Clinical Examinations: An Environmental Scan

    PubMed Central

    Ellerton, Cindy; Evans, Cathy

    2015-01-01

    ABSTRACT Purpose: To identify professional behaviours measured in objective structured clinical examinations (OSCEs) by Canadian university physical therapy (PT) programs. Method: A cross-sectional telephone survey was conducted to review current practice and determine which OSCE items Canadian PT programs are using to measure PT students' professional behaviours. Telephone interviews using semi-structured questions were conducted with individual instructors responsible for courses that included an OSCE as part of the assessment component. Results: Nine PT programmes agreed to take part in the study, and all reported conducting at least one OSCE. The number and characteristics of OSCEs varied both within and across programs. Participants identified 31 professional behaviour items for use in an OSCE; these items clustered into four categories: communication (n=14), respect (n=10), patient safety (n=4), and physical therapists' characteristics (n=3). Conclusions: All Canadian entry-level PT programmes surveyed assess professional behaviours in OSCE-type examinations; however, the content and style of assessment is variable. The local environment should be considered when determining what professional behaviours are appropriate to assess in the OSCE context in individual programmes. PMID:25931656

  8. An objective structured clinical exam to measure intrinsic CanMEDS roles

    PubMed Central

    Kassam, Aliya; Cowan, Michèle; Donnon, Tyrone

    2016-01-01

    Background The CanMEDS roles provide a comprehensive framework to organize competency-based curricula; however, there is a challenge in finding feasible, valid, and reliable assessment methods to measure intrinsic roles such as Communicator and Collaborator. The objective structured clinical exam (OSCE) is more commonly used in postgraduate medical education for the assessment of clinical skills beyond medical expertise. Method We developed the CanMEDS In-Training Exam (CITE), a six-station OSCE designed to assess two different CanMEDS roles (one primary and one secondary) and general communication skills at each station. Correlation coefficients were computed for CanMEDS roles within and between stations, and for general communication, global rating, and total scores. One-way analysis of variance (ANOVA) was used to investigate differences between year of residency, sex, and the type of residency program. Results In total, 63 residents participated in the CITE; 40 residents (63%) were from internal medicine programs, whereas the remaining 23 (37%) were pursuing other specialties. There was satisfactory internal consistency for all stations, and the total scores of the stations were strongly correlated with the global scores r=0.86, p<0.05. Noninternal medicine residents scored higher in terms of the Professional competency overall, whereas internal medicine residents scored significantly higher in the Collaborator competency overall. Discussion The OSCE checklists developed for the assessment of intrinsic CanMEDS roles were functional, but the specific items within stations required more uniformity to be used between stations. More generic types of checklists may also improve correlations across stations. Conclusion An OSCE measuring intrinsic competence is feasible; however, further development of our cases and checklists is needed. We provide a model of how to develop an OSCE to measure intrinsic CanMEDS roles that educators may adopt as residency programs move

  9. Formative Assessment of Procedural Skills: Students' Responses to the Objective Structured Clinical Examination and the Integrated Performance Procedural Instrument

    ERIC Educational Resources Information Center

    Nestel, Debra; Kneebone, Roger; Nolan, Carmel; Akhtar, Kash; Darzi, Ara

    2011-01-01

    Assessment of clinical skills is a critical element of undergraduate medical education. We compare a traditional approach to procedural skills assessment--the Objective Structured Clinical Examination (OSCE) with the Integrated Performance Procedural Instrument (IPPI). In both approaches, students work through "stations" or "scenarios" undertaking…

  10. Objective structured clinical examination for pharmacy students in Qatar: cultural and contextual barriers to assessment.

    PubMed

    Wilby, K J; Black, E K; Austin, Z; Mukhalalati, B; Aboulsoud, S; Khalifa, S I

    2016-07-10

    This study aimed to evaluate the feasibility and psychometric defensibility of implementing a comprehensive objective structured clinical examination (OSCE) on the complete pharmacy programme for pharmacy students in a Middle Eastern context, and to identify facilitators and barriers to implementation within new settings. Eight cases were developed, validated, and had standards set according to a blueprint, and were assessed with graduating pharmacy students. Assessor reliability was evaluated using inter-class coefficients (ICCs). Concurrent validity was evaluated by comparing OSCE results to professional skills course grades. Field notes were maintained to generate recommendations for implementation in other contexts. The examination pass mark was 424 points out of 700 (60.6%). All 23 participants passed. Mean performance was 74.6%. Low to moderate inter-rater reliability was obtained for analytical and global components (average ICC 0.77 and 0.48, respectively). In conclusion, OSCE was feasible in Qatar but context-related validity and reliability concerns must be addressed prior to future iterations in Qatar and elsewhere.

  11. Construct Validity and Generalizability of Simulation-Based Objective Structured Clinical Examination Scenarios

    PubMed Central

    Sidi, Avner; Gravenstein, Nikolaus; Lampotang, Samsun

    2014-01-01

    Background It is not known if construct-related validity (progression of scores with different levels of training) and generalizability of Objective Structured Clinical Examination (OSCE) scenarios previously used with non-US graduating anesthesiology residents translate to a US training program. Objective We assessed for progression of scores with training for a validated high-stakes simulation-based anesthesiology examination. Methods Fifty US anesthesiology residents in postgraduate years (PGYs) 2 to 4 were evaluated in operating room, trauma, and resuscitation scenarios developed for and used in a high-stakes Israeli Anesthesiology Board examination, requiring a score of 70% on the checklist for passing (including all critical items). Results The OSCE error rate was lower for PGY-4 than PGY-2 residents in each field, and for most scenarios within each field. The critical item error rate was significantly lower for PGY-4 than PGY-3 residents in operating room scenarios, and for PGY-4 than PGY-2 residents in resuscitation scenarios. The final pass rate was significantly higher for PGY-3 and PGY-4 than PGY-2 residents in operating room scenarios, and also was significantly higher for PGY-4 than PGY-2 residents overall. PGY-4 residents had a better error rate, total scenarios score, general evaluation score, critical items error rate, and final pass rate than PGY-2 residents. Conclusions The comparable error rates, performance grades, and pass rates for US PGY-4 and non-US (Israeli) graduating (PGY-4 equivalent) residents, and the progression of scores among US residents with training level, demonstrate the construct-related validity and generalizability of these high-stakes OSCE scenarios. PMID:26279774

  12. Right person, right skills, right job: the contribution of objective structured clinical examinations in advancing staff nurse experts.

    PubMed

    Mitchell, Marion; Strube, Petra; Vaux, Amanda; West, Nicky; Auditore, Anthony

    2013-10-01

    Recruitment processes need to discriminate among candidates to ensure that the right person with the right skills is selected for advancement opportunities. An innovative recruitment process using an objective structured clinical examination grounded in best practice guidelines resulted in improved recruitment practices for senior nursing clinical expert roles. Candidates' skills, knowledge, and attitudes in the areas of patient focus, clinical expertise, teamwork, and leadership were assessed using a clinical simulation. Candidates achieving advancement were assessed at 6 months to validate the efficacy of the process.

  13. Assessment of photoselective vaporization of prostate skills during Urology Objective Structured Clinical Examinations (OSCE)

    PubMed Central

    Noureldin, Yasser A.; Elkoushy, Mohamed A.; Fahmy, Nader; Carrier, Serge; Elhilali, Mostafa M.; Andonian, Sero

    2015-01-01

    Introduction: We evaluated the use of the GreenLight Simulator (GL-SIM) (American Medical Systems, Guelph, ON) in the skill assessment of postgraduate trainees (PGTs) in photoselective vaporization of the prostate (PVP). We also sought to determine whether previous PVP experience or GL-SIM practice improved performance. Methods: PGTs in postgraduate years (PGY-3 to PGY-5) from all 4 Quebec urology training programs were recruited during 2 annual Objective Structured Clinical Examinations (OSCEs). During a 20-minute OSCE station, PGTs were asked to perform 2 exercises: (1) identification of endoscopic landmarks and (2) a PVP of a 30-g normal prostate. Grams vaporized, global scores, and number of correct anatomical landmarks were recorded and correlated with PGY level, practice on the GL-SIM, and previous PVP experience. Results: In total, 25 PGTs were recruited at each OSCE, with 13 PGTs participating in both OSCEs. When comparing scores from the first and second OSCEs, there was a significant improvement in the number of grams vaporized (2.9 vs. 4.3 g; p = 0.003) and global score (100 vs. 165; p = 0.03). There was good correlation between the number of previously performed PVPs and the global score (r = 0.4, p = 0.04). Similarly, PGTs with previous practice on the GL-SIM had significantly higher global score (100.6 vs. 162.6; p = 0.04) and grams vaporized (3.1 vs. 4.1 g; p = 0.04) when compared with those who did not practice on GL-SIM. Furthermore, there were significantly more competent PGTs among those who had previously practiced on the GL-SIM (32.7% vs. 10.2%; p = 0.009). PGY level did not significantly affect grams vaporized or global score (p > 0.05). Conclusion: Performance on the GL-SIM at OSCEs significantly correlated with previous practice on the GL-SIM and previous PVP experience rather than PGY level. Furthermore, there were significantly more competent PGTs among those who had previously practiced on the GL-SIM. PMID:25737763

  14. Exploration of Nursing Faculty Members' Lived Experiences of Objective Structured Clinical Examination (OSCE) in Undergraduate Nursing Education

    ERIC Educational Resources Information Center

    Obizoba, Cordelia O.

    2014-01-01

    The purpose of this phenomenological study was to gain an understanding of nursing faculty members' lived experiences of Objective Structured Clinical Examination (OSCE) in undergraduate nursing education. As owners of their programs' curriculum, nursing faculties are charged with the responsibility of providing needed knowledge, skills, and…

  15. The interrater reliability of an objective structured practical examination in measuring the clinical reasoning ability of chiropractic students

    PubMed Central

    Rose, Kevin A.; Babajanian, Jesika

    2016-01-01

    Objective: The objective structured practical examination (OSPE) is a case-based assessment that can be used to assess the clinical reasoning ability of students. The reliability of using an OSPE for this purpose has not been reported in the literature. The objective of this study was to determine the interrater reliability of the OSPE in measuring the clinical reasoning ability of chiropractic students. Methods: Two examiners tested each student simultaneously when enough were available as a check for interrater reliability. The scores for students over 4 exam administrations were compiled, and we calculated an intraclass correlation coefficient (ICC) using 1-way random single measures. Results: Paired scores were available for 133 students. The ICC was .685, showing a fair-to-good level of agreement for faculty in assessing the clinical reasoning ability of chiropractic students using an OSPE. Conclusion: The OSPE can be a valuable tool for testing clinical reasoning abilities because it can simulate the decision-making process that needs to be implemented in clinical practice. Faculty members at our chiropractic college were able to achieve an acceptable level of reliability in measuring the clinical reasoning abilities of students using an OSPE. Other health professional programs may consider using this tool for assessing the clinical reasoning skills of their students. PMID:27115474

  16. Objective Eulerian coherent structures.

    PubMed

    Serra, Mattia; Haller, George

    2016-05-01

    We define objective Eulerian Coherent Structures (OECSs) in two-dimensional, non-autonomous dynamical systems as the instantaneously most influential material curves. Specifically, OECSs are stationary curves of the averaged instantaneous material stretching-rate or material shearing-rate functionals. From these objective (frame-invariant) variational principles, we obtain explicit differential equations for hyperbolic, elliptic, and parabolic OECSs. As an illustration, we compute OECSs in an unsteady ocean velocity data set. In comparison to structures suggested by other common Eulerian diagnostic tools, we find OECSs to be the correct short-term cores of observed trajectory deformation patterns. PMID:27249950

  17. Implementation of an Electronic Objective Structured Clinical Exam for Assessing Practical Skills in Pre-Professional Physiotherapy and Occupational Therapy Programs: Examiner and Course Coordinator Perspectives

    ERIC Educational Resources Information Center

    Snodgrass, Suzanne J.; Ashby, Samantha E.; Rivett, Darren A.; Russell, Trevor

    2014-01-01

    Assessment of practical clinical skills is essential in the health fields. Objective Structured Clinical Exams (OSCEs), where examiners assess students performing clinical procedures on simulated patients (actors), are central to the evaluation of practical skills. However, traditional OSCEs require considerable time-investment to administer, and…

  18. [Implementation of Objective Structured Clinical Examination I of the Department of Nursing--Introduction of Simulation-Based Education].

    PubMed

    Anan, Ayumi; Nagamatsu, Yuki; Chou, Satoko; Sato, Aki; Matsuoka, Chieko; Toyofuku, Kayo; Jitsuzaki, Mina; Nakamura, Emi; Hirowatari, Kanako; Fujiki, Kumiko; Nakamae, Miyuki; Kodama, Hiromi; Hagiwara, Tomoko

    2015-12-01

    The Department of Nursing of the university revised its curriculum for students admitted in 2012 or later, including the introduction of integrated subjects. With the aim of improving the practical clinical skills of students and integrating knowledge, skills, and techniques, the following integrated subjects: Objective Structured Clinical Examination (OSCE) I held in the first term of the third-year (15 hours as one credit), and OSCE II held in the second term of the fourth year (30 hours as one credit), were adopted, and simulation-based education was introduced. In this report, we summarized our experience of a simulation education system for nursing students in the year 2014 aiming to improve students' skill of wheelchair transfer of a patient with left hemiplegia and patient's living environment. Many positive responses, such as usefulness in future nursing training, were obtained upon the introduction of the simulation education system. Issues to be addressed in the future, including lack of sufficient time to practice and availability of rooms, were also noticed. PMID:26667198

  19. Objective Structured Clinical Examination (OSCE)-based Assessment of the Advanced Trauma Life Support (ATLS) Course in Iran

    PubMed Central

    Abbasi, Hamid Reza; Amini, Mitra; Bolandparvaz, Shahram; Paydar, Shahram; Ali, Jameel; Sefidbakht, Sepideh

    2016-01-01

    Objective: To evaluate the effect of advance trauma life support (ATLS®) training on general surgery residents clinical reasoning skills using the national boards-style objective structured clinical examination (OSCE). Methods: This cross-sectional single-center study was conducted in Shiraz University of Medical Sciences including 51 surgery residents that participated in a mandatory national board style OSCE between May 2014 and May 2015. OSCE scores of two groups of general surgery residents including 23 ATLS® trained and 28 non-ATLS® trained were compared using Mann-Whitney U test. The exam was graded out of 20 points and the passing score was ≥14 including 40% trauma cases. Results: There were 8(15.7%) women and 43(84.3%) men among the participants with mean age of 31.12 ± 2.69 and 33.67 ± 4.39 years in women and men respectively. Overall 7 (87.5%) women and 34 (79.07%) men passed the OSCE. The trauma section OSCE score was significantly higher in the ATLS® trained participants when compared to non-ATLS®(7.79 ± 0.81vs.6.90 ± 1.00; p=0.001). In addition, the total score was also significantly higher in ATLS® trained residents (16.07 ± 1.41 vs. 14.60 ± 1.40; p=0.001). There was no association between gender and ATLS® score (p=0.245) or passing the OSCE (p=0.503). Conclusion: ATLS® training is associated with improved overall OSCE scores of general surgery residents completing the board examinations suggesting a positive transfer of ATLS learned skills to management of simulated surgical patients including trauma cases. PMID:27331063

  20. From object structure to object function

    NASA Astrophysics Data System (ADS)

    Zlateva, Stoyanka D.; Vaina, Lucia M.

    1991-03-01

    In this paper we provide a mathematical support for the nature of the shape representation methods useful for the computation of possible functions of an objects as derived from its shape structure. We discuss the concepts of parts and subparts of objects in the framework of axis based shape representation methods and boundary based methods. We propose a new method for obtaining descriptions of parts which based on a theorem from differential geometry (Pogorelov 1974) that any regular surface can be approximated in a finite environment with a given accuracy by a parabolloid of one of the following types - elliptic, hyperbolic and a parabolloid degenerating into a plane or a parabolic cylinder. Based on these considerations we suggest a heuristic for the approximation of convex object parts by a polyhedra, cylinder, ellipsoid or generalized cone with straight axis depending on the presence of plane, parabolic, elliptic subsets in their boundary, and nonconvex object parts by generalized cones with curved axis. This approach allows to obtain a primitive based shape description after the decomposition of the object shape through the more general boundary-based methods. We present examples of decomposing and describing shapes of common objects in terms of their parts, subparts and associated features.

  1. Test of Integrated Professional Skills: Objective Structured Clinical Examination/Simulation Hybrid Assessment of Obstetrics-Gynecology Residents' Skill Integration

    PubMed Central

    Winkel, Abigail Ford; Gillespie, Colleen; Hiruma, Marissa T.; Goepfert, Alice R.; Zabar, Sondra; Szyld, Demian

    2014-01-01

    Background Assessment of obstetrics-gynecology residents' ability to integrate clinical judgment, interpersonal skills, and technical ability in a uniform fashion is required to document achievement of benchmarks of competency. An observed structured clinical examination that incorporates simulation and bench models uses direct observation of performance to generate formative feedback and standardized evaluation. Methods The Test of Integrated Professional Skills (TIPS) is a 5-station performance-based assessment that uses standardized patients and complex scenarios involving ultrasonography, procedural skills, and evidence-based medicine. Standardized patients and faculty rated residents by using behaviorally anchored checklists. Mean scores reflecting performance in TIPS were compared across competency domains and by developmental level (using analysis of variance) and then compared to standard faculty clinical evaluations (using Spearman ρ). Participating faculty and residents were also asked to evaluate the usefulness of the TIPS. Results Twenty-four residents participated in the TIPS. Checklist items used to assess competency were sufficiently reliable, with Cronbach α estimates from 0.69 to 0.82. Performance improved with level of training, with wide variation in performance. Standard faculty evaluations did not correlate with TIPS performance. Several residents who were rated as average or above average by faculty performed poorly on the TIPS (> 1 SD below the mean). Both faculty and residents found the TIPS format useful, providing meaningful evaluation and opportunity for feedback. Conclusions A simulation-based observed structured clinical examination facilitates observation of a range of skills, including competencies that are difficult to observe and measure in a standardized way. Debriefing with faculty provides an important interface for identification of performance gaps and individualization of learning plans. PMID:24701321

  2. Objective structured clinical examinations (OSCEs) as a summative evaluation tool in a ruminant health management rotation for final-year DVM students.

    PubMed

    Bateman, Ken; Menzies, Paula; Sandals, David; Duffield, Todd; LeBlanc, Stephen; Leslie, Ken; Lissemore, Kerry; Swackhammer, Rob

    2008-01-01

    The objective structured clinical examination (OSCE) has been used for 10 years at the Ontario Veterinary College, University of Guelph, to evaluate the clinical competencies in ruminant health management of final-year DVM students. The performance of these students in the summative assessment, which includes the use of OSCEs, was compared to their formative assessment, given at the end of the rotation. Specifically, classification of students' performance as poor (bottom 10% of the grade range versus "serious deficits") or superior ("A grade" versus "exceeds expectations") was compared. Agreement between the two types of assessment is slight, regardless of whether assessing diagnostic process skills or technical skills--and regardless of whether all students were assessed or only those enrolled in food-animal or mixed streams in their final year--which suggests that the two assess different types of skills. OSCEs are a useful and viable tool for objectively assessing clinical skills in ruminant health management.

  3. Learning from the Narrative Comments of Standardized Patients during an Objective Structured Clinical Examination of Fourth-Year Medical Students.

    ERIC Educational Resources Information Center

    Wilkerson, LuAnn; Rose, Mike

    The standardized patient (SP) examination is used in a majority of medical schools to test clinical skills. This exam usually yields both numerical ratings of clinical skill and narrative comments by patients or observers, yet most empirical studies of SP assessment focus on the numerical ratings only. This study analyzes the comments on a recent…

  4. Learning objectives in resident training. Objectives in clinical chemistry.

    PubMed

    Barrett, D A

    1976-06-01

    The use of learning objectives has recently found extensive application in the evolution of medical school curricula; however, they have not been utilized systematically in the education of pathology residents. In attempting to define the end-point behavior or objectives of a resident during a rotation in clinical biochemistry, 567 midwestern pathologists, clinical chemists and medical technologists working in chemistry sections rated proposed objectives as essentail, desirable but not essential, or not needed. Twenty-four of 52 objectives were considered essential for the resident to achieve by 75% or more of the respondents. These included 10 of 33 related to technical knowledge, 5 to 10 related to business and supervisory skills, 5 of 5 related to investigative problem solving, and 4 of 4 related to communicating with persons outside of the laboratory. In general, respondents considered knowledge of principles more important than technical skills. Management, business and communicative skills were highly rated.

  5. Mental health and learning disability nursing students' perceptions of the usefulness of the objective structured clinical examination to assess their competence in medicine administration.

    PubMed

    Hemingway, Steve; Stephenson, John; Roberts, Bronwyn; McCann, Terence

    2014-08-01

    The aim of this study was to evaluate mental health and learning disability nursing students' perceptions of the usefulness of the objective structured clinical examination (OSCE) in assessing their administration of medicine competence. Learning disability (n = 24) and mental health (n = 46) students from a single cohort were invited to evaluate their experience of the OSCE. A 10-item survey questionnaire was used, comprising open- and closed-response questions. Twelve (50%) learning disability and 32 (69.6%) mental health nursing students participated. The OSCE was rated highly compared to other theoretical assessments; it was also reported as clinically real and as a motivational learning strategy. However, it did not rate as well as clinical practice. Content analysis of written responses identified four themes: (i) benefits of the OSCE; (ii) suggestions to improve the OSCE; (iii) concern about the lack of clinical reality of the OSCE; and (iv) OSCE-induced stress. The themes, although repeating some of the positive statistical findings, showed that participants were critical of the university setting as a place to conduct clinical assessment, highlighted OSCE-related stress, and questioned the validity of the OSCE as a real-world assessment. The OSCE has an important role in the development of student nurses' administration of medicine skills. However, it might hinder their performance as a result of the stress of being assessed in a simulated environment. PMID:25180411

  6. Terminal Behavioral Objectives for Teaching Clinical Toxicology to Clinical Pharmacists

    ERIC Educational Resources Information Center

    Veltri, Joseph C.; And Others

    1976-01-01

    As a first step in the development of a competency-based clinical toxicology clerkship, a set of terminal behavioral objectives were developed that reflect the anticipated role that clinical pharmacists should play as part of the clinical toxicology team. The evaluation approaches used at the University of Utah are presented. (LBH)

  7. The feasibility and acceptability of administering a telemedicine objective structured clinical exam as a solution for providing equivalent education to remote and rural learners

    PubMed Central

    Palmer, RT; Biagioli, FE; Mujcic, J; Schneider, BN; Spires, L; Dodson, LG

    2016-01-01

    Introduction Although many medical schools incorporate distance learning into their curricula, assessing students at a distance can be challenging. While some assessments are relatively simple to administer to remote students, other assessments, such as objective structured clinical exams (OSCEs) are not. This article describes a means to more effectively and efficiently assess distance learners and evaluate the feasibility and acceptability of the assessment. Methods We developed a teleOSCE, administered online in real time, to two cohorts of students on a rural clerkship rotation and assessed the feasibility and acceptability of using such an approach to assess medical students’ clinical skills at rural locations. Project feasibility was defined as having development and implementation costs of less than $5000. Project acceptability was determined by analyzing student interview transcripts. A qualitative case study design framework was chosen due to the novel nature of the activity. Results The implementation cost of the teleOSCE was approximately US$1577.20, making it a feasible educational endeavor. Interview data indicated the teleOSCE was also acceptable to students. Conclusions The teleOSCE format may be useful to other institutions as a method to centrally administer clinical skills exams for assessment of distance medical students. PMID:26632083

  8. E-learning module on chronic low back pain in older adults: evidence of effect on medical student objective structured clinical examination performance.

    PubMed

    Weiner, Debra K; Morone, Natalia E; Spallek, Heiko; Karp, Jordan F; Schneider, Michael; Washburn, Carol; Dziabiak, Michael P; Hennon, John G; Elnicki, D Michael

    2014-06-01

    The Institute of Medicine has highlighted the urgent need to close undergraduate and graduate educational gaps in treating pain. Chronic low back pain (CLBP) is one of the most common pain conditions, and older adults are particularly vulnerable to potential morbidities associated with misinformed treatment. An e-learning case-based interactive module was developed at the University of Pittsburgh Center of Excellence in Pain Education, one of 12 National Institutes of Health-designated centers, to teach students important principles for evaluating and managing CLBP in older adults. A team of six experts in education, information technology, pain management, and geriatrics developed the module. Teaching focused on common errors, interactivity, and expert modeling and feedback. The module mimicked a patient encounter using a standardized patient (the older adult with CLBP) and a pain expert (the patient provider). Twenty-eight medical students were not exposed to the module (Group 1) and 27 were exposed (Group 2). Their clinical skills in evaluating CLBP were assessed using an objective structured clinical examination (OSCE). Mean scores were 62.0 ± 8.6 for Group 1 and 79.5 ± 10.4 for Group 2 (P < .001). Using an OSCE pass-fail cutoff score of 60%, 17 of 28 Group 1 students (60.7%) and 26 of 27 Group 2 students (96.3%) passed. The CLBP OSCE was one of 10 OSCE stations in which students were tested at the end of a Combined Ambulatory Medicine and Pediatrics Clerkship. There were no between-group differences in performance on eight of the other nine OSCE stations. This module significantly improved medical student clinical skills in evaluating CLBP. Additional research is needed to ascertain the effect of e-learning modules on more-advanced learners and on improving the care of older adults with CLBP.

  9. The Implementation and Development of an Objective Structured Clinical Examination in the Community Pharmacy Course of a Select Gulf-Region Academic Institution (Ras Al Khaimah College of Pharmaceutical Sciences): A Pilot Study

    ERIC Educational Resources Information Center

    Al-Azzawi, Amad Mohammed Jamil; Nagavi, B.G.; Hachim, Mahmood Y.; Mossa, Omar H.

    2016-01-01

    Background: Objective Structured Clinical Examinations (OSCEs) were used to assess translational pharmacotherapeutic skills of a Gulf-region representative academic institution. Aim: The aim of the current study was to assess the clinical skills of students enrolled within the third year Bachelor of Pharmacy (BPharm) programme within Ras Al…

  10. Object Recognition and Random Image Structure Evolution

    ERIC Educational Resources Information Center

    Sadr, Jvid; Sinha, Pawan

    2004-01-01

    We present a technique called Random Image Structure Evolution (RISE) for use in experimental investigations of high-level visual perception. Potential applications of RISE include the quantitative measurement of perceptual hysteresis and priming, the study of the neural substrates of object perception, and the assessment and detection of subtle…

  11. Evaluation of a Problem-based Learning Workshop Using Pre- and Post-test Objective Structured Clinical Examinations and Standardized Patients.

    ERIC Educational Resources Information Center

    Davis, Paul; Kvern, Brent; Donen, Neil; Andrews, Elaine; Nixon, Olga

    2000-01-01

    Pre/posttest data on 40 physicians who completed problem-based clinical scenarios on osteoporosis revealed that 39 showed improvement or modest change in postworkshop scores, especially in terms of management of male patients, determination of risk factors, and use and interpretation of bone density tests. (SK)

  12. Structured Course Objects in a Digital Library

    NASA Technical Reports Server (NTRS)

    Maly, K.; Zubair, M.; Liu, X.; Nelson, M.; Zeil, S.

    1999-01-01

    We are developing an Undergraduate Digital Library Framework (UDLF) that will support creation/archiving of courses and reuse of existing course material to evolve courses. UDLF supports the publication of course materials for later instantiation for a specific offering and allows the addition of time-dependent and student-specific information and structures. Instructors and, depending on permissions, students can access the general course materials or the materials for a specific offering. We are building a reference implementation based on NCSTRL+, a digital library derived from NCSTRL. Digital objects in NCSTRL+ are called buckets, self-contained entities that carry their own methods for access and display. Current bucket implementations have a two level structure of packages and elements. This is not a rich enough structure for course objects in UDLF. Typically, courses can only be modeled as a multilevel hierarchy and among different courses, both the syntax and semantics of terms may vary. Therefore, we need a mechanism to define, within a particular library, course models, their constituent objects, and the associated semantics in a flexible, extensible way. In this paper, we describe our approach to define and implement these multilayered course objects. We use XML technology to emulate complex data structures within the NCSTRL+ buckets. We have developed authoring and browsing tools to manipulate these course objects. In our current implementation a user downloading an XML based course bucket also downloads the XML-aware tools: an applet that enables the user to edit or browse the bucket. We claim that XML provides an effective means to represent multi-level structure of a course bucket.

  13. An exploration of student nurses' thoughts and experiences of using a video-recording to assess their performance of cardiopulmonary resuscitation (CPR) during a mock objective structured clinical examination (OSCE).

    PubMed

    Paul, Fiona

    2010-09-01

    Cardiopulmonary resuscitation (CPR) is an essential skill taught within undergraduate nursing programmes. At the author's institution, students must pass the CPR objective structured clinical examination (OSCE) before progressing to second year. However, some students have difficulties developing competence in CPR and evidence suggests that resuscitation skills may only be retained for several months. This has implications for practice as nurses are required to be competent in CPR. Therefore, further opportunities for students to develop these skills are necessary. An action research project was conducted with six students who were assessed by an examiner at a video-recorded mock OSCE. Students self-assessed their skills using the video and a checklist. Semi-structured interviews were conducted to compare checklist scores, and explore students' thoughts and experiences of the OSCE. The findings indicate that students may need to repeat this exercise by comparing their previous and current performances to develop both their self-assessment and CPR skills. Although there were some differences between the examiner's and student's checklist scores, all students reported the benefits of participating in this project, e.g. discussion and identification of knowledge and skills deficits, thus emphasising the benefits of formative assessments to prepare students for summative assessments and ultimately clinical practice.

  14. Improving International Research with Clinical Specimens: 5 Achievable Objectives

    PubMed Central

    LaBaer, Joshua

    2012-01-01

    Our increased interest in translational research has created a large demand for blood, tissue and other clinical samples, which find use in a broad variety of research including genomics, proteomics, and metabolomics. Hundreds of millions of dollars have been invested internationally on the collection, storage and distribution of samples. Nevertheless, many researchers complain in frustration about their inability to obtain relevant and/or useful samples for their research. Lack of access to samples, poor condition of samples, and unavailability of appropriate control samples have slowed our progress in the study of diseases and biomarkers. In this editorial, I focus on five major challenges that thwart clinical sample use for translational research and propose near term objectives to address them. They include: (1) defining our biobanking needs; (2) increasing the use of and access to standard operating procedures; (3) mapping inter-observer differences for use in normalizing diagnoses; (4) identifying natural internal protein controls; and (5) redefining the clinical sample paradigm by building partnerships with the public. In each case, I believe that we have the tools at hand required to achieve the objective within 5 years. Potential paths to achieve these objectives are explored. However we solve these problems, the future of proteomics depends on access to high quality clinical samples, collected under standardized conditions, accurately annotated and shared under conditions that promote the research we need to do. PMID:22998582

  15. Towards a smart object network for clinical services.

    PubMed

    Sedlmayr, Martin; Becker, Andreas; Muench, Ulli; Meier, Fritz; Prokosch, Hans-Ulrich; Ganslandt, Thomas

    2009-11-14

    Radio Frequency Identification (RFID) technology has become prevalent in logistics to support and optimize processes and numerous projects investigate its opportunities and challenges in the clinical context. However, most approaches are focused on one specific application using only a few possibilities of the technology. We describe the development of a smart object network to serve as a generic platform for various clinical services. Based on two disparate scenarios - tracking medical devices and transfusion safety - the architecture, implementation issues and prospects of such a platform are discussed.

  16. Dynamic object management for distributed data structures

    NASA Technical Reports Server (NTRS)

    Totty, Brian K.; Reed, Daniel A.

    1992-01-01

    In distributed-memory multiprocessors, remote memory accesses incur larger delays than local accesses. Hence, insightful allocation and access of distributed data can yield substantial performance gains. The authors argue for the use of dynamic data management policies encapsulated within individual distributed data structures. Distributed data structures offer performance, flexibility, abstraction, and system independence. This approach is supported by data from a trace-driven simulation study of parallel scientific benchmarks. Experimental data on memory locality, message count, message volume, and communication delay suggest that data-structure-specific data management is superior to a single, system-imposed policy.

  17. Transforming Clinical Imaging Data for Virtual Reality Learning Objects

    ERIC Educational Resources Information Center

    Trelease, Robert B.; Rosset, Antoine

    2008-01-01

    Advances in anatomical informatics, three-dimensional (3D) modeling, and virtual reality (VR) methods have made computer-based structural visualization a practical tool for education. In this article, the authors describe streamlined methods for producing VR "learning objects," standardized interactive software modules for anatomical sciences…

  18. Objectives of QC systems and QA function in clinical research.

    PubMed

    Poy, E

    1993-12-01

    Over the recent years, the concept of Good Clinical Practice (GCP) has rapidly evolved over the world, with guidelines and regulations now existing not only in the U.S.A. but also in Europe, Scandinavia, Japan, and Australia. The systematic measures laid down in GCP are to ensure that clinical studies are conducted in conformity with strict ethical rules, are performed according to high-quality standards, and result in authentic, verifiable scientific data. Different aspects in managing quality in the clinical field are to be presented: (1) The definition of a two-stage quality system: it identifies the differences between quality control activities which reside with the operational units and auditing activities performed by an independent Quality Assurance group, which assesses the efficiency and integrity of the control systems established to ensure the quality. (2) The multidisciplinary picture of a clinical study: every operational staff contributes to quality through a chain using the "quality in/quality out" concept. (3) The review of the main responsibilities of the main professionals (Sponsor, Monitor, and Investigator) in a GCP environment, to show that quality is achievable by involving appropriate qualified staff. (4) The need of proactive control systems to reduce the risk of error and increase the credibility and confidence in building quality. (5) The role and objectives of a Quality Assurance Group.

  19. Conflict between object structural and functional affordances in peripersonal space.

    PubMed

    Kalénine, Solène; Wamain, Yannick; Decroix, Jérémy; Coello, Yann

    2016-10-01

    Recent studies indicate that competition between conflicting action representations slows down planning of object-directed actions. The present study aims to assess whether similar conflict effects exist during manipulable object perception. Twenty-six young adults performed reach-to-grasp and semantic judgements on conflictual objects (with competing structural and functional gestures) and non-conflictual objects (with similar structural and functional gestures) presented at difference distances in a 3D virtual environment. Results highlight a space-dependent conflict between structural and functional affordances. Perceptual judgments on conflictual objects were slower that perceptual judgments on non-conflictual objects, but only when objects were presented within reach. Findings demonstrate that competition between structural and functional affordances during object perception induces a processing cost, and further show that object position in space can bias affordance competition.

  20. Conflict between object structural and functional affordances in peripersonal space.

    PubMed

    Kalénine, Solène; Wamain, Yannick; Decroix, Jérémy; Coello, Yann

    2016-10-01

    Recent studies indicate that competition between conflicting action representations slows down planning of object-directed actions. The present study aims to assess whether similar conflict effects exist during manipulable object perception. Twenty-six young adults performed reach-to-grasp and semantic judgements on conflictual objects (with competing structural and functional gestures) and non-conflictual objects (with similar structural and functional gestures) presented at difference distances in a 3D virtual environment. Results highlight a space-dependent conflict between structural and functional affordances. Perceptual judgments on conflictual objects were slower that perceptual judgments on non-conflictual objects, but only when objects were presented within reach. Findings demonstrate that competition between structural and functional affordances during object perception induces a processing cost, and further show that object position in space can bias affordance competition. PMID:27327864

  1. Objective Structured Video Examinations (OSVEs) for geriatrics education.

    PubMed

    Simpson, Deborah; Helm, Robin; Drewniak, Theresa; Ziebert, Monica M; Brown, Diane; Mitchell, Julie; Havas, Nancy; Denson, Kathryn; Gehl, Suzanne; Kerwin, Diana; Bragg, Dawn St A; Denson, Steven; Gleason Heffron, Mary; Harsch, Harold H; Duthie, Edmund H

    2006-01-01

    The Medical College of Wisconsin (MCW) and the Wisconsin Geriatric Education Center (WGEC) are committed to developing educational materials for primary care physicians in training. In response to the opportunity created by the Accreditation Council for Graduate Medical Education (ACGME) competency mandate, an MCW-led interdisciplinary working group has developed competency-linked video-based assessment tools for use in primary care residency training programs. Modeled after the Objective Structured Clinical Examinations (OSCE), used as part of the medical licensing examination process, we created geriatric-focused Objective Structured Video Examinations (OSVEs) as a strategy to infuse geriatrics into residency training. Each OSVE tool contains a 1-3 minute video trigger that is associated with a series of multiple choice and/or constructed response questions (e.g., fill in the blank). These questions assess residents' understanding of video-demonstrated ACGME competencies including professionalism, systems-based practice, communication, and practice-based learning. An instructor's guide and scoring key are provided for each tool. Response to the OSVEs has been overwhelmingly enthusiastic including greater than 90% commitment by statewide faculty to use the tools in residency training.

  2. Method for preventing micromechanical structures from adhering to another object

    DOEpatents

    Smith, J.H.; Ricco, A.J.

    1998-06-16

    A method for preventing micromechanical structures from adhering to another object includes the step of immersing a micromechanical structure and its associated substrate in a chemical species that does not stick to itself. The method can be employed during the manufacture of micromechanical structures to prevent micromechanical parts from sticking or adhering to one another and their associated substrate surface. 3 figs.

  3. Method for preventing micromechanical structures from adhering to another object

    DOEpatents

    Smith, James H.; Ricco, Antonio J.

    1998-01-01

    A method for preventing micromechanical structures from adhering to another object includes the step of immersing a micromechanical structure and its associated substrate in a chemical species that does not stick to itself. The method can be employed during the manufacture of micromechanical structures to prevent micromechanical parts from sticking or adhering to one another and their associated substrate surface.

  4. Active Structured Learning for High-Speed Object Detection

    NASA Astrophysics Data System (ADS)

    Lampert, Christoph H.; Peters, Jan

    High-speed smooth and accurate visual tracking of objects in arbitrary, unstructured environments is essential for robotics and human motion analysis. However, building a system that can adapt to arbitrary objects and a wide range of lighting conditions is a challenging problem, especially if hard real-time constraints apply like in robotics scenarios. In this work, we introduce a method for learning a discriminative object tracking system based on the recent structured regression framework for object localization. Using a kernel function that allows fast evaluation on the GPU, the resulting system can process video streams at speed of 100 frames per second or more.

  5. Learning Clinical Procedures Through Internet Digital Objects: Experience of Undergraduate Students Across Clinical Faculties

    PubMed Central

    Li, Tse Yan; Wong, Kin; Tse, Christine Shuk Kwan; Chan, Ying Yee

    2015-01-01

    Background Various digital learning objects (DLOs) are available via the World Wide Web, showing the flow of clinical procedures. It is unclear to what extent these freely accessible Internet DLOs facilitate or hamper students’ acquisition of clinical competence. Objective This study aimed to understand the experience of undergraduate students across clinical disciplines—medicine, dentistry, and nursing—in using openly accessible Internet DLOs, and to investigate the role of Internet DLOs in facilitating their clinical learning. Methods Mid-year and final-year groups were selected from each undergraduate clinical degree program of the University of Hong Kong—Bachelor of Medicine and Bachelor of Surgery (MBBS), Bachelor of Dental Surgery (BDS), and Bachelor of Nursing (BNurs). All students were invited to complete a questionnaire on their personal and educational backgrounds, and their experiences and views on using Internet DLOs in learning clinical procedures. The questionnaire design was informed by the findings of six focus groups. Results Among 439 respondents, 97.5% (428/439) learned a variety of clinical procedures through Internet DLOs. Most nursing students (107/122, 87.7%) learned preventive measures through Internet DLOs, with a lower percentage of medical students (99/215, 46.0%) and dental students (43/96, 45%) having learned them this way (both P<.001). Three-quarters (341/439, 77.7%) of students accessed DLOs through public search engines, whereas 93.2% (409/439) accessed them by watching YouTube videos. Students often shared DLOs with classmates (277/435, 63.7%), but rarely discussed them with teachers (54/436, 12.4%). The accuracy, usefulness, and importance of Internet DLOs were rated as 6.85 (SD 1.48), 7.27 (SD 1.53), and 7.13 (SD 1.72), respectively, out of a high score of 10. Conclusions Self-exploration of DLOs in the unrestricted Internet environment is extremely common among current e-generation learners and was regarded by students

  6. Object-relations and spirituality: revisiting a clinical dialogue.

    PubMed

    Gurney, Andrea G; Rogers, Steven A

    2007-10-01

    Antagonism and separateness has characterized the relationship between psychotherapy and religion/spirituality throughout the history of psychology, beginning with Freudian psychoanalytic theory. Recently, however, spirituality, broadly defined as a transcendent relationship with a higher being, has begun to reemerge as a central concept in therapeutic work. There is fertile ground for exploring how spirituality can be enfolded into psychotherapeutic practice, particularly from an object-relations standpoint. The purpose of this article, therefore, is to examine points of convergence and divergence between spirituality and object-relations theory and explore the integration of spirituality with object-relations therapy, with the hope of replacing historical antagonism with thoughtful and intentional integration.

  7. Auditing clinical research data: objectives, applications and results.

    PubMed

    Justice, R L

    1983-01-01

    Formal auditing of clinical research data has become a standard contemporary practice within the pharmaceutical industry. Its basic purpose is to provide documentation relevant to an assessment of the quality and integrity of data collected in the course of a clinical trial. This paper outlines the audit procedures developed within one major pharmaceutical firm. These procedures require an intensive investigation of internal and external aspects of study management, records management, data entry, data analysis and statistical report preparation. A qualitative evaluation of the results achieved by this auditing procedure are presented.

  8. Detection and location of metallic objects imbedded in nonmetallic structures

    NASA Technical Reports Server (NTRS)

    Brown, R. L.; Neuschaefer, R. W.

    1968-01-01

    Small battery operated eddy current proximity measuring device detects and locates metal objects the size of a dime at distances up to one foot within nonmetallic structures. This device weighs approximately two pounds, occupies approximately 60 cubic inches, and is battery powered.

  9. Computerization of the Structured-Objective Rorschach Test

    ERIC Educational Resources Information Center

    Ingenohl, Ingo

    1973-01-01

    SORTSCOR performs raw scoring of the Structured-Objective Rorschach Test (SORT) and REPORT subsequently writes a narrative report in easily readable, nonclinical language. Complete documentation is available, at cost, from the author at Quinnipiac College, Hamden, Conn. 06518. (Author/CB)

  10. Video object motion tracking: a structured versus unstructured mesh topology

    NASA Astrophysics Data System (ADS)

    Badawy, Wael

    2001-11-01

    This paper presents a novel concept for very low bit rate video codec. It uses a new hierarchical adaptive structured mesh topology. The proposed video codec can be used in wireless video applications. It uses structures to model the dynamics of the video object where the proposed the adaptive structure splitting significantly reduces the number of bits used for mesh description. Moreover, it reduces the latency of motion estimation and compensation operations. A comprehensive performance study is presented for the proposed mesh-based motion tracking and the commonly used techniques. It shows the superior of the proposed concept compare to the current MPEG techniques.

  11. Hierarchical object parsing from structured noisy point clouds.

    PubMed

    Barbu, Adrian

    2013-07-01

    Object parsing and segmentation from point clouds are challenging tasks because the relevant data is available only as thin structures along object boundaries or other features, and is corrupted by large amounts of noise. To handle this kind of data, flexible shape models are desired that can accurately follow the object boundaries. Popular models such as active shape and active appearance models (AAMs) lack the necessary flexibility for this task, while recent approaches such as the recursive compositional models make model simplifications to obtain computational guarantees. This paper investigates a hierarchical Bayesian model of shape and appearance in a generative setting. The input data is explained by an object parsing layer which is a deformation of a hidden principal component analysis (PCA) shape model with Gaussian prior. The paper also introduces a novel efficient inference algorithm that uses informed data-driven proposals to initialize local searches for the hidden variables. Applied to the problem of object parsing from structured point clouds such as edge detection images, the proposed approach obtains state-of-the-art parsing errors on two standard datasets without using any intensity information.

  12. Object-oriented structures supporting remote sensing databases

    NASA Technical Reports Server (NTRS)

    Wichmann, Keith; Cromp, Robert F.

    1995-01-01

    Object-oriented databases show promise for modeling the complex interrelationships pervasive in scientific domains. To examine the utility of this approach, we have developed an Intelligent Information Fusion System based on this technology, and applied it to the problem of managing an active repository of remotely-sensed satellite scenes. The design and implementation of the system is compared and contrasted with conventional relational database techniques, followed by a presentation of the underlying object-oriented data structures used to enable fast indexing into the data holdings.

  13. Objective Clinical Assessment of Posture Patterns after Implant Breast Augmentation

    PubMed Central

    Mandrini, Silvia; Finotti, Valentina; Dall’Angelo, Anna; Malovini, Alberto; Chierico, Simona; Faga, Angela; Dalla Toffola, Elena

    2015-01-01

    Background: An increased weight of the breasts causes several spinal postural alterations that reduce the ability to perform dynamic tasks requiring a stable balance. The effects of the increased weight of the breasts on static posture after implant breast augmentation have not been investigated yet. Methods: Forty volunteer healthy women were asked to wear different sized breast implants (800, 400, and 300 g) inside a dedicated sports bra for 6½ consecutive hours during their everyday life activities, 1 day for every implant size. Posture changes were assessed with the association of a physiatric clinical examination with a static force platform analysis. Results: A significant increase in cervical lordosis after the use of 400-g breast implants and upward was demonstrated. This alteration was stable between the 400-g and 800-g breast implants. The 400-g (per breast) implant might therefore be the load threshold that breaks the cervical postural physiologic balance. A significant increase in lumbar lordosis was demonstrated only after the use of the 800-g breast implants. The static force platform assessment demonstrated a worsening of the balance independent from the visual control with the use of 400-g and 800-g implants. Conclusions: Heavy breast implants proved to induce reversible alterations in the spinal curve, and 400 g is the cutoff for functional physiologic compensation in the short term. Such a weight might be considered the safety limit for the use of breast implants for cosmetic purposes. PMID:26218390

  14. Motor Performance Assessment in Parkinson’s Disease: Association between Objective In-Clinic, Objective In-Home, and Subjective/Semi-Objective Measures

    PubMed Central

    Toosizadeh, Nima; Mohler, Jane; Lei, Hong; Parvaneh, Saman; Sherman, Scott; Najafi, Bijan

    2015-01-01

    Advances in wearable technology allow for the objective assessment of motor performance in both in-home and in-clinic environments and were used to explore motor impairments in Parkinson’s disease (PD). The aims of this study were to: 1) assess differences between in-clinic and in-home gait speed, and sit-to-stand and stand-to-sit duration in PD patients (in comparison with healthy controls); and 2) determine the objective physical activity measures, including gait, postural balance, instrumented Timed-up-and-go (iTUG), and in-home spontaneous physical activity (SPA), with the highest correlation with subjective/semi-objective measures, including health survey, fall history (fallers vs. non-fallers), fear of falling, pain, Unified Parkinson's Disease Rating Scale, and PD stage (Hoehn and Yahr). Objective assessments of motor performance were made by measuring physical activities in the same sample of PD patients (n = 15, Age: 71.2±6.3 years) and age-matched healthy controls (n = 35, Age: 71.9±3.8 years). The association between in-clinic and in-home parameters, and between objective parameters and subjective/semi-objective evaluations in the PD group was assessed using linear regression-analysis of variance models and reported as Pearson correlations (R). Both in-home SPA and in-clinic assessments demonstrated strong discriminatory power in detecting impaired motor function in PD. However, mean effect size (0.94±0.37) for in-home measures was smaller compared to in-clinic assessments (1.30±0.34) for parameters that were significantly different between PD and healthy groups. No significant correlation was observed between identical in-clinic and in-home parameters in the PD group (R = 0.10–0.25; p>0.40), while the healthy showed stronger correlation in gait speed, sit-to-stand duration, and stand-to-sit duration (R = 0.36–0.56; p<0.03). This suggests a better correlation between supervised and unsupervised motor function assessments in healthy controls

  15. Several strategies for evaluating the objectivity of measurements in clinical research and practice

    PubMed Central

    Keating, Joseph C

    1988-01-01

    The objectivity (interexaminer reliability) of measurement in chiropractic provides a basis for judging the quality of information in clinical research and practice. Objectivity may be determined by formal measurement evaluation studies and by sampling within clinical trials. Interpretation of inter-examiner reliability requires descriptive and inferential statistics selected on the basis of the mathematical properties of data, appreciation of the clinical meaning of a particular measure, and recognition of the role of chance. Methods of data analysis include scatter-plots, contingency tables, time-series graphs, and correlational and concordance coefficients. Many kinds of objectivity evaluations are well within the capacities of private practitioners and student clinicians.

  16. Clinical simulation as a boundary object in design of health IT-systems.

    PubMed

    Rasmussen, Stine Loft; Jensen, Sanne; Lyng, Karen Marie

    2013-01-01

    Healthcare organizations are very complex, holding numerous stakeholders with various approaches and goals towards the design of health IT-systems. Some of these differences may be approached by applying the concept of boundary objects in a participatory IT-design process. Traditionally clinical simulation provides the opportunity to evaluate the design and the usage of clinical IT-systems without endangering the patients and interrupting clinical work. In this paper we present how clinical simulation additionally holds the potential to function as a boundary object in the design process. The case points out that clinical simulation provides an opportunity for discussions and mutual learning among the various stakeholders involved in design of standardized electronic clinical documentation templates. The paper presents and discusses the use of clinical simulation in the translation, transfer and transformation of knowledge between various stakeholders in a large healthcare organization. PMID:23941951

  17. Subjective - Objective Sleep Comparisons and Discrepancies Among Clinically-Anxious and Healthy Children.

    PubMed

    Alfano, Candice A; Patriquin, Michelle A; De Los Reyes, Andres

    2015-10-01

    We compared subjective and objective sleep patterns and problems, and examined cross-method correspondence across parent reports, child reports, and actigraphy-derived sleep variables in clinically-anxious children and healthy controls. In a multi-site, cross-sectional study, 75 pre-adolescent children (6 to 11 years; M = 8.7 years; SD = 1.4; n = 39/52 % female) were examined including 39 with a diagnosis of primary generalized anxiety disorder (GAD) and 36 controls recruited from university-based clinics in Houston, TX and Washington, DC. Structured interviews, validated sleep questionnaires, and 1 week of actigraphy data were utilized. Despite subjective reports of significantly greater sleep problems among anxious children, actigraphy data revealed no significant differences between the groups. All parents estimated earlier bedtimes and greater total sleep duration relative to actigraphy, and all children endorsed more sleep problems than parents. With few exceptions, subjective reports exhibited low and non-significant correspondence with actigraphy-based sleep patterns and problems. Our findings suggest that high rates of sleep complaints found among children with GAD (and their parents) are not corroborated by objective sleep abnormalities, with the exception of marginally prolonged sleep onset latency compared to controls. Objective-subjective sleep discrepancies were observed in both groups but more apparent overall in the GAD group. Frequent complaints of sleep problems and daytime tiredness among anxious youth might more accurately reflect difficulties prior to the actual sleep period, cognitive-affective biases associated with sleep, and/or poor sleep quality. Findings highlight the importance of considering sleep from multiple perspectives.

  18. The Development of Clinical Reasoning Skills: A Major Objective of the Anatomy Course

    ERIC Educational Resources Information Center

    Elizondo-Omana, Rodrigo E.; Lopez, Santos Guzman

    2008-01-01

    Traditional medical school curricula have made a clear demarcation between the basic biomedical sciences and the clinical years. It is our view that a comprehensive medical education necessarily involves an increased correlation between basic science knowledge and its clinical applications. A basic anatomy course should have two main objectives:…

  19. Structure and Evolution of Kuiper Belt Objects and Dwarf Planets

    NASA Astrophysics Data System (ADS)

    McKinnon, W. B.; Prialnik, D.; Stern, S. A.; Coradini, A.

    Kuiper belt objects (KBOs) accreted from a mélange of volatile ices, carbonaceous matter, and rock of mixed interstellar and solar nebular provenance. The transneptunian region, where this accretion took place, was likely more radially compact than today. This and the influence of gas drag during the solar nebula epoch argue for more rapid KBO accretion than usually considered. Early evolution of KBOs was largely the result of heating due to radioactive decay, the most important potential source being 26Al, whereas long-term evolution of large bodies is controlled by the decay of U, Th, and 40K. Several studies are reviewed dealing with the evolution of KBO models, calculated by means of one-dimensional numerical codes that solve the heat and mass balance equations. It is shown that, depending on parameters (principally rock content and porous conductivity), KBO interiors may have reached relatively high temperatures. The models suggest that KBOs likely lost ices of very volatile species during early evolution, whereas ices of less-volatile species should be retained in cold, less-altered subsurface layers. Initially amorphous ice may have crystallized in KBO interiors, releasing volatiles trapped in the amorphous ice, and some objects may have lost part of these volatiles as well. Generally, the outer layers are far less affected by internal evolution than the inner part, which in the absence of other effects (such as collisions) predicts a stratified composition and altered porosity distribution. Kuiper belt objects are thus unlikely to be "the most pristine objects in the solar system," but they do contain key information as to how the early solar system accreted and dynamically evolved. For large (dwarf planet) KBOs, long-term radiogenic heating alone may lead to differentiated structures -- rock cores, ice mantles, volatile-ice-rich "crusts," and even oceans. Persistence of oceans and (potential) volcanism to the present day depends strongly on body size and

  20. Reconstruction of buried objects embedded in circular opaque structures

    NASA Astrophysics Data System (ADS)

    Persico, Raffaele; Gennarelli, Gianluca; Soldovieri, Francesco

    2014-05-01

    This contribution deals with the ground penetrating radar imaging of targets embedded in a visually opaque circular structure. The problem has practical relevance in civil engineering and archeological prospections, where structures of interest such as columns or pillars may have to be inspected in non-invasive way in order to detect the possible presence of anomalies (e.g. cracks, water infiltrations, and so on). In this framework, we investigate the possibility to inspect the circular region of interest thanks to a radar system composed by two antennas that are in contact with the structure and rotate simultaneously around it in order to illuminate and measure the field scattered by buried objects from multiple directions. Two different measurement strategies are examined. The first one is the multimonostatic configuration where the backscattered signal is collected by the transmitting antenna itself, as it moves along the circular observation line. The second acquisition strategy is the multibistatic one, with the transmitting and receiving antennas shifted by a constant angular offset of ninety degrees as they move around the column. From the mathematical viewpoint, the imaging problem is formulated as a linear inverse scattering one holding under Born approximation [1]. Furthermore, the Green's function of a homogeneous medium [2] is used to simplify the evaluation of the kernel of the integral equation. The inverse problem is then solved via the Truncated Singular Value Decomposition algorithm [3] in order to obtain a regularized solution. Tomographic reconstructions based on full-wave synthetic data generated by the Finite Difference Time Domain code GPRmax2D [4] are shown to assess the effectiveness of the reconstruction process. REFERENCES [1] W. C. Chew, Waves and fields in inhomogeneous media, IEEE Press, 1995. [2] R. F. Harrington, Time harmonic electromagnetic waves, McGraw-Hill, New York, USA, 1961. [3] M. Bertero and P. Boccacci, Introduction to

  1. Rapid Changes in the Structure of the BN Object

    NASA Technical Reports Server (NTRS)

    Danchi, William C.; Gezari, D. Y.; Greenhill, L. J.; Najita, J.; Monnier, J. D.; Tuthill, P. G.; Wishnow, E. H.; Townes, C. H.; Fisher, Richard R. (Technical Monitor)

    2001-01-01

    The BN/KL region in Orion is the archetypal region of high-mass star formation, radiating approx. 10(sup)5 Lsun and displaying promininent bulk outflows. In particular, there is no certain identification of the sources responsible for the high luminosity and outflows, and is the origin of a major explosive event (Shultz et al. 1999, ApJ, 511, 282). Using 18.7 and 12.5 micron data from observations in December 1999 and October 2000 made at the Keck I telescope, we discovered that the BN Object has a companion previously seen only at radio wavelengths (Menten & Reid 1995, ApJ, 445, L157). We call this companion B2 and it is about 1.5 arcsec West of the bright component. We also see changes in the shape of BN and the emission of "blobs" or "bullets" of material. While B2 remains unchanged and in the same place between the two epochs, there is an additional structure in BN to the South-South-East and the North-East, as well as a finger of material pointing North from B2 itself. Such a change has not been seen before in the infrared. We have looked very carefully at these images, calibrator images taken within a few minutes of the source images, as well as our previous images and cannot find any technical faults with the data. We explore the implications of these results, in particular, can these features be connected with previously observed "bullets" or "fingers" (see Allen & Burton 1993, for example), making BN a source for the bullets, implying they are not from IRc2 as previously thought? Or could they be produced by an interaction between material from BN and other sources such as IRc2?

  2. What is an Objective Structured Practical Examination in Anatomy?

    ERIC Educational Resources Information Center

    Yaqinuddin, Ahmed; Zafar, Muhammad; Ikram, Muhammad Faisal; Ganguly, Paul

    2013-01-01

    Assessing teaching-learning outcomes in anatomical knowledge is a complex task that requires the evaluation of multiple domains: theoretical, practical, and clinical knowledge. In general, theoretical knowledge is tested by a written examination system constituted by multiple choice questions (MCQs) and/or short answer questions (SAQ). The…

  3. Hopf-algebraic structure of combinatorial objects and differential operators

    NASA Technical Reports Server (NTRS)

    Grossman, Robert; Larson, Richard G.

    1989-01-01

    A Hopf-algebraic structure on a vector space which has as basis a family of trees is described. Some applications of this structure to combinatorics and to differential operators are surveyed. Some possible future directions for this work are indicated.

  4. Objective evaluation of fine motor manipulation-a new clinical tool.

    PubMed

    Andersen Hammond, Elizabeth R; Shay, Barbara L; Szturm, Tony

    2009-01-01

    A new performance-based tool has been developed to accurately and precisely evaluate finger/hand function during manipulation of any object, independent of geometric and surface properties. The objectives of this study were to show test-retest reliability and evaluate criterion validity. Twenty healthy, right-handed participants were recruited. Three objects ranging in weight and size, requiring two or three fingers, were instrumented with a motion sensor that tracked 3D linear/angular motion. A computerized visual-guided tracking task was used to quantify motor performance during object manipulation. Two testing periods, one week apart were performed to evaluate test-retest reliability. Criterion validity was assessed by comparing performance with this tool to performance on commonly used clinical dexterity tests. Global performance, temporal accuracy, and amplitude consistency during manipulation of the objects compared with the reference waveform were highly reliable on the two testing occasions. Low-moderate correlations between the clinical dexterity tests and the task protocol indicate that different aspects of hand function were measured. The task protocol directly measures the ability of the hand to coordinate movement in response to a visual tracking target. Providing effective and objective ways to evaluate manual dexterity and hand function is a critical part of evidence-based practice.

  5. Structuring Clinical Workflows for Diabetes Care

    PubMed Central

    Lasierra, N.; Oberbichler, S.; Toma, I.; Fensel, A.; Hoerbst, A.

    2014-01-01

    Summary Background Electronic health records (EHRs) play an important role in the treatment of chronic diseases such as diabetes mellitus. Although the interoperability and selected functionality of EHRs are already addressed by a number of standards and best practices, such as IHE or HL7, the majority of these systems are still monolithic from a user-functionality perspective. The purpose of the OntoHealth project is to foster a functionally flexible, standards-based use of EHRs to support clinical routine task execution by means of workflow patterns and to shift the present EHR usage to a more comprehensive integration concerning complete clinical workflows. Objectives The goal of this paper is, first, to introduce the basic architecture of the proposed OntoHealth project and, second, to present selected functional needs and a functional categorization regarding workflow-based interactions with EHRs in the domain of diabetes. Methods A systematic literature review regarding attributes of workflows in the domain of diabetes was conducted. Eligible references were gathered and analyzed using a qualitative content analysis. Subsequently, a functional workflow categorization was derived from diabetes-specific raw data together with existing general workflow patterns. Results This paper presents the design of the architecture as well as a categorization model which makes it possible to describe the components or building blocks within clinical workflows. The results of our study lead us to identify basic building blocks, named as actions, decisions, and data elements, which allow the composition of clinical workflows within five identified contexts. Conclusions The categorization model allows for a description of the components or building blocks of clinical workflows from a functional view. PMID:25024765

  6. Language structure in the n -object naming game.

    PubMed

    Lipowski, Adam; Lipowska, Dorota

    2009-11-01

    We examine a naming game with two agents trying to establish a common vocabulary for n objects. Such efforts lead to the emergence of language that allows for an efficient communication and exhibits some degree of homonymy and synonymy. Although homonymy reduces the communication efficiency, it seems to be a dynamical trap that persists for a long, and perhaps indefinite, time. On the other hand, synonymy does not reduce the efficiency of communication but appears to be only a transient feature of the language. Thus, in our model the role of synonymy decreases and in the long-time limit it becomes negligible. A similar rareness of synonymy is observed in present natural languages. The role of noise, that distorts the communicated words, is also examined. Although, in general, the noise reduces the communication efficiency, it also regroups the words so that they are more evenly distributed within the available "verbal" space.

  7. User-specific interfaces for clinical data-management systems: an object-based approach.

    PubMed Central

    Wilton, R.

    1992-01-01

    Multiple user-specific visual interfaces are desirable in any computer-based clinical data-management system that is used by different people with different jobs to perform. The programming and maintenance problems of supporting multiple user interfaces to a single information system can be addressed by separating user-interface functionality from data-management subsystems, and by building user interfaces from object-based software components whose functionality is bound to an underlying server-client data-management architecture. Experience with this approach in a patient-tracking system suggests that this object-based approach is viable in the design of a user interface for a clinical information system. PMID:1482880

  8. Anomalous sea surface structures as an object of statistical topography.

    PubMed

    Klyatskin, V I; Koshel, K V

    2015-06-01

    By exploiting ideas of statistical topography, we analyze the stochastic boundary problem of emergence of anomalous high structures on the sea surface. The kinematic boundary condition on the sea surface is assumed to be a closed stochastic quasilinear equation. Applying the stochastic Liouville equation, and presuming the stochastic nature of a given hydrodynamic velocity field within the diffusion approximation, we derive an equation for a spatially single-point, simultaneous joint probability density of the surface elevation field and its gradient. An important feature of the model is that it accounts for stochastic bottom irregularities as one, but not a single, perturbation. Hence, we address the assumption of the infinitely deep ocean to obtain statistic features of the surface elevation field and the squared elevation gradient field. According to the calculations, we show that clustering in the absolute surface elevation gradient field happens with the unit probability. It results in the emergence of rare events such as anomalous high structures and deep gaps on the sea surface almost in every realization of a stochastic velocity field. PMID:26172788

  9. Magnetic field structure around cores with very low luminosity objects

    NASA Astrophysics Data System (ADS)

    Soam, A.; Maheswar, G.; Lee, Chang Won; Dib, Sami; Bhatt, H. C.; Tamura, Motohide; Kim, Gwanjeong

    2015-01-01

    Aims: We carried out optical polarimetry of five dense cores, (IRAM 04191, L1521F, L328, L673-7, and L1014) which are found to harbour very low luminosity objects (VeLLOs; Lint ≲ 0.1 L⊙). This study was conducted mainly to understand the role played by the magnetic field in the formation of very low and substellar mass range objects. Methods: Light from the stars, while passing through the dust grains that are aligned with their short axis parallel to an external magnetic field, becomes linearly polarised. The polarisation position angles measured for the stars can provide the plane-of-the sky magnetic field orientation. Because the light in the optical wavelength range is most efficiently polarised by the dust grains typically found at the outer layers of the molecular clouds, optical polarimetry mostly traces the magnetic field orientation of the core envelope. Results: The polarisation observations of stars projected on IRAM 04191, L328, L673-7, and L1014 were obtained in the R-band and those of L1521F were obtained in the V-band. The angular offsets between the envelope magnetic field direction (inferred from optical polarisation measurements) and the outflow position angles from the VeLLOs in IRAM 04191, L1521F, L328, L673-7, and L1014 are found to be 84°, 53°, 24°, 08°, and 15°, respectively. The mean value of the offsets for all the five clouds is ~ 37°. If we exclude IRAM 04191, the mean value reduces to become ~ 25°. In IRAM 04191, the offset between the projected envelope and the inner magnetic field (inferred from the submillimetre data obtained using SCUBA-POL) is found to be ~ 68°. The inner magnetic field, however, is found to be nearly aligned with the projected position angles of the minor axis, the rotation axis of the cloud, and the outflow from the IRAM 04191-IRS. We discuss a possible explanation for the nearly perpendicular orientation between the envelope and core scale magnetic fields in IRAM 04191. The angular offset between the

  10. 30 CFR 77.403 - Mobile equipment; falling object protective structures (FOPS).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Mobile equipment; falling object protective... object protective structures (FOPS). (a) When necessary to protect the operator of the equipment, all... underground coal mines shall be provided with substantial falling object protective structures (FOPS)....

  11. Organizational and Spatial Dynamics of Attentional Focusing in Hierarchically Structured Objects

    ERIC Educational Resources Information Center

    Yeari, Menahem; Goldsmith, Morris

    2011-01-01

    Is the focusing of visual attention object-based, space-based, both, or neither? Attentional focusing latencies in hierarchically structured compound-letter objects were examined, orthogonally manipulating global size (larger vs. smaller) and organizational complexity (two-level structure vs. three-level structure). In a dynamic focusing task,…

  12. "Active" and "passive" learning of three-dimensional object structure within an immersive virtual reality environment.

    PubMed

    James, K H; Humphrey, G K; Vilis, T; Corrie, B; Baddour, R; Goodale, M A

    2002-08-01

    We used a fully immersive virtual reality environment to study whether actively interacting with objects would effect subsequent recognition, when compared with passively observing the same objects. We found that when participants learned object structure by actively rotating the objects, the objects were recognized faster during a subsequent recognition task than when object structure was learned through passive observation. We also found that participants focused their study time during active exploration on a limited number of object views, while ignoring other views. Overall, our results suggest that allowing active exploration of an object during initial learning can facilitate recognition of that object, perhaps owing to the control that the participant has over the object views upon which they can focus. The virtual reality environment is ideal for studying such processes, allowing realistic interaction with objects while maintaining experimenter control. PMID:12395554

  13. [Clinical laboratory medicine: continuous amelioration with a book of objectives and satisfaction survey].

    PubMed

    Reix, Nathalie; Agin, Arnaud; Bahram, Seiamak; Dali-Youcef, Nassim; Grucker, Daniel; Jaulhac, Benoît; Lepiller, Quentin; Lessinger, Jean-Marc; Mauvieux, Laurent; Monier, Laurie; Schramm, Frédéric; Stoll-Keller, Françoise; Vallat, Laurent; Ludes, Bertrand; Candolfi, Ermanno; Filisetti, Denis

    2015-01-01

    We report in this publication the use of two educational tools, a questionnaire of satisfaction and a training book, to improve the training of students during their internship in clinical laboratory at the "Pôle de biologie des Hôpitaux universitaires de Strasbourg" in France. First, the ongoing training was assessed by the interns with a questionnaire measuring satisfaction. The analysis of this questionnaire identified four key points to improve: 1) define the teaching objectives, 2) organize the training with a schedule, 3) revise certain teaching methods and 4) ensure better integration of the students in the team of medical biologists. After this assessment, we implemented a training book to answer these four points. Indeed, the training book presents the objectives, the schedule of training, and how to validate the educational objectives. A new assessment was performed again using the same methodology. Results showed an improvement in student satisfaction from 74 to 88 %. The questionnaire of satisfaction and the training book are presented in this article. The aim of the assessment of training combined with the training book is to incite the actors of the training (students and teachers) to continually improve the training. The objectives of the Pôle de Biologie are to obtain an 80 % satisfaction rate during the 6 months trainings and to reduce or eliminate dissatisfaction, and finally to ensure the validation by students of 80 to 100 % of their predetermined objectives.

  14. [Feasibility and limits of clinical neurophysiology with regard to the objective evaluation of neurological consequences following accidents].

    PubMed

    Zipper, Stephan G

    2014-09-01

    It is not unusual for a neurological expert to have problems defining the precise anatomical location and the required objective proof of damage, especially if the medical history and the neurological report released by the clinic prove inadequate in terms of providing a reliable assessment. This may well result from somatoform disorders, dissociation, aggravation and simulation, as well as dissimulation and complex organic diagnostic findings. A range of standardised neurophysiologic procedures is available for the objective measuring of motor, vegetative and sensory systems; a brief summary of the most frequent occurrences is given here, along with their significance for appraising damage resulting from an accident. Target groups primarily include surgeons, orthopaedists, lawyers and insurance specialists. Structural improvements and measures to integrate immigrant doctors is essential.

  15. Tetrasomy Y by structural rearrangement: clinical report.

    PubMed

    DesGroseilliers, Martin; Lemyre, Emmanuelle; Dallaire, Louis; Lemieux, Nicole

    2002-09-01

    Poly-Y karyotypes, except for 47,XYY, are rare events in humans. For instance, Y chromosome tetrasomy has been reported 10 times, 2 of which were by structural rearrangement. We present a 2-year-and-4-month-old boy who was referred for cytogenetic assessment because of global psychomotor delay. The GTG- and CBG-banded karyotypes on PHA-stimulated lymphocytes showed two cell populations, one of them contained two identical isodicentric Y chromosomes, which was seen in 93% of metaphases analyzed, and a 45,X cell line (7%). This was confirmed by FISH with probes DYZ3 (recognizing the centromeric region of the Y chromosome), 91H4.5 (recognizing Yp11.2), and DYZ1 (recognizing Y heterochromatin in Yq12). The breakpoint has occurred near the telomeric end of the heterochromatic region. Therefore, the karyotype is mos 47,X,idic(Y)(q12)x2[123]/45,X[9]. This is the second time that such a karyotype has been reported. This chromosomal anomaly was formed most likely by a U-type exchange. Clinical features included speech delay, short stature, brachycephaly, large ears, bilateral epicanthal folds, hypertelorism, delayed teeth eruption, bilateral radio-ulnar synostosis, bilateral fifth finger clinodactyly, normal external genitalia, and impulsive behavior. The father had normal phenotype and karyotype. A review of the tetrasomy Y patients is presented. All patients with Y chromosome tetrasomy exhibit some degree of mental retardation, various skeletal abnormalities, and facial dysmorphism. Nevertheless, the correlation between karyotype and phenotype is not yet well defined since few cases have been reported. This clinical report will be helpful in defining the phenotypic range associated with tetrasomy Y. PMID:12210299

  16. 48 CFR 1815.404-471 - NASA structured approach for profit or fee objective.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false NASA structured approach for profit or fee objective. 1815.404-471 Section 1815.404-471 Federal Acquisition Regulations System... NEGOTIATION Contract Pricing 1815.404-471 NASA structured approach for profit or fee objective....

  17. Systems and methods for estimating the structure and motion of an object

    DOEpatents

    Dani, Ashwin P; Dixon, Warren

    2015-11-03

    In one embodiment, the structure and motion of a stationary object are determined using two images and a linear velocity and linear acceleration of a camera. In another embodiment, the structure and motion of a stationary or moving object are determined using an image and linear and angular velocities of a camera.

  18. Objective Bayesian fMRI analysis-a pilot study in different clinical environments.

    PubMed

    Magerkurth, Joerg; Mancini, Laura; Penny, William; Flandin, Guillaume; Ashburner, John; Micallef, Caroline; De Vita, Enrico; Daga, Pankaj; White, Mark J; Buckley, Craig; Yamamoto, Adam K; Ourselin, Sebastien; Yousry, Tarek; Thornton, John S; Weiskopf, Nikolaus

    2015-01-01

    Functional MRI (fMRI) used for neurosurgical planning delineates functionally eloquent brain areas by time-series analysis of task-induced BOLD signal changes. Commonly used frequentist statistics protect against false positive results based on a p-value threshold. In surgical planning, false negative results are equally if not more harmful, potentially masking true brain activity leading to erroneous resection of eloquent regions. Bayesian statistics provides an alternative framework, categorizing areas as activated, deactivated, non-activated or with low statistical confidence. This approach has not yet found wide clinical application partly due to the lack of a method to objectively define an effect size threshold. We implemented a Bayesian analysis framework for neurosurgical planning fMRI. It entails an automated effect-size threshold selection method for posterior probability maps accounting for inter-individual BOLD response differences, which was calibrated based on the frequentist results maps thresholded by two clinical experts. We compared Bayesian and frequentist analysis of passive-motor fMRI data from 10 healthy volunteers measured on a pre-operative 3T and an intra-operative 1.5T MRI scanner. As a clinical case study, we tested passive motor task activation in a brain tumor patient at 3T under clinical conditions. With our novel effect size threshold method, the Bayesian analysis revealed regions of all four categories in the 3T data. Activated region foci and extent were consistent with the frequentist analysis results. In the lower signal-to-noise ratio 1.5T intra-operative scanner data, Bayesian analysis provided improved brain-activation detection sensitivity compared with the frequentist analysis, albeit the spatial extents of the activations were smaller than at 3T. Bayesian analysis of fMRI data using operator-independent effect size threshold selection may improve the sensitivity and certainty of information available to guide neurosurgery.

  19. Objective Bayesian fMRI analysis—a pilot study in different clinical environments

    PubMed Central

    Magerkurth, Joerg; Mancini, Laura; Penny, William; Flandin, Guillaume; Ashburner, John; Micallef, Caroline; De Vita, Enrico; Daga, Pankaj; White, Mark J.; Buckley, Craig; Yamamoto, Adam K.; Ourselin, Sebastien; Yousry, Tarek; Thornton, John S.; Weiskopf, Nikolaus

    2015-01-01

    Functional MRI (fMRI) used for neurosurgical planning delineates functionally eloquent brain areas by time-series analysis of task-induced BOLD signal changes. Commonly used frequentist statistics protect against false positive results based on a p-value threshold. In surgical planning, false negative results are equally if not more harmful, potentially masking true brain activity leading to erroneous resection of eloquent regions. Bayesian statistics provides an alternative framework, categorizing areas as activated, deactivated, non-activated or with low statistical confidence. This approach has not yet found wide clinical application partly due to the lack of a method to objectively define an effect size threshold. We implemented a Bayesian analysis framework for neurosurgical planning fMRI. It entails an automated effect-size threshold selection method for posterior probability maps accounting for inter-individual BOLD response differences, which was calibrated based on the frequentist results maps thresholded by two clinical experts. We compared Bayesian and frequentist analysis of passive-motor fMRI data from 10 healthy volunteers measured on a pre-operative 3T and an intra-operative 1.5T MRI scanner. As a clinical case study, we tested passive motor task activation in a brain tumor patient at 3T under clinical conditions. With our novel effect size threshold method, the Bayesian analysis revealed regions of all four categories in the 3T data. Activated region foci and extent were consistent with the frequentist analysis results. In the lower signal-to-noise ratio 1.5T intra-operative scanner data, Bayesian analysis provided improved brain-activation detection sensitivity compared with the frequentist analysis, albeit the spatial extents of the activations were smaller than at 3T. Bayesian analysis of fMRI data using operator-independent effect size threshold selection may improve the sensitivity and certainty of information available to guide neurosurgery

  20. Understanding BL Lacertae objects. Structural and kinematic mode changes in the BL Lac object PKS 0735+178

    NASA Astrophysics Data System (ADS)

    Britzen, S.; Witzel, A.; Gong, B. P.; Zhang, J. W.; Gopal-Krishna; Goyal, A.; Aller, M. F.; Aller, H. D.; Zensus, J. A.

    2010-06-01

    Context. We present evidence that parsec-scale jets in BL Lac objects may be significantly distinct in kinematics from their counterparts in quasars. We argued this previously for the BL lac sources 1803+784 and 0716+714 and report here a similar pattern for another well-known BL Lac object, PKS 0735+178, whose nuclear jet is found to exhibit kinematics atypical of quasars. Aims: By analyzing the pc-scale jet morphology and its changes in 0735+178 we seek to understand the emission processes in BL Lac objects and to decipher their differences from quasars. A detailed study of the jet components' motion reveals that the standard AGN paradigm of apparent superluminal motion does not always describe the kinematics in BL Lac objects. We study 0735+178 here to augment and improve the understanding of the peculiar motions in the jets of BL Lac objects as a class. Methods: We analyzed 15 GHz VLBA (Very Long Baseline Array) observations (2 cm/MOJAVE survey) performed at 23 epochs between 1995.27 and 2008.91. Multiple Gaussians were fitted to the derived VLBA data, to trace the kinematical and flux density evolution of the individual VLBI (Very Long Baseline Interferometry) components in the nuclear jet. We then compared the jet kinematics with the optical and radio light curves available for this BL Lac object and point out some striking correlations between the properties of the radio knots and the features in the light curves. Results: We found a drastic structural mode change in the VLBI jet of 0735+178, between 2000.4 and 2001.8 when its twice sharply bent trajectory turned into a linear shape. We further found that this jet had undergone a similar transition sometime between December 1981 and June 1983. A mode change, occurring in the reverse direction (between mid-1992 and mid-1995) has already been reported in the literature. These structural mode changes are found to be reflected in changed kinematical behavior of the nuclear jet, manifested as an apparent

  1. Learning the 3-D structure of objects from 2-D views depends on shape, not format

    PubMed Central

    Tian, Moqian; Yamins, Daniel; Grill-Spector, Kalanit

    2016-01-01

    Humans can learn to recognize new objects just from observing example views. However, it is unknown what structural information enables this learning. To address this question, we manipulated the amount of structural information given to subjects during unsupervised learning by varying the format of the trained views. We then tested how format affected participants' ability to discriminate similar objects across views that were rotated 90° apart. We found that, after training, participants' performance increased and generalized to new views in the same format. Surprisingly, the improvement was similar across line drawings, shape from shading, and shape from shading + stereo even though the latter two formats provide richer depth information compared to line drawings. In contrast, participants' improvement was significantly lower when training used silhouettes, suggesting that silhouettes do not have enough information to generate a robust 3-D structure. To test whether the learned object representations were format-specific or format-invariant, we examined if learning novel objects from example views transfers across formats. We found that learning objects from example line drawings transferred to shape from shading and vice versa. These results have important implications for theories of object recognition because they suggest that (a) learning the 3-D structure of objects does not require rich structural cues during training as long as shape information of internal and external features is provided and (b) learning generates shape-based object representations independent of the training format. PMID:27153196

  2. Comparative assessment of students’ performance and perceptions on objective structured practical models in undergraduate pathology teaching

    PubMed Central

    Htwe, Than Than; Ismail, Sabaridah Binti; Low, Gary Kim Kuan

    2014-01-01

    INTRODUCTION Assessment is an important factor that drives student learning, as students tend to mainly focus on the material to be assessed. The current practice in teaching pathology extensively applies objective-structured practical examination for the assessment of students. As students will have to deal with real patients during clinical years, it is preferred that students learn and practise via potted specimens and slides instead of picture plates. This study aimed to assess the preferred assesment method of pathology practical exercises. METHODS This was a cross-sectional survey carried out in two consecutive batches of Phase 2 medical students. Student competency was assessed using both the traditional (TD) (i.e. use of potted specimens and slides) and picture plate (PP) methods. To compare the two assessment methods, we compared the mean scores obtained by the students and examined student perception of the two methods. RESULTS The mean scores obtained via the PP method were significantly higher than those obtained via the TD method for almost all the components tested. CONCLUSION We found that students performed significantly better (p < 0.05) when assessed using the PP method instead of the TD method. PP preparations might provide better visuals, thus aiding understanding, than the TD method. The findings of this study are valuable in identifying and improving our current teaching and assessment methods of medical students, in line with advancements in information technology. PMID:25273936

  3. 3d Modeling of cultural heritage objects with a structured light system.

    NASA Astrophysics Data System (ADS)

    Akca, Devrim

    3D modeling of cultural heritage objects is an expanding application area. The selection of the right technology is very important and strictly related to the project requirements, budget and user's experience. The triangulation based active sensors, e.g. structured light systems are used for many kinds of 3D object reconstruction tasks and in particular for 3D recording of cultural heritage objects. This study presents the experiences in the results of two such projects in which a close-range structured light system is used for the 3D digitization. The paper includes the essential steps of the 3D object modeling pipeline, i.e. digitization, registration, surface triangulation, editing, texture mapping and visualization. The capabilities of the used hardware and software are addressed. Particular emphasis is given to a coded structured light system as an option for data acquisition.

  4. A rudimentary database for three-dimensional objects using structural representation

    NASA Technical Reports Server (NTRS)

    Sowers, James P.

    1987-01-01

    A database which enables users to store and share the description of three-dimensional objects in a research environment is presented. The main objective of the design is to make it a compact structure that holds sufficient information to reconstruct the object. The database design is based on an object representation scheme which is information preserving, reasonably efficient, and yet economical in terms of the storage requirement. The determination of the needed data for the reconstruction process is guided by the belief that it is faster to do simple computations to generate needed data/information for construction than to retrieve everything from memory. Some recent techniques of three-dimensional representation that influenced the design of the database are discussed. The schema for the database and the structural definition used to define an object are given. The user manual for the software developed to create and maintain the contents of the database is included.

  5. Determining the 3-D structure and motion of objects using a scanning laser range sensor

    NASA Technical Reports Server (NTRS)

    Nandhakumar, N.; Smith, Philip W.

    1993-01-01

    In order for the EVAHR robot to autonomously track and grasp objects, its vision system must be able to determine the 3-D structure and motion of an object from a sequence of sensory images. This task is accomplished by the use of a laser radar range sensor which provides dense range maps of the scene. Unfortunately, the currently available laser radar range cameras use a sequential scanning approach which complicates image analysis. Although many algorithms have been developed for recognizing objects from range images, none are suited for use with single beam, scanning, time-of-flight sensors because all previous algorithms assume instantaneous acquisition of the entire image. This assumption is invalid since the EVAHR robot is equipped with a sequential scanning laser range sensor. If an object is moving while being imaged by the device, the apparent structure of the object can be significantly distorted due to the significant non-zero delay time between sampling each image pixel. If an estimate of the motion of the object can be determined, this distortion can be eliminated; but, this leads to the motion-structure paradox - most existing algorithms for 3-D motion estimation use the structure of objects to parameterize their motions. The goal of this research is to design a rigid-body motion recovery technique which overcomes this limitation. The method being developed is an iterative, linear, feature-based approach which uses the non-zero image acquisition time constraint to accurately recover the motion parameters from the distorted structure of the 3-D range maps. Once the motion parameters are determined, the structural distortion in the range images is corrected.

  6. Structure and method for controlling the thermal emissivity of a radiating object

    DOEpatents

    DeSteese, John G.; Antoniak, Zenen I.; White, Michael; Peters, Timothy J.

    2004-03-30

    A structure and method for changing or controlling the thermal emissivity of the surface of an object in situ, and thus, changing or controlling the radiative heat transfer between the object and its environment in situ, is disclosed. Changing or controlling the degree of blackbody behavior of the object is accomplished by changing or controlling certain physical characteristics of a cavity structure on the surface of the object. The cavity structure, defining a plurality of cavities, may be formed by selectively removing material(s) from the surface, selectively adding a material(s) to the surface, or adding an engineered article(s) to the surface to form a new radiative surface. The physical characteristics of the cavity structure that are changed or controlled include cavity area aspect ratio, cavity longitudinal axis orientation, and combinations thereof. Controlling the cavity area aspect ratio may be by controlling the size of the cavity surface area, the size of the cavity aperture area, or a combination thereof. The cavity structure may contain a gas, liquid, or solid that further enhances radiative heat transfer control and/or improves other properties of the object while in service.

  7. New conceptual design of aeroelastic wing structures by multi-objective optimization

    NASA Astrophysics Data System (ADS)

    Sleesongsom, S.; Bureerat, S.

    2013-01-01

    Internal structural layouts and component sizes of aircraft wing structures have a significant impact on aircraft performance such as aeroelastic characteristics and mass. This work presents an approach to achieve simultaneous partial topology and sizing optimization of a three-dimensional wing-box structure. A multi-objective optimization problem is assigned to optimize lift effectiveness, buckling factor and mass of a structure. Design constraints include divergence and flutter speeds, buckling factor and stresses. The topology and sizing design variables for wing internal components are based on a ground element approach. The design problem is solved by multi-objective population-based incremental learning (MOPBIL). The Pareto optimum results lead to unconventional wing structures that are superior to their conventional counterparts.

  8. Complex Network Clustering by a Multi-objective Evolutionary Algorithm Based on Decomposition and Membrane Structure

    PubMed Central

    Ju, Ying; Zhang, Songming; Ding, Ningxiang; Zeng, Xiangxiang; Zhang, Xingyi

    2016-01-01

    The field of complex network clustering is gaining considerable attention in recent years. In this study, a multi-objective evolutionary algorithm based on membranes is proposed to solve the network clustering problem. Population are divided into different membrane structures on average. The evolutionary algorithm is carried out in the membrane structures. The population are eliminated by the vector of membranes. In the proposed method, two evaluation objectives termed as Kernel J-means and Ratio Cut are to be minimized. Extensive experimental studies comparison with state-of-the-art algorithms proves that the proposed algorithm is effective and promising. PMID:27670156

  9. Development and Initial Testing of a Structured Clinical Observation Tool to Assess Pharmacotherapy Competence

    ERIC Educational Resources Information Center

    Young, John Q.; Lieu, Sandra; O'Sullivan, Patricia; Tong, Lowell

    2011-01-01

    Objective: The authors developed and tested the feasibility and utility of a new direct-observation instrument to assess trainee performance of a medication management session. Methods: The Psychopharmacotherapy-Structured Clinical Observation (P-SCO) instrument was developed based on multiple sources of expertise and then implemented in 4…

  10. Measurement of object structure from size-encoded images generated by optically-implemented Gabor filters.

    PubMed

    Sierra, Heidy; Zheng, Jing-Yi; Rabin, Bryan; Boustany, Nada N

    2012-12-17

    We use optical Fourier processing based on two dimensional (2D) Gabor filters to obtain size-encoded images which depict with 20nm sensitivity to size while preserving a 0.36μm spatial resolution, the spatial distribution of structural features within transparent objects. The size of the object feature measured at each pixel in the encoded image is determined by the optimal Gabor filter period, S(max), that maximizes the scattering signal from that location in the object. We show that S(max) (in μm) depends linearly on feature size (also in μm) over a size range from 0.11μm to 2μm. This linear response remains largely unchanged when the refractive index ratio is varied and can be predicted from numerical simulations of Gabor-filtered light scattering. Pixel histograms of the size-encoded images of isolated spheres and diatoms were used to generate highly resolved size distributions ("size spectra") exhibiting sharp peaks characterizing the known major structural features within the studied objects. Dynamic signal associated with changes in selected feature sizes within living cells is also demonstrated. Taken together, our data suggest that a label-free, direct and objective measurement of sample structure is enabled by the size-encoded images and associated pixel histograms generated from a calibrated optical processing microscope based on Gabor filtering.

  11. A Trial of the Objective Structured Practical Examination in Physiology at Melaka Manipal Medical College, India

    ERIC Educational Resources Information Center

    Abraham, Reem Rachel; Raghavendra, Rao; Surekha, Kamath; Asha, Kamath

    2009-01-01

    A single examination does not fulfill all the functions of assessment. The present study was undertaken to determine the reliability and student satisfaction regarding the objective structured practical examination (OSPE) as a method of assessment of laboratory exercises in physiology before implementing it in the forthcoming university…

  12. Pharmacodynamic endpoints as clinical trial objectives to answer important questions in oncology drug development.

    PubMed

    Parchment, Ralph E; Doroshow, James H

    2016-08-01

    Analyzing the molecular interplay between malignancies and therapeutic agents is rarely a straightforward process, but we hope that this special issue of Seminars has highlighted the clinical value of such endeavors as well as the relevant theoretical and practical considerations. Here, we conclude with both an overview of the various high-value applications of clinical pharmacodynamics (PD) in developmental therapeutics and an outline of the framework for incorporating PD analyses into the design of clinical trials. Given the increasingly recognized importance of determining and administering the biologically effective dose (BED) and schedule of targeted agents, we explain how clinical PD biomarkers specific to the agent mechanism of action (MOA) can be used for the development of pharmacodynamics-guided biologically effective dosage regimens (PD-BEDR) to maximize the efficacy and minimize the toxicity of targeted therapies. In addition, we discuss how MOA-based PD biomarker analyses can be used both as patient selection diagnostic tools and for designing novel drug combinations targeting the specific mutational signature of a given malignancy. We also describe the role of PD analyses in clinical trials, including for MOA confirmation and dosage regimen optimization during phase 0 trials as well as for correlating molecular changes with clinical efficacy when establishing proof-of-concept in phase I/II trials. Finally, we outline the critical technological developments that are needed to enhance the quality and quantity of future clinical PD data collection, broaden the types of molecular questions that can be answered in the clinic, and, ultimately, improve patient outcomes. PMID:27663483

  13. Pharmacodynamic endpoints as clinical trial objectives to answer important questions in oncology drug development.

    PubMed

    Parchment, Ralph E; Doroshow, James H

    2016-08-01

    Analyzing the molecular interplay between malignancies and therapeutic agents is rarely a straightforward process, but we hope that this special issue of Seminars has highlighted the clinical value of such endeavors as well as the relevant theoretical and practical considerations. Here, we conclude with both an overview of the various high-value applications of clinical pharmacodynamics (PD) in developmental therapeutics and an outline of the framework for incorporating PD analyses into the design of clinical trials. Given the increasingly recognized importance of determining and administering the biologically effective dose (BED) and schedule of targeted agents, we explain how clinical PD biomarkers specific to the agent mechanism of action (MOA) can be used for the development of pharmacodynamics-guided biologically effective dosage regimens (PD-BEDR) to maximize the efficacy and minimize the toxicity of targeted therapies. In addition, we discuss how MOA-based PD biomarker analyses can be used both as patient selection diagnostic tools and for designing novel drug combinations targeting the specific mutational signature of a given malignancy. We also describe the role of PD analyses in clinical trials, including for MOA confirmation and dosage regimen optimization during phase 0 trials as well as for correlating molecular changes with clinical efficacy when establishing proof-of-concept in phase I/II trials. Finally, we outline the critical technological developments that are needed to enhance the quality and quantity of future clinical PD data collection, broaden the types of molecular questions that can be answered in the clinic, and, ultimately, improve patient outcomes.

  14. Orientation estimation of anatomical structures in medical images for object recognition

    NASA Astrophysics Data System (ADS)

    Bağci, Ulaş; Udupa, Jayaram K.; Chen, Xinjian

    2011-03-01

    Recognition of anatomical structures is an important step in model based medical image segmentation. It provides pose estimation of objects and information about "where" roughly the objects are in the image and distinguishing them from other object-like entities. In,1 we presented a general method of model-based multi-object recognition to assist in segmentation (delineation) tasks. It exploits the pose relationship that can be encoded, via the concept of ball scale (b-scale), between the binary training objects and their associated grey images. The goal was to place the model, in a single shot, close to the right pose (position, orientation, and scale) in a given image so that the model boundaries fall in the close vicinity of object boundaries in the image. Unlike position and scale parameters, we observe that orientation parameters require more attention when estimating the pose of the model as even small differences in orientation parameters can lead to inappropriate recognition. Motivated from the non-Euclidean nature of the pose information, we propose in this paper the use of non-Euclidean metrics to estimate orientation of the anatomical structures for more accurate recognition and segmentation. We statistically analyze and evaluate the following metrics for orientation estimation: Euclidean, Log-Euclidean, Root-Euclidean, Procrustes Size-and-Shape, and mean Hermitian metrics. The results show that mean Hermitian and Cholesky decomposition metrics provide more accurate orientation estimates than other Euclidean and non-Euclidean metrics.

  15. Differential visualisation of a spectrally selective structure of strongly scattering objects

    SciTech Connect

    Kuratov, A S; Rudenko, V N; Shuvalov, V V

    2014-07-31

    We describe a modification of the algorithm for the fast approximate solution of the diffuse optical tomography inverse problem. In this modification the amount of a priori (auxiliary) information necessary for the visualisation of the internal structure of the object is reduced by using a differential measurement scheme. The experiment is performed at two different wavelengths, and some a priori information, necessary to reconstruct only the spectrally selective component of the internal structure (the difference structure of the spatial distributions of the extinction coefficient at the wavelength employed), is replaced by the data of one of these measurements. (laser biophotonics)

  16. Dynamic structured illumination microscopy: Focused imaging and optical sectioning for moving objects

    NASA Astrophysics Data System (ADS)

    Krzewina, Leo G.; Kim, Myung K.

    2006-02-01

    Structured illumination microscopy (SIM) is a valuable tool for three-dimensional microscopy and has numerous applications in bioscience. Its success has been limited to static objects, though, as three sequential image acquisitions are required per final processed, focused image. To overcome this problem we have developed a multicolored grid which when used in tandem with a color camera is capable of performing SIM with just a single exposure. Images and movies demonstrating optical sectioning of three-dimensional objects are presented, and results of applying color SIM for wide-field focused imaging are compared to those of SIM. From computer modeling and analytical calculations a theoretical estimate of the maximum observable object velocity in both the lateral and axial directions is available, implying that the new method will be capable of imaging a variety of live objects. Sample images of the technique applied to lens paper and a pigeon feather are included to show both advantages and disadvantages of CSIM.

  17. Integrated fuzzy logic and genetic algorithms for multi-objective control of structures using MR dampers

    NASA Astrophysics Data System (ADS)

    Yan, Gang; Zhou, Lily L.

    2006-09-01

    This study presents a design strategy based on genetic algorithms (GA) for semi-active fuzzy control of structures that have magnetorheological (MR) dampers installed to prevent damage from severe dynamic loads such as earthquakes. The control objective is to minimize both the maximum displacement and acceleration responses of the structure. Interactive relationships between structural responses and input voltages of MR dampers are established by using a fuzzy controller. GA is employed as an adaptive method for design of the fuzzy controller, which is here known as a genetic adaptive fuzzy (GAF) controller. The multi-objectives are first converted to a fitness function that is used in standard genetic operations, i.e. selection, crossover, and mutation. The proposed approach generates an effective and reliable fuzzy logic control system by powerful searching and self-learning adaptive capabilities of GA. Numerical simulations for single and multiple damper cases are given to show the effectiveness and efficiency of the proposed intelligent control strategy.

  18. Inpainting for videos with dynamic objects using texture and structure reconstruction

    NASA Astrophysics Data System (ADS)

    Voronin, V. V.; Marchuk, V. I.; Gapon, N. V.; Zhuravlev, A. V.; Maslennikov, S.; Stradanchenko, S.

    2015-05-01

    This paper describes a novel inpainting approach for removing marked dynamic objects from videos captured with a camera, so long as the objects occlude parts of the scene with a static background. Proposed approach allow to remove objects or restore missing or tainted regions present in a video sequence by utilizing spatial and temporal information from neighboring scenes. The algorithm iteratively performs following operations: achieve frame; update the scene model; update positions of moving objects; replace parts of the frame occupied by the objects marked for remove with use of a background model. In this paper, we extend an image inpainting algorithm based texture and structure reconstruction by incorporating an improved strategy for video. An image inpainting approach based on the construction of a composite curve for the restoration of the edges of objects in a frame using the concepts of parametric and geometric continuity is presented. It is shown that this approach allows to restore the curved edges and provide more flexibility for curve design in damaged frame by interpolating the boundaries of objects by cubic splines. After edge restoration stage, a texture reconstruction using patch-based method is carried out. We demonstrate the performance of a new approach via several examples, showing the effectiveness of our algorithm and compared with state-of-the-art video inpainting methods.

  19. Determination of the object surface function by structured light: application to the study of spinal deformities

    NASA Astrophysics Data System (ADS)

    Buendía, M.; Salvador, R.; Cibrián, R.; Laguia, M.; Sotoca, J. M.

    1999-01-01

    The projection of structured light is a technique frequently used to determine the surface shape of an object. In this paper, a new procedure is described that efficiently resolves the correspondence between the knots of the projected grid and those obtained on the object when the projection is made. The method is based on the use of three images of the projected grid. In two of them the grid is projected over a flat surface placed, respectively, before and behind the object; both images are used for calibration. In the third image the grid is projected over the object. It is not reliant on accurate determination of the camera and projector pair relative to the grid and object. Once the method is calibrated, we can obtain the surface function by just analysing the projected grid on the object. The procedure is especially suitable for the study of objects without discontinuities or large depth gradients. It can be employed for determining, in a non-invasive way, the patient's back surface function. Symmetry differences permit a quantitative diagnosis of spinal deformities such as scoliosis.

  20. Description and status update on GELLO: a proposed standardized object-oriented expression language for clinical decision support.

    PubMed

    Sordo, Margarita; Boxwala, Aziz A; Ogunyemi, Omolola; Greenes, Robert A

    2004-01-01

    A major obstacle to sharing computable clinical knowledge is the lack of a common language for specifying expressions and criteria. Such a language could be used to specify decision criteria, formulae, and constraints on data and action. Al-though the Arden Syntax addresses this problem for clinical rules, its generalization to HL7's object-oriented data model is limited. The GELLO Expression language is an object-oriented language used for expressing logical conditions and computations in the GLIF3 (GuideLine Interchange Format, v. 3) guideline modeling language. It has been further developed under the auspices of the HL7 Clinical Decision Support Technical Committee, as a proposed HL7 standard., GELLO is based on the Object Constraint Language (OCL), because it is vendor-independent, object-oriented, and side-effect-free. GELLO expects an object-oriented data model. Although choice of model is arbitrary, standardization is facilitated by ensuring that the data model is compatible with the HL7 Reference Information Model (RIM).

  1. Miniature objective lens for array digital pathology: design improvement based on clinical evaluation

    NASA Astrophysics Data System (ADS)

    McCall, Brian; Pierce, Mark; Graviss, Edward A.; Richards-Kortum, Rebecca R.; Tkaczyk, Tomasz S.

    2016-03-01

    A miniature objective designed for digital detection of Mycobacterium tuberculosis (MTB) was evaluated for diagnostic accuracy. The objective was designed for array microscopy, but fabricated and evaluated at this stage of development as a single objective. The counts and diagnoses of patient samples were directly compared for digital detection and standard microscopy. The results were found to be correlated and highly concordant. The evaluation of this lens by direct comparison to standard fluorescence sputum smear microscopy presented unique challenges and led to some new insights in the role played by the system parameters of the microscope. The design parameters and how they were developed are reviewed in light of these results. New system parameters are proposed with the goal of easing the challenges of evaluating the miniature objective and maintaining the optical performance that produced the agreeable results presented without over-optimizing. A new design is presented that meets and exceeds these criteria.

  2. Hidden gifts of love: a clinical application of object relations theory.

    PubMed

    Steinberg, Naomi

    2010-08-01

    Using an extended clinical example, the author applies aspects of Kleinian, Fairbairnian, and Bionian theory to demonstrate how individuals may come to hide away feelings of both love and aggression. In the clinical material presented, a version of a schizoid retreat was understood as a pervasive response to trauma. The author attempts to explore more specifically the nature of a 'traumatizing outer world' ( Guntrip, 1969 ) and how these experiences cause an individual to retreat and undermine movement toward healthy adult dependency. An understanding of these dynamics helps inform the psychoanalytic treatment process and can serve as a type of roadmap in navigating through challenging transference-countertransference enactments.

  3. Object Motion with Structured Optical Illumination as a Basis for Far-Subwavelength Resolution

    NASA Astrophysics Data System (ADS)

    Webb, Kevin J.; Chen, Yulu; Smith, Trevor A.

    2016-08-01

    An imaging method based on object motion with structured light illumination and far-field measurement data that results in far-subwavelength image information is proposed. Simulations with realistic noisy data show that this approach will lead to the ability to distinguish object features on the nanometer scale using visible light, without the need for fluorophores. The principle is that far-field measurements with controlled motion in a spatially varying incident field add information about nanometer-scale dimensions and material properties.

  4. Objective clinical and laboratory studies of immediate hypersensitivity reactions to foods in asthmatic children.

    PubMed

    May, C D

    1976-10-01

    Clinical and laboratory observations were made with 38 children afflicted with chronic severe asthma (reversible obstructive airway disease) in which hypersensitivity to food was incriminated in the histories. Symptoms were evoked in double-blind food challenges in only 11/38 children and 14/70 challenges, and were characteristic of immediate-type hypersensitivity and were chiefly gastrointestinal, even though asthma was the common presenting complaint. There were no delayed reactions. Peanut was responsible for 8 reactions, egg for 5, and cow's milk for 1. The feature that most successfully identified those having positive reactions in challenges was a significant wheal reaction in a skin test by puncture technique using a verified extract of 1:20 W/V concentration. No subject with clinically significant, symptomatic hypersensitivity to food had a negative puncture test, and puncture tests were positive in only 10/56 instances of negative reactions in food challenges. Laboratory observations included release of histamine and enzymes from leukocytes and the levels of neutrophil enzymes in serum before and after food provocation tests. While these determinations were of interest with respect to the immunochemical basis of reactions to foods, they did not prove useful for practical clinical diagnosis. The outstanding laboratory findings was the occurrence of "spontaneous" release of 25% to 100% of the histamine from leukocytes in all cases proved clinically hypersensitive by food challenges, which suggests that this may be an indicator of immediate-type hypersensitivity to food. From the findings in the study, a general approach to food hypersensitivity was developed in which the immunologic components coupled with quantitative concentration-response relationships serve to render comprehensible the distinction between asymptomatic (immunologic) hypersensitivity and symptomatic (clinical) hypersensitivity.

  5. Design of 3d Topological Data Structure for 3d Cadastre Objects

    NASA Astrophysics Data System (ADS)

    Zulkifli, N. A.; Rahman, A. Abdul; Hassan, M. I.

    2016-09-01

    This paper describes the design of 3D modelling and topological data structure for cadastre objects based on Land Administration Domain Model (LADM) specifications. Tetrahedral Network (TEN) is selected as a 3D topological data structure for this project. Data modelling is based on the LADM standard and it is used five classes (i.e. point, boundary face string, boundary face, tetrahedron and spatial unit). This research aims to enhance the current cadastral system by incorporating 3D topology model based on LADM standard.

  6. [Does clinical risk management require a structured conflict management?].

    PubMed

    Neumann, Stefan

    2015-01-01

    A key element of clinical risk management is the analysis of errors causing near misses or patient damage. After analyzing the causes and circumstances, measures for process improvement have to be taken. Process management, human resource development and other established methods are used. If an interpersonal conflict is a contributory factor to the error, there is usually no structured conflict management available which includes selection criteria for various methods of conflict processing. The European University Viadrina in Frankfurt (Oder) has created a process model for introducing a structured conflict management system which is suitable for hospitals and could fill the gap in the methodological spectrum of clinical risk management. There is initial evidence that a structured conflict management reduces staff fluctuation and hidden conflict costs. This article should be understood as an impulse for discussion on to what extent the range of methods of clinical risk management should be complemented by conflict management.

  7. Refining the Structure and Content of Clinical Genomic Reports

    PubMed Central

    DORSCHNER, MICHAEL O.; AMENDOLA, LAURA M.; SHIRTS, BRIAN H.; KIEDROWSKI, LESLI; SALAMA, JOSEPH; GORDON, ADAM S.; FULLERTON, STEPHANIE M.; TARCZY-HORNOCH, PETER; BYERS, PETER H.; JARVIK, GAIL P.

    2014-01-01

    To effectively articulate the results of exome and genome sequencing we refined the structure and content of molecular test reports. To communicate results of a randomized control trial aimed at the evaluation of exome sequencing for clinical medicine, we developed a structured narrative report. With feedback from genetics and non-genetics professionals, we developed separate indication-specific and incidental findings reports. Standard test report elements were supplemented with research study-specific language, which highlighted the limitations of exome sequencing and provided detailed, structured results, and interpretations. The report format we developed to communicate research results can easily be transformed for clinical use by removal of research-specific statements and disclaimers. The development of clinical reports for exome sequencing has shown that accurate and open communication between the clinician and laboratory is ideally an ongoing process to address the increasing complexity of molecular genetic testing. PMID:24616401

  8. Paying for prevention in clinical practice: Aligning provider remuneration with system objectives

    PubMed Central

    2015-01-01

    Evidence on the efficacy of preventive procedures in oral health care has not been matched by uptake of prevention in clinical practice. Reducing oral disease in the population reduces the size of the future market for treatment. Hence a provider's intention to adopt prevention in clinical practice may be offset by the financial implications of such behaviour. Effective prevention may therefore depend upon prevention-friendly methods of remuneration if providers are to be rewarded appropriately for doing what the system expects them to do. This paper considers whether changing the way providers are paid for delivering care can be expected to change the utilisation of preventive care in the population in terms of the proportion of the population receiving preventive care, the distribution of preventive care in the population and the pattern of preventive care received. A conceptual framework is presented that identifies the determinants of rewards under different approaches to provider remuneration. The framework is applied to develop recommendations for paying for prevention in clinical practice. Literature on provider payment in dental care is reviewed to assess the evidence base for the effects of changing payment methods, identify gaps in the evidence-base and inform the design of future research on dental remuneration. PMID:26390928

  9. Paying for prevention in clinical practice: Aligning provider remuneration with system objectives.

    PubMed

    Birch, Stephen

    2015-01-01

    Evidence on the efficacy of preventive procedures in oral health care has not been matched by uptake of prevention in clinical practice. Reducing oral disease in the population reduces the size of the future market for treatment. Hence a provider's intention to adopt prevention in clinical practice may be offset by the financial implications of such behaviour. Effective prevention may therefore depend upon prevention-friendly methods of remuneration if providers are to be rewarded appropriately for doing what the system expects them to do. This paper considers whether changing the way providers are paid for delivering care can be expected to change the utilisation of preventive care in the population in terms of the proportion of the population receiving preventive care, the distribution of preventive care in the population and the pattern of preventive care received. A conceptual framework is presented that identifies the determinants of rewards under different approaches to provider remuneration. The framework is applied to develop recommendations for paying for prevention in clinical practice. Literature on provider payment in dental care is reviewed to assess the evidence base for the effects of changing payment methods, identify gaps in the evidence-base and inform the design of future research on dental remuneration.

  10. Information Object Definition–based Unified Modeling Language Representation of DICOM Structured Reporting

    PubMed Central

    Tirado-Ramos, Alfredo; Hu, Jingkun; Lee, K.P.

    2002-01-01

    Supplement 23 to DICOM (Digital Imaging and Communications for Medicine), Structured Reporting, is a specification that supports a semantically rich representation of image and waveform content, enabling experts to share image and related patient information. DICOM SR supports the representation of textual and coded data linked to images and waveforms. Nevertheless, the medical information technology community needs models that work as bridges between the DICOM relational model and open object-oriented technologies. The authors assert that representations of the DICOM Structured Reporting standard, using object-oriented modeling languages such as the Unified Modeling Language, can provide a high-level reference view of the semantically rich framework of DICOM and its complex structures. They have produced an object-oriented model to represent the DICOM SR standard and have derived XML-exchangeable representations of this model using World Wide Web Consortium specifications. They expect the model to benefit developers and system architects who are interested in developing applications that are compliant with the DICOM SR specification. PMID:11751804

  11. Affectedness and direct objects: the role of lexical semantics in the acquisition of verb argument structure.

    PubMed

    Gropen, J; Pinker, S; Hollander, M; Goldberg, R

    1991-12-01

    How do speakers predict the syntax of a verb from its meaning? Traditional theories posit that syntactically relevant information about semantic arguments consists of a list of thematic roles like "agent", "theme", and "goal", which are linked onto a hierarchy of grammatical positions like subject, object and oblique object. For verbs involving motion, the entity caused to move is defined as the "theme" or "patient" and linked to the object. However, this fails for many common verbs, as in fill water into the glass and cover a sheet onto the bed. In more recent theories verbs' meanings are multidimensional structures in which the motions, changes, and other events can be represented in separate but connected substructures; linking rules are sensitive to the position of an argument in a particular configuration. The verb's object would be linked not to the moving entity but to the argument specified as "affected" or caused to change as the main event in the verb's meaning. The change can either be one of location, resulting from motion in a particular manner, or of state, resulting from accommodating or reacting to a substance. For example, pour specifies how a substance moves (downward in a stream), so its substance argument is the object (pour the water/glass); fill specifies how a container changes (from not full to full), so its stationary container argument is the object (fill the glass/water). The newer theory was tested in three experiments. Children aged 3;4-9;4 and adults were taught made-up verbs, presented in a neutral syntactic context (this is mooping), referring to a transfer of items to a surface or container. Subjects were tested on their willingness to encode the moving items or the surface as the verb's object. For verbs where the items moved in a particular manner (e.g., zig-zagging), people were more likely to express the moving items as the object; for verbs where the surface changed state (e.g., shape, color, or fullness), people were more

  12. A Grading System To Evaluate Objectively the Strength of Pre-Clinical Data of Acute Neuroprotective Therapies for Clinical Translation in Spinal Cord Injury

    PubMed Central

    Okon, Elena B.; Tsai, Eve; Beattie, Michael S.; Bresnahan, Jacqueline C.; Magnuson, David K.; Reier, Paul J.; McTigue, Dana M.; Popovich, Phillip G.; Blight, Andrew R.; Oudega, Martin; Guest, James D.; Weaver, Lynne C.; Fehlings, Michael G.; Tetzlaff, Wolfram

    2011-01-01

    Abstract The past three decades have seen an explosion of research interest in spinal cord injury (SCI) and the development of hundreds of potential therapies that have demonstrated some promise in pre-clinical experimental animal models. A growing number of these treatments are seeking to be translated into human clinical trials. Conducting such a clinical trial, however, is extremely costly, not only for the time and money required to execute it, but also for the limited resources that will then no longer be available to evaluate other promising therapies. The decision about what therapies have sufficient pre-clinical evidence of efficacy to justify testing in humans is therefore of utmost importance. Here, we have developed a scoring system for objectively grading the body of pre-clinical literature on neuroprotective treatments for acute SCI. The components of the system include an evaluation of a number of factors that are thought to be important in considering the “robustness” of a therapy's efficacy, including the animal species and injury models that have been used to test it, the time window of efficacy, the types of functional improvements effected by it, and whether efficacy has been independently replicated. The selection of these factors was based on the results of a questionnaire that was performed within the SCI research community. A modified Delphi consensus-building exercise was then conducted with experts in pre-clinical SCI research to refine the criteria and decide upon how to score them. Finally, the grading system was applied to a series of potential neuroprotective treatments for acute SCI. This represents a systematic approach to developing an objective method of evaluating the extent to which the pre-clinical literature supports the translation of a particular experimental treatment into human trials. PMID:20507235

  13. Learning to explore the structure of kinematic objects in a virtual environment

    PubMed Central

    Buckmann, Marcus; Gaschler, Robert; Höfer, Sebastian; Loeben, Dennis; Frensch, Peter A.; Brock, Oliver

    2015-01-01

    The current study tested the quantity and quality of human exploration learning in a virtual environment. Given the everyday experience of humans with physical object exploration, we document substantial practice gains in the time, force, and number of actions needed to classify the structure of virtual chains, marking the joints as revolute, prismatic, or rigid. In line with current work on skill acquisition, participants could generalize the new and efficient psychomotor patterns of object exploration to novel objects. On the one hand, practice gains in exploration performance could be captured by a negative exponential practice function. On the other hand, they could be linked to strategies and strategy change. After quantifying how much was learned in object exploration and identifying the time course of practice-related gains in exploration efficiency (speed), we identified what was learned. First, we identified strategy components that were associated with efficient (fast) exploration performance: sequential processing, simultaneous use of both hands, low use of pulling rather than pushing, and low use of force. Only the latter was beneficial irrespective of the characteristics of the other strategy components. Second, we therefore characterized efficient exploration behavior by strategies that simultaneously take into account the abovementioned strategy components. We observed that participants maintained a high level of flexibility, sampling from a pool of exploration strategies trading the level of psycho-motoric challenges with exploration speed. We discuss the findings pursuing the aim of advancing intelligent object exploration by combining analytic (object exploration in humans) and synthetic work (object exploration in robots) in the same virtual environment. PMID:25904878

  14. Integrated electronic records as the resolution of ethical tensions between clinical and managerial objectives.

    PubMed

    Rigby, M J; Robins, S C

    1995-01-01

    Traditionally there is considerable tension between the objectives of clinicians and managers--each claiming an ethical grounding, one to optimize care to the individual and the other to optimize the use of health resources for the client population. Hitherto, there has been a latent challenge in finding empirically supported common ground. However, the development of integrated electronic records, particularly for patients receiving preventive, rehabilitative, or long-term care, has provided a common medium. A successful major development in the United Kingdom is described.

  15. Determination of three-dimensional structured objects, vascular structures, and imaging geometry from single-plane and biplane projection images

    NASA Astrophysics Data System (ADS)

    Nazareth, Daryl P.

    . Thus, overdependence on the calibration object may degrade accuracy. As a result of these techniques, more accurate values of diameters and lengths will be available during surgical procedures. In addition accurate 3D measures may be useful in clinical decision making, such as in assessing vessel tortuousity and access, during interventional procedures.

  16. Measuring the 3D shape of high temperature objects using blue sinusoidal structured light

    NASA Astrophysics Data System (ADS)

    Zhao, Xianling; Liu, Jiansheng; Zhang, Huayu; Wu, Yingchun

    2015-12-01

    The visible light radiated by some high temperature objects (less than 1200 °C) almost lies in the red and infrared waves. It will interfere with structured light projected on a forging surface if phase measurement profilometry (PMP) is used to measure the shapes of objects. In order to obtain a clear deformed pattern image, a 3D measurement method based on blue sinusoidal structured light is proposed in this present work. Moreover, a method for filtering deformed pattern images is presented for correction of the unwrapping phase. Blue sinusoidal phase-shifting fringe pattern images are projected on the surface by a digital light processing (DLP) projector, and then the deformed patterns are captured by a 3-CCD camera. The deformed pattern images are separated into R, G and B color components by the software. The B color images filtered by a low-pass filter are used to calculate the fringe order. Consequently, the 3D shape of a high temperature object is obtained by the unwrapping phase and the calibration parameter matrixes of the DLP projector and 3-CCD camera. The experimental results show that the unwrapping phase is completely corrected with the filtering method by removing the high frequency noise from the first harmonic of the B color images. The measurement system can complete the measurement in a few seconds with a relative error of less than 1 : 1000.

  17. 3D shape shearography with integrated structured light projection for strain inspection of curved objects

    NASA Astrophysics Data System (ADS)

    Anisimov, Andrei G.; Groves, Roger M.

    2015-05-01

    Shearography (speckle pattern shearing interferometry) is a non-destructive testing technique that provides full-field surface strain characterization. Although real-life objects especially in aerospace, transport or cultural heritage are not flat (e.g. aircraft leading edges or sculptures), their inspection with shearography is of interest for both hidden defect detection and material characterization. Accurate strain measuring of a highly curved or free form surface needs to be performed by combining inline object shape measuring and processing of shearography data in 3D. Previous research has not provided a general solution. This research is devoted to the practical questions of 3D shape shearography system development for surface strain characterization of curved objects. The complete procedure of calibration and data processing of a 3D shape shearography system with integrated structured light projector is presented. This includes an estimation of the actual shear distance and a sensitivity matrix correction within the system field of view. For the experimental part a 3D shape shearography system prototype was developed. It employs three spatially-distributed shearing cameras, with Michelson interferometers acting as the shearing devices, one illumination laser source and a structured light projector. The developed system performance was evaluated with a previously reported cylinder specimen (length 400 mm, external diameter 190 mmm) loaded by internal pressure. Further steps for the 3D shape shearography prototype and the technique development are also proposed.

  18. STRUCTURED JETS IN BL LAC OBJECTS: EFFICIENT PeV NEUTRINO FACTORIES?

    SciTech Connect

    Tavecchio, Fabrizio; Ghisellini, Gabriele; Guetta, Dafne

    2014-09-20

    The origin of high-energy neutrinos (0.1–1 PeV range) detected by IceCube remains a mystery. In this work, we explore the possibility that efficient neutrino production can occur in structured jets of BL Lac objects, characterized by a fast inner spine surrounded by a slower layer. This scenario has been widely discussed in the framework of the high-energy emission models for BL Lac objects and radio galaxies. One of the relevant consequences of a velocity structure is the enhancement of the inverse Compton emission caused by the radiative coupling of the two zones. We show that a similar boosting could occur for the neutrino output of the spine through the photo-meson reaction of high-energy protons scattering off the amplified soft target photon field of the layer. Assuming the local density and the cosmological evolution of γ-ray BL Lac object derived from Fermi Large Area Telescope data, we calculate the expected diffuse neutrino intensity, which can match the IceCube data for a reasonable choice of parameters.

  19. Needle-based fluorescence endomicroscopy via structured illumination with a plastic, achromatic objective

    PubMed Central

    Kyrish, Matthew; Dobbs, Jessica; Jain, Shalini; Wang, Xiao; Yu, Dihua; Richards-Kortum, Rebecca

    2013-01-01

    Abstract. In order to diagnose cancer, a sample must be removed, prepared, and examined under a microscope, which is expensive, invasive, and time consuming. Fiber optic fluorescence endomicroscopy, where an image guide is used to obtain high-resolution images of tissue in vivo, has shown promise as an alternative to conventional biopsies. However, the resolution of standard endomicroscopy is limited by the fiber bundle sampling frequency and out-of-focus light. A system is presented which incorporates a plastic, achromatic objective to increase the sampling and which provides optical sectioning via structured illumination to reject background light. An image is relayed from the sample by a fiber bundle with the custom 2.1-mm outer diameter objective lens integrated to the distal tip. The objective is corrected for the excitation and the emission wavelengths of proflavine (452 and 515 nm). It magnifies the object onto the fiber bundle to improve the system’s lateral resolution by increasing the sampling. The plastic lenses were fabricated via single-point diamond turning and assembled using a zero alignment technique. Ex vivo images of normal and neoplastic murine mammary tissues stained with proflavine are captured. The system achieves higher contrast and resolves smaller features than standard fluorescence endomicroscopy. PMID:24002190

  20. Line-Based Object Recognition using Hausdorff Distance: From Range Images to Molecular Secondary Structure

    SciTech Connect

    Guerra, C; Pascucci, V

    2004-12-13

    Object recognition algorithms are fundamental tools in automatic matching of geometric shapes within a background scene. Many approaches have been proposed in the past to solve the object recognition problem. Two of the key aspects that distinguish them in terms of their practical usability are: (i) the type of input model description and (ii) the comparison criteria used. In this paper we introduce a novel scheme for 3D object recognition based on line segment representation of the input shapes and comparison using the Hausdor distance. This choice of model representation provides the flexibility to apply the scheme in different application areas. We define several variants of the Hausdor distance to compare the models within the framework of well defined metric spaces. We present a matching algorithm that efficiently finds a pattern in a 3D scene. The algorithm approximates a minimization procedure of the Hausdor distance. The output error due to the approximation is guaranteed to be within a known constant bound. Practical results are presented for two classes of objects: (i) polyhedral shapes extracted from segmented range images and (ii) secondary structures of large molecules. In both cases the use of our approximate algorithm allows to match correctly the pattern in the background while achieving the efficiency necessary for practical use of the scheme. In particular the performance is improved substantially with minor degradation of the quality of the matching.

  1. Online Deformable Object Tracking Based on Structure-Aware Hyper-Graph.

    PubMed

    Du, Dawei; Qi, Honggang; Li, Wenbo; Wen, Longyin; Huang, Qingming; Lyu, Siwei

    2016-08-01

    Recent advances in online visual tracking focus on designing part-based model to handle the deformation and occlusion challenges. However, previous methods usually consider only the pairwise structural dependences of target parts in two consecutive frames rather than the higher order constraints in multiple frames, making them less effective in handling large deformation and occlusion challenges. This paper describes a new and efficient method for online deformable object tracking. Different from most existing methods, this paper exploits higher order structural dependences of different parts of the tracking target in multiple consecutive frames. We construct a structure-aware hyper-graph to capture such higher order dependences, and solve the tracking problem by searching dense subgraphs on it. Furthermore, we also describe a new evaluating data set for online deformable object tracking (the Deform-SOT data set), which includes 50 challenging sequences with full annotations that represent realistic tracking challenges, such as large deformations and severe occlusions. The experimental result of the proposed method shows considerable improvement in performance over the state-of-the-art tracking methods. PMID:27214901

  2. Extensible Stylesheet Language Formatting Objects (XSL-FO): a tool to transform patient data into attractive clinical reports.

    PubMed

    Simonaitis, Linas; Belsito, Anne; Warvel, Jeff; Hui, Siu; McDonald, Clement J

    2006-01-01

    Clinicians at Wishard Hospital in Indianapolis print and carry clinical reports called "Pocket Rounds". This paper describes a new process we developed to improve these clinical reports. The heart of our new process is a World Wide Web Consortium standard: Extensible Stylesheet Language Formatting Objects (XSL-FO). Using XSL-FO stylesheets we generated Portable Document Format (PDF) and PostScript reports with complex formatting: columns, tables, borders, shading, indents, dividing lines. We observed patterns of clinical report printing during a eight month study period on three Medicine wards. Usage statistics indicated that clinicians accepted the new system enthusiastically: 78% of 26,418 reports were printed using the new system. We surveyed 67 clinical users. Respondents gave the new reports a rating of 4.2 (on a 5 point scale); they gave the old reports a rating of 3.4. The primary complaint was that it took longer to print the new reports. We believe that XSL-FO is a promising way to transform text data into functional and attractive clinical reports: relatively easy to implement and modify.

  3. Objective structured practical examination (OSPE) in Forensic Medicine: students' point of view.

    PubMed

    Menezes, Ritesh G; Nayak, Vinod C; Binu, V S; Kanchan, Tanuj; Rao, P P Jagadish; Baral, Prakash; Lobo, Stany W

    2011-11-01

    The purpose of this study was to assess the attitudes of undergraduate medical students towards the objective structured practical examination (OSPE) in Forensic Medicine, in a medical college in Nepal. Participants included 59 undergraduate medical students of the 7th semester. Findings indicated that the OSPE was an acceptable tool considering the conduct of practical examination in Forensic Medicine at the undergraduate level. The overall mean attitude score was towards the favourable side. Students strongly agreed that the OSPE tested a wide range of skills. They also strongly agreed that it was a good form of examination as well as a learning experience. The introduction of the OSPE replacing the conventional method of practical examination in Forensic Medicine is a step in the right direction taken to objectively assess undergraduate medical students.

  4. Archiving shape and appearance of cultural heritage objects using structured light projection and multispectral imaging

    NASA Astrophysics Data System (ADS)

    Sitnik, Robert; Krzesłowski, Jakub; Maczkowski, Grzegorz

    2012-02-01

    To create faithful reproduction of a cultural heritage object, it is crucial to gather information on intrinsic optical properties of the object's surface, as well as its geometry. An integrated device has been developed that performs a three-dimensional measurement using structured light projection, followed by multispectral imaging for precise color retrieval and directional illumination for estimating bidirectional reflectance distribution function (BRDF) parameters. The main advantage shown in this work is the use of only one detector during the whole acquisition process to assure ideal correspondence of multimodal surface data in the image space. A method is shown for performing the measurement using an integrated device. Methods of data organization and processing are described facilitating robust operation of the developed software. A prototype setup for the integrated system is presented together with measurement parameters and sample measurement.

  5. Objective Sleep Structure and Cardiovascular Risk Factors in the General Population: The HypnoLaus Study

    PubMed Central

    Haba-Rubio, José; Marques-Vidal, Pedro; Andries, Daniela; Tobback, Nadia; Preisig, Martin; Vollenweider, Peter; Waeber, Gérard; Luca, Gianina; Tafti, Mehdi; Heinzer, Raphaël

    2015-01-01

    Study Objectives: To evaluate the association between objective sleep measures and metabolic syndrome (MS), hypertension, diabetes, and obesity. Design: Cross-sectional study. Setting: General population sample. Participants: There were 2,162 patients (51.2% women, mean age 58.4 ± 11.1). Interventions: Patients were evaluated for hypertension, diabetes, overweight/obesity, and MS, and underwent a full polysomnography (PSG). Measurements and Results: PSG measured variables included: total sleep time (TST), percentage and time spent in slow wave sleep (SWS) and in rapid eye movement (REM) sleep, sleep efficiency and arousal index (ArI). In univariate analyses, MS was associated with decreased TST, SWS, REM sleep, and sleep efficiency, and increased ArI. After adjustment for age, sex, smoking, alcohol, physical activity, drugs that affect sleep and depression, the ArI remained significantly higher, but the difference disappeared in patients without significant sleep disordered breathing (SDB). Differences in sleep structure were also found according to the presence or absence of hypertension, diabetes, and overweight/obesity in univariate analysis. However, these differences were attenuated after multivariate adjustment and after excluding subjects with significant SDB. Conclusions: In this population-based sample we found significant associations between sleep structure and metabolic syndrome (MS), hypertension, diabetes, and obesity. However, these associations were cancelled after multivariate adjustment. We conclude that normal variations in sleep contribute little if any to MS and associated disorders. Citation: Haba-Rubio J, Marques-Vidal P, Andries D, Tobback N, Preisig M, Vollenweider P, Waeber G, Luca G, Tafti M, Heinzer R. Objective sleep structure and cardiovascular risk factors in the general population: the HypnoLaus study. SLEEP 2015;38(3):391–400. PMID:25325467

  6. An integrated control/structure design method using multi-objective optimization

    NASA Technical Reports Server (NTRS)

    Gupta, Sandeep; Joshi, Suresh M.

    1991-01-01

    The benefits are demonstrated of a multiobjective optimization based control structure integrated design methodology. An application of the proposed CSI methodology to the integrated design of the Spacecraft COntrol Lab Experiment (SCOLE) configuration is presented. Integrated design resulted in reducing both the control performance measure and the mass. Thus, better overall performance is achieved through integrated design optimization. The mutliobjective optimization approach used provides Pareto optimal solutions by unconstrained minimization of a differentiable KS function. Furthermore, adjusting the parameters gives insight into the trade-offs involved between different objectives.

  7. Objective assessment of biomagnetic devices and alternative clinical therapies using infrared thermal imaging

    NASA Astrophysics Data System (ADS)

    Rockley, Graham J.

    2001-03-01

    The overwhelming introduction of magnetic devices and other alternative therapies into the health care market prompts the need for objective evaluation of these techniques through the use of infrared thermal imaging. Many of these therapies are reported to promote the stimulation of blood flow or the relief of pain conditions. Infrared imaging is an efficient tool to assess such changes in the physiological state. Therefore, a thermal imager can help document and substantiate whether these therapies are in fact providing an effective change to the local circulation. Thermal images may also indicate whether the change is temporary or sustained. As a specific case example, preliminary findings will be presented concerning the use of magnets and the effect they have on peripheral circulation. This will include a discussion of the recommended protocols for this type of infrared testing. This test model can be applied to the evaluation of other devices and therapeutic procedures which are reputed to affect circulation such as electro acupuncture, orthopedic footwear and topical ointments designed to relieve pain or inflammation.

  8. Clinical and objective data on spinal cord stimulation for the treatment of severe Raynaud's phenomenon.

    PubMed

    Neuhauser, B; Perkmann, R; Klingler, P J; Giacomuzzi, S; Kofler, A; Fraedrich, G

    2001-11-01

    Ischemic vascular disease of the upper extremity represents a difficult therapeutic problem wherein medical treatment often fails. Epidural spinal cord stimulation has been shown to be an effective alternative in severe peripheral arterial disease. Although this method has been used for nearly two decades only limited experience exists in Raynaud's phenomenon of the upper limbs. In addition objective parameters to prove therapeutic success are not well defined. Herein we describe a patient with severe primary Raynaud's phenomenon over several years who had significant pain relief and complete healing of ischemic digital ulcerations after spinal cord stimulation. Pain level was evaluated using a visual rating scale before and after surgery. Microcirculatory parameters were assessed before and after spinal cord stimulation by capillary microscopy and laser Doppler anemometry. Significant improvement of red blood cell velocity, capillary density, and capillary permeability was demonstrated. At follow-up 18 months after surgery the patient had no complaints and all ulcerations of her fingertips had healed. Spinal cord stimulation appears to be an effective treatment in severe cases of Raynaud's phenomenon and we recommend its use in the case of failed medical therapy. Pain rating and capillary microscopy enable one to assess and visualize the effects of spinal cord stimulation.

  9. Structural Model Tuning Capability in an Object-Oriented Multidisciplinary Design, Analysis, and Optimization Tool

    NASA Technical Reports Server (NTRS)

    Lung, Shun-fat; Pak, Chan-gi

    2008-01-01

    Updating the finite element model using measured data is a challenging problem in the area of structural dynamics. The model updating process requires not only satisfactory correlations between analytical and experimental results, but also the retention of dynamic properties of structures. Accurate rigid body dynamics are important for flight control system design and aeroelastic trim analysis. Minimizing the difference between analytical and experimental results is a type of optimization problem. In this research, a multidisciplinary design, analysis, and optimization [MDAO] tool is introduced to optimize the objective function and constraints such that the mass properties, the natural frequencies, and the mode shapes are matched to the target data as well as the mass matrix being orthogonalized.

  10. Structural Model Tuning Capability in an Object-Oriented Multidisciplinary Design, Analysis, and Optimization Tool

    NASA Technical Reports Server (NTRS)

    Lung, Shun-fat; Pak, Chan-gi

    2008-01-01

    Updating the finite element model using measured data is a challenging problem in the area of structural dynamics. The model updating process requires not only satisfactory correlations between analytical and experimental results, but also the retention of dynamic properties of structures. Accurate rigid body dynamics are important for flight control system design and aeroelastic trim analysis. Minimizing the difference between analytical and experimental results is a type of optimization problem. In this research, a multidisciplinary design, analysis, and optimization (MDAO) tool is introduced to optimize the objective function and constraints such that the mass properties, the natural frequencies, and the mode shapes are matched to the target data as well as the mass matrix being orthogonalized.

  11. Proposal for a new objective method to evaluate low-level laser therapy efficacy in clinical practice

    NASA Astrophysics Data System (ADS)

    Antipa, Ciprian; Nicolescu, Alin; Pascu, Mihail-Lucian; Vlaiculescu, Mihaela; Ionescu, Elena

    2000-06-01

    Until now there is a lack of objective methods to evaluate the clinical efficacy of low level lasers (LLL). The reported results in this paper are showing that the cutaneous ultrasound could be a valuable method to be used in order to objectify the results obtained in low level laser therapy (LLLT). 52 patients with osteoarthritis were divided into three groups: Group A:19 patients treated with IR emitted laser diode, CW, 3mW power, 780 nm wavelengths. Group B: 18 patients treated with the same IR laser diode as above and He-Ne laser, CW, 2mW power. Group C: 14 patients exposed to placebo laser. To every patient was done cutaneous ultrasound before and after LLLT and we followed also the clinical evolution. The positive results meaning significant US favorable changes were found in 73.9 percent for group A and 77.7 percent for group B and 21.4 percent for PLACEBO group. We conclude that cutaneous ultrasound could be an objective method to appreciate the clinical efficacy of low power lasers.

  12. Structure elucidation and chromatographic identification of anthraquinone components of cochineal (Dactylopius coccus) detected in historical objects.

    PubMed

    Stathopoulou, Konstantina; Valianou, Lemonia; Skaltsounis, Alexios-Leandros; Karapanagiotis, Ioannis; Magiatis, Prokopios

    2013-12-01

    Cochineal is one of the most well known organic red dyes. Dactylopius coccus Costa (Dactylopiidae) is a scale insect that is used as the source of the dye known as Mexican cochineal. Although cochineal is today a natural food colorant (E120) and although it has been used in art objects (textiles and paintings) for centuries, its exact chemical consistency is not well clarified except for carminic acid which is the major component and kermesic and flavokermesic acids. Several minor components (typically less than 5% of the colouring material) remained unknown or partially studied, although their presence has been reported in numerous analytical works related to art objects. Chemical investigation of the methanol extract of the dried insects, after subsequent HPLC chromatographic separations, led to the isolation and structure elucidation of six new anthraquinones, along with the known compounds carminic acid, kermesic acid and flavokermesic acid. The new compounds formerly described as DCII and DCIII, were found to be the 2-C-glucoside of flavokermesic acid and 4-aminocarminic acid, respectively, while DCIV and DCVII were found to be the α/β C-glucofuranosides of kermesic acid, and were studied as a mixture due to equilibrium. In addition, 3-O-glucoside of flavokermesic acid (DCOFK), and 3,4-dideoxycarminic acid (DDCA) were identified. The structures of the new compounds were elucidated on the basis of their NMR and MS data. Finally, the new compounds were detected in silk dyed with cochineal, lake pigment and, furthermore, in historical objects of the cultural heritage (icon and textile) using LC-DAD and LC-MS. PMID:24267092

  13. Characterization of the Interior Density Structure of Near Earth Objects with Muons

    NASA Astrophysics Data System (ADS)

    Prettyman, T. H.; Sykes, M. V.; Miller, R. S.; Pinsky, L. S.; Empl, A.; Nolan, M. C.; Koontz, S. L.; Lawrence, D. J.; Mittlefehldt, D. W.; Reddell, B. D.

    2015-12-01

    Near Earth Objects (NEOs) are a diverse population of short-lived asteroids originating from the main belt and Jupiter family comets. Some have orbits that are easy to access from Earth, making them attractive as targets for science and exploration as well as a potential resource. Some pose a potential impact threat. NEOs have undergone extensive collisional processing, fragmenting and re-accreting to form rubble piles, which may be compositionally heterogeneous (e.g., like 2008 TC3, the precursor to Almahata Sitta). At present, little is known about their interior structure or how these objects are held together. The wide range of inferred NEO macroporosities hint at complex interiors. Information about their density structure would aid in understanding their formation and collisional histories, the risks they pose to human interactions with their surfaces, the constraints on industrial processing of NEO resources, and the selection of hazard mitigation strategies (e.g., kinetic impactor vs nuclear burst). Several methods have been proposed to characterize asteroid interiors, including radar imaging, seismic tomography, and muon imaging (muon radiography and tomography). Of these, only muon imaging has the potential to determine interior density structure, including the relative density of constituent fragments. Muons are produced by galactic cosmic ray showers within the top meter of asteroid surfaces. High-energy muons can traverse large distances through rock with little deflection. Muons transmitted through an Itokawa-sized asteroid can be imaged using a compact hodoscope placed on or near the surface. Challenges include background rejection and correction for variations in muon production with surface density. The former is being addressed by hodoscope design. Surface density variations can be determined via radar or muon limb imaging. The performance of muon imaging is evaluated for prospective NEO interior-mapping missions.

  14. The "Bantu Clinic": a genealogy of the African patient as object and effect of South African clinical medicine, 1930-1990.

    PubMed

    Butchart, A

    1997-12-01

    This paper is about power, medicine and the identity of the African as a patient of western medicine. From a conventional perspective and as encoded in the current "quest for wholeness" that characterises South African biomedical discourse, the African patient--like any other patient--has always existed as an authentic and subjectified being, whose true attributes and experiences have been denied by the "mechanistic," "reductionistic" and "ethnocentric" practices of clinical medicine. Against this liberal humanist perspective on the body as ontologically independent of power, this paper offers a Foucaultian reading of the African patient as-like any other patient--contingent upon the force relations immanent within and relayed through the clinical practices of biomedicine. A quintessential form of disciplinary micro-power, these fabricate the most intimate recesses of the human body as manageable objects of medical knowledge and social consciousness to make possible the great control strategies of repression, segmentation and liberation that are the usual focus of conventional investigations into the place and function of medicine in society. Since the 1930s when the African body first emerged as a discrete object of a secular clinical knowledge, these have repeatedly transformed the attributes and identity of the African patient, and the paper traces this archaeology of South African clinical perception from then until the 1990s to show how its "quest for wholeness" is not an end point of "discovery" or "liberation," but merely another ephemeral crystallization of socio-medical knowledge in a constantly changing force field of disciplinary power. PMID:9492973

  15. Comparing the Effects of Objective Structured Assessment of Technical Skills (OSATS) and Traditional Method on Learning of Students

    PubMed Central

    Mansoorian, Mohammad Reza; Hosseiny, Marzeih Sadat; Khosravan, Shahla; Alami, Ali; Alaviani, Mehri

    2015-01-01

    Background: Despite the benefits of the objective structured assessment of technical skills (OSATS) and it appropriateness for evaluating clinical abilities of nursing students , few studies are available on the application of this method in nursing education. Objectives: The purpose of this study was to compare the effect of using OSATS and traditional methods on the students’ learning. We also aimed to signify students’ views about these two methods and their views about the scores they received in these methods in a medical emergency course. Patients and Methods: A quasi-experimental study was performed on 45 first semester students in nursing and medical emergencies passing a course on fundamentals of practice. The students were selected by a census method and evaluated by both the OSATS and traditional methods. Data collection was performed using checklists prepared based on the ‘text book of nursing procedures checklists’ published by Iranian nursing organization and a questionnaire containing learning rate and students’ estimation of their received scores. Descriptive statistics as well as paired t-test and independent samples t-test were used in data analysis. Results: The mean of students’ score in OSATS was significantly higher than their mean score in traditional method (P = 0.01). Moreover, the mean of self-evaluation score after the traditional method was relatively the same as the score the students received in the exam. However, the mean of self-evaluation score after the OSATS was relatively lower than the scores the students received in the OSATS exam. Most students believed that OSATS can evaluate a wide range of students’ knowledge and skills compared to traditional method. Conclusions: Results of this study indicated the better effect of OSATS on learning and its relative superiority in precise assessment of clinical skills compared with the traditional evaluation method. Therefore, we recommend using this method in evaluation of

  16. Transforming clinical imaging and 3D data for virtual reality learning objects: HTML5 and mobile devices implementation.

    PubMed

    Trelease, Robert B; Nieder, Gary L

    2013-01-01

    Web deployable anatomical simulations or "virtual reality learning objects" can easily be produced with QuickTime VR software, but their use for online and mobile learning is being limited by the declining support for web browser plug-ins for personal computers and unavailability on popular mobile devices like Apple iPad and Android tablets. This article describes complementary methods for creating comparable, multiplatform VR learning objects in the new HTML5 standard format, circumventing platform-specific limitations imposed by the QuickTime VR multimedia file format. Multiple types or "dimensions" of anatomical information can be embedded in such learning objects, supporting different kinds of online learning applications, including interactive atlases, examination questions, and complex, multi-structure presentations. Such HTML5 VR learning objects are usable on new mobile devices that do not support QuickTime VR, as well as on personal computers. Furthermore, HTML5 VR learning objects can be embedded in "ebook" document files, supporting the development of new types of electronic textbooks on mobile devices that are increasingly popular and self-adopted for mobile learning.

  17. Transforming clinical imaging and 3D data for virtual reality learning objects: HTML5 and mobile devices implementation.

    PubMed

    Trelease, Robert B; Nieder, Gary L

    2013-01-01

    Web deployable anatomical simulations or "virtual reality learning objects" can easily be produced with QuickTime VR software, but their use for online and mobile learning is being limited by the declining support for web browser plug-ins for personal computers and unavailability on popular mobile devices like Apple iPad and Android tablets. This article describes complementary methods for creating comparable, multiplatform VR learning objects in the new HTML5 standard format, circumventing platform-specific limitations imposed by the QuickTime VR multimedia file format. Multiple types or "dimensions" of anatomical information can be embedded in such learning objects, supporting different kinds of online learning applications, including interactive atlases, examination questions, and complex, multi-structure presentations. Such HTML5 VR learning objects are usable on new mobile devices that do not support QuickTime VR, as well as on personal computers. Furthermore, HTML5 VR learning objects can be embedded in "ebook" document files, supporting the development of new types of electronic textbooks on mobile devices that are increasingly popular and self-adopted for mobile learning. PMID:23212750

  18. Subjective and objective quality of life, levels of life skills, and their clinical determinants in outpatients with schizophrenia.

    PubMed

    Aki, Hirofumi; Tomotake, Masahito; Kaneda, Yasuhiro; Iga, Jun-Ichi; Kinouchi, Sawako; Shibuya-Tayoshi, Sumiko; Tayoshi, Shin-Ya; Motoki, Ikuyo; Moriguchi, Kazuhiko; Sumitani, Satsuki; Yamauchi, Ken; Taniguchi, Takahide; Ishimoto, Yasuhito; Ueno, Shu-Ichi; Ohmori, Tetsuro

    2008-02-28

    The purpose of the present study is to investigate the relationships among subjective and objective quality of life (QOL), and levels of life skills, and their clinical determinants in outpatients with schizophrenia by using schizophrenia disease-specific QOL measures. Data collected from 64 outpatients were analyzed. Subjective QOL was measured with the Schizophrenia Quality of Life Scale (SQLS) and objective QOL with the Quality of Life Scale (QLS). Patients' family members completed the Life Skills Profile (LSP). Clinical symptoms were also assessed with several scales including the Brief Psychiatric Rating Scale (BPRS) and the Calgary Depression Scale for Schizophrenia (CDSS). Only the motivation/energy scale, but not the other scales of the SQLS, correlated with the QLS. The LSP rated by the family showed significant correlations with both the SQLS and the QLS. The CDSS score predicted each scale of the SQLS, and the BPRS negative symptoms score predicted the QLS. The LSP was predicted by the BPRS negative symptoms score and the CDSS score independently. These results indicate that the patient's QOL could be predicted by the life skills measured by a family member and suggest that active treatment for depressive and negative symptoms might be recommended to improve the patient's QOL and life skills.

  19. Incremental Structured Dictionary Learning for Video Sensor-Based Object Tracking

    PubMed Central

    Xue, Ming; Yang, Hua; Zheng, Shibao; Zhou, Yi; Yu, Zhenghua

    2014-01-01

    To tackle robust object tracking for video sensor-based applications, an online discriminative algorithm based on incremental discriminative structured dictionary learning (IDSDL-VT) is presented. In our framework, a discriminative dictionary combining both positive, negative and trivial patches is designed to sparsely represent the overlapped target patches. Then, a local update (LU) strategy is proposed for sparse coefficient learning. To formulate the training and classification process, a multiple linear classifier group based on a K-combined voting (KCV) function is proposed. As the dictionary evolves, the models are also trained to timely adapt the target appearance variation. Qualitative and quantitative evaluations on challenging image sequences compared with state-of-the-art algorithms demonstrate that the proposed tracking algorithm achieves a more favorable performance. We also illustrate its relay application in visual sensor networks. PMID:24549252

  20. Lightweight Object Oriented Structure analysis: Tools for building Tools to Analyze Molecular Dynamics Simulations

    PubMed Central

    Romo, Tod D.; Leioatts, Nicholas; Grossfield, Alan

    2014-01-01

    LOOS (Lightweight Object-Oriented Structure-analysis) is a C++ library designed to facilitate making novel tools for analyzing molecular dynamics simulations by abstracting out the repetitive tasks, allowing developers to focus on the scientifically relevant part of the problem. LOOS supports input using the native file formats of most common biomolecular simulation packages, including CHARMM, NAMD, Amber, Tinker, and Gromacs. A dynamic atom selection language based on the C expression syntax is included and is easily accessible to the tool-writer. In addition, LOOS is bundled with over 120 pre-built tools, including suites of tools for analyzing simulation convergence, 3D histograms, and elastic network models. Through modern C++ design, LOOS is both simple to develop with (requiring knowledge of only 4 core classes and a few utility functions) and is easily extensible. A python interface to the core classes is also provided, further facilitating tool development. PMID:25327784

  1. A multi-objective evolutionary algorithm for protein structure prediction with immune operators.

    PubMed

    Judy, M V; Ravichandran, K S; Murugesan, K

    2009-08-01

    Genetic algorithms (GA) are often well suited for optimisation problems involving several conflicting objectives. It is more suitable to model the protein structure prediction problem as a multi-objective optimisation problem since the potential energy functions used in the literature to evaluate the conformation of a protein are based on the calculations of two different interaction energies: local (bond atoms) and non-local (non-bond atoms) and experiments have shown that those types of interactions are in conflict, by using the potential energy function, Chemistry at Harvard Macromolecular Mechanics. In this paper, we have modified the immune inspired Pareto archived evolutionary strategy (I-PAES) algorithm and denoted it as MI-PAES. It can effectively exploit some prior knowledge about the hydrophobic interactions, which is one of the most important driving forces in protein folding to make vaccines. The proposed MI-PAES is comparable with other evolutionary algorithms proposed in literature, both in terms of best solution found and the computational time and often results in much better search ability than that of the canonical GA.

  2. Student's perspectives on objective structured practical examination (OSPE) in Forensic Medicine - a report from India.

    PubMed

    Pramod Kumar, G N; Sentitoshi; Nath, Dhritiman; Menezes, Ritesh G; Kanchan, Tanuj

    2015-05-01

    The objective of the present study was to know the perceptions of students regarding objective structured practical examination (OSPE) as a tool for assessment in Forensic Medicine. The present study was conducted in the Department of Forensic Medicine and Toxicology, Mahatma Gandhi Medical College and Research Institute (MGMCRI), Pondicherry, India. Undergraduate medical students of the 4th semester were enrolled in the study to know their perceptions regarding OSPE. The students were briefed regarding OSPE with a PowerPoint presentation and interaction. An examination was conducted using OSPE with10 stations and a total of 74 students participated in the study. The feedback was collected using a preformed proforma consisting of 12 items and analyzed. Most of the participants (82.4%) agreed that OSPE is a better method of examination than the conventional/traditional practical examination. The majority of the participants (77.0%) said that the OSPE covered wide range of knowledge than the conventional practical examination. A large number of students (63.5%) were of the opinion that the OSPE may be exhausting and stressful if number of stations are increased. Overall a larger proportion of the participants preferred OSPE over the conventional practical examination considering the various attributes examined in the study.

  3. Creating Shareable Clinical Decision Support Rules for a Pharmacogenomics Clinical Guideline Using Structured Knowledge Representation

    PubMed Central

    Linan, Margaret K.; Sottara, Davide; Freimuth, Robert R.

    2015-01-01

    Pharmacogenomics (PGx) guidelines contain drug-gene relationships, therapeutic and clinical recommendations from which clinical decision support (CDS) rules can be extracted, rendered and then delivered through clinical decision support systems (CDSS) to provide clinicians with just-in-time information at the point of care. Several tools exist that can be used to generate CDS rules that are based on computer interpretable guidelines (CIG), but none have been previously applied to the PGx domain. We utilized the Unified Modeling Language (UML), the Health Level 7 virtual medical record (HL7 vMR) model, and standard terminologies to represent the semantics and decision logic derived from a PGx guideline, which were then mapped to the Health eDecisions (HeD) schema. The modeling and extraction processes developed here demonstrate how structured knowledge representations can be used to support the creation of shareable CDS rules from PGx guidelines. PMID:26958298

  4. How we avoid patient shortage with an integrated analysis of learning objectives and clinical data during development of undergraduate medical curricula.

    PubMed

    Balzer, Felix; Bietenbeck, Andreas; Spies, Claudia; Dittmar, Martin; Lehmann, Lars; Sugiharto, Firman; Ahlers, Olaf

    2015-01-01

    Access to patients is a crucial factor for student-centred medical education. However, increasing numbers of students, teacher shortage, a patient spectrum consisting of rarer diseases, and quicker discharges limit this necessary access, and therefore pose a challenge for curriculum designers. The herein presented algorithm improves access to patients in four steps by using routinely available electronic patient data already during curriculum development. Step I: Learning objectives are mapped to appropriate ICD-10 (International Statistical Classification of Diseases) codes. Step II: It is determined which learning opportunities need to be considered first for patient allocation in order to maximise overall benefit. Step III: Hospital's departments with the highest expertise on respective learning objectives are assessed and selected for teaching. Step IV: Patients of the chosen department that present the best match for a given learning opportunity are assigned to participation. This integrated analysis of learning objectives and existing clinical data during curriculum development is a well-structured method to maximise access to patients. Furthermore, this algorithm identifies learning objectives of a curriculum that do not correspond well to the spectrum of patients of the respective teaching hospital and which should therefore be taught in learning formats without patient contact.

  5. Coordinate-independent mapping of structural and functional data by objective relational transformation (ORT).

    PubMed Central

    Stephan, K E; Zilles, K; Kötter, R

    2000-01-01

    Neuroscience has produced an enormous amount of structural and functional data. Powerful database systems are required to make these data accessible for computational approaches such as higher-order analyses and simulations. Available databases for key data such as anatomical and functional connectivity between cortical areas, however, are still hampered by methodological problems. These problems arise predominantly from the parcellation problem, the use of incongruent parcellation schemes by different authors. We here present a coordinate-independent mathematical method to overcome this problem: objective relational transformation (ORT). Based on new classifications for brain data and on methods from theoretical computer science, ORT represents a formally defined, transparent transformation method for reproducible, coordinate-independent mapping of brain data to freely chosen parcellation schemes. We describe the methodology of ORT and discuss its strengths and limitations. Using two practical examples, we show that ORT in conjunction with connectivity databases like CoCoMac (http://www.cocomac.org) is an important tool for analyses of cortical organization and structure-function relationships. PMID:10703043

  6. UAV-based urban structural damage assessment using object-based image analysis and semantic reasoning

    NASA Astrophysics Data System (ADS)

    Fernandez Galarreta, J.; Kerle, N.; Gerke, M.

    2015-06-01

    Structural damage assessment is critical after disasters but remains a challenge. Many studies have explored the potential of remote sensing data, but limitations of vertical data persist. Oblique imagery has been identified as more useful, though the multi-angle imagery also adds a new dimension of complexity. This paper addresses damage assessment based on multi-perspective, overlapping, very high resolution oblique images obtained with unmanned aerial vehicles (UAVs). 3-D point-cloud assessment for the entire building is combined with detailed object-based image analysis (OBIA) of façades and roofs. This research focuses not on automatic damage assessment, but on creating a methodology that supports the often ambiguous classification of intermediate damage levels, aiming at producing comprehensive per-building damage scores. We identify completely damaged structures in the 3-D point cloud, and for all other cases provide the OBIA-based damage indicators to be used as auxiliary information by damage analysts. The results demonstrate the usability of the 3-D point-cloud data to identify major damage features. Also the UAV-derived and OBIA-processed oblique images are shown to be a suitable basis for the identification of detailed damage features on façades and roofs. Finally, we also demonstrate the possibility of aggregating the multi-perspective damage information at building level.

  7. Assessment of clinical outcomes of Roth and MBT bracket prescription using the American Board of Orthodontics Objective Grading System

    PubMed Central

    Jain, Mahesh; Varghese, Joseph; Mascarenhas, Rohan; Mogra, Subraya; Shetty, Siddarth; Dhakar, Nidhi

    2013-01-01

    Background: There is always a need to assess whether small changes in bracket prescription can lead to visually detectable differences in tooth positions. However, with little clinical evidence to show advantages of any of the popularly used bracket systems, orthodontists are forced to make clinical decisions with little scientific guidance. Aim: To compare the orthodontic cases finished with Roth and MBT prescription using American Board of Orthodontics-Objective Grading System (ABO-OGS). Settings and Design: Department of Orthodontics, Post-graduate dental college, retrospective cross-sectional study. Materials and Methods: Forty patients selected were divided into two groups of 20 patients each finished with straight wire appliance using Roth and MBT prescription, respectively. The examiner ability was assessed and calibrated by one of the ABO certified clinician to grade cases using the OGS. Statistical Analysis: Unpaired student t-test was used and P < 0.05 was accepted as significant. Results and Conclusions: MBT bracket group had a lower score of 2.60 points in buccolingual inclination and lower score of 1.10 points in occlusal contact category that was statistically significant when compared with Roth group. The difference in total ABO-OGS score was 2.65 points showing that the outcome for the MBT prescription was better than that of the Roth prescription, which is statistically significant, but with little or no clinical significance. It can be concluded that use of either one of the Roth and MBT bracket prescriptions have no impact to the overall clinical outcome and quality of treatment entirely depends on clinician judgment and experience. PMID:24124295

  8. The sperm chromatin structure assay: a review of clinical applications.

    PubMed

    Love, Charles C

    2005-10-01

    The sperm chromatin structure assay (SCSA) was introduced by as a method to determine the susceptibility of sperm DNA to denaturation and how those results related to fertility. This initial study used human sperm and was followed by studies in bulls and boars . This assay was one of the first to introduce the technique of flow cytometry, which has the ability to evaluate specific sperm compartments of large numbers of sperm in a short time, as a methodology to evaluate sperm quality and further define the relationship of sperm quality to fertility. For any assay to be of use clinically, it must not only be validated and adapted for the species of interest, but guidelines that associate specific levels of fertility with assay results must be defined. This review will describe how our laboratory uses the SCSA for clinical diagnosis of reduced fertility in the stallion. PMID:16140481

  9. SEMCARE: Multilingual Semantic Search in Semi-Structured Clinical Data.

    PubMed

    López-García, Pablo; Kreuzthaler, Markus; Schulz, Stefan; Scherr, Daniel; Daumke, Philipp; Markó, Kornél; Kors, Jan A; van Mulligen, Erik M; Wang, Xinkai; Gonna, Hanney; Behr, Elijah; Honrado, Ángel

    2016-01-01

    The vast amount of clinical data in electronic health records constitutes a great potential for secondary use. However, most of this content consists of unstructured or semi-structured texts, which is difficult to process. Several challenges are still pending: medical language idiosyncrasies in different natural languages, and the large variety of medical terminology systems. In this paper we present SEMCARE, a European initiative designed to minimize these problems by providing a multi-lingual platform (English, German, and Dutch) that allows users to express complex queries and obtain relevant search results from clinical texts. SEMCARE is based on a selection of adapted biomedical terminologies, together with Apache UIMA and Apache Solr as open source state-of-the-art natural language pipeline and indexing technologies. SEMCARE has been deployed and is currently being tested at three medical institutions in the UK, Austria, and the Netherlands, showing promising results in a cardiology use case.

  10. SEMCARE: Multilingual Semantic Search in Semi-Structured Clinical Data.

    PubMed

    López-García, Pablo; Kreuzthaler, Markus; Schulz, Stefan; Scherr, Daniel; Daumke, Philipp; Markó, Kornél; Kors, Jan A; van Mulligen, Erik M; Wang, Xinkai; Gonna, Hanney; Behr, Elijah; Honrado, Ángel

    2016-01-01

    The vast amount of clinical data in electronic health records constitutes a great potential for secondary use. However, most of this content consists of unstructured or semi-structured texts, which is difficult to process. Several challenges are still pending: medical language idiosyncrasies in different natural languages, and the large variety of medical terminology systems. In this paper we present SEMCARE, a European initiative designed to minimize these problems by providing a multi-lingual platform (English, German, and Dutch) that allows users to express complex queries and obtain relevant search results from clinical texts. SEMCARE is based on a selection of adapted biomedical terminologies, together with Apache UIMA and Apache Solr as open source state-of-the-art natural language pipeline and indexing technologies. SEMCARE has been deployed and is currently being tested at three medical institutions in the UK, Austria, and the Netherlands, showing promising results in a cardiology use case. PMID:27139390

  11. Saving Lives and Money: A Multi-Objective Optimization Approach to the Selection of Structural Retrofits

    NASA Astrophysics Data System (ADS)

    Franco, G.; Deodatis, G.; Smyth, A.

    2005-12-01

    The existence of large numbers of poorly constructed buildings in earthquake-prone areas has made large scale retrofitting campaigns a desirable strategy for reducing the risk of loss of life and infrastructure. Since the retrofitting operation must be, therefore, carried out for numerous buildings, it has become a necessity to find the most attractive retrofitting solution for a given type of buildings that significantly reduces the risk of loss of life while remaining as economic as possible. Each retrofit solution for an existing building carries a set of potential costs and benefits over a given period of time. Some of these costs and benefits can be taken into account in terms of monetary values, whereas others cannot. The value of lives spared or lives lost that may potentially occur over the lifespan of a building as a consequence of choosing a particular retrofit cannot be easily measured in terms of money. In the absence of better methods to incorporate the value of life into economic analyses, a somewhat arbitrary monetary quantity based on personal insurance or personal productivity is often chosen as a proxy to quantify it. These quantities, however, not only fail to capture the otherwise incalculable cost of life, but are also strongly dependent on the economy under study. In this work, the monetary costs of construction and structural damage are clearly differentiated from the loss of life, which is simply measured as the number of potential casualties in a certain earthquake scenario. Finding the best retrofit then becomes a multi-objective optimization problem, whose purpose is to find the cheapest solution that saves most lives. The conflicting nature of the objectives causes the appearance of not only one optimal solution but of a set of most convenient solutions that capture the different levels of trade-off between costs and lives saved. A large number of possible structural retrofits must be considered in order to find the set of best solutions

  12. Queries of nature neighbor objects on UnitsDelaunay structure in spatial database

    NASA Astrophysics Data System (ADS)

    Li, Jiatian; Zhao, Renliang; Chen, Jun

    2006-10-01

    In recent years, the research on models of spatial relation computation can be divided into two types: the spatial relation among intersected entities and the spatial relation among the non-intersected entities. Currently, the latter is often used distance, direction and coordinate systems and other methods to study. But these quantitative methods are difficult to sympathize with human natural language understanding and space cognitive habits. Nature neighbor relationship is a vital space relationship. It can answer such questions as "Which hospital are adjacent to the moving object?" "Which schools are adjacent to the McDonald's shop?" In this paper, we analyzed two methods to compute the nature neighbor relationships: Voronoi diagram method and Delaunay triangulation method. We found the main problems for applying these methods to spatial selection are the overall and repetitive calculation. In some basic theory: (i) Define function f in order to distinct different types of triangle. According to the different sources of the nodes, the f is individually equal to 0, 1 and 2. And then the 3×3 matrix C is built on the f. According to the different values of |C|, we can divide the triangles as three types: α, β, γ. (ii) Taking into account that the triangles of type α is not entirely internal concave polygon, we divide the type α into type α and δ on the condition whether the polygon includes the focus of the triangle or not. Then the D(P) composed by Q includes four types of triangles: α, β, γ and δ. (iii) Demonstrate that the space scope of Q in R2 is equal to the space scope of triangle set T of type α in D(P) , reasoned out the complement of Q in R2 is equivalence with the set {Tβ union Tγ union Tδ} and the nature neighbor relationship can only exist in the set {Tβ union Tγ union Tδ}. (iv) For β and γ-type triangle we posed a subset of their sources and demonstrated the certainty in the context of natural subset of the space adjacent to the

  13. The Netherlands XTC Toxicity (NeXT) study: objectives and methods of a study investigating causality, course, and clinical relevance.

    PubMed

    De Win, Maartje M L; Jager, Gerry; Vervaeke, Hylke K E; Schilt, Thelma; Reneman, Liesbeth; Booij, Jan; Verhulst, Frank C; Den Heeten, Gerard J; Ramsey, Nick F; Korf, Dirk J; Van den Brink, Wim

    2005-01-01

    This paper describes the objectives and methods of The Netherlands XTC Toxicity (NeXT) study focussing on the causality, course, and clinical relevance of ecstasy neurotoxicity. Previous studies suggest that ecstasy (3,4 methylene-dioxymethamphetamine, MDMA, XTC) is toxic toward brain serotonin axons, but most of these studies have serious methodological limitations. The current study is a combination of different approaches with three substudies: (1) a crosssectional substudy among heavy ecstasy users and controls with variation in drug use, which will provide information about potential neurotoxic consequences of ecstasy in relation to other drugs; (2) a prospective cohort substudy in ecstasy-naive subjects with high risk for future ecstasy use, which will provide information on the causality and short-term course of ecstasy use and potential neurotoxicity, and (3) a retrospective cohort substudy in lifetime ecstasy users and matched controls of an existing epidemiological sample that will provide information on long-term course and outcome of ecstasy use in the general population. Neurotoxicity is studied using (a) different imaging techniques (beta-CIT SPECT, 1H-MR spectroscopy, diffusion tensor imaging, perfusion weighted imaging and functional magnetic resonance imaging), and (b) neuropsychological and psychiatric assessments of memory, depression, and personality. The combined results will lead to conclusions that can be used in prevention messages, clinical decision making, and the development of an (inter)national ecstasy policy.

  14. Stellar structure modeling using a parallel genetic algorithm for objective global optimization

    NASA Astrophysics Data System (ADS)

    Metcalfe, Travis S.; Charbonneau, Paul

    2003-02-01

    Genetic algorithms are a class of heuristic search techniques that apply basic evolutionary operators in a computational setting. We have designed a fully parallel and distributed hardware/software implementation of the generalized optimization subroutine PIKAIA, which utilizes a genetic algorithm to provide an objective determination of the globally optimal parameters for a given model against an observational data set. We have used this modeling tool in the context of white dwarf asteroseismology, i.e., the art and science of extracting physical and structural information about these stars from observations of their oscillation frequencies. The efficient, parallel exploration of parameter-space made possible by genetic-algorithm-based numerical optimization led us to a number of interesting physical results: (1) resolution of a hitherto puzzling discrepancy between stellar evolution models and prior asteroseismic inferences of the surface helium layer mass for a DBV white dwarf; (2) precise determination of the central oxygen mass fraction in a white dwarf star; and (3) a preliminary estimate of the astrophysically important but experimentally uncertain rate for the 12C(α,γ)16O nuclear reaction. These successes suggest that a broad class of computationally intensive modeling applications could also benefit from this approach.

  15. The naphthalene state of the science symposium: objectives, organization, structure, and charge.

    PubMed

    Belzer, Richard B; Bus, James S; Cavalieri, Ercole L; Lewis, Steven C; North, D Warner; Pleus, Richard C

    2008-07-01

    This report provides a summary of the objectives, organization, structure and charge for the naphthalene state of the science symposium (NS(3)), Monterey, CA, October 9-12, 2006. A 1-day preliminary conference was held followed by a 3-day state of the science symposium covering four topics judged by the Planning Committee to be crucial for developing valid and reliable scientific estimates of low-dose human cancer risk from naphthalene. The Planning Committee reviewed the relevant scientific literature to identify singularly knowledgeable researchers and a pool of scientists qualified to serve as expert panelists. In two cases, independent scientists were commissioned to develop comprehensive reviews of the relevant science in a specific area for which no leading researcher could be identified. Researchers and expert panelists alike were screened for conflicts of interest. All policy issues related to risk assessment practices and risk management were scrupulously excluded. NS(3) was novel in several ways and provides an innovative model for the effective use of peer review to identify scientific uncertainties and propose research strategies for reducing or eliminating them prior to the conduct of risk assessment.

  16. Measurement equivalence of the Toronto Structured Interview for Alexithymia across language, gender, and clinical status.

    PubMed

    Keefer, Kateryna V; Taylor, Graeme J; Parker, James D A; Inslegers, Ruth; Michael Bagby, R

    2015-08-30

    The Toronto Structured Interview for Alexithymia (TSIA) has been translated into Dutch, German, and Italian and validated in clinical and nonclinical populations. In order to make valid comparisons across different population groups, it is important to establish measurement equivalence across variables such as language, gender, and clinical status. Our objective in this study was to establish measurement equivalence in relation to language (English, Dutch, German, and Italian), gender, and clinical status (non-clinical, psychiatric, and medical) using differential item functioning (DIF). The sample was composed of 842 adults representing the four language groups, all of whom had undergone the TSIA assessment as part of several earlier studies. Ordinal Logistic Regression was employed to explore DIF of the TSIA items. Although several items were found to exhibit DIF for language, gender, or clinical status, all of these effects were within an acceptable range. These findings provide support for the measurement equivalence of the TSIA, and allow researchers to reliably compare results from studies using the TSIA across the four language groups, gender, and clinical status.

  17. Chemistry of massive young stellar objects with a disk-like structure

    NASA Astrophysics Data System (ADS)

    Isokoski, K.; Bottinelli, S.; van Dishoeck, E. F.

    2013-06-01

    Aims: Our goal is to take an inventory of complex molecules in three well-known high-mass protostars for which disks or toroids have been claimed and to study the similarities and differences with a sample of massive young stellar objects (YSOs) without evidence of such flattened disk-like structures. With a disk-like geometry, UV radiation can escape more readily and potentially affect the ice and gas chemistry on hot-core scales. Methods: A partial submillimeter line survey, targeting CH3OH, H2CO, C2H5OH, HCOOCH3, CH3OCH3, CH3CN, HNCO, NH2CHO, C2H5CN, CH2CO, HCOOH, CH3CHO, and CH3CCH, was made toward three massive YSOs with disk-like structures, IRAS 20126+4104, IRAS 18089-1732, and G31.41+0.31. Rotation temperatures and column densities were determined by the rotation diagram method, as well as by independent spectral modeling. The molecular abundances were compared with previous observations of massive YSOs without evidence of any disk structure, targeting the same molecules with the same settings and using the same analysis method. Results: Consistent with previous studies, different complex organic species have different characteristic rotation temperatures and can be classified either as warm (>100 K) or cold (<100 K). The excitation temperatures and abundance ratios are similar from source to source and no significant difference can be established between the two source types. Acetone, CH3COCH3, is detected for the first time in G31.41+0.31 and IRAS 18089-1732. Temperatures and abundances derived from the two analysis methods generally agree within factors of a few. Conclusions: The lack of chemical differentiation between massive YSOs with and without observed disks suggest either that the chemical complexity is already fully established in the ices in the cold prestellar phase or that the material experiences similar physical conditions and UV exposure through outflow cavities during the short embedded lifetime. Appendices are available in electronic form

  18. Incidental and Context-Responsive Activation of Structure- and Function-Based Action Features during Object Identification

    ERIC Educational Resources Information Center

    Lee, Chia-lin; Middleton, Erica; Mirman, Daniel; Kalenine, Solene; Buxbaum, Laurel J.

    2013-01-01

    Previous studies suggest that action representations are activated during object processing, even when task-irrelevant. In addition, there is evidence that lexical-semantic context may affect such activation during object processing. Finally, prior work from our laboratory and others indicates that function-based ("use") and structure-based…

  19. Method and apparatus for detecting internal structures of bulk objects using acoustic imaging

    DOEpatents

    Deason, Vance A.; Telschow, Kenneth L.

    2002-01-01

    Apparatus for producing an acoustic image of an object according to the present invention may comprise an excitation source for vibrating the object to produce at least one acoustic wave therein. The acoustic wave results in the formation of at least one surface displacement on the surface of the object. A light source produces an optical object wavefront and an optical reference wavefront and directs the optical object wavefront toward the surface of the object to produce a modulated optical object wavefront. A modulator operatively associated with the optical reference wavefront modulates the optical reference wavefront in synchronization with the acoustic wave to produce a modulated optical reference wavefront. A sensing medium positioned to receive the modulated optical object wavefront and the modulated optical reference wavefront combines the modulated optical object and reference wavefronts to produce an image related to the surface displacement on the surface of the object. A detector detects the image related to the surface displacement produced by the sensing medium. A processing system operatively associated with the detector constructs an acoustic image of interior features of the object based on the phase and amplitude of the surface displacement on the surface of the object.

  20. A real options approach to clinical faculty salary structure.

    PubMed

    Kahn, Marc J; Long, Hugh W

    2012-01-01

    One can use the option theory model originally developed to price financial opportunities in security markets to analyze many other economic arrangements such as the salary structures of clinical faculty in an academic medical center practice plan. If one views the underlying asset to be the portion (labeled "salary") of the economic value of the collections made for the care provided patients by the physician, then a salary guarantee can be considered a put option provided the physician, the guarantee having value to the physician only when the actual salary earned is less than the salary guarantee. Similarly, within an incentive plan, a salary cap can be thought of as a call option provided to the practice plan since a salary cap only has value to the practice plan when a physician's earnings exceed the cap. Further, based on analysis of prior earnings, the Black-Scholes options pricing model can be used both to price each option and to determine a financially neutral balance between a salary guarantee and a salary cap by equating the prices of the implied put and call options. We suggest that such analysis is superior to empirical methods for setting clinical faculty salary structure in the academic practice plan setting. PMID:23155746

  1. Development of the Objective, Structured Communication Assessment of Residents (OSCAR) Tool for Measuring Communication Skills With Patients

    PubMed Central

    Caron, Aleece; Perzynski, Adam; Thomas, Charles; Saade, Jimmy Y.; McFarlane, Michael; Becker, Jeffery

    2013-01-01

    Background Although interpersonal and communication skills are essential to physician practice, there is a dearth of effective tools to meaningfully teach and assess communication skills. Objective The purpose of our study was to create a standardized tool for evaluation of communication skills for residents across specialties. Methods We designed an Objective, Structured Communication Assessment of Residents (OSCAR) tool, consisting of 4 clinical stations, to assess intern communication skills with relationship development, their establishment of case goals, and their organization and time management skills. Interns from 11 training programs completed the stations, with senior residents trained to function as standardized patients. The 4 stations' scenarios were a disruptive patient, handling a phone call for a narcotics refill, disclosing a medical mistake, and delivering bad news. Results Eighty-three interns completed OSCAR during orientation. The assessment took interns about 40 minutes to complete, and participants were given immediate feedback by the standardized patients. The total possible score for each station was 50. Resident performance was highest for disclosing a medical error (94%, 47 of 50), followed by handling a disruptive patient (90%, 45 of 50), disclosing bad news (86%, 43 of 50), and handling the phone call for the narcotics refill (62%, 31 of 50). Multivariate analysis of variance results indicated differences between residents from US and international medical schools, but there were no significant differences across specialties. Interrater reliability was excellent for each station (> 0.80). Conclusions OSCAR is a practical tool for assessing interns' communication skills to provide timely results to program directors. PMID:24455003

  2. Correlating Photoreceptor Mosaic Structure to Clinical Findings in Stargardt Disease

    PubMed Central

    Razeen, Moataz M.; Cooper, Robert F.; Langlo, Christopher S.; Goldberg, Mara R.; Wilk, Melissa A.; Han, Dennis P.; Connor, Thomas B.; Fishman, Gerald A.; Collison, Frederick T.; Sulai, Yusufu N.; Dubra, Alfredo; Carroll, Joseph; Stepien, Kimberly E.

    2016-01-01

    Purpose To demonstrate a method for correlating photoreceptor mosaic structure with optical coherence tomography (OCT) and microperimetry findings in patients with Stargardt disease. Methods A total of 14 patients with clinically diagnosed Stargardt disease were imaged using confocal and split-detection adaptive optics scanning light ophthalmoscopy. Cone photoreceptors were identified manually in a band along the temporal meridian. Resulting values were compared to a normative database (n = 9) to generate cone density deviation (CDD) maps. Manual measurement of outer nuclear layer plus Henle fiber layer (ONL+HFL) thickness was performed, in addition to determination of the presence of ellipsoid zone (EZ) and interdigitation zone (IZ) bands on OCT. These results, along with microperimetry data, were overlaid with the CDD maps. Results Wide variation in foveal structure and CDD maps was seen within this small group. Disruption of ONL+HFL and/or IZ band was seen in all patients, with EZ band preservation in regions with low cone density in 38% of locations analyzed. Normality of retinal lamellar structure on OCT corresponded with cone density and visual function at 50/78 locations analyzed. Outer retinal tubulations containing photoreceptor-like structures were observed in 3 patients. Conclusions The use of CDD color-coded maps enables direct comparison of cone mosaic local density with other measures of retinal structure and function. Larger normative datasets and improved tools for automation of image alignment are needed. Translational Relevance The approach described facilitates comparison of complex multimodal data sets from patients with inherited retinal degeneration, and can be expanded to incorporate other structural imaging or functional testing. PMID:26981328

  3. The Objective Structured Clinical Examination (OSCE): AMEE Guide No. 81. Part II: organisation & administration.

    PubMed

    Khan, Kamran Z; Gaunt, Kathryn; Ramachandran, Sankaranarayanan; Pushkar, Piyush

    2013-09-01

    The organisation, administration and running of a successful OSCE programme need considerable knowledge, experience and planning. Different teams looking after various aspects of OSCE need to work collaboratively for an effective question bank development, examiner training and standardised patients' training. Quality assurance is an ongoing process taking place throughout the OSCE cycle. In order for the OSCE to generate reliable results it is essential to pay attention to each and every element of quality assurance, as poorly standardised patients, untrained examiners, poor quality questions and inappropriate scoring rubrics each will affect the reliability of the OSCE. The validity will also be influenced if the questions are not realistic and mapped against the learning outcomes of the teaching programme. This part of the Guide addresses all these important issues in order to help the reader setup and quality assure their new or existing OSCE programmes.

  4. Developing an Objective Structured Clinical Examination to Assess Work-Integrated Learning in Exercise Physiology

    ERIC Educational Resources Information Center

    Naumann, Fiona; Moore, Keri; Mildon, Sally; Jones, Philip

    2014-01-01

    This paper aims to develop a valid method to assess the key competencies of the exercise physiology profession acquired through work-integrated learning (WIL). In order to develop a competency-based assessment, the key professional tasks needed to be identified and the test designed so students' competency in different tasks and settings could be…

  5. [Using Objective Structured Clinical Examination (OSCE) across different levels of pediatric training].

    PubMed

    Di Lalla, Sandra; Manjarin, Mercedes; Torres, Fernando; Ossorio, María Fabiana; Wainsztein, Raquel; Ferrero, Fernando

    2014-01-01

    Antecedentes:Evaluar competencias profesionales es objetivo principal de todo programa de capacitación; el examen clínico objetivo estructurado (ECOE) es una herramienta útil para explorarlas. Objetivo:Describimos la implementación del ECOE en tres instancias de enseñanza de la pediatría (carrera de especialista, módulo pediatría del internado anual rotatorio, materia pediatría en el grado). Métodos: En relación con situaciones y patologías frecuentes en pediatría, se evaluaron conocimiento aplicado, juicio clínico y habilidad comunicacional. Resultados: En el posgrado el ECOE se aplica desde hace 8 años, examinando 330 alumnos, con 60%-82% de aprobación. En el Internado Anual Rotatorio el ECOE se emplea desde hace 2 años, examinando 12 alumnos, con 84% de aprobación. En el grado el ECOE se empleó sólo en una oportunidad, examinando 15 alumnos, con 93,4% de aprobación. Conclusión:En nuestra experiencia, a pesar de desafíos logísticos, la implementación del ECOE fue factible en distintas instancias de enseñanza de la pediatría.

  6. The Efficacy of Structural Priming on the Acquisition of Double Object Construction by Chinese EFL Learners

    ERIC Educational Resources Information Center

    Jiang, Lin; Huang, Kang

    2015-01-01

    Structural priming refers to the tendency of speakers to reuse the same structural pattern as one that was previously encountered (Bock, 1986). The effectiveness of structural priming has been an issue of much discussion in the field of second language acquisition over decades. This study aims at investigating the role of structural priming in…

  7. Envelope structure of deeply embedded young stellar objects in the Serpens Molecular Cloud

    NASA Technical Reports Server (NTRS)

    Hogerheijde, M. R.; van Dishoeck, E. F.; Salverda, J. M.; Blake, G. A.

    1999-01-01

    Aperture-synthesis and single-dish (sub-) millimeter molecular-line and continuum observations reveal in great detail the envelope structure of deeply embedded young stellar objects (SMM 1 = FIRS 1, SMM 2, SMM 3, SMM 4) in the densely star-forming Serpens Molecular Cloud. SMM 1, 3, and 4 show partially resolved (>2" = 800 AU) continuum emission in the beam of the Owens Valley Millimeter Array at lambda = 3.4-1.4 mm. The continuum visibilities accurately constrain the density structure in the envelopes, which can be described by a radial power law with slope -2.0 +/- 0.5 on scales of 300 to 8000 AU. Inferred envelope masses within a radius of 8000 AU are 8.7, 3.0, and 5.3 Msolar for SMM 1, 3, and 4, respectively. A point source with 20%-30% of the total flux at 1.1 mm is required to fit the observations on long baselines, corresponding to warm envelope material within approximately 100 AU or a circumstellar disk. No continuum emission is detected interferometrically toward SMM 2, corresponding to an upper limit of 0.2 Msolar assuming Td = 24 K. The lack of any compact dust emission suggests that the SMM 2 core does not contain a central protostar. Aperture-synthesis observations of the 13CO, C18O, HCO+, H13CO+, HCN, H13CN, N2H+ 1-0, SiO 2-1, and SO 2(2)-1(1) transitions reveal compact emission toward SMM 1, 3, and 4. SMM 2 shows only a number of clumps scattered throughout the primary field of view, supporting the conclusion that this core does not contain a central star. The compact molecular emission around SMM 1, 3, and 4 traces 5"-10" (2000-4000 AU) diameter cores that correspond to the densest regions of the envelopes, as well as material directly associated with the molecular outflow. Especially prominent are the optically thick HCN and HCO+ lines that show up brightly along the walls of the outflow cavities. SO and SiO trace shocked material, where their abundances may be enhanced by 1-2 orders of magnitude over dark-cloud values. A total of 31 molecular

  8. Envelope structure of deeply embedded young stellar objects in the Serpens Molecular Cloud.

    PubMed

    Hogerheijde, M R; van Dishoeck, E F; Salverda, J M; Blake, G A

    1999-03-01

    Aperture-synthesis and single-dish (sub-) millimeter molecular-line and continuum observations reveal in great detail the envelope structure of deeply embedded young stellar objects (SMM 1 = FIRS 1, SMM 2, SMM 3, SMM 4) in the densely star-forming Serpens Molecular Cloud. SMM 1, 3, and 4 show partially resolved (>2" = 800 AU) continuum emission in the beam of the Owens Valley Millimeter Array at lambda = 3.4-1.4 mm. The continuum visibilities accurately constrain the density structure in the envelopes, which can be described by a radial power law with slope -2.0 +/- 0.5 on scales of 300 to 8000 AU. Inferred envelope masses within a radius of 8000 AU are 8.7, 3.0, and 5.3 Msolar for SMM 1, 3, and 4, respectively. A point source with 20%-30% of the total flux at 1.1 mm is required to fit the observations on long baselines, corresponding to warm envelope material within approximately 100 AU or a circumstellar disk. No continuum emission is detected interferometrically toward SMM 2, corresponding to an upper limit of 0.2 Msolar assuming Td = 24 K. The lack of any compact dust emission suggests that the SMM 2 core does not contain a central protostar. Aperture-synthesis observations of the 13CO, C18O, HCO+, H13CO+, HCN, H13CN, N2H+ 1-0, SiO 2-1, and SO 2(2)-1(1) transitions reveal compact emission toward SMM 1, 3, and 4. SMM 2 shows only a number of clumps scattered throughout the primary field of view, supporting the conclusion that this core does not contain a central star. The compact molecular emission around SMM 1, 3, and 4 traces 5"-10" (2000-4000 AU) diameter cores that correspond to the densest regions of the envelopes, as well as material directly associated with the molecular outflow. Especially prominent are the optically thick HCN and HCO+ lines that show up brightly along the walls of the outflow cavities. SO and SiO trace shocked material, where their abundances may be enhanced by 1-2 orders of magnitude over dark-cloud values. A total of 31 molecular

  9. Expert nurses' clinical reasoning under uncertainty: representation, structure, and process.

    PubMed Central

    Fonteyn, M. E.; Grobe, S. J.

    1992-01-01

    How do expert nurses reason when planning care and making clinical decisions for a patient who is at risk, and whose outcome is uncertain? In this study, a case study involving a critically ill elderly woman whose condition deteriorated over time, was presented in segments to ten expert critical care nurses. Think aloud method was used to elicit knowledge from these experts to provide conceptual information about their knowledge and to reveal their reasoning processes and problem-solving strategies. The verbatim transcripts were then analyzed using a systematic three-step method that makes analysis easier and adds creditability to study findings by providing a means of retracing and explaining analysis results. Findings revealed information about how patient problems were represented during reasoning, the manner in which experts subjects structured their plan of care, and the reasoning processes and heuristics they used to formulate solutions for resolving the patient's problems and preventing deterioration in the patient's condition. PMID:1482907

  10. Cystathionine γ-lyase: clinical, metabolic, genetic, and structural studies

    PubMed Central

    Kraus, Jan P.; Hašek, Jindrich; Kožich, Viktor; Collard, Renata; Venezia, Sarah; Janošíková, Bohumila; Wang, Jian; Stabler, Sally P.; Allen, Robert H.; Jakobs, Cornelis; Finn, Christine T.; Chien, Yin-Hsiu; Hwu, Wuh-Liang; Hegele, Robert A.; Mudd, S. Harvey

    2009-01-01

    We report studies of six individuals with marked elevations of cystathionine in plasma and/or urine. Studies of CTH, the gene that encodes cystathionine γ-lyase, revealed the presence among these individuals of either homozygous or compound heterozygous forms of a novel large deletion, p.Gly57_Gln196del, two novel missense mutations, c.589C>T (p.Arg197Cys) and c.932C>T (p.Thr311Ile), and one previously reported alteration, c.200C>T (p.Thr67Ile). Another novel missense mutation, c.185G>T (p.Arg62His), was found in heterozygous form in three mildly hypercystathioninemic members of a Taiwanese family. In one severely hypercystathioninemic individual no CTH mutation was found. Brief clinical histories of the cystathioninemic/cystathioninuric patients are presented. Most of the novel mutations were expressed and the CTH activities of the mutant proteins determined. The crystal structure of the human enzyme, hCTH, and the evidence available as to the effects of the mutations in question, as well as those of the previously reported p.Gln240Glu, on protein structure, enzymatic activity, and responsiveness to vitamin B6 administration are discussed. Among healthy Czech controls, 9.3% were homozygous for CTH c.1208G>T (p.Ser403Ile), previously found homozygously in 7.5% of Canadians for whom plasma total homocysteine (tHcy) had been measured. Compared to wild-type homozygotes, among the 55 Czech c.1208G>T (p.Ser403Ile) homozygotes a greater level of plasma cystathionine was found only after methionine loading. Three of the four individuals homozygous or compound heterozygous for inactivating CTH mutations had mild plasma tHcy elevations, perhaps indicating a cause-and-effect relationship. The experience with the present patients provides no evidence that severe loss of CTH activity is accompanied by adverse clinical effects. PMID:19428278

  11. Clinical Significance of Umami Taste and Umami-Related Gene Expression Analysis for the Objective Assessment of Umami Taste Loss.

    PubMed

    Shoji, Noriaki; Satoh-Ku Riwada, Shizuko; Sasano, Takashi

    2016-01-01

    Loss of umami taste sensation affects quality of life and causes weight loss and health problems, particularly in the elderly. We recently expanded the use of the filter paper disc method to include assessment of umami taste sensitivity, using monosodium glutamate as the test solution. This test showed high diagnostic performance for discriminating between normal taste function and disorders in sensation of the umami taste, according to established cut-off values. The test also revealed: (1) some elderly patients suffered from specific loss of umami taste sensation with preservation of the other four taste sensations (sweet, salty, sour, and bitter); (2) umami taste disorder caused a loss of appetite and decline in weight, resulting in poor health; (3) appetite, weight and overall health improved after appropriate treatment for umami taste disorder. Because of the subjective nature of the test, however, it may not be useful for patients who cannot express which taste sensation is induced by a tastant, such as those with dementia. Most recently, using tissue samples collected from the tongue by scraping the foliate papillae, we showed that evaluation of umami taste receptor gene expression may be clinically useful for the objective genetic diagnosis of umami taste disorders. PMID:26881442

  12. Local x-ray structure analysis of optically manipulated biological micro-objects

    SciTech Connect

    Cojoc, Dan; Ferrari, Enrico; Santucci, Silvia C.; Amenitsch, Heinz; Sartori, Barbara; Rappolt, Michael; Marmiroli, Benedetta; Burghammer, Manfred; Riekel, Christian

    2010-12-13

    X-ray diffraction using micro- and nanofocused beams is well suited for nanostructure analysis at different sites of a biological micro-object. To conduct in vitro studies without mechanical contact, we developed object manipulation by optical tweezers in a microfluidic cell. Here we report x-ray microdiffraction analysis of a micro-object optically trapped in three dimensions. We revealed the nanostructure of a single starch granule at different points and investigated local radiation damage induced by repeated x-ray exposures at the same position, demonstrating high stability and full control of the granule orientation by multiple optical traps.

  13. A structured approach to the integration of the clinical and didactic components of health career programs.

    PubMed

    Greenberg, N S; Feifer, I

    1980-02-01

    This paper presents a tested approach to a systematic progression of learning from the classroom to the clinical internship. The approach uses workbooks to integrate all facets of the training continuum. The basic model is training continuum. The basic model is called TAR. T refers to theory or teaching; A to application, which occurs during the clinical component; and R to reinforcement provided through seminars scheduled concurrently with fieldwork. The entire concept is introduced to students during a required weekly fieldwork preparation component scheduled prior to the first theory course. Clinicians and academicians participated in all phases of the three-year, HEW-funded project, which included development of interrelated performance objectives for the teaching, application and reinforcement components. Analysis of data from clinicians, students and faculty indicated that the TAR model provides a needed integrating structure.

  14. The search for structure - Object classification in large data sets. [for astronomers

    NASA Technical Reports Server (NTRS)

    Kurtz, Michael J.

    1988-01-01

    Research concerning object classifications schemes are reviewed, focusing on large data sets. Classification techniques are discussed, including syntactic, decision theoretic methods, fuzzy techniques, and stochastic and fuzzy grammars. Consideration is given to the automation of MK classification (Morgan and Keenan, 1973) and other problems associated with the classification of spectra. In addition, the classification of galaxies is examined, including the problems of systematic errors, blended objects, galaxy types, and galaxy clusters.

  15. Gist in time: Scene semantics and structure enhance recall of searched objects.

    PubMed

    Josephs, Emilie L; Draschkow, Dejan; Wolfe, Jeremy M; Võ, Melissa L-H

    2016-09-01

    Previous work has shown that recall of objects that are incidentally encountered as targets in visual search is better than recall of objects that have been intentionally memorized (Draschkow, Wolfe, & Võ, 2014). However, this counter-intuitive result is not seen when these tasks are performed with non-scene stimuli. The goal of the current paper is to determine what features of search in a scene contribute to higher recall rates when compared to a memorization task. In each of four experiments, we compare the free recall rate for target objects following a search to the rate following a memorization task. Across the experiments, the stimuli include progressively more scene-related information. Experiment 1 provides the spatial relations between objects. Experiment 2 adds relative size and depth of objects. Experiments 3 and 4 include scene layout and semantic information. We find that search leads to better recall than explicit memorization in cases where scene layout and semantic information are present, as long as the participant has ample time (2500ms) to integrate this information with knowledge about the target object (Exp. 4). These results suggest that the integration of scene and target information not only leads to more efficient search, but can also contribute to stronger memory representations than intentional memorization.

  16. Gist in time: Scene semantics and structure enhance recall of searched objects.

    PubMed

    Josephs, Emilie L; Draschkow, Dejan; Wolfe, Jeremy M; Võ, Melissa L-H

    2016-09-01

    Previous work has shown that recall of objects that are incidentally encountered as targets in visual search is better than recall of objects that have been intentionally memorized (Draschkow, Wolfe, & Võ, 2014). However, this counter-intuitive result is not seen when these tasks are performed with non-scene stimuli. The goal of the current paper is to determine what features of search in a scene contribute to higher recall rates when compared to a memorization task. In each of four experiments, we compare the free recall rate for target objects following a search to the rate following a memorization task. Across the experiments, the stimuli include progressively more scene-related information. Experiment 1 provides the spatial relations between objects. Experiment 2 adds relative size and depth of objects. Experiments 3 and 4 include scene layout and semantic information. We find that search leads to better recall than explicit memorization in cases where scene layout and semantic information are present, as long as the participant has ample time (2500ms) to integrate this information with knowledge about the target object (Exp. 4). These results suggest that the integration of scene and target information not only leads to more efficient search, but can also contribute to stronger memory representations than intentional memorization. PMID:27270227

  17. Distinct Roles for Medial Temporal Lobe Structures in Memory for Objects and Their Locations

    ERIC Educational Resources Information Center

    Buffalo, Elizabeth A.; Bellgowan, Patrick S. F.; Martin, Alex

    2006-01-01

    The ability to learn and retain novel information depends on a system of structures in the medial temporal lobe (MTL) including the hippocampus and the surrounding entorhinal, perirhinal, and parahippocampal cortices. Damage to these structures produces profound memory deficits; however, the unique contribution to memory of each of these…

  18. Parallel compression of data chunks of a shared data object using a log-structured file system

    DOEpatents

    Bent, John M.; Faibish, Sorin; Grider, Gary

    2016-10-25

    Techniques are provided for parallel compression of data chunks being written to a shared object. A client executing on a compute node or a burst buffer node in a parallel computing system stores a data chunk generated by the parallel computing system to a shared data object on a storage node by compressing the data chunk; and providing the data compressed data chunk to the storage node that stores the shared object. The client and storage node may employ Log-Structured File techniques. The compressed data chunk can be de-compressed by the client when the data chunk is read. A storage node stores a data chunk as part of a shared object by receiving a compressed version of the data chunk from a compute node; and storing the compressed version of the data chunk to the shared data object on the storage node.

  19. Validation of radiographic simulation codes including x-ray phase effects for millimeter-size objects with micrometer structures.

    PubMed

    Martz, Harry E; Kozioziemski, Bernard J; Lehman, Sean K; Hau-Riege, Stefan; Schneberk, Daniel J; Barty, Anton

    2007-01-01

    The mix between x-ray phase and attenuation information needs to be understood for accurate object recovery from radiography and tomography data. We are researching and experimentally validating algorithms that simulate x-ray phase contrast to determine the required physics necessary for quantitative object recovery. The results of a study are described to determine if a multislice (beam-propagation) method is required for simulating x-ray radiographs. We conclude that the multislice method is not required for accurate simulation of greater than or equal to 8 keV x-ray radiographs of millimeter-size objects with micrometer structures.

  20. The structure of Herbig-Haro object 43 and Orion dark cloud extinction

    NASA Technical Reports Server (NTRS)

    Schwartz, R. D.; Dopita, M. A.; Cohen, M.

    1984-01-01

    New ultraviolet and optical observations of Herbig-Haro Object No. 43 are reported. Continuum and emission line fluxes in the range 1250 A equal to or less than lambda equal to less than 7350A have been measured. The continuum fluxes are best matched by an enhanced H two photon component added to H free bound emission, assuming theta Ori extinction curve with E(B-V) = 0.2, R = 5. The strucutre and dynamics of three components within the object are discussed. The object has a radiative output of equal to or greater than 0.23 infrared luminosity in ultraviolet and optical radiation combined. The energy requirements are discussed in terms of the production of shock waves by a collimated, supersonic mass outflow from a nearby infrared source.

  1. Molecular and clinical characteristics of 26 cases with structural Y chromosome aberrations.

    PubMed

    Kim, J-W; Park, S-Y; Ryu, H-M; Lee, D-E; Lee, B-Y; Kim, S-Y; Park, Y-S; Lee, H-S; Seo, J-T

    2012-01-01

    Structural abnormalities include various types of translocations, inversions, deletions, duplications and isochromosomes. Structural abnormalities of the Y chromosome are estimated to affect less than 1% of the newborn male population and are particularly hazardous for male reproductive function. The objective of this study was to characterize a group of patients with structural abnormalities of the Y chromosome. All patients who visited our laboratory between 2007 and 2010 underwent cytogenetic investigations. Among these, we detected 26 patients with structural abnormalities of the Y chromosome. To confirm the structural Y chromosome alterations, we used special bandings, FISH and multiplex PCR to detect Y chromosome microdeletions. Of the 26 patients presented here, 11 had an isodicentric Y chromosome, 7 had an inversion, 3 had a translocation, 2 had a derivative, 2 had a Yqs and 1 had a deletion. Sixteen were diagnosed with azoospermia, 8 as normal fertile males and 1 as a man who was unable to donate semen due to mental retardation. One of the patients having 45,X/46,X,idic(Y) was reported to be phenotypically female with primary amenorrhea and without uterus. Deletions of the AZFbc region were correlated with the sperm concentration (p < 0.05), but no correlation with the levels of FSH, LH, testosterone, prolactin and estradiol were found. The present report shows that the precise identification of structural Y chromosome aberrations may be clinically important for genetic counseling and assisted reproductive technology treatment.

  2. OPM Scheme Editor 2: A graphical editor for specifying object-protocol structures

    SciTech Connect

    Chen, I-Min A.; Markowitz, V.M.; Pang, F.; Ben-Shachar, O.

    1993-07-01

    This document describes an X-window based Schema Editor for the Object-Protocol Model (OPM). OPM is a data model that supports the specification of complex object and protocol classes. objects and protocols are qualified in OPM by attributes that are defined over (associated with) value classes. Connections of object and protocol classes are expressed in OPM via attributes. OPM supports the specification (expansion) of protocols in terms of alternative and sequences of component (sub) protocols. The OPM Schema Editor allows specifying, displaying, modifying, and browsing through OPM schemas. The OPM Schema Editor generates an output file that can be used as input to an OPM schema translation tool that maps OPM schemas into definitions for relational database management systems. The OPM Schema Editor was implemented using C++ and the X11 based Motif toolkit, on Sun SPARCstation under Sun Unix OS 4.1. This document consists of the following parts: (1) A tutorial consisting of seven introductory lessons for the OPM Schema Editor. (2) A reference manual describing all the windows and functions of the OPM Schema Editor. (3) An appendix with an overview of OPM.

  3. Innovative Language-Based & Object-Oriented Structured AMR Using Fortran 90 and OpenMP

    NASA Technical Reports Server (NTRS)

    Norton, C.; Balsara, D.

    1999-01-01

    Parallel adaptive mesh refinement (AMR) is an important numerical technique that leads to the efficient solution of many physical and engineering problems. In this paper, we describe how AMR programing can be performed in an object-oreinted way using the modern aspects of Fortran 90 combined with the parallelization features of OpenMP.

  4. Constructing a Validity Argument for the Objective Structured Assessment of Technical Skills (OSATS): A Systematic Review of Validity Evidence

    ERIC Educational Resources Information Center

    Hatala, Rose; Cook, David A.; Brydges, Ryan; Hawkins, Richard

    2015-01-01

    In order to construct and evaluate the validity argument for the Objective Structured Assessment of Technical Skills (OSATS), based on Kane's framework, we conducted a systematic review. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, Scopus, and selected reference lists through February 2013. Working in duplicate, we selected…

  5. Parallel checksumming of data chunks of a shared data object using a log-structured file system

    DOEpatents

    Bent, John M.; Faibish, Sorin; Grider, Gary

    2016-09-06

    Checksum values are generated and used to verify the data integrity. A client executing in a parallel computing system stores a data chunk to a shared data object on a storage node in the parallel computing system. The client determines a checksum value for the data chunk; and provides the checksum value with the data chunk to the storage node that stores the shared object. The data chunk can be stored on the storage node with the corresponding checksum value as part of the shared object. The storage node may be part of a Parallel Log-Structured File System (PLFS), and the client may comprise, for example, a Log-Structured File System client on a compute node or burst buffer. The checksum value can be evaluated when the data chunk is read from the storage node to verify the integrity of the data that is read.

  6. Assessment of Semi-Structured Clinical Interview for Mobile Phone Addiction Disorder

    PubMed Central

    Alavi, Seyyed Salman; Jannatifard, Fereshteh; Mohammadi Kalhori, Soroush; Sepahbodi, Ghazal; BabaReisi, Mohammad; Sajedi, Sahar; Farshchi, Mojtaba; KhodaKarami, Rasul; Hatami Kasvaee, Vahid

    2016-01-01

    Objective: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) classified mobile phone addiction disorder under “impulse control disorder not elsewhere classified”. This study surveyed the diagnostic criteria of DSM-IV-TR for the diagnosis of mobile phone addiction in correspondence with Iranian society and culture. Method: Two hundred fifty students of Tehran universities were entered into this descriptive-analytical and cross-sectional study. Quota sampling method was used. At first, semi- structured clinical interview (based on DSM-IV-TR) was performed for all the cases, and another specialist reevaluated the interviews. Data were analyzed using content validity, inter-scorer reliability (Kappa coefficient) and test-retest via SPSS18 software. Results: The content validity of the semi- structured clinical interview matched the DSM–IV-TR criteria for behavioral addiction. Moreover, their content was appropriate, and two items, including “SMS pathological use” and “High monthly cost of using the mobile phone” were added to promote its validity. Internal reliability (Kappa) and test–retest reliability were 0.55 and r = 0.4 (p<0. 01) respectively. Conclusion: The results of this study revealed that semi- structured diagnostic criteria of DSM-IV-TR are valid and reliable for diagnosing mobile phone addiction, and this instrument is an effective tool to diagnose this disorder. PMID:27437008

  7. Object Oriented Learning Objects

    ERIC Educational Resources Information Center

    Morris, Ed

    2005-01-01

    We apply the object oriented software engineering (OOSE) design methodology for software objects (SOs) to learning objects (LOs). OOSE extends and refines design principles for authoring dynamic reusable LOs. Our learning object class (LOC) is a template from which individualised LOs can be dynamically created for, or by, students. The properties…

  8. Hydration structures near finite-sized nanoscopic objects reconstructed using inelastic x-ray scattering measurements.

    PubMed

    Coridan, Robert H; Schmidt, Nathan W; Lai, Ghee Hwee; Wong, Gerard C L

    2009-10-21

    Recent work has shown that it is possible to use high resolution dynamical structure factor S(q,ω) data measured with inelastic x-ray scattering to reconstruct the Green's function of water, which describes its dynamical density response to a point charge. Here, we generalize this approach and describe a strategy for reconstructing hydration behavior near simple charge distributions with excluded volumes, with the long term goal of engaging hydration processes in complex molecular systems. We use this Green's function based imaging of dynamics method to generate hydration structures and show that they are consistent with those of well-studied model systems.

  9. THE USE OF THE ANALYST AND THE SENSE OF BEING REAL: THE CLINICAL MEANING OF WINNICOTT'S "THE USE OF AN OBJECT".

    PubMed

    Fabozzi, Paolo

    2016-01-01

    "The Use of an Object and Relating through Identifications" (1968) represents Donald Winnicott's theoretical and clinical legacy. The author develops this concept from a clinical point of view, through the analysis of a woman with psychotic functioning. He reflects upon the dramatic quality of risks inherent in the processes linked to the use of the object with seriously disturbed patients. He explores different meanings of the analyst's survival, linking it to the analyst's response. The processes of the use of the object--that is, the encounter between the patient's potential destructiveness and the analyst's capacity to respond through his own judicious subjectivity--let the patient experience the analyst's capacity to keep his own subjectivity, authenticity, and creativity alive. It is starting from the traces of this live object that patients gradually form their own personal sense of being real. PMID:26784713

  10. 30 CFR 77.403 - Mobile equipment; falling object protective structures (FOPS).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... requirements of the State of California, Division of Industrial Safety, General Safety Orders, Register 72... structures (FOPS). 77.403 Section 77.403 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE...

  11. Structure and Evolution of Kuiper Belt Objects: The Case for Compositional Classes

    NASA Astrophysics Data System (ADS)

    McKinnon, William B.; Prialnik, D.; Stern, S. A.

    2007-10-01

    Kuiper belt objects (KBOs) accreted from a mélange of ices, carbonaceous matter, and rock of mixed interstellar and solar nebular provenance. The transneptunian region, where this accretion took place, was likely more radially compact than today. This and the influence of gas drag during the solar nebula epoch argue for more rapid KBO accretion than usually considered. Early evolution of KBOs was largely the result of radiogenic heating, with both short-term and long-term contributions being potentially important. Depending on rock content and porous conductivity, KBO interiors may have reached relatively high temperatures. Models suggest that KBOs likely lost very volatile ices during early evolution, whereas less volatile ices should be retained in cold, less altered subsurface layers; initially amorphous ice may have crystallized in the interior as well, releasing trapped volatiles. Generally, KBOs should be stratified in terms of composition and porosity, albeit subject to impact disruption and collisional stripping. KBOs are thus unlikely to be "the most pristine objects in the Solar System.” Large (dwarf planet) KBOs may be fully differentiated. KBO surface color and compositional classes are usually discussed in terms of "nature vs. nurture,” i.e., a generic primordial composition vs. surface processing, but the true nature of KBOs also depends on how they have evolved. The broad range of albedos now found in the Kuiper belt, deep water-ice absorptions on some objects, evidence for differentiation of Pluto and 2003 EL61, and a range of densities incompatible with a single, primordial composition and variable porosity strongly imply significant, intrinsic compositional differences among KBOs. The interplay of formation zone (accretion rate), body size, and dynamical (collisional) history may yield KBO compositional classes (and their spectral correlates) that recall the different classes of asteroids in the inner Solar System, but whose members are

  12. Tracing the efficient curve for multi-objective control-structure optimization

    NASA Technical Reports Server (NTRS)

    Rakowska, J.; Haftka, R. T.; Watson, L. T.

    1992-01-01

    A recently developed active set algorithm for tracing parameterized optima is adapted to multiobjective optimization. The algorithm traces a path of Kuhn-Tucker points using homotopy curve tracking techniques, and is based on identifying and maintaining the set of active constraints. Second order necessary optimality conditions are used to determine nonoptimal stationary points on the path. In the bi-objective optimization case the algorithm is used to trace the curve of efficient solution (Pareto optima). As an example, the algorithm is applied to the simultaneous minimization of the weight and control force of a ten-bar truss with two collocated sensors and actuators, with some interesting results.

  13. Solid-state structure of a degradation product frequently observed on historic metal objects.

    PubMed

    Dinnebier, Robert E; Runčevski, Tomče; Fischer, Andrea; Eggert, Gerhard

    2015-03-16

    In the course of the investigation of glass-induced metal corrosion processes, a microcrystalline sodium copper formate hydroxide oxide hydrate, Cu4Na4O(HCOO)8(H2O)4(OH)2, was detected on a series of antique works of art, and its crystal structure was determined ab initio from high-resolution laboratory X-ray powder diffraction data using the method of charge flipping, simulated annealing, and difference-Fourier analysis (P42/n, a = 8.425 109(97) Å, c = 17.479 62(29) Å, V = 1240.747(35) Å(3), Z = 8). In the crystal structure, the metal cations are interconnected in a two-dimensional metal-organic framework via the oxygen atoms of the formate, hydroxide, and oxide anions. Doublets of face-sharing square pyramidal Cu(2+) polyhedra are linked via a single, central oxide oxygen atom to give a paddle-wheel arrangement, while the Na(+) cations are organized in Na2O11 moieties with highly disordered, edge-sharing octahedral coordination. In addition, hydrogen bonding plays an important role in stabilizing the crystal structure. PMID:25710277

  14. Integration of multi-objective structural optimization into cementless hip prosthesis design: Improved Austin-Moore model.

    PubMed

    Kharmanda, G

    2016-11-01

    A new strategy of multi-objective structural optimization is integrated into Austin-Moore prosthesis in order to improve its performance. The new resulting model is so-called Improved Austin-Moore. The topology optimization is considered as a conceptual design stage to sketch several kinds of hollow stems according to the daily loading cases. The shape optimization presents the detailed design stage considering several objectives. Here, A new multiplicative formulation is proposed as a performance scale in order to define the best compromise between several requirements. Numerical applications on 2D and 3D problems are carried out to show the advantages of the proposed model. PMID:27028554

  15. Observing microscopic structures of a relativistic object using a time-stretch strategy

    NASA Astrophysics Data System (ADS)

    Roussel, E.; Evain, C.; Le Parquier, M.; Szwaj, C.; Bielawski, S.; Manceron, L.; Brubach, J.-B.; Tordeux, M.-A.; Ricaud, J.-P.; Cassinari, L.; Labat, M.; Couprie, M.-E.; Roy, P.

    2015-05-01

    Emission of light by a single electron moving on a curved trajectory (synchrotron radiation) is one of the most well-known fundamental radiation phenomena. However experimental situations are more complex as they involve many electrons, each being exposed to the radiation of its neighbors. This interaction has dramatic consequences, one of the most spectacular being the spontaneous formation of spatial structures inside electrons bunches. This fundamental effect is actively studied as it represents one of the most fundamental limitations in electron accelerators, and at the same time a source of intense terahertz radiation (Coherent Synchrotron Radiation, or CSR). Here we demonstrate the possibility to directly observe the electron bunch microstructures with subpicosecond resolution, in a storage ring accelerator. The principle is to monitor the terahertz pulses emitted by the structures, using a strategy from photonics, time-stretch, consisting in slowing-down the phenomena before recording. This opens the way to unpreceeded possibilities for analyzing and mastering new generation high power coherent synchrotron sources.

  16. Observing microscopic structures of a relativistic object using a time-stretch strategy

    PubMed Central

    Roussel, E.; Evain, C.; Le Parquier, M.; Szwaj, C.; Bielawski, S.; Manceron, L.; Brubach, J.-B.; Tordeux, M.-A.; Ricaud, J.-P.; Cassinari, L.; Labat, M.; Couprie, M.-E; Roy, P.

    2015-01-01

    Emission of light by a single electron moving on a curved trajectory (synchrotron radiation) is one of the most well-known fundamental radiation phenomena. However experimental situations are more complex as they involve many electrons, each being exposed to the radiation of its neighbors. This interaction has dramatic consequences, one of the most spectacular being the spontaneous formation of spatial structures inside electrons bunches. This fundamental effect is actively studied as it represents one of the most fundamental limitations in electron accelerators, and at the same time a source of intense terahertz radiation (Coherent Synchrotron Radiation, or CSR). Here we demonstrate the possibility to directly observe the electron bunch microstructures with subpicosecond resolution, in a storage ring accelerator. The principle is to monitor the terahertz pulses emitted by the structures, using a strategy from photonics, time-stretch, consisting in slowing-down the phenomena before recording. This opens the way to unpreceeded possibilities for analyzing and mastering new generation high power coherent synchrotron sources. PMID:26020859

  17. An object-oriented approach for parallel self adaptive mesh refinement on block structured grids

    NASA Technical Reports Server (NTRS)

    Lemke, Max; Witsch, Kristian; Quinlan, Daniel

    1993-01-01

    Self-adaptive mesh refinement dynamically matches the computational demands of a solver for partial differential equations to the activity in the application's domain. In this paper we present two C++ class libraries, P++ and AMR++, which significantly simplify the development of sophisticated adaptive mesh refinement codes on (massively) parallel distributed memory architectures. The development is based on our previous research in this area. The C++ class libraries provide abstractions to separate the issues of developing parallel adaptive mesh refinement applications into those of parallelism, abstracted by P++, and adaptive mesh refinement, abstracted by AMR++. P++ is a parallel array class library to permit efficient development of architecture independent codes for structured grid applications, and AMR++ provides support for self-adaptive mesh refinement on block-structured grids of rectangular non-overlapping blocks. Using these libraries, the application programmers' work is greatly simplified to primarily specifying the serial single grid application and obtaining the parallel and self-adaptive mesh refinement code with minimal effort. Initial results for simple singular perturbation problems solved by self-adaptive multilevel techniques (FAC, AFAC), being implemented on the basis of prototypes of the P++/AMR++ environment, are presented. Singular perturbation problems frequently arise in large applications, e.g. in the area of computational fluid dynamics. They usually have solutions with layers which require adaptive mesh refinement and fast basic solvers in order to be resolved efficiently.

  18. Multi-objective shape optimization of plate structure under stress criteria based on sub-structured mixed FEM and genetic algorithms

    NASA Astrophysics Data System (ADS)

    Garambois, Pierre; Besset, Sebastien; Jézéquel, Louis

    2015-07-01

    This paper presents a methodology for the multi-objective (MO) shape optimization of plate structure under stress criteria, based on a mixed Finite Element Model (FEM) enhanced with a sub-structuring method. The optimization is performed with a classical Genetic Algorithm (GA) method based on Pareto-optimal solutions and considers thickness distributions parameters and antagonist objectives among them stress criteria. We implement a displacement-stress Dynamic Mixed FEM (DM-FEM) for plate structure vibrations analysis. Such a model gives a privileged access to the stress within the plate structure compared to primal classical FEM, and features a linear dependence to the thickness parameters. A sub-structuring reduction method is also computed in order to reduce the size of the mixed FEM and split the given structure into smaller ones with their own thickness parameters. Those methods combined enable a fast and stress-wise efficient structure analysis, and improve the performance of the repetitive GA. A few cases of minimizing the mass and the maximum Von Mises stress within a plate structure under a dynamic load put forward the relevance of our method with promising results. It is able to satisfy multiple damage criteria with different thickness distributions, and use a smaller FEM.

  19. [State Hygiene Institute, 1918-1954 organisational structure, objectives and tasks].

    PubMed

    Wieckowska, E

    2001-01-01

    After Poland regained its independence in 1918, research units were set up to provide scientific assistance to the state health and epidemiological service then being created. Towards the end of 1918 The State Central Hygiene Institute was established and, following successive reorganisations, transformed into the State Hygiene Institute. It operated at Chocimska str. 24 throughout the entire pre-war period, adapting its organisational structure to current needs. As a state public-health institution, it tracked down sources of communicable diseases and the way they were spread, and conducted research to detect cases of Asian cholera and carriers of contagious diseases. It produced vaccinations of other biological products used in the treatment and prevention of epidemics and made a significant contribution to the war on communicable diseases. It also served as the central state institution in charge of inspecting the country's epidemiological condition as well as a scientific-research facility designed to maintain it at a suitable level in accordance with international norms. With various organisational modifications it survived World War Two, its continued existence being maintained by the German occupation authorities. Reactivated after the war it continues to function to this day at its old location - ulica Chocimska 24, where it serves as a scientific-research facility for health and epidemiological services transferred to a separate organisational structure after 1950. Health and sanitary stations became state institutions in charge of anti-epidemic campaigns and were responsible for the country's health and epidemiological situation. In 1954, the State Health Inspectorate co-operating with the Ministry of Health was set up. The State Hygiene Institute functions to this day and it is the supervisory, co-ordinating and scientific-research institution of the State Health and Epidemiological Service.

  20. An object-based multisensoral approach for the derivation of urban land use structures in the city of Rostock, Germany

    NASA Astrophysics Data System (ADS)

    Lindner, Martin; Hese, Sören; Berger, Christian; Schmullius, Christiane

    2011-11-01

    The present work is part of the Enviland-2 research project, which investigates the synergism between radar- and optical satellite data for ENVIronment and LAND use applications. The urban work package of Enviland aims at the combined analysis of RapidEye and TerraSAR-X data for the parameterization of different urban land use structures. This study focuses on the development of a transferable, object-based rule set for the derivation of urban land use structures at block level. The data base consists of RapidEye and TerraSAR-X imagery, as well as height information of a LiDAR nDSM (normalized Digital Surface Model) and object boundaries of ATKIS (Official Topographic Cartographic Information System) vector data for a study area in the city of Rostock, Germany. The classification of various land cover units forms the basis of the analysis. Therefore, an object-based land cover classification is implemented that uses feature level fusion to combine the information of all available input data. Besides spectral values also shape and context features are employed to characterize and extract specific land cover objects as indicators for the prevalent land use. The different land use structures are then determined by typical combinations and constellations of the extracted land use indicators and land cover proportions. Accuracy assessment is done by utilizing the available ATKIS information. From this analysis the land use structure classes residential, industrial/commercial, other built-up, allotments, sports facility, forest, grassland, other green spaces, squares/parking areas and water are distinguished with an overall accuracy of 63.2 %.

  1. Effectiveness of structured, hospital-based, nurse-led atrial fibrillation clinics: a comparison between a real-world population and a clinical trial population

    PubMed Central

    Qvist, Ina; Hendriks, Jeroen M L; Møller, Dorthe S; Albertsen, Andi E; Mogensen, Helle M; Oddershede, Gitte D; Odgaard, Annette; Mortensen, Leif Spange; Johnsen, Søren Paaske; Frost, Lars

    2016-01-01

    Objective A previous randomised trial showed that structured, nurse-led atrial fibrillation (AF) care is superior to conventional AF care, although further research is needed to determine the outcomes of such care in a real-world setting. We compared the outcomes of patients in real-world, nurse-led, structured hospital AF clinics with the outcomes of a randomised trial of the efficacy of a nurse-led AF clinic, with respect to a composite outcome of cardiovascular-related hospitalisation and death. Methods All patients were referred to the AF nurse specialist by cardiologists. The AF nurse specialist provided patient education, risk-factor control and stimulated empowerment and compliance. During follow-up, treatment was adjusted according to clinical guidelines. Patient education was repeated, and compliance with medical treatment was controlled. The study size was powered as a non-inferiority study. Outcome measures were adjudicated by the same principles in both cohorts. Results A total of 596 patients from the real world and 356 patients from a clinical trial were included in this study. No significant difference between groups with respect to age, type of AF or CHA2DS2VASc score was found. The composite primary end point occurred with an incidence rate of 8.0 (95% CI 6.1 to 10.4) per 100 person-years in the real-world population and 8.3 (95% CI 6.3 to 10.9) per 100 person-years in the clinical trial, with a crude HR of 0.83 (95% CI 0.56 to 1.23). Conclusions Structured, nurse-led, hospital-based AF care appears to be effective, and patient outcomes in an actual, hospital-based, structured AF care are as least as good as those in trial settings. PMID:26835143

  2. Thermophysical Fluid Dynamics: the Key to the Structures of Fluid Objects

    NASA Astrophysics Data System (ADS)

    Houben, H.

    2013-12-01

    It has become customary to model the hydrodynamics of fluid planets like Jupiter and Saturn by spinning up general circulation models until they reach a statistical steady state. This approach is physically sound, based on the thermodynamic expectation that the system will eventually achieve a state of maximum entropy, but the models have not been specifically designed for this purpose. Over the course of long integrations, numerical artifacts can drive the system to a state that does not correspond to the physically realistic end state. A different formulation of the governing equations promises better results. The equations of motion are recast as scalar conservation laws in which the diabatic and irreversible terms (both entropy-changing) are clearly identified. The balance between these terms defines the steady state of the system analytically, without the need for any temporal integrations. The conservation of mass in this system is trivial. Conservation of angular momentum replaces the zonal momentum equation and determines the zonal wind from a balance between the tidal torque and frictional dissipation. The principle of wave-mean flow non-interaction is preserved. Bernoulli's Theorem replaces the energy equation. The potential temperature structure is determined by the balance between work done against friction and heat transfer by convection and radiation. An equation of state and the traditional momentum equations in the meridional plane are sufficient to complete the model. Based on the assumption that the final state vertical and meridional winds are small compared to the zonal wind (in any case they are impossible to predict ab initio as they are driven by wave flux convergences), these last equations determine the pressure and density (and hence gravity) fields of the basic state. The thermal wind relation (in its most general form with the axial derivative of the zonal wind balancing the baroclinicity) is preserved. The model is not hydrostatic (in

  3. Transforming Clinical Imaging and 3D Data for Virtual Reality Learning Objects: HTML5 and Mobile Devices Implementation

    ERIC Educational Resources Information Center

    Trelease, Robert B.; Nieder, Gary L.

    2013-01-01

    Web deployable anatomical simulations or "virtual reality learning objects" can easily be produced with QuickTime VR software, but their use for online and mobile learning is being limited by the declining support for web browser plug-ins for personal computers and unavailability on popular mobile devices like Apple iPad and Android…

  4. Age structure and mortality of walleyes in Kansas reservoirs: Use of mortality caps to establish realistic management objectives

    USGS Publications Warehouse

    Quist, M.C.; Stephen, J.L.; Guy, C.S.; Schultz, R.D.

    2004-01-01

    Age structure, total annual mortality, and mortality caps (maximum mortality thresholds established by managers) were investigated for walleye Sander vitreus (formerly Stizostedion vitreum) populations sampled from eight Kansas reservoirs during 1991-1999. We assessed age structure by examining the relative frequency of different ages in the population; total annual mortality of age-2 and older walleyes was estimated by use of a weighted catch curve. To evaluate the utility of mortality caps, we modeled threshold values of mortality by varying growth rates and management objectives. Estimated mortality thresholds were then compared with observed growth and mortality rates. The maximum age of walleyes varied from 5 to 11 years across reservoirs. Age structure was dominated (???72%) by walleyes age 3 and younger in all reservoirs, corresponding to ages that were not yet vulnerable to harvest. Total annual mortality rates varied from 40.7% to 59.5% across reservoirs and averaged 51.1% overall (SE = 2.3). Analysis of mortality caps indicated that a management objective of 500 mm for the mean length of walleyes harvested by anglers was realistic for all reservoirs with a 457-mm minimum length limit but not for those with a 381-mm minimum length limit. For a 500-mm mean length objective to be realized for reservoirs with a 381-mm length limit, managers must either reduce mortality rates (e.g., through restrictive harvest regulations) or increase growth of walleyes. When the assumed objective was to maintain the mean length of harvested walleyes at current levels, the observed annual mortality rates were below the mortality cap for all reservoirs except one. Mortality caps also provided insight on management objectives expressed in terms of proportional stock density (PSD). Results indicated that a PSD objective of 20-40 was realistic for most reservoirs. This study provides important walleye mortality information that can be used for monitoring or for inclusion into

  5. Scalability of surrogate-assisted multi-objective optimization of antenna structures exploiting variable-fidelity electromagnetic simulation models

    NASA Astrophysics Data System (ADS)

    Koziel, Slawomir; Bekasiewicz, Adrian

    2016-10-01

    Multi-objective optimization of antenna structures is a challenging task owing to the high computational cost of evaluating the design objectives as well as the large number of adjustable parameters. Design speed-up can be achieved by means of surrogate-based optimization techniques. In particular, a combination of variable-fidelity electromagnetic (EM) simulations, design space reduction techniques, response surface approximation models and design refinement methods permits identification of the Pareto-optimal set of designs within a reasonable timeframe. Here, a study concerning the scalability of surrogate-assisted multi-objective antenna design is carried out based on a set of benchmark problems, with the dimensionality of the design space ranging from six to 24 and a CPU cost of the EM antenna model from 10 to 20 min per simulation. Numerical results indicate that the computational overhead of the design process increases more or less quadratically with the number of adjustable geometric parameters of the antenna structure at hand, which is a promising result from the point of view of handling even more complex problems.

  6. X-ray Powder Diffraction in Conservation Science: Towards Routine Crystal Structure Determination of Corrosion Products on Heritage Art Objects.

    PubMed

    Dinnebier, Robert E; Fischer, Andrea; Eggert, Gerhard; Runčevski, Tomče; Wahlberg, Nanna

    2016-01-01

    The crystal structure determination and refinement process of corrosion products on historic art objects using laboratory high-resolution X-ray powder diffraction (XRPD) is presented in detail via two case studies. The first material under investigation was sodium copper formate hydroxide oxide hydrate, Cu4Na4O(HCOO)8(OH)2∙4H2O (sample 1) which forms on soda glass/copper alloy composite historic objects (e.g., enamels) in museum collections, exposed to formaldehyde and formic acid emitted from wooden storage cabinets, adhesives, etc. This degradation phenomenon has recently been characterized as "glass induced metal corrosion". For the second case study, thecotrichite, Ca3(CH3COO)3Cl(NO3)2∙6H2O (sample 2), was chosen, which is an efflorescent salt forming needlelike crystallites on tiles and limestone objects which are stored in wooden cabinets and display cases. In this case, the wood acts as source for acetic acid which reacts with soluble chloride and nitrate salts from the artifact or its environment. The knowledge of the geometrical structure helps conservation science to better understand production and decay reactions and to allow for full quantitative analysis in the frequent case of mixtures. PMID:27341300

  7. X-ray Powder Diffraction in Conservation Science: Towards Routine Crystal Structure Determination of Corrosion Products on Heritage Art Objects.

    PubMed

    Dinnebier, Robert E; Fischer, Andrea; Eggert, Gerhard; Runčevski, Tomče; Wahlberg, Nanna

    2016-01-01

    The crystal structure determination and refinement process of corrosion products on historic art objects using laboratory high-resolution X-ray powder diffraction (XRPD) is presented in detail via two case studies. The first material under investigation was sodium copper formate hydroxide oxide hydrate, Cu4Na4O(HCOO)8(OH)2∙4H2O (sample 1) which forms on soda glass/copper alloy composite historic objects (e.g., enamels) in museum collections, exposed to formaldehyde and formic acid emitted from wooden storage cabinets, adhesives, etc. This degradation phenomenon has recently been characterized as "glass induced metal corrosion". For the second case study, thecotrichite, Ca3(CH3COO)3Cl(NO3)2∙6H2O (sample 2), was chosen, which is an efflorescent salt forming needlelike crystallites on tiles and limestone objects which are stored in wooden cabinets and display cases. In this case, the wood acts as source for acetic acid which reacts with soluble chloride and nitrate salts from the artifact or its environment. The knowledge of the geometrical structure helps conservation science to better understand production and decay reactions and to allow for full quantitative analysis in the frequent case of mixtures.

  8. Spun-wrapped aligned nanofiber (SWAN) lithography for fabrication of micro/nano-structures on 3D objects.

    PubMed

    Ye, Zhou; Nain, Amrinder S; Behkam, Bahareh

    2016-07-01

    Fabrication of micro/nano-structures on irregularly shaped substrates and three-dimensional (3D) objects is of significant interest in diverse technological fields. However, it remains a formidable challenge thwarted by limited adaptability of the state-of-the-art nanolithography techniques for nanofabrication on non-planar surfaces. In this work, we introduce Spun-Wrapped Aligned Nanofiber (SWAN) lithography, a versatile, scalable, and cost-effective technique for fabrication of multiscale (nano to microscale) structures on 3D objects without restriction on substrate material and geometry. SWAN lithography combines precise deposition of polymeric nanofiber masks, in aligned single or multilayer configurations, with well-controlled solvent vapor treatment and etching processes to enable high throughput (>10(-7) m(2) s(-1)) and large-area fabrication of sub-50 nm to several micron features with high pattern fidelity. Using this technique, we demonstrate whole-surface nanopatterning of bulk and thin film surfaces of cubes, cylinders, and hyperbola-shaped objects that would be difficult, if not impossible to achieve with existing methods. We demonstrate that the fabricated feature size (b) scales with the fiber mask diameter (D) as b(1.5)∝D. This scaling law is in excellent agreement with theoretical predictions using the Johnson, Kendall, and Roberts (JKR) contact theory, thus providing a rational design framework for fabrication of systems and devices that require precisely designed multiscale features.

  9. Spun-wrapped aligned nanofiber (SWAN) lithography for fabrication of micro/nano-structures on 3D objects.

    PubMed

    Ye, Zhou; Nain, Amrinder S; Behkam, Bahareh

    2016-07-01

    Fabrication of micro/nano-structures on irregularly shaped substrates and three-dimensional (3D) objects is of significant interest in diverse technological fields. However, it remains a formidable challenge thwarted by limited adaptability of the state-of-the-art nanolithography techniques for nanofabrication on non-planar surfaces. In this work, we introduce Spun-Wrapped Aligned Nanofiber (SWAN) lithography, a versatile, scalable, and cost-effective technique for fabrication of multiscale (nano to microscale) structures on 3D objects without restriction on substrate material and geometry. SWAN lithography combines precise deposition of polymeric nanofiber masks, in aligned single or multilayer configurations, with well-controlled solvent vapor treatment and etching processes to enable high throughput (>10(-7) m(2) s(-1)) and large-area fabrication of sub-50 nm to several micron features with high pattern fidelity. Using this technique, we demonstrate whole-surface nanopatterning of bulk and thin film surfaces of cubes, cylinders, and hyperbola-shaped objects that would be difficult, if not impossible to achieve with existing methods. We demonstrate that the fabricated feature size (b) scales with the fiber mask diameter (D) as b(1.5)∝D. This scaling law is in excellent agreement with theoretical predictions using the Johnson, Kendall, and Roberts (JKR) contact theory, thus providing a rational design framework for fabrication of systems and devices that require precisely designed multiscale features. PMID:27283144

  10. Psychiatric Clinical Programs for Refugees: Development, Staffing, Structure, and Training.

    ERIC Educational Resources Information Center

    Kinzie, J. David

    This paper describes the development of clinical programs for the psychiatric needs of refugees. It begins with a discussion of the known psychiatric epidemiology of immigrants and refugees: the increased likelihood of depression, schizophrenia, reactive psychoses from trauma, and organic or psychophysiological disorders. Barriers that refugees…

  11. Implementation of an FTIR calibration curve for fast and objective determination of changes in protein secondary structure during formulation development.

    PubMed

    Vonhoff, Sebastian; Condliffe, Jamie; Schiffter, Heiko

    2010-01-01

    The aim of this study was to develop a quick and objective method for the determination of changes in protein secondary structure by Fourier transform infrared spectroscopy (FTIR). Structural shifts from native regions (alpha-helix, intramolecular beta-sheet) to aggregated strands (intermolecular beta-sheet) were used to evaluate protein damage. FTIR spectra of 16 different proteins were recorded and quantified by peak fitting of the non-deconvolved and baseline corrected amide I bands. The resulting percentile secondary structures were correlated with the shape and intensity of the area normalized amide I bands using an interval partial least squares algorithm (iPLS). Structural elements were focused on the following regions: alpha-helix 1660-1650 cm(-1), intramolecular beta-sheet 1695-1683 cm(-1) and 1644-1620 cm(-1), intermolecular beta-sheet 1620-1595 cm(-1). Three calibration curves were created from the data sets. Calculated alpha-helix content ranged from 0% to 79.59%, intramolecular beta-sheet from 10.64% to 63.89% and intermolecular beta-sheet from 0.23% to 9.70%. The linear relationship between actual values (as determined by peak fitting) and calculated values was evaluated by correlation coefficient and root mean square error of calibration while cross-validation was performed to detect possible outliers. Results were verified by including two proteins as validation standards and comparing the calculated values to peak fitting and X-ray data. Structural changes of human serum albumin (HSA) due to elevated temperatures and the fibrillation of glucagon were quantified by calibration curve analysis. Performance and reliability of the iPLS algorithm were evaluated by comparing calculated secondary structure elements with results from peak fitting and circular dichroism. Different methods for the determination of secondary structure gave slightly different results but overall tendencies concurred. Additionally, formation of HSA aggregates could be linked to

  12. Clinical and Biochemical Markers of Cardiovascular Structure and Function in Women With the Metabolic Syndrome.

    PubMed

    Velarde, Gladys P; Sherazi, Saadia; Kraemer, Dale F; Bravo-Jaimes, Katia; Butterfield, Ryan; Amico, Tonja; Steinmetz, Sherry D; Guzman, Maricela; Martin, Dale; Dodani, Sunita; Smith, Brian H

    2015-12-01

    The pathobiological impact of individual components of the metabolic syndrome (MS) on cardiac structural and functional parameters in women with isolated MS is not known. The objectives of this study were (1) to compare biochemical (prothrombotic, lipogenic, and inflammatory) and imaging (carotid intima-media thickening and basic cardiac structural measurements) markers in women with and without MS and (2) to examine if any of these markers associated or predicted cardiac structural differences between the 2 groups. This cross-sectional pilot study included 88 women with MS and 35 women without it. MS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Patients with diagnosis of diabetes were excluded. Compared with healthy subjects, women with MS had higher levels of intercellular adhesion molecule, myeloperoxidase, C-reactive protein, plasminogen activator inhibitor-1, leptin, apolipoprotein-B, and lower levels of apolipoprotein-A1 (p <0.001 for all). They also had higher mean ventricular septum, posterior wall thickness, left ventricular (LV) mass, carotid intima-media thickness (p <0.001 for all), and left atrial diameter (p = 0.015). In multivariable regression models, waist circumference and systolic blood pressure (BP) were significant predictors of: ventricular septum (p = 0.005 and p = 0.001, respectively), posterior wall thickness (p = 0.008 and p = 0.040, respectively), and LV mass (p <0.001 and p = 0.013, respectively). Significant predictors for carotid intima-media thickness were systolic BP, glucose, and leptin (p <0.0001, p = 0.034, and p = 0.002, respectively). In conclusion, there are significant clinical, biochemical, and cardiovascular structural differences in women with isolated MS compared with those without. Waist circumference and systolic BP had the strongest association with cardiac structural differences in this group of women.

  13. Clinical and Biochemical Markers of Cardiovascular Structure and Function in Women With the Metabolic Syndrome.

    PubMed

    Velarde, Gladys P; Sherazi, Saadia; Kraemer, Dale F; Bravo-Jaimes, Katia; Butterfield, Ryan; Amico, Tonja; Steinmetz, Sherry D; Guzman, Maricela; Martin, Dale; Dodani, Sunita; Smith, Brian H

    2015-12-01

    The pathobiological impact of individual components of the metabolic syndrome (MS) on cardiac structural and functional parameters in women with isolated MS is not known. The objectives of this study were (1) to compare biochemical (prothrombotic, lipogenic, and inflammatory) and imaging (carotid intima-media thickening and basic cardiac structural measurements) markers in women with and without MS and (2) to examine if any of these markers associated or predicted cardiac structural differences between the 2 groups. This cross-sectional pilot study included 88 women with MS and 35 women without it. MS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Patients with diagnosis of diabetes were excluded. Compared with healthy subjects, women with MS had higher levels of intercellular adhesion molecule, myeloperoxidase, C-reactive protein, plasminogen activator inhibitor-1, leptin, apolipoprotein-B, and lower levels of apolipoprotein-A1 (p <0.001 for all). They also had higher mean ventricular septum, posterior wall thickness, left ventricular (LV) mass, carotid intima-media thickness (p <0.001 for all), and left atrial diameter (p = 0.015). In multivariable regression models, waist circumference and systolic blood pressure (BP) were significant predictors of: ventricular septum (p = 0.005 and p = 0.001, respectively), posterior wall thickness (p = 0.008 and p = 0.040, respectively), and LV mass (p <0.001 and p = 0.013, respectively). Significant predictors for carotid intima-media thickness were systolic BP, glucose, and leptin (p <0.0001, p = 0.034, and p = 0.002, respectively). In conclusion, there are significant clinical, biochemical, and cardiovascular structural differences in women with isolated MS compared with those without. Waist circumference and systolic BP had the strongest association with cardiac structural differences in this group of women. PMID:26482181

  14. [A new objective clinical method in the evaluation of the status of blood flow in conjunctival vessels].

    PubMed

    Polunin, G S; Pirogova, E P; Iarovaia, L D

    1989-01-01

    The suggested method for assessment of the blood aggregation characteristics in the conjunctival vessels is based on microdensitometry of the blood stream microphotographs. The method permits a graphic recording of the blood stream. The potentialities of the developed technique have been studied in comparison of the blood aggregation in patients with diabetic retinopathy and in normal subjects. The data evidence an increased coagulation activity of the blood in patients with diabetes mellitus vs. normal subjects, this correlating with the biochemical findings in examinations of these patients' hemostasis. The clinical method for assessment of the blood aggregation characteristics may be useful for the prognosis of the course of various diseases and for monitoring the treatment efficacy.

  15. Psychosocial and demographic correlates of objectively measured physical activity in structured and unstructured after-school recreation sessions.

    PubMed

    Rosenkranz, Richard R; Welk, Gregory J; Hastmann, Tanis J; Dzewaltowski, David A

    2011-07-01

    Most studies of psychosocial and demographic correlates of physical activity (PA) have examined relationships across various types of physical and social environments, rather than within a specific environmental behavior setting. The objective of this study was to investigate correlates of PA in structured and unstructured after-school recreation sessions. This study is cross-sectional. School records, questionnaires, and anthropometry were used to obtain demographic and psychosocial variables. Third and fourth-grade children (n = 230) from seven schools wore Actigraph GT1M accelerometers up to six times per year during after-school programming. Accelerometer data were processed to determine percentage of time in moderate-to-vigorous PA (T scores, reflective of an individual child's PA level relative to group mean, were computed for each session and averaged across sessions). Pearson correlations, point-biserial correlations, and mixed-model analyses were used to determine significant associations with PA for each session type (structured and unstructured). For structured sessions, gender, PA barriers self-efficacy, and PA enjoyment were significantly related to PA. For unstructured sessions, only gender was related to PA. Despite equivalent opportunities to participate in active recreation, boys were more active than girls, and children varied in PA level partly due to psychosocial factors. Our results showed that PA self-efficacy and enjoyment explained variability in structured PA sessions.

  16. The Acute Asthma Severity Assessment Protocol (AASAP) study: objectives and methods of a study to develop an acute asthma clinical prediction rule.

    PubMed

    Arnold, Donald H; Gebretsadik, Tebeb; Abramo, Thomas J; Sheller, James R; Resha, Donald J; Hartert, Tina V

    2012-06-01

    Acute asthma exacerbations are one of the most common reasons for paediatric emergency department visits and hospitalisations, and a relapse frequently necessitates repeat urgent care. While care plans exist, there are no acute asthma prediction rules (APRs) to assess severity and predict outcome. The primary objective of the Acute Asthma Severity Assessment Protocol study is to develop a multivariable APR for acute asthma exacerbations in paediatric patients. A prospective, convenience sample of paediatric patients aged 5-17 years with acute asthma exacerbations who present to an urban, academic, tertiary paediatric emergency department was enrolled. The study protocol and data analysis plan conform to accepted biostatistical and clinical standards for clinical prediction rule development. Modelling of the APR will be performed once the entire sample size of 1500 has accrued. It is anticipated that the APR will improve resource utilisation in the emergency department, aid in standardisation of disease assessment and allow physician and non-physician providers to participate in earlier objective decision making. The objective of this report is to describe the study objectives and detailed methodology of the Acute Asthma Severity Assessment Protocol study.

  17. Structural and diffusion imaging versus clinical assessment to monitor amyotrophic lateral sclerosis

    PubMed Central

    Cardenas-Blanco, Arturo; Machts, Judith; Acosta-Cabronero, Julio; Kaufmann, Joern; Abdulla, Susanne; Kollewe, Katja; Petri, Susanne; Schreiber, Stefanie; Heinze, Hans-Jochen; Dengler, Reinhard; Vielhaber, Stefan; Nestor, Peter J.

    2016-01-01

    Amyotrophic lateral sclerosis is a progressive neurodegenerative disease that affects upper and lower motor neurons. Observational and intervention studies can be tracked using clinical measures such as the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) but for a complete understanding of disease progression, objective in vivo biomarkers of both central and peripheral motor pathway pathology are highly desirable. The aim of this study was to determine the utility of structural and diffusion imaging as central nervous system biomarkers compared to the standard clinical measure, ALSFRS-R, to track longitudinal evolution using three time-point measurements. N = 34 patients with ALS were scanned and clinically assessed three times at a mean of three month time intervals. The MRI biomarkers were structural T1-weighted volumes for cortical thickness measurement as well as deep grey matter volumetry, voxel-based morphometry and diffusion tensor imaging (DTI). Cortical thickness focused specifically on the precentral gyrus while quantitative DTI biomarkers focused on the corticospinal tracts. The evolution of imaging biomarkers and ALSFRS-R scores over time were analysed using a mixed effects model that accounted for the scanning interval as a fixed effect variable, and, the initial measurements and time from onset as random variables. The mixed effects model showed a significant decrease in the ALSFRS-R score, (p < 0.0001, and an annual rate of change (AROC) of − 7.3 points). Similarly, fractional anisotropy of the corticospinal tract showed a significant decrease (p = 0.009, AROC = − 0.0066) that, in turn, was driven by a significant increase in radial diffusivity combined with a trend to decrease in axial diffusivity. No significant change in cortical thickness of the precentral gyrus was found (p > 0.5). In addition, deep grey matter volumetry and voxel-based morphometry also identified no significant changes. Furthermore, the

  18. An objective biochemical assessment of therapeutic response in metastatic breast cancer: a study with external review of clinical data.

    PubMed Central

    Williams, M. R.; Turkes, A.; Pearson, D.; Griffiths, K.; Blamey, R. W.

    1990-01-01

    A series of tumour related markers have been examined in 179 patients receiving primary endocrine therapy for metastatic breast cancer. Significant correlations between therapeutic response (UICC criteria after 6 months of treatment) and appropriate alterations in serum concentrations of carcinoembryonic antigen, ferritin, c-reactive protein, orosomucoid and the erythrocyte sedimentation rate, have been observed when changes in these markers were examined only at high serum concentrations. By combining these five markers a 'therapeutic index' of response has been devised which can be employed at an early stage of treatment in more than 90% of patients, giving an overall sensitivity/specificity of 90%/78% for therapeutic response or disease stabilisation over a 6-month period. The design of an objective measurement of response, which is easy to perform, has the potential to replace the existing, largely subjective. UICC criteria for retrospective judgement of response, and may also be used to direct systemic endocrine therapy. PMID:2137007

  19. Spun-wrapped aligned nanofiber (SWAN) lithography for fabrication of micro/nano-structures on 3D objects

    NASA Astrophysics Data System (ADS)

    Ye, Zhou; Nain, Amrinder S.; Behkam, Bahareh

    2016-06-01

    Fabrication of micro/nano-structures on irregularly shaped substrates and three-dimensional (3D) objects is of significant interest in diverse technological fields. However, it remains a formidable challenge thwarted by limited adaptability of the state-of-the-art nanolithography techniques for nanofabrication on non-planar surfaces. In this work, we introduce Spun-Wrapped Aligned Nanofiber (SWAN) lithography, a versatile, scalable, and cost-effective technique for fabrication of multiscale (nano to microscale) structures on 3D objects without restriction on substrate material and geometry. SWAN lithography combines precise deposition of polymeric nanofiber masks, in aligned single or multilayer configurations, with well-controlled solvent vapor treatment and etching processes to enable high throughput (>10-7 m2 s-1) and large-area fabrication of sub-50 nm to several micron features with high pattern fidelity. Using this technique, we demonstrate whole-surface nanopatterning of bulk and thin film surfaces of cubes, cylinders, and hyperbola-shaped objects that would be difficult, if not impossible to achieve with existing methods. We demonstrate that the fabricated feature size (b) scales with the fiber mask diameter (D) as b1.5 ~ D. This scaling law is in excellent agreement with theoretical predictions using the Johnson, Kendall, and Roberts (JKR) contact theory, thus providing a rational design framework for fabrication of systems and devices that require precisely designed multiscale features.Fabrication of micro/nano-structures on irregularly shaped substrates and three-dimensional (3D) objects is of significant interest in diverse technological fields. However, it remains a formidable challenge thwarted by limited adaptability of the state-of-the-art nanolithography techniques for nanofabrication on non-planar surfaces. In this work, we introduce Spun-Wrapped Aligned Nanofiber (SWAN) lithography, a versatile, scalable, and cost-effective technique for

  20. The status of and future research into Myalgic Encephalomyelitis and Chronic Fatigue Syndrome: the need of accurate diagnosis, objective assessment, and acknowledging biological and clinical subgroups

    PubMed Central

    Twisk, Frank N. M.

    2014-01-01

    Although Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS) are used interchangeably, the diagnostic criteria define two distinct clinical entities. Cognitive impairment, (muscle) weakness, circulatory disturbances, marked variability of symptoms, and, above all, post-exertional malaise: a long-lasting increase of symptoms after a minor exertion, are distinctive symptoms of ME. This latter phenomenon separates ME, a neuro-immune illness, from chronic fatigue (syndrome), other disorders and deconditioning. The introduction of the label, but more importantly the diagnostic criteria for CFS have generated much confusion, mostly because chronic fatigue is a subjective and ambiguous notion. CFS was redefined in 1994 into unexplained (persistent or relapsing) chronic fatigue, accompanied by at least four out of eight symptoms, e.g., headaches and unrefreshing sleep. Most of the research into ME and/or CFS in the last decades was based upon the multivalent CFS criteria, which define a heterogeneous patient group. Due to the fact that fatigue and other symptoms are non-discriminative, subjective experiences, research has been hampered. Various authors have questioned the physiological nature of the symptoms and qualified ME/CFS as somatization. However, various typical symptoms can be assessed objectively using standardized methods. Despite subjective and unclear criteria and measures, research has observed specific abnormalities in ME/CFS repetitively, e.g., immunological abnormalities, oxidative and nitrosative stress, neurological anomalies, circulatory deficits and mitochondrial dysfunction. However, to improve future research standards and patient care, it is crucial that patients with post-exertional malaise (ME) and patients without this odd phenomenon are acknowledged as separate clinical entities that the diagnosis of ME and CFS in research and clinical practice is based upon accurate criteria and an objective assessment of characteristic symptoms

  1. A Meta-Model for Structuring the Clinical Interview.

    ERIC Educational Resources Information Center

    Ivey, Allen E.; Matthews, William J.

    1984-01-01

    Presents a meta-model based on genetic epistemology for interviewing structure. Discusses developing rapport, gathering information, determining outcome, exploring alternatives and confronting incongruity, generalizing and transfering training, and the model's usefulness for counselors in planning sessions, developing interviewing summary notes,…

  2. Diagnostic and functional structure of a high-resolution thyroid nodule clinic.

    PubMed

    Fernández-García, José Carlos; Mancha-Doblas, Isabel; Ortega-Jiménez, María Victoria; Ruiz-Escalante, José Francisco; Castells-Fusté, Ignasi; Tofé-Povedano, Santiago; Argüelles-Jiménez, Iñaki; Tinahones, Francisco José

    2014-01-01

    Appearance of a thyroid nodule has become a daily occurrence in clinical practice. Adequate thyroid nodule assessment requires several diagnostic tests and multiple medical appointments, which results in a substantial delay in diagnosis. Implementation of a high-resolution thyroid nodule clinic largely avoids these drawbacks by condensing in a single appointment all tests required for adequate evaluation of thyroid nodule. This paper reviews the diagnostic and functional structure of a high-resolution thyroid nodule clinic.

  3. A Four- and Five-Factor Structural Model for Wechsler Tests: Does It Really Matter Clinically?

    ERIC Educational Resources Information Center

    Schwartz, David M.

    2013-01-01

    The purpose of this commentary is to focus on the clinical utility of the four- and five-factor structural models for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) and Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV). It provides a discussion of important considerations when evaluating the clinical utility of the…

  4. Morphology and structure of extremely red objects at z ∼ 1 in the CANDELS-COSMOS field

    NASA Astrophysics Data System (ADS)

    Fang, Guan-Wen; Ma, Zhong-Yang; Chen, Yang; Kong, Xu

    2015-06-01

    Using high-resolution HST/Wide Field Camera 3 F125W imaging from the CANDELS-COSMOS field, we report the structural and morphological properties of extremely red objects (EROs) at z ∼ 1. Based on the UVJ color criteria, we separate EROs into two types: old passive galaxies (OGs) and dusty star-forming galaxies (DGs). For a given stellar mass, we find that the mean size of OGs (DGs) is smaller by a factor of ∼ 2 (1.5) than that of present-day early-type (late-type) galaxies at a rest-frame optical wavelength. We derive the average effective radii of OGs and DGs, corresponding to 2.09 ± 1.13 kpc and 3.27 ± 1.14 kpc, respectively. Generally, the DGs are heterogeneous, with mixed features including bulges, disks and irregular structures, with relatively high M20, large size and low G. By contrast, OGs have elliptical-like compact morphologies with lower M20, smaller size and higher G, indicating a more concentrated and symmetric spatial extent of the stellar population distribution in OGs than DGs. These findings imply that OGs and DGs have different evolutionary processes, and that the minor merger scenario is the most likely mechanism for the structural properties of OGs. However, the size evolution of DGs is possibly due to the secular evolution of galaxies. Supported by the National Natural Science Foundation of China.

  5. Calibration and 3D reconstruction of underwater objects with non-single-view projection model by structured light stereo imaging.

    PubMed

    Wang, Yexin; Negahdaripour, Shahriar; Aykin, Murat D

    2016-08-20

    Establishing the projection model of imaging systems is critical in 3D reconstruction of object shapes from multiple 2D views. When deployed underwater, these are enclosed in waterproof housings with transparent glass ports that generate nonlinear refractions of optical rays at interfaces, leading to invalidation of the commonly assumed single-viewpoint (SVP) model. In this paper, we propose a non-SVP ray tracing model for the calibration of a projector-camera system, employed for 3D reconstruction based on the structured light paradigm. The projector utilizes dot patterns, having established that the contrast loss is less severe than for traditional stripe patterns in highly turbid waters. Experimental results are presented to assess the achieved calibrating accuracy. PMID:27556973

  6. Special Features of the Structure of Secular Resonances in the Dynamics of Near-Earth Space Objects

    NASA Astrophysics Data System (ADS)

    Bordovitsyna, T. V.; Tomilova, I. V.

    2016-07-01

    The special features of the structure of secular resonances in the near-earth orbital space bounded by the following range of orbital parameters: semimajor axis from 8000 to 55 000 km, inclination from 0 to 90°, and eccentricity equal to 0.01, 0.6, and 0.8 are analyzed. The influence of stable and unstable secular resonances on the long-term orbital evolution of near-earth space objects is also considered. It is demonstrated that the joint effect of the stable secular resonances of different spectral classes does not violate the regularity of motion. The chaoticity arises when stable secular resonances of one spectral class are imposed.

  7. MBBS student perceptions about physiology subject teaching and objective structured practical examination based formative assessment for improving competencies.

    PubMed

    Lakshmipathy, K

    2015-09-01

    The objectives of the present study were to 1) assess student attitudes to physiology, 2) evaluate student opinions about the influence of an objective structured practical examination (OSPE) on competence, and 3) assess the validity and reliability of an indigenously designed feedback questionnaire. A structured questionnaire containing 16 item statements, 8 items on an Osgood's 5-point semantic differential scale and 8 items on a Likert's 5-point scale, was used. Options were assigned scores of 1-5 according to weightage. For Osgood's semantic differential scale items, a χ(2)-test was done to analyze student attitudes toward the subject. For Likert scale items, mean score and SD were calculated to analyze student opinions of the OSPE. Item validity was assessed by item analysis, and reliability was assessed by calculating Crohnbach's α. The subject as a whole was interesting to 82% of the students (n = 135). The theory was interesting to 75% of the students (n = 132) but complex to 42% (n = 118). The practical was interesting to 93% of the students (n = 134); 76% of the students (n = 104) felt that the practical was simple, whereas 4% felt it was complex. The OSPE was interesting to 79% of the students (n = 131); 57% of the students (n = 116) felt it was simple, whereas 24% found it complex. Components of the subject, intricateness, and student interests were strongly associated. Students chose options on a higher weight scale, favoring the OSPE. Items were found to be valid and reliable. In conclusion, the subject of physiology was interesting but not simple to understand. Student interests varied with the components of the subject, and the components of the subject had varied intricateness. Students were in favor of the OSPE for assessment. The questionnaire used for the study was valid and reliable.

  8. Exploring the structure and organization of information within nursing clinical handovers.

    PubMed

    Johnson, Maree; Jefferies, Diana; Nicholls, Daniel

    2012-10-01

    Clinical handover is the primary source of patient information for nurses; however, inadequate information transfer compromises patient safety. We investigated the content and organization of information conveyed at 81 handovers. A structure that captures and presents the information transferred at handover emerged: identification of the patient and clinical risks, clinical history/presentation, clinical status, care plan and outcomes/goals of care (ICCCO). This approach covers essential information while allowing for prioritization of information when required. Further research into the impact of ICCCO on patient safety is in progress.

  9. The biomedical disciplines and the structure of biomedical and clinical knowledge.

    PubMed

    Nederbragt, H

    2000-11-01

    The relation between biomedical knowledge and clinical knowledge is discussed by comparing their respective structures. The knowledge of a disease as a biological phenomenon is constructed by the interaction of facts and theories from the main biomedical disciplines: epidemiology, diagnostics, clinical trial, therapy development and pathogenesis. Although these facts and theories are based on probabilities and extrapolations, the interaction provides a reliable and coherent structure, comparable to a Kuhnian paradigma. In the structure of clinical knowledge, i.e. knowledge of the patient with the disease, not only biomedical knowledge contributes to the structure but also economic and social relations, ethics and personal experience. However, the interaction between each of the participating "knowledges" in clinical knowledge is not based on mutual dependency and accumulation of different arguments from each, as in biomedical knowledge, but on competition and partial exclusion. Therefore, the structure of biomedical knowledge is different from that of clinical knowledge. This difference is used as the basis for a discussion in which the place of technology, evidence-based medicine and the gap between scientific and clinical knowledge are evaluated. PMID:11196221

  10. The biomedical disciplines and the structure of biomedical and clinical knowledge.

    PubMed

    Nederbragt, H

    2000-11-01

    The relation between biomedical knowledge and clinical knowledge is discussed by comparing their respective structures. The knowledge of a disease as a biological phenomenon is constructed by the interaction of facts and theories from the main biomedical disciplines: epidemiology, diagnostics, clinical trial, therapy development and pathogenesis. Although these facts and theories are based on probabilities and extrapolations, the interaction provides a reliable and coherent structure, comparable to a Kuhnian paradigma. In the structure of clinical knowledge, i.e. knowledge of the patient with the disease, not only biomedical knowledge contributes to the structure but also economic and social relations, ethics and personal experience. However, the interaction between each of the participating "knowledges" in clinical knowledge is not based on mutual dependency and accumulation of different arguments from each, as in biomedical knowledge, but on competition and partial exclusion. Therefore, the structure of biomedical knowledge is different from that of clinical knowledge. This difference is used as the basis for a discussion in which the place of technology, evidence-based medicine and the gap between scientific and clinical knowledge are evaluated.

  11. Structured Interview of Personality Organization (STIPO): preliminary psychometrics in a clinical sample.

    PubMed

    Stern, Barry L; Caligor, Eve; Clarkin, John F; Critchfield, Kenneth L; Horz, Susanne; MacCornack, Verna; Lenzenweger, Mark F; Kernberg, Otto F

    2010-01-01

    In this article, we describe the development and preliminary psychometric properties of the Structured Interview of Personality Organization (STIPO), a semistructured interview designed for the dimensional assessment of identity, primitive defenses, and reality testing, the three primary content domains in the model of personality health and disorder elaborated by Kernberg (1984; Kernberg & Caligor, 2005). Results of this investigation, conducted in a clinical sample representing a broad range of personality pathology, indicate that identity and primitive defenses as operationalized in the STIPO are internally consistent and that interrater reliability for all 3 content domains is adequate. Validity findings suggest that the assessment of one's sense of self and significant others (Identity) is predictive of measures of positive and negative affect, whereas the maladaptive ways in which the subject uses his or her objects for purposes of regulating one's self experience (Primitive Defenses) is predictive of measures of aggression and personality disorder traits associated with cluster B personality disorders. We discuss implications of these findings in terms of the theory-driven and trait-based assessment of personality pathology. PMID:20013454

  12. Medical image segmentation using object atlas versus object cloud models

    NASA Astrophysics Data System (ADS)

    Phellan, Renzo; Falcão, Alexandre X.; Udupa, Jayaram K.

    2015-03-01

    Medical image segmentation is crucial for quantitative organ analysis and surgical planning. Since interactive segmentation is not practical in a production-mode clinical setting, automatic methods based on 3D object appearance models have been proposed. Among them, approaches based on object atlas are the most actively investigated. A key drawback of these approaches is that they require a time-costly image registration process to build and deploy the atlas. Object cloud models (OCM) have been introduced to avoid registration, considerably speeding up the whole process, but they have not been compared to object atlas models (OAM). The present paper fills this gap by presenting a comparative analysis of the two approaches in the task of individually segmenting nine anatomical structures of the human body. Our results indicate that OCM achieve a statistically significant better accuracy for seven anatomical structures, in terms of Dice Similarity Coefficient and Average Symmetric Surface Distance.

  13. Behaviors of the percentage depth dose curves along the beam axis of a phantom filled with different clinical PTO objects, a Monte Carlo Geant4 study

    NASA Astrophysics Data System (ADS)

    EL Bakkali, Jaafar; EL Bardouni, Tarek; Safavi, Seyedmostafa; Mohammed, Maged; Saeed, Mroan

    2016-08-01

    The aim of this work is to assess the capabilities of Monte Carlo Geant4 code to reproduce the real percentage depth dose (PDD) curves generated in phantoms which mimic three important clinical treatment situations that include lung slab, bone slab, bone-lung slab geometries. It is hoped that this work will lead us to a better understanding of dose distributions in an inhomogeneous medium, and to identify any limitations of dose calculation algorithm implemented in the Geant4 code. For this purpose, the PDD dosimetric functions associated to the three clinical situations described above, were compared to one produced in a homogeneous water phantom. Our results show, firstly, that the Geant4 simulation shows potential mistakes on the shape of the calculated PDD curve of the first physical test object (PTO), and it is obviously not able to successfully predict dose values in regions near to the boundaries between two different materials. This is, surely due to the electron transport algorithm and it is well-known as the artifacts at interface phenomenon. To deal with this issue, we have added and optimized the StepMax parameter to the dose calculation program; consequently the artifacts due to the electron transport were quasi disappeared. However, the Geant4 simulation becomes painfully slow when we attempt to completely resolve the electron artifact problems by considering a smaller value of an electron StepMax parameter. After electron transport optimization, our results demonstrate the medium-level capabilities of the Geant4 code to modeling dose distribution in clinical PTO objects.

  14. A Marginal Structural Model Analysis for Loneliness: Implications for Intervention Trials and Clinical Practice

    ERIC Educational Resources Information Center

    VanderWeele, Tyler J.; Hawkley, Louise C.; Thisted, Ronald A.; Cacioppo, John T.

    2011-01-01

    Objective: Clinical scientists, policymakers, and individuals must make decisions concerning effective interventions that address health-related issues. We use longitudinal data on loneliness and depressive symptoms and a new class of causal models to illustrate how empirical evidence can be used to inform intervention trial design and clinical…

  15. Parsec-scale H I absorption structure in a low-redshift galaxy seen against a compact symmetric object

    NASA Astrophysics Data System (ADS)

    Biggs, A. D.; Zwaan, M. A.; Hatziminaoglou, E.; Péroux, C.; Liske, J.

    2016-11-01

    We present global VLBI observations of the 21-cm transition of atomic hydrogen seen in absorption against the radio source J0855+5751. The foreground absorber (SDSS J085519.05+575140.7) is a dwarf galaxy at z = 0.026. As the background source is heavily resolved by VLBI, the data allow us to map the properties of the foreground H I gas with a spatial resolution of 2 pc. The absorbing gas corresponds to a single coherent structure with an extent >35 pc, but we also detect significant and coherent variations, including a change in the H I optical depth by a factor of 5 across a distance of ≲ 6 pc. The large size of the structure provides support for the Heiles & Troland model of the interstellar medium, as well as its applicability to external galaxies. The large variations in H I optical depth also suggest that caution should be applied when interpreting TS measurements from radio-detected DLAs. In addition, the distorted appearance of the background radio source is indicative of a strong jet-cloud interaction in its host galaxy. We have measured its redshift (z = 0.541 86) using optical spectroscopy on the William Herschel Telescope and this confirms that J0855+5751 is an FR II radio source with a physical extent of <1 kpc and supports the previous identification of this source as a compact symmetric object. These sources often show absorption associated with the host galaxy and we suggest that both H I and OH should be searched for in J0855+5751.

  16. Objective evaluation by reflectance spectrophotometry can be of clinical value for the verification of blanching/non blanching erythema in the sacral area.

    PubMed

    Sterner, Eila; Fossum, Bjöörn; Berg, Elisabeth; Lindholm, Christina; Stark, André

    2014-08-01

    Early detection of non blanching erythema (pressure ulcer category I) is necessary to prevent any further skin damage. An objective method to discriminate between blanching/non blanching erythema is presently not available. The purpose of this investigation was to explore if a non invasive objective method could differentiate between blanching/non blanching erythema in the sacral area of patients undergoing hip fracture surgery. Seventy-eight patients were included. The sacral area of all patients was assessed using (i) conventional finger-press test and (ii) digital reading of the erythema index assessed with reflectance spectrophotometry. The patients were examined at admission and during 5 days postsurgery. Reflectance spectrophotometry measurements proved able to discriminate between blanching/non blanching erythema. The reliability, quantified by the intra-class correlation coefficient, was excellent between repeated measurements over the measurement period, varying between 0·82 and 0·96, and a significant change was recorded in the areas from day 1 to day 5 (P < 0·0001). The value from the reference point did not show any significant changes over the same period (P = 0·32). An objective method proven to identify early pressure damage to tissue can be a valuable tool in clinical practice.

  17. Evidence-based protocol for structural rehabilitation of the spine and posture: review of clinical biomechanics of posture (CBP®) publications

    PubMed Central

    Oakley, Paul A.; Harrison, Donald D.; Harrison, Deed E.; Haas, Jason W.

    2005-01-01

    BACKGROUND Although practice protocols exist for SMT and functional rehabilitation, no practice protocols exist for structural rehabilitation. Traditional chiropractic practice guidelines have been limited to acute and chronic pain treatment, with limited inclusion of functional and exclusion of structural rehabilitation procedures. OBJECTIVE (1) To derive an evidence-based practice protocol for structural rehabilitation from publications on Clinical Biomechanics of Posture (CBP®) methods, and (2) to compare the evidence for Diversified, SMT, and CBP®. METHODS Clinical control trials utilizing CBP® methods and spinal manipulative therapy (SMT) were obtained from searches in Mantis, CINAHL, and Index Medicus. Using data from SMT review articles, evidence for Diversified Technique (as taught in chiropractic colleges), SMT, and CBP® were rated and compared. RESULTS From the evidence from Clinical Control Trials on SMT and CBP®, there is very little evidence support for Diversified (our rating = 18), as taught in chiropractic colleges, for the treatment of pain subjects, while CBP® (our rating = 46) and SMT for neck pain (rating = 58) and low back pain (our rating = 202) have evidence-based support. CONCLUSIONS While CBP® Technique has approximately as much evidence-based support as SMT for neck pain, CBP® has more evidence to support its methods than the Diversified technique taught in chiropractic colleges, but not as much as SMT for low back pain. The evolution of chiropractic specialization has occurred, and doctors providing structural-based chiropractic care require protocol guidelines for patient quality assurance and standardization. A structural rehabilitation protocol was developed based on evidence from CBP® publications. PMID:17549209

  18. LASER BIOLOGY AND MEDICINE: Visualisation of details of a complicated inner structure of model objects by the method of diffusion optical tomography

    NASA Astrophysics Data System (ADS)

    Tret'yakov, Evgeniy V.; Shuvalov, Vladimir V.; Shutov, I. V.

    2002-11-01

    An approximate algorithm is tested for solving the problem of diffusion optical tomography in experiments on the visualisation of details of the inner structure of strongly scattering model objects containing scattering and semitransparent inclusions, as well as absorbing inclusions located inside other optical inhomogeneities. The stability of the algorithm to errors is demonstrated, which allows its use for a rapid (2 — 3 min) image reconstruction of the details of objects with a complicated inner structure.

  19. Development of a teaching module for parenteral drug administration and objective structured practical examination stations in pharmacology

    PubMed Central

    Devi, Vasudha; Upadhye, Prachitee; Ram, Pradhum; Menezes, Ritesh G.

    2013-01-01

    Objectives: Safe parenteral drug administration includes preparation of safe medication for administration. Training medical students is crucial to minimize medication administration errors. The study aims to develop a module to teach drug preparation skills and to develop objective structured practical examination (OSPE) stations to assess these skills. Students’ perceptions regarding the module were also assessed. Materials and Methods: A module was developed to teach following skills to 2nd year medical students: Aspiration of a drug from the ampule, aspiration of the drug from the vial, aspiration of the drug in powdered form from vial (reconstitution), and setting up an intravenous (IV) infusion. A randomized case control study design was used to establish the validity of OSPE stations. Student volunteers were grouped into case (n = 20) and control groups (n = 20) by simple randomization. The test group watched videos of skills and received demonstration of skills and a practice session before OSPE, whereas the control group watched videos before the OSPE and received demonstration and a practice session only after the OSPE. Each student was assessed by two faculty members during OSPE using a validated checklist. Mean OSPE scores of control and test groups were compared using independent samples t-test. Interrater reliability and concurrent validity of stations were analyzed using interclass correlation coefficient (ICC) and Pearson correlation, respectively. Students’ responses were expressed as median and interquartile range. Results: The response rate in the questionnaire was 100%. Significant difference between mean scores (P < 0.05) of test and control groups revealed fulfillment of construct validity of OSPE stations. Interrater reliability (ICC > 0.7) and concurrent validity (r value > 7) of all the stations was high. Perceptions revealed acceptability of module and OSPE stations by students (median 4, scale 1-5). Conclusions: A module to teach drug

  20. Development of a heart failure filter for Medline: an objective approach using evidence-based clinical practice guidelines as an alternative to hand searching

    PubMed Central

    2011-01-01

    Background Heart failure is a highly debilitating syndrome with a poor prognosis primarily affecting the elderly. Clinicians wanting timely access to heart failure evidence to provide optimal patient care can face many challenges in locating this evidence. This study developed and validated a search filter of high clinical utility for the retrieval of heart failure articles in OvidSP Medline. Methods A Clinical Advisory Group was established to advise study investigators. The study set of 876 relevant articles from four heart failure clinical practice guidelines was divided into three datasets: a Term Identification Set, a Filter Development Set, and a Filter Validation Set. A further validation set (the Cochrane Validation Set) was formed using studies included in Cochrane heart failure systematic reviews. Candidate search terms were identified via word frequency analysis. The filter was developed by creating combinations of terms and recording their performance in retrieving items from the Filter Development Set. The filter's recall was then validated in both the Filter Validation Set and the Cochrane Validation Set. A precision estimate was obtained post-hoc by running the filter in Medline and screening the first 200 retrievals for relevance to heart failure. Results The four-term filter achieved a recall of 96.9% in the Filter Development Set; 98.2% in the Filter Validation Set; and 97.8% in the Cochrane Validation Set. Of the first 200 references retrieved by the filter when run in Medline, 150 were deemed relevant and 50 irrelevant. The post-hoc precision estimate was therefore 75%. Conclusions This study describes an objective method for developing a validated heart failure filter of high recall performance and then testing its precision post-hoc. Clinical practice guidelines were found to be a feasible alternative to hand searching in creating a gold standard for filter development. Guidelines may be especially appropriate given their clinical utility. A

  1. Envelope structure on 700 AU scales and the molecular outflows of low-mass young stellar objects

    NASA Technical Reports Server (NTRS)

    Hogerheijde, M. R.; van Dishoeck, E. F.; Blake, G. A.; van Langevelde, H. J.

    1998-01-01

    Aperture synthesis observations of HCO+ J = 1-0, 13CO 1-0, and C18O 1-0 obtained with the Owens Valley Millimeter Array are used to probe the small-scale (5" approximately 700 AU) structure of the molecular envelopes of a well-defined sample of nine embedded low-mass young stellar objects in Taurus. The interferometer results can be understood in terms of: (1) a core of radius approximately or less than 1000 AU surrounding the central star, possibly flattened and rotating; (2) condensations scattered throughout the envelope that may be left over from the inhomogeneous structure of the original cloud core or that may have grown during collapse; and (3) material within the outflow or along the walls of the outflow cavity. Masses of the central cores are 0.001-0.1 M (solar), and agree well with dust continuum measurements. Averaged over the central 20" (3000 AU) region, an HCO+ abundance of 4 x 10(-8) is inferred, with a spread of a factor of 3 between the different sources. Reanalysis of previously presented single-dish data yields an HCO+ abundance of (5.0 +/- 1.7) x 10(-9), which may indicate an average increase by a factor of a few on the smaller scales sampled by the interferometer. Part of this apparent abundance variation could be explained by contributions from extended cloud emission to the single-dish C18O lines, and uncertainties in the assumed excitation temperatures and opacities. The properties of the molecular envelopes and outflows are further investigated through single-dish observations of 12CO J = 6-5, 4-3, and 3-2, 13CO 6-5 and 3-2, and C18O 3-2 and 2-1, obtained with the James Clerk Maxwell and IRAM 30 m telescopes, along with the Caltech Submillimeter Observatory. Ratios of the mid-J CO lines are used to estimate the excitation temperature, with values of 25-80 K derived for the gas near line centre. The outflow wings show a similar range, although Tex is enhanced by a factor of 2-3 in at least two sources. In contrast to the well-studied L1551

  2. Envelope structure on 700 AU scales and the molecular outflows of low-mass young stellar objects.

    PubMed

    Hogerheijde, M R; van Dishoeck, E F; Blake, G A; van Langevelde, H J

    1998-07-20

    Aperture synthesis observations of HCO+ J = 1-0, 13CO 1-0, and C18O 1-0 obtained with the Owens Valley Millimeter Array are used to probe the small-scale (5" approximately 700 AU) structure of the molecular envelopes of a well-defined sample of nine embedded low-mass young stellar objects in Taurus. The interferometer results can be understood in terms of: (1) a core of radius approximately or less than 1000 AU surrounding the central star, possibly flattened and rotating; (2) condensations scattered throughout the envelope that may be left over from the inhomogeneous structure of the original cloud core or that may have grown during collapse; and (3) material within the outflow or along the walls of the outflow cavity. Masses of the central cores are 0.001-0.1 M (solar), and agree well with dust continuum measurements. Averaged over the central 20" (3000 AU) region, an HCO+ abundance of 4 x 10(-8) is inferred, with a spread of a factor of 3 between the different sources. Reanalysis of previously presented single-dish data yields an HCO+ abundance of (5.0 +/- 1.7) x 10(-9), which may indicate an average increase by a factor of a few on the smaller scales sampled by the interferometer. Part of this apparent abundance variation could be explained by contributions from extended cloud emission to the single-dish C18O lines, and uncertainties in the assumed excitation temperatures and opacities. The properties of the molecular envelopes and outflows are further investigated through single-dish observations of 12CO J = 6-5, 4-3, and 3-2, 13CO 6-5 and 3-2, and C18O 3-2 and 2-1, obtained with the James Clerk Maxwell and IRAM 30 m telescopes, along with the Caltech Submillimeter Observatory. Ratios of the mid-J CO lines are used to estimate the excitation temperature, with values of 25-80 K derived for the gas near line centre. The outflow wings show a similar range, although Tex is enhanced by a factor of 2-3 in at least two sources. In contrast to the well-studied L1551

  3. Objective evaluation of methods to track motion from clinical cardiac-gated tagged MRI without the use of a gold standard

    NASA Astrophysics Data System (ADS)

    Parages, Felipe M.; Denney, Thomas S.; Brankov, Jovan G.

    2015-03-01

    Cardiac-gated MRI is widely used for the task of measuring parameters related to heart motion. More specifically, gated tagged MRI is the preferred modality to estimate local deformation (strain) and rotational motion (twist) of myocardial tissue. Many methods have been proposed to estimate cardiac motion from gated MRI sequences. However, when dealing with clinical data, evaluation of these methods is problematic due to the absence of gold-standards for cardiac motion. To overcome that, a linear regression scheme known as regression-without-truth (RWT) was proposed in the past. RWT uses priors to model the distribution of true values, thus enabling us to assess image-analysis algorithms without knowledge of the ground-truth. Furthermore, it allows one to rank methods by means of an objective figure-of-merit γ (i.e. precision). In this work we apply RWT to compare the performance of several gated MRI motion-tracking methods (e.g. non-rigid registration, feature based, harmonic phase) at the task of estimating myocardial strain and left-ventricle (LV) twist, from a population of 18 clinical human cardiac-gated tagged MRI studies.

  4. Comparing the organisational structure of the preoperative assessment clinic at eight university hospitals.

    PubMed

    Edward, G M; Biervliet, J D; Hollmann, M W; Schlack, W S; Preckel, B

    2008-01-01

    The preoperative assessment clinic (PAC) has been implemented in most major hospitals. However, there is no uniformity in the way PACs are organised. We compared the organisational structure of the PACs from all eight university hospitals in The Netherlands, looking at the following variables: number of patients visiting the PAC, staffing of the PAC, opening hours, scheduling, and additional preoperative diagnostic testing. The number of patients seen yearly varies from 7.000 to 13.500. In all clinics, the preoperative assessment was performed by anaesthetists and residents. In five PACs, preoperative assessment was also performed by physician assistants or nurse practitioners. Opening hours varied. Consultations are by appointment, 'walk-in', or a combination of these two. In four clinics additional testing is performed at the PAC itself. This study shows that the organisational structure of the PAC at similar university hospitals varies greatly; this can have important implications when designing a benchmarking process.

  5. Towards symbiosis in knowledge representation and natural language processing for structuring clinical practice guidelines.

    PubMed

    Weng, Chunhua; Payne, Philip R O; Velez, Mark; Johnson, Stephen B; Bakken, Suzanne

    2014-01-01

    The successful adoption by clinicians of evidence-based clinical practice guidelines (CPGs) contained in clinical information systems requires efficient translation of free-text guidelines into computable formats. Natural language processing (NLP) has the potential to improve the efficiency of such translation. However, it is laborious to develop NLP to structure free-text CPGs using existing formal knowledge representations (KR). In response to this challenge, this vision paper discusses the value and feasibility of supporting symbiosis in text-based knowledge acquisition (KA) and KR. We compare two ontologies: (1) an ontology manually created by domain experts for CPG eligibility criteria and (2) an upper-level ontology derived from a semantic pattern-based approach for automatic KA from CPG eligibility criteria text. Then we discuss the strengths and limitations of interweaving KA and NLP for KR purposes and important considerations for achieving the symbiosis of KR and NLP for structuring CPGs to achieve evidence-based clinical practice.

  6. Clinical Application of the Mean Babbling Level and Syllable Structure Level

    ERIC Educational Resources Information Center

    Morris, Sherrill R.

    2010-01-01

    Purpose: This clinical exchange reviews two independent phonological assessment measures: mean babbling level (MBL) and syllable structure level (SSL). Both measures summarize phonetic inventory and syllable shape in a calculated average and have been used in research to describe the phonological abilities of children ages 9 to 36 months. An…

  7. Structural empowerment and professional nursing practice behaviors of baccalaureate nursing students in clinical learning environments.

    PubMed

    Livsey, Kae R

    2009-01-01

    This study examines the associations between professional behaviors of baccalaureate nursing students and student perceptions of select factors within the clinical learning environment, including the role of clinical faculty leadership. Participants (n=243) were recruited from a randomly selected list of 1000 members of the National Student Nurses Association (NSNA) among sixteen states within the Southern region of the United States. Results revealed a direct relationship exists between student perceptions of structural empowerment in their clinical learning environment and professional nursing practice behaviors among students. Also found was that relationships between variables in the model are significantly strengthened by student perceptions of strong leadership behaviors of clinical faculty. Findings from this study may assist nurse educators by contributing knowledge relevant to support/facilitate the transition of individuals from student nurses to professional registered nurses and, thus enhance the impact of professional nurses' contributions in healthcare delivery.

  8. The Structure of Three-Dimensional Object Representations in Human Vision: Evidence from Whole-Part Matching

    ERIC Educational Resources Information Center

    Leek, E. Charles; Reppa, Irene; Arguin, Martin

    2005-01-01

    This article examines how the human visual system represents the shapes of 3-dimensional (3D) objects. One long-standing hypothesis is that object shapes are represented in terms of volumetric component parts and their spatial configuration. This hypothesis is examined in 3 experiments using a whole-part matching paradigm in which participants…

  9. Reasoning about a Structured Object: Three- and Four-Year-Olds' Grasp of a "Borderline Case" and an "Unexcluded Middle."

    ERIC Educational Resources Information Center

    Sharpe, Dean; Cote, Marie-Helene; Eakin, Laurel

    1999-01-01

    Two experiments assessed preschoolers' understanding of objects possessing a property in part only and their understanding that different parts of an object may possess opposed properties. Results suggested that children as young as 3 years possess a sophisticated ability to reason about the heritability of properties from parts to wholes.…

  10. Objective and subjective measures for sleep disorders.

    PubMed

    Zhang, Lin; Zhao, Zhong-Xin

    2007-07-01

    Subjective and objective measures of sleep structure or quality could help to characterize the chronic sleep disturbances, with relation to patients' risk factor profiles and co-morbidities. Studies have shown that discrepancies can occur between subjective data regarding sleep disturbances and the impact of insomnia and objective assays, and surrogate markers of sleep and sleep disturbances. Both objective and subjective measures should be incorporated into clinic studies. It seems likely that sleep quality is represented by a combination of more than one subjective sleep parameter. Objective and subjective assessments of sleep quality may relate to different parameters. Future studies incorporated both subjective and objective measures could help to address the sleep disorders.

  11. The Vital Role of Patient Feedback in the Critical Assessment of a Patient-Centered Care Objective Structured Clinical Examination

    ERIC Educational Resources Information Center

    Rentfro, Allison Carothers

    2011-01-01

    Priorities in medical education have increasingly emphasized teaching skills and fostering attitudes related to patient-centered care (Beckman & Frankel, 2003; Haidet & Paterniti, 2003). The challenge for academic medical centers is to implement these competencies into their curriculum and assess the outcomes. Using a qualitative single…

  12. Retrospective Analysis of Clinical and Cost Outcomes Associated with Methicillin-Resistant Staphylococcus aureus Complicated Skin and Skin Structure Infections Treated with Daptomycin, Vancomycin, or Linezolid

    PubMed Central

    Wright, Bradley M.; Eiland, Edward H.

    2011-01-01

    Objective. The objective of this analysis was to compare clinical and cost outcomes associated with patients who had suspected or documented methicillin-resistant Staphylococcus aureus (MRSA) infections treated with daptomycin, vancomycin, or linezolid in complicated skin and skin structure infections (cSSSIs). Design. This was a retrospective analysis conducted from February to June of 2007. Appropriate data was collected, collated, and subsequently evaluated with the purpose of quantifying length of stay, antibiotic therapy duration, clinical cure rates, adverse drug events, and cost of hospitalization. Results. All 82 patients included in the analysis experienced clinical cure. The duration of antibiotic therapy was similar among the three groups yet the length of hospitalization was slightly shorter in the daptomycin group. Conclusions. The incidence of resistant staphylococcal infections is increasing; therefore, judicious use of MRSA active agents is paramount. Future studies are necessary to determine if MRSA treatment options can be stratified based on the severity of the infectious process. PMID:22567330

  13. A Pilot Clinical Trial to Objectively Assess the Efficacy of Electroacupuncture on Gait in Patients with Parkinson's Disease Using Body Worn Sensors

    PubMed Central

    Lei, Hong

    2016-01-01

    Background Gait disorder, a key contributor to fall and poor quality of life, represents a major therapeutic challenge in Parkinson’s disease (PD). The efficacy of acupuncture for PD remains unclear, largely due to methodological flaws and lack of studies using objective outcome measures. Objective To objectively assess the efficacy of electroacupuncture (EA) for gait disorders using body-worn sensor technology in patients with PD. Methods In this randomized pilot study, both the patients and assessors were masked. Fifteen PD patients were randomly assigned to an experimental group (n = 10) or to a control group (n = 5). Outcomes were assessed at baseline and after completion of three weekly EA treatments. Measurements included gait analysis during single-task habitual walking (STHW), dual-task habitual walking (DTHW), single-task fast walking (STFW), dual-task fast walking (DTFW). In addition, Unified Parkinson's Disease Rating Scale (UPDRS), SF-12 health survey, short Falls Efficacy Scale-International (FES-I), and visual analog scale (VAS) for pain were utilized. Results All gait parameters were improved in the experimental group in response to EA treatment. After adjustment by age and BMI, the improvement achieved statistical significant level for gait speed under STHW, STFW, and DTFW (9%-19%, p<0.05) as well as stride length during DTFW (9%, p = 0.037) and midswing speed during STFW (6%, p = 0.033). No significant changes were observed in the control group (p>0.110). The highest correlation between gait parameters and UPRDS scores at baseline was observed between gait speed during STFW and UPDRS II (r = -0.888, p = 0.004). The change in this gait parameter in response to active intervention was positively correlated with baseline UPDRS (r = 0.595, p = 0.057). Finally, comparison of responses to treatment between groups showed significant improvement, prominently in gait speed (effect size 0.32–1.16, p = 0.001). Conclusions This study provides the objective

  14. Disrupted topological organization of structural and functional brain connectomes in clinically isolated syndrome and multiple sclerosis

    PubMed Central

    Shu, Ni; Duan, Yunyun; Xia, Mingrui; Schoonheim, Menno M.; Huang, Jing; Ren, Zhuoqiong; Sun, Zheng; Ye, Jing; Dong, Huiqing; Shi, Fu-Dong; Barkhof, Frederik; Li, Kuncheng; Liu, Yaou

    2016-01-01

    The brain connectome of multiple sclerosis (MS) has been investigated by several previous studies; however, it is still unknown how the network changes in clinically isolated syndrome (CIS), the earliest stage of MS, and how network alterations on a functional level relate to the structural level in MS disease. Here, we investigated the topological alterations of both the structural and functional connectomes in 41 CIS and 32 MS patients, compared to 35 healthy controls, by combining diffusion tensor imaging and resting-state functional MRI with graph analysis approaches. We found that the structural connectome showed a deviation from the optimal pattern as early as the CIS stage, while the functional connectome only showed local changes in MS patients, not in CIS. When comparing two patient groups, the changes appear more severe in MS. Importantly, the disruptions of structural and functional connectomes in patients occurred in the same direction and locally correlated in sensorimotor component. Finally, the extent of structural network changes was correlated with several clinical variables in MS patients. Together, the results suggested early disruption of the structural brain connectome in CIS patients and provided a new perspective for investigating the relationship of the structural and functional alterations in MS. PMID:27403924

  15. SeaDataNet : Pan-European infrastructure for marine and ocean data management - Project objectives, structure and components

    NASA Astrophysics Data System (ADS)

    Maudire, G.; Maillard, C.; Fichaut, M.; Manzella, G.; Schaap, D. M. A.

    2009-04-01

    SeaDataNet : Pan-European infrastructure for marine and ocean data management Project objectives, structure and components G. Maudire (1), C. Maillard (1), G. Manzella (2), M. Fichaut (1), D.M.A. Schaap (3), E. Iona (4) and the SeaDataNet consortium. (1) IFREMER, Brest, France (Gilbert.Maudire@ifremer.fr), (2) ENEA, La Spezia, Italy, (3) Mariene Informatie Service 'MARIS', Voorburg, The Netherlands, (4) Hellenic Centre for Marine Research-HCMR, Anavyssos, Greece. Since a large part of the earth population lives near the oceans or carries on activities directly or indirectly linked to the seas (fishery and aquaculture, exploitation of sea bottom resources, international shipping, tourism), knowledge of oceans is of primary importance for security and economy. However, observation and monitoring of the oceans remains difficult and expensive even if real improvements have been achieved using research vessels and submersibles, satellites and automatic observatories like buoys, floats and seafloor observatories transmitting directly to the shore using global transmission systems. More than 600 governmental or private organizations are active in observation of seas bordering Europe, but European oceanographic data are fragmented, not always validated and not always easily accessible. That highlights the need of international collaboration to tend toward a comprehensive view of ocean mechanisms, resources and changes. SeaDataNet is an Integrated research Infrastructure Initiative (I3) in European Union Framework Program 6 (2006 - 2011) to provide the data management system adapted both to the fragmented observation systems and to the users need for an integrated access to data, meta-data, products and services. Its major objectives are to: - encourage long-term archiving at national level to secure ocean data taking into account that all the observations made in the variable oceanic environment can never be remade if they are lost; - promote best practices for data

  16. The Structure of Clinical Consultation: A Case of Non-Native Speakers of English as Participants

    PubMed Central

    Bagheri, H.; Ibrahim, N. A.; Habil, H.

    2015-01-01

    Background: In many parts of the world, patients may find it difficult to visit doctors who share the same language and culture due to the intermingling of people and international recruitment of doctors among many other reasons. In these multilingual multicultural settings (MMSs), doctor-patient interactions face new communication challenges. This study aims to identify the structure of clinical consultation and its phases in an MMS where both doctors and patients are non-native speakers (NNSs) of English. Method: This study takes on a discourse analytic approach to examine the structure of clinical consultation as an activity type. 25 clinical consultation sessions between non-native speakers of English in a public healthcare centre in Malaysia were audio-recorded. Findings and Discussion: The results show that there are some deviations from the mainstream structure of clinical consultations although, in general, the pattern is compatible with previous studies. Deviations are particularly marked in the opening and closing phases of consultation. Conclusion: In almost all interactions, there is a straightforward manner of beginning medical consultations. The absence of greetings may have naturally reduced the length of talk. Hence, by directly entering medical talks, the doctors voice their concern on the curing aspects of the consultation rather than its caring facets. The preference of curing priority to caring is more goal-oriented and in alignment with the consultation as an activity type. PMID:25560336

  17. Contemporary phase III clinical trial endpoints in advanced ovarian cancer: assessing the pros and cons of objective response rate, progression-free survival, and overall survival.

    PubMed

    Tate Thigpen, J

    2015-01-01

    Among gynecologic cancers, ovarian cancer provides the greatest challenge because 75% to 80% of patients present with stage III/IV disease. Over the last 40 years, a series of large trials conducted by the Gynecologic Oncology Group and other cooperative groups has produced striking improvements in patient outcome; but the majority still dies of their disease. Further research in both the laboratory and the clinic is essential to continued improvement in patient management. Clinical trials, however, have become a major challenge because of issues with trial endpoints. Historically, overall survival (OS) has been regarded as the "gold standard" of endpoints. Lack of effective treatment for patients who progressed on or recurred after front-line therapy allowed trials to avoid obfuscation of OS by post-progression therapy. More recently, studies have identified over 20 agents active against ovarian cancer. Reasonable evidence shows that effective post-progression therapy with multiple lines of active agents can render the survival endpoint uninterpretable. Two other endpoints avoid this problem. The objective response rate, assessed by the Response Evaluation Criteria in Solid Tumors (RECIST), is an accepted endpoint for accelerated approval in ovarian cancer. More importantly, progression-free survival (PFS), measured from study entry to progression of disease, avoids post-progression therapy completely. Without effective post-progression therapy (prior to 1990), data show that PFS is a surrogate for OS. Recent experience with 4 large trials of bevacizumab shows that PFS can be accurately assessed if progression is clearly defined and if timing of assessments is consistent in all study arms. Acceptance of PFS as the optimal endpoint for ovarian cancer trials by investigators and regulatory agencies is crucial to further advances in management because effective post-progression therapy has rendered differences in OS virtually impossible to assess reliably.

  18. Instructor and Dental Student Perceptions of Clinical Communication Skills via Structured Assessments.

    PubMed

    McKenzie, Carly T

    2016-05-01

    The aim of this study was to use structured assessments to assess dental students' clinical communication skills exhibited during patient appointments. Fourth-year dental students (n=55) at the University of Alabama at Birmingham evaluated their own interpersonal skills in a clinical setting utilizing the Four Habits Coding Scheme. An instructor also assessed student-patient clinical communication. These assessments were used to identify perceived strengths and weaknesses in students' clinical communication. Both instructor assessments and student self-assessments pinpointed the following clinical communication skills as effective the most often: patient greeting, avoidance of jargon, and non-verbal behavior. There was also relative agreement between instructor assessments and student self-assessments regarding clinical communication skills that were rated as not effective most frequently: ensuring patient comprehension, identification of patient feelings, and exploration of barriers to treatment. These resulted pointed to strengths and weaknesses in the portion of the curriculum designed to prepare students for effective provider-patient communication. These results may suggest a need for the school's current behavioral science curriculum to better address discussion of potential treatment barriers and patient feelings as well as techniques to ensure patient comprehension.

  19. 3D OCT imaging in clinical settings: toward quantitative measurements of retinal structures

    NASA Astrophysics Data System (ADS)

    Zawadzki, Robert J.; Fuller, Alfred R.; Zhao, Mingtao; Wiley, David F.; Choi, Stacey S.; Bower, Bradley A.; Hamann, Bernd; Izatt, Joseph A.; Werner, John S.

    2006-02-01

    The acquisition speed of current FD-OCT (Fourier Domain - Optical Coherence Tomography) instruments allows rapid screening of three-dimensional (3D) volumes of human retinas in clinical settings. To take advantage of this ability requires software used by physicians to be capable of displaying and accessing volumetric data as well as supporting post processing in order to access important quantitative information such as thickness maps and segmented volumes. We describe our clinical FD-OCT system used to acquire 3D data from the human retina over the macula and optic nerve head. B-scans are registered to remove motion artifacts and post-processed with customized 3D visualization and analysis software. Our analysis software includes standard 3D visualization techniques along with a machine learning support vector machine (SVM) algorithm that allows a user to semi-automatically segment different retinal structures and layers. Our program makes possible measurements of the retinal layer thickness as well as volumes of structures of interest, despite the presence of noise and structural deformations associated with retinal pathology. Our software has been tested successfully in clinical settings for its efficacy in assessing 3D retinal structures in healthy as well as diseased cases. Our tool facilitates diagnosis and treatment monitoring of retinal diseases.

  20. Recognizing clinical entities in hospital discharge summaries using Structural Support Vector Machines with word representation features

    PubMed Central

    2013-01-01

    Background Named entity recognition (NER) is an important task in clinical natural language processing (NLP) research. Machine learning (ML) based NER methods have shown good performance in recognizing entities in clinical text. Algorithms and features are two important factors that largely affect the performance of ML-based NER systems. Conditional Random Fields (CRFs), a sequential labelling algorithm, and Support Vector Machines (SVMs), which is based on large margin theory, are two typical machine learning algorithms that have been widely applied to clinical NER tasks. For features, syntactic and semantic information of context words has often been used in clinical NER systems. However, Structural Support Vector Machines (SSVMs), an algorithm that combines the advantages of both CRFs and SVMs, and word representation features, which contain word-level back-off information over large unlabelled corpus by unsupervised algorithms, have not been extensively investigated for clinical text processing. Therefore, the primary goal of this study is to evaluate the use of SSVMs and word representation features in clinical NER tasks. Methods In this study, we developed SSVMs-based NER systems to recognize clinical entities in hospital discharge summaries, using the data set from the concept extration task in the 2010 i2b2 NLP challenge. We compared the performance of CRFs and SSVMs-based NER classifiers with the same feature sets. Furthermore, we extracted two different types of word representation features (clustering-based representation features and distributional representation features) and integrated them with the SSVMs-based clinical NER system. We then reported the performance of SSVM-based NER systems with different types of word representation features. Results and discussion Using the same training (N = 27,837) and test (N = 45,009) sets in the challenge, our evaluation showed that the SSVMs-based NER systems achieved better performance than the CRFs

  1. Crossed unilateral lesions of temporal lobe structures and cholinergic cell bodies impair visual conditional and object discrimination learning in monkeys.

    PubMed

    Barefoot, H C; Baker, H F; Ridley, R M

    2002-02-01

    Monkeys with excitotoxic lesions of the CA1/subiculum region in the right hemisphere and with immunotoxic lesions of the cholinergic cells of the diagonal band in the left hemisphere were impaired on a visual conditional task. In this task, correct choice of one of two objects depends on which of two background fields both objects are presented against, irrespective of the spatial positions of the objects. They were not impaired on simple object or shape discrimination tasks. The pattern of impairments is the same as that seen after bilateral excitotoxic lesions of CA1/subiculum, implying that the diagonal band lesion disables the ipsilateral CA1/subiculum. It also argues that CA1/subiculum, sustained by its cholinergic input, is necessary for some forms of nonspatial conditional learning. Addition of an inferotemporal (IT) cortical ablation to the left hemisphere did not affect simple visual discrimination learning, although all the monkeys then failed to learn a new visual conditional task. This demonstrates that intact IT cortex in only one hemisphere is sufficient to sustain simple visual discrimination learning but implies that the cholinergic input and the inferotemporal cortical input to the hippocampus both contribute to visual conditional learning. The subsequent addition of an immunotoxic lesion of the basal nucleus of Meynert in the right hemisphere resulted in an additional impairment on a difficult shape discrimination. This argues that it is the cholinergic projection to the inferotemporal cortex, rather than to the rest of the cortex, which contributes to visual discrimination learning and memory.

  2. Clitics and Object Expression in the L3 Acquisition of Brazilian Portuguese: Structural Similarity Matters for Transfer

    ERIC Educational Resources Information Center

    Montrul, Silvina; Dias, Rejanes; Santos, Helade

    2011-01-01

    This article addresses the role of previously acquired languages in the acquisition of a third language (L3) in two experimental studies on object expression in Brazilian Portuguese (BP). Participants were English-speaking learners of BP as L3 with knowledge of Spanish as a second language (L2) and Spanish-speaking learners of BP with knowledge of…

  3. New complete structure of Hafnia alvei clinical isolate strain PCM 2670 semi-rough lipopolysaccharide.

    PubMed

    Bobko, Ewelina; Tyras, Michal; Jachymek, Wojciech

    2013-06-01

    Hafnia alvei strain PCM 2670 is a clinical isolate from a patient with chronic reproductive tract infection. The novel structure of the semi-rough lipopolysaccharide was established with the use of NMR spectroscopy and mass spectrometry as well as immunochemical techniques. According to the mass spectrometry data, heptose in the oligosaccharide is partially substituted by glycine. H. alvei PCM 2670 core structure encompasses the common core of H. alvei which is modified with two additional galactose units. [structure: see text]. The 6-substituted galactose is the O-antigen repeating unit substitution residue. The repeating unit consists of five monosaccharide residues and has the following structure: →2)-β-Galp-(1→6)-α-Glcp-(1→6)-αGlcpNAc3OAc-(1→4)-α-GalpA-(1→3)-β-GlcpNAc6OAc-(1→6)-core. PMID:23643833

  4. Connecting Personality Structure and Dynamics: Towards a More Evidence-Based and Clinically Useful Diagnostic Scheme.

    PubMed

    Hopwood, Christopher J; Zimmermann, Johannes; Pincus, Aaron L; Krueger, Robert F

    2015-08-01

    The purpose of this special issue of the Journal of Personality Disorders is to promote the integration of personality structure and dynamics towards more evidence-based and clinically useful conceptualizations of personality pathology. In this article, we describe a contemporary model of personality structure that is useful for distinguishing patients from one another and the connections between this structure and within-person dynamics that occur across different levels of an individual personality, across situations, and within situations. In so doing, we connect the personality trait tradition that has tended to emphasize stable individual differences with traditions that have tended to focus on the more dynamic aspects of interpersonal behavior and emotional experience. We then introduce the empirical articles in this special issue within this integrative context, in order to demonstrate the value in connecting personality structure to dynamics for research and practice.

  5. Reinforcement of thin-walled root canal structures for placement of esthetic dowels: a clinical report.

    PubMed

    Ayad, Mohamed F; Bahannan, Salma A; Rosenstiel, Stephen F

    2011-01-01

    Thin-walled root canals always present a challenge to dentists to select a restorative treatment that does not further weaken the thin tooth structure. The prognosis of dowel and core restorations can be unpredictable. This clinical report describes the treatment of a patient with extensive caries extending into the root canal of an endodontically treated maxillary central incisor. The use of a flowable composite resin in combination with a quartz fiber reinforced post is described, resulting in the rehabilitation of a structurally compromised root canal with satisfactory esthetic and functional outcomes.

  6. Love Objects.

    ERIC Educational Resources Information Center

    Cusack, Lynne

    1998-01-01

    Discusses the role of "security" or "transition" objects, such as a blanket or stuffed toy, in children's development of self-comfort and autonomy. Notes the influence of parents in the child-object relationship, and discusses children's responses to losing a security object, and the developmental point at which a child will give up such an…

  7. Object crowding.

    PubMed

    Wallace, Julian M; Tjan, Bosco S

    2011-05-25

    Crowding occurs when stimuli in the peripheral fields become harder to identify when flanked by other items. This phenomenon has been demonstrated extensively with simple patterns (e.g., Gabors and letters). Here, we characterize crowding for everyday objects. We presented three-item arrays of objects and letters, arranged radially and tangentially in the lower visual field. Observers identified the central target, and we measured contrast energy thresholds as a function of target-to-flanker spacing. Object crowding was similar to letter crowding in spatial extent but was much weaker. The average elevation in threshold contrast energy was in the order of 1 log unit for objects as compared to 2 log units for letters and silhouette objects. Furthermore, we examined whether the exterior and interior features of an object are differentially affected by crowding. We used a circular aperture to present or exclude the object interior. Critical spacings for these aperture and "donut" objects were similar to those of intact objects. Taken together, these findings suggest that crowding between letters and objects are essentially due to the same mechanism, which affects equally the interior and exterior features of an object. However, for objects defined with varying shades of gray, it is much easier to overcome crowding by increasing contrast.

  8. Citizenship Objectives.

    ERIC Educational Resources Information Center

    Committee on Assessing the Progress of Education, Ann Arbor, MI.

    The general procedures used to develop educational objectives for the National Assessment of Educational Progress are outlined, as are the procedures used to develop citizenship objectives. Ten general objectives are stated: "show concern for the welfare and dignity of others"; "support rights and freedoms of all individuals"; "help maintain law…

  9. Effects of structured written feedback by cards on medical students’ performance at Mini Clinical Evaluation Exercise (Mini-CEX) in an outpatient clinic

    PubMed Central

    HAGHANI, FARIBA; HATEF KHORAMI, MOHAMMAD; FAKHARI, MOHAMMAD

    2016-01-01

    Introduction Feedback cards are recommended as a feasible tool for structured written feedback delivery in clinical education while effectiveness of this tool on the medical students’ performance is still questionable.  The purpose of this study was to compare the effects of structured written feedback by cards as well as verbal feedback versus verbal feedback alone on the clinical performance of medical students at the Mini Clinical Evaluation Exercise (Mini-CEX) test in an outpatient clinic. Methods This is a quasi-experimental study with pre- and post-test comprising four groups in two terms of medical students’ externship. The students’ performance was assessed through the Mini-Clinical Evaluation Exercise (Mini-CEX) as a clinical performance evaluation tool. Structured written feedbacks were given to two experimental groups by designed feedback cards as well as verbal feedback, while in the two control groups feedback was delivered verbally as a routine approach in clinical education. Results By consecutive sampling method, 62 externship students were enrolled in this study and seven students were excluded from the final analysis due to their absence for three days. According to the ANOVA analysis and Post Hoc Tukey test,  no statistically significant difference was observed among the four groups at the pre-test, whereas a statistically significant difference was observed between the experimental and control groups at the post-test  (F = 4.023, p =0.012). The effect size of the structured written feedbacks on clinical performance was 0.19. Conclusion Structured written feedback by cards could improve the performance of medical students in a statistical sense. Further studies must be conducted in other clinical courses with longer durations. PMID:27382581

  10. Outcomes of Health System Structures, Highly Pertinent Clinical Information, Idea Stimulators, Clinical Reviews, and Prediction Tools: JABFM Exemplified.

    PubMed

    Bowman, Marjorie A; Neale, Anne Victoria; Seehusen, Dean A

    2016-01-01

    This issue exemplifies the types of articles that JABFM publishes to advance family medicine. We have articles on the implications of health system organizational structures. Three of these are international articles at the level of the national health system (1 from China) and systematic local health interventions (1 from Canada and 1 from Netherlands). Inside the United States, where there are more family physicians, there is less obesity, and designation as a Patient Centered Medical Home is related to increased rates of colorectal cancer screening. Review articles on common clinical topics discuss treatments that are changing (acne in pregnancy) or lack consensus (distal radial fractures). We have articles on making life easier in the office, such as for predicting Vitamin D levels, osteoporosis, and pre-diabetes in normal weight adults. There are articles to raise awareness of the "newest" testing or treatments, that is, auditory brainstem implants. "Reminder" articles highlight known entities that need to be reinforced to prevent over-/underdiagnosis or treatment, for example, "cotton fever." Another article discusses the increased risk for postoperative complications with sleep apnea. We also provide "thought" pieces, in this case about the terminology we are using to extend our concept of patient-centered medical homes.

  11. Outcomes of Health System Structures, Highly Pertinent Clinical Information, Idea Stimulators, Clinical Reviews, and Prediction Tools: JABFM Exemplified.

    PubMed

    Bowman, Marjorie A; Neale, Anne Victoria; Seehusen, Dean A

    2016-01-01

    This issue exemplifies the types of articles that JABFM publishes to advance family medicine. We have articles on the implications of health system organizational structures. Three of these are international articles at the level of the national health system (1 from China) and systematic local health interventions (1 from Canada and 1 from Netherlands). Inside the United States, where there are more family physicians, there is less obesity, and designation as a Patient Centered Medical Home is related to increased rates of colorectal cancer screening. Review articles on common clinical topics discuss treatments that are changing (acne in pregnancy) or lack consensus (distal radial fractures). We have articles on making life easier in the office, such as for predicting Vitamin D levels, osteoporosis, and pre-diabetes in normal weight adults. There are articles to raise awareness of the "newest" testing or treatments, that is, auditory brainstem implants. "Reminder" articles highlight known entities that need to be reinforced to prevent over-/underdiagnosis or treatment, for example, "cotton fever." Another article discusses the increased risk for postoperative complications with sleep apnea. We also provide "thought" pieces, in this case about the terminology we are using to extend our concept of patient-centered medical homes. PMID:26957371

  12. Calcareous concretions and psammoma bodies in sputum smears: do these similar structures have different clinical significance?

    PubMed

    Martínez-Girón, Rafael; Martínez-Torre, Santiago; Tamargo-Peláez, María Luisa; López-Cabanilles, María Dolores; Torre-Bayón, Concepción

    2014-09-01

    Different noncellular elements, such as round concentric calcified laminated structures, may be found in sputum smears. If these structures appear isolated on the background of the smear, the term usually used to describe them is "calcareous concretions" (CC). On the contrary, when the structures are part of epithelial cell groups or small tissue fragments, the term used to describe them is "Psammoma bodies" (PB). The aim of this work is to establish the relationship between these structures and pulmonary disease, especially lung carcinoma, by searching for the presence of CC and/or PB in sputum smears. Our study has taken as a basis 16.716 sputum smears from 696 patients obtained during a 7-year period (2003-2009). After reviewing them, it was found that from the total, 66 cases (0.39%) contained round calcified structures, 57 of them (0.34%) corresponding to CC, and the remaining 9 ones (0.05%) corresponding to PB. From these 57 CC cases, 56 corresponded to benign entities, and only one was found with lung carcinoma. On the other hand, from the 9 PB cases all of them (100%) were related to lung adenocarcinoma. We conclude that, even having a similar morphological structure, these aforementioned calcified structures we have observed in sputum smears have different and relevant clinical significance.

  13. A Multi-Objective Approach for Protein Structure Prediction Based on an Energy Model and Backbone Angle Preferences.

    PubMed

    Tsay, Jyh-Jong; Su, Shih-Chieh; Yu, Chin-Sheng

    2015-07-03

    Protein structure prediction (PSP) is concerned with the prediction of protein tertiary structure from primary structure and is a challenging calculation problem. After decades of research effort, numerous solutions have been proposed for optimisation methods based on energy models. However, further investigation and improvement is still needed to increase the accuracy and similarity of structures. This study presents a novel backbone angle preference factor, which is one of the factors inducing protein folding. The proposed multiobjective optimisation approach simultaneously considers energy models and backbone angle preferences to solve the ab initio PSP. To prove the effectiveness of the multiobjective optimisation approach based on the energy models and backbone angle preferences, 75 amino acid sequences with lengths ranging from 22 to 88 amino acids were selected from the CB513 data set to be the benchmarks. The data sets were highly dissimilar, therefore indicating that they are meaningful. The experimental results showed that the root-mean-square deviation (RMSD) of the multiobjective optimization approach based on energy model and backbone angle preferences was superior to those of typical energy models, indicating that the proposed approach can facilitate the ab initio PSP.

  14. A Multi-Objective Approach for Protein Structure Prediction Based on an Energy Model and Backbone Angle Preferences

    PubMed Central

    Tsay, Jyh-Jong; Su, Shih-Chieh; Yu, Chin-Sheng

    2015-01-01

    Protein structure prediction (PSP) is concerned with the prediction of protein tertiary structure from primary structure and is a challenging calculation problem. After decades of research effort, numerous solutions have been proposed for optimisation methods based on energy models. However, further investigation and improvement is still needed to increase the accuracy and similarity of structures. This study presents a novel backbone angle preference factor, which is one of the factors inducing protein folding. The proposed multiobjective optimisation approach simultaneously considers energy models and backbone angle preferences to solve the ab initio PSP. To prove the effectiveness of the multiobjective optimisation approach based on the energy models and backbone angle preferences, 75 amino acid sequences with lengths ranging from 22 to 88 amino acids were selected from the CB513 data set to be the benchmarks. The data sets were highly dissimilar, therefore indicating that they are meaningful. The experimental results showed that the root-mean-square deviation (RMSD) of the multiobjective optimization approach based on energy model and backbone angle preferences was superior to those of typical energy models, indicating that the proposed approach can facilitate the ab initio PSP. PMID:26151847

  15. An algorithm to unveil the inner structure of objects concealed by beam divergence in radiographic image acquisition systems

    SciTech Connect

    Almeida, G. L.; Silvani, M. I.; Lopes, R. T.

    2014-11-11

    Two main parameters rule the performance of an Image Acquisition System, namely, spatial resolution and contrast. For radiographic systems using cone beam arrangements, the farther the source, the better the resolution, but the contrast would diminish due to the lower statistics. A closer source would yield a higher contrast but it would no longer reproduce the attenuation map of the object, as the incoming beam flux would be reduced by unequal large divergences and attenuation factors. This work proposes a procedure to correct these effects when the object is comprised of a hull - or encased in it - possessing a shape capable to be described in analytical geometry terms. Such a description allows the construction of a matrix containing the attenuation factors undergone by the beam from the source until its final destination at each coordinate on the 2D detector. Each matrix element incorporates the attenuation suffered by the beam after its travel through the hull wall, as well as its reduction due to the square of distance to the source and the angle it hits the detector surface. When the pixel intensities of the original image are corrected by these factors, the image contrast, reduced by the overall attenuation in the exposure phase, are recovered, allowing one to see details otherwise concealed due to the low contrast. In order to verify the soundness of this approach, synthetic images of objects of different shapes, such as plates and tubes, incorporating defects and statistical fluctuation, have been generated, recorded for further comparison and afterwards processed to improve their contrast. The developed algorithm which, generates processes and plots the images has been written in Fortran 90 language. As the resulting final images exhibit the expected improvements, it therefore seemed worthwhile to carry out further tests with actual experimental radiographies.

  16. An algorithm to unveil the inner structure of objects concealed by beam divergence in radiographic image acquisition systems

    NASA Astrophysics Data System (ADS)

    Almeida, G. L.; Silvani, M. I.; Lopes, R. T.

    2014-11-01

    Two main parameters rule the performance of an Image Acquisition System, namely, spatial resolution and contrast. For radiographic systems using cone beam arrangements, the farther the source, the better the resolution, but the contrast would diminish due to the lower statistics. A closer source would yield a higher contrast but it would no longer reproduce the attenuation map of the object, as the incoming beam flux would be reduced by unequal large divergences and attenuation factors. This work proposes a procedure to correct these effects when the object is comprised of a hull - or encased in it - possessing a shape capable to be described in analytical geometry terms. Such a description allows the construction of a matrix containing the attenuation factors undergone by the beam from the source until its final destination at each coordinate on the 2D detector. Each matrix element incorporates the attenuation suffered by the beam after its travel through the hull wall, as well as its reduction due to the square of distance to the source and the angle it hits the detector surface. When the pixel intensities of the original image are corrected by these factors, the image contrast, reduced by the overall attenuation in the exposure phase, are recovered, allowing one to see details otherwise concealed due to the low contrast. In order to verify the soundness of this approach, synthetic images of objects of different shapes, such as plates and tubes, incorporating defects and statistical fluctuation, have been generated, recorded for further comparison and afterwards processed to improve their contrast. The developed algorithm which, generates processes and plots the images has been written in Fortran 90 language. As the resulting final images exhibit the expected improvements, it therefore seemed worthwhile to carry out further tests with actual experimental radiographies.

  17. Comparison of lipopolysaccharide structures of Bordetella pertussis clinical isolates from pre- and post-vaccine era.

    PubMed

    Albitar-Nehme, Sami; Basheer, Soorej M; Njamkepo, Elisabeth; Brisson, Jean-Robert; Guiso, Nicole; Caroff, Martine

    2013-08-30

    Endotoxins are lipopolysaccharides (LPS), and major constituents of the outer membrane of Gram-negative bacteria. Bordetella pertussis LPS were the only major antigens, of this agent of whooping-cough, that were not yet analyzed on isolates from the pre- and post-vaccination era. We compared here the LPS structures of four clinical isolates with that of the vaccine strain BP 1414. All physico-chemical analyses, including SDS-PAGE, TLC, and different MALDI mass spectrometry approaches were convergent. They helped demonstrating that, on the contrary to some other B. pertussis major antigens, no modification occurred in the dodecasaccharide core structure, as well as in the whole LPS molecules. These results are rendering these major antigens good potential vaccine components. Molecular modeling of this conserved LPS structure also confirmed the conclusions of previous experiments leading to the production of anti-LPS monoclonal antibodies and defining the main epitopes of these major antigens.

  18. Multi-objective genetic algorithms based structural optimization and experimental investigation of the planet carrier in wind turbine gearbox

    NASA Astrophysics Data System (ADS)

    Yi, Pengxing; Dong, Lijian; Shi, Tielin

    2014-12-01

    To improve the dynamic performance and reduce the weight of the planet carrier in wind turbine gearbox, a multi-objective optimization method, which is driven by the maximum deformation, the maximum stress and the minimum mass of the studied part, is proposed by combining the response surface method and genetic algorithms in this paper. Firstly, the design points' distribution for the design variables of the planet carrier is established with the central composite design (CCD) method. Then, based on the computing results of finite element analysis (FEA), the response surface analysis is conducted to find out the proper sets of design variable values. And a multi-objective genetic algorithm (MOGA) is applied to determine the direction of optimization. As well, this method is applied to design and optimize the planet carrier in a 1.5MW wind turbine gearbox, the results of which are validated by an experimental modal test. Compared with the original design, the mass and the stress of the optimized planet carrier are respectively reduced by 9.3% and 40%. Consequently, the cost of planet carrier is greatly reduced and its stability is also improved.

  19. The Impact of Structured Inter-professional Education on Health Care Professional Students' Perceptions of Collaboration in a Clinical Setting

    PubMed Central

    Lee, Sam; Lombardo, Samantha; Salama, Mariam; Ellis, Sandi; Kay, Theresa; Davies, Robyn; Landry, Michel D.

    2012-01-01

    ABSTRACT Purpose: To examine how a structured inter-professional education (IPE) clinical placement influences health care professional (HCP) students' perceptions of inter-professional collaboration (IPC) relative to that of students in a traditional clinical placement. Methods: This study used a mixed-methods design. The Interdisciplinary Education Perception Scale (IEPS) was administered to HCP students (n=36) in two Toronto hospitals before and after a structured 5-week IPE clinical placement to examine changes in their perceptions of IPC. Students in a traditional clinical placement (n=28) were used as a control group. Focus groups were then conducted with seven students who took part in the structured IPE clinical placement. A coding framework was devised a priori, and the qualitative results were used to explain the quantitative findings. Results: There were no statistically significant differences between groups after the structured IPE clinical placement, but the intervention group showed a greater positive trend in total IEPS scores from baseline to follow-up. Qualitative data suggest that students valued the knowledge and skills gained through the structured IPE clinical placement. Conclusions: Findings suggest that structured IPE clinical placements may provide students with valuable collaborative learning opportunities, enhanced respect for other professionals, and insight into the value of IPC in healthcare delivery. More research is needed to explore other factors that influence specific perceptions among physical therapy students. PMID:23450044

  20. Structural Neuroimaging of the Medial Temporal Lobe in Alzheimer's Disease Clinical Trials.

    PubMed

    Menéndez-González, Manuel; de Celis Alonso, Benito; Salas-Pacheco, José; Arias-Carrión, Oscar

    2015-01-01

    Atrophy in the medial temporal lobe (MTA) is being used as a criterion to support a diagnosis of Alzheimer's disease (AD). There are several structural neuroimaging approaches for quantifying MTA, including semiquantitative visual rating scales, volumetry (3D), planimetry (2D), and linear measures (1D). Current applications of structural neuroimaging in Alzheimer's disease clinical trials (ADCTs) incorporate it as a tool for improving the selection of subjects for enrollment or for stratification, for tracking disease progression, or providing evidence of target engagement for new therapeutic agents. It may also be used as a surrogate marker, providing evidence of disease-modifying effects. However, despite the widespread use of volumetric magnetic resonance imaging (MRI) in ADCTs, there are some important challenges and limitations, such as difficulties in the interpretation of results, limitations in translating results into clinical practice, and reproducibility issues, among others. Solutions to these issues may arise from other methodologies that are able to link the results of volumetric MRI from trials with conventional MRIs performed in routine clinical practice (linear or planimetric methods). Also of potential benefit are automated volumetry, using indices for comparing the relative rate of atrophy of different regions instead of absolute rates of atrophy, and combining structural neuroimaging with other biomarkers. In this review, authors present the existing structural neuroimaging approaches for MTA quantification. They then discuss solutions to the limitations of the different techniques as well as the current challenges of the field. Finally, they discuss how the current advances in AD neuroimaging can help AD diagnosis. PMID:26402089

  1. Structural brain MRI studies in eye diseases: are they clinically relevant? A review of current findings.

    PubMed

    Prins, Doety; Hanekamp, Sandra; Cornelissen, Frans W

    2016-03-01

    Many eye diseases reduce visual acuity or are associated with visual field defects. Because of the well-defined retinotopic organization of the connections of the visual pathways, this may affect specific parts of the visual pathways and cortex, as a result of either deprivation or transsynaptic degeneration. For this reason, over the past several years, numerous structural magnetic resonance imaging (MRI) studies have examined the association of eye diseases with pathway and brain changes. Here, we review structural MRI studies performed in human patients with the eye diseases albinism, amblyopia, hereditary retinal dystrophies, age-related macular degeneration (AMD) and glaucoma. We focus on two main questions. First, what have these studies revealed? Second, what is the potential clinical relevance of their findings? We find that all the aforementioned eye diseases are indeed associated with structural changes in the visual pathways and brain. As such changes have been described in very different eye diseases, in our view the most parsimonious explanation is that these are caused by the loss of visual input and the subsequent deprivation of the visual pathways and brain regions, rather than by transsynaptic degeneration. Moreover, and of clinical relevance, for some of the diseases - in particular glaucoma and AMD - present results are compatible with the view that the eye disease is part of a more general neurological or neurodegenerative disorder that also affects the brain. Finally, establishing structural changes of the visual pathways has been relevant in the context of new therapeutic strategies to restore retinal function: it implies that restoring retinal function may not suffice to also effectively restore vision. Future structural MRI studies can contribute to (i) further establish relationships between ocular and neurological neurodegenerative disorders, (ii) investigate whether brain degeneration in eye diseases is reversible, (iii) evaluate the use

  2. Validity and reliability of the Structured Clinical Interview for Depersonalization–Derealization Spectrum (SCI-DER)

    PubMed Central

    Mula, Marco; Pini, Stefano; Calugi, Simona; Preve, Matteo; Masini, Matteo; Giovannini, Ilaria; Conversano, Ciro; Rucci, Paola; Cassano, Giovanni B

    2008-01-01

    This study evaluates the validity and reliability of a new instrument developed to assess symptoms of depersonalization: the Structured Clinical Interview for the Depersonalization-Derealization Spectrum (SCI-DER). The instrument is based on a spectrum model that emphasizes soft-signs, sub-threshold syndromes as well as clinical and subsyndromal manifestations. Items of the interview include, in addition to DSM-IV criteria for depersonalization, a number of features derived from clinical experience and from a review of phenomenological descriptions. Study participants included 258 consecutive patients with mood and anxiety disorders, 16.7% bipolar I disorder, 18.6% bipolar II disorder, 32.9% major depression, 22.1% panic disorder, 4.7% obsessive compulsive disorder, and 1.5% generalized anxiety disorder; 2.7% patients were also diagnosed with depersonalization disorder. A comparison group of 42 unselected controls was enrolled at the same site. The SCI-DER showed excellent reliability and good concurrent validity with the Dissociative Experiences Scale. It significantly discriminated subjects with any diagnosis of mood and anxiety disorders from controls and subjects with depersonalization disorder from controls. The hypothesized structure of the instrument was confirmed empirically. PMID:19183789

  3. Topological defects and electro-convective flows in anisotropic fluids: A microfluidic platform for nano-objects tunable structuring

    NASA Astrophysics Data System (ADS)

    Provenzano, C.; Mazzulla, A.; Chiaravalloti, F.; Audia, B.; Cipparrone, G.

    2016-08-01

    Anisotropic fluids are a class of soft materials that offer wide possibilities for engineering a small scale laboratory; their physical properties can be manipulated on short length scale by appropriate confining conditions and external stimuli leading the systems across fascinating phenomena. In this work, two of these phenomena are combined to create a microfluidic platform for reconfigurable nanoparticles (NPs) patterning: the formation of topological defects and the electrically controlled convective flows. Here, the nanoscopic environments created by defects within liquid crystals have been used as linear nano-reservoirs of NPs. Afterwards, virtual channel flows that connect the linear reservoirs have been created by exploiting electro-convective rolls. The reported results reveal a strategy for managing nanometric objects based on anisotropic fluids and connected phenomena, proposing an unconventional microfluidic device characterized by switchable and contactless micro-channels.

  4. Interactions between a fractal tree-like object and hydrodynamic turbulence: flow structure and characteristic mixing length

    NASA Astrophysics Data System (ADS)

    Meneveau, C. V.; Bai, K.; Katz, J.

    2011-12-01

    The vegetation canopy has a significant impact on various physical and biological processes such as forest microclimate, rainfall evaporation distribution and climate change. Most scaled laboratory experimental studies have used canopy element models that consist of rigid vertical strips or cylindrical rods that can be typically represented through only one or a few characteristic length scales, for example the diameter and height for cylindrical rods. However, most natural canopies and vegetation are highly multi-scale with branches and sub-branches, covering a wide range of length scales. Fractals provide a convenient idealization of multi-scale objects, since their multi-scale properties can be described in simple ways (Mandelbrot 1982). While fractal aspects of turbulence have been studied in several works in the past decades, research on turbulence generated by fractal objects started more recently. We present an experimental study of boundary layer flow over fractal tree-like objects. Detailed Particle-Image-Velocimetry (PIV) measurements are carried out in the near-wake of a fractal-like tree. The tree is a pre-fractal with five generations, with three branches and a scale reduction factor 1/2 at each generation. Its similarity fractal dimension (Mandelbrot 1982) is D ~ 1.58. Detailed mean velocity and turbulence stress profiles are documented, as well as their downstream development. We then turn attention to the turbulence mixing properties of the flow, specifically to the question whether a mixing length-scale can be identified in this flow, and if so, how it relates to the geometric length-scales in the pre-fractal object. Scatter plots of mean velocity gradient (shear) and Reynolds shear stress exhibit good linear relation at all locations in the flow. Therefore, in the transverse direction of the wake evolution, the Boussinesq eddy viscosity concept is appropriate to describe the mixing. We find that the measured mixing length increases with increasing

  5. OGOLEM: Global cluster structure optimisation for arbitrary mixtures of flexible molecules. A multiscaling, object-oriented approach

    NASA Astrophysics Data System (ADS)

    Dieterich, Johannes M.; Hartke, Bernd

    2010-02-01

    In practical applications, global cluster structure optimisation has so far been limited largely to homogeneous clusters of atoms or small molecules, with little or no choice in the calculation of inter-particle forces. We eliminate these limitations by presenting a new program suite OGOLEM that is universal by design, both in cluster composition (including arbitrarily heterogeneous clusters of complicated molecules) and in its interfaces to force calculation backends. This is demonstrated by exemplary applications in two novel fields: strongly heterogeneous Lennard-Jones clusters (ternary, quaternary, quinary) and mixed clusters of the aminoglycoside Kanamycin A with sodium cations.

  6. Structural and biomechanical aspects of equine sacroiliac joint function and their relationship to clinical disease.

    PubMed

    Goff, L M; Jeffcott, L B; Jasiewicz, J; McGowan, C M

    2008-06-01

    Pain originating from the sacroiliac joint (SIJ) in horses has long been associated with poor performance, yet specific diagnosis of sacroiliac dysfunction (SID) has been difficult to achieve. Clinical presentation of SID appears to fall into two categories. The first, presenting as pain and poor performance, is responsive to local analgesia of periarticular structures with poorly defined pathology. The second presents primarily as poor performance with bony pathological changes as a result of chronic instability. Diagnostic tests based on biomechanics as well as manual provocation for SIJ pain have formed the basis of tests currently used to diagnose SIJ dysfunction in humans. This review summarises the anatomy and biomechanics of the equine SIJ and current biomechanical, innervation and motor control concepts in human SID. The relationship between abnormal SIJ motion and altered neuromotor control with clinical disease of the equine SIJ are discussed. Future utilisation of these principles to develop new diagnostic and management tools for the equine SID is promising.

  7. Disgust proneness and obsessive-compulsive symptoms in a clinical sample: structural differentiation from negative affect.

    PubMed

    Olatunji, Bunmi O; Ebesutani, Chad; David, Bieke; Fan, Qianqian; McGrath, Patrick B

    2011-10-01

    Although a growing body of research has revealed robust associations between disgust and obsessive-compulsive disorder (OCD) symptoms, there remains a paucity of research examining the specificity of this association in clinical samples. The present study employed structural equation modeling to differentiate disgust from negative affect in the prediction of OCD symptoms in a clinical sample (n=153). Results indicate that disgust and negative affect latent factors were independently related to OCD symptoms. However, when both variables were simultaneously modeled as predictors, latent disgust remained significantly associated with OCD symptoms, whereas the association between latent negative affect and OCD symptoms became nonsignificant. Multiple statistical tests of mediation converged in support of disgust as a significant intervening variable between negative affect and OCD symptoms. The implications of these findings for further delineating the role of individual differences in disgust proneness in the development of OCD are discussed.

  8. Self-imaging of transparent objects and structures in focusing of spatially phase-modulated laser radiation into a weakly absorbing medium

    SciTech Connect

    Bubis, E L

    2011-06-30

    Self-imaging of transparent objects and structures in focusing of a spatially phase-modulated laser beam into an extended weakly absorbing medium is described. The laser power level that is necessary for effective imaging corresponds to the illuminating beam power when thermal self-defocusing starts evolving in the medium. The effect can be described in terms of the ideology of Zernike's classical phase-contrast method. Edge enhancement in visualised images of transparent objects is experimentally demonstrated. Self-imaging of a microscopic object in the form of transparent letters and long-lived refractive-index fluctuations in liquid glycerol is shown. Due to the adaptivity of the process under consideration, unlike the classical case, self-imaging occurs also in the situations where a beam is displaced (undergoes random walk) as a whole in the Fourier plane, for example, in the presence of thermal flows. (image processing)

  9. The factor structure and psychometric properties of the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM) in Norwegian clinical and non-clinical samples

    PubMed Central

    2013-01-01

    Background The Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) is a 34-item instrument developed to monitor clinically significant change in out-patients. The CORE-OM covers four domains: well-being, problems/symptoms, functioning and risk, and sums up in two total scores: the mean of All items, and the mean of All non-risk items. The aim of this study was to examine the psychometric properties of the Norwegian translation of the CORE-OM. Methods A clinical sample of 527 out-patients from North Norwegian specialist psychiatric services, and a non-clinical sample of 464 persons were obtained. The non-clinical sample was a convenience sample consisting of friends and family of health personnel, and of students of medicine and clinical psychology. Students also reported psychological stress. Exploratory factor analysis (EFA) was employed in half the clinical sample. Confirmatory (CFA) factor analyses modelling the theoretical sub-domains were performed in the remaining half of the clinical sample. Internal consistency, means, and gender and age differences were studied by comparing the clinical and non-clinical samples. Stability, effect of language (Norwegian versus English), and of psychological stress was studied in the sub-sample of students. Finally, cut-off scores were calculated, and distributions of scores were compared between clinical and non-clinical samples, and between students reporting stress or no stress. Results The results indicate that the CORE-OM both measures general (g) psychological distress and sub-domains, of which risk of harm separates most clearly from the g factor. Internal consistency, stability and cut-off scores compared well with the original English version. No, or only negligible, language effects were found. Gender differences were only found for the well-being domain in the non-clinical sample and for the risk domain in the clinical sample. Current patient status explained differences between clinical and non-clinical

  10. Cost Structure and Clinical Outcome of a Stem Cell Transplantation Program in a Developing Country: The Experience in Northeast Mexico

    PubMed Central

    Heredia-Salazar, Alberto Carlos; Cantú-Rodríguez, Olga G.; Gutiérrez-Aguirre, Homero; Villarreal-Villarreal, César Daniel; Mancías-Guerra, Consuelo; Herrera-Garza, José Luís; Gómez-Almaguer, David

    2015-01-01

    Background and Objective. Hematopoietic stem cell transplantation (HSCT) in developing countries is cost-limited. Our primary goal was to determine the cost structure for the HSCT program model developed over the last decade at our public university hospital and to assess its clinical outcomes. Materials and Methods. Adults and children receiving an allogeneic hematopoietic stem cell transplant from January 2010 to February 2011 at our hematology regional reference center were included. Laboratory tests, medical procedures, chemotherapy drugs, other drugs, and hospitalization costs were scrutinized to calculate the total cost for each patient and the median cost for the procedure. Data regarding clinical evolution were incorporated into the analysis. Physician fees are not charged at the institution and therefore were not included. Results. Fifty patients were evaluated over a 1-year period. The total estimated cost for an allogeneic HSCT was $12,504. The two most expensive diseases to allograft were non-Hodgkin lymphoma ($11,760 ± $2,236) for the malignant group and thalassemia ($12,915 ± $5,170) for the nonmalignant group. Acute lymphoblastic leukemia ($11,053 ± 2,817) and acute myeloblastic leukemia ($10,251 ± $1,538) were the most frequent indications for HSCT, with 11 cases each. Median out-of-pocket expenses were $1,605, and 1-year follow-up costs amounted to $1,640, adding up to a total cost of $15,749 for the first year. The most expensive components were drugs and laboratory tests. Conclusion. Applying the cost structure described, HSCT is an affordable option for hematological patients living in a developing country. PMID:25746343

  11. Population genetic structure of clinical and environmental isolates of Blastomyces dermatitidis, Based on 27 Polymorphic Microsatellite Markers

    USGS Publications Warehouse

    Meece, J.K.; Anderson, J.L.; Fisher, M.C.; Henk, D.A.; Sloss, Brian L.; Reed, K.D.

    2011-01-01

    Blastomyces dermatitidis, a thermally dimorphic fungus, is the etiologic agent of North American blastomycosis. Clinical presentation is varied, ranging from silent infections to fulminant respiratory disease and dissemination to skin and other sites. Exploration of the population genetic structure of B. dermatitidis would improve our knowledge regarding variation in virulence phenotypes, geographic distribution, and difference in host specificity. The objective of this study was to develop and test a panel of microsatellite markers to delineate the population genetic structure within a group of clinical and environmental isolates of B. dermatitidis. We developed 27 microsatellite markers and genotyped B. dermatitidis isolates from various hosts and environmental sources (n = 112). Assembly of a neighbor-joining tree of allele-sharing distance revealed two genetically distinct groups, separated by a deep node. Bayesian admixture analysis showed that two populations were statistically supported. Principal coordinate analysis also reinforced support for two genetic groups, with the primary axis explaining 61.41% of the genetic variability. Group 1 isolates average 1.8 alleles/locus, whereas group 2 isolates are highly polymorphic, averaging 8.2 alleles/locus. In this data set, alleles at three loci are unshared between the two groups and appear diagnostic. The mating type of individual isolates was determined by PCR. Both mating type-specific genes, the HMG and ??-box domains, were represented in each of the genetic groups, with slightly more isolates having the HMG allele. One interpretation of this study is that the species currently designated B. dermatitidis includes a cryptic subspecies or perhaps a separate species. ?? 2011, American Society for Microbiology.

  12. Population genetic structure of clinical and environmental isolates of Blastomyces dermatitidis based on 27 polymorphic microsatellite markers

    USGS Publications Warehouse

    Meece, Jennifer K.; Anderson, Jennifer L.; Fisher, Matthew C.; Henk, Daniel A.; Sloss, Brian L.; Reed, Kurt D.

    2011-01-01

    Blastomyces dermatitidis, a thermally dimorphic fungus, is the etiologic agent of North American blastomycosis. Clinical presentation is varied, ranging from silent infections to fulminant respiratory disease and dissemination to skin and other sites. Exploration of the population genetic structure of B. dermatitidis would improve our knowledge regarding variation in virulence phenotypes, geographic distribution, and difference in host specificity. The objective of this study was to develop and test a panel of microsatellite markers to delineate the population genetic structure within a group of clinical and environmental isolates of B. dermatitidis. We developed 27 microsatellite markers and genotyped B. dermatitidis isolates from various hosts and environmental sources (n=112). Assembly of a neighbor-joining tree of allele-sharing distance revealed two genetically distinct groups, separated by a deep node. Bayesian admixture analysis showed that two populations were statistically supported. Principal coordinate analysis also reinforced support for two genetic groups, with the primary axis explaining 61.41% of the genetic variability. Group 1 isolates average 1.8 alleles/locus, whereas group 2 isolates are highly polymorphic, averaging 8.2 alleles/locus. In this data set, alleles at three loci are unshared between the two groups and appear diagnostic. The mating type of individual isolates was determined by PCR. Both mating type-specific genes, the HMG and α-box domains, were represented in each of the genetic groups, with slightly more isolates having the HMG allele. One interpretation of this study is that the species currently designated B. dermatitidis includes a cryptic subspecies or perhaps a separate species.

  13. Factor Structure and Clinical Utility of the Beck Depression Inventory in Patients with Binge Eating Disorder and Obesity

    PubMed Central

    Udo, Tomoko; McKee, Sherry A.; Grilo, Carlos M.

    2015-01-01

    Objective The Beck Depression Inventory (BDI) is often used to assess depression symptoms, but its factor structure and clinical utility have not been evaluated in patients with binge eating disorder (BED) and obesity. Methods 882 treatment-seeking obese patients with BED were administered structured interviews (SCID-I/P) and completed self-report questionnaires. Results Exploratory and confirmatory factor analyses supported a brief 16-item BDI version with a three-factor structure (affective, attitudinal, and somatic). Both 21- and 16-item versions showed excellent internal consistency (both α=0.89) and had significant correlation patterns with different aspects of eating disorder psychopathology; three factors showed significant but variable associations with eating disorder psychopathology. Area under the curves (AUC) for both BDI versions were significant in predicting major depressive disorder (MDD; AUC=0.773 [16-item], 73.5% sensitivity/70.2% specificity, AUC=0.769 [21-item], 79.5% sensitivity/64.1% specificity) and mood disorders (AUC=0.763 [16-item], 67.1% sensitivity/71.5% specificity, AUC=0.769 [21-item], 84.2% sensitivity/55.7% specificity). 21-item BDI (cut-off score ≥16) showed higher negative predictive values (94.0% vs. 93.0% [MDD]; 92.4% vs. 88.3% [mood disorders]) than brief 16-item BDI (cut-off score ≥13). Conclusions Both BDI versions demonstrated moderate performance as a screening instrument for MDD/mood disorders in obese patients with BED. Advantages and disadvantages for both versions are discussed. A three-factor structure has potential to inform the conceptualization of depression features. PMID:25537344

  14. Information object definition-based unified modeling language representation of DICOM structured reporting: a case study of transcoding DICOM to XML.

    PubMed

    Tirado-Ramos, Alfredo; Hu, Jingkun; Lee, K P

    2002-01-01

    Supplement 23 to DICOM (Digital Imaging and Communications for Medicine), Structured Reporting, is a specification that supports a semantically rich representation of image and waveform content, enabling experts to share image and related patient information. DICOM SR supports the representation of textual and coded data linked to images and waveforms. Nevertheless, the medical information technology community needs models that work as bridges between the DICOM relational model and open object-oriented technologies. The authors assert that representations of the DICOM Structured Reporting standard, using object-oriented modeling languages such as the Unified Modeling Language, can provide a high-level reference view of the semantically rich framework of DICOM and its complex structures. They have produced an object-oriented model to represent the DICOM SR standard and have derived XML-exchangeable representations of this model using World Wide Web Consortium specifications. They expect the model to benefit developers and system architects who are interested in developing applications that are compliant with the DICOM SR specification.

  15. Trusted Objects

    SciTech Connect

    CAMPBELL,PHILIP L.; PIERSON,LYNDON G.; WITZKE,EDWARD L.

    1999-10-27

    In the world of computers a trusted object is a collection of possibly-sensitive data and programs that can be allowed to reside and execute on a computer, even on an adversary's machine. Beyond the scope of one computer we believe that network-based agents in high-consequence and highly reliable applications will depend on this approach, and that the basis for such objects is what we call ''faithful execution.''

  16. An empirical assessment of social structural and cultural change in clinical directorates.

    PubMed

    Braithwaite, Jeffrey

    2006-12-01

    The results of two observational studies of clinical directorates (CDs) are presented. The paper exposes fresh perspectives about the management of hospitals and CDs, and suggests that the most important axis on which hospital decision-making rests continues to be profession rather than the CD, even though CDs are designed at least in part to mitigate professional tribalism and bridge professional divides. In empiricising social structural and cultural theories it seems clear that changes to the prescribed organisational framework, which CDs represent, have had negligible effects on behaviour. This being the case, the paper questions the benefits alleged to have accrued from establishing CDs and calls for more effective, micro-behavioural change strategies than merely altering the structure. PMID:17214253

  17. Structural determination of the polysaccharide isolated from biofilms produced by a clinical strain of Klebsiella pneumoniae.

    PubMed

    Cescutti, Paola; De Benedetto, Gianluigi; Rizzo, Roberto

    2016-07-22

    Klebsiella pneumoniae are Gram negative opportunistic pathogens producing capsular (K) polysaccharides. Seventy-seven different K antigens have been described and they are the basis for K serotyping. Capsular polysaccharides are important virulence factors and have a relevant role for the structure of biofilm communities. Nevertheless, little information is available on the polysaccharides produced in biofilm matrices by Klebsiella spp. In the present study, a clinical isolate of Klebsiella pneumoniae was grown both on cellulose membranes deposited on agar plates, where it formed an adherent biofilm, and in liquid medium, where it formed floating biofilms (flocs). Extraction and purification of the polysaccharide fraction showed that only one main carbohydrate polymer was present in both adherent biofilms and flocs. Composition and linkage analysis, Smith degradation followed by ESI-MS, 1D and 2D NMR spectroscopy revealed that the polysaccharide belong to the type K24 and has the following structure. PMID:27182661

  18. Reduced-Order Modeling and Wavelet Analysis of Turbofan Engine Structural Response Due to Foreign Object Damage "FOD" Events

    NASA Technical Reports Server (NTRS)

    Turso, James A.; Lawrence, Charles; Litt, Jonathan S.

    2007-01-01

    The development of a wavelet-based feature extraction technique specifically targeting FOD-event induced vibration signal changes in gas turbine engines is described. The technique performs wavelet analysis of accelerometer signals from specified locations on the engine and is shown to be robust in the presence of significant process and sensor noise. It is envisioned that the technique will be combined with Kalman filter thermal/ health parameter estimation for FOD-event detection via information fusion from these (and perhaps other) sources. Due to the lack of high-frequency FOD-event test data in the open literature, a reduced-order turbofan structural model (ROM) was synthesized from a finite-element model modal analysis to support the investigation. In addition to providing test data for algorithm development, the ROM is used to determine the optimal sensor location for FOD-event detection. In the presence of significant noise, precise location of the FOD event in time was obtained using the developed wavelet-based feature.

  19. Reduced-Order Modeling and Wavelet Analysis of Turbofan Engine Structural Response Due to Foreign Object Damage (FOD) Events

    NASA Technical Reports Server (NTRS)

    Turso, James; Lawrence, Charles; Litt, Jonathan

    2004-01-01

    The development of a wavelet-based feature extraction technique specifically targeting FOD-event induced vibration signal changes in gas turbine engines is described. The technique performs wavelet analysis of accelerometer signals from specified locations on the engine and is shown to be robust in the presence of significant process and sensor noise. It is envisioned that the technique will be combined with Kalman filter thermal/health parameter estimation for FOD-event detection via information fusion from these (and perhaps other) sources. Due to the lack of high-frequency FOD-event test data in the open literature, a reduced-order turbofan structural model (ROM) was synthesized from a finite element model modal analysis to support the investigation. In addition to providing test data for algorithm development, the ROM is used to determine the optimal sensor location for FOD-event detection. In the presence of significant noise, precise location of the FOD event in time was obtained using the developed wavelet-based feature.

  20. High resolution spectroscopic mapping imaging applied in situ to multilayer structures for stratigraphic identification of painted art objects

    NASA Astrophysics Data System (ADS)

    Karagiannis, Georgios Th.

    2016-04-01

    The development of non-destructive techniques is a reality in the field of conservation science. These techniques are usually not so accurate, as the analytical micro-sampling techniques, however, the proper development of soft-computing techniques can improve their accuracy. In this work, we propose a real-time fast acquisition spectroscopic mapping imaging system that operates from the ultraviolet to mid infrared (UV/Vis/nIR/mIR) area of the electromagnetic spectrum and it is supported by a set of soft-computing methods to identify the materials that exist in a stratigraphic structure of paint layers. Particularly, the system acquires spectra in diffuse-reflectance mode, scanning in a Region-Of-Interest (ROI), and having wavelength range from 200 up to 5000 nm. Also, a fuzzy c-means clustering algorithm, i.e., the particular soft-computing algorithm, produces the mapping images. The evaluation of the method was tested on a byzantine painted icon.

  1. Usability: a critical success factor for managing change in the clinical info-structure.

    PubMed

    Kay, S

    2005-06-01

    There can be no doubt that the clinical info-structure is being significantly enriched with the deployment of new systems throughout the health sector. From a technological perspective, the initial emphasis has been mainly on functionality and only latterly on the usability of these clinical information systems. However, the large scale and rapid pace of the changes being wrought in the health sector will have a major impact on clinicians and patients, not least in how they interact with the technology. Therefore, it is not only hardware and software but people-ware, too, that needs to be actively managed; not simply a one-off functional specification but an ongoing, complex relationship. Usability is the human factor that encompasses the ethical, educational, and evaluative aspects of design. There is also a strong case for regarding usability of clinical information systems as a key critical success factor for the management of change within the health-care domain. In particular, the relationship between usability, and education and training is examined. PMID:16338806

  2. The Structure of Pathological Gambling among Korean Gamblers: A Cluster and Factor Analysis of Clinical and Demographic Characteristics

    ERIC Educational Resources Information Center

    Lee, Tae Kyung; LaBrie, Richard A.; Grant, Jon E.; Kim, Suck Won; Shaffer, Howard J.

    2008-01-01

    This paper reports the underlying structure of the demographic and clinical characteristics of level 3 (i.e., pathological) Korean casino gamblers. The participants reported their gambling behavior and clinical characteristics known to be associated with gambling problems (e.g., alcohol use problems, eating disorders, depression, anxiety, and…

  3. Multi-objective inverse design of sub-wavelength optical focusing structures for heat assisted magnetic recording

    NASA Astrophysics Data System (ADS)

    Bhargava, Samarth; Yablonovitch, Eli

    2014-09-01

    We report using Inverse Electromagnetic Design to computationally optimize the geometric shapes of metallic optical antennas or near-field transducers (NFTs) and dielectric waveguide structures that comprise a sub-wavelength optical focusing system for practical use in Heat Assisted Magnetic Recording (HAMR). This magnetic data-recording scheme relies on focusing optical energy to locally heat the area of a single bit, several hundred square nanometers on a hard disk, to the Curie temperature of the magnetic storage layer. There are three specifications of the optical system that must be met to enable HAMR as a commercial technology. First, to heat the media at scan rates upward of 10 m/s, ~1mW of light (<1% of typical laser diode output power) must be focused to a 30nm×30nm spot on the media. Second, the required lifetime of many years necessitates that the nano-scale NFT must not over-heat from optical absorption. Third, to avoid undesired erasing or interference of adjacent tracks on the media, there must be minimal stray optical radiation away from the hotspot on the hard disk. One cannot design the light delivery system by tackling each of these challenges independently, because they are governed by coupled electromagnetic phenomena. Instead, we propose multiobjective optimization using Inverse Electromagnetic Design in conjunction with a commercial 3D FDTD Maxwell's equations solver. We computationally generated designs of a metallic NFT and a high-index waveguide grating that meet the HAMR specifications simultaneously. Compared to a mock industry design, our proposed design has a similar optical coupling efficiency, ~3x improved suppression of stray optical radiation, and a 60% (280°C) reduction in NFT temperature rise. We also distributed the Inverse Electromagnetic Design software online so that industry partners can use it as a repeatable design process.

  4. Functional and structural MRI biomarkers to detect pre-clinical neurodegeneration.

    PubMed

    Abdulkadir, Ahmed; Ronneberger, Olaf; Wolf, Robert Christian; Pfleiderer, Bettina; Saft, Carsten; Klöppel, Stefan

    2013-02-01

    The availability of an accurate genetic test to identify Huntington's Disease (HD) in the pre-symptomatic stage makes HD an important model to develop biomarkers for other neurodegenerative diseases, such as pre-clinical Alzheimer's Disease. We reasoned that functional changes, measured by functional MRI (fMRI), would precede gray matter changes and that performing a task specifically affected by the disease would carry the clearest signature. Separate cohorts of HD gene mutations carriers and controls performed four different fMRI tasks, probing functions either primarly affected by the disease (i.e. motor control), higher cognitive functions (i.e. working memory and irritability), or basic sensory functions (i.e. auditory system). With the aim to compare fMRI and structural MRI biomarkers, all subjects underwent an additional high-resolution T1-weighted MRI. Best classification performance was achived from fMRI-based activations with motor sequence tapping and task-induced irritation. Classification performance based on gray matter probability maps was also significantly above chance and similar to that of fMRI. Both were sufficiently informative to separate gene mutation carriers that were on average 17 years before predicted disease onset from controls with up to 80% accuracy. Further analyses showed that classification accuracy was best in regions of interest with low within-group heterogeneity in relation to disease specific changes. Our study indicates that structural and some functional markers can accurately detect pre-clinical neurodegeneration. However, the lower variability and easier processing of the strucutral MRI data make latter the more useful tool for disease detection in a clinical setting.

  5. Shoulder Structure and Function Following the Modified Latarjet Procedure: A Clinical and Radiological Review

    PubMed Central

    Garewal, Devinder; Evans, Mathew; Taylor, David; Hoy, Gregory A.; Barwood, Shane; Connell, David

    2013-01-01

    Background To evaluate the clinical and radiological outcomes of the modified Latarjet procedure for traumatic, antero-inferior glenohumeral joint instability. Methods Case series were used with a mean follow-up of 21.3 months for clinical and radiological review and 47.2 months for recurrent instability. Shoulder function was evaluated by clinical examination and validated shoulder scales: Western Ontario Shoulder Stability Index (WOSI), Melbourne Instability Shoulder Score (MISS) and l'Insalata Shoulder Questionnaire. Shoulder structure was evaluated by computed tomography. Results Thirty-two cases were enrolled (mean age 27.0 years). One patient reported a redislocation during the follow-up period. Clinical examination revealed that the median external rotation (at 0° and 90° abduction) was reduced on the operative side by 7.5° (p < 0.01) and 10° (p < 0.001), respectively. Subjective shoulder function was good. Mean (SD) scores on the WOSI, MISS and l'Insalata scales were 78.0 (19.7), 75.8 (11.5) and 89.3 (9.9), respectively. No loss of subscapularis strength was identified (p > 0.05). Radiological evaluation revealed a mean (SD) pre-operative glenoid surface area loss of 169.5 (48.5) mm2 reconstituted surgically by a bone block of 225.4 (73.8) mm2. Subscapularis muscle bulk was reduced on the operative side, above the level of the muscle split (p < 0.05). Conclusions The Latarjet procedure reliably restores lost glenoid surface area, shoulder stability, strength and function. A small loss of external rotation is expected and related to altered subscapularis anatomy. PMID:27582905

  6. Early object relations into new objects.

    PubMed

    Downey, T W

    2001-01-01

    Two strands of change are suggested by this review, one maturational, the other therapeutic or developmental (Hartmann and Kris, 1945). By "maturational" I mean to suggest energies that infuse the individual from earliest life in a manner that includes object relations, but for the healthy exercise of which object relations per se need not be of central and crucial importance. Within wide limits such energies may be delayed until growth conditions prevail without significant distortion of certain of the organism's ego functions. Therapeutic change is analogous to developmental change in that both involve the crucial presence of another to release energies. In therapeutic change these are energies that have been repressed beyond the reach of developmental dynamics. In everyday development crisis and synthesis alternate in conjunction with new and emerging objects to add to the psychological structures brought to the fore by maturation. In many instances, as we see with John, over time and in a less focussed manner, developmental changes can approximate therapeutic change and visa versa. Freud-Dann in their "experiment" pursued one line, in which the equipmental delay brought on by extremely adverse living circumstances was redressed by providing an interpersonally enriching, loving, developmentally facilitating milieu. The sketches of individual children and John's subsequent story provide a perspective into what becomes the stuff of growth and what remains the stuff of neurosis. The developmental reserves and ego resilience of these children were impressive but probably not extraordinary. Usual growth ensued as soon as they were provided with the rich soil of Bulldogs Bank instead of the desert sand of the Tereszin concentration camp. However, no one can escape such adverse circumstances without having taken in the stuff of neurosis. Affects and percepts that were not assimilatable or even available to consciousness at the time remain buried in the unconscious

  7. Early object relations into new objects.

    PubMed

    Downey, T W

    2001-01-01

    Two strands of change are suggested by this review, one maturational, the other therapeutic or developmental (Hartmann and Kris, 1945). By "maturational" I mean to suggest energies that infuse the individual from earliest life in a manner that includes object relations, but for the healthy exercise of which object relations per se need not be of central and crucial importance. Within wide limits such energies may be delayed until growth conditions prevail without significant distortion of certain of the organism's ego functions. Therapeutic change is analogous to developmental change in that both involve the crucial presence of another to release energies. In therapeutic change these are energies that have been repressed beyond the reach of developmental dynamics. In everyday development crisis and synthesis alternate in conjunction with new and emerging objects to add to the psychological structures brought to the fore by maturation. In many instances, as we see with John, over time and in a less focussed manner, developmental changes can approximate therapeutic change and visa versa. Freud-Dann in their "experiment" pursued one line, in which the equipmental delay brought on by extremely adverse living circumstances was redressed by providing an interpersonally enriching, loving, developmentally facilitating milieu. The sketches of individual children and John's subsequent story provide a perspective into what becomes the stuff of growth and what remains the stuff of neurosis. The developmental reserves and ego resilience of these children were impressive but probably not extraordinary. Usual growth ensued as soon as they were provided with the rich soil of Bulldogs Bank instead of the desert sand of the Tereszin concentration camp. However, no one can escape such adverse circumstances without having taken in the stuff of neurosis. Affects and percepts that were not assimilatable or even available to consciousness at the time remain buried in the unconscious

  8. Characterization of the horizontal structure of the tropical forest canopy using object-based LiDAR and multispectral image analysis

    NASA Astrophysics Data System (ADS)

    Dupuy, Stéphane; Lainé, Gérard; Tassin, Jacques; Sarrailh, Jean-Michel

    2013-12-01

    This article's goal is to explore the benefits of using Digital Surface Model (DSM) and Digital Terrain Model (DTM) derived from LiDAR acquisitions for characterizing the horizontal structure of different facies in forested areas (primary forests vs. secondary forests) within the framework of an object-oriented classification. The area under study is the island of Mayotte in the western Indian Ocean. The LiDAR data were the data originally acquired by an airborne small-footprint discrete-return LiDAR for the "Litto3D" coastline mapping project. They were used to create a Digital Elevation Model (DEM) at a spatial resolution of 1 m and a Digital Canopy Model (DCM) using median filtering. The use of two successive segmentations at different scales allowed us to adjust the segmentation parameters to the local structure of the landscape and of the cover. Working in object-oriented mode with LiDAR allowed us to discriminate six vegetation classes based on canopy height and horizontal heterogeneity. This heterogeneity was assessed using a texture index calculated from the height-transition co-occurrence matrix. Overall accuracy exceeds 90%. The resulting product is the first vegetation map of Mayotte which emphasizes the structure over the composition.

  9. Scaling Out and Evaluation of OBSecAn, an Automated Section Annotator for Semi-Structured Clinical Documents, on a Large VA Clinical Corpus

    PubMed Central

    Tran, Le-Thuy T.; Divita, Guy; Redd, Andrew; Carter, Marjorie E.; Samore, Matthew; Gundlapalli, Adi V.

    2015-01-01

    “Identifying and labeling” (annotating) sections improves the effectiveness of extracting information stored in the free text of clinical documents. OBSecAn, an automated ontology-based section annotator, was developed to identify and label sections of semi-structured clinical documents from the Department of Veterans Affairs (VA). In the first step, the algorithm reads and parses the document to obtain and store information regarding sections into a structure that supports the hierarchy of sections. The second stage detects and makes correction to errors in the parsed structure. The third stage produces the section annotation output using the final parsed tree. In this study, we present the OBSecAn method and its scale to a million document corpus and evaluate its performance in identifying family history sections. We identify high yield sections for this use case from note titles such as primary care and demonstrate a median rate of 99% in correctly identifying a family history section. PMID:26958260

  10. Initial clinical experience using the EchoNavigator®-system during structural heart disease interventions

    PubMed Central

    Balzer, Jan; Zeus, Tobias; Hellhammer, Katharina; Veulemans, Verena; Eschenhagen, Silke; Kehmeier, Eva; Meyer, Christian; Rassaf, Tienush; Kelm, Malte

    2015-01-01

    AIM: To present our initial clinical experience using this innovative software solution for guidance of percutaneous structural heart disease interventions. METHODS: Left atrial appendage, atrial septal defect and paravalvular leak closure, transaortic valve repair and MitraClip® procedures were performed in the catheter laboratory under fluoroscopic and echocardiographic guidance. The two-dimensional and three-dimensional images generated by the transesophageal echocardiography probe were interfaced with the fluoroscopic images in real-time using the EchoNavigator®-system. RESULTS: The application of the novel image fusion technology was safe and led to a better appreciation of multimodality imaging guidance due to improved visualization of the complex relationship between catheter devices and anatomical structures. CONCLUSION: The EchoNavigator®-system is a feasible and safe tool for guidance of interventional procedures in structural heart disease. This innovative technology may improve confidence of interventional cardiologists in targeting and positioning interventional devices in order to increase safety, accuracy, and efficacy of percutaneous interventions in the catheter laboratory. PMID:26413233

  11. Clinical significance of knowledge about the structure, function, and impairments of working memory

    PubMed Central

    Brodziak, Andrzej; Brewczyński, Adam; Bajor, Grzegorz

    2013-01-01

    A review of contemporary research on the working memory system (WMS) is important, both due to the need to focus the discussion on further necessary investigations on the structure and function of this key part of the human brain, as well as to share this knowledge with clinicians. In our introduction we try to clarify the actual terminology and provide an intuitively understandable model for 3 basic cognitive operations: perception, recognition, imagery, and manipulation of recalled mental images. We emphasize the importance of knowledge of the structure and function of the WMS for the possibility to demonstrate the links between genetic polymorphisms and the prevalence to some mental disorders. We also review current knowledge of working memory dysfunction in the most common diseases and specific clinical situations such as maturation and aging. Finally, we briefly discuss methods for assessment of WMS capacity. This article establishes a kind of compendium of knowledge for clinicians who are not familiar with the structure and operation of the WMS. PMID:23645218

  12. Effects of the SpeechEasy on Objective and Perceived Aspects of Stuttering: A 6-Month, Phase I Clinical Trial in Naturalistic Environments

    ERIC Educational Resources Information Center

    Pollard, Ryan; Ellis, John B.; Finan, Don; Ramig, Peter R.

    2009-01-01

    Purpose: Effects of the SpeechEasy when used under extraclinical conditions over several months were investigated. Primary purposes were to help establish Phase I level information about the therapeutic utility of the SpeechEasy and to compare those results with previous findings obtained in laboratory and clinical settings. Method: Eleven adults…

  13. Relationship Between Foveal Cone Structure and Clinical Measures of Visual Function in Patients With Inherited Retinal Degenerations

    PubMed Central

    Ratnam, Kavitha; Carroll, Joseph; Porco, Travis C.; Duncan, Jacque L.; Roorda, Austin

    2013-01-01

    Purpose. To study the relationship between cone spacing and density and clinical measures of visual function near the fovea. Methods. High-resolution images of the photoreceptor mosaic were obtained with adaptive optics scanning laser ophthalmoscopy from 26 patients with inherited retinal degenerations. Cone spacing measures were made close to or at the foveal center (mean [SD] eccentricity, 0.02 [0.03] degree; maximum eccentricity, 0.13 degree) and were converted to Z-scores, fraction of cones, and percentage-of-cones-below-average compared with normal values for each location (based on 37 age-similar visually normal eyes). Z-scores and percentage of cones below average were compared with best-corrected visual acuity (VA) and foveal sensitivity. Results. Visual acuity was significantly correlated with cone spacing (Spearman rank correlation ρ = −0.60, P = 0.003) and was preserved (≥80 letters), despite cone density measures that were 52% below normal. Foveal sensitivity showed significant correlation with cone spacing (ρ = −0.47, P = 0.017) and remained normal (≥35 decibels), despite density measures that were approximately 52% to 62% below normal. Conclusions. Cone density was reduced by up to 62% below normal at or near the fovea in eyes with VA and sensitivity that remained within normal limits. Despite a significant correlation with foveal cone spacing, VA and sensitivity are insensitive indicators of the integrity of the foveal cone mosaic. Direct, objective measures of cone structure may be more sensitive indicators of disease severity than VA or foveal sensitivity in eyes with inherited retinal degenerations. (ClinicalTrials.gov number, NCT00254605.) PMID:23908179

  14. New insights of an old defense system: structure, function, and clinical relevance of the complement system.

    PubMed

    Ehrnthaller, Christian; Ignatius, Anita; Gebhard, Florian; Huber-Lang, Markus

    2011-01-01

    The complement system was discovered a century ago as a potent defense cascade of innate immunity. After its first description, continuous experimental and clinical research was performed, and three canonical pathways of activation were established. Upon activation by traumatic or surgical tissue damage, complement reveals beneficial functions of pathogen and danger defense by sensing and clearing injured cells. However, the latest research efforts have provided a more distinct insight into the complement system and its clinical subsequences. Complement has been shown to play a significant role in the pathogenesis of various inflammatory processes such as sepsis, multiorgan dysfunction, ischemia/reperfusion, cardiovascular diseases and many others. The three well-known activation pathways of the complement system have been challenged by newer findings that demonstrate direct production of central complement effectors (for example, C5a) by serine proteases of the coagulation cascade. In particular, thrombin is capable of producing C5a, which not only plays a decisive role on pathogens and infected/damaged tissues, but also acts systemically. In the case of uncontrolled complement activation, "friendly fire" is generated, resulting in the destruction of healthy host tissue. Therefore, the traditional research that focuses on a mainly positive-acting cascade has now shifted to the negative effects and how tissue damage originated by the activation of the complement can be contained. In a translational approach including structure-function relations of this ancient defense system, this review provides new insights of complement-mediated clinical relevant diseases and the development of complement modulation strategies and current research aspects.

  15. The validity and clinical utility of structured diagnoses of antisocial personality disorder with forensic patients.

    PubMed

    Marin-Avellan, Luisa E; McGauley, Gillian A; Campbell, Colin D; Fonagy, Peter

    2014-08-01

    Current DSM-based instruments for personality disorders (PDs) limit the investigation of the course and outcome of treatment of these disorders. This study examined the validity of the Shedler-Westen Assessment Procedure-200 (SWAP-200) and the Structured Clinical Interview for DSM-IV Axis II PD (SCID-II) in a sample of forensic PD patients. Results based on 66 participants indicated that the SWAP-200 Q-factors reduced the frequency of diagnostic comorbidity of PD categories by half compared with the SCID-II. Only the SWAP-200's Antisocial PD category showed good convergent and discriminant validity with respect to other instruments describing aspects of PD. The validity of the cutoff score for severe antisocial PD was confirmed, and this category predicted severe incidents in the hospital at 1 year of follow-up. A violence risk scale was constructed, which differentiated violent and nonviolent offenders. The results support the validity of the SWAP-200 and its potential clinical utility with forensic PD patients.

  16. Valuing structured professional judgment: predictive validity, decision-making, and the clinical-actuarial conflict.

    PubMed

    Falzer, Paul R

    2013-01-01

    Structured professional judgment (SPJ) has received considerable attention as an alternative to unstructured clinical judgment and actuarial assessment, and as a means of resolving their ongoing conflict. However, predictive validity studies have typically relied on receiver operating characteristic (ROC) analysis, the same technique commonly used to validate actuarial assessment tools. This paper presents SPJ as distinct from both unstructured clinical judgment and actuarial assessment. A key distinguishing feature of SPJ is the contribution of modifiable factors, either dynamic or protective, to summary risk ratings. With modifiable factors, the summary rating scheme serves as a prognostic model rather than a classification procedure. However, prognostic models require more extensive and thorough predictive validity testing than can be provided by ROC analysis. It is proposed that validation should include calibration and reclassification techniques, as well as additional measures of discrimination. Several techniques and measures are described and illustrated. The paper concludes by tracing the limitations of ROC analysis to its philosophical foundation and its origin as a statistical theory of decision-making. This foundation inhibits the performance of crucial tasks, such as determining the sufficiency of a risk assessment and examining the evidentiary value of statistical findings. The paper closes by noting a current effort to establish a viable and complementary relationship between SPJ and decision-making theory.

  17. [Clinical research. XIII. Research design contribution in the structured revision of an article].

    PubMed

    Talavera, Juan O; Rivas-Ruiz, Rodolfo

    2013-01-01

    The quality of information obtained in accordance to research design is integrated to the revision structured in relation to the causality model, used in the article "Reduction in the Incidence of Nosocomial Pneumonia Poststroke by Using the 'Turn-mob' Program", which corresponds to a clinical trial design. Points to identify and analyze are ethical issues in order to safeguard the security and respect for patients, randomization that seek to create basal homogeneous groups, subjects with the same probability of receiving any of the maneuvers in comparison, with the same pre maneuver probability of adherence, and which facilitate the blinding of outcome measurement and the distribution between groups of subjects with the same probability of leaving the study for reasons beyond the maneuvers. Other aspects are the relativity of comparison, the blinding of the maneuver, the parallel application of comparative maneuver, early stopping, and analysis according to the degree of adherence. The analysis in accordance with the design is complementary, since it is done based on the architectural model of causality, and the statistical and clinical relevance consideration.

  18. Structure Based In Silico Analysis of Quinolone Resistance in Clinical Isolates of Salmonella Typhi from India

    PubMed Central

    Sharma, Priyanka; Sharma, Sujata; Singh, Tej P.; Kapil, Arti; Kaur, Punit

    2015-01-01

    Enteric fever is a major cause of morbidity in several parts of the Indian subcontinent. The treatment for typhoid fever majorly includes the fluoroquinolone group of antibiotics. Excessive and indiscriminate use of these antibiotics has led to development of acquired resistance in the causative organism Salmonella Typhi. The resistance towards fluoroquinolones is associated with mutations in the target gene of DNA Gyrase. We have estimated the Minimum Inhibitory Concentration (MIC) of commonly used fluoroquinolone representatives from three generations, ciprofloxacin, ofloxacin, levofloxacin and moxifloxacin, for 100 clinical isolates of Salmonella Typhi from patients in the Indian subcontinent. The MICs have been found to be in the range of 0.032 to 8 μg/ml. The gene encoding DNA Gyrase was subsequently sequenced and point mutations were observed in DNA Gyrase in the quinolone resistance determining region comprising Ser83Phe/Tyr and Asp87Tyr/Gly. The binding ability of these four fluoroquinolones in the quinolone binding pocket of wild type as well as mutant DNA Gyrase was computationally analyzed by molecular docking to assess their differential binding behaviour. This study has revealed that mutations in DNA Gyrase alter the characteristics of the binding pocket resulting in the loss of crucial molecular interactions and consequently decrease the binding affinity of fluoroquinolones with the target protein. The present study assists in understanding the underlying molecular and structural mechanism for decreased fluoroquinolone susceptibility in clinical isolates as a consequence of mutations in DNA Gyrase. PMID:25962113

  19. Clinical implications of recent insights into the structural biology of beta2 adrenoceptors.

    PubMed

    Amezcua-Gutierrez, Marcos Antonio; Cipres-Flores, Fabiola Jimena; Trujillo-Ferrara, Jose Guadalupe; Soriano-Ursua, Marvin Antonio

    2012-09-01

    Analysis of the crystal structure of beta-2 adrenoceptors (β2ARs) is providing new insights into the functioning of this receptor and perhaps of G-protein coupled receptors (GPCRs) as a whole. This class of receptors represents the target of at least a third of the drugs on the market and plays an essential role in the study of therapetic drug-response. Among GPCRs, the β2AR is the best understood in terms of function, expression and activation. Regarding the interaction of β2ARs with a specific ligand, polymorphisms, conformational changes and stereoselectivity are important factors. Agonist affinity for β2ARs is influenced by the polymorphisms of these receptors, which in some cases appear to affect susceptibility to disorders. Conformational changes that take place upon the approach of a given ligand, as well as the stereoselectivity of this class of receptors can modify the intrinsic activity of β2ARs (and certainly of other receptors as well). Hence, a deepening understanding of these factors can provide new data on affinity and specifically the key residues involved in recognition of β2AR agonists. The deepening the understanding of the factors involved in ligand affinity for β2ARs will assist in the development of β2AR agonists that are more selective and potent, and that have longer term action. Not only are β2AR agonists employed as therapeutic agents, but also in diagnosis. Currently, the main clinical application of targeting human β2ARs is to treat asthma with bronchodilators. However, they are also used to treat other maladies in their acute or chronic forms, including heart conditions, metabolic disorders and muscle wasting. This review shows the scope and the possible future clinical implications of data from structures of β2ARs.

  20. Mathematical Modeling of Human Glioma Growth Based on Brain Topological Structures: Study of Two Clinical Cases

    PubMed Central

    Suarez, Cecilia; Maglietti, Felipe; Colonna, Mario; Breitburd, Karina; Marshall, Guillermo

    2012-01-01

    Gliomas are the most common primary brain tumors and yet almost incurable due mainly to their great invasion capability. This represents a challenge to present clinical oncology. Here, we introduce a mathematical model aiming to improve tumor spreading capability definition. The model consists in a time dependent reaction-diffusion equation in a three-dimensional spatial domain that distinguishes between different brain topological structures. The model uses a series of digitized images from brain slices covering the whole human brain. The Talairach atlas included in the model describes brain structures at different levels. Also, the inclusion of the Brodmann areas allows prediction of the brain functions affected during tumor evolution and the estimation of correlated symptoms. The model is solved numerically using patient-specific parametrization and finite differences. Simulations consider an initial state with cellular proliferation alone (benign tumor), and an advanced state when infiltration starts (malign tumor). Survival time is estimated on the basis of tumor size and location. The model is used to predict tumor evolution in two clinical cases. In the first case, predictions show that real infiltrative areas are underestimated by current diagnostic imaging. In the second case, tumor spreading predictions were shown to be more accurate than those derived from previous models in the literature. Our results suggest that the inclusion of differential migration in glioma growth models constitutes another step towards a better prediction of tumor infiltration at the moment of surgical or radiosurgical target definition. Also, the addition of physiological/psychological considerations to classical anatomical models will provide a better and integral understanding of the patient disease at the moment of deciding therapeutic options, taking into account not only survival but also life quality. PMID:22761843

  1. Mathematical modeling of human glioma growth based on brain topological structures: study of two clinical cases.

    PubMed

    Suarez, Cecilia; Maglietti, Felipe; Colonna, Mario; Breitburd, Karina; Marshall, Guillermo

    2012-01-01

    Gliomas are the most common primary brain tumors and yet almost incurable due mainly to their great invasion capability. This represents a challenge to present clinical oncology. Here, we introduce a mathematical model aiming to improve tumor spreading capability definition. The model consists in a time dependent reaction-diffusion equation in a three-dimensional spatial domain that distinguishes between different brain topological structures. The model uses a series of digitized images from brain slices covering the whole human brain. The Talairach atlas included in the model describes brain structures at different levels. Also, the inclusion of the Brodmann areas allows prediction of the brain functions affected during tumor evolution and the estimation of correlated symptoms. The model is solved numerically using patient-specific parametrization and finite differences. Simulations consider an initial state with cellular proliferation alone (benign tumor), and an advanced state when infiltration starts (malign tumor). Survival time is estimated on the basis of tumor size and location. The model is used to predict tumor evolution in two clinical cases. In the first case, predictions show that real infiltrative areas are underestimated by current diagnostic imaging. In the second case, tumor spreading predictions were shown to be more accurate than those derived from previous models in the literature. Our results suggest that the inclusion of differential migration in glioma growth models constitutes another step towards a better prediction of tumor infiltration at the moment of surgical or radiosurgical target definition. Also, the addition of physiological/psychological considerations to classical anatomical models will provide a better and integral understanding of the patient disease at the moment of deciding therapeutic options, taking into account not only survival but also life quality.

  2. Beyond Program Objectives.

    PubMed

    Baessler, Matthew; Best, William; Sexton, Martha

    2016-06-01

    Graduate students in eight diverse health care professional programs participated together in a pilot course entitled, "An Interprofessional Approach to Patient Care." Through postcourse discussions with the clinical nurse leader students, faculty discovered that beyond meeting program objectives, the nursing learners gained numerous unexpected insights about interprofessional collaborative practice. J Contin Educ Nurs. 2016;47(6):248-249. PMID:27232220

  3. Real-time object recognition in multidimensional images based on joined extended structural tensor and higher-order tensor decomposition methods

    NASA Astrophysics Data System (ADS)

    Cyganek, Boguslaw; Smolka, Bogdan

    2015-02-01

    In this paper a system for real-time recognition of objects in multidimensional video signals is proposed. Object recognition is done by pattern projection into the tensor subspaces obtained from the factorization of the signal tensors representing the input signal. However, instead of taking only the intensity signal the novelty of this paper is first to build the Extended Structural Tensor representation from the intensity signal that conveys information on signal intensities, as well as on higher-order statistics of the input signals. This way the higher-order input pattern tensors are built from the training samples. Then, the tensor subspaces are built based on the Higher-Order Singular Value Decomposition of the prototype pattern tensors. Finally, recognition relies on measurements of the distance of a test pattern projected into the tensor subspaces obtained from the training tensors. Due to high-dimensionality of the input data, tensor based methods require high memory and computational resources. However, recent achievements in the technology of the multi-core microprocessors and graphic cards allows real-time operation of the multidimensional methods as is shown and analyzed in this paper based on real examples of object detection in digital images.

  4. A Distributed, Collaborative, Structuring Model for a Clinical-Guideline Digital-Library

    PubMed Central

    Shahar, Yuval; Shalom, Erez; Mayaffit, Alon; Young, Ohad; Galperin, Maya; Martins, Susana; Goldstein, Mary

    2003-01-01

    The Digital Electronic Guideline Library (DeGeL) is a Web-based framework and a set of distributed tools that facilitate gradual conversion of clinical guidelines from free text, through semi-structured text, to a fully structured, executable representation. Thus, guidelines exist in a hybrid, multiple-format representation The three formats support increasingly sophisticated computational tasks. The tools perform semantic markup, classification, search, and browsing, and support computational modules that we are developing, for run-time application and retrospective quality assessment. We describe the DeGeL architecture and its collaborative-authoring authorization model, which is based on (1) multiple medical-specialty authoring groups, each including a group manager who controls group authorizations, and (2) a hierarchical authorization model based on the different functions involved in the hybrid guideline-specification process. We have implemented the core modules of the DeGeL architecture and demonstrated distributed markup and retrieval using the knowledge roles of two guidelines ontologies (Asbru and GEM). We are currently evaluating several of the DeGeL tools. PMID:14728241

  5. A distributed, collaborative, structuring model for a clinical-guideline digital-library.

    PubMed

    Shahar, Yuval; Shalom, Erez; Mayaffit, Alon; Young, Ohad; Galperin, Maya; Martins, Susana; Goldstein, Mary

    2003-01-01

    The Digital Electronic Guideline Library (DeGeL) is a Web-based framework and a set of distributed tools that facilitate gradual conversion of clinical guidelines from free text, through semi-structured text, to a fully structured, executable representation. Thus, guidelines exist in a hybrid, multiple-format representation The three formats support increasingly sophisticated computational tasks. The tools perform semantic markup, classification, search, and browsing, and support computational modules that we are developing, for run-time application and retrospective quality assessment. We describe the DeGeL architecture and its collaborative-authoring authorization model, which is based on (1) multiple medical-specialty authoring groups, each including a group manager who controls group authorizations, and (2) a hierarchical authorization model based on the different functions involved in the hybrid guideline-specification process. We have implemented the core modules of the DeGeL architecture and demonstrated distributed markup and retrieval using the knowledge roles of two guidelines ontologies (Asbru and GEM). We are currently evaluating several of the DeGeL tools.

  6. Structure-activity relationship studies on clinically relevant HIV-1 NNRTIs.

    PubMed

    Rawal, R K; Murugesan, V; Katti, S B

    2012-01-01

    In addition to the nucleoside reverse transcriptase inhibitors (NRTIs), protease inhibitors (PIs) and integrase inhibitors (INIs), nonnucleoside reverse transcriptase inhibitors (NNRTIs) have contributed significantly in the treatment of HIV-1 infections. More than 60 structurally different classes of compounds have been identified as NNRTIs, which are specifically inhibiting HIV-1 reverse transcriptase (RT). Five NNRTIs (nevirapine, delavirdine, efavirenz, etravirine and rilpivirine) have been approved by US Food and Drug Administration (FDA) for clinical use. The NNRTIs bind with a specific 'pocket' site of HIV-1 RT (allosteric site) that is closely associated with the NRTI binding site. Due to mutations of the amino acid residues surrounding the NNRTI-binding site, NNRTIs are notorious for rapidly eliciting resistance. Though, the emergence of resistant HIV strains can be circumvented if the NNRTIs are used either alone or in combination with NRTIs (AZT, 3TC, ddI, ddC, TVD or d4T) and PIs (Indinavir, nelfinavir, saquinavir, ritonavir and lopinavir etc.) as shown by both a decrease in plasma HIV-1 RNA levels and increased CD4 T-cells. Here we are going to discuss recent advances in structure activity relationship studies on nevirapine, delavirdine, efavirenz, etravirine, rilpivirine and 4-thiazolidinones (privileged scaffold) HIV-1 NNRTIs.

  7. CT Lesion Model-Based Structural Allografts: Custom Fabrication and Clinical Experience

    PubMed Central

    Brune, Jan Claas; Hesselbarth, Uwe; Seifert, Philipp; Nowack, Dimitri; von Versen, Rüdiger; Smith, Mark David; Seifert, Dirk

    2012-01-01

    Summary Background Patients requiring knee and hip revision arthroplasty often present with difficult anatomical situations that limit options for surgery. Customised mega-implants may be one of few remaining treatment options. However, extensive damage to residual bone stock may also be present, and in such cases even customised prosthetics may be difficult to implant. Small quantities of lost bone can be replaced with standard allografts or autologous bone. Larger defects may require structural macro-allografts, sometimes in combination with implants (allograft-prosthesis composites). Methods Herein, we describe a process for manufacturing lesion-specific large structural allografts according to a 3D, full-scale, lithographically generated defect model. These macro-allografts deliver the volume and the mechanical stability necessary for certain complex revisions. They are patient-and implant-matched, negate some requirements for additional implants and biomaterials and save time in the operating theatre by eliminating the requirement for intra-operative sizing and shaping of standard allografts. Conclusion While a robust data set from long-term follow-up of patients receiving customised macro-allografts is not yet available, initial clinical experience and results suggest that lesion-matched macro-allografts can be an important component of revision joint surgery. PMID:23800856

  8. CBCL Clinical Scales Discriminate ADHD Youth with Structured-Interview Derived Diagnosis of Oppositional Defiant Disorder (ODD)

    ERIC Educational Resources Information Center

    Biederman, Joseph; Ball, Sarah W.; Monuteaux, Michael C.; Kaiser, Roselinde; Faraone, Stephen V.

    2008-01-01

    Objective: To evaluate the association between the clinical scales of the child behavior checklist (CBCL) and the comorbid diagnosis of oppositional defiant disorder (ODD) in a large sample of youth with attention deficit hyperactivity disorder (ADHD). Method: The sample consisted of 101 girls and 106 boys ages 6 to 17 with ADHD. Conditional…

  9. Quantum origins of objectivity

    NASA Astrophysics Data System (ADS)

    Horodecki, R.; Korbicz, J. K.; Horodecki, P.

    2015-03-01

    In spite of all of its successes, quantum mechanics leaves us with a central problem: How does nature create a bridge from fragile quanta to the objective world of everyday experience? Here we find that a basic structure within quantum mechanics that leads to the perceived objectivity is a so-called spectrum broadcast structure. We uncover this based on minimal assumptions, without referring to any dynamical details or a concrete model. More specifically, working formally within the decoherence theory setting with multiple environments (called quantum Darwinism), we show how a crucial for quantum mechanics notion of nondisturbance due to Bohr [N. Bohr, Phys. Rev. 48, 696 (1935), 10.1103/PhysRev.48.696] and a natural definition of objectivity lead to a canonical structure of a quantum system-environment state, reflecting objective information records about the system stored in the environment.

  10. Why it is difficult to see the anima as a helpful object: critique and clinical relevance of the theory of archetypes.

    PubMed

    von Raffay, A

    2000-10-01

    This paper is divided into three parts. The first deals briefly with more general aspects of the theory of archetypes (as conceived by Jung); the second examines the anima archetype in rather more detail, because it is, apart from the self, the main archetype in Jung's thought; and the third discusses the clinical repercussions of the anima theory and of the theory of the archetypes in general. The various references to Jung himself and certain circumstances of his life are included here on the assumption that personal problems in his biography contributed decisively to the constitution of his theory, so that deeper insights accure if they are taken into account.

  11. Why it is difficult to see the anima as a helpful object: critique and clinical relevance of the theory of archetypes.

    PubMed

    von Raffay, A

    2000-10-01

    This paper is divided into three parts. The first deals briefly with more general aspects of the theory of archetypes (as conceived by Jung); the second examines the anima archetype in rather more detail, because it is, apart from the self, the main archetype in Jung's thought; and the third discusses the clinical repercussions of the anima theory and of the theory of the archetypes in general. The various references to Jung himself and certain circumstances of his life are included here on the assumption that personal problems in his biography contributed decisively to the constitution of his theory, so that deeper insights accure if they are taken into account. PMID:11077760

  12. Structures' validation profiles in Transmission of Imaging and Data (TRIAD) for automated National Clinical Trials Network (NCTN) clinical trial digital data quality assurance.

    PubMed

    Giaddui, Tawfik; Yu, Jialu; Manfredi, Denise; Linnemann, Nancy; Hunter, Joanne; O'Meara, Elizabeth; Galvin, James; Bialecki, Brian; Xiao, Ying

    2016-01-01

    Transmission of Imaging and Data (TRIAD) is a standard-based system built by the American College of Radiology to provide the seamless exchange of images and data for accreditation of clinical trials and registries. Scripts of structures' names validation profiles created in TRIAD are used in the automated submission process. It is essential for users to understand the logistics of these scripts for successful submission of radiation therapy cases with less iteration.

  13. Factor structure of a Korean-language version of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) in a clinical sample of clients with alcohol dependence.

    PubMed

    Chun, Young-Min; Cho, Sung-Min; Shin, Sung-Man

    2010-12-01

    The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) is an instrument used to measure the level of motivation in regards to changing drinking and other addictive behaviors. While some initial factor analysis studies on the SOCRATES described a three-factor orthogonal structure of the scale, some other studies found a two-factor correlated structure. Therefore, the primary objective of the present study was to test the validity of the Korean language version of the instrument using a Korean population. The study examined the factor structure of the Korean version of the SOCRATES with clinical samples consisting of 219 inpatients and 271 outpatients with alcohol dependency. An exploratory factor analysis with an alpha factoring method revealed a three-factor correlated structure (i.e., Taking Steps, Recognition, and Ambivalence). The factorial structure of the SOCRATES Korean version corresponded almost exactly to that of its original French version as well as the German version. Moreover, confirmatory factor analyses showed that a three-factor correlated structure provided the best fit for the data.

  14. HIV-1 Protease with 20 Mutations Exhibits Extreme Resistance to Clinical Inhibitors through Coordinated Structural Rearrangements

    SciTech Connect

    Agniswamy, Johnson; Shen, Chen-Hsiang; Aniana, Annie; Sayer, Jane M.; Louis, John M.; Weber, Irene T.

    2012-06-28

    The escape mutant of HIV-1 protease (PR) containing 20 mutations (PR20) undergoes efficient polyprotein processing even in the presence of clinical protease inhibitors (PIs). PR20 shows >3 orders of magnitude decreased affinity for PIs darunavir (DRV) and saquinavir (SQV) relative to PR. Crystal structures of PR20 crystallized with yttrium, substrate analogue p2-NC, DRV, and SQV reveal three distinct conformations of the flexible flaps and diminished interactions with inhibitors through the combination of multiple mutations. PR20 with yttrium at the active site exhibits widely separated flaps lacking the usual intersubunit contacts seen in other inhibitor-free dimers. Mutations of residues 35-37 in the hinge loop eliminate interactions and perturb the flap conformation. Crystals of PR20/p2-NC contain one uninhibited dimer with one very open flap and one closed flap and a second inhibitor-bound dimer in the closed form showing six fewer hydrogen bonds with the substrate analogue relative to wild-type PR. PR20 complexes with PIs exhibit expanded S2/S2' pockets and fewer PI interactions arising from coordinated effects of mutations throughout the structure, in agreement with the strikingly reduced affinity. In particular, insertion of the large aromatic side chains of L10F and L33F alters intersubunit interactions and widens the PI binding site through a network of hydrophobic contacts. The two very open conformations of PR20 as well as the expanded binding site of the inhibitor-bound closed form suggest possible approaches for modifying inhibitors to target extreme drug-resistant HIV.

  15. Retinal Structures and Visual Cortex Activity are Impaired Prior to Clinical Vision Loss in Glaucoma

    PubMed Central

    Murphy, Matthew C.; Conner, Ian P.; Teng, Cindy Y.; Lawrence, Jesse D.; Safiullah, Zaid; Wang, Bo; Bilonick, Richard A.; Kim, Seong-Gi; Wollstein, Gadi; Schuman, Joel S.; Chan, Kevin C.

    2016-01-01

    Glaucoma is the second leading cause of blindness worldwide and its pathogenesis remains unclear. In this study, we measured the structure, metabolism and function of the visual system by optical coherence tomography and multi-modal magnetic resonance imaging in healthy subjects and glaucoma patients with different degrees of vision loss. We found that inner retinal layer thinning, optic nerve cupping and reduced visual cortex activity occurred before patients showed visual field impairment. The primary visual cortex also exhibited more severe functional deficits than higher-order visual brain areas in glaucoma. Within the visual cortex, choline metabolism was perturbed along with increasing disease severity in the eye, optic radiation and visual field. In summary, this study showed evidence that glaucoma deterioration is already present in the eye and the brain before substantial vision loss can be detected clinically using current testing methods. In addition, cortical cholinergic abnormalities are involved during trans-neuronal degeneration and can be detected non-invasively in glaucoma. The current results can be of impact for identifying early glaucoma mechanisms, detecting and monitoring pathophysiological events and eye-brain-behavior relationships, and guiding vision preservation strategies in the visual system, which may help reduce the burden of this irreversible but preventable neurodegenerative disease. PMID:27510406

  16. Retinal Structures and Visual Cortex Activity are Impaired Prior to Clinical Vision Loss in Glaucoma.

    PubMed

    Murphy, Matthew C; Conner, Ian P; Teng, Cindy Y; Lawrence, Jesse D; Safiullah, Zaid; Wang, Bo; Bilonick, Richard A; Kim, Seong-Gi; Wollstein, Gadi; Schuman, Joel S; Chan, Kevin C

    2016-01-01

    Glaucoma is the second leading cause of blindness worldwide and its pathogenesis remains unclear. In this study, we measured the structure, metabolism and function of the visual system by optical coherence tomography and multi-modal magnetic resonance imaging in healthy subjects and glaucoma patients with different degrees of vision loss. We found that inner retinal layer thinning, optic nerve cupping and reduced visual cortex activity occurred before patients showed visual field impairment. The primary visual cortex also exhibited more severe functional deficits than higher-order visual brain areas in glaucoma. Within the visual cortex, choline metabolism was perturbed along with increasing disease severity in the eye, optic radiation and visual field. In summary, this study showed evidence that glaucoma deterioration is already present in the eye and the brain before substantial vision loss can be detected clinically using current testing methods. In addition, cortical cholinergic abnormalities are involved during trans-neuronal degeneration and can be detected non-invasively in glaucoma. The current results can be of impact for identifying early glaucoma mechanisms, detecting and monitoring pathophysiological events and eye-brain-behavior relationships, and guiding vision preservation strategies in the visual system, which may help reduce the burden of this irreversible but preventable neurodegenerative disease. PMID:27510406

  17. The Structured Clinical Interview for DSM-IV Childhood Diagnoses (Kid-SCID): first psychometric evaluation in a Dutch sample of clinically referred youths.

    PubMed

    Roelofs, Jeffrey; Muris, Peter; Braet, Caroline; Arntz, Arnoud; Beelen, Imke

    2015-06-01

    The Structured Clinical Interview for DSM-IV Childhood Disorders (Kid-SCID) is a semi-structured interview for the classification of psychiatric disorders in children and adolescents. This study presents a first evaluation of the psychometric properties of the Kid-SCID in a Dutch sample of children and adolescents who had been referred to an outpatient treatment centre for mental health problems. Results indicated that the inter-rater reliability of the Kid-SCID classifications and the internal consistency of various (dimensional) criteria of the diagnoses were moderate to good. Further, for most Kid-SCID diagnoses, reasonable agreement between children and parents was found. Finally, the correspondence between the Kid-SCID and the final clinical diagnosis as established after the full intake procedure, which included the information as provided by the Kid-SCID, ranged from poor to good. Results are discussed in the light of methodological issues pertaining to the assessment of psychiatric disorders in youths. The Kid-SCID can generally be seen as a reliable and useful tool that can assist clinicians in carrying out clinical evaluations of children and adolescents.

  18. Structural Equation Analyses of Clinical Subpopulation Differences and Comparative Treatment Outcomes: Characterizing the Daily Lives of Drug Addicts.

    ERIC Educational Resources Information Center

    Aiken, Leona S.; And Others

    1994-01-01

    Used structural equation modeling for comparative treatment outcome research conducted with heterogeneous clinical subpopulations within large multimodality treatment settings. Evaluated effect of early period of treatment on daily lives of 486 clients in 2 drug abuse treatment modalities (methadone maintenance and outpatient counseling).…

  19. [The root of the deep and fast ongoing evolution of both structure and methodology of clinical research].

    PubMed

    Tavazzi, Luigi

    2016-03-01

    The growing scientific knowledge and technology development are leading to radical changes in biological and medical research. The prevalent lines of development deal with a pragmatic evolution of controlled clinical trials, a massive diffusion of observational research, which is progressively incorporated in clinical practice, new models and designs of clinical research, the systematic use of information technology to build up vast networks of medical centers producing huge amounts of shared data to be managed through the big data methodology, personalized as well as precision medicine, a reshaped physician-patient relationship based on a co-working principle. All this is leading to profound changes in public health governance, a renewal of clinical epidemiology and prevention, a modified structure of several specific sectors of medical care, hopefully guided by scientific evidences. A few aspects of such an evolving picture are discussed in this article.

  20. A structured exercise programme during haemodialysis for patients with chronic kidney disease: clinical benefit and long-term adherence

    PubMed Central

    Anding, Kirsten; Bär, Thomas; Trojniak-Hennig, Joanna; Kuchinke, Simone; Krause, Rolfdieter; Rost, Jan M; Halle, Martin

    2015-01-01

    Objective Long-term studies regarding the effect of a structured physical exercise programme (SPEP) during haemodialysis (HD) assessing compliance and clinical benefit are scarce. Study design A single-centre clinical trial, non-randomised, investigating 46 patients with HD (63.2±16.3 years, male/female 24/22, dialysis vintage 4.4 years) performing an SPEP over 5 years. The SPEP (twice/week for 60 min during haemodialysis) consisted of a combined resistance (8 muscle groups) and endurance (supine bicycle ergometry) training. Exercise intensity was continuously adjusted to improvements of performance testing. Changes in endurance and resistance capacity, physical functioning and quality of life (QoL) were analysed over 1 year in addition to long-term adherence and economics of the programme over 5 years. Average power per training session, maximal strength tests (maximal exercise repetitions/min), three performance-based tests for physical function, SF36 for QoL were assessed in the beginning and every 6 months thereafter. Results 78% of the patients completed the programme after 1 year and 43% after 5 years. Participants were divided—according to adherence to the programme—into three groups: (1) high adherence group (HA, >80% of 104 training sessions within 12 months), (2) moderate adherence (MA, 60–80%), and 3. Low adherence group (LA, <60%)) with HA and MA evaluated quantitatively. One-year follow-up data revealed significant (p<0.05) improvement for both groups in all measured parameters: exercise capacity (HA: 55%, MA: 45%), strength (HA: >120%, MA: 40–50%), QoL in three scores of SF36 subscales and physical function in the three tests taken between 11% and 31%. Moreover, a quantitative correlation analysis revealed a close association (r=0.8) between large improvement of endurance capacity and weak physical condition (HA). Conclusions The exercise programme described improves physical function significantly and can be integrated

  1. Unveiling the near-infrared structure of the massive-young stellar object NGC 3603 IRS 9A* with sparse aperture masking and spectroastrometry

    NASA Astrophysics Data System (ADS)

    Sanchez-Bermudez, J.; Hummel, C. A.; Tuthill, P.; Alberdi, A.; Schödel, R.; Lacour, S.; Stanke, T.

    2016-04-01

    Context. Contemporary theory holds that massive stars gather mass during their initial phases via accreting disk-like structures. However, conclusive evidence for disks has remained elusive for most massive young objects. This is mainly due to significant observational challenges: objects are rare and located at great distances within dusty, highly opaque environments. Incisive studies, even targeting individual objects, are therefore relevant to the progression of the field. NGC 3603 IRS 9A* is a young massive stellar object that is still surrounded by an envelope of molecular gas for which previous mid-infrared observations with long-baseline interferometry have provided evidence of a plausible disk of 50 mas diameter at its core. Aims: This work aims at a comprehensive study of the physics and morphology of IRS 9A at near-infrared wavelengths. Methods: New sparse aperture-masking interferometry data, taken with the near-infrared camera NACO of the Very Large Telescope (VLT) at Ks and L' wavelengths, were analyzed together with archival high-resolution H2 and Brγ lines obtained with the cryogenic high-resolution infrared schelle spectrograph (CRIRES). Results: The trends in the calibrated visibilities at Ks and L'-bands suggest the presence of a partially resolved compact object with an angular size of ≤30 mas at the core of IRS 9A, together with the presence of over-resolved flux. The spectroastrometric signal of the H2 line, obtained from the CRIRES spectra, shows that this spectral feature proceeds from the large-scale extended emission (~300 mas), while the Brγ line appears to be formed at the core of the object (~20 mas). To better understand the physics that drive IRS 9A, we have performed continuum radiative transfer modeling. Our best model supports the existence of a compact disk with an angular diameter of 20 mas, together with an outer envelope of 1'' exhibiting a polar cavity with an opening angle of ~30°. This model reproduces the MIR morphology

  2. Belt-hierarchic structure of th ring, satellite and planet systems: prediction S/2001 U1 and others objects in Solar system

    NASA Astrophysics Data System (ADS)

    Barkin, Yu. V.

    2003-04-01

    BELT-HIERARCHIC STRUCTURE OF THE RING, SATELLITE AND PLANET SYSTEMS: PREDICTION S/2001 U1 AND OTHERS OBJECTS IN SOLAR SYSTEM Yu.V.Barkin Sternberg Astronomical Institute, Moscow, Russia, barkin@sai.msu.ru Structure regularities of the planet and satellite systems have been studied. Statistic analysis of the distribution of the major semi-axes of the orbits of the planets, comets and centaurs of the Solar system, satellite and ring systems of Jupiter, Saturn, Neptune and Uran, exoplanet systems of the pulsars PSR 1257+12, PSR 1828-11 and of the main consequence star Ups And was fulfilled. The following empirical regularities were described [1]: 1) the bodies of systems are combined into hierarchic groups and main from them combine 5 companions; 2) differences of the major semi-axes of the neighboring orbits for bodies of every group are constant; 4) for main neighboring hierarchic group these distances are distinguished in 6 times increasing to external grope; 5) the filling of the gropes and some present changes in their structure are caused by the past catastrophes in corresponding systems. The special method of reconstruction of the catastrophes which had place in the life of the Solar system (SS) was developed. Suggested method has let us to explain uniformly observed values of the major semi-axes and average values of eccentricities of the planets. In particular the Pancul’s hypothesis about Jupiter formation from two giant protoplanets (Jupiter I and Jupiter II) was confirmed. The new empirical law of the filling of the orbits of the regular groups of the planets or satellites (or rings structures) of the hierarchic ordered systems of celestial bodies was established. It was shown that sum number of bodies is proportional to the value of catastrophic value of the eccentricities which are same for first, second ,.... and fifth orbits of all gropes. The theoretical numbers of bodies for pointed orbits practically coincide with their observed numbers in main

  3. Biofilm Morphotypes and Population Structure among Staphylococcus epidermidis from Commensal and Clinical Samples

    PubMed Central

    Harris, Llinos G.; Murray, Susan; Pascoe, Ben; Bray, James; Meric, Guillaume; Magerios, Leonardos; Wilkinson, Thomas S.; Jeeves, Rose; Rohde, Holger; Schwarz, Stefan; de Lencastre, Herminia; Miragaia, Maria; Rolo, Joana; Bowden, Rory; Jolley, Keith A.; Maiden, Martin C. J.; Mack, Dietrich; Sheppard, Samuel K.

    2016-01-01

    Bacterial species comprise related genotypes that can display divergent phenotypes with important clinical implications. Staphylococcus epidermidis is a common cause of nosocomial infections and, critical to its pathogenesis, is its ability to adhere and form biofilms on surfaces, thereby moderating the effect of the host’s immune response and antibiotics. Commensal S. epidermidis populations are thought to differ from those associated with disease in factors involved in adhesion and biofilm accumulation. We quantified the differences in biofilm formation in 98 S. epidermidis isolates from various sources, and investigated population structure based on ribosomal multilocus typing (rMLST) and the presence/absence of genes involved in adhesion and biofilm formation. All isolates were able to adhere and form biofilms in in vitro growth assays and confocal microscopy allowed classification into 5 biofilm morphotypes based on their thickness, biovolume and roughness. Phylogenetic reconstruction grouped isolates into three separate clades, with the isolates in the main disease associated clade displaying diversity in morphotype. Of the biofilm morphology characteristics, only biofilm thickness had a significant association with clade distribution. The distribution of some known adhesion-associated genes (aap and sesE) among isolates showed a significant association with the species clonal frame. These data challenge the assumption that biofilm-associated genes, such as those on the ica operon, are genetic markers for less invasive S. epidermidis isolates, and suggest that phenotypic characteristics, such as adhesion and biofilm formation, are not fixed by clonal descent but are influenced by the presence of various genes that are mobile among lineages. PMID:26978068

  4. Biofilm Morphotypes and Population Structure among Staphylococcus epidermidis from Commensal and Clinical Samples.

    PubMed

    Harris, Llinos G; Murray, Susan; Pascoe, Ben; Bray, James; Meric, Guillaume; Magerios, Leonardos; Wilkinson, Thomas S; Jeeves, Rose; Rohde, Holger; Schwarz, Stefan; de Lencastre, Herminia; Miragaia, Maria; Rolo, Joana; Bowden, Rory; Jolley, Keith A; Maiden, Martin C J; Mack, Dietrich; Sheppard, Samuel K

    2016-01-01

    Bacterial species comprise related genotypes that can display divergent phenotypes with important clinical implications. Staphylococcus epidermidis is a common cause of nosocomial infections and, critical to its pathogenesis, is its ability to adhere and form biofilms on surfaces, thereby moderating the effect of the host's immune response and antibiotics. Commensal S. epidermidis populations are thought to differ from those associated with disease in factors involved in adhesion and biofilm accumulation. We quantified the differences in biofilm formation in 98 S. epidermidis isolates from various sources, and investigated population structure based on ribosomal multilocus typing (rMLST) and the presence/absence of genes involved in adhesion and biofilm formation. All isolates were able to adhere and form biofilms in in vitro growth assays and confocal microscopy allowed classification into 5 biofilm morphotypes based on their thickness, biovolume and roughness. Phylogenetic reconstruction grouped isolates into three separate clades, with the isolates in the main disease associated clade displaying diversity in morphotype. Of the biofilm morphology characteristics, only biofilm thickness had a significant association with clade distribution. The distribution of some known adhesion-associated genes (aap and sesE) among isolates showed a significant association with the species clonal frame. These data challenge the assumption that biofilm-associated genes, such as those on the ica operon, are genetic markers for less invasive S. epidermidis isolates, and suggest that phenotypic characteristics, such as adhesion and biofilm formation, are not fixed by clonal descent but are influenced by the presence of various genes that are mobile among lineages.

  5. Biofilm Morphotypes and Population Structure among Staphylococcus epidermidis from Commensal and Clinical Samples.

    PubMed

    Harris, Llinos G; Murray, Susan; Pascoe, Ben; Bray, James; Meric, Guillaume; Magerios, Leonardos; Wilkinson, Thomas S; Jeeves, Rose; Rohde, Holger; Schwarz, Stefan; de Lencastre, Herminia; Miragaia, Maria; Rolo, Joana; Bowden, Rory; Jolley, Keith A; Maiden, Martin C J; Mack, Dietrich; Sheppard, Samuel K

    2016-01-01

    Bacterial species comprise related genotypes that can display divergent phenotypes with important clinical implications. Staphylococcus epidermidis is a common cause of nosocomial infections and, critical to its pathogenesis, is its ability to adhere and form biofilms on surfaces, thereby moderating the effect of the host's immune response and antibiotics. Commensal S. epidermidis populations are thought to differ from those associated with disease in factors involved in adhesion and biofilm accumulation. We quantified the differences in biofilm formation in 98 S. epidermidis isolates from various sources, and investigated population structure based on ribosomal multilocus typing (rMLST) and the presence/absence of genes involved in adhesion and biofilm formation. All isolates were able to adhere and form biofilms in in vitro growth assays and confocal microscopy allowed classification into 5 biofilm morphotypes based on their thickness, biovolume and roughness. Phylogenetic reconstruction grouped isolates into three separate clades, with the isolates in the main disease associated clade displaying diversity in morphotype. Of the biofilm morphology characteristics, only biofilm thickness had a significant association with clade distribution. The distribution of some known adhesion-associated genes (aap and sesE) among isolates showed a significant association with the species clonal frame. These data challenge the assumption that biofilm-associated genes, such as those on the ica operon, are genetic markers for less invasive S. epidermidis isolates, and suggest that phenotypic characteristics, such as adhesion and biofilm formation, are not fixed by clonal descent but are influenced by the presence of various genes that are mobile among lineages. PMID:26978068

  6. Building an innovation electronic nursing record pilot structure with nursing clinical pathway.

    PubMed

    Hao, Angelica Te-Hui; Huang, Li-Fang; Wu, Li-Bin; Kao, Ching-Chiu; Lu, Mei-Show; Jian, Wen-Shan; Chang, Her-Kung; Hsu, Chien-Yeh

    2006-01-01

    The nursing process consists of five interrelated steps: assessment, diagnosis, planning, implementation, and evaluation. In the nursing process, the nurse confronts a great deal of data and information. The amount of data and information may exceed the amount the nurse can process efficiently and correctly. Thus, the nurse needs assistance to become proficient in the planning of nursing care, due to the difficulty of simultaneously processing a large set of information. Thus, some form of assistance will be needed to help nurses to become more proficient in planning nursing care. Using computer technology to support clinicians' decision making may provide high-quality, patient-centered, and efficient healthcare. Although some existing nursing information systems aid in the nursing process, they only provide the most rudimentary decision support--i.e., standard care plans associated with common nursing diagnoses. Such a computerized decision support system helps the nurse develop a care plan step-by-step. But it does not assist the nurse in the decision-making process. The decision process about how to derive nursing diagnoses from data and how to individualize the care plans still remains in the mind of the nurse. The purpose of this study is to develop a pilot structure in an electronic nursing record system integrated with international nursing standards for improving the proficiency and accuracy of the plan of care in the clinical pathway process. The pilot system has shown promise in assisting both student nurses and beginner nurses. It also shows promise in helping experts who need to work in a practice area that is outside of their immediate domain.

  7. DICOM for quantitative imaging biomarker development: a standards based approach to sharing clinical data and structured PET/CT analysis results in head and neck cancer research.

    PubMed

    Fedorov, Andriy; Clunie, David; Ulrich, Ethan; Bauer, Christian; Wahle, Andreas; Brown, Bartley; Onken, Michael; Riesmeier, Jörg; Pieper, Steve; Kikinis, Ron; Buatti, John; Beichel, Reinhard R

    2016-01-01

    Background. Imaging biomarkers hold tremendous promise for precision medicine clinical applications. Development of such biomarkers relies heavily on image post-processing tools for automated image quantitation. Their deployment in the context of clinical research necessitates interoperability with the clinical systems. Comparison with the established outcomes and evaluation tasks motivate integration of the clinical and imaging data, and the use of standardized approaches to support annotation and sharing of the analysis results and semantics. We developed the methodology and tools to support these tasks in Positron Emission Tomography and Computed Tomography (PET/CT) quantitative imaging (QI) biomarker development applied to head and neck cancer (HNC) treatment response assessment, using the Digital Imaging and Communications in Medicine (DICOM(®)) international standard and free open-source software. Methods. Quantitative analysis of PET/CT imaging data collected on patients undergoing treatment for HNC was conducted. Processing steps included Standardized Uptake Value (SUV) normalization of the images, segmentation of the tumor using manual and semi-automatic approaches, automatic segmentation of the reference regions, and extraction of the volumetric segmentation-based measurements. Suitable components of the DICOM standard were identified to model the various types of data produced by the analysis. A developer toolkit of conversion routines and an Application Programming Interface (API) were contributed and applied to create a standards-based representation of the data. Results. DICOM Real World Value Mapping, Segmentation and Structured Reporting objects were utilized for standards-compliant representation of the PET/CT QI analysis results and relevant clinical data. A number of correction proposals to the standard were developed. The open-source DICOM toolkit (DCMTK) was improved to simplify the task of DICOM encoding by introducing new API abstractions

  8. DICOM for quantitative imaging biomarker development: a standards based approach to sharing clinical data and structured PET/CT analysis results in head and neck cancer research.

    PubMed

    Fedorov, Andriy; Clunie, David; Ulrich, Ethan; Bauer, Christian; Wahle, Andreas; Brown, Bartley; Onken, Michael; Riesmeier, Jörg; Pieper, Steve; Kikinis, Ron; Buatti, John; Beichel, Reinhard R

    2016-01-01

    Background. Imaging biomarkers hold tremendous promise for precision medicine clinical applications. Development of such biomarkers relies heavily on image post-processing tools for automated image quantitation. Their deployment in the context of clinical research necessitates interoperability with the clinical systems. Comparison with the established outcomes and evaluation tasks motivate integration of the clinical and imaging data, and the use of standardized approaches to support annotation and sharing of the analysis results and semantics. We developed the methodology and tools to support these tasks in Positron Emission Tomography and Computed Tomography (PET/CT) quantitative imaging (QI) biomarker development applied to head and neck cancer (HNC) treatment response assessment, using the Digital Imaging and Communications in Medicine (DICOM(®)) international standard and free open-source software. Methods. Quantitative analysis of PET/CT imaging data collected on patients undergoing treatment for HNC was conducted. Processing steps included Standardized Uptake Value (SUV) normalization of the images, segmentation of the tumor using manual and semi-automatic approaches, automatic segmentation of the reference regions, and extraction of the volumetric segmentation-based measurements. Suitable components of the DICOM standard were identified to model the various types of data produced by the analysis. A developer toolkit of conversion routines and an Application Programming Interface (API) were contributed and applied to create a standards-based representation of the data. Results. DICOM Real World Value Mapping, Segmentation and Structured Reporting objects were utilized for standards-compliant representation of the PET/CT QI analysis results and relevant clinical data. A number of correction proposals to the standard were developed. The open-source DICOM toolkit (DCMTK) was improved to simplify the task of DICOM encoding by introducing new API abstractions

  9. DICOM for quantitative imaging biomarker development: a standards based approach to sharing clinical data and structured PET/CT analysis results in head and neck cancer research

    PubMed Central

    Clunie, David; Ulrich, Ethan; Bauer, Christian; Wahle, Andreas; Brown, Bartley; Onken, Michael; Riesmeier, Jörg; Pieper, Steve; Kikinis, Ron; Buatti, John; Beichel, Reinhard R.

    2016-01-01

    Background. Imaging biomarkers hold tremendous promise for precision medicine clinical applications. Development of such biomarkers relies heavily on image post-processing tools for automated image quantitation. Their deployment in the context of clinical research necessitates interoperability with the clinical systems. Comparison with the established outcomes and evaluation tasks motivate integration of the clinical and imaging data, and the use of standardized approaches to support annotation and sharing of the analysis results and semantics. We developed the methodology and tools to support these tasks in Positron Emission Tomography and Computed Tomography (PET/CT) quantitative imaging (QI) biomarker development applied to head and neck cancer (HNC) treatment response assessment, using the Digital Imaging and Communications in Medicine (DICOM®) international standard and free open-source software. Methods. Quantitative analysis of PET/CT imaging data collected on patients undergoing treatment for HNC was conducted. Processing steps included Standardized Uptake Value (SUV) normalization of the images, segmentation of the tumor using manual and semi-automatic approaches, automatic segmentation of the reference regions, and extraction of the volumetric segmentation-based measurements. Suitable components of the DICOM standard were identified to model the various types of data produced by the analysis. A developer toolkit of conversion routines and an Application Programming Interface (API) were contributed and applied to create a standards-based representation of the data. Results. DICOM Real World Value Mapping, Segmentation and Structured Reporting objects were utilized for standards-compliant representation of the PET/CT QI analysis results and relevant clinical data. A number of correction proposals to the standard were developed. The open-source DICOM toolkit (DCMTK) was improved to simplify the task of DICOM encoding by introducing new API abstractions

  10. Space, structure and social dynamics within the clinical setting: two case studies of assisted reproduction in Mexico City.

    PubMed

    González-Santos, Sandra P

    2011-01-01

    Drawing on the concept of therapeutic environments and comparing two case studies, this paper explores the interaction between the spatial factors of the clinical setting, the structural elements of the health system, and the specific treatment requirements of assisted reproduction in order to see the type and degree of privacy and accessibility, as well as the particular social dynamics (i.e. patient-physician and among patients) fostered in two Mexico City fertility clinics. Both cases suggest that certain types of therapeutic environments encourage the formation of spontaneous support groups while others favour the patient-physician relationship. PMID:20961798

  11. Numerical integration of gravitational field for general three-dimensional objects and its application to gravitational study of grand design spiral arm structure

    NASA Astrophysics Data System (ADS)

    Fukushima, Toshio

    2016-08-01

    We present a method to integrate the gravitational field for general three-dimensional objects. By adopting the spherical polar coordinates centered at the evaluation point as the integration variables, we numerically compute the volume integral representation of the gravitational potential and of the acceleration vector. The variable transformation completely removes the algebraic singularities of the original integrals. The comparison with exact solutions reveals around 15 digits accuracy of the new method. Meanwhile, the 6 digit accuracy of the integrated gravitational field is realized by around 106 evaluations of the integrand per evaluation point, which costs at most a few seconds at a PC with Intel Core i7-4600U CPU running at 2.10 GHz clock. By using the new method, we show the gravitational field of a grand design spiral arm structure as an example. The computed gravitational field shows not only spiral shaped details but also a global feature composed of a thick oblate spheroid and a thin disc. The developed method is directly applicable to the electromagnetic field computation by means of Coulomb's law, the Biot-Savart law, and their retarded extensions. Sample FORTRAN 90 programs and test results are electronically available.

  12. Objective convective updraft identification and tracking: Part 1. Structure and thermodynamics of convection in the rainband regions of two hurricane simulations

    NASA Astrophysics Data System (ADS)

    Terwey, Wesley D.; Rozoff, Christopher M.

    2014-06-01

    To better understand the life cycles of convective elements in numerical model simulations, a convective updraft tracking algorithm, dubbed the Statistical and Programmable Objective Updraft Tracker (SPOUT), is developed. SPOUT identifies updraft cores in horizontal slices through a given model data set, links these cores in three dimensions to form vertically coherent updrafts, and then tracks updrafts in time via estimates of the mean local advection. SPOUT is evaluated in idealized hurricane simulations from both the Regional Atmospheric Modeling System (RAMS) and Weather Research and Forecasting (WRF). In both simulations, SPOUT indicates most updrafts live less than 60 min, but some can persist for over 2 h. Updrafts are typically manifested as shallow cumulus, cumulus congestus, and deep cumulonimbus. Overall, there is reasonable agreement between the vigor of convection and the amount of localized conditional convective instability. Also, the majority of updrafts attain a tilted structure that is in accordance with the localized vertical wind shear. Nonetheless, there are striking differences between models, with the higher-resolution WRF simulation producing around twice as many updrafts as RAMS. Moreover, the WRF updrafts are significantly weaker. This paper highlights the utility of SPOUT for studying convective life cycles in high-resolution numerical simulations and provides some basic features of convection in two hurricane simulations.

  13. A randomized, double-blind, Phase 2 study to evaluate subjective and objective outcomes in patients with acute bacterial skin and skin structure infections treated with delafloxacin, linezolid or vancomycin

    PubMed Central

    Kingsley, Jeff; Mehra, Purvi; Lawrence, Laura E.; Henry, Eugenia; Duffy, Erin; Cammarata, Sue K.; Pullman, John

    2016-01-01

    Objectives Delafloxacin is an investigational anionic fluoroquinolone being developed to treat infections caused by Gram-positive and -negative organisms. This clinical trial evaluated the efficacy and safety of delafloxacin in the treatment of acute bacterial skin and skin structure infections (ABSSSIs). Methods In a double-blind, Phase 2 trial, 256 patients were randomized (1 : 1 : 1) to 300 mg of delafloxacin, 600 mg of linezolid or 15 mg/kg vancomycin (actual body weight), each administered intravenously twice daily for 5–14 days. Randomization was stratified by infection category. The primary endpoint was the investigator's assessment of cure, defined as complete resolution of baseline signs and symptoms at follow-up. Secondary endpoints included reductions in the total areas of erythema and induration and assessments of bacterial eradication. This trial has been registered at ClinicalTrials.gov under registration number NCT01283581. Results Cure rates were significantly greater with delafloxacin versus vancomycin (mean difference: −16.3%; 95% CI, −30.3% to −2.3%; P = 0.031); differences were significant for obese patients (BMI ≥30 kg/m2; mean difference: −30.0%; 95% CI, −50.7% to −9.3%; P = 0.009), but not for non-obese patients. Cure rates with delafloxacin and linezolid were similar. Using digital measurement, the percentage decrease in total erythema area was significantly greater with delafloxacin versus vancomycin at follow-up (−96.4% versus −84.5%; P = 0.028). There were no differences in bacterial eradication among the treatment groups. The most frequently reported treatment-emergent adverse events were nausea, diarrhoea and vomiting. Conclusions These data show that delafloxacin is effective in the treatment of ABSSSIs and is well tolerated. PMID:26679243

  14. Structural Competency in the U.S. Healthcare Crisis: Putting Social and Policy Interventions Into Clinical Practice.

    PubMed

    Hansen, H; Metzl, J

    2016-06-01

    This symposium of the Journal of Bioethical Inquiry illustrates structural competency: how clinical practitioners can intervene on social and institutional determinants of health. It will require training clinicians to see and act on structural barriers to health, to adapt imaginative structural approaches from fields outside of medicine, and to collaborate with disciplines and institutions outside of medicine. Case studies of effective work on all of these levels are presented in this volume. The contributors exemplify structural competency from many angles, from the implications of epigenetics for environmental intervention in personalized medicine to the ways clinicians can act on fundamental causes of disease, address abuses of power in clinical training, racially desegregate cities to reduce health disparities, address the systemic causes of torture by police, and implement harm-reduction programs for addiction in the face of punitive drug laws. Together, these contributors demonstrate the unique roles that clinicians can play in breaking systemic barriers to health and the benefit to the U.S. healthcare system of adopting innovations from outside of the United States and outside of clinical medicine. PMID:27178191

  15. Factor structure of the General Health Questionnaire-28 (GHQ-28) from infertile women attending the Yazd Research and Clinical Center for Infertility

    PubMed Central

    Shayan, Zahra; Pourmovahed, Zahra; Najafipour, Fatemeh; Abdoli, Ali Mohammad; Mohebpour, Fatemeh; Najafipour, Sedighe

    2015-01-01

    Background: Nowadays, infertility problems have become a social concern, and are associated with multiple psychological and social problems. Also, it affects the interpersonal communication between the individual, familial, and social characteristics. Since women are exposed to stressors of physical, mental, social factors, and treatment of infertility, providing a psychometric screening tool is necessary for disorders of this group. Objective: The aim of this study was to determine the factor structure of the general health questionnaire-28 to discover mental disorders in infertile women. Materials and Methods: In this study, 220 infertile women undergoing treatment of infertility were selected from the Yazd Research and Clinical Center for Infertility with convenience sampling in 2011. After completing the general health questionnaire by the project manager, validity and, reliability of the questionnaire were calculated by confirmatory factor structure and Cronbach's alpha, respectively. Results: Four factors, including anxiety and insomnia, social dysfunction, depression, and physical symptoms were extracted from the factor structure. 50.12% of the total variance was explained by four factors. The reliability coefficient of the questionnaire was obtained 0.90. Conclusion: Analysis of the factor structure and reliability of General Health Questionnaire-28 showed that it is suitable as a screening instrument for assessing general health of infertile women. PMID:27141541

  16. [Structure and function of class 1 integron in clinical isolates of Klebsiella pneumoniae].

    PubMed

    Yuejin, Zhang; Qingli, Chang; Qian, Wang; Junwan, Lu; Huan, Wang; Peizhen, Li; Jun, Ying; Qiyu, Bao; Yunliang, Hu

    2014-06-01

    To investigate molecular mechanism of multi-resistance of Klebsiella pneumoniae and its spreading, 179 strains isolated from different clinical samples in the period of 2002-2007 with serious resistance to 14 anti-bacterial agents were examined. Among them, 118 (65.9%) were resistant to at least two anti-bacterial agents; 36.3% (65/179) were found to contain class 1 integrons. There was a significant difference for resistance rate between the integron positive and the negative groups, especially for antimicrobial agents of aminoglycosides, quinolones and sulfonamides (P<0.01). Gene cassette structures of the class 1 integrons in these bacteria were analyzed and their resistance genes were further cloned and tested for antibiotic resistance activities. Fifteen gene cassettes were identified with dfrA17-aadA5 being the most popular form. Three recombinant plasmids pET28a-dhfr17, pET28a-dhfr17-orfF and pET28a-dhfr17-orfF-aadA2 were cloned from a gene cassette of dhfr17-orfF-aadA2. When introduced into a recipient E. coli strain BL21, all of them rendered resistance to co-trimoxazole, with minimum inhibitory concentration (MIC) value up to 256 µg/µL. The E. coli BL21 carrying pET28a- dhfr17 or pET28a-dhfr17-orfF had the same MIC value of 8 µg/µL to streptomycin as the recipient strain without plasmid. However, the E. coli carrying pET28a-dhfr17-orfF-aadA2 was resistant to streptomycin with MIC level up to 256 µg/µL. In conclusion, class 1 integrons were regularly identified in Klebsiella pneumoniae. They mainly carry resistance genes against antimicrobial agents of aminoglycosides and sulfonamide. Transferable plasmid carrying integrons with resistance genes may play an important role in resistance spreading among bacterial species.

  17. Population Structure of Clinical Pseudomonas aeruginosa from West and Central African Countries

    PubMed Central

    Cholley, Pascal; Ka, Roughyatou; Guyeux, Christophe; Thouverez, Michelle; Guessennd, Nathalie; Ghebremedhin, Beniam; Frank, Thierry; Bertrand, Xavier; Hocquet, Didier

    2014-01-01

    Background Pseudomonas aeruginosa (PA) has a non-clonal, epidemic population with a few widely distributed and frequently encountered sequence types (STs) called ‘high-risk clusters’. Clinical P. aeruginosa (clinPA) has been studied in all inhabited continents excepted in Africa, where a very few isolates have been analyzed. Here, we characterized a collection of clinPA isolates from four countries of West and Central Africa. Methodology 184 non-redundant isolates of clinPA from hospitals of Senegal, Ivory Coast, Nigeria, and Central African Republic were genotyped by MLST. We assessed their resistance level to antibiotics by agar diffusion and identified the extended-spectrum β-lactamases (ESBLs) and metallo-β-lactamases (MBLs) by sequencing. The population structure of the species was determined by a nucleotide-based analysis of the entire PA MLST database and further localized on the phylogenetic tree (i) the sequence types (STs) of the present collection, (ii) the STs by continents, (iii) ESBL- and MBL-producing STs from the MLST database. Principal Findings We found 80 distinct STs, of which 24 had no relationship with any known STs. ‘High-risk’ international clonal complexes (CC155, CC244, CC235) were frequently found in West and Central Africa. The five VIM-2-producing isolates belonged to CC233 and CC244. GES-1 and GES-9 enzymes were produced by one CC235 and one ST1469 isolate, respectively. We showed the spread of ‘high-risk’ international clonal complexes, often described as multidrug-resistant on other continents, with a fully susceptible phenotype. The MBL- and ESBL-producing STs were scattered throughout the phylogenetic tree and our data suggest a poor association between a continent and a specific phylogroup. Conclusions ESBL- and MBL-encoding genes are borne by both successful international clonal complexes and distinct local STs in clinPA of West and Central Africa. Furthermore, our data suggest that the spread of a ST could be

  18. The GuideView System for Interactive, Structured, Multi-modal Delivery of Clinical Guidelines

    NASA Technical Reports Server (NTRS)

    Iyengar, Sriram; Florez-Arango, Jose; Garcia, Carlos Andres

    2009-01-01

    GuideView is a computerized clinical guideline system which delivers clinical guidelines in an easy-to-understand and easy-to-use package. It may potentially enhance the quality of medical care or allow non-medical personnel to provide acceptable levels of care in situations where physicians or nurses may not be available. Such a system can be very valuable during space flight missions when a physician is not readily available, or perhaps the designated medical personnel is unable to provide care. Complex clinical guidelines are broken into simple steps. At each step clinical information is presented in multiple modes, including voice,audio, text, pictures, and video. Users can respond via mouse clicks or via voice navigation. GuideView can also interact with medical sensors using wireless or wired connections. The system's interface is illustrated and the results of a usability study are presented.

  19. Developing a competency-based educational structure within clinical and translational science.

    PubMed

    Dilmore, Terri Collin; Moore, Debra W; Bjork, Zuleikha

    2013-04-01

    In the emerging field of clinical and translational science (CTS), where researchers use both basic and clinical science research methodologies to move discoveries to clinical practice, establishing standards of competence is essential for preparing physician-scientists for the profession and for defining the field. The diversity of skills needed to execute quality research within the field of CTS has heightened the importance of an educational process that requires learners to demonstrate competence. Particularly within the more applied clinical science disciplines where there is a multi- or interdisciplinary approach to conducting research, defining and articulating the unique role and associated competencies of a physician-scientist is necessary. This paper describes a systematic process for developing a competency-based educational framework within a CTS graduate program at one institution.

  20. Automatic recognition of disorders, findings, pharmaceuticals and body structures from clinical text: an annotation and machine learning study.

    PubMed

    Skeppstedt, Maria; Kvist, Maria; Nilsson, Gunnar H; Dalianis, Hercules

    2014-06-01

    Automatic recognition of clinical entities in the narrative text of health records is useful for constructing applications for documentation of patient care, as well as for secondary usage in the form of medical knowledge extraction. There are a number of named entity recognition studies on English clinical text, but less work has been carried out on clinical text in other languages. This study was performed on Swedish health records, and focused on four entities that are highly relevant for constructing a patient overview and for medical hypothesis generation, namely the entities: Disorder, Finding, Pharmaceutical Drug and Body Structure. The study had two aims: to explore how well named entity recognition methods previously applied to English clinical text perform on similar texts written in Swedish; and to evaluate whether it is meaningful to divide the more general category Medical Problem, which has been used in a number of previous studies, into the two more granular entities, Disorder and Finding. Clinical notes from a Swedish internal medicine emergency unit were annotated for the four selected entity categories, and the inter-annotator agreement between two pairs of annotators was measured, resulting in an average F-score of 0.79 for Disorder, 0.66 for Finding, 0.90 for Pharmaceutical Drug and 0.80 for Body Structure. A subset of the developed corpus was thereafter used for finding suitable features for training a conditional random fields model. Finally, a new model was trained on this subset, using the best features and settings, and its ability to generalise to held-out data was evaluated. This final model obtained an F-score of 0.81 for Disorder, 0.69 for Finding, 0.88 for Pharmaceutical Drug, 0.85 for Body Structure and 0.78 for the combined category Disorder+Finding. The obtained results, which are in line with or slightly lower than those for similar studies on English clinical text, many of them conducted using a larger training data set, show that

  1. Automatic recognition of disorders, findings, pharmaceuticals and body structures from clinical text: an annotation and machine learning study.

    PubMed

    Skeppstedt, Maria; Kvist, Maria; Nilsson, Gunnar H; Dalianis, Hercules

    2014-06-01

    Automatic recognition of clinical entities in the narrative text of health records is useful for constructing applications for documentation of patient care, as well as for secondary usage in the form of medical knowledge extraction. There are a number of named entity recognition studies on English clinical text, but less work has been carried out on clinical text in other languages. This study was performed on Swedish health records, and focused on four entities that are highly relevant for constructing a patient overview and for medical hypothesis generation, namely the entities: Disorder, Finding, Pharmaceutical Drug and Body Structure. The study had two aims: to explore how well named entity recognition methods previously applied to English clinical text perform on similar texts written in Swedish; and to evaluate whether it is meaningful to divide the more general category Medical Problem, which has been used in a number of previous studies, into the two more granular entities, Disorder and Finding. Clinical notes from a Swedish internal medicine emergency unit were annotated for the four selected entity categories, and the inter-annotator agreement between two pairs of annotators was measured, resulting in an average F-score of 0.79 for Disorder, 0.66 for Finding, 0.90 for Pharmaceutical Drug and 0.80 for Body Structure. A subset of the developed corpus was thereafter used for finding suitable features for training a conditional random fields model. Finally, a new model was trained on this subset, using the best features and settings, and its ability to generalise to held-out data was evaluated. This final model obtained an F-score of 0.81 for Disorder, 0.69 for Finding, 0.88 for Pharmaceutical Drug, 0.85 for Body Structure and 0.78 for the combined category Disorder+Finding. The obtained results, which are in line with or slightly lower than those for similar studies on English clinical text, many of them conducted using a larger training data set, show that

  2. Effective management of attention-deficit/hyperactivity disorder (ADHD) through structured re-assessment: the Dundee ADHD Clinical Care Pathway.

    PubMed

    Coghill, David; Seth, Sarah

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) has become a major aspect of the work of child and adolescent psychiatrists and paediatricians in the UK. In Scotland, Child and Adolescent Mental Health Services were required to address an increase in referral rates and changes in evidence-based medicine and guidelines without additional funding. In response to this, clinicians in Dundee have, over the past 15 years, pioneered the use of integrated psychiatric, paediatric, nursing, occupational therapy, dietetic and psychological care with the development of a clearly structured, evidence-based assessment and treatment pathway to provide effective therapy for children and adolescents with ADHD. The Dundee ADHD Clinical Care Pathway (DACCP) uses standard protocols for assessment, titration and routine monitoring of clinical care and treatment outcomes, with much of the clinical work being nurse led. The DACCP has received international attention and has been used as a template for service development in many countries. This review describes the four key stages of the clinical care pathway (referral and pre-assessment; assessment, diagnosis and treatment planning; initiating treatment; and continuing care) and discusses translation of the DACCP into other healthcare systems. Tools for healthcare professionals to use or adapt according to their own clinical settings are also provided. PMID:26587055

  3. Evolution, current structure, and role of a primary care clinical pharmacy service in an integrated managed care organization.

    PubMed

    Heilmann, Rachel M F; Campbell, Stephanie M; Kroner, Beverly A; Proksel, Jenel R; Billups, Sarah J; Witt, Daniel M; Helling, Dennis K

    2013-01-01

    The impact of the declining number of primary care physicians is exacerbated by a growing elderly population in need of chronic disease management. Primary care clinical pharmacy specialists, with their unique knowledge and skill set, are well suited to address this gap. At Kaiser Permanente of Colorado (KPCO), primary care clinical pharmacy specialists have a long history of integration with medical practices and are located in close proximity to physicians, nurses, and other members of the health care team. Since 1992, Primary Care Clinical Pharmacy Services (PCCPS) has expanded from 4 to 30 full-time equivalents (FTEs) to provide services in all KPCO medical office buildings. With this growth in size, PCCPS has evolved to play a vital role in working with primary care medical teams to ensure that drug therapy is effective, safe, and affordable. In addition, PCCPS specialists provide ambulatory teaching sites for pharmacy students and pharmacy residents. There is approximately 1 specialist FTE for every 13,000 adult KPCO members and every 9 clinical FTEs of internal medicine and family medicine physicians. All clinical pharmacy specialists in the pharmacy department are required to have a PharmD degree, to complete postgraduate year 2 residencies, and, as a condition of employment, to become board certified in an applicable specialty. The evolution, current structure, and role of PCCPS at KPCO, including factors facilitating successful integration within the medical team, are highlighted. Patient and nonpatient care responsibilities are described.

  4. Antisocial Personality Disorder Subscale (Chinese Version) of the Structured Clinical Interview for the DSM-IV Axis II disorders: validation study in Cantonese-speaking Hong Kong Chinese.

    PubMed

    Tang, D Y Y; Liu, A C Y; Leung, M H T; Siu, B W M

    2013-06-01

    OBJECTIVE. Antisocial personality disorder (ASPD) is a risk factor for violence and is associated with poor treatment response when it is a co-morbid condition with substance abuse. It is an under-recognised clinical entity in the local Hong Kong setting, for which there are only a few available Chinese-language diagnostic instruments. None has been tested for its psychometric properties in the Cantonese-speaking population in Hong Kong. This study therefore aimed to assess the reliability and validity of the Chinese version of the ASPD subscale of the Structured Clinical Interview for the DSM-IV Axis II Disorders (SCID-II) in Hong Kong Chinese. METHODS. This assessment tool was modified according to dialectal differences between Mainland China and Hong Kong. Inpatients in Castle Peak Hospital, Hong Kong, who were designated for priority follow-up based on their assessed propensity for violence and who fulfilled the inclusion criteria for the study, were recruited. To assess the level of agreement, best-estimate diagnosis made by a multidisciplinary team was compared with diagnostic status determined by the SCID-II ASPD subscale. The internal consistency, sensitivity, and specificity of the subscale were also calculated. RESULTS. The internal consistency of the subscale was acceptable at 0.79, whereas the test-retest reliability and inter-rater reliability showed an excellent and good agreement of 0.90 and 0.86, respectively. Best-estimate clinical diagnosis-SCID diagnosis agreement was acceptable at 0.76. The sensitivity, specificity, positive and negative predictive values were 0.91, 0.86, 0.83, and 0.93, respectively. CONCLUSION. The Chinese version of the SCID-II ASPD subscale is reliable and valid for diagnosing ASPD in a Cantonese-speaking clinical population.

  5. Reflective type objective based spectral-domain phase-sensitive optical coherence tomography for high-sensitive structural and functional imaging of cochlear microstructures through intact bone of an excised guinea pig cochlea

    NASA Astrophysics Data System (ADS)

    Subhash, Hrebesh M.; Wang, Ruikang K.; Chen, Fangyi; Nuttall, Alfred L.

    2013-03-01

    Most of the optical coherence tomographic (OCT) systems for high resolution imaging of biological specimens are based on refractive type microscope objectives, which are optimized for specific wave length of the optical source. In this study, we present the feasibility of using commercially available reflective type objective for high sensitive and high resolution structural and functional imaging of cochlear microstructures of an excised guinea pig through intact temporal bone. Unlike conventional refractive type microscopic objective, reflective objective are free from chromatic aberrations due to their all-reflecting nature and can support a broadband of spectrum with very high light collection efficiency.

  6. Paradoxical antifungal activity and structural observations in biofilms formed by echinocandin-resistant Candida albicans clinical isolates.

    PubMed

    Walraven, Carla J; Bernardo, Stella M; Wiederhold, Nathan P; Lee, Samuel A

    2014-02-01

    Echinocandin-resistant clinical isolates of Candida albicans have been reported, and key-hot spot mutations in the FKS1 gene, which encodes a major glucan synthase subunit, have been identified in these (caspofungin-resistant [CAS-R]) strains. Although these mutations result in phenotypic resistance to echinocandins in planktonic cells, there is little data on antifungal susceptibilities of CAS-R C. albicans strains within biofilms. Thus, we analyzed biofilms formed by 12 C. albicans CAS-R clinical strains in which we previously identified FKS1 hot-spot mutations and compared the sessile antifungal and paradoxical activity of anidulafungin (ANID), caspofungin (CAS), and micafungin (MICA). Biofilms were formed in a 96-well static microplate model and assayed using both tetrazolium-salt reduction and crystal violet assays, as well as examination by scanning electron microscopy. We first sought to assess biofilm formation and structure in these fks1 mutants and found that the biofilm mass and metabolic activities were reduced in most of the fks1 mutants as compared with reference strain SC5314. Structural analyses revealed that the fks1 mutant biofilms were generally less dense and had a clear predominance of yeast and pseudohyphae, with unusual "pit"-like cell surface structures. We also noted that sessile minimum inhibitory concentrations (MICs) to ANID, CAS, and MICA were higher than planktonic MICs of all but one strain. The majority of strains demonstrated a paradoxical effect (PE) to particular echinocandins, in either planktonic or sessile forms. Overall, biofilms formed by echinocandin-resistant clinical isolates demonstrated varied PEs to echinocandins and were structurally characterized by a preponderance of yeast, pseudohyphae, and pit-like structures. PMID:24576999

  7. Paradoxical antifungal activity and structural observations in biofilms formed by echinocandin-resistant Candida albicans clinical isolates.

    PubMed

    Walraven, Carla J; Bernardo, Stella M; Wiederhold, Nathan P; Lee, Samuel A

    2014-02-01

    Echinocandin-resistant clinical isolates of Candida albicans have been reported, and key-hot spot mutations in the FKS1 gene, which encodes a major glucan synthase subunit, have been identified in these (caspofungin-resistant [CAS-R]) strains. Although these mutations result in phenotypic resistance to echinocandins in planktonic cells, there is little data on antifungal susceptibilities of CAS-R C. albicans strains within biofilms. Thus, we analyzed biofilms formed by 12 C. albicans CAS-R clinical strains in which we previously identified FKS1 hot-spot mutations and compared the sessile antifungal and paradoxical activity of anidulafungin (ANID), caspofungin (CAS), and micafungin (MICA). Biofilms were formed in a 96-well static microplate model and assayed using both tetrazolium-salt reduction and crystal violet assays, as well as examination by scanning electron microscopy. We first sought to assess biofilm formation and structure in these fks1 mutants and found that the biofilm mass and metabolic activities were reduced in most of the fks1 mutants as compared with reference strain SC5314. Structural analyses revealed that the fks1 mutant biofilms were generally less dense and had a clear predominance of yeast and pseudohyphae, with unusual "pit"-like cell surface structures. We also noted that sessile minimum inhibitory concentrations (MICs) to ANID, CAS, and MICA were higher than planktonic MICs of all but one strain. The majority of strains demonstrated a paradoxical effect (PE) to particular echinocandins, in either planktonic or sessile forms. Overall, biofilms formed by echinocandin-resistant clinical isolates demonstrated varied PEs to echinocandins and were structurally characterized by a preponderance of yeast, pseudohyphae, and pit-like structures.

  8. An application of cmaps in the description of clinical information structure and logic in electronic health records.

    PubMed

    Brewer, Allen; Helfgott, Maxwell A; Novak, Joseph; Schanhals, Rick

    2012-09-01

    The development and implementation of competent and cost-effective computerized medical records that profoundly improve physician productivity and knowledge management will require the development of a new paradigm for the representation and analysis of medical knowledge and logic. Medical knowledge is acquired inductively by observing, measuring, and eliciting information from patients in a process that is investigational rather than transactional. Most, if not all, current approaches to health information technology (HIT) rely on a logic and data structure that imposes significant limitations on the ability of physicians to thoroughly and efficiently document and access empiric patient data because the information is almost invariably organized in a way which presumes, rather than makes explicit, the relationships of concepts and their meaning. Cmapping provides a graphical method of capturing and displaying expert content knowledge that is simple to comprehend and modify and provides a foundation for a dynamic, inductive, and inclusive method of clinical documentation and research. The basis of medical decision analysis along with representative samples of medical knowledge modeling in the Cmap format is presented. The knowledge structures that are captured in Cmaps can be expressed directly in propositional logic, enabling the capability to convert Cmapped clinical expressions to be used to define a description logic for clinical evidence documentation and analysis that can in turn be mapped to multiple natural languages. The described description logic approach can be used to formulate digital messages and documents and to automate the process of converting description specifications formulated in propositional logic into operational electronic health record solutions for capture and reporting of clinical encounters. It has also been demonstrated that using Cmaps to elicit content knowledge from physicians to build point-of-care clinical documentation screens

  9. Availability of Structured and Unstructured Clinical Data for Comparative Effectiveness Research and Quality Improvement: A Multisite Assessment

    PubMed Central

    Capurro, Daniel; PhD, Meliha Yetisgen; van Eaton, Erik; Black, Robert; Tarczy-Hornoch, Peter

    2014-01-01

    Introduction: A key attribute of a learning health care system is the ability to collect and analyze routinely collected clinical data in order to quickly generate new clinical evidence, and to monitor the quality of the care provided. To achieve this vision, clinical data must be easy to extract and stored in computer readable formats. We conducted this study across multiple organizations to assess the availability of such data specifically for comparative effectiveness research (CER) and quality improvement (QI) on surgical procedures. Setting: This study was conducted in the context of the data needed for the already established Surgical Care and Outcomes Assessment Program (SCOAP), a clinician-led, performance benchmarking, and QI registry for surgical and interventional procedures in Washington State. Methods: We selected six hospitals, managed by two Health Information Technology (HIT) groups, and assessed the ease of automated extraction of the data required to complete the SCOAP data collection forms. Each data element was classified as easy, moderate, or complex to extract. Results: Overall, a significant proportion of the data required to automatically complete the SCOAP forms was not stored in structured computer-readable formats, with more than 75 percent of all data elements being classified as moderately complex or complex to extract. The distribution differed significantly between the health care systems studied. Conclusions: Although highly desirable, a learning health care system does not automatically emerge from the implementation of electronic health records (EHRs). Innovative methods to improve the structured capture of clinical data are needed to facilitate the use of routinely collected clinical data for patient phenotyping. PMID:25848594

  10. Reprint of "new complete structure of Hafnia alvei clinical isolate strain PCM 2670 semi-rough lipopolysaccharide".

    PubMed

    Bobko, Ewelina; Tyras, Michal; Jachymek, Wojciech

    2013-08-30

    Hafnia alvei strain PCM 2670 is a clinical isolate from a patient with chronic reproductive tract infection. The novel structure of the semi-rough lipopolysaccharide was established with the use of NMR spectroscopy and mass spectrometry as well as immunochemical techniques. According to the mass spectrometry data, heptose in the oligosaccharide is partially substituted by glycine. H. alvei PCM 2670 core structure encompasses the common core of H. alvei which is modified with two additional galactose units. [formula see text] The 6-substituted galactose is the O-antigen repeating unit substitution residue. The repeating unit consists of five monosaccharide residues and has the following structure: →2)-β-Galp-(1→6)-α-Glcp-(1→6)-αGlcpNAc3OAc-(1→4)-α-GalpA-(1→3)-β-GlcpNAc6OAc-(1→6)-core. PMID:23927934

  11. Rhizomes of Eremostachys laciniata: Isolation and Structure Elucidation of Chemical Constituents and a Clinical Trial on Inflammatory Diseases

    PubMed Central

    Delazar, Abbas; Sarker, Satyajit D.; Nahar, Lutfun; Jalali, Shahriar Barzegar; Modaresi, Masoud; Hamedeyazdan, Sanaz; Babaei, Hossein; Javadzadeh, Yousef; Asnaashari, Solmaz; Bamdad Moghadam, Sadeighe

    2013-01-01

    Purpose: The purpose of this study was the isolation and structure elucidation of chemical compounds from the rhizomes of Eremostachys laciniata (L) Bunge (EL), an Iranian traditional medicinal herb with a thick root and pale purple or white flowers as well as the clinical studies on the therapeutic efficacy and safety of topical application of the EL extract in the management of some inflammatory conditions, e.g., arthritis, rheumatoid arthritis and septic arthritis (Riter’s syndrome). Methods: The structures of the isolated compounds were elucidated unequivocally on the basis of one and two dimensional NMR, UV and HR-FABMS spectroscopic data analyses. A single-blinded randomized clinical trial was carried out with the extract of the rhizomes of E. laciniata (EL) to determine the efficacy and safety of the traditional uses of EL compared to that of piroxicam in treatment of inflammatory diseases, e.g., osteoarthritis, rheumatoid arthritis and Reiter’s syndrome. Results: Eleven iridoid glycosides, two phenylethanoids and two phytosterols were isolated and identified for the first time from the rhizomes of EL. After 14 days of treatment with the EL and piroxicam ointments, all groups showed significant improvements compared to the control groups. EL (5%) ointment induced better initial therapeutic response than piroxicam (5%) onitment. Conclusion: This clinical trial established that EL was suitable for topical applications as a safe and effective complementary therapy for inflammatory diseases. PMID:24312865

  12. Therapist turnover and new program sustainability in mental health clinics as a function of organizational culture, climate, and service structure.

    PubMed

    Glisson, Charles; Schoenwald, Sonja K; Kelleher, Kelly; Landsverk, John; Hoagwood, Kimberly Eaton; Mayberg, Stephen; Green, Philip

    2008-03-01

    The present study incorporates organizational theory and organizational characteristics in examining issues related to the successful implementation of mental health services. Following the theoretical foundations of socio-technical and cultural models of organizational effectiveness, organizational climate, culture, legal and service structures, and workforce characteristics are examined as correlates of therapist turnover and new program sustainability in a nationwide sample of mental health clinics. Results of General Linear Modeling (GLM) with the organization as the unit of analysis revealed that organizations with the best climates as measured by the Organizational Social Context (OSC) profiling system, had annual turnover rates (10%) that were less than half the rates found in organizations with the worst climates (22%). In addition, organizations with the best culture profiles sustained new treatment or service programs over twice as long (50 vs. 24 months) as organizations with the worst cultures. Finally, clinics with separate children's services units had higher turnover rates than clinics that served adults and children within the same unit. The findings suggest that strategies to support the implementation of new mental health treatments and services should attend to organizational culture and climate, and to the compatibility of organizational service structures with the demand characteristics of treatments. PMID:18080741

  13. Therapist turnover and new program sustainability in mental health clinics as a function of organizational culture, climate, and service structure.

    PubMed

    Glisson, Charles; Schoenwald, Sonja K; Kelleher, Kelly; Landsverk, John; Hoagwood, Kimberly Eaton; Mayberg, Stephen; Green, Philip

    2008-03-01

    The present study incorporates organizational theory and organizational characteristics in examining issues related to the successful implementation of mental health services. Following the theoretical foundations of socio-technical and cultural models of organizational effectiveness, organizational climate, culture, legal and service structures, and workforce characteristics are examined as correlates of therapist turnover and new program sustainability in a nationwide sample of mental health clinics. Results of General Linear Modeling (GLM) with the organization as the unit of analysis revealed that organizations with the best climates as measured by the Organizational Social Context (OSC) profiling system, had annual turnover rates (10%) that were less than half the rates found in organizations with the worst climates (22%). In addition, organizations with the best culture profiles sustained new treatment or service programs over twice as long (50 vs. 24 months) as organizations with the worst cultures. Finally, clinics with separate children's services units had higher turnover rates than clinics that served adults and children within the same unit. The findings suggest that strategies to support the implementation of new mental health treatments and services should attend to organizational culture and climate, and to the compatibility of organizational service structures with the demand characteristics of treatments.

  14. A Secreted Ankyrin-Repeat Protein from Clinical Stenotrophomonas maltophilia Isolates Disrupts Actin Cytoskeletal Structure.

    PubMed

    MacDonald, Logan C; O'Keefe, Sean; Parnes, Mei-Fan; MacDonald, Hanlon; Stretz, Lindsey; Templer, Suzanne J; Wong, Emily L; Berger, Bryan W

    2016-01-01

    Stenotrophomonas maltophilia is an emerging, multidrug-resistant pathogen of increasing importance for the immunocompromised, including cystic fibrosis patients. Despite its significance as an emerging pathogen, relatively little is known regarding the specific factors and mechanisms that contribute to its pathogenicity. We identify and characterize a putative ankyrin-repeat protein (Smlt3054) unique to clinical S. maltophilia isolates that binds F-actin in vitro and co-localizes with actin in transfected HEK293a cells. Smlt3054 is endogenously expressed and secreted from clinical S. maltophilia isolates, but not an environmental isolate (R551-3). The in vitro binding of Smlt3054 to F-actin resulted in a thickening of the filaments as observed by TEM. Ectopic expression of Smlt3054-GFP exhibits strong co-localization with F-actin, with distinct, retrograde F-actin waves specifically associated with Smlt3054 in individual cells as well as formation of dense, internal inclusions at the expense of retrograde F-actin waves. Collectively, our results point to an interaction between Smlt3054 and F-actin. Furthermore, as a potentially secreted protein unique to clinical S. maltophilia isolates, Smlt3054 may serve as a starting point for understanding the mechanisms by which S. maltophilia has become an emergent pathogen. PMID:27622948

  15. [Active clinical surveillance for detection of Legionnaires' disease: implications for health care structures].

    PubMed

    Marchesi, I; Bargellini, A; Cencetti, S; Concetti, S; Marchegiano, P; Cauteruccio, L; Casolari, C; Borella, P

    2007-01-01

    In an university hospital of about 900 beds, a clinical surveillance was activated to detect cases of Legionnaires' disease in patients affected by community and/or nosocomial-acquired pneumonia. In the hospital Legionella spp was detected in the hot water distribution system and various disinfecting and control procedures were adopted to reduce contamination. Contemporary, the clinical surveillance began with the systematic detection of Legionella urinary antigen among recovered pneumonia, seroconversion as confirmation test and the collection of respiratory secretions or other biological materials to isolate the microorganism in patients positive to the urinary antigen. From September 2003 to May 2005, 486 pneumonia were followed, 98 of which considered of nosocomial origin. In total, 15 cases of community-acquired Legionnaires' disease were detected by the urinary test, whereas no cases of nosocomial origin were found. The characteristics of the detected cases are described in comparison with the other pneumonia and the surveillance cost was evaluated. The systematic clinical surveillance for Legionella infections is feasible with limit costs, allows to detect community-acquired cases otherwise unknown and to ascertain the absence/presence of nosocomial-acquired pneumonia, irrespective of the environment contamination. PMID:17937322

  16. ARTEMIS Science Objectives

    NASA Technical Reports Server (NTRS)

    Sibeck, D. G.; Angelopoulos, V.; Brain, D. A.; Delory, G. T.; Eastwood, J. P.; Farrell, W. M.; Grimm, R. E.; Halekas, J. S.; Hasegawa, H.; Hellinger, P.; Khurana, K. K.; Lillis, R. J.; Oieroset, M.; Phan, T.-D.; Raeder, J.; Russell, C. T.; Schriver, D.; Slavin, J. A.; Travnicel, P. M.; Weygand, J. M.

    2011-01-01

    NASA's two spacecraft ARTEMIS mission will address both heliospheric and planetary research questions, first while in orbit about the Earth with the Moon and subsequently while in orbit about the Moon. Heliospheric topics include the structure of the Earth's magnetotail; reconnection, particle acceleration, and turbulence in the Earth's magnetosphere, at the bow shock, and in the solar wind; and the formation and structure of the lunar wake. Planetary topics include the lunar exosphere and its relationship to the composition of the lunar surface, the effects of electric fields on dust in the exosphere, internal structure of the Moon, and the lunar crustal magnetic field. This paper describes the expected contributions of ARTEMIS to these baseline scientific objectives.

  17. Factor structure and clinical correlates of the Food Thought Suppression Inventory within treatment seeking obese women with binge eating disorder.

    PubMed

    Barnes, Rachel D; Sawaoka, Takuya; White, Marney A; Masheb, Robin M; Grilo, Carlos M

    2013-01-01

    Prior research on the relations among eating behaviors and thought suppression is limited to a measure of general thought suppression, the White Bear Suppression Inventory. To address this limitation, researchers recently validated the Food Thought Suppression Inventory (FTSI). Analyses using this measure suggest that food thought suppression is distinct from and is more predictive of eating disorder psychopathology than is general thought suppression. The FTSI, however, has not yet been validated in clinical samples. The purpose of the current study is to examine the factor structure and clinical correlates of the FTSI within treatment seeking obese women with binge eating disorder (BED; N=128). Analyses revealed a valid and reliable one-factor measure of food thought suppression that was related to higher levels of eating and general psychopathology. The findings provide evidence for the use of the FTSI with obese women with BED. Future research should examine the psychometric properties of the FTSI within larger and more diverse samples.

  18. Characterization of the microbunch time structure of proton pencil beams at a clinical treatment facility.

    PubMed

    Petzoldt, J; Roemer, K E; Enghardt, W; Fiedler, F; Golnik, C; Hueso-González, F; Helmbrecht, S; Kormoll, T; Rohling, H; Smeets, J; Werner, T; Pausch, G

    2016-03-21

    Proton therapy is an advantageous treatment modality compared to conventional radiotherapy. In contrast to photons, charged particles have a finite range and can thus spare organs at risk. Additionally, the increased ionization density in the so-called Bragg peak close to the particle range can be utilized for maximum dose deposition in the tumour volume. Unfortunately, the accuracy of the therapy can be affected by range uncertainties, which have to be covered by additional safety margins around the treatment volume. A real-time range and dose verification is therefore highly desired and would be key to exploit the major advantages of proton therapy. Prompt gamma rays, produced in nuclear reactions between projectile and target nuclei, can be used to measure the proton's range. The prompt gamma-ray timing (PGT) method aims at obtaining this information by determining the gamma-ray emission time along the proton path using a conventional time-of-flight detector setup. First tests at a clinical accelerator have shown the feasibility to observe range shifts of about 5 mm at clinically relevant doses. However, PGT spectra are smeared out by the bunch time spread. Additionally, accelerator related proton bunch drifts against the radio frequency have been detected, preventing a potential range verification. At OncoRay, first experiments using a proton bunch monitor (PBM) at a clinical pencil beam have been conducted. Elastic proton scattering at a hydrogen-containing foil could be utilized to create a coincident proton-proton signal in two identical PBMs. The selection of coincident events helped to suppress uncorrelated background. The PBM setup was used as time reference for a PGT detector to correct for potential bunch drifts. Furthermore, the corrected PGT data were used to image an inhomogeneous phantom. In a further systematic measurement campaign, the bunch time spread and the proton transmission rate were measured for several beam energies between 69 and 225 Me

  19. Characterization of the microbunch time structure of proton pencil beams at a clinical treatment facility.

    PubMed

    Petzoldt, J; Roemer, K E; Enghardt, W; Fiedler, F; Golnik, C; Hueso-González, F; Helmbrecht, S; Kormoll, T; Rohling, H; Smeets, J; Werner, T; Pausch, G

    2016-03-21

    Proton therapy is an advantageous treatment modality compared to conventional radiotherapy. In contrast to photons, charged particles have a finite range and can thus spare organs at risk. Additionally, the increased ionization density in the so-called Bragg peak close to the particle range can be utilized for maximum dose deposition in the tumour volume. Unfortunately, the accuracy of the therapy can be affected by range uncertainties, which have to be covered by additional safety margins around the treatment volume. A real-time range and dose verification is therefore highly desired and would be key to exploit the major advantages of proton therapy. Prompt gamma rays, produced in nuclear reactions between projectile and target nuclei, can be used to measure the proton's range. The prompt gamma-ray timing (PGT) method aims at obtaining this information by determining the gamma-ray emission time along the proton path using a conventional time-of-flight detector setup. First tests at a clinical accelerator have shown the feasibility to observe range shifts of about 5 mm at clinically relevant doses. However, PGT spectra are smeared out by the bunch time spread. Additionally, accelerator related proton bunch drifts against the radio frequency have been detected, preventing a potential range verification. At OncoRay, first experiments using a proton bunch monitor (PBM) at a clinical pencil beam have been conducted. Elastic proton scattering at a hydrogen-containing foil could be utilized to create a coincident proton-proton signal in two identical PBMs. The selection of coincident events helped to suppress uncorrelated background. The PBM setup was used as time reference for a PGT detector to correct for potential bunch drifts. Furthermore, the corrected PGT data were used to image an inhomogeneous phantom. In a further systematic measurement campaign, the bunch time spread and the proton transmission rate were measured for several beam energies between 69 and 225 Me

  20. Characterization of the microbunch time structure of proton pencil beams at a clinical treatment facility

    NASA Astrophysics Data System (ADS)

    Petzoldt, J.; Roemer, K. E.; Enghardt, W.; Fiedler, F.; Golnik, C.; Hueso-González, F.; Helmbrecht, S.; Kormoll, T.; Rohling, H.; Smeets, J.; Werner, T.; Pausch, G.

    2016-03-01

    Proton therapy is an advantageous treatment modality compared to conventional radiotherapy. In contrast to photons, charged particles have a finite range and can thus spare organs at risk. Additionally, the increased ionization density in the so-called Bragg peak close to the particle range can be utilized for maximum dose deposition in the tumour volume. Unfortunately, the accuracy of the therapy can be affected by range uncertainties, which have to be covered by additional safety margins around the treatment volume. A real-time range and dose verification is therefore highly desired and would be key to exploit the major advantages of proton therapy. Prompt gamma rays, produced in nuclear reactions between projectile and target nuclei, can be used to measure the proton’s range. The prompt gamma-ray timing (PGT) method aims at obtaining this information by determining the gamma-ray emission time along the proton path using a conventional time-of-flight detector setup. First tests at a clinical accelerator have shown the feasibility to observe range shifts of about 5 mm at clinically relevant doses. However, PGT spectra are smeared out by the bunch time spread. Additionally, accelerator related proton bunch drifts against the radio frequency have been detected, preventing a potential range verification. At OncoRay, first experiments using a proton bunch monitor (PBM) at a clinical pencil beam have been conducted. Elastic proton scattering at a hydrogen-containing foil could be utilized to create a coincident proton-proton signal in two identical PBMs. The selection of coincident events helped to suppress uncorrelated background. The PBM setup was used as time reference for a PGT detector to correct for potential bunch drifts. Furthermore, the corrected PGT data were used to image an inhomogeneous phantom. In a further systematic measurement campaign, the bunch time spread and the proton transmission rate were measured for several beam energies between 69 and 225

  1. STANDARDIZING THE STRUCTURE OF STROKE CLINICAL AND EPIDEMIOLOGIC RESEARCH DATA: THE NINDS STROKE COMMON DATA ELEMENT (CDE) PROJECT

    PubMed Central

    Saver, Jeffrey L.; Warach, Steven; Janis, Scott; Odenkirchen, Joanne; Becker, Kyra; Benavente, Oscar; Broderick, Joseph; Dromerick, Alexander W.; Duncan, Pamela; Elkind, Mitchell S. V.; Johnston, Karen; Kidwell, Chelsea S.; Meschia, James F.; Schwamm, Lee

    2012-01-01

    Background and Purpose The National Institute of Neurological Disorders and Stroke initiated development of stroke-specific Common Data Elements (CDEs) as part of a project to develop data standards for funded clinical research in all fields of neuroscience. Standardizing data elements in translational, clinical and population research in cerebrovascular disease could decrease study start-up time, facilitate data sharing, and promote well-informed clinical practice guidelines. Methods A Working Group of diverse experts in cerebrovascular clinical trials, epidemiology, and biostatistics met regularly to develop a set of Stroke CDEs, selecting among, refining, and adding to existing, field-tested data elements from national registries and funded trials and studies. Candidate elements were revised based on comments from leading national and international neurovascular research organizations and the public. Results The first iteration of the NINDS stroke-specific CDEs comprises 980 data elements spanning nine content areas: 1) Biospecimens and Biomarkers; 2) Hospital Course and Acute Therapies; 3) Imaging; 4) Laboratory Tests and Vital Signs; 5) Long Term Therapies; 6) Medical History and Prior Health Status; 7) Outcomes and Endpoints; 8) Stroke Presentation; 9) Stroke Types and Subtypes. A CDE website provides uniform names and structures for each element, a data dictionary, and template case report forms (CRFs) using the CDEs. Conclusion Stroke-specific CDEs are now available as standardized, scientifically-vetted variable structures to facilitate data collection and data sharing in cerebrovascular patient-oriented research. The CDEs are an evolving resource that will be iteratively improved based on investigator use, new technologies, and emerging concepts and research findings. PMID:22308239

  2. Shape Similarity, Better than Semantic Membership, Accounts for the Structure of Visual Object Representations in a Population of Monkey Inferotemporal Neurons

    PubMed Central

    DiCarlo, James J.; Zecchina, Riccardo; Zoccolan, Davide

    2013-01-01

    The anterior inferotemporal cortex (IT) is the highest stage along the hierarchy of visual areas that, in primates, processes visual objects. Although several lines of evidence suggest that IT primarily represents visual shape information, some recent studies have argued that neuronal ensembles in IT code the semantic membership of visual objects (i.e., represent conceptual classes such as animate and inanimate objects). In this study, we investigated to what extent semantic, rather than purely visual information, is represented in IT by performing a multivariate analysis of IT responses to a set of visual objects. By relying on a variety of machine-learning approaches (including a cutting-edge clustering algorithm that has been recently developed in the domain of statistical physics), we found that, in most instances, IT representation of visual objects is accounted for by their similarity at the level of shape or, more surprisingly, low-level visual properties. Only in a few cases we observed IT representations of semantic classes that were not explainable by the visual similarity of their members. Overall, these findings reassert the primary function of IT as a conveyor of explicit visual shape information, and reveal that low-level visual properties are represented in IT to a greater extent than previously appreciated. In addition, our work demonstrates how combining a variety of state-of-the-art multivariate approaches, and carefully estimating the contribution of shape similarity to the representation of object categories, can substantially advance our understanding of neuronal coding of visual objects in cortex. PMID:23950700

  3. Stable feature selection for clinical prediction: exploiting ICD tree structure using Tree-Lasso.

    PubMed

    Kamkar, Iman; Gupta, Sunil Kumar; Phung, Dinh; Venkatesh, Svetha

    2015-02-01

    Modern healthcare is getting reshaped by growing Electronic Medical Records (EMR). Recently, these records have been shown of great value towards building clinical prediction models. In EMR data, patients' diseases and hospital interventions are captured through a set of diagnoses and procedures codes. These codes are usually represented in a tree form (e.g. ICD-10 tree) and the codes within a tree branch may be highly correlated. These codes can be used as features to build a prediction model and an appropriate feature selection can inform a clinician about important risk factors for a disease. Traditional feature selection methods (e.g. Information Gain, T-test, etc.) consider each variable independently and usually end up having a long feature list. Recently, Lasso and related l1-penalty based feature selection methods have become popular due to their joint feature selection property. However, Lasso is known to have problems of selecting one feature of many correlated features randomly. This hinders the clinicians to arrive at a stable feature set, which is crucial for clinical decision making process. In this paper, we solve this problem by using a recently proposed Tree-Lasso model. Since, the stability behavior of Tree-Lasso is not well understood, we study the stability behavior of Tree-Lasso and compare it with other feature selection methods. Using a synthetic and two real-world datasets (Cancer and Acute Myocardial Infarction), we show that Tree-Lasso based feature selection is significantly more stable than Lasso and comparable to other methods e.g. Information Gain, ReliefF and T-test. We further show that, using different types of classifiers such as logistic regression, naive Bayes, support vector machines, decision trees and Random Forest, the classification performance of Tree-Lasso is comparable to Lasso and better than other methods. Our result has implications in identifying stable risk factors for many healthcare problems and therefore can

  4. Understanding organization structures of the college, university, high school, clinical, and professional settings.

    PubMed

    Goforth, Mike; Almquist, Jon; Matney, Martin; Abdenour, Thomas E; Kyle, James; Leaman, Joe; Montgomery, Scott

    2007-04-01

    Athletes participate at many different levels of competition--from amateur to professional, from backyard sandlot to Yankee Stadium. There are as many different organized structures involved in providing medical care to athletes as there are types of athletes themselves. Although the organizational structures involved in providing medical care for a little league team in a small town are different from those involved in providing care for a professional baseball team, the mission is the same-caring for athletes. This is the central theme of this article. Though there are different organizational structures, there are more common threads than differences in the mission of those who provide medical care for athletes at any level.

  5. Nursing Clinical Documentation System Structured on NANDA-I, NOC, and NIC Classification Systems.

    PubMed

    Peres, Heloisa Helena C; de Almeida Lopes M da Cruz, Diná; Tellez, Michelle; de Cassia Gengo e Silva, Rita; dos S Diogo, Regina Celia; Ortiz, Diley Cardoso F; Ortiz, Dóris R

    2015-01-01

    Information is a key feature that health professionals need to exercise their profession with efficiency and quality. This study aims to present the experience of the usage of an electronic system for clinical documentation in nursing in a university hospital. It is a methodological research of technology production. The system was developed in four phases: Conception, Elaboration, Construction, and Transition, and was named Electronic Documentation System of the University of São Paulo Nursing Process (PROCEnf-USP™). The knowledge base of PROCEnf-USP™ was organized in hierarchy of domains and classes, according to NNN linkages.

  6. The Structured Clinical Interview for DSM-III-R Dissociative Disorders: preliminary report on a new diagnostic instrument.

    PubMed

    Steinberg, M; Rounsaville, B; Cicchetti, D V

    1990-01-01

    The authors describe the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D), which investigates five groups of dissociative symptoms (amnesia, depersonalization, derealization, identity confusion, and identity alteration) and systematically rates both the severity of individual symptoms and the evaluation of overall diagnosis of dissociative disorder. Preliminary findings from a study of 48 subjects with and without psychiatric diagnoses indicate good to excellent reliability and discriminant validity for the SCID-D as a diagnostic instrument for the five dissociative disorders and as a tool for the evaluation of dissociative symptoms encountered within nondissociative syndromes.

  7. NCL Objective #5 - Nanotechnology Characterization Lab (NCL)

    Cancer.gov

    Nanotechnology Characterization Lab (NCL) Objective #5: Engage and Facilitate Academic and Industrial-based Knowledge Sharing of Nanomaterial Performance Data and Behavior Resulting from Pre-Clinical Testing.

  8. A randomised controlled trial of structured nurse-led outpatient clinic follow-up for dyspeptic patients after direct access gastroscopy

    PubMed Central

    2009-01-01

    Background Dyspepsia is a common disorder in the community, with many patients referred for diagnostic gastroscopy by their General Practitioner (GP). The National Institute of Clinical Excellence (NICE) recommends follow-up after investigation for cost effective management, including lifestyle advice and drug use. An alternative strategy may be the use of a gastro-intestinal nurse practitioner (GNP) instead of the GP. The objective of this study is to compare the effectiveness and costs of systematic GNP led follow-up to usual care by GPs in dyspeptic patients following gastroscopy. Results Direct access adult dyspeptic patients referred for gastroscopy; without serious pathology, were followed-up in a structured nurse-led outpatient clinic. Outcome measurement used to compare the two study cohorts (GNP versus GP) included Glasgow dyspepsia severity (Gladys) score, Health Status Short Form 12 (SF12), ulcer healing drug (UHD) use and costs. One hundred and seventy five patients were eligible after gastroscopy, 89 were randomised to GNP follow-up and 86 to GP follow-up. Follow-up at 6 months was 81/89 (91%) in the GNP arm and 79/86 (92%) in the GP arm. On an intention to treat analysis, adjusted mean differences (95%CI) at follow-up between Nurse and GP follow-up were: Gladys score 2.30 (1.4–3.2) p < 0.001, SF12 140.6 (96.5–184.8) p =< 0.001 and UHD costs £39.60 (£24.20–£55.10) p =< 0.001, all in favour of nurse follow-up. Conclusion A standardised and structured follow-up by one gastrointestinal nurse practitioner was effective and may save drug costs in patients after gastroscopy. These findings need replication in other centres. PMID:19200356

  9. Hypothyroidism Side Effect in Patients Treated with Sunitinib or Sorafenib: Clinical and Structural Analyses.

    PubMed

    Shu, Mao; Zai, Xiaoli; Zhang, Beina; Wang, Rui; Lin, Zhihua

    2016-01-01

    Tyrosine kinase inhibitors (TKIs) provide more effective targeted treatments for cancer, but are subject to a variety of adverse effects, such as hypothyroidism. TKI-induced hypothyroidism is a highly complicated issue, because of not only the unrealized toxicological mechanisms, but also different incidences of individual TKI drugs. While sunitinib is suspected for causing thyroid dysfunction more often than other TKIs, sorafenib is believed to be less risky. Here we integrated clinical data and in silico drug-protein interactions to examine the pharmacological distinction between sunitinib and sorafenib. Statistical analysis on the FDA Adverse Event Reporting System (FAERS) confirmed that sunitinib is more concurrent with hypothyroidism than sorafenib, which was observed in both female and male patients. Then, we used docking method and identified 3 proteins specifically binding to sunitinib but not sorafenib, i.e., retinoid X receptor alpha, retinoic acid receptors beta and gamma. As potential off-targets of sunitinib, these proteins are well known to assemble with thyroid hormone receptors, which can explain the profound impact of sunitinib on thyroid function. Taken together, we established a strategy of integrated analysis on clinical records and drug off-targets, which can be applied to explore the molecular basis of various adverse drug reactions.

  10. Hypothyroidism Side Effect in Patients Treated with Sunitinib or Sorafenib: Clinical and Structural Analyses

    PubMed Central

    Shu, Mao; Zai, Xiaoli; Zhang, Beina; Wang, Rui; Lin, Zhihua

    2016-01-01

    Tyrosine kinase inhibitors (TKIs) provide more effective targeted treatments for cancer, but are subject to a variety of adverse effects, such as hypothyroidism. TKI-induced hypothyroidism is a highly complicated issue, because of not only the unrealized toxicological mechanisms, but also different incidences of individual TKI drugs. While sunitinib is suspected for causing thyroid dysfunction more often than other TKIs, sorafenib is believed to be less risky. Here we integrated clinical data and in silico drug-protein interactions to examine the pharmacological distinction between sunitinib and sorafenib. Statistical analysis on the FDA Adverse Event Reporting System (FAERS) confirmed that sunitinib is more concurrent with hypothyroidism than sorafenib, which was observed in both female and male patients. Then, we used docking method and identified 3 proteins specifically binding to sunitinib but not sorafenib, i.e., retinoid X receptor alpha, retinoic acid receptors beta and gamma. As potential off-targets of sunitinib, these proteins are well known to assemble with thyroid hormone receptors, which can explain the profound impact of sunitinib on thyroid function. Taken together, we established a strategy of integrated analysis on clinical records and drug off-targets, which can be applied to explore the molecular basis of various adverse drug reactions. PMID:26784451

  11. Hypothyroidism Side Effect in Patients Treated with Sunitinib or Sorafenib: Clinical and Structural Analyses.

    PubMed

    Shu, Mao; Zai, Xiaoli; Zhang, Beina; Wang, Rui; Lin, Zhihua

    2016-01-01

    Tyrosine kinase inhibitors (TKIs) provide more effective targeted treatments for cancer, but are subject to a variety of adverse effects, such as hypothyroidism. TKI-induced hypothyroidism is a highly complicated issue, because of not only the unrealized toxicological mechanisms, but also different incidences of individual TKI drugs. While sunitinib is suspected for causing thyroid dysfunction more often than other TKIs, sorafenib is believed to be less risky. Here we integrated clinical data and in silico drug-protein interactions to examine the pharmacological distinction between sunitinib and sorafenib. Statistical analysis on the FDA Adverse Event Reporting System (FAERS) confirmed that sunitinib is more concurrent with hypothyroidism than sorafenib, which was observed in both female and male patients. Then, we used docking method and identified 3 proteins specifically binding to sunitinib but not sorafenib, i.e., retinoid X receptor alpha, retinoic acid receptors beta and gamma. As potential off-targets of sunitinib, these proteins are well known to assemble with thyroid hormone receptors, which can explain the profound impact of sunitinib on thyroid function. Taken together, we established a strategy of integrated analysis on clinical records and drug off-targets, which can be applied to explore the molecular basis of various adverse drug reactions. PMID:26784451

  12. Structural basis for effectiveness of siderophore-conjugated monocarbams against clinically relevant strains of Pseudomonas aeruginosa

    SciTech Connect

    Han, Seungil; Zaniewski, Richard P.; Marr, Eric S.; Lacey, Brian M.; Tomaras, Andrew P.; Evdokimov, Artem; Miller, J. Richard; Shanmugasundaram, Veerabahu

    2012-02-08

    Pseudomonas aeruginosa is an opportunistic Gram-negative pathogen that causes nosocomial infections for which there are limited treatment options. Penicillin-binding protein PBP3, a key therapeutic target, is an essential enzyme responsible for the final steps of peptidoglycan synthesis and is covalently inactivated by {beta}-lactam antibiotics. Here we disclose the first high resolution cocrystal structures of the P. aeruginosa PBP3 with both novel and marketed {beta}-lactams. These structures reveal a conformational rearrangement of Tyr532 and Phe533 and a ligand-induced conformational change of Tyr409 and Arg489. The well-known affinity of the monobactam aztreonam for P. aeruginosa PBP3 is due to a distinct hydrophobic aromatic wall composed of Tyr503, Tyr532, and Phe533 interacting with the gem-dimethyl group. The structure of MC-1, a new siderophore-conjugated monocarbam complexed with PBP3 provides molecular insights for lead optimization. Importantly, we have identified a novel conformation that is distinct to the high-molecular-weight class B PBP subfamily, which is identifiable by common features such as a hydrophobic aromatic wall formed by Tyr503, Tyr532, and Phe533 and the structural flexibility of Tyr409 flanked by two glycine residues. This is also the first example of a siderophore-conjugated triazolone-linked monocarbam complexed with any PBP. Energetic analysis of tightly and loosely held computed hydration sites indicates protein desolvation effects contribute significantly to PBP3 binding, and analysis of hydration site energies allows rank ordering of the second-order acylation rate constants. Taken together, these structural, biochemical, and computational studies provide a molecular basis for recognition of P. aeruginosa PBP3 and open avenues for future design of inhibitors of this class of PBPs.

  13. Structural basis for effectiveness of siderophore-conjugated monocarbams against clinically relevant strains of Pseudomonas aeruginosa

    PubMed Central

    Han, Seungil; Zaniewski, Richard P.; Marr, Eric S.; Lacey, Brian M.; Tomaras, Andrew P.; Evdokimov, Artem; Miller, J. Richard; Shanmugasundaram, Veerabahu

    2010-01-01

    Pseudomonas aeruginosa is an opportunistic Gram-negative pathogen that causes nosocomial infections for which there are limited treatment options. Penicillin-binding protein PBP3, a key therapeutic target, is an essential enzyme responsible for the final steps of peptidoglycan synthesis and is covalently inactivated by β-lactam antibiotics. Here we disclose the first high resolution cocrystal structures of the P. aeruginosa PBP3 with both novel and marketed β-lactams. These structures reveal a conformational rearrangement of Tyr532 and Phe533 and a ligand-induced conformational change of Tyr409 and Arg489. The well-known affinity of the monobactam aztreonam for P. aeruginosa PBP3 is due to a distinct hydrophobic aromatic wall composed of Tyr503, Tyr532, and Phe533 interacting with the gem-dimethyl group. The structure of MC-1, a new siderophore-conjugated monocarbam complexed with PBP3 provides molecular insights for lead optimization. Importantly, we have identified a novel conformation that is distinct to the high-molecular-weight class B PBP subfamily, which is identifiable by common features such as a hydrophobic aromatic wall formed by Tyr503, Tyr532, and Phe533 and the structural flexibility of Tyr409 flanked by two glycine residues. This is also the first example of a siderophore-conjugated triazolone-linked monocarbam complexed with any PBP. Energetic analysis of tightly and loosely held computed hydration sites indicates protein desolvation effects contribute significantly to PBP3 binding, and analysis of hydration site energies allows rank ordering of the second-order acylation rate constants. Taken together, these structural, biochemical, and computational studies provide a molecular basis for recognition of P. aeruginosa PBP3 and open avenues for future design of inhibitors of this class of PBPs. PMID:21135211

  14. Inhibition of human aldehyde oxidase activity by diet-derived constituents: structural influence, enzyme-ligand interactions, and clinical relevance.

    PubMed

    Barr, John T; Jones, Jeffrey P; Oberlies, Nicholas H; Paine, Mary F

    2015-01-01

    The mechanistic understanding of interactions between diet-derived substances and conventional medications in humans is nascent. Most investigations have examined cytochrome P450-mediated interactions. Interactions mediated by other phase I enzymes are understudied. Aldehyde oxidase (AO) is a phase I hydroxylase that is gaining recognition in drug design and development programs. Taken together, a panel of structurally diverse phytoconstituents (n = 24) was screened for inhibitors of the AO-mediated oxidation of the probe substrate O(6)-benzylguanine. Based on the estimated IC50 (<100 μM), 17 constituents were advanced for Ki determination. Three constituents were described best by a competitive inhibition model, whereas 14 constituents were described best by a mixed-mode model. The latter model consists of two Ki terms, Kis and Kii, which ranged from 0.26-73 and 0.80-120 μM, respectively. Molecular modeling was used to glean mechanistic insight into AO inhibition. Docking studies indicated that the tested constituents bound within the AO active site and elucidated key enzyme-inhibitor interactions. Quantitative structure-activity relationship modeling identified three structural descriptors that correlated with inhibition potency (r(2) = 0.85), providing a framework for developing in silico models to predict the AO inhibitory activity of a xenobiotic based solely on chemical structure. Finally, a simple static model was used to assess potential clinically relevant AO-mediated dietary substance-drug interactions. Epicatechin gallate and epigallocatechin gallate, prominent constituents in green tea, were predicted to have moderate to high risk. Further characterization of this uncharted type of interaction is warranted, including dynamic modeling and, potentially, clinical evaluation. PMID:25326286

  15. Population genetic structure of Taenia solium from Madagascar and Mexico: implications for clinical profile diversity and immunological technology.

    PubMed

    Vega, Rodrigo; Piñero, Daniel; Ramanankandrasana, Bienvenue; Dumas, Michel; Bouteille, Bernard; Fleury, Agnes; Sciutto, Edda; Larralde, Carlos; Fragoso, Gladis

    2003-11-01

    Taenia solium is a cestode parasitic of humans and pigs that strongly impacts on public health in developing countries. Its larvae (cysticercus) lodge in the brain, causing neurocysticercosis, and in other tissues, like skeletal muscle and subcutaneous space, causing extraneuronal cysticercosis. Prevalences of these two clinical manifestations vary greatly among continents. Also, neurocysticercosis may be clinically heterogeneous, ranging from asymptomatic forms to severely incapacitating and even fatal presentation. Further, vaccine design and diagnosis technology have met with difficulties in sensitivity, specificity and reproducibility. Parasite diversity underlying clinical heterogeneity and technological difficulties is little explored. Here, T. solium genetic population structure and diversity was studied by way of random amplified polymorphic DNA in individual cysticerci collected from pigs in Madagascar and two regions in Mexico. The amplification profiles of T. solium were also compared with those of the murine cysticercus Taenia crassiceps (ORF strain). We show significant genetic differentiation between Madagascar and Mexico and between regions in Mexico, but less so between cysticerci from different localities in Mexico and none between cysticerci from different tissues from the same pig. We also found restricted genetic variability within populations and gene flow was estimated to be low between populations. Thus, genetic differentiation of T. solium suggests that different evolutionary paths have been taken and provides support for its involvement in the differential tissue distribution of cysticerci and varying degrees of severity of the disease. It may also explain difficulties in the development of vaccines and tools for immunodiagnosis.

  16. A randomized controlled clinical trial of a nurse-led structured psychosocial intervention program for people with first-onset mental illness in psychiatric outpatient clinics.

    PubMed

    Chien, Wai-Tong; Bressington, Daniel

    2015-09-30

    This study aimed to test the effectiveness of a nurse-led structured psychosocial intervention program in Chinese patients with first-onset mental illness. A single-blind, parallel group, randomized controlled trial design was used. The study involved 180 participants with mild to moderate-severe symptoms of psychotic or mood disorders who were newly referred to two psychiatric outpatient clinics in Hong Kong. Patients were randomly assigned to either an eight-session nurse-led psychosocial intervention program (plus usual care) or usual psychiatric outpatient care (both n=90). The primary outcome was psychiatric symptoms. Outcomes were measured at recruitment, one week and 12 months post-intervention. Patients in the psychosocial intervention group reported statistically significant improvements in symptoms compared to treatment as usual. There were also significant improvements in illness insight and perceived quality of life and reduction in length of re-hospitalizations over the 12-month follow-up. The findings provide evidence that the nurse-led psychosocial intervention program resulted in improved health outcomes in Chinese patients with first-onset mental illness.

  17. Factor structure of the SOCRATES in a clinical sample of adolescents.

    PubMed

    Maisto, Stephen A; Chung, Tammy A; Cornelius, Jack R; Martin, Christopher S

    2003-06-01

    This study investigated the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES; W. R. Miller & J. S. Tonigan, 1996) in adolescents presenting for treatment of alcohol use disorder (AUD). The participants were 80 males and 43 females (mean age = 16.8 years) who presented for AUD treatment (95.1% outpatient, 4.9% inpatient). Participants completed assessments at baseline and 1 year and provided information on alcohol use and related variables monthly between these 2 assessments. Principal-components and confirmatory factor analyses of the baseline SOCRATES identified 2 factors, Taking Steps and Recognition, which showed good internal consistency and concurrent and predictive evidence of validity. The results were interpreted as supporting the use of the SOCRATES with clinical samples of adolescents.

  18. Associations between CMS's Clinical Performance Measures project benchmarks, profit structure, and mortality in dialysis units.

    PubMed

    Szczech, L A; Klassen, P S; Chua, B; Hedayati, S S; Flanigan, M; McClellan, W M; Reddan, D N; Rettig, R A; Frankenfield, D L; Owen, W F

    2006-06-01

    Prior studies observing greater mortality in for-profit dialysis units have not captured information about benchmarks of care. This study was undertaken to examine the association between profit status and mortality while achieving benchmarks. Utilizing data from the US Renal Data System and the Centers for Medicare & Medicaid Services' end-stage renal disease (ESRD) Clinical Performance Measures project, hemodialysis units were categorized as for-profit or not-for-profit. Associations with mortality at 1 year were estimated using Cox regression. Two thousand six hundred and eighty-five dialysis units (31,515 patients) were designated as for-profit and 1018 (15,085 patients) as not-for-profit. Patients in for-profit facilities were more likely to be older, black, female, diabetic, and have higher urea reduction ratio (URR), hematocrit, serum albumin, and transferrin saturation. Patients (19.4 and 18.6%) in for-profit and not-for-profit units died, respectively. In unadjusted analyses, profit status was not associated with mortality (hazard ratio (HR)=1.04, P=0.09). When added to models with profit status, the following resulted in a significant association between profit status (for-profit vs not-for-profit) and increasing mortality risk: URR, hematocrit, albumin, and ESRD Network. In adjusted models, patients in for-profit facilities had a greater death risk (HR 1.09, P=0.004). More patients in for-profit units met clinical benchmarks. Survival among patients in for-profit units was similar to not-for-profit units. This suggests that in the contemporary era, interventions in for-profit dialysis units have not impaired their ability to deliver performance benchmarks and do not affect survival. PMID:16732194

  19. Albumin Homodimers in Patients with Cirrhosis: Clinical and Prognostic Relevance of a Novel Identified Structural Alteration of the Molecule

    PubMed Central

    Baldassarre, Maurizio; Domenicali, Marco; Naldi, Marina; Laggetta, Maristella; Giannone, Ferdinando A.; Biselli, Maurizio; Patrono, Daniela; Bertucci, Carlo; Bernardi, Mauro; Caraceni, Paolo

    2016-01-01

    Decompensated cirrhosis is associated to extensive post-transcriptional changes of human albumin (HA). This study aims to characterize the occurrence of HA homodimerization in a large cohort of patients with decompensated cirrhosis and to evaluate its association with clinical features and prognosis. HA monomeric and dimeric isoforms were identified in peripheral blood by using a HPLC-ESI-MS technique in 123 cirrhotic patients hospitalized for acute decompensation and 50 age- and sex-comparable healthy controls. Clinical and biochemical parameters were recorded and patients followed up to one year. Among the monomeric isoforms identified, the N- and C-terminal truncated and the native HA underwent homodimerization. All three homodimers were significantly more abundant in patients with cirrhosis, acute-on-chronic liver failure and correlate with the prognostic scores. The homodimeric N-terminal truncated isoform was independently associated to disease complications and was able to stratify 1-year survival. As a result of all these changes, the monomeric native HA was significantly decreased in patients with cirrhosis, being also associated with a poorer prognosis. In conclusion homodimerization is a novel described structural alteration of the HA molecule in decompensated cirrhosis and contributes to the progressive reduction of the monomeric native HA, the only isoform provided of structural and functional integrity. PMID:27782157

  20. Comparative Evaluation for Brain Structural Connectivity Approaches: Towards Integrative Neuroinformatics Tool for Epilepsy Clinical Research.

    PubMed

    Yang, Sheng; Tatsuoka, Curtis; Ghosh, Kaushik; Lacuey-Lecumberri, Nuria; Lhatoo, Samden D; Sahoo, Satya S

    2016-01-01

    Recent advances in brain fiber tractography algorithms and diffusion Magnetic Resonance Imaging (MRI) data collection techniques are providing new approaches to study brain white matter connectivity, which play an important role in complex neurological disorders such as epilepsy. Epilepsy affects approximately 50 million persons worldwide and it is often described as a disorder of the cortical network organization. There is growing recognition of the need to better understand the role of brain structural networks in the onset and propagation of seizures in epilepsy using high resolution non-invasive imaging technologies. In this paper, we perform a comparative evaluation of two techniques to compute structural connectivity, namely probabilistic fiber tractography and statistics derived from fractional anisotropy (FA), using diffusion MRI data from a patient with rare case of medically intractable insular epilepsy. The results of our evaluation demonstrate that probabilistic fiber tractography provides a more accurate map of structural connectivity and may help address inherent complexities of neural fiber layout in the brain, such as fiber crossings. This work provides an initial result towards building an integrative informatics tool for neuroscience that can be used to accurately characterize the role of fiber tract connectivity in neurological disorders such as epilepsy. PMID:27570685

  1. [Individual variability in the structure and topography of the celiac plexus and its clinical significance].

    PubMed

    Vlasova, M I

    2000-01-01

    Using anatomical and histological methods individual variability of structure and topography of coeliac plexus 94 preparations of adults of both sexes were studied. In 32% coeliac plexus was presented as a multitude of small ganglia connected by a network of nerve fibres remote from visceral branches of aorta. In 38% the plexus was composed of middle sized ganglia concentrated into groups at the level of coeliac trunk from the left and at the level of the source of superior mesenteric artery without contacts wit lig.arcuatum from right, histologically ganglia had lobular structure with low amount of connective tissue (29%-50%). In 30% it was comprised of 2-4 large conglomerates of ganglia attached to lig.arcuatum from the bottom forming a dense circle around the vessel, decline in neuron relative number was discovered histologically. Single neurons surrounded by rough fibrous tissue were observed instead of lobules (42-94%). Correlation between structure and topography of the plexus and skeletotopy of coeliac trunk, aorta and lig.arcuatum were established which can be used to reveal "risk" groups involving neuroganglionic component in extravasal compression of coeliac trunk.

  2. Comparative Evaluation for Brain Structural Connectivity Approaches: Towards Integrative Neuroinformatics Tool for Epilepsy Clinical Research

    PubMed Central

    Yang, Sheng; Tatsuoka, Curtis; Ghosh, Kaushik; Lacuey-Lecumberri, Nuria; Lhatoo, Samden D.; Sahoo, Satya S.

    2016-01-01

    Recent advances in brain fiber tractography algorithms and diffusion Magnetic Resonance Imaging (MRI) data collection techniques are providing new approaches to study brain white matter connectivity, which play an important role in complex neurological disorders such as epilepsy. Epilepsy affects approximately 50 million persons worldwide and it is often described as a disorder of the cortical network organization. There is growing recognition of the need to better understand the role of brain structural networks in the onset and propagation of seizures in epilepsy using high resolution non-invasive imaging technologies. In this paper, we perform a comparative evaluation of two techniques to compute structural connectivity, namely probabilistic fiber tractography and statistics derived from fractional anisotropy (FA), using diffusion MRI data from a patient with rare case of medically intractable insular epilepsy. The results of our evaluation demonstrate that probabilistic fiber tractography provides a more accurate map of structural connectivity and may help address inherent complexities of neural fiber layout in the brain, such as fiber crossings. This work provides an initial result towards building an integrative informatics tool for neuroscience that can be used to accurately characterize the role of fiber tract connectivity in neurological disorders such as epilepsy. PMID:27570685

  3. Structural Mechanics Predictions Relating to Clinical Coronary Stent Fracture in a 5 Year Period in FDA MAUDE Database.

    PubMed

    Everett, Kay D; Conway, Claire; Desany, Gerard J; Baker, Brian L; Choi, Gilwoo; Taylor, Charles A; Edelman, Elazer R

    2016-02-01

    Endovascular stents are the mainstay of interventional cardiovascular medicine. Technological advances have reduced biological and clinical complications but not mechanical failure. Stent strut fracture is increasingly recognized as of paramount clinical importance. Though consensus reigns that fractures can result from material fatigue, how fracture is induced and the mechanisms underlying its clinical sequelae remain ill-defined. In this study, strut fractures were identified in the prospectively maintained Food and Drug Administration's (FDA) Manufacturer and User Facility Device Experience Database (MAUDE), covering years 2006-2011, and differentiated based on specific coronary artery implantation site and device configuration. These data, and knowledge of the extent of dynamic arterial deformations obtained from patient CT images and published data, were used to define boundary conditions for 3D finite element models incorporating multimodal, multi-cycle deformation. The structural response for a range of stent designs and configurations was predicted by computational models and included estimation of maximum principal, minimum principal and equivalent plastic strains. Fatigue assessment was performed with Goodman diagrams and safe/unsafe regions defined for different stent designs. Von Mises stress and maximum principal strain increased with multimodal, fully reversed deformation. Spatial maps of unsafe locations corresponded to the identified locations of fracture in different coronary arteries in the clinical database. These findings, for the first time, provide insight into a potential link between patient adverse events and computational modeling of stent deformation. Understanding of the mechanical forces imposed under different implantation conditions may assist in rational design and optimal placement of these devices. PMID:26467552

  4. [Hemodialysis with biological object].

    PubMed

    Eventov, V L; Maksimenko, V A; Zhidkov, I L; Andrianova, M Iu

    2005-01-01

    The essence of the method of biodialysis (hemodialysis with biological object) developed and suggested by the authors for clinical use consists in that the healthy organism exerts, through a system of mass transfer, a therapeutic action on the sick organism. Blood from the affected and healthy organisms is perfused through individual mass exchangers (dialyzers, hemodiafilters and hemofilters), which are hydraulically connected by a circulating transport medium. Metabolites that accumulate in blood of the affected organism diffuse into the transport medium and, from there, into blood of the healthy organism, which metabolizes them. The reverse process occurs simultaneously: substances, whose concentration in blood of the sick organism is less versus the healthy organism, diffuse from blood of the healthy organism to blood of patient. The method suggested by us can be used in clinical practice for normalizing a variety of parameters in patients with hepatic and renal insufficiency. Besides, a number of substances can be transferred from the healthy donor to patient in the process of biodialysis, which opens promising potentialities for the treatment of many diseases.

  5. Endothelial nitric oxide synthase: From biochemistry and gene structure to clinical implications of NOS3 polymorphisms.

    PubMed

    Oliveira-Paula, Gustavo H; Lacchini, Riccardo; Tanus-Santos, Jose E

    2016-01-10

    Nitric oxide (NO) is an important vasodilator with a well-established role in cardiovascular homeostasis. While mediator is synthesized from L-arginine by neuronal, endothelial, and inducible nitric oxide synthases (NOS1,NOS3 and NOS2 respectively), NOS3 is the most important isoform for NO formation in the cardiovascular system. NOS3 is a dimeric enzyme whose expression and activity are regulated at transcriptional, posttranscriptional,and posttranslational levels. The NOS3 gene, which encodes NOS3, exhibits a number of polymorphic sites including single nucleotide polymorphisms (SNPs), variable number of tandem repeats (VNTRs), microsatellites, and insertions/deletions. Some NOS3 polymorphisms show functional effects on NOS3 expression or activity, thereby affecting NO formation. Interestingly, many studies have evaluated the effects of functional NOS3 polymorphisms on disease susceptibility and drug responses. Moreover, some studies have investigated how NOS3 haplotypes may impact endogenous NO formation and disease susceptibility. In this article,we carried out a comprehensive review to provide a basic understanding of biochemical mechanisms involved in NOS3 regulation and how genetic variations in NOS3 may translate into relevant clinical and pharmacogenetic implications. PMID:26428312

  6. Endothelial nitric oxide synthase: From biochemistry and gene structure to clinical implications of NOS3 polymorphisms.

    PubMed

    Oliveira-Paula, Gustavo H; Lacchini, Riccardo; Tanus-Santos, Jose E

    2016-01-10

    Nitric oxide (NO) is an important vasodilator with a well-established role in cardiovascular homeostasis. While mediator is synthesized from L-arginine by neuronal, endothelial, and inducible nitric oxide synthases (NOS1,NOS3 and NOS2 respectively), NOS3 is the most important isoform for NO formation in the cardiovascular system. NOS3 is a dimeric enzyme whose expression and activity are regulated at transcriptional, posttranscriptional,and posttranslational levels. The NOS3 gene, which encodes NOS3, exhibits a number of polymorphic sites including single nucleotide polymorphisms (SNPs), variable number of tandem repeats (VNTRs), microsatellites, and insertions/deletions. Some NOS3 polymorphisms show functional effects on NOS3 expression or activity, thereby affecting NO formation. Interestingly, many studies have evaluated the effects of functional NOS3 polymorphisms on disease susceptibility and drug responses. Moreover, some studies have investigated how NOS3 haplotypes may impact endogenous NO formation and disease susceptibility. In this article,we carried out a comprehensive review to provide a basic understanding of biochemical mechanisms involved in NOS3 regulation and how genetic variations in NOS3 may translate into relevant clinical and pharmacogenetic implications.

  7. Nontypable Haemophilus influenzae Displays a Prevalent Surface Structure Molecular Pattern in Clinical Isolates

    PubMed Central

    Mauro, Silvia; Hood, Derek W.; Viadas, Cristina; Calatayud, Laura; Morey, Pau; Servin, Alain; Liñares, Josefina; Oliver, Antonio; Bengoechea, José Antonio; Garmendia, Junkal

    2011-01-01

    Non-typable Haemophilus influenzae (NTHi) is a Gram negative pathogen that causes acute respiratory infections and is associated with the progression of chronic respiratory diseases. Previous studies have established the existence of a remarkable genetic variability among NTHi strains. In this study we show that, in spite of a high level of genetic heterogeneity, NTHi clinical isolates display a prevalent molecular feature, which could confer fitness during infectious processes. A total of 111 non-isogenic NTHi strains from an identical number of patients, isolated in two distinct geographical locations in the same period of time, were used to analyse nine genes encoding bacterial surface molecules, and revealed the existence of one highly prevalent molecular pattern (lgtF+, lic2A+, lic1D+, lic3A+, lic3B+, siaA−, lic2C+, ompP5+, oapA+) displayed by 94.6% of isolates. Such a genetic profile was associated with a higher bacterial resistance to serum mediated killing and enhanced adherence to human respiratory epithelial cells. PMID:21698169

  8. [Clinical, structural-functional and haemodynamic correlates of cerebral venous blood circulation disturbances].

    PubMed

    Todua, F I; Verulashvili, I V; Kortushvili, M G; Gachechiladze, D G

    2006-01-01

    Difficulties of liquor circulation as a result of cerebrospinal fluid absorption and venous drainage of the entire intracranial space, in particular in the presence of venous system abnormalities in the forms of hypoplasia or aplasia of venous sinuses, play an essentiale role in cerebral venous dyscirculation. The symmetric character of hydrocephaly in chronic insufficiency of cerebral blood circulation and strong dependence of chronic cerebrovascular insufficiency on passive congestion suggest that the latter is characteristic of the blood supply system in whole. The MPI analysis of 120 patients revealed signs of cerebral ischemic lesions in 72% of cases, i.e. dilatation of liquor-containing spaces, multiple lacunar infarctions, especially in deep brain regions, diffusive changes of the periventricular white matter etc. Low indices of the blood flow increase during antiorthostatic loading, a trend towards decreasing of PI parameters and difficulty of blood flow in conditional insonation of intracranial veins in cases of "pseudotumorous syndrome" in patients with clinical signs of passive congestion. Venous dilatation of convexital brain areas and intensification of contrasting of direct sinus and vein of Galen were observed in venous infarctions.

  9. Clinical Scenarios in Chronic Kidney Disease: Kidneys' Structural Changes in End-Stage Renal Disease.

    PubMed

    Meola, Mario; Samoni, Sara; Petrucci, Ilaria

    2016-01-01

    Acquired cystic kidney disease (ACKD) and renal cell carcinoma (RCC) are the most important manifestations of end-stage kidneys' structural changes. ACKD is caused by kidney damage or scarring and it is characterized by the presence of small, multiple cortical and medullary cysts filled with a fluid similar to preurine. ACKD prevalence varies according to predialysis and dialysis age and its pathogenesis is unknown, although it is stated that progressive destruction of renal tissue induces hypertrophy/compensatory hyperplasia of residual nephrons and may trigger the degenerative process. ACKD is almost asymptomatic, but it can lead to several complications (bleeding, rupture, infections, RCC). Ultrasound (US) is the first level imaging technique in ACKD, because of its sensitivity and reliability. The most serious complication of ACKD is RCC, which is stimulated by the same growth factors and proto-oncogenes that lead to the genesis of cysts. Two different histological types of RCC have been identified: (1) RCC associated with ACKD and (2) papillary renal clear cell carcinoma. Tumors in end-stage kidneys are mainly small, multifocal and bilateral, with a papillary structure and a low degree of malignancy. At US, RCC appears as a small inhomogeneous nodule (<3 cm), clearly outlined from the renal profile and hypoechoic if compared with sclerotic parenchyma. In some cases, tumor appears as a homogeneous and hyperechoic multifocal mass. The most specific US sign of a small tumor in end-stage kidney is the important arterial vascularization, in contrast with renal parenchymal vascular sclerosis. PMID:27169876

  10. Abnormal hippocampal structure and function in clinical anxiety and comorbid depression.

    PubMed

    Cha, Jiook; Greenberg, Tsafrir; Song, Inkyung; Blair Simpson, Helen; Posner, Jonathan; Mujica-Parodi, Lilianne R

    2016-05-01

    Given the high prevalence rates of comorbidity of anxiety and depressive disorders, identifying a common neural pathway to both disorders is important not only for better diagnosis and treatment, but also for a more complete conceptualization of each disease. Hippocampal abnormalities have been implicated in anxiety and depression, separately; however, it remains unknown whether these abnormalities are also implicated in their comorbidity. Here we address this question by testing 32 adults with generalized anxiety disorder (15 GAD only and 17 comorbid MDD) and 25 healthy controls (HC) using multimodal MRI (structure, diffusion and functional) and automated hippocampal segmentation. We demonstrate that (i) abnormal microstructure of the CA1 and CA2-3 is associated with GAD/MDD comorbidity and (ii) decreased anterior hippocampal reactivity in response to repetition of the threat cue is associated with GAD (with or without MDD comorbidity). In addition, mediation-structural equation modeling (SEM) reveals that our hippocampal and dimensional symptom data are best explained by a model describing a significant influence of abnormal hippocampal microstructure on both anxiety and depression-mediated through its impact on abnormal hippocampal threat processing. Collectively, our findings show a strong association between changes in hippocampal microstructure and threat processing, which together may present a common neural pathway to comorbidity of anxiety and depression.

  11. Reduction of the Number of Major Representative Allergens: From Clinical Testing to 3-Dimensional Structures

    PubMed Central

    He, Ying; Liu, Xueting; Huang, Yuyi; Zou, Zehong; Chen, Huifang; Lai, He; Wu, Qiurong; Zhang, Junyan; Wang, Shan; Zhang, Jianguo; Tao, Ailin; Sun, Baoqing

    2014-01-01

    Vast amounts of allergen sequence data have been accumulated, thus complicating the identification of specific allergenic proteins when performing diagnostic allergy tests and immunotherapy. This study aims to rank the importance/potency of the allergens so as to logically reduce the number of allergens and/or allergenic sources. Meta-analysis of 62 allergenic sources used for intradermal testing on 3,335 allergic patients demonstrated that in southern China, mite, sesame, spiny amaranth, Pseudomonas aeruginosa, and house dust account for 88.0% to 100% of the observed positive reactions to the 62 types of allergenic sources tested. The Kolmogorov-Smironov Test results of the website-obtained allergen data and allergen family featured peptides suggested that allergen research in laboratories worldwide has been conducted in parallel on many of the same species. The major allergens were reduced to 21 representative allergens, which were further divided into seven structural classes, each of which contains similar structural components. This study therefore has condensed numerous allergenic sources and major allergens into fewer major representative ones, thus allowing for the use of a smaller number of allergens when conducting comprehensive allergen testing and immunotherapy treatments. PMID:24778467

  12. Clinical Scenarios in Chronic Kidney Disease: Kidneys' Structural Changes in End-Stage Renal Disease.

    PubMed

    Meola, Mario; Samoni, Sara; Petrucci, Ilaria

    2016-01-01

    Acquired cystic kidney disease (ACKD) and renal cell carcinoma (RCC) are the most important manifestations of end-stage kidneys' structural changes. ACKD is caused by kidney damage or scarring and it is characterized by the presence of small, multiple cortical and medullary cysts filled with a fluid similar to preurine. ACKD prevalence varies according to predialysis and dialysis age and its pathogenesis is unknown, although it is stated that progressive destruction of renal tissue induces hypertrophy/compensatory hyperplasia of residual nephrons and may trigger the degenerative process. ACKD is almost asymptomatic, but it can lead to several complications (bleeding, rupture, infections, RCC). Ultrasound (US) is the first level imaging technique in ACKD, because of its sensitivity and reliability. The most serious complication of ACKD is RCC, which is stimulated by the same growth factors and proto-oncogenes that lead to the genesis of cysts. Two different histological types of RCC have been identified: (1) RCC associated with ACKD and (2) papillary renal clear cell carcinoma. Tumors in end-stage kidneys are mainly small, multifocal and bilateral, with a papillary structure and a low degree of malignancy. At US, RCC appears as a small inhomogeneous nodule (<3 cm), clearly outlined from the renal profile and hypoechoic if compared with sclerotic parenchyma. In some cases, tumor appears as a homogeneous and hyperechoic multifocal mass. The most specific US sign of a small tumor in end-stage kidney is the important arterial vascularization, in contrast with renal parenchymal vascular sclerosis.

  13. A Structured Protocol Model of Depression Care versus Clinical Acumen: A Cluster Randomized Trial of the Effects on Depression Screening, Diagnostic Evaluation, and Treatment Uptake in Ugandan HIV Clinics

    PubMed Central

    Wagner, Glenn J.; Ngo, Victoria; Goutam, Prodyumna; Glick, Peter; Musisi, Seggane; Akena, Dickens

    2016-01-01

    Depression is common among people living with HIV, and it has consequences for both HIV prevention and treatment response, yet depression treatment is rarely integrated into HIV care in sub-Saharan Africa, partly due to the paucity of mental health professionals. We conducted a cluster randomized controlled trial of two task-shifting models to facilitating depression care delivered by medical providers: one that utilized a structured protocol, and one that relied on clinical acumen, in 10 HIV clinics in Uganda. Both models started with routine depression screening of all clients at triage using the 2-item Patient Health Questionnaire (PHQ-2), from which we enrolled 1252 clients (640 at structured protocol clinics, 612 at clinical acumen clinics) who had screened positive over 12 months. We compared the two models on (1) proportion of all client participants, and those clinically depressed (based on survey-administered 9-item PHQ-9>9), who received post-screening evaluation for depression using the PHQ-9; and (2) proportion of clinically depressed who were prescribed antidepressant therapy. Linear probability regression analyses were conducted using a wild cluster bootstrap to control for clustering; patient characteristics, clinic size and time fixed effects were included as covariates. Among all client participants, those in the structured protocol arm were far more likely to have received further evaluation by a medical provider using the PHQ-9 (84% vs. 49%; beta = .33; p = .01). Among the clinically depressed clients (n = 369), the advantage of the structured protocol model over clinical acumen was not statistically significant with regard to PHQ-9 depression evaluation (93% vs. 68%; beta = .21; p = .14) or prescription of antidepressants (69% vs. 58%; beta = .10; p = .50), in part because only 30% of clients who screened positive were clinically depressed. These findings reveal that in both models depression care practices were widely adopted by providers, and

  14. A National Content Analysis of PhD Program Objectives, Structures, and Curricula: Do Programs Address the Full Range of Social Work's Needs?

    ERIC Educational Resources Information Center

    Drisko, James; Hunnicutt, Christie; Berenson, Laura

    2015-01-01

    The Group for the Advancement of Doctoral Education (GADE) promotes excellence in PhD education in Social Work. GADE's 2013 Quality Guidelines for PhD Programs heavily emphasize preparation for research. Little is known, however, about the details of the contemporary social work PhD program structure and curriculum. Several prior surveys have…

  15. Learning Object Repositories

    ERIC Educational Resources Information Center

    Lehman, Rosemary

    2007-01-01

    This chapter looks at the development and nature of learning objects, meta-tagging standards and taxonomies, learning object repositories, learning object repository characteristics, and types of learning object repositories, with type examples. (Contains 1 table.)

  16. Transneptunian Object Taxonomy

    NASA Astrophysics Data System (ADS)

    Fulchignoni, M.; Belskaya, I.; Barucci, M. A.; de Sanctis, M. C.; Doressoundiram, A.

    A taxonomic scheme based on multivariate statistics is proposed to distinguish groups of TNOs having the same behavior concerning their BVRIJ colors. As in the case of asteroids, the broadband spectrophotometry provides a first hint about the bulk compositional properties of the TNOs' surfaces. Principal components (PC) analysis shows that most of the TNOs' color variability can be accounted for by a single component (i.e., a linear combination of the colors): All the studied objects are distributed along a quasicontinuous trend spanning from "gray" (neutral color with respect to those of the Sun) to very "red" (showing a spectacular increase in the reflectance of the I and J bands). A finer structure is superimposed to this trend and four homogeneous "compositional" classes emerge clearly, and independently from the PC analysis, if the TNO sample is analyzed with a grouping technique (the G-mode statistics). The first class (designed as BB) contains the objects that are neutral in color with respect to the Sun, while the RR class contains the very red ones. Two intermediate classes are separated by theG mode: the BR and the IR, which are clearly distinguished by the reflectance relative increases in the R and I bands. Some characteristics of the classes are deduced that extend to all the objects of a given class the properties that are common to those members of the class for which more detailed data are available (observed activity, full spectra, albedo). The distributions of the classes with respect to the distance from the Sun and to the orbital inclination give some hints on the chemico-physical structure of the inner part of the Kuiper belt. An interpretation of the average broadband spectra of the four classes as the result of modifying processes (collisions, space weathering, degassing, etc.), allows us to read the proposed taxonomy in terms of the evolution of TNOs.

  17. Subjectivity, objectivity, and triangular space.

    PubMed

    Britton, Ronald

    2004-01-01

    The author reviews his ideas on subjectivity, objectivity, and the third position in the psychoanalytic encounter, particularly in clinical work with borderline and narcissistic patients. Using the theories of Melanie Klein and Wilfred Bion as a basis, the author describes his concept of triangular space. A case presentation of a particular type of narcissistic patient illustrates the principles discussed.

  18. Subjectivity, objectivity, and triangular space.

    PubMed

    Britton, Ronald

    2004-01-01

    The author reviews his ideas on subjectivity, objectivity, and the third position in the psychoanalytic encounter, particularly in clinical work with borderline and narcissistic patients. Using the theories of Melanie Klein and Wilfred Bion as a basis, the author describes his concept of triangular space. A case presentation of a particular type of narcissistic patient illustrates the principles discussed. PMID:14750465

  19. Ultrasound in the diagnosis of peripheral neuropathy: structure meets function in the neuromuscular clinic.

    PubMed

    Gallardo, Elena; Noto, Yu-Ichi; Simon, Neil G

    2015-10-01

    Peripheral nerve ultrasound (US) has emerged as a promising technique for the diagnosis of peripheral nerve disorders. While most experience with US has been reported in the context of nerve entrapment syndromes, the role of US in the diagnosis of peripheral neuropathy (PN) has recently been explored. Distinctive US findings have been reported in patients with hereditary, immune-mediated, infectious and axonal PN; US may add complementary information to neurophysiological studies in the diagnostic work-up of PN. This review describes the characteristic US findings in PN reported to date and a classification of abnormal nerve US patterns in PN is proposed. Closer scrutiny of nerve abnormalities beyond assessment of nerve calibre may allow for more accurate diagnostic classification of PN, as well as contribute to the understanding of the intersection of structure and function in PN.

  20. Object locating system

    DOEpatents

    Novak, J.L.; Petterson, B.

    1998-06-09

    A sensing system locates an object by sensing the object`s effect on electric fields. The object`s effect on the mutual capacitance of electrode pairs varies according to the distance between the object and the electrodes. A single electrode pair can sense the distance from the object to the electrodes. Multiple electrode pairs can more precisely locate the object in one or more dimensions. 12 figs.

  1. Object locating system

    DOEpatents

    Novak, James L.; Petterson, Ben

    1998-06-09

    A sensing system locates an object by sensing the object's effect on electric fields. The object's effect on the mutual capacitance of electrode pairs varies according to the distance between the object and the electrodes. A single electrode pair can sense the distance from the object to the electrodes. Multiple electrode pairs can more precisely locate the object in one or more dimensions.

  2. Structural Validation of the Abridged Autism Spectrum Quotient-Short Form in a Clinical Sample of People with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Kuenssberg, Renate; Murray, Aja L.; Booth, Tom; McKenzie, Karen

    2014-01-01

    The primary aim of this article was to provide a structural validation of the 28-item Autism Spectrum Quotient-Short Form questionnaire in a sample of adults with clinically diagnosed autism spectrum disorders ("n" = 148). Confirmatory factor analysis demonstrated that the proposed structure, comprising a second-order Social Skills…

  3. Clinical efficacy of dalbavancin for the treatment of acute bacterial skin and skin structure infections (ABSSSI)

    PubMed Central

    Leuthner, Kimberly D; Buechler, Kristin A; Kogan, David; Saguros, Agafe; Lee, H Stephen

    2016-01-01

    Acute bacterial skin and skin structure infections (ABSSSI) are a common disease causing patients to seek treatment through the health care system. With the continued increase of drug-resistant bacterial pathogens, these infections are becoming more difficult to successfully cure. Lipoglycopeptides have unique properties that allow the drug to remain active toward both common and challenging pathogens at the infected site for lengthy periods of time. Dalbavancin, a new lipoglycopeptide, provides two unique dosing regimens for the treatment of ABSSSI. The original regimen of 1,000 mg intravenous infusion followed by a 500 mg intravenous infusion after a week has been shown as safe and effective in multiple, randomized noninferiority trials. These studies also demonstrated that dalbavancin was similar to standard regimens in terms of both safety and tolerability. Recently a single 1,500 mg dose was demonstrated to be equivalent to the dalbavancin two-dose regimen for treating ABSSSI. With the introduction of dalbavancin, clinicians have the option to provide an intravenous antimicrobial agent shown to be as effective as traditional therapies, without requiring admission into the hospitals or prescribing a medication which may not be utilized optimally. Further understanding of dalbavancin and its unusual properties can provide unique treatment situations with potential benefits for both the patient and the overall health care system, which should be further explored. PMID:27354809

  4. Validity of a self-reported diagnosis of depression among participants in a cohort study using the Structured Clinical Interview for DSM-IV (SCID-I)

    PubMed Central

    Sanchez-Villegas, Almudena; Schlatter, Javier; Ortuno, Felipe; Lahortiga, Francisca; Pla, Jorge; Benito, Silvia; Martinez-Gonzalez, Miguel A

    2008-01-01

    Background Depression assessment in population studies is usually based on depressive symptoms scales. However, the use of scales could lead to the choice of an arbitrary cut-off point depending on the sample characteristics and on the patient diagnosis. Thus, the use of a medical diagnosis of depression could be a more appropriate approach. Objective To validate a self-reported physician diagnosis of depression using the Structured Clinical Interview for DSM-IV (SCID-I) as Gold Standard and to assess the factors associated to a valid self-reported diagnosis. Methods The SUN Project is a cohort study based on university graduates followed-up through postal questionnaires. The response to the question included in the questionnaire: Have you ever been diagnosed of depression by a physician? was compared to that obtained through the SCID-I applied by a psychiatrist or a clinical psychologist. The percentages of confirmed depression and non-depression were assessed for the overall sample and according to several characteristics. Logistic regression models were fitted to ascertain the association between different factors and a correct classification regarding depression status. Results The percentage of confirmed depression was 74.2%; 95% confidence interval (95% CI) = 63.3–85.1. Out of 42 participants who did not report a depression diagnosis in the questionnaire, 34 were free of the disease (%confirmed non-depression = 81.1%; 95% CI = 69.1–92.9). The probability of being a true positive was higher among ex-smokers and non-smokers and among those overweight or obese but the differences were not statistically significant. Conclusion The validity of a self-reported diagnosis of depression in the SUN cohort is adequate. Thus, this question about depression diagnosis could be used in further investigations regarding this disease in this graduate cohort study. PMID:18558014

  5. Comorbid personality disorders and substance use disorders of mentally ill homicide offenders: a structured clinical study on dual and triple diagnoses.

    PubMed

    Putkonen, Anu; Kotilainen, Irma; Joyal, Christian C; Tiihonen, Jari

    2004-01-01

    Comorbid substance use disorders (SUDs) increase the risk of homicide by persons with major mental disorders (MMDs). However, there are no published data from clinical interviews or lifetime objective documents on the prevalence of lifetime personality disorder (PD) or SUD among a comprehensive sample of mentally ill homicide offenders. Therefore, a nationally representative sample of men with MMD (n = 90) who had committed or attempted homicide was assessed using the research version of the Structured Clinical Interview for DSM-IV Axis I and Axis II Disorders. Lifetime documents, records, and questionnaires from persons who knew the subjects since childhood were used. Seventy-eight percent of the mentally ill homicide offenders were diagnosed with schizophrenia, 17 percent with schizoaffective disorder, and 5 percent with other psychosis. A lifetime SUD was detected in 74 percent and alcohol use disorder in 72 percent. PD accounted for 51 percent, in 47 percent as antisocial personality disorder (APD). All subjects diagnosed with PD had SUD. Only 25 percent of the subjects had neither SUD nor PD. Among persons with dual diagnoses (MMD and SUD), about two-thirds had PD or APD. These results indicated that there were two-thirds major diagnostic categories of psychotic homicide offenders: about one-half had triple diagnosis (APD + SUD + MMD), one-quarter had "pure" dual diagnosis (SUD + MMD), and one-quarter had "pure" MMD. The fourth possible category, "APD + MMD but no SUD," was not found. The prevention of severe violence by persons with MMD necessitates effective treatments for those with dual diagnosis who also have a history of APD. PMID:15176762

  6. Multi-objective optimization of typhoon inundation forecast models with cross-site structures for a water-level gauging network by integrating ARMAX with a genetic algorithm

    NASA Astrophysics Data System (ADS)

    Ouyang, Huei-Tau

    2016-08-01

    The forecasting of inundation levels during typhoons requires that multiple objectives be taken into account, including the forecasting capacity with regard to variations in water level throughout the entire weather event, the accuracy that can be attained in forecasting peak water levels, and the time at which peak water levels are likely to occur. This paper proposed a means of forecasting inundation levels in real time using monitoring data from a water-level gauging network. ARMAX was used to construct water-level forecast models for each gauging station using input variables including cumulative rainfall and water-level data from other gauging stations in the network. Analysis of the correlation between cumulative rainfall and water-level data makes it possible to obtain the appropriate accumulation duration of rainfall and the time lags associated with each gauging station. Analyses on cross-site water levels as well as on cumulative rainfall enable the identification of associate sites pertaining to each gauging station that share high correlations with regard to water level and low mutual information with regard to cumulative rainfall. Water-level data from the identified associate sites are used as a second input variable for the water-level forecast model of the target site. Three indices were considered in the selection of an optimal model: the coefficient of efficiency (CE), error in the stage of peak water level (ESP), and relative time shift (RTS). A multi-objective genetic algorithm was employed to derive an optimal Pareto set of models capable of performing well in the three objectives. A case study was conducted on the Xinnan area of Yilan County, Taiwan, in which optimal water-level forecast models were established for each of the four water-level gauging stations in the area. Test results demonstrate that the model best able to satisfy ESP exhibited significant time shift, whereas the models best able to satisfy CE and RTS provide accurate

  7. [Attitudes concerning military duty and personality structures. Clinical, psychometric and projective study of Jehovah wittnesses and conscientious objectors (author's transl)].

    PubMed

    Jadot, F; Paquay, J; Timsit, M

    1979-01-01

    Refusal of military duty appearing to be a deviant social attitude, the authors have investigated the relationship between this behaviour and personality. They hypothesize that the rigid attitude of the Jehovah Wittness, refusing military duty and civil service, would be linked to paranoïd structure, and conscientious objectors to border-line states. A triple approach (clinical, Rorschach and aggressivity inventory of Buss and Durkee) was used; representative groups of these two populations were compared to control military recruits. Rorschach protocoles did not differentiate the Jehovah and control group, both being characterized by poor items and retraction. The authors interpret there data by possible absence of motivation in controls, or a rigid psychological organisation, which could be related habits in life and spirit of our societies. For the objectors, these are richer and more open. Five out of twelve appear to have a border-line organisation. PMID:543432

  8. COGNITION, ACTION, AND OBJECT MANIPULATION

    PubMed Central

    Rosenbaum, David A.; Chapman, Kate M.; Weigelt, Matthias; Weiss, Daniel J.; van der Wel, Robrecht

    2012-01-01

    Although psychology is the science of mental life and behavior, it has paid little attention to the means by which mental life is translated into behavior. One domain where links between cognition and action have been explored is the manipulation of objects. This article reviews psychological research on this topic, with special emphasis on the tendency to grasp objects differently depending on what one plans to do with the objects. Such differential grasping has been demonstrated in a wide range of object manipulation tasks, including grasping an object in a way that reveals anticipation of the object's future orientation, height, and required placement precision. Differential grasping has also been demonstrated in a wide range of behaviors, including one-hand grasps, two-hand grasps, walking, and transferring objects from place to place as well as from person to person. The populations in whom the tendency has been shown are also diverse, including nonhuman primates as well as human adults, children, and babies. Meanwhile, the tendency is compromised in a variety of clinical populations and in children of a surprisingly advanced age. Verbal working memory is compromised as well if words are memorized while object manipulation tasks are performed; the recency portion of the serial position curve is reduced in this circumstance. In general, the research reviewed here points to rich connections between cognition and action as revealed through the study of object manipulation. Other implications concern affordances, Donders' Law, and naturalistic observation and the teaching of psychology. PMID:22448912

  9. Cognition, action, and object manipulation.

    PubMed

    Rosenbaum, David A; Chapman, Kate M; Weigelt, Matthias; Weiss, Daniel J; van der Wel, Robrecht

    2012-09-01

    Although psychology is the science of mental life and behavior, little attention has been paid to the means by which mental life is translated into behavior. One domain in which links between cognition and action have been explored is the manipulation of objects. This article reviews psychological research on this topic, with special emphasis on the tendency to grasp objects differently depending on what one plans to do with the objects. Such differential grasping has been demonstrated in a wide range of object manipulation tasks, including grasping an object in a way that reveals anticipation of the object's future orientation, height, and required placement precision. Differential grasping has also been demonstrated in a wide range of behaviors, including 1-hand grasps, 2-hand grasps, walking, and transferring objects from place to place as well as from person to person. The populations in which the tendency has been shown are also diverse, including nonhuman primates as well as human adults, children, and babies. The tendency is compromised in a variety of clinical populations and in children of a surprisingly advanced age. Verbal working memory is compromised as well if words are memorized while object manipulation tasks are performed; the recency portion of the serial position curve is reduced in this circumstance. In general, the research reviewed here points to rich connections between cognition and action as revealed through the study of object manipulation. Other implications concern affordances, Donders' law, naturalistic observation, and the teaching of psychology.

  10. Construction and characterization of infectious hepatitis C virus chimera containing structural proteins directly from genotype 1b clinical isolates.

    PubMed

    Lu, Jie; Tao, Wanyin; Li, Rui; Xiang, Yu; Zhang, Nan; Xiang, Xiaogang; Xie, Qing; Zhong, Jin

    2013-08-15

    HCV genotype is a major determinant of clinical outcome, and GT1b HCV infection is the most difficult to treat and also the predominant genotype in East Asia and Europe. We developed 1b/JFH-1 inter-genotypic recombinants containing the structural genes (Core, E1, E2), p7 and the 1stTMD of NS2 directly from GT1b clinical isolates. Through a cloning selection strategy, we obtained 4 functional clones from 3 cases of GT1b patients' sera, which could produce infectious viruses in Huh7.5.1 cells. Sequencing analysis of recovered viruses from serial passage and reverse genetics revealed that adaptive mutations in the GT1b-originated region were enough for the enhancement of infectivity. A monoclonal antibody to E2 and original patient sera could efficiently block 3 of the viruses (26C3mt, 52B6mt and 79L9) while had little effect on 26C6mt viruses. The availability of 1b/JFH-1 chimeric viruses will be important for studies of isolate-specific neutralization and useful in evaluating antiviral therapies.

  11. Category-specificity in visual object recognition.

    PubMed

    Gerlach, Christian

    2009-06-01

    Are all categories of objects recognized in the same manner visually? Evidence from neuropsychology suggests they are not: some brain damaged patients are more impaired in recognizing natural objects than artefacts whereas others show the opposite impairment. Category-effects have also been demonstrated in neurologically intact subjects, but the findings are contradictory and there is no agreement as to why category-effects arise. This article presents a pre-semantic account of category-effects (PACE) in visual object recognition. PACE assumes two processing stages: shape configuration (the binding of shape elements into elaborate shape descriptions) and selection (among competing representations in visual long-term memory), which are held to be differentially affected by the structural similarity between objects. Drawing on evidence from clinical studies, experimental studies with neurologically intact subjects and functional imaging studies, it is argued that PACE can account for category-effects at both behavioural and neural levels in patients and neurologically intact subjects. The theory also accounts for the way in which category-effects are affected by different task parameters (the degree of perceptual differentiation called for), stimulus characteristics (whether stimuli are presented as silhouettes, full line-drawings, or fragmented forms), stimulus presentation (stimulus exposure duration and position) as well as interactions between these parameters.

  12. Object links in the repository

    NASA Technical Reports Server (NTRS)

    Beck, Jon; Eichmann, David

    1991-01-01

    Some of the architectural ramifications of extending the Eichmann/Atkins lattice-based classification scheme to encompass the assets of the full life-cycle of software development are explored. In particular, we wish to consider a model which provides explicit links between objects in addition to the edges connecting classification vertices in the standard lattice. The model we consider uses object-oriented terminology. Thus, the lattice is viewed as a data structure which contains class objects which exhibit inheritance. A description of the types of objects in the repository is presented, followed by a discussion of how they interrelate. We discuss features of the object-oriented model which support these objects and their links, and consider behavior which an implementation of the model should exhibit. Finally, we indicate some thoughts on implementing a prototype of this repository architecture.

  13. Structure-based prediction of subtype-selectivity of Histamine H3 receptor selective antagonists in clinical trials

    PubMed Central

    Kim, Soo-Kyung; Fristrup, Peter; Abrol, Ravinder; Goddard, William A.

    2011-01-01

    Histamine receptors (HRs) are excellent drug targets for the treatment of diseases such as schizophrenia, psychosis, depression, migraine, allergies, asthma ulcers, and hypertension. Among them, the human H3 Histamine receptor (hH3HR) antagonists have been proposed for specific therapeutic applications, including treatment of Alzheimer's disease, attention deficit hyperactivity disorder (ADHD), epilepsy, and obesity.1 However, many of these drug candidates cause undesired side effects through the cross-reactivity with other histamine receptor subtypes. In order to develop improved selectivity and activity for such treatments it would be useful to have the three dimensional structures for all four HRs. We report here the predicted structures of four HR subtypes (H1, H2, H3, and H4) using the GEnSeMBLE (GPCR Ensemble of Structures in Membrane BiLayer Environment) Monte Carlo protocol.2 sampling ~ 35 million combinations of helix packings to predict the 10 most stable packings for each of the four subtypes. Then we used these best 10 protein structures with the DarwinDock Monte Carlo protocol to sample ~ 50,000*20 poses to predict the optimum ligand-protein structures for various agonists and antagonists. We find that E2065.46 contributes most in binding H3 selective agonists (5, 6, 7) in agreement with experimental mutation studies. We also find that conserved E5.46/ S5.43 in both of hH3HR and hH4HR are involved in H3/ H4 subtype selectivity. In addition, we find that M3786.55 in hH3HR provides additional hydrophobic interactions different from hH4HR (the corresponding amino acid of T3236.55 in hH4HR) to provide additional subtype bias. From these studies we developed a pharmacophore model based on our predictions for known hH3HR selective antagonists in clinical study [ABT-239 1, GSK-189,254 2, PF-3654746 3, and BF2.649 (Tiprolisant) 4] that suggests critical selectivity directing elements are: the basic proton interacting with D1143.32, the spacer, the aromatic

  14. Picturing Objects in Infancy

    ERIC Educational Resources Information Center

    Shinskey, Jeanne L.; Jachens, Liza J.

    2014-01-01

    Infants' transfer of information from pictures to objects was tested by familiarizing 9-month-olds (N = 31) with either a color or black-and-white photograph of an object and observing their preferential reaching for the real target object versus a distractor. One condition tested object recognition by keeping both objects visible, and the…

  15. Selecting a Reference Object

    ERIC Educational Resources Information Center

    Miller, Jared E.; Carlson, Laura A.; Hill, Patrick L.

    2011-01-01

    One way to describe the location of an object is to relate it to another object. Often there are many nearby objects, each of which could serve as a candidate to be the reference object. A common theoretical assumption is that features that make a given object salient relative to the candidate set are instrumental in determining which is selected.…

  16. Association of change in brain structure to objectively measured physical activity and sedentary behavior in older adults: Age, Gene/Environment Susceptibility-Reykjavik Study.

    PubMed

    Arnardottir, Nanna Yr; Koster, Annemarie; Domelen, Dane R Van; Brychta, Robert J; Caserotti, Paolo; Eiriksdottir, Gudny; Sverrisdottir, Johanna E; Sigurdsson, Sigurdur; Johannsson, Erlingur; Chen, Kong Y; Gudnason, Vilmundur; Harris, Tamara B; Launer, Lenore J; Sveinsson, Thorarinn

    2016-01-01

    Many studies have examined the hypothesis that greater participation in physical activity (PA) is associated with less brain atrophy. Here we examine, in a sub-sample (n=352, mean age 79.1 years) of the Age, Gene/Environment Susceptibility-Reykjavik Study cohort, the association of the baseline and 5-year change in magnetic resonance imaging (MRI)-derived volumes of gray matter (GM) and white matter (WM) to active and sedentary behavior (SB) measured at the end of the 5-year period by a hip-worn accelerometer for seven consecutive days. More GM (β=0.11; p=0.044) and WM (β=0.11; p=0.030) at baseline was associated with more total physical activity (TPA). Also, when adjusting for baseline values, the 5-year change in GM (β=0.14; p=0.0037) and WM (β=0.11; p=0.030) was associated with TPA. The 5-year change in WM was associated with SB (β=-0.11; p=0.0007). These data suggest that objectively measured PA and SB late in life are associated with current and prior cross-sectional measures of brain atrophy, and that change over time is associated with PA and SB in expected directions.

  17. Numerical Analysis Objects

    NASA Astrophysics Data System (ADS)

    Henderson, Michael

    1997-08-01

    The Numerical Analysis Objects project (NAO) is a project in the Mathematics Department of IBM's TJ Watson Research Center. While there are plenty of numerical tools available today, it is not an easy task to combine them into a custom application. NAO is directed at the dual problems of building applications from a set of tools, and creating those tools. There are several "reuse" projects, which focus on the problems of identifying and cataloging tools. NAO is directed at the specific context of scientific computing. Because the type of tools is restricted, problems such as tools with incompatible data structures for input and output, and dissimilar interfaces to tools which solve similar problems can be addressed. The approach we've taken is to define interfaces to those objects used in numerical analysis, such as geometries, functions and operators, and to start collecting (and building) a set of tools which use these interfaces. We have written a class library (a set of abstract classes and implementations) in C++ which demonstrates the approach. Besides the classes, the class library includes "stub" routines which allow the library to be used from C or Fortran, and an interface to a Visual Programming Language. The library has been used to build a simulator for petroleum reservoirs, using a set of tools for discretizing nonlinear differential equations that we have written, and includes "wrapped" versions of packages from the Netlib repository. Documentation can be found on the Web at "http://www.research.ibm.com/nao". I will describe the objects and their interfaces, and give examples ranging from mesh generation to solving differential equations.

  18. The rise of cancer in urban India: Cultural understandings, structural inequalities and the emergence of the clinic.

    PubMed

    Broom, Alex; Doron, Assa

    2012-05-01

    Cancer services in India have evolved and expanded significantly in recent years, with a surge in the availability of biomedical oncological treatment facilities for certain cohorts of the Indian population in urban areas. Despite significant and sustained economic development in many areas of India, major issues persist in the delivery of cancer care, even in the context of relatively prosperous urban populations. This article explores the dilemmas evident in Indian cancer care as perceived by a group of Indian oncology clinicians. Specifically, the interviews focused on their perspectives on the key challenges facing cancer patients, particularly in relation to help-seeking and access to care. The main concerns that emerged in the interviews were: (a) practical constraint (i.e. access and treatment); (b) cultural values (i.e. communication, stigma and the clinic); and (c) structural conditions (i.e. inequalities related to place, gender and class). We unpack these as important elements of cancer care in contemporary India, and present Farmer's notion of structural violence, among other concepts, as potentially useful for understanding some facets of this social problem. We conclude that without a greater understanding of social and cultural issues shaping cancer care in India, little progress will be made in coping with a disease that is set to become a major burden within an increasingly prosperous and ageing population.

  19. Integrating population variation and protein structural analysis to improve clinical interpretation of missense variation: application to the WD40 domain.

    PubMed

    Laskowski, Roman A; Tyagi, Nidhi; Johnson, Diana; Joss, Shelagh; Kinning, Esther; McWilliam, Catherine; Splitt, Miranda; Thornton, Janet M; Firth, Helen V; Wright, Caroline F

    2016-03-01

    We present a generic, multidisciplinary approach for improving our understanding of novel missense variants in recently discovered disease genes exhibiting genetic heterogeneity, by combining clinical and population genetics with protein structural analysis. Using six new de novo missense diagnoses in TBL1XR1 from the Deciphering Developmental Disorders study, together with population variation data, we show that the β-propeller structure of the ubiquitous WD40 domain provides a convincing way to discriminate between pathogenic and benign variation. Children with likely pathogenic mutations in this gene have severely delayed language development, often accompanied by intellectual disability, autism, dysmorphology and gastrointestinal problems. Amino acids affected by likely pathogenic missense mutations are either crucial for the stability of the fold, forming part of a highly conserved symmetrically repeating hydrogen-bonded tetrad, or located at the top face of the β-propeller, where 'hotspot' residues affect the binding of β-catenin to the TBLR1 protein. In contrast, those altered by population variation are significantly less likely to be spatially clustered towards the top face or to be at buried or highly conserved residues. This result is useful not only for interpreting benign and pathogenic missense variants in this gene, but also in other WD40 domains, many of which are associated with disease. PMID:26740553

  20. Nonclinical and clinical Enterococcus faecium strains, but not Enterococcus faecalis strains, have distinct structural and functional genomic features.

    PubMed

    Kim, Eun Bae; Marco, Maria L

    2014-01-01

    Certain strains of Enterococcus faecium and Enterococcus faecalis contribute beneficially to animal health and food production, while others are associated with nosocomial infections. To determine whether there are structural and functional genomic features that are distinct between nonclinical (NC) and clinical (CL) strains of those species, we analyzed the genomes of 31 E. faecium and 38 E. faecalis strains. Hierarchical clustering of 7,017 orthologs found in the E. faecium pangenome revealed that NC strains clustered into two clades and are distinct from CL strains. NC E. faecium genomes are significantly smaller than CL genomes, and this difference was partly explained by significantly fewer mobile genetic elements (ME), virulence factors (VF), and antibiotic resistance (AR) genes. E. faecium ortholog comparisons identified 68 and 153 genes that are enriched for NC and CL strains, respectively. Proximity analysis showed that CL-enriched loci, and not NC-enriched loci, are more frequently colocalized on the genome with ME. In CL genomes, AR genes are also colocalized with ME, and VF are more frequently associated with CL-enriched loci. Genes in 23 functional groups are also differentially enriched between NC and CL E. faecium genomes. In contrast, differences were not observed between NC and CL E. faecalis genomes despite their having larger genomes than E. faecium. Our findings show that unlike E. faecalis, NC and CL E. faecium strains are equipped with distinct structural and functional genomic features indicative of adaptation to different environments.

  1. Integrating population variation and protein structural analysis to improve clinical interpretation of missense variation: application to the WD40 domain

    PubMed Central

    Laskowski, Roman A.; Tyagi, Nidhi; Johnson, Diana; Joss, Shelagh; Kinning, Esther; McWilliam, Catherine; Splitt, Miranda; Thornton, Janet M.; Firth, Helen V.; Wright, Caroline F.

    2016-01-01

    We present a generic, multidisciplinary approach for improving our understanding of novel missense variants in recently discovered disease genes exhibiting genetic heterogeneity, by combining clinical and population genetics with protein structural analysis. Using six new de novo missense diagnoses in TBL1XR1 from the Deciphering Developmental Disorders study, together with population variation data, we show that the β-propeller structure of the ubiquitous WD40 domain provides a convincing way to discriminate between pathogenic and benign variation. Children with likely pathogenic mutations in this gene have severely delayed language development, often accompanied by intellectual disability, autism, dysmorphology and gastrointestinal problems. Amino acids affected by likely pathogenic missense mutations are either crucial for the stability of the fold, forming part of a highly conserved symmetrically repeating hydrogen-bonded tetrad, or located at the top face of the β-propeller, where ‘hotspot’ residues affect the binding of β-catenin to the TBLR1 protein. In contrast, those altered by population variation are significantly less likely to be spatially clustered towards the top face or to be at buried or highly conserved residues. This result is useful not only for interpreting benign and pathogenic missense variants in this gene, but also in other WD40 domains, many of which are associated with disease. PMID:26740553

  2. Glycan analysis of Fonsecaea monophora from clinical and environmental origins reveals different structural profile and human antigenic response.

    PubMed

    Burjack, Juliana R; Santana-Filho, Arquimedes P; Ruthes, Andrea C; Riter, Daniel S; Vicente, Vania A; Alvarenga, Larissa M; Sassaki, Guilherme L

    2014-01-01

    Dematiaceous fungi constitute a large and heterogeneous group, characterized by having a dark pigment, the dihydroxynaftalen melanin-DHN, inside their cell walls. In nature they are found mainly as soil microbiota or decomposing organic matter, and are spread in tropical and subtropical regions. The fungus Fonsecaea monophora causes chromoblastomycosis in humans, and possesses essential mechanisms that may enhance pathogenicity, proliferation and dissemination inside the host. Glycoconjugates confer important properties to these pathogenic microorganisms. In this work, structural characterization of glycan structures present in two different strains of F. monophora MMHC82 and FE5p4, from clinical and environmental origins, respectively, was performed. Each one were grown on Minimal Medium (MM) and Czapeck-Dox (CD) medium, and the water soluble cell wall glycoconjugates and exopolysaccharides (EPS) were evaluated by NMR, methylation and principal component analysis (PCA). By combining the methylation and 2D NMR analyses, it was possible to visualize the glycosidic profiles of the complex carbohydrate mixtures. Significant differences were observed in β-D-Galf-(1→5) and (1→6) linkages, α- and β-D-Glcp-(1→3), (1→4), and (1→6) units, as well as in α-D-Manp. PCA from (1)H-NMR data showed that MMHC82 from CD medium showed a higher variation in the cell wall carbohydrates, mainly related to O-2 substituted β-D-Galf (δ 106.0/5.23 and δ 105.3/5.23) units. In order to investigate the antigenic response of the glycoconjugates, these were screened against serum from chromoblastomycosis patients. The antigen which contained the cell wall of MMHC82 grown in MM had β-D-Manp units that promoted higher antigenic response. The distribution of these fungal species in nature and the knowledge of how cell wall polysaccharides and glycoconjugates structure vary, may contribute to the better understanding and the elucidation of the pathology caused by this fungus.

  3. Relations among early object recognition skills: Objects and letters

    PubMed Central

    Augustine, Elaine; Jones, Susan S.; Smith, Linda B.; Longfield, Erica

    2014-01-01

    Human visual object recognition is multifaceted, with several domains of expertise. Developmental relations between young children's letter recognition and their 3-dimensional object recognition abilities are implicated on several grounds but have received little research attention. Here, we ask how preschoolers’ success in recognizing letters relates to their ability to recognize 3-dimensional objects from sparse shape information alone. A relation is predicted because perception of the spatial relations is critical in both domains. Seventy-three 2 ½- to 4-year-old children completed a Letter Recognition task, measuring the ability to identify a named letter among 3 letters with similar shapes, and a “Shape Caricature Recognition” task, measuring recognition of familiar objects from sparse, abstract information about their part shapes and the spatial relations among those parts. Children also completed a control “Shape Bias” task, in which success depends on recognition of overall object shape but not of relational structure. Children's success in letter recognition was positively related to their shape caricature recognition scores, but not to their shape bias scores. The results suggest that letter recognition builds upon developing skills in attending to and representing the relational structure of object shape, and that these skills are common to both 2-dimensional and 3-dimensional object perception. PMID:25969673

  4. Use of Drop-In Clinic Versus Appointment-Based Care for LGBT Youth: Influences on the Likelihood to Access Different Health-Care Structures.

    PubMed

    Newman, Bernie S; Passidomo, Kim; Gormley, Kate; Manley, Alecia

    2014-06-01

    The structure of health-care service delivery can address barriers that make it difficult for lesbian, gay, bisexual, and transgender (LGBT) adolescents to use health services. This study explores the differences among youth who access care in one of two service delivery structures in an LGBT health-care center: the drop-in clinic or the traditional appointment-based model. Analysis of 578 records of LGBT and straight youth (aged 14-24) who accessed health care either through a drop-in clinic or appointment-based care within the first year of offering the drop-in clinic reveals patterns of use when both models are available. We studied demographic variables previously shown to be associated with general health-care access to determine how each correlated with a tendency to use the drop-in structure versus routine appointments. Once the covariates were identified, we conducted a logistic regression analysis to identify its association with likelihood of using the drop-in clinic. Insurance status, housing stability, education, race, and gender identity were most strongly associated with the type of clinic used. Youth who relied on Medicaid, those in unstable housing, and African Americans were most likely to use the drop-in clinic. Transgender youth and those with higher education were more likely to use the appointment-based clinic. Although sexual orientation and HIV status were not related to type of clinic used, youth who were HIV positive used the appointment-based clinic more frequently. Both routes to health care served distinct populations who often experience barriers to accessible, affordable, and knowledgeable care. Further study of the factors related to accessing health care may clarify the extent to which drop-in hours in a youth-friendly context may increase the use of health care by the most socially marginalized youth.

  5. Use of Drop-In Clinic Versus Appointment-Based Care for LGBT Youth: Influences on the Likelihood to Access Different Health-Care Structures.

    PubMed

    Newman, Bernie S; Passidomo, Kim; Gormley, Kate; Manley, Alecia

    2014-06-01

    The structure of health-care service delivery can address barriers that make it difficult for lesbian, gay, bisexual, and transgender (LGBT) adolescents to use health services. This study explores the differences among youth who access care in one of two service delivery structures in an LGBT health-care center: the drop-in clinic or the traditional appointment-based model. Analysis of 578 records of LGBT and straight youth (aged 14-24) who accessed health care either through a drop-in clinic or appointment-based care within the first year of offering the drop-in clinic reveals patterns of use when both models are available. We studied demographic variables previously shown to be associated with general health-care access to determine how each correlated with a tendency to use the drop-in structure versus routine appointments. Once the covariates were identified, we conducted a logistic regression analysis to identify its association with likelihood of using the drop-in clinic. Insurance status, housing stability, education, race, and gender identity were most strongly associated with the type of clinic used. Youth who relied on Medicaid, those in unstable housing, and African Americans were most likely to use the drop-in clinic. Transgender youth and those with higher education were more likely to use the appointment-based clinic. Although sexual orientation and HIV status were not related to type of clinic used, youth who were HIV positive used the appointment-based clinic more frequently. Both routes to health care served distinct populations who often experience barriers to accessible, affordable, and knowledgeable care. Further study of the factors related to accessing health care may clarify the extent to which drop-in hours in a youth-friendly context may increase the use of health care by the most socially marginalized youth. PMID:26789623

  6. Uniqueness Theorem for Black Objects

    SciTech Connect

    Rogatko, Marek

    2010-06-23

    We shall review the current status of uniqueness theorem for black objects in higher dimensional spacetime. At the beginning we consider static charged asymptotically flat spacelike hypersurface with compact interior with both degenerate and non-degenerate components of the event horizon in n-dimensional spacetime. We gave some remarks concerning partial results in proving uniqueness of stationary axisymmetric multidimensional solutions and winding numbers which can uniquely characterize the topology and symmetry structure of black objects.

  7. Development and implementation of an automatic integration system for fibre optic sensors in the braiding process with the objective of online-monitoring of composite structures

    NASA Astrophysics Data System (ADS)

    Hufenbach, W.; Gude, M.; Czulak, A.; Kretschmann, Martin

    2014-04-01

    Increasing economic, political and ecological pressure leads to steadily rising percentage of modern processing and manufacturing processes for fibre reinforced polymers in industrial batch production. Component weights beneath a level achievable by classic construction materials, which lead to a reduced energy and cost balance during product lifetime, justify the higher fabrication costs. However, complex quality control and failure prediction slow down the substitution by composite materials. High-resolution fibre-optic sensors (FOS), due their low diameter, high measuring point density and simple handling, show a high applicability potential for an automated sensor-integration in manufacturing processes, and therefore the online monitoring of composite products manufactured in industrial scale. Integrated sensors can be used to monitor manufacturing processes, part tests as well as the component structure during product life cycle, which simplifies allows quality control during production and the optimization of single manufacturing processes.[1;2] Furthermore, detailed failure analyses lead to a enhanced understanding of failure processes appearing in composite materials. This leads to a lower wastrel number and products of a higher value and longer product life cycle, whereby costs, material and energy are saved. This work shows an automation approach for FOS-integration in the braiding process. For that purpose a braiding wheel has been supplemented with an appliance for automatic sensor application, which has been used to manufacture preforms of high-pressure composite vessels with FOS-networks integrated between the fibre layers. All following manufacturing processes (vacuum infiltration, curing) and component tests (quasi-static pressure test, programmed delamination) were monitored with the help of the integrated sensor networks. Keywords: SHM, high-pressure composite vessel, braiding, automated sensor integration, pressure test, quality control, optic

  8. ADHD: Is Objective Diagnosis Possible?

    PubMed Central

    Johnson, Lynda G.

    2005-01-01

    Although attention deficit/hyperactivity disorder (ADHD) is one of the most common cognitive disorders, the usual diagnostic procedures pursued by psychiatrists, neurologists, pediatricians, and family practitioners are based largely, if not exclusively, on subjective assessments of perceived behavior. The recommended approaches to ADHD diagnosis are reviewed, first from the perspective of the various expert panels, and then from the research literature upon which those recommendations are based. The authors agree that ADHD is a clinical diagnosis, and that the assessment of subjective reports can be systematic. But they propose that objective data should also contribute to the clinical diagnosis of ADHD; and that new computerized assessment technology can generate objective cognitive data in an efficient and cost-effective way. Computerized tests can also improve the assessment of treatment response over time. PMID:21120096

  9. Comparison of structural allograft and traditional autograft technique in occipitocervical fusion: radiological and clinical outcomes from a single institution.

    PubMed

    Godzik, Jakub; Ravindra, Vijay M; Ray, Wilson Z; Schmidt, Meic H; Bisson, Erica F; Dailey, Andrew T

    2015-08-01

    OBJECT The authors' objectives were to compare the rate of fusion after occipitoatlantoaxial arthrodesis using structural allograft with the fusion rate from using autograft, to evaluate correction of radiographic parameters, and to describe symptom relief with each graft technique. METHODS The authors assessed radiological fusion at 6 and 12 months after surgery and obtained radiographic measurements of C1-2 and C2-7 lordotic angles, C2-7 sagittal vertical alignments, and posterior occipitocervical angles at preoperative, postoperative, and final follow-up examinations. Demographic data, intraoperative details, adverse events, and functional outcomes were collected from hospitalization records. Radiological fusion was defined as the presence of bone trabeculation and no movement between the graft and the occiput or C-2 on routine flexion-extension cervical radiographs. Radiographic measurements were obtained from lateral standing radiographs with patients in the neutral position. RESULTS At the University of Utah, 28 adult patients underwent occipitoatlantoaxial arthrodesis between 2003 and 2010 using bicortical allograft, and 11 patients were treated using iliac crest autograft. Mean follow-up for all patients was 20 months (range 1-108 months). Of the 27 patients with a minimum of 12 months of follow-up, 18 (95%) of 19 in the allograft group and 8 (100%) of 8 in the autograft group demonstrated evidence of bony fusion shown by imaging. Patients in both groups demonstrated minimal deterioration of sagittal vertical alignment at final follow-up. Operative times were comparable, but patients undergoing occipitocervical fusion with autograft demonstrated greater blood loss (316 ml vs 195 ml). One (9%) of 11 patients suffered a significant complication related to autograft harvesting. CONCLUSIONS The use of allograft in occipitocervical fusion allows a high rate of successful arthrodesis yet avoids the potentially significant morbidity and pain associated with

  10. Structural Integration as an Adjunct to Outpatient Rehabilitation for Chronic Nonspecific Low Back Pain: A Randomized Pilot Clinical Trial

    PubMed Central

    Jacobson, Eric E.; Meleger, Alec L.; Bonato, Paolo; Wayne, Peter M.; Langevin, Helene M.; Kaptchuk, Ted J.; Davis, Roger B.

    2015-01-01

    Structural Integration (SI) is an alternative method of manipulation and movement education. To obtain preliminary data on feasibility, effectiveness, and adverse events (AE), 46 outpatients from Boston area with chronic nonspecific low back pain (CNSLBP) were randomized to parallel treatment groups of SI plus outpatient rehabilitation (OR) versus OR alone. Feasibility data were acceptable except for low compliance with OR and lengthy recruitment time. Intent-to-treat data on effectiveness were analyzed by Wilcoxon rank sum, n = 23 per group. Median reductions in VAS Pain, the primary outcome, of −26 mm in SI + OR versus 0 in OR alone were not significantly different (P = 0.075). Median reductions in RMDQ, the secondary outcome, of −2 points in SI + OR versus 0 in OR alone were significantly different (P = 0.007). Neither the proportions of participants with nor the seriousness of AE were significantly different. SI as an adjunct to OR for CNSLBP is not likely to provide additional reductions in pain but is likely to augment short term improvements in disability with a low additional burden of AE. A more definitive trial is feasible, but OR compliance and recruitment might be challenging. This trial is registered with ClinicalTrials.gov (NCT01322399). PMID:25945112

  11. Synthesis and structure of silver complexes with nicotinate-type ligands having antibacterial activities against clinically isolated antibiotic resistant pathogens.

    PubMed

    Abu-Youssef, Morsy A M; Dey, Raja; Gohar, Yousry; Massoud, Alshima'a A; Ohrström, Lars; Langer, Vratislav

    2007-07-23

    The synthesis and low-temperature X-ray crystal structures of five new silver complexes, [Ag(2)-mu-O,O'(2-aminonicotinium)(2)(NO(3))(2)](n) (7), [Ag(isonicotinamide)(2)-mu-O,O'(NO(3))](2) (8), [Ag(ethyl nicotinate)(2)](NO(3)) (9), [Ag(ethyl isonicotinate)(2)(NO(3))] (10), and [Ag(methyl isonicotinate)(2)(H(2)O)](NO(3)) (11), are presented and fully characterized by spectral and elemental analysis. The antimicrobial activities of these complexes were screened using 12 different clinical isolates belonging to four pathogenic bacteria, S. aureus, S. pyogenes, P. mirabilis, and Ps. Aeruginosa, all obtained from diabetic foot ulcers. These tested bacteria were resistant for at least 10 antibiotics commonly used for treatment of diabetic foot ulcers. Compounds 7 and 8 had considerable activity against Ps. Aeruginosa (MIC values 2-8 microg/mL), compound 9 against S. aureus (MIC 4-16 microg/mL) and S. pyogenes (MIC 2-4 microg/mL), and also 9 and 11 against P. mirabilis (MIC 1-16 microg/mL). All complexes were non-toxic for daphnia at concentrations above 512 microg/mL overnight.

  12. Assessing Traumatic Event Exposure: Comparing the Traumatic Life Events Questionnaire to the Structured Clinical Interview for DSM-IV

    PubMed Central

    Peirce, Jessica M.; Burke, Christopher K.; Stoller, Kenneth B.; Neufeld, Karin J.; Brooner, Robert K.

    2011-01-01

    Posttraumatic stress disorder (PTSD) diagnosis requires first identifying a traumatic event, but very few studies have evaluated methods of potential traumatic event assessment and their impact on PTSD diagnosis. We compared a behaviorally-specific comprehensive multiple-item traumatic event measure to a single-item measure to determine their impact on traumatic event identification and subsequent PTSD diagnosis. In a within-subject, counterbalanced design, the Traumatic Life Events Questionnaire (TLEQ; Kubany et al., 2000) was compared to the single-question traumatic event assessment in the Structured Clinical Interview for DSM-IV (SCID; First, Spitzer, Gibbon, & Williams, 1998) in 129 participants in opioid dependence treatment. The TLEQ produced a 9-fold higher rate of traumatic events reported by the participants as compared to the SCID. As a result, PTSD diagnoses in the sample increased to 33% after the TLEQ measure from 24% after the SCID. The increase in potential traumatic event identification and PTSD diagnosis was greater in women than men. This study provides strong support for the use of comprehensive traumatic event assessments to measure traumatic events and PTSD diagnoses, particularly in women. PMID:19485675

  13. Clinical and mutational investigations of tyrosinemia type II in Northern Tunisia: identification and structural characterization of two novel TAT mutations.

    PubMed

    Charfeddine, C; Monastiri, K; Mokni, M; Laadjimi, A; Kaabachi, N; Perin, O; Nilges, M; Kassar, S; Keirallah, M; Guediche, M N; Kamoun, M R; Tebib, N; Ben Dridi, M F; Boubaker, S; Ben Osman, A; Abdelhak, S

    2006-06-01

    Tyrosinemia type II or Richner-Hanhart Syndrome (RHS) is an autosomal recessive disorder characterized by keratitis, palmoplantar keratosis, mental retardation, and elevated blood tyrosine levels. The disease is due to a deficiency of hepatic cytosolic tyrosine aminotransferase (TATc), an enzyme involved in the tyrosine catabolic pathway. Because of the high rate of consanguinity this disorder seems to be relatively common among the Arab and Mediterranean populations. RHS is characterized by inter and intrafamilial phenotypic variability. A large spectrum of mutations within TATc gene has been shown to be responsible for RHS. In the present study, we report the clinical features and the molecular investigation of RHS in three unrelated consanguineous Tunisian families including 7 patients with confirmed biochemical diagnosis of tyrosinemia type II. Mutation analyses were performed and two novel missense mutations were identified (C151Y) and (L273P) within exon 5 and exon 8, respectively. The 3D-structural characterization of these mutations provides evidence of defective folding of the mutant proteins, and likely alteration of the enzymatic activity. Phenotype variability was observed even among individuals sharing the same pathogenic mutation.

  14. Seeing Objects as Faces Enhances Object Detection.

    PubMed

    Takahashi, Kohske; Watanabe, Katsumi

    2015-10-01

    The face is a special visual stimulus. Both bottom-up processes for low-level facial features and top-down modulation by face expectations contribute to the advantages of face perception. However, it is hard to dissociate the top-down factors from the bottom-up processes, since facial stimuli mandatorily lead to face awareness. In the present study, using the face pareidolia phenomenon, we demonstrated that face awareness, namely seeing an object as a face, enhances object detection performance. In face pareidolia, some people see a visual stimulus, for example, three dots arranged in V shape, as a face, while others do not. This phenomenon allows us to investigate the effect of face awareness leaving the stimulus per se unchanged. Participants were asked to detect a face target or a triangle target. While target per se was identical between the two tasks, the detection sensitivity was higher when the participants recognized the target as a face. This was the case irrespective of the stimulus eccentricity or the vertical orientation of the stimulus. These results demonstrate that seeing an object as a face facilitates object detection via top-down modulation. The advantages of face perception are, therefore, at least partly, due to face awareness.

  15. Seeing Objects as Faces Enhances Object Detection

    PubMed Central

    Watanabe, Katsumi

    2015-01-01

    The face is a special visual stimulus. Both bottom-up processes for low-level facial features and top-down modulation by face expectations contribute to the advantages of face perception. However, it is hard to dissociate the top-down factors from the bottom-up processes, since facial stimuli mandatorily lead to face awareness. In the present study, using the face pareidolia phenomenon, we demonstrated that face awareness, namely seeing an object as a face, enhances object detection performance. In face pareidolia, some people see a visual stimulus, for example, three dots arranged in V shape, as a face, while others do not. This phenomenon allows us to investigate the effect of face awareness leaving the stimulus per se unchanged. Participants were asked to detect a face target or a triangle target. While target per se was identical between the two tasks, the detection sensitivity was higher when the participants recognized the target as a face. This was the case irrespective of the stimulus eccentricity or the vertical orientation of the stimulus. These results demonstrate that seeing an object as a face facilitates object detection via top-down modulation. The advantages of face perception are, therefore, at least partly, due to face awareness. PMID:27648219

  16. Seeing Objects as Faces Enhances Object Detection

    PubMed Central

    Watanabe, Katsumi

    2015-01-01

    The face is a special visual stimulus. Both bottom-up processes for low-level facial features and top-down modulation by face expectations contribute to the advantages of face perception. However, it is hard to dissociate the top-down factors from the bottom-up processes, since facial stimuli mandatorily lead to face awareness. In the present study, using the face pareidolia phenomenon, we demonstrated that face awareness, namely seeing an object as a face, enhances object detection performance. In face pareidolia, some people see a visual stimulus, for example, three dots arranged in V shape, as a face, while others do not. This phenomenon allows us to investigate the effect of face awareness leaving the stimulus per se unchanged. Participants were asked to detect a face target or a triangle target. While target per se was identical between the two tasks, the detection sensitivity was higher when the participants recognized the target as a face. This was the case irrespective of the stimulus eccentricity or the vertical orientation of the stimulus. These results demonstrate that seeing an object as a face facilitates object detection via top-down modulation. The advantages of face perception are, therefore, at least partly, due to face awareness.

  17. Seeing Objects as Faces Enhances Object Detection.

    PubMed

    Takahashi, Kohske; Watanabe, Katsumi

    2015-10-01

    The face is a special visual stimulus. Both bottom-up processes for low-level facial features and top-down modulation by face expectations contribute to the advantages of face perception. However, it is hard to dissociate the top-down factors from the bottom-up processes, since facial stimuli mandatorily lead to face awareness. In the present study, using the face pareidolia phenomenon, we demonstrated that face awareness, namely seeing an object as a face, enhances object detection performance. In face pareidolia, some people see a visual stimulus, for example, three dots arranged in V shape, as a face, while others do not. This phenomenon allows us to investigate the effect of face awareness leaving the stimulus per se unchanged. Participants were asked to detect a face target or a triangle target. While target per se was identical between the two tasks, the detection sensitivity was higher when the participants recognized the target as a face. This was the case irrespective of the stimulus eccentricity or the vertical orientation of the stimulus. These results demonstrate that seeing an object as a face facilitates object detection via top-down modulation. The advantages of face perception are, therefore, at least partly, due to face awareness. PMID:27648219

  18. Zero-Copy Objects System

    NASA Technical Reports Server (NTRS)

    Burleigh, Scott C.

    2011-01-01

    Zero-Copy Objects System software enables application data to be encapsulated in layers of communication protocol without being copied. Indirect referencing enables application source data, either in memory or in a file, to be encapsulated in place within an unlimited number of protocol headers and/or trailers. Zero-copy objects (ZCOs) are abstract data access representations designed to minimize I/O (input/output) in the encapsulation of application source data within one or more layers of communication protocol structure. They are constructed within the heap space of a Simple Data Recorder (SDR) data store to which all participating layers of the stack must have access. Each ZCO contains general information enabling access to the core source data object (an item of application data), together with (a) a linked list of zero or more specific extents that reference portions of this source data object, and (b) linked lists of protocol header and trailer capsules. The concatenation of the headers (in ascending stack sequence), the source data object extents, and the trailers (in descending stack sequence) constitute the transmitted data object constructed from the ZCO. This scheme enables a source data object to be encapsulated in a succession of protocol layers without ever having to be copied from a buffer at one layer of the protocol stack to an encapsulating buffer at a lower layer of the stack. For large source data objects, the savings in copy time and reduction in memory consumption may be considerable.

  19. Objectives and Preparing Tests.

    ERIC Educational Resources Information Center

    Purohit, Anal A.; Bober, Kenneth F.

    1984-01-01

    The concepts behind, and construction of, specific behavioral objectives are examined as steps that are preliminary to evaluating student performance through tests. A taxonomy of educational objectives and guidelines in preparing them are outlined in detail. (MSE)

  20. NCL Objective #4 - Nanotechnology Characterization Lab (NCL)

    Cancer.gov

    The Nanotechnology Characterization Lab (NCL) Objective #4: Examine the Biological and Functional Characteristics of MultiComponent/Combinatorial Aspects of Nanoscaled Therapeutic, Molecular and Clinical Diagnostics, and Detection Platforms.

  1. A First Look at the Structured Clinical Interview for "DSM-IV" Personality Disorders Screening Questionnaire: More Than Just a Screener?

    ERIC Educational Resources Information Center

    Piedmont, Ralph L.; Sherman, Martin F.; Sherman, Nancy C.; Williams, Joseph E. G.

    2003-01-01

    This study examined the psychometrics of the Structured Clinical Interview for DSM-IV Personality Disorders Personality Questionnaire (SCID-IIP) self-report personality questionnaire. The responses to the instrument were found reliable and evidenced good self-other convergence. Correlations with external criteria showed the SCID-IIP to contain…

  2. Do Clinical Evaluations in a Psychiatry Clerkship Favor Students with Positive Personality Characteristics?

    ERIC Educational Resources Information Center

    Chibnall, John T.; Blaskiewicz, Robert J.

    2008-01-01

    Objective: The authors examine associations of personality characteristics, National Board of Medical Examiners subject examination performance, and Objective Structured Clinical Examination performance with clinical evaluations of third-year medical students in a psychiatry clerkship. Methods: Students completed the Revised NEO Personality…

  3. Linking HIV-positive adolescents to care in 15 different clinics across the United States: Creating solutions to address structural barriers for linkage to care

    PubMed Central

    Philbin, Morgan M.; Tanner, Amanda E.; DuVal, Anna; Ellen, Jonathan; Kapogiannis, Bill; Fortenberry, J. Dennis

    2013-01-01

    Linkage to care is a critical corollary to expanded HIV testing, but many adolescents are not successfully linked to care, in part due to fragmented care systems. Through a collaboration of the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC) and the Adolescent Trials Network (ATN), a linkage to care outreach worker was provided to ATN clinics. Factors related to linkage were explored to better understand how to improve retention rates and health outcomes for HIV-positive adolescents. We conducted 124 interviews with staff at 15 Adolescent Trials Network clinics to better understand linkage to care processes, barriers, and facilitators. Content analysis was conducted focusing on structural barriers to care and potential solutions, specifically at the macro-, meso-, and micro-levels. Macro-level barriers included navigating health insurance policies, transportation to appointments, and ease of collecting and sharing client-level contact information between testing agencies, local health departments and clinics; meso-level barriers included lack of youth friendliness within clinic space and staff, and duplication of linkage services; micro-level barriers included adolescents’ readiness for care and adolescent developmental capacity. Staff initiated solutions included providing transportation for appointments and funding clinic visits and tests with a range of grants and clinic funds while waiting for insurance approval. However, such solutions were often ad hoc and partial, using micro-level solutions to address macro-level barriers. Comprehensive initiatives to improve linkage to care are needed to address barriers to HIV-care for adolescents, whose unique developmental needs make accessing care particularly challenging. Matching the level of structural solution to the level of structural barriers (i.e., macro-level with macro-level), such as creating policy to address needed youth healthcare entitlements versus covering

  4. Ownership and Object History

    ERIC Educational Resources Information Center

    Friedman, Ori; Neary, Karen R.; Defeyter, Margaret A.; Malcolm, Sarah L.

    2011-01-01

    Appropriate behavior in relation to an object often requires judging whether it is owned and, if so, by whom. The authors propose accounts of how people make these judgments. Our central claim is that both judgments often involve making inferences about object history. In judging whether objects are owned, people may assume that artifacts (e.g.,…

  5. Objects in Motion

    ERIC Educational Resources Information Center

    Damonte, Kathleen

    2004-01-01

    One thing scientists study is how objects move. A famous scientist named Sir Isaac Newton (1642-1727) spent a lot of time observing objects in motion and came up with three laws that describe how things move. This explanation only deals with the first of his three laws of motion. Newton's First Law of Motion says that moving objects will continue…

  6. Survivability via Control Objectives

    SciTech Connect

    CAMPBELL,PHILIP L.

    2000-08-11

    Control objectives open an additional front in the survivability battle. A given set of control objectives is valuable if it represents good practices, it is complete (it covers all the necessary areas), and it is auditable. CobiT and BS 7799 are two examples of control objective sets.

  7. Learning Objects and Gerontology

    ERIC Educational Resources Information Center

    Weinreich, Donna M.; Tompkins, Catherine J.

    2006-01-01

    Virtual AGE (vAGE) is an asynchronous educational environment that utilizes learning objects focused on gerontology and a learning anytime/anywhere philosophy. This paper discusses the benefits of asynchronous instruction and the process of creating learning objects. Learning objects are "small, reusable chunks of instructional media" Wiley…

  8. On the Crime Object

    ERIC Educational Resources Information Center

    Akutaev, Rasul M.; Magomedov, Guseyn B.

    2016-01-01

    The relevance of the research of this problem is caused by the theoretical and practical needs of a specific concept of the crime object as one of the corpus delicti signs essentially the determining and defining its object and objective side, thereby--the nature of socially dangerous act. Besides, being a facultative sign of corpus delicti, the…

  9. The Language of Objection

    ERIC Educational Resources Information Center

    Duffy, Francis M.

    2010-01-01

    Whenever the author talks to audiences about transforming school systems, without exception people raise objections. The half dozen most common objections often come in the form of "Yes, nice idea but..." What follows the "but" is the objection. The author learned a technique for responding to these "buts" from family members who work in sales.…

  10. Presentation on Instructional Objectives

    ERIC Educational Resources Information Center

    Naz, Bibi Asia

    2009-01-01

    "Learning can be defined as change in a student's capacity for performance as a result of experience" (Kenneth D. Moore). The intended changes should be specified in instructional objectives. Viewed in this context, an objective can be defined as a clear and unambiguous description of your instructional intent. An objective is not a statement of…

  11. [Behavioral Objectives in English.

    ERIC Educational Resources Information Center

    Meade, Richard; And Others

    1970-01-01

    This edition of the "Virginia English Bulletin" is devoted primarily to articles about behavioral objectives and the teaching of English. In "Behavioral Objectives for English?" Richard A. Meade argues that these objectives ought to include the acquisition not only of skills and knowledge but also of understandings, insights, and feelings. He also…

  12. Preceptors’ Self-Assessment of Their Ability to Perform the Learning Objectives of an Experiential Program

    PubMed Central

    2012-01-01

    Objective. To evaluate preceptors’ perception of their ability to perform the Structured Practical Experiences in Pharmacy (SPEP) learning objectives through a self-assessment activity. Methods. A self-assessment instrument consisting of 28 learning objectives associated with clinic, community, and hospital pharmacy practice experiences were developed. Preceptors rated their performance ability for each of the learning objectives using a 3-point Likert scale. Results. Of the 116 preceptors, 89 (77%) completed the self-assessment survey instrument. The overall preceptor responses to the items on performance of the 28 SPEP learning objectives ranged from good to excellent. Years of experience, practice experience setting, and involvement as a SPEP or SPEP and PharmD preceptor had no influence on their self-reported capabilities. Conclusion. Most preceptors rated their ability to perform the learning objectives for the structured practical experiences in pharmacy as high. Competency areas requiring further preceptor development were identified. PMID:23193333

  13. Data-Driven Objectness.

    PubMed

    Hongwen Kang; Hebert, Martial; Efros, Alexei A; Kanade, Takeo

    2015-01-01

    We propose a data-driven approach to estimate the likelihood that an image segment corresponds to a scene object (its "objectness") by comparing it to a large collection of example object regions. We demonstrate that when the application domain is known, for example, in our case activity of daily living (ADL), we can capture the regularity of the domain specific objects using millions of exemplar object regions. Our approach to estimating the objectness of an image region proceeds in two steps: 1) finding the exemplar regions that are the most similar to the input image segment; 2) calculating the objectness of the image segment by combining segment properties, mutual consistency across the nearest exemplar regions, and the prior probability of each exemplar region. In previous work, parametric objectness models were built from a small number of manually annotated objects regions, instead, our data-driven approach uses 5 million object regions along with their metadata information. Results on multiple data sets demonstrates our data-driven approach compared to the existing model based techniques. We also show the application of our approach in improving the performance of object discovery algorithms. PMID:26353218

  14. Effect of structured physical activity on prevention of serious fall injuries in adults aged 70-89: randomized clinical trial (LIFE Study)

    PubMed Central

    Pahor, Marco; Guralnik, Jack M; McDermott, Mary M; King, Abby C; Buford, Thomas W; Strotmeyer, Elsa S; Nelson, Miriam E; Sink, Kaycee M; Demons, Jamehl L; Kashaf, Susan S; Walkup, Michael P; Miller, Michael E

    2016-01-01

    Objective To test whether a long term, structured physical activity program compared with a health education program reduces the risk of serious fall injuries among sedentary older people with functional limitations. Design Multicenter, single blinded randomized trial (Lifestyle Interventions and Independence for Elders (LIFE) study). Setting Eight centers across the United States, February 2010 to December 2011. Participants 1635 sedentary adults aged 70-89 years with functional limitations, defined as a short physical performance battery score ≤9, but who were able to walk 400 m. Interventions A permuted block algorithm stratified by field center and sex was used to allocate interventions. Participants were randomized to a structured, moderate intensity physical activity program (n=818) conducted in a center (twice a week) and at home (3-4 times a week) that included aerobic, strength, flexibility, and balance training activities, or to a health education program (n=817) consisting of workshops on topics relevant to older people and upper extremity stretching exercises. Main outcome measures Serious fall injuries, defined as a fall that resulted in a clinical, non-vertebral fracture or that led to a hospital admission for another serious injury, was a prespecified secondary outcome in the LIFE Study. Outcomes were assessed every six months for up to 42 months by staff masked to intervention assignment. All participants were included in the analysis. Results Over a median follow-up of 2.6 years, a serious fall injury was experienced by 75 (9.2%) participants in the physical activity group and 84 (10.3%) in the health education group (hazard ratio 0.90, 95% confidence interval 0.66 to 1.23; P=0.52). These results were consistent across several subgroups, including sex. However, in analyses that were not prespecified, sex specific differences were observed for rates of all serious fall injuries (rate ratio 0.54, 95% confidence interval 0.31 to 0.95 in men

  15. Kuiper Belt Objects (Invited)

    NASA Astrophysics Data System (ADS)

    Tegler, S. C.; Romanishin, W.

    1999-09-01

    The Kuiper belt represents an exciting, new frontier in solar system research. About 200 Kuiper belt objects (KBOs) with diameters larger than 100 km are known to exist between 30 and 50 AU from the Sun. Surveys indicate that there may be as many as 100,000 KBOs larger than 100 km and perhaps billions of KBOs larger than 1 km between 30 and 50 AU. Although the total mass in these bodies is perhaps a few tenths of an Earth mass, accretion calculations indicate that the primordial Kuiper belt must have contained 10 to 30 Earth masses of material between 30 and 50 AU in order to explain the growth of large KBOs and the Pluto and Charon system in the 100 million years before the onset of the disruptive influence of Neptune. Once Neptune reached a fraction of its current mass, dynamical studies indicate that a combination of erosional collisions and mean motion and secular resonances sculpted the belt into its present day mass and structure. The influence of the resonances can be seen in the belt today as about one-third of the known KBOs are in a stable 2:3 mean motion resonance with Neptune, i.e. eccentric and inclined orbits, that approach or cross the orbit of Neptune, and semi-major axes, a, about 39.4 AU. Many KBOs with a > 42 AU are sufficiently far from Neptune that they are on stable, low inclination, low eccentricity, non-resonant orbits. A combination of resonances and disruptive collisions continue to deplete the Kuiper belt today as they inject KBOs or collision fragments inward into the solar system as Centaur objects and Jupiter family comets. Physical studies of KBOs are in their infancy. Perhaps one of the most surprising results is the observation that KBO colors and hence their surface compositions divide neatly into a grey and an extraordinarily red population. The red population suggests some surfaces are rich in complex carbon-bearing molecules. The colors exhibit no trend with resonant or non-resonant orbits or object size and suggest that

  16. Robot Grasps Rotating Object

    NASA Technical Reports Server (NTRS)

    Wilcox, Brian H.; Tso, Kam S.; Litwin, Todd E.; Hayati, Samad A.; Bon, Bruce B.

    1991-01-01

    Experimental robotic system semiautomatically grasps rotating object, stops rotation, and pulls object to rest in fixture. Based on combination of advanced techniques for sensing and control, constructed to test concepts for robotic recapture of spinning artificial satellites. Potential terrestrial applications for technology developed with help of system includes tracking and grasping of industrial parts on conveyor belts, tracking of vehicles and animals, and soft grasping of moving objects in general.

  17. Propelling Extended Objects

    ERIC Educational Resources Information Center

    Humbert, Richard

    2010-01-01

    A force acting on just part of an extended object (either a solid or a volume of a liquid) can cause all of it to move. That motion is due to the transmission of the force through the object by its material. This paper discusses how the force is distributed to all of the object by a gradient of stress or pressure in it, which creates the local…

  18. Moving Object Control System

    NASA Technical Reports Server (NTRS)

    Arndt, G. Dickey (Inventor); Carl, James R. (Inventor)

    2001-01-01

    A method is provided for controlling two objects relatively moveable with respect to each other. A plurality of receivers are provided for detecting a distinctive microwave signal from each of the objects and measuring the phase thereof with respect to a reference signal. The measured phase signal is used to determine a distance between each of the objects and each of the plurality of receivers. Control signals produced in response to the relative distances are used to control the position of the two objects.

  19. Objects of Maximum Electromagnetic Chirality

    NASA Astrophysics Data System (ADS)

    Fernandez-Corbaton, Ivan; Fruhnert, Martin; Rockstuhl, Carsten

    2016-07-01

    We introduce a definition of the electromagnetic chirality of an object and show that it has an upper bound. Reciprocal objects attain the upper bound if and only if they are transparent for all the fields of one polarization handedness (helicity). Additionally, electromagnetic duality symmetry, i.e., helicity preservation upon interaction, turns out to be a necessary condition for reciprocal objects to attain the upper bound. We use these results to provide requirements for the design of such extremal objects. The requirements can be formulated as constraints on the polarizability tensors for dipolar objects or on the material constitutive relations for continuous media. We also outline two applications for objects of maximum electromagnetic chirality: a twofold resonantly enhanced and background-free circular dichroism measurement setup, and angle-independent helicity filtering glasses. Finally, we use the theoretically obtained requirements to guide the design of a specific structure, which we then analyze numerically and discuss its performance with respect to maximal electromagnetic chirality.

  20. Implementing a system of structured clinical supervision with a group of DipHE(nursing) RMN students.

    PubMed

    Markham, V; Turner, P

    1998-01-01

    Clinical supervision is to become an integral part of mental health nursing, and the United Kingdom Central Council for Nursing, Midwifery & Health Visiting has recommended that it be incorporated in pre-registration education. This paper describes teachers' experiences of delivering a programme of clinical supervision education within the mental health branch of a diploma in nursing course. It outlines the implementation and evaluation of the programme, including discussion of the process and difficulties encountered. The programme appears to have provided a positive first experience for the students and to have given them the enthusiasm to adopt clinical supervision as part of their future roles as qualified practitioners.