[Selective attention and schizophrenia before the administration of neuroleptics].

PubMed

Lussier, I; Stip, E

1999-01-01

In recent years, the presence of attention deficits has been recognized as a key feature of schizophrenia. Past studies reveal that selective attention, or the ability to select relevant information while ignoring simultaneously irrelevant information, is disturbed in schizophrenic patients. According to Treisman feature-integration theory of selective attention, visual search for conjunctive targets (e.g., shape and color) requires controlled processes, that necessitate attention and operate in a serial manner. Reaction times (RTs) are therefore function of the number of stimuli in the display. When subjects are asked to detect the presence or absence of a target in an array of a variable number of stimuli, different performance patterns are expected for positive (present target) and negative trials (absent target). For positive trials, a self-terminating search is triggered, that is, the search is ended when the target is encountered. For negative trials, an exhaustive search strategy is displayed, where each stimulus is examined before the search can end; the RT slope pattern is thus double that of the positive trials. To assess the integrity of these processes, thirteen drug naive schizophrenic patients were compared to twenty normal control subjects. Neuroleptic naive patients were chosen as subjects to avoid the potential influence of medication and chronicity-related factors on performance. The subjects had to specify as fast as possible the presence or absence of the target in an array of a variable number of stimuli presented in a circular display, and comprising or not the target. Results showed that the patients can use self-terminating search strategies as well as normal control subjects. However, their ability to trigger exhaustive search strategies is impaired. Not only were patients slower than controls, but their pattern of RT results was different. These results argue in favor of an early impairment in selective attention capacities in schizophrenia, which appears before the introduction of neuroleptics. The attention performance was also shown to present some association to clinical symptoms.

Patient, physician and presentational influences on clinical decision making for breast cancer: results from a factorial experiment.

PubMed

McKinlay, J B; Burns, R B; Durante, R; Feldman, H A; Freund, K M; Harrow, B S; Irish, J T; Kasten, L E; Moskowitz, M A

1997-02-01

This study examines the influence of six patient characteristics (age, race, socioeconomic status, comorbidities, mobility and presentational style) and two physician characteristics (medical specialty and years of clinical experience) on physicians' clinical decision making behaviour in the evaluation treatment of an unknown and known breast cancer. Physicians' variability and certainty associated with diagnostic and treatment behaviour were also examined. Separate analyses explored the influence of these non-medical factors on physicians' cognitive processes. Using a fractional factorial design, 128 practising physicians were shown two videotaped scenarios and asked about possible diagnoses and medical recommendations. Results showed that physicians displayed considerable variability in response to several patient-based factors. Physician characteristics also emerged as important predictors of clinical behaviour, thus confirming the complexity of the medical decision-making process.

Surgical planning for radical prostatectomies using three-dimensional visualization and a virtual reality display system

NASA Astrophysics Data System (ADS)

Kay, Paul A.; Robb, Richard A.; King, Bernard F.; Myers, R. P.; Camp, Jon J.

1995-04-01

Thousands of radical prostatectomies for prostate cancer are performed each year. Radical prostatectomy is a challenging procedure due to anatomical variability and the adjacency of critical structures, including the external urinary sphincter and neurovascular bundles that subserve erectile function. Because of this, there are significant risks of urinary incontinence and impotence following this procedure. Preoperative interaction with three-dimensional visualization of the important anatomical structures might allow the surgeon to understand important individual anatomical relationships of patients. Such understanding might decrease the rate of morbidities, especially for surgeons in training. Patient specific anatomic data can be obtained from preoperative 3D MRI diagnostic imaging examinations of the prostate gland utilizing endorectal coils and phased array multicoils. The volumes of the important structures can then be segmented using interactive image editing tools and then displayed using 3-D surface rendering algorithms on standard work stations. Anatomic relationships can be visualized using surface displays and 3-D colorwash and transparency to allow internal visualization of hidden structures. Preoperatively a surgeon and radiologist can interactively manipulate the 3-D visualizations. Important anatomical relationships can better be visualized and used to plan the surgery. Postoperatively the 3-D displays can be compared to actual surgical experience and pathologic data. Patients can then be followed to assess the incidence of morbidities. More advanced approaches to visualize these anatomical structures in support of surgical planning will be implemented on virtual reality (VR) display systems. Such realistic displays are `immersive,' and allow surgeons to simultaneously see and manipulate the anatomy, to plan the procedure and to rehearse it in a realistic way. Ultimately the VR systems will be implemented in the operating room (OR) to assist the surgeon in conducting the surgery. Such an implementation will bring to the OR all of the pre-surgical planning data and rehearsal experience in synchrony with the actual patient and operation to optimize the effectiveness and outcome of the procedure.

Epithelial–mesenchymal transition biomarkers and support vector machine guided model in preoperatively predicting regional lymph node metastasis for rectal cancer

PubMed Central

Fan, X-J; Wan, X-B; Huang, Y; Cai, H-M; Fu, X-H; Yang, Z-L; Chen, D-K; Song, S-X; Wu, P-H; Liu, Q; Wang, L; Wang, J-P

2012-01-01

Background: Current imaging modalities are inadequate in preoperatively predicting regional lymph node metastasis (RLNM) status in rectal cancer (RC). Here, we designed support vector machine (SVM) model to address this issue by integrating epithelial–mesenchymal-transition (EMT)-related biomarkers along with clinicopathological variables. Methods: Using tissue microarrays and immunohistochemistry, the EMT-related biomarkers expression was measured in 193 RC patients. Of which, 74 patients were assigned to the training set to select the robust variables for designing SVM model. The SVM model predictive value was validated in the testing set (119 patients). Results: In training set, eight variables, including six EMT-related biomarkers and two clinicopathological variables, were selected to devise SVM model. In testing set, we identified 63 patients with high risk to RLNM and 56 patients with low risk. The sensitivity, specificity and overall accuracy of SVM in predicting RLNM were 68.3%, 81.1% and 72.3%, respectively. Importantly, multivariate logistic regression analysis showed that SVM model was indeed an independent predictor of RLNM status (odds ratio, 11.536; 95% confidence interval, 4.113–32.361; P<0.0001). Conclusion: Our SVM-based model displayed moderately strong predictive power in defining the RLNM status in RC patients, providing an important approach to select RLNM high-risk subgroup for neoadjuvant chemoradiotherapy. PMID:22538975

Manometric assessment of idiopathic megarectum in constipated children

PubMed Central

Chiarioni, Giuseppe; de Roberto, Giuseppe; Mazzocchi, Alessandro; Morelli, Antonio; Bassotti, Gabrio

2005-01-01

AIM: Chronic constipation is a frequent finding in children. In this age range, the concomitant occurrence of megarectum is not uncommon. However, the definition of megarectum is variable, and a few data exist for Italy. We studied anorectal manometric variables and sensation in a group of constipated children with megarectum defined by radiologic criteria. Data from this group were compared with those obtained in a similar group of children with recurrent abdominal pain. METHODS: Anorectal testing was carried out in both groups by standard manometric technique and rectal balloon expulsion test. RESULTS: Megarectum patients displayed discrete abnormalities of anorectal variables and sensation with respect to controls. In particular, the pelvic floor function appeared to be impaired in most patients. CONCLUSION: Constipated children with megarectum have abnormal anorectal function and sensation. These findings may be helpful for a better understanding of the pathophysiological basis of this condition. PMID:16273619

A novel DNMT1 mutation associated with early onset hereditary sensory and autonomic neuropathy, cataplexy, cerebellar atrophy, scleroderma, endocrinopathy, and common variable immune deficiency.

PubMed

Fox, Robin; Ealing, John; Murphy, Helen; Gow, David P; Gosal, David

2016-09-01

DNA methyltransferase 1 (DNMT1) is an enzyme which has a role in methylation of DNA, gene regulation, and chromatin stability. Missense mutations in the DNMT1 gene have been previously associated with two neurological syndromes: hereditary sensory and autonomic neuropathy type 1 with dementia and deafness (HSAN1E) and autosomal dominant cerebellar ataxia, deafness, and narcolepsy (ADCA-DN). We report a case showing overlap of both of these syndromes plus associated clinical features of common variable immune deficiency, scleroderma, and endocrinopathy that could also be mutation associated. Our patient was found to be heterozygous for a previously unreported frameshift mutation, c.1635_1637delCAA p.(Asn545del) in the DNMT1 gene exon 20. This case displays both the first frameshift mutation described in the literature which is associated with a phenotype with a high degree of overlap between HSAN1E and ADCA-DN and early age of onset (c. 8 years). Our case is also of interest as the patient displays a number of new non-neurological features, which could also be DNMT1 mutation related. © 2016 Peripheral Nerve Society.

Healthcare waste management: qualitative and quantitative appraisal of nurses in a tertiary care hospital of India.

PubMed

Shivalli, Siddharudha; Sanklapur, Vasudha

2014-01-01

The nurse's role in healthcare waste management is crucial. (1) To appraise nurses quantitatively and qualitatively regarding healthcare waste management; (2) to elicit the determinants of knowledge and attitudes of healthcare waste management. A cross-sectional study was undertaken at a tertiary care hospital of Mangalore, India. Self-administered pretested questionnaire and "nonparticipatory observation" were used for quantitative and qualitative appraisals. Percentage knowledge score was calculated based on their total knowledge score. Nurses' knowledge was categorized as excellent (>70%), good (50-70%), and poor (<50%). Chi square test was applied to judge the association of study variables with their attitudes and knowledge. Out of 100 nurses 47 had excellent knowledge (>70% score). Most (86%) expressed the need of refresher training. No study variable displayed significant association (P > 0.05) with knowledge. Apt segregation practices were followed except in casualty. Patients and entourages misinterpreted the colored containers. Nurses' knowledge and healthcare waste management practices were not satisfactory. There is a need of refresher trainings at optimum intervals to ensure sustainability and further improvement. Educating patients and their entourages and display of segregation information board in local language are recommended.

Serum magnesium but not calcium was associated with hemorrhagic transformation in stroke overall and stroke subtypes: a case-control study in China.

PubMed

Tan, Ge; Yuan, Ruozhen; Wei, ChenChen; Xu, Mangmang; Liu, Ming

2018-05-26

Association between serum calcium and magnesium versus hemorrhagic transformation (HT) remains to be identified. A total of 1212 non-thrombolysis patients with serum calcium and magnesium collected within 24 h from stroke onset were enrolled. Backward stepwise multivariate logistic regression analysis was conducted to investigate association between calcium and magnesium versus HT. Calcium and magnesium were entered into logistic regression analysis in two models, separately: model 1, as continuous variable (per 1-mmol/L increase), and model 2, as four-categorized variable (being collapsed into quartiles). HT occurred in 140 patients (11.6%). Serum calcium was slightly lower in patients with HT than in patient without HT (P = 0.273). But serum magnesium was significantly lower in patients with HT than in patients without HT (P = 0.007). In logistic regression analysis, calcium displayed no association with HT. Magnesium, as either continuous or four-categorized variable, was independently and inversely associated with HT in stroke overall and stroke of large-artery atherosclerosis (LAA). The results demonstrated that serum calcium had no association with HT in patients without thrombolysis after acute ischemic stroke. Serum magnesium in low level was independently associated with increasing HT in stroke overall and particularly in stroke of LAA.

Pilot Preferences on Displayed Aircraft Control Variables

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.; Gregory, Irene M.

2013-01-01

The experiments described here explored how pilots want available maneuver authority information transmitted and how this information affects pilots before and after an aircraft failure. The aircraft dynamic variables relative to flight performance were narrowed to energy management variables. A survey was conducted to determine what these variables should be. Survey results indicated that bank angle, vertical velocity, and airspeed were the preferred variables. Based on this, two displays were designed to inform the pilot of available maneuver envelope expressed as bank angle, vertical velocity, and airspeed. These displays were used in an experiment involving control surface failures. Results indicate the displayed limitations in bank angle, vertical velocity, and airspeed were helpful to the pilots during aircraft surface failures. However, the additional information did lead to a slight increase in workload, a small decrease in perceived aircraft flying qualities, and no effect on aircraft situation awareness.

Renal hybrid oncocytic/chromophobe tumors - a review.

PubMed

Hes, Ondrej; Petersson, Fredrik; Kuroda, Naoto; Hora, Milan; Michal, Michal

2013-10-01

Hybrid oncocytic/chromophobe tumors (HOCT) occur in three clinico-pathologic situations; (1) sporadically, (2) in association with renal oncocytomatosis and (3) in patients with Birt-Hogg-Dubé syndrome (BHD). There are no specific clinical symptoms in patients with sporadic or HOCT associated with oncocytosis/oncocytomatosis. HOCT in patients with BHD are usually encountered on characteristic BHD clinicopathologic background. Sporadic HOCT are composed of neoplastic cells with eosinophilic oncocytic cytoplasm. Tumors are usually arranged in a solid-alveolar pattern. Some neoplastic cells may have a perinuclear halo, no raisinoid nuclei are present. HOCT occurring in patients with oncocytomatosis are morphologically identical to sporadic HOCT. HOCT in BHD frequently display 3 morphologic patterns, either in isolation or in combination; (1) An admixture of areas typical of RO and CHRCC, respectively, (2) Scattered chromophobe cells in the background of a typical RO, (3) Large eosinophilic cells with intracytoplasmic vacuoles. The immunohistochemical profiles of HOCT in all clinicopathologic and morphologic groups differ slightly. The majority of tumors express parvalbumin, antimitochondrial antigen and CK 7. CD117 is invariably positive. HOCT show significant molecular genetic heterogeneity. The highest degree of variability in numerical chromosomal changes is present in sporadic HOCT. HOCT in the setting of oncocytomatosis have revealed a lesser degree of variability in the chromosomal numerical aberrations. HOCT in patients with BHD display FLCN gene mutations, which are absent in the other groups. HOCT (all three clinicopathologic groups) seem to behave indolently, as no evidence of aggressive behavior has been documented. However, no report with follow up longer than 10 years has been published.

Interest of active posturography to detect age-related and early Parkinson's disease-related impairments in mediolateral postural control.

PubMed

Bonnet, Cédrick T; Delval, Arnaud; Defebvre, Luc

2014-11-15

Patients with Parkinson's disease display impairments of postural control most particularly in active, challenging conditions. The objective of the present study was to analyze early signs of disease-related and also age-related impairments in mediolateral body extension and postural control. Fifty-five participants (18 Hoehn and Yahr stage 2 patients in the off-drug condition, 18 healthy elderly control subjects, and 19 young adults) were included in the study. The participants performed a quiet stance task and two active tasks that analyzed the performance in mediolateral body motion: a limit of stability and a rhythmic weight shift task. As expected, the patients displayed significantly lower and slower body displacement (head, neck, lower back, center of pressure) than elderly control subjects when performing the two body excursion tasks. However, the behavioral variability in both tasks was similar between the groups. Under these active conditions, the patients showed significantly lower contribution of the hip postural control mechanisms compared with the elderly control subjects. Overall, the patients seemed to lower their performance in order to prevent a mediolateral postural instability. However, these patients, at an early stage of their disease, were not unstable in quiet stance. Complementarily, elderly control subjects displayed slower body performance than young adults, which therefore showed an additional age-related impairment in mediolateral postural control. Overall, the study illustrated markers of age-related and Parkinson's disease impairments in mediolateral postural control that may constrain everyday activities in elderly adults and even more in patients with Parkinson's disease. Copyright © 2014 the American Physiological Society.

Attachment insecurity and psychological resources associated with adjustment disorders.

PubMed

Ponizovsky, Alexander M; Levov, Kathy; Schultz, Yakov; Radomislensky, Ira

2011-04-01

This study examined the adult attachment styles, interpersonal distance from potential attachment figures and strangers, coping strategies, perceived social support, and stress-related self-variables among patients diagnosed with adjustment disorders (AJD). Seventy patients at an outpatient clinic and 61 matched controls completed a battery of standardized questionnaires. Univariate and multivariate statistical analyses were used to evaluate the parameters of interest. Using attachment theory (J. Bowlby, 1988) and the dynamic stress-vulnerability model of depressive disorder (G. W. Brown & T. O. Harris, 1989) as the analytical frameworks, the authors hypothesized that participants with AJD would: (a) display more insecure attachment styles, (b) be less tolerant of close interpersonal proximity, (c) use more emotion-oriented coping strategies, (d) display lower self-efficacy and self-esteem, and (e) perceive less social support from family, friends, and significant others. We further hypothesized that these variables would be predictive of depressive symptoms. All of the hypotheses were confirmed. The results suggest that the insecure fearful-avoidant attachment style is associated with severe depressive symptoms in patients with AJD. However, other psychosocial factors, such as low self-esteem and poor social support from friends, were more predictive of AJD symptoms. The findings warrant further studies on the risk and protective effects of these factors in the development of AJD and other stress-induced disorders. © 2011 American Orthopsychiatric Association.

Media and Memory: The Impact of Presentation Style on Middle Aged and Older Adults' Recall of Health Information

ERIC Educational Resources Information Center

Wilson, Elizabeth Anne Hamann

2009-01-01

Educational tools such as printed pamphlets and videos can enhance patients' understanding and memory of health-related information, but in order for such materials to be effective, designers of such tools should take care to understand the impact of variables such as the medium in which information is displayed, the type of information to be…

Copy Number Alterations Associated with Acute Lymphoblastic Leukemia in Mexican Children. A report from The Mexican Inter-Institutional Group for the identification of the causes of childhood leukemia.

PubMed

Rosales-Rodríguez, Beatriz; Fernández-Ramírez, Fernando; Núñez-Enríquez, Juan Carlos; Velázquez-Wong, Ana Claudia; Medina-Sansón, Aurora; Jiménez-Hernández, Elva; Flores-Lujano, Janet; Peñaloza-González, José Gabriel; Espinosa-Elizondo, Rosa Martha; Pérez-Saldívar, María Luisa; Torres-Nava, José Refugio; Martín-Trejo, Jorge Alfonso; Martínez-Morales, Gabriela Bibiana; Bekker-Méndez, Vilma Carolina; Mejía-Aranguré, Juan Manuel; Rosas-Vargas, Haydee

2016-11-01

B-cell precursor acute lymphocytic leukemia (B-ALL) represents a worldwide public health issue. Particularly, Mexico is one of the countries with the highest incidence of ALL in children. Between the multiple factors involved in ALL etiology, genetic alterations are clearly one of the most relevant features. In this work, a group of 24 B-ALL patients, all negative for the four most frequent gene fusions (ETV6-RUNX1, BCR-ABL1, TCF3-PBX1 and MLL-AF4), were included in a high-resolution microarray analysis in order to evaluate genomic copy-number alterations (CNAs). The results of this preliminary report showed a broad genomic heterogeneity among the studied samples; 58% of the patients were hyperdiploid and 33% displayed a chromosome 9p deletion of variable length affecting genes CDKN2A/B, two patients displayed genomic instability with a high number of focal CNAs, three patients presented unique duplications affecting 2q, 12p and 1q, respectively, and one patient displayed no copy number imbalances. The copy-number profile of 44 genes previously related to B-ALL was heterogeneous as well. Overall results highlight the need for a detailed description of the genetic alterations in ALL cancer cells in order to understand the molecular pathogenesis of the disease and to identify any prognostic markers with clinical significance. Copyright © 2016 IMSS. Published by Elsevier Inc. All rights reserved.

Perception of smile esthetics by laypeople of different ages.

PubMed

Sriphadungporn, Chompunuch; Chamnannidiadha, Niramol

2017-12-01

Age is a factor affecting smile esthetics. Three variables of smile esthetics associated with the maxillary anterior teeth and age-related changes have recently received considerable attention: (i) the incisal edge position of the maxillary central incisors, (ii) the maxillary gingival display, and (iii) the presence of a black triangle between the maxillary central incisors. The aim of this study was to evaluate the influence of age on smile esthetic perception based on these three variables in a group of Thai laypeople. The smiles were constructed from a photograph of a female smile. Smile photographs were altered in various increments using three variables: the incisal edge position of the maxillary incisors, gingival display, and a black triangle between the maxillary central incisors. The photographs were shown to a group of 240 Thai laypeople. The subjects were divided into two groups: a younger group, 15-29 years old (n = 120) and an older group, 36-52 years old (n = 120). Each subject was asked to score the attractiveness of each smile separately using a visual analog scale. Smile attractiveness scores concerning the incisal edge positions of the maxillary central incisors were similar between the two groups. However, upper lip coverage was rated as unattractive by the younger group. A gingival display of 0 and 2 mm was rated as most attractive by the younger group. Upper lip coverage and gingival display of 0 and 2 mm were considered attractive by the older group. Excessive gingival display (6 mm) was scored as unattractive by both groups. A black triangle ranging from 1 to 2.5 mm between the maxillary central incisors was scored differently between the two groups. The older group was more tolerant of the black triangle size. Age impacts smile perception based on maxillary gingival display and the presence of a black triangle between the maxillary central incisors, but not of the incisal edge position of the maxillary central incisors. Due to the variation in esthetic perception of each individual, participation between orthodontists and patients for decision-making and treatment planning is a crucial process to provide successful results.

Respiratory sinus arrhythmia in Chagas disease.

PubMed

Neves, Victor Ribeiro; Peltola, Mirja; Huikuri, Heikki; Rocha, Manoel Otávio da Costa; Ribeiro, Antonio Luiz

2014-10-01

We applied the respiratory sinus arrhythmia (RSA) quantification algorithm to 24-hour ECG recordings of Chagas disease (ChD) patients with (G1, n=148) and without left ventricular dysfunction (LVD) (G2, n=33), and in control subjects (G0, n=28). Both ChD groups displayed a reduced RSA index; G1=299 (144-812); G2=335 (162-667), p=0.011, which was correlated with vagal indexes of heart rate variability analysis. RSA index is a marker of vagal modulation in ChD patients. Copyright © 2014 Elsevier B.V. All rights reserved.

YSOVAR: MID-INFRARED VARIABILITY OF YOUNG STELLAR OBJECTS AND THEIR DISKS IN THE CLUSTER IRAS 20050+2720

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

Poppenhaeger, K.; Wolk, S. J.; Hora, J. L.

2015-10-15

We present a time-variability study of young stellar objects (YSOs) in the cluster IRAS 20050+2720, performed at 3.6 and 4.5 μm with the Spitzer Space Telescope; this study is part of the Young Stellar Object VARiability (YSOVAR) project. We have collected light curves for 181 cluster members over 60 days. We find a high variability fraction among embedded cluster members of ca. 70%, whereas young stars without a detectable disk display variability less often (in ca. 50% of the cases) and with lower amplitudes. We detect periodic variability for 33 sources with periods primarily in the range of 2–6 days.more » Practically all embedded periodic sources display additional variability on top of their periodicity. Furthermore, we analyze the slopes of the tracks that our sources span in the color–magnitude diagram (CMD). We find that sources with long variability time scales tend to display CMD slopes that are at least partially influenced by accretion processes, while sources with short variability timescales tend to display extinction-dominated slopes. We find a tentative trend of X-ray detected cluster members to vary on longer timescales than the X-ray undetected members.« less

An efficient method for variable region assembly in the construction of scFv phage display libraries using independent strand amplification

PubMed Central

Sotelo, Pablo H.; Collazo, Noberto; Zuñiga, Roberto; Gutiérrez-González, Matías; Catalán, Diego; Ribeiro, Carolina Hager; Aguillón, Juan Carlos; Molina, María Carmen

2012-01-01

Phage display library technology is a common method to produce human antibodies. In this technique, the immunoglobulin variable regions are displayed in a bacteriophage in a way that each filamentous virus displays the product of a single antibody gene on its surface. From the collection of different phages, it is possible to isolate the virus that recognizes specific targets. The most common form in which to display antibody variable regions in the phage is the single chain variable fragment format (scFv), which requires assembly of the heavy and light immunoglobulin variable regions in a single gene. In this work, we describe a simple and efficient method for the assembly of immunoglobulin heavy and light chain variable regions in a scFv format. This procedure involves a two-step reaction: (1) DNA amplification to produce the single strand form of the heavy or light chain gene required for the fusion; and (2) mixture of both single strand products followed by an assembly reaction to construct a complete scFv gene. Using this method, we produced 6-fold more scFv encoding DNA than the commonly used splicing by overlap extension PCR (SOE-PCR) approach. The scFv gene produced by this method also proved to be efficient in generating a diverse scFv phage display library. From this scFv library, we obtained phages that bound several non-related antigens, including recombinant proteins and rotavirus particles. PMID:22692130

Individual memory change after anterior temporal lobectomy: a base rate analysis using regression-based outcome methodology.

PubMed

Martin, R C; Sawrie, S M; Roth, D L; Gilliam, F G; Faught, E; Morawetz, R B; Kuzniecky, R

1998-10-01

To characterize patterns of base rate change on measures of verbal and visual memory after anterior temporal lobectomy (ATL) using a newly developed regression-based outcome methodology that accounts for effects of practice and regression towards the mean, and to comment on the predictive utility of baseline memory measures on postoperative memory outcome. Memory change was operationalized using regression-based change norms in a group of left (n = 53) and right (n = 48) ATL patients. All patients were administered tests of episodic verbal (prose recall, list learning) and visual (figure reproduction) memory, and semantic memory before and after ATL. ATL patients displayed a wide range of memory outcome across verbal and visual memory domains. Significant performance declines were noted for 25-50% of left ATL patients on verbal semantic and episodic memory tasks, while one-third of right ATL patients displayed significant declines in immediate and delayed episodic prose recall. Significant performance improvement was noted in an additional one-third of right ATL patients on delayed prose recall. Base rate change was similar between the two ATL groups across immediate and delayed visual memory. Approximately one-fourth of all patients displayed clinically meaningful losses on the visual memory task following surgery. Robust relationships between preoperative memory measures and nonstandardized change scores were attenuated or reversed using standardized memory outcome techniques. Our results demonstrated substantial group variability in memory outcome for ATL patients. These results extend previous research by incorporating known effects of practice and regression to the mean when addressing meaningful neuropsychological change following epilepsy surgery. Our findings also suggest that future neuropsychological outcome studies should take steps towards controlling for regression-to-the-mean before drawing predictive conclusions.

The hedonic drive to consume palatable foods appears to be lower in gastric band carriers than in severely obese patients who have not undergone a bariatric surgery.

PubMed

Ullrich, J; Ernst, B; Wilms, B; Thurnheer, M; Hallschmid, M; Schultes, B

2013-04-01

We have recently shown that severely obese patients display a markedly enhanced drive to consume palatable food, and that this hedonic hunger is reduced after gastric bypass surgery. Adjustable gastric banding is another frequently performed bariatric operation with unknown effects on hedonic hunger motivation. Here, we compared the level of hedonic hunger in patients who have undergone a gastric banding with that in severely obese patients who have not undergone a bariatric operation and nonobese controls. In a cross-sectional case-control study, 116 gastric banding patients, 138 severely obese patients, and 133 nonobese controls were examined with the Power of Food Scale (PFS), a questionnaire that reliably measures an individual's motivation to consume highly palatable food. While the severely obese patients displayed markedly higher aggregated PFS scores and scores on the subdomain "generally available" and "physically present" food than the nonobese controls (all P < 0.001), the gastric banding patients showed significantly lower scores on all of these variables than the obese patients (all P < 0.001). However, the generally available food score was still higher in gastric banding patients than in the nonobese controls (P = 0.001). Data suggest that adjustable gastric banding may reduce the excessive appetite for palatable foods in severely obese patients. This suggestion needs to be confirmed in longitudinal studies.

Mutation Pattern of Paired Immunoglobulin Heavy and Light Variable Domains in Chronic Lymphocytic Leukemia B Cells

PubMed Central

Ghiotto, Fabio; Marcatili, Paolo; Tenca, Claudya; Calevo, Maria Grazia; Yan, Xiao-Jie; Albesiano, Emilia; Bagnara, Davide; Colombo, Monica; Cutrona, Giovanna; Chu, Charles C; Morabito, Fortunato; Bruno, Silvia; Ferrarini, Manlio; Tramontano, Anna; Fais, Franco; Chiorazzi, Nicholas

2011-01-01

B-cell chronic lymphocytic leukemia (CLL) patients display leukemic clones bearing either germline or somatically mutated immunoglobulin heavy variable (IGHV ) genes. Most information on CLL immunoglobulins (Igs), such as the definition of stereotyped B-cell receptors (BCRs), was derived from germline unmutated Igs. In particular, detailed studies on the distribution and nature of mutations in paired heavy- and light-chain domains of CLL clones bearing mutated Igs are lacking. To address the somatic hyper-mutation dynamics of CLL Igs, we analyzed the mutation pattern of paired IGHV–diversity-joining (IGHV-D-J ) and immunoglobulin kappa/lambda variable-joining (IGK/LV-J ) rearrangements of 193 leukemic clones that displayed ≥2% mutations in at least one of the two immunoglobulin variable (IGV ) genes (IGHV and/or IGK/LV ). The relationship between the mutation frequency in IGHV and IGK/LV complementarity determining regions (CDRs) and framework regions (FRs) was evaluated by correlation analysis. Replacement (R) mutation frequency within IGK/LV chain CDRs correlated significantly with mutation frequency of paired IGHV CDRs in λ but not κ isotype CLL clones. CDRs of IGKV-J rearrangements displayed a lower percentage of R mutations than IGHVs. The frequency/pattern of mutations in kappa CLL Igs differed also from that in κ-expressing normal B cells described in the literature. Instead, the mutation frequency within the FRs of IGHV and either IGKV or IGLV was correlated. Notably, the amount of diversity introduced by replaced amino acids was comparable between IGHVs and IGKVs. The data indicate a different mutation pattern between κ and λ isotype CLL clones and suggest an antigenic selection that, in κ samples, operates against CDR variation. PMID:21785810

Variable life-adjusted display (VLAD) for hip fracture patients: a prospective trial.

PubMed

Williams, H; Gwyn, R; Smith, A; Dramis, A; Lewis, J

2015-08-01

With restructuring within the NHS, there is increased public and media interest in surgical outcomes. The Nottingham Hip Fracture Score (NHFS) is a well-validated tool in predicting 30-day mortality in hip fractures. VLAD provides a visual plot in real time of the difference between the cumulative expected mortality and the actual death occurring. Survivors are incorporated as a positive value equal to 1 minus the probability of survival and deaths as a negative value equal to the probability of survival. Downward deflections indicate mortality and potentially suboptimal care. We prospectively included every hip fracture admitted to UHW that underwent surgery from January-August 2014. NHFS was then calculated and predicted survival identified. A VLAD plot was then produced comparing the predicted with the actual 30-day mortality. Two hundred and seventy-seven patients have completed the 30-day follow-up, and initial results showed that the actual 30-day mortality (7.2 %) was much lower than that predicted by the NHFS (8.0 %). This was reflected by a positive trend on the VLAD plot. Variable life-adjusted display provides an easy-to-use graphical representation of risk-adjusted survival over time and can act as an "early warning" system to identify trends in mortality for hip fractures.

[A novel protein equalizer based on single chain variable fragment display M13 phage library for nephropathy patient urine study].

PubMed

Zhao, Peng; Tao, Dingyin; Liang, Zhen; Zhang, Lihua; Zhang, Yukui

2009-05-01

A novel protein equalizer was developed with single chain variable fragment (scFv) library displaying M13 phage covalently bonded on monolithic cryogel. Due to the great number and various kinds of displayed scFv fragments, as well as strong and specific binding capacity between scFv fragments and proteins, a new protein equalizer technology is preferable in the pretreatment of complex protein samples. After the sample dissolved in phosphate buffer solution (PBS), it was repeatedly loaded onto the equalizer for five times, the bound proteins were in sequence eluted by 2 mol/L NaCl and 50 mmol/L Gly-HC1 (pH 2.5) solution, followed by digestion with thrombin. All proteins or peptides collected from each fraction were further analyzed by high performance liquid chromatography-electrospray tandem mass spectrometry (RPLC-ESI-MS/MS) with a serially coupled long microcolumn. Compared with the untreated samples, the identified protein number was increased from 142 to 396. Furthermore, from sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) analysis results, it was found that the protein concentration difference was reduced obviously in the eluant of direct sample loading, and most high abundance proteins were identified in the eluant of NaCl. All these results demonstrate that the novel protein equalizer with scFv display M13 phage library immobilized on cyrogel could effectively reduce the dynamic range of proteins in complex samples, enabling the identification of more low abundance proteins.

Music therapy for chronic tinnitus: variability of tinnitus pitch in the course of therapy.

PubMed

Hutter, Elisabeth; Grapp, Miriam; Argstatter, Heike; Bolay, Hans Volker

2014-04-01

In general, tinnitus pitch has been observed to be variable across time for most patients experiencing tinnitus. Some tinnitus therapies relate to the dominant tinnitus pitch in order to adjust therapeutic interventions. As studies focusing on tinnitus pitch rarely conduct consecutive pitch matching in therapeutic settings, little is known about the course and variability of tinnitus pitch during therapeutic interventions. The purpose of this study was to investigate the variability and development of tinnitus pitch in the course of therapeutic interventions. Tinnitus pitch was suspected to be highly variable. The researchers conducted a descriptive, retrospective analysis of data. A total of 175 adult patients experiencing chronic tinnitus served as participants. All patients had received a neuro-music therapy according to the "Heidelberg Model of Music Therapy for Chronic Tinnitus." During therapeutic interventions lasting for 5 consecutive days, the individual tinnitus frequency was assessed daily by means of a tinnitus pitch-matching procedure. The extent of variability in tinnitus pitch was calculated by mean ratios of frequencies between subsequent tinnitus measurements. Analysis of variance of repeated measures and post hoc paired samples t-tests were used for comparison of means in tinnitus frequencies, and the test-retest reliability of measurements was obtained by the Pearson product-moment correlation coefficient. Tinnitus pitch displayed a variability of approximately 3/5 to 4/5 octaves per day. Overall, the mean frequency declined in the course of the therapy. Detailed analysis revealed three groups of patients with diverging tinnitus progression. The test-retest reliability between assessments turned out to be robust (r = 0.74 or higher). Considerable variation in tinnitus pitch was found. Consequently, a frequent rechecking of tinnitus frequency is suggested during frequency-specific acoustic stimulation in order to train appropriate frequency bands. American Academy of Audiology.

Clinical outcomes and frontal plane two-dimensional biomechanics during the 30-second single leg stance test in patients before and after hip abductor tendon reconstructive surgery.

PubMed

Huxtable, Rose E; Ackland, Timothy R; Janes, Gregory C; Ebert, Jay R

2017-07-01

Hip abductor tendon tears are a common cause of Greater Trochanteric Pain Syndrome. Conservative treatments are often ineffective and surgical reconstruction may be recommended. This study investigated the improvement in clinical outcomes and frontal plane two-dimensional biomechanics during a 30-second single leg stance test, in patients undergoing reconstruction. We hypothesized that clinical scores and pertinent biomechanical variables would significantly improve post-surgery, and these outcomes would be significantly correlated. Twenty-one patients with symptomatic tendon tears underwent reconstruction. Patients were evaluated pre-surgery, and at 6 and 12months post-surgery, using patient-reported outcome measures, assessment of hip abductor strength and six-minute walk capacity. Frontal plane, two-dimensional, biomechanical variables including pelvis-on-femur angle, pelvic drop, trunk lean and lateral pelvic shift, were evaluated throughout a 30-second single leg stance test. ANOVA evaluated outcomes over time, while Pearson's correlations investigated associations between clinical scores, pain, functional and biomechanical outcome variables. While clinical and functional measures significantly improved (P<0.05) over time, no significant group differences (P>0.05) were observed in biomechanical variables from pre- to post-surgery. While five patients displayed a positive Trendelenburg sign pre-surgery, only one was positive post-surgery. Clinical outcomes and biomechanical variables during the single leg stance test were not correlated. Despite improvements in clinical and functional measures over time, biomechanical changes during a weight bearing single leg stance test were not significantly different following tendon repair. Follow up beyond 12months may be required, whereby symptomatic relief may precede functional and biomechanical improvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

Joint symbolic dynamics as a model-free approach to study interdependence in cardio-respiratory time series.

PubMed

Baumert, Mathias; Brown, Rachael; Duma, Stephen; Broe, G Anthony; Kabir, Muammar M; Macefield, Vaughan G

2012-01-01

Heart rate and respiration display fluctuations that are interlinked by central regulatory mechanisms of the autonomic nervous system (ANS). Joint assessment of respiratory time series along with heart rate variability (HRV) may therefore provide information on ANS dysfunction. The aim of this study was to investigate cardio-respiratory interaction in patients with Parkinson's disease (PD), a neurodegenerative disorder that is associated with progressive ANS dysfunction. Short-term ECG and respiration were recorded in 25 PD patients and 28 healthy controls during rest. To assess ANS dysfunction we analyzed joint symbolic dynamics of heart rate and respiration, cardio-respiratory synchrograms along with heart rate variability. Neither HRV nor cardio-respiratory synchrograms were significantly altered in PD patients. Symbolic analysis, however, identified a significant reduction in cardio-respiratory interactions in PD patients compared to healthy controls (16 ± 3.6 % vs. 20 ± 6.1 %; p= 0.02). In conclusion, joint symbolic analysis of cardio-respiratory dynamics provides a powerful tool to detect early signs of autonomic nervous system dysfunction in Parkinson's disease patients at an early stage of the disease.

Salivary alpha-amylase and cortisol responsiveness following electrical stimulation stress in patients with the generalized type of social anxiety disorder.

PubMed

Tamura, A; Maruyama, Y; Ishitobi, Y; Kawano, A; Ando, T; Ikeda, R; Inoue, A; Imanaga, J; Okamoto, S; Kanehisa, M; Ninomiya, T; Tanaka, Y; Tsuru, J; Akiyoshi, J

2013-11-01

Social anxiety disorder is believed to be a stress-induced disease. Although it can be inferred from the symptoms during attacks that there exists some abnormality of autonomic nervous system in any of the stress systems in social anxiety disorder, little evidence has been reported. This study focused on comparing the reactivity of 2 stress systems, the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis in patients with social anxiety disorder. 32 patients with the generalized type of social anxiety disorder were compared with 80 age- and gender-matched controls. We collected saliva samples from patients and controls before and after electrical stimulation to measure the concentrations of salivary alpha-amylase (sAA) and salivary cortisol. Profile of Mood State (POMS) and State-Trait Anxiety Inventory (STAI) scores and Heart Rate Variability (HRV) were also determined following stimulation. SAA in patients displayed a significantly higher level at baseline and a significantly larger response to electrical stimulation as compared to controls, whereas no group differences were seen in any HRV. Neither within-subject nor group differences were seen in salivary cortisol levels. These results suggest that SAD patients displayed enhanced ANS (but not HPA axis) activity vs. healthy controls. © Georg Thieme Verlag KG Stuttgart · New York.

Coagulation Alteration and Deep Vein Thrombosis in Brain Tumor Patients During the Perioperative Period.

PubMed

Guo, Xiaopeng; Zhang, Fa; Wu, Yue; Gao, Lu; Wang, Qiang; Wang, Zihao; Feng, Chenzhe; Yang, Yi; Xing, Bing; Xu, Zhiqin

2018-06-01

To explore coagulation function in patients with brain tumors before and after craniotomy and tumor resection and to analyze its correlation with deep vein thrombosis (DVT). This study enrolled 133 consecutive patients with brain tumors. Coagulation evaluation and limb venous ultrasonography were performed before and after surgery. Clinical characteristics and dynamic changes in coagulation parameters were recorded, and their correlations with DVT were analyzed. The incidence of postoperative DVT in patients with brain tumors was 10.5%. The average age of patients with DVT was older compared with patients without DVT (63.21 ± 11.21 years vs. 50.24 ± 11.95 years, P < 0.001), and the incidence of hepatitis B (21% vs. 4%, P = 0.035) was higher in patients with DVT compared with patients without DVT. D-dimer and fibrinogen were the most variable parameters during the perioperative period. In patients with DVT, D-dimer levels displayed a "zigzagging-rise" trend and were significantly higher than levels in patients without DVT. Platelet levels displayed a "first-descend-then-rise" trend and were significantly lower in patients with DVT on the second and third postoperative days. In patients with brain tumors, D-dimer and fibrinogen were elevated postoperatively, manifesting as hypercoagulability. Postoperative DVT was correlated with aging and hepatitis B. A "zigzagging-rise" trend of D-dimer and a "sharp-descent" trend of platelets in the early postoperative period might predict DVT in patients with brain tumors. Copyright © 2018 Elsevier Inc. All rights reserved.

New clinical and histological patterns of acute disseminated histoplasmosis in human immunodeficiency virus-positive patients with acquired immunodeficiency syndrome.

PubMed

Ollague Sierra, Jose E; Ollague Torres, Jose M

2013-04-01

Histoplasmosis has attained increasing relevance in the past 3 decades because of the appearance of the human immunodeficiency virus (HIV). In most immunocompetent persons, the infection is asymptomatic or can produce a respiratory condition with symptoms and radiological images similar to those observed in pulmonary tuberculosis; in non-HIV+ immunocompromised patients, it can cause respiratory symptoms or evolve into a disseminated infection. The same can occur in acquired immunodeficiency syndrome (AIDS) patients. We have observed a series of HIV+ patients with AIDS who presented with cutaneous histoplasmosis and in whom the clinical and histopathological features were highly unusual, including variable mucocutaneous lesions that were difficult to diagnose clinically. These patients displayed unusual, previously undescribed, histological patterns, including lichenoid pattern, nodular pseudomyxoid pattern, pyogenic granuloma-like pattern, perifollicular pattern, and superficial (S), mid (M), and deep perivascular dermatitis; and more commonly encountered patterns, such as histiocytic lobular panniculitis and focal nodular dermatitis. The novel histopathological patterns of cutaneous involvement by histoplasmosis seen in these patients resembled other common inflammatory and infectious conditions and required a high level of suspicion and the application of special stains for organisms for confirmation. These new, clinical, and histological findings do not seem to be commonly encountered in HIV- patients infected with the fungus but seem to be displayed most prominently in HIV+ patients with AIDS.

Cardiopulmonary data-acquisition system

NASA Technical Reports Server (NTRS)

Crosier, W. G.; Reed, R. A.

1981-01-01

Computerized system controls and monitors bicycle and treadmill cardiovascular stress tests. It acquires and reduces stress data and displays heart rate, blood pressure, workload, respiratory rate, exhaled-gas composition, and other variables. Data are printed on hard-copy terminal every 30 seconds for quick operator response to patient. Ergometer workload is controlled in real time according to experimental protocol. Collected data are stored directly on tape in analog form and on floppy disks in digital form for later processing.

Intravenous infusion of phage-displayed antibody library in human cancer patients: enrichment and cancer-specificity of tumor-homing phage-antibodies.

PubMed

Shukla, Girja S; Krag, David N; Peletskaya, Elena N; Pero, Stephanie C; Sun, Yu-Jing; Carman, Chelsea L; McCahill, Laurence E; Roland, Thomas A

2013-08-01

Phage display is a powerful method for target discovery and selection of ligands for cancer treatment and diagnosis. Our goal was to select tumor-binding antibodies in cancer patients. Eligibility criteria included absence of preexisting anti-phage-antibodies and a Stage IV cancer status. All patients were intravenously administered 1 × 10(11) TUs/kg of an scFv library 1 to 4 h before surgical resection of their tumors. No significant adverse events related to the phage library infusion were observed. Phage were successfully recovered from all tumors. Individual clones from each patient were assessed for binding to the tumor from which clones were recovered. Multiple tumor-binding phage-antibodies were identified. Soluble scFv antibodies were produced from the phage clones showing higher tumor binding. The tumor-homing phage-antibodies and derived soluble scFvs were found to bind varying numbers (0-5) of 8 tested normal human tissues (breast, cervix, colon, kidney, liver, spleen, skin, and uterus). The clones that showed high tumor-specificity were found to bind corresponding tumors from other patients also. Clone enrichment was observed based on tumor binding and DNA sequence data. Clone sequences of multiple variable regions showed significant matches to certain cancer-related antibodies. One of the clones (07-2,355) that was found to share a 12-amino-acid-long motif with a reported IL-17A antibody was further studied for competitive binding for possible antigen target identification. We conclude that these outcomes support the safety and utility of phage display library panning in cancer patients for ligand selection and target discovery for cancer treatment and diagnosis.

[Thrombopenia and radial aplasia: 2 cases with platelet function and ultrastructural studies of megakaryocytes and platelets (author's transl)].

PubMed

Juhan, I; Bayle, J; Mattei, J F; Thevenieau, D; Perrimond, H; Muratore, R

1979-10-01

The authors report on two cases of congenital thrombopenia with radial aplasia. Both children display several formative abnormalities and a mild thrombopenia; hemorragic manifestations occurred in the first case only. Megacryoblastic to platelets series, as studied with electronic microscopy, show small-sized, "microcytic" and hypogranular megacaryocytes, displaying a maturative disorder (dysmegacaryocytopoiesis). In functional studies, platelets of the first patient show an imperfect nucleotidic release and do not agregate normally with ristocetin. The second case exhibits mostly a PF3 reduction. The variety of expression of the megacaryocytic-platelets disorders appears likewise in the squelettal and visceral malformations. The whole disorder could be ascribed to a pleiotropic abnormal gene with a variable expressivity.

Real time monitoring of risk-adjusted paediatric cardiac surgery outcomes using variable life-adjusted display: implementation in three UK centres

PubMed Central

Pagel, Christina; Utley, Martin; Crowe, Sonya; Witter, Thomas; Anderson, David; Samson, Ray; McLean, Andrew; Banks, Victoria; Tsang, Victor; Brown, Katherine

2013-01-01

Objective To implement routine in-house monitoring of risk-adjusted 30-day mortality following paediatric cardiac surgery. Design Collaborative monitoring software development and implementation in three specialist centres. Patients and methods Analyses incorporated 2 years of data routinely audited by the National Institute of Cardiac Outcomes Research (NICOR). Exclusion criteria were patients over 16 or undergoing non-cardiac or only catheter procedures. We applied the partial risk adjustment in surgery (PRAiS) risk model for death within 30 days following surgery and generated variable life-adjusted display (VLAD) charts for each centre. These were shared with each clinical team and feedback was sought. Results Participating centres were Great Ormond Street Hospital, Evelina Children's Hospital and The Royal Hospital for Sick Children in Glasgow. Data captured all procedures performed between 1 January 2010 and 31 December 2011. This incorporated 2490 30-day episodes of care, 66 of which were associated with a death within 30 days.The VLAD charts generated for each centre displayed trends in outcomes benchmarked to recent national outcomes. All centres ended the 2-year period within four deaths from what would be expected. The VLAD charts were shared in multidisciplinary meetings and clinical teams reported that they were a useful addition to existing quality assurance initiatives. Each centre is continuing to use the prototype software to monitor their in-house surgical outcomes. Conclusions Timely and routine monitoring of risk-adjusted mortality following paediatric cardiac surgery is feasible. Close liaison with hospital data managers as well as clinicians was crucial to the success of the project. PMID:23564473

Alternate Metabolic Programs Define Regional Variation of Relevant Biological Features in Renal Cell Carcinoma Progression.

PubMed

Brooks, Samira A; Khandani, Amir H; Fielding, Julia R; Lin, Weili; Sills, Tiffany; Lee, Yueh; Arreola, Alexandra; Milowsky, Mathew I; Wallen, Eric M; Woods, Michael E; Smith, Angie B; Nielsen, Mathew E; Parker, Joel S; Lalush, David S; Rathmell, W Kimryn

2016-06-15

Clear cell renal cell carcinoma (ccRCC) has recently been redefined as a highly heterogeneous disease. In addition to genetic heterogeneity, the tumor displays risk variability for developing metastatic disease, therefore underscoring the urgent need for tissue-based prognostic strategies applicable to the clinical setting. We have recently employed the novel PET/magnetic resonance (MR) image modality to enrich our understanding of how tumor heterogeneity can relate to gene expression and tumor biology to assist in defining individualized treatment plans. ccRCC patients underwent PET/MR imaging, and these images subsequently used to identify areas of varied intensity for sampling. Samples from 8 patients were subjected to histologic, immunohistochemical, and microarray analysis. Tumor subsamples displayed a range of heterogeneity for common features of hypoxia-inducible factor expression and microvessel density, as well as for features closely linked to metabolic processes, such as GLUT1 and FBP1. In addition, gene signatures linked with disease risk (ccA and ccB) also demonstrated variable heterogeneity, with most tumors displaying a dominant panel of features across the sampled regions. Intriguingly, the ccA- and ccB-classified samples corresponded with metabolic features and functional imaging levels. These correlations further linked a variety of metabolic pathways (i.e., the pentose phosphate and mTOR pathways) with the more aggressive, and glucose avid ccB subtype. Higher tumor dependency on exogenous glucose accompanies the development of features associated with the poor risk ccB subgroup. Linking these panels of features may provide the opportunity to create functional maps to enable enhanced visualization of the heterogeneous biologic processes of an individual's disease. Clin Cancer Res; 22(12); 2950-9. ©2016 AACR. ©2016 American Association for Cancer Research.

Performance, physiological, and oculometer evaluation of VTOL landing displays

NASA Technical Reports Server (NTRS)

North, R. A.; Stackhouse, S. P.; Graffunder, K.

1979-01-01

A methodological approach to measuring workload was investigated for evaluation of new concepts in VTOL aircraft displays. Physiological, visual response, and conventional flight performance measures were recorded for landing approaches performed in the NASA Visual Motion Simulator (VMS). Three displays (two computer graphic and a conventional flight director), three crosswind amplitudes, and two motion base conditions (fixed vs. moving base) were tested in a factorial design. Multivariate discriminant functions were formed from flight performance and/or visual response variables. The flight performance variable discriminant showed maximum differentation between crosswind conditions. The visual response measure discriminant maximized differences between fixed vs. motion base conditions and experimental displays. Physiological variables were used to attempt to predict the discriminant function values for each subject/condition trial. The weights of the physiological variables in these equations showed agreement with previous studies. High muscle tension, light but irregular breathing patterns, and higher heart rate with low amplitude all produced higher scores on this scale and thus represent higher workload levels.

Association between history and physical examination factors and change in lumbar multifidus muscle thickness after spinal manipulation in patients with low back pain

PubMed Central

Koppenhaver, Shane L.; Fritz, Julie M.; Hebert, Jeffrey J.; Kawchuk, Greg N.; Parent, Eric C.; Gill, Norman W.; Childs, John D.; Teyhen, Deydre S.

2012-01-01

Understanding the clinical characteristics of patients with low back pain (LBP) who display improved lumbar multifidus (LM) muscle function after spinal manipulative therapy (SMT) may provide insight into a potentially synergistic interaction between SMT and exercise. Therefore, the purpose of this study was to identify the baseline historical and physical examination factors associated with increased contracted LM muscle thickness one week after SMT. Eighty-one participants with LBP underwent a baseline physical examination and ultrasound imaging assessment of the LM muscle during submaximal contraction before and one week after SMT. The relationship between baseline examination variables and 1-week change in contracted LM thickness was assessed using correlation analysis and hierarchical multiple linear regression. Four variables best predicted the magnitude of increases in contracted LM muscle thickness after SMT. When combined, these variables suggest that patients with LBP, (1) that are fairly acute, (2) have at least a moderately good prognosis without focal and irritable symptoms, and (3) exhibit signs of spinal instability, may be the best candidates for a combined SMT and LSE treatment approach. PMID:22516351

Association between history and physical examination factors and change in lumbar multifidus muscle thickness after spinal manipulation in patients with low back pain.

PubMed

Koppenhaver, Shane L; Fritz, Julie M; Hebert, Jeffrey J; Kawchuk, Greg N; Parent, Eric C; Gill, Norman W; Childs, John D; Teyhen, Deydre S

2012-10-01

Understanding the clinical characteristics of patients with low back pain (LBP) who display improved lumbar multifidus (LM) muscle function after spinal manipulative therapy (SMT) may provide insight into a potentially synergistic interaction between SMT and exercise. Therefore, the purpose of this study was to identify the baseline historical and physical examination factors associated with increased contracted LM muscle thickness one week after SMT. Eighty-one participants with LBP underwent a baseline physical examination and ultrasound imaging assessment of the LM muscle during submaximal contraction before and one week after SMT. The relationship between baseline examination variables and 1-week change in contracted LM thickness was assessed using correlation analysis and hierarchical multiple linear regression. Four variables best predicted the magnitude of increases in contracted LM muscle thickness after SMT. When combined, these variables suggest that patients with LBP, (1) that are fairly acute, (2) have at least a moderately good prognosis without focal and irritable symptoms, and (3) exhibit signs of spinal instability, may be the best candidates for a combined SMT and lumbar stabilization exercise (LSE) treatment approach. Published by Elsevier Ltd.

Modular Construction of Large Non-Immune Human Antibody Phage-Display Libraries from Variable Heavy and Light Chain Gene Cassettes.

PubMed

Lee, Nam-Kyung; Bidlingmaier, Scott; Su, Yang; Liu, Bin

2018-01-01

Monoclonal antibodies and antibody-derived therapeutics have emerged as a rapidly growing class of biological drugs for the treatment of cancer, autoimmunity, infection, and neurological diseases. To support the development of human antibodies, various display techniques based on antibody gene repertoires have been constructed over the last two decades. In particular, scFv-antibody phage display has been extensively utilized to select lead antibodies against a variety of target antigens. To construct a scFv phage display that enables efficient antibody discovery, and optimization, it is desirable to develop a system that allows modular assembly of highly diverse variable heavy chain and light chain (Vκ and Vλ) repertoires. Here, we describe modular construction of large non-immune human antibody phage-display libraries built on variable gene cassettes from heavy chain and light chain repertoires (Vκ- and Vλ-light can be made into independent cassettes). We describe utility of such libraries in antibody discovery and optimization through chain shuffling.

Clinical dysphagia risk predictors after prolonged orotracheal intubation

PubMed Central

de Medeiros, Gisele Chagas; Sassi, Fernanda Chiarion; Mangilli, Laura Davison; Zilberstein, Bruno; de Andrade, Claudia Regina Furquim

2014-01-01

OBJECTIVES: To elucidate independent risk factors for dysphagia after prolonged orotracheal intubation. METHODS: The participants were 148 consecutive patients who underwent clinical bedside swallowing assessments from September 2009 to September 2011. All patients had received prolonged orotracheal intubations and were admitted to one of several intensive care units of a large Brazilian school hospital. The correlations between the conducted water swallow test results and dysphagia risk levels were analyzed for statistical significance. RESULTS: Of the 148 patients included in the study, 91 were male and 57 were female (mean age, 53.64 years). The univariate analysis results indicated that specific variables, including extraoral loss, multiple swallows, cervical auscultation, vocal quality, cough, choking, and other signs, were possible significant high-risk indicators of dysphagia onset. The multivariate analysis results indicated that cervical auscultation and coughing were independent predictive variables for high dysphagia risk. CONCLUSIONS: Patients displaying extraoral loss, multiple swallows, cervical auscultation, vocal quality, cough, choking and other signs should benefit from early swallowing evaluations. Additionally, early post-extubation dysfunction recognition is paramount in reducing the morbidity rate in this high-risk population. PMID:24473554

Clinical dysphagia risk predictors after prolonged orotracheal intubation.

PubMed

Medeiros, Gisele Chagas de; Sassi, Fernanda Chiarion; Mangilli, Laura Davison; Zilberstein, Bruno; Andrade, Claudia Regina Furquim de

2014-01-01

To elucidate independent risk factors for dysphagia after prolonged orotracheal intubation. The participants were 148 consecutive patients who underwent clinical bedside swallowing assessments from September 2009 to September 2011. All patients had received prolonged orotracheal intubations and were admitted to one of several intensive care units of a large Brazilian school hospital. The correlations between the conducted water swallow test results and dysphagia risk levels were analyzed for statistical significance. Of the 148 patients included in the study, 91 were male and 57 were female (mean age, 53.64 years). The univariate analysis results indicated that specific variables, including extraoral loss, multiple swallows, cervical auscultation, vocal quality, cough, choking, and other signs, were possible significant high-risk indicators of dysphagia onset. The multivariate analysis results indicated that cervical auscultation and coughing were independent predictive variables for high dysphagia risk. Patients displaying extraoral loss, multiple swallows, cervical auscultation, vocal quality, cough, choking and other signs should benefit from early swallowing evaluations. Additionally, early post-extubation dysfunction recognition is paramount in reducing the morbidity rate in this high-risk population.

Population pharmacokinetic (PK) analysis of laromustine, an emerging alkylating agent, in cancer patients.

PubMed

Nassar, Ala F; Wisnewski, Adam V; King, Ivan

2017-05-01

1. Alkylating agents are capable of introducing an alkyl group into nucleophilic sites on DNA or RNA through covalent bond. Laromustine is an active member of a relatively new class of sulfonylhydrazine prodrugs under development as antineoplastic alkylating agents, and displays significant single-agent activity. 2. This is the first report of the population pharmacokinetic analysis of laromustine, 106 patients, 66 with hematologic malignancies and 40 with solid tumors, participated in five clinical trials worldwide. Of these, 104 patients were included in the final NONMEM analysis. 3. The population estimates for total clearance (CL) and volume of distribution of the central compartment (V 1 ) were 96.3 L/h and 45.9 L, associated with high inter-patient variability of 52.9% and 79.8% and inter-occasion variability of 26.7% and 49.3%, respectively. The population estimates for Q and V 2 were 73.2 L/h and 29.9 L, and inter-patient variability in V 2 was 63.1%, respectively. 4. The estimate of V ss (75.8 L) exceeds total body water, indicating that laromustine is distributed to tissues. The half-life is short, less than 1 h, reflecting rapid clearance. Population PK analysis showed laromustine pharmacokinetics to be independent of dose and organ function with no effect on subsequent dosing cycles.

The high prevalence of impulse control behaviors in patients with early-onset Parkinson's disease: A cross-sectional multicenter study.

PubMed

Vela, L; Martínez Castrillo, J C; García Ruiz, P; Gasca-Salas, C; Macías Macías, Y; Pérez Fernández, E; Ybot, I; Lopez Valdés, E; Kurtis, M M; Posada Rodriguez, I J; Mata, M; Ruiz Huete, C; Eimil, M; Borrue, C; Del Val, J; López-Manzanares, L; Rojo Sebastian, A; Marasescu, R

2016-09-15

In Parkinson's disease patients, impulse control disorders (ICDs) have been associated with younger age and early disease onset, yet the prevalence of ICDs in early-onset Parkinson's disease (EOPD) patients has yet to be studied. Thus, we set out to compare the prevalence of impulse control behaviors (ICBs) in a cohort of EOPD patients with that in age and gender matched healthy controls (HCs), as well as to analyze the association of these symptoms with the use of dopaminergic drugs and other clinical or demographic factors. A cross-sectional, multicenter study was carried out on patients recruited from outpatient Movement Disorder Clinics, assessing ICBs using the short form of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP). In addition, depression and quality of life (QoL) were measured, along with other demographic and clinical variables. Of the 87 EOPD patients, 49 (58.3%) displayed an ICB, as did 28 of the 87 HCs (32.9%; p=0.001). Most of the EOPD patients that displayed an ICB (91.8%) were medicated with a dopamine agonist (DA) and accordingly, DA treatment was associated with a 7-fold increased risk of developing an ICB. Patients with ICBs had a higher depression score and a worse QoL. ICBs are much more prevalent in EOPD patients than in HCs and they are associated with DA intake, depression and a worse QoL. Copyright © 2016 Elsevier B.V. All rights reserved.

Identification of fibrillin 1 gene mutations in patients with bicuspid aortic valve (BAV) without Marfan syndrome

PubMed Central

2014-01-01

Background Bicuspid aortic valve (BAV) is the most frequent congenital heart disease with frequent involvement in thoracic aortic dilatation, aneurysm and dissection. Although BAV and Marfan syndrome (MFS) share some clinical features, and some MFS patients with BAV display mutations in FBN1, the gene encoding fibrillin-1, the genetic background of isolated BAV is poorly defined. Methods Ten consecutive BAV patients [8 men, age range 24–42 years] without MFS were clinically characterized. BAV phenotype and function, together with evaluation of aortic morphology, were comprehensively assessed by Doppler echocardiography. Direct sequencing of each FBN1 exon with flanking intron sequences was performed on eight patients. Results We detected three FBN1 mutations in two patients (aged 24 and 25 years) displaying aortic root aneurysm ≥50 mm and moderate aortic regurgitation. In particular, one patient had two mutations (p.Arg2726Trp and p.Arg636Gly) one of which has been previously associated with variable Marfanoid phenotypes. The other patient showed a pArg529Gln substitution reported to be associated with an incomplete MFS phenotype. Conclusions The present findings enlarge the clinical spectrum of isolated BAV to include patients with BAV without MFS who have involvement of FBN1 gene. These results underscore the importance of accurate phenotyping of BAV aortopathy and of clinical characterization of BAV patients, including investigation of systemic connective tissue manifestations and genetic testing. PMID:24564502

Accuracy of manual QRS duration assessment: its importance in patient selection for cardiac resynchronization and implantable cardioverter defibrillator therapy.

PubMed

Tomlinson, David R; Bashir, Yaver; Betts, Timothy R; Rajappan, Kim

2009-05-01

Patients with left ventricular systolic dysfunction and electrocardiographic QRS duration (QRSd) >or=120 ms may obtain symptomatic and prognostic benefits from cardiac resynchronization therapy (CRT). However, clinical trials do not describe the methods used to measure QRSd. We investigated the effect of electrocardiogram (ECG) display format and paper speed on the accuracy of manual QRSd assessment and concordance of manual QRSd with computer-calculated mean and maximal QRSd. Six cardiologists undertook QRSd measurements on ECGs, with computer-calculated mean QRSd close to 120 ms. Display formats were 12-lead, 6-limb, and 6-precordial leads, each at 25 and 50 mm/s. When the computer-calculated mean was used to define QRSd, manual assessment demonstrated 97 and 83% concordance at categorizing QRSd as < and >or=120 ms, respectively. Using the computer-calculated maximal QRSd, manual assessment demonstrated 83% concordance when QRSd was <120 ms and 19% concordance when QRSd was >or=120 ms. The six-precordial lead format demonstrated significantly less intra and inter-observer variabilities than the 12-lead, but this did not improve concordance rates. Manual QRSd assessments demonstrate significant variability, and concordance with computer-calculated measurement depends on whether QRSd is defined as the mean or maximal value. Consensus is required both on the most appropriate definition of QRSd and its measurement.

An object-oriented approach to data display and storage: 3 years experience, 25,000 cases.

PubMed

Sainsbury, D A

1993-11-01

Object-oriented programming techniques were used to develop computer based data display and storage systems. These have been operating in the 8 anaesthetising areas of the Adelaide Children's Hospital for 3 years. The analogue and serial outputs from an array of patient monitors are connected to IBM compatible PC-XT computers. The information is displayed on a colour screen as wave-form and trend graphs and digital format in 'real time'. The trend data is printed simultaneously on a dot matrix printer. This data is also stored for 24 hours on 'hard' disk. The major benefit has been the provision of a single visual focus for all monitored variables. The automatic logging of data has been invaluable in the analysis of critical incidents. The systems were made possible by recent, rapid improvements in computer hardware and software. This paper traces the development of the program and demonstrates the advantages of object-oriented programming techniques.

Distal 10q monosomy: new evidence for a neurobehavioral condition?

PubMed

Plaisancié, Julie; Bouneau, Laurence; Cances, Claude; Garnier, Christelle; Benesteau, Jacques; Leonard, Samantha; Bourrouillou, Georges; Calvas, Patrick; Vigouroux, Adeline; Julia, Sophie; Bieth, Eric

2014-01-01

Pure distal monosomy of the long arm of chromosome 10 is a rare cytogenetic abnormality. The location and size of the deletions described in this region are variable. Nevertheless, the patients share characteristic facial appearance, variable cognitive impairment and neurobehavioral manifestations. A Minimal Critical Region corresponding to a 600 kb Smallest Region of deletion Overlap (SRO) has been proposed. In this report, we describe four patients with a distal 10q26 deletion, who displayed attention-deficit/hyperactivity disorders (ADHD). One of them had a marked behavioral profile and relatively preserved cognitive functions. Interestingly, the SRO was not included in the deleted segment of this patient suggesting that this deletion could contain candidate genes involved in the control of neurobehavioral functions. One of these candidates was the CALY gene, known for its association with ADHD patients and whose expression level was shown to be correlated with neurobehavioral disturbances in varying animal models. This report emphasizes the importance of the behavioral problems as a cardinal feature of the 10q microdeletion syndrome. Haploinsufficiency of CALY could play a crucial role in the development of the behavioral troubles within these patients. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

[Personality variables, psychopathological alterations and personality disorders in alcohol-dependent patients according to Cloninger's typology of alcohol abuse].

PubMed

Echeburúa, Enrique; Bravo de Medina, Ricardo; Aizpiri, Javier

2008-11-01

In this paper, an evaluation of Cloninger's typology of alcohol abuse in personality, psychopathology and personality disorders is carried out. The sample consisted of 158 alcoholics in treatment (56 Type I alcohol-dependent patients and 102 Type II alcohol-dependent patients). All subjects were assessed with diverse assessment tools related to personality (Impulsiveness Scale, Sensation Seeking Scale and STAI), psychopathology (SCL-90-R, BDI and Inadaptation Scale) and personality disorders (IPDE). The main findings were that Type II alcohol-dependent patients were more impulsive and sensation-seeking and they displayed more hostility and emotional distress than Type I alcohol-dependent patients. Personality disorders were not so prevalent in the case of Type I alcohol-dependent patients. The most specific personality disorders for Type II alcohol-dependent patients were narcissistic and paranoid. The implications of this study for further research are commented on.

Embedded Touch Sensing Circuit Using Mutual Capacitance for Active-Matrix Organic Light-Emitting Diode Display

NASA Astrophysics Data System (ADS)

Park, Young-Ju; Seok, Su-Jeong; Park, Sang-Ho; Kim, Ohyun

2011-03-01

We propose and simulate an embedded touch sensing circuit for active-matrix organic light-emitting diode (AMOLED) displays. The circuit consists of three thin-film transistors (TFTs), one fixed capacitor, and one variable capacitor. AMOLED displays do not have a variable capacitance characteristic, so we realized a variable capacitor to detect touches in the sensing pixel by exploiting the change in the mutual capacitance between two electrodes that is caused by touch. When a dielectric substance approaches two electrodes, the electric field is shunted so that the mutual capacitance decreases. We use the existing TFT process to form the variable capacitor, so no additional process is needed. We use advanced solid-phase-crystallization TFTs because of their stability and uniformity. The proposed circuit detects multi-touch points by a scanning process.

Postural steadiness and ankle force variability in peripheral neuropathy

PubMed Central

Paxton, Roger J.; Feldman-Kothe, Caitlin; Trabert, Megan K.; Hitchcock, Leah N.; Reiser, Raoul F.; Tracy, Brian L.

2015-01-01

Introduction The purpose was to determine the effect of peripheral neuropathy (PN) on motor output variability for ankle muscles of older adults, and the relation between ankle motor variability and postural stability in PN patients. Methods Older adults with (O-PN) and without PN (O), and young adults (Y) underwent assessment of standing postural stability and ankle muscle force steadiness. Results O-PN displayed impaired ankle muscle force control and postural stability compared with O and Y groups. For O-PN, the amplitude of plantarflexor force fluctuations was moderately correlated with postural stability under no-vision conditions (r = 0.54, P = 0.01). Discussion The correlation of variations in ankle force with postural stability in PN suggests a contribution of ankle muscle dyscontrol to the postural instability that impacts physical function for older adults with PN. PMID:26284897

Self-Reported Sleep Disturbances in Patients with Dissociative Identity Disorder and Post-Traumatic Stress Disorder and How They Relate to Cognitive Failures and Fantasy Proneness

PubMed Central

van Heugten – van der Kloet, Dalena; Huntjens, Rafaele; Giesbrecht, Timo; Merckelbach, Harald

2014-01-01

Sleep disturbances, fantasy proneness, cognitive failures, and dissociative symptoms are related to each other. However, the co-occurrence of these phenomena has been primarily studied in non-clinical samples. We investigated the correlations between these phenomena in dissociative identity disorder (DID) patients, post-traumatic stress disorder (PTSD) patients, and healthy controls. Both patient groups reported more sleep problems and lower sleep quality and displayed higher levels of fantasy proneness and cognitive failures than controls. However, the two patient groups did not differ with regard to these variables. Moreover, a higher level of unusual sleep experiences tended to predict participants belonging to the DID group, while specifically a lower sleep quality and more cognitive failures tended to predict participants belonging to the PTSD group. PMID:24600412

Self-reported sleep disturbances in patients with dissociative identity disorder and post-traumatic stress disorder and how they relate to cognitive failures and fantasy proneness.

PubMed

van Heugten-van der Kloet, Dalena; Huntjens, Rafaele; Giesbrecht, Timo; Merckelbach, Harald

2014-01-01

Sleep disturbances, fantasy proneness, cognitive failures, and dissociative symptoms are related to each other. However, the co-occurrence of these phenomena has been primarily studied in non-clinical samples. We investigated the correlations between these phenomena in dissociative identity disorder (DID) patients, post-traumatic stress disorder (PTSD) patients, and healthy controls. Both patient groups reported more sleep problems and lower sleep quality and displayed higher levels of fantasy proneness and cognitive failures than controls. However, the two patient groups did not differ with regard to these variables. Moreover, a higher level of unusual sleep experiences tended to predict participants belonging to the DID group, while specifically a lower sleep quality and more cognitive failures tended to predict participants belonging to the PTSD group.

Examination of an Electronic Patient Record Display Method to Protect Patient Information Privacy.

PubMed

Niimi, Yukari; Ota, Katsumasa

2017-02-01

Electronic patient records facilitate the provision of safe, high-quality medical care. However, because personnel can view almost all stored information, this study designed a display method using a mosaic blur (pixelation) to temporarily conceal information patients do not want shared. This study developed an electronic patient records display method for patient information that balanced the patient's desire for personal information protection against the need for information sharing among medical personnel. First, medical personnel were interviewed about the degree of information required for both individual duties and team-based care. Subsequently, they tested a mock display method that partially concealed information using a mosaic blur, and they were interviewed about the effectiveness of the display method that ensures patient privacy. Participants better understood patients' demand for confidentiality, suggesting increased awareness of patients' privacy protection. However, participants also indicated that temporary concealment of certain information was problematic. Other issues included the inconvenience of removing the mosaic blur to obtain required information and risk of insufficient information for medical care. Despite several issues with using a display method that temporarily conceals information according to patient privacy needs, medical personnel could accept this display method if information essential to medical safety remains accessible.

Genomic characterization of recurrent high-grade astroblastoma.

PubMed

Bale, Tejus A; Abedalthagafi, Malak; Bi, Wenya Linda; Kang, Yun Jee; Merrill, Parker; Dunn, Ian F; Dubuc, Adrian; Charbonneau, Sarah K; Brown, Loreal; Ligon, Azra H; Ramkissoon, Shakti H; Ligon, Keith L

2016-01-01

Astroblastomas are rare primary brain tumors, diagnosed based on histologic features. Not currently assigned a WHO grade, they typically display indolent behavior, with occasional variants taking a more aggressive course. We characterized the immunohistochemical characteristics, copy number (high-resolution array comparative genomic hybridization, OncoCopy) and mutational profile (targeted next-generation exome sequencing, OncoPanel) of a cohort of seven biopsies from four patients to identify recurrent genomic events that may help distinguish astroblastomas from other more common high-grade gliomas. We found that tumor histology was variable across patients and between primary and recurrent tumor samples. No common molecular features were identified among the four tumors. Mutations commonly observed in astrocytic tumors (IDH1/2, TP53, ATRX, and PTEN) or ependymoma were not identified. However one case with rapid clinical progression displayed mutations more commonly associated with GBM (NF1(N1054H/K63)*, PIK3CA(R38H) and ERG(A403T)). Conversely, another case, originally classified as glioblastoma with nine-year survival before recurrence, lacked a GBM mutational profile. Other mutations frequently seen in lower grade gliomas (BCOR, BCORL1, ERBB3, MYB, ATM) were also present in several tumors. Copy number changes were variable across tumors. Our findings indicate that astroblastomas have variable growth patterns and morphologic features, posing significant challenges to accurate classification in the absence of diagnostically specific copy number alterations and molecular features. Their histopathologic overlap with glioblastoma will likely confound the observation of long-term GBM "survivors". Further genomic profiling is needed to determine whether these tumors represent a distinct entity and to guide management strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

Intra-individual biological variation in sweat chloride concentrations in CF, CFTR dysfunction, and healthy pediatric subjects.

PubMed

Cirilli, Natalia; Raia, Valeria; Rocco, Ilaria; De Gregorio, Fabiola; Tosco, Antonella; Salvadori, Laura; Sepe, Angela Ornella; Buzzetti, Roberto; Minicuci, Nadia; Castaldo, Giuseppe

2018-04-02

The sweat test is one of the main diagnostic tools used in newborn screening programs and as a confirmatory test, in case of suspect of Cystic Fibrosis (CF). Since sweat chloride (Cl) concentration is also considered an appropriate parameter to explore the efficacy of CFTR modulators in clinical trials, it is crucial to evaluate the biological variability of this test in healthy and pathological conditions. The aim of this pilot study was to determine the intra-individual biological variability of sweat Cl, both in healthy individuals and CF patients and to assess its correlation with diet, season, and menstrual cycle. Thirty-five out of 36 selected subjects (6-18 years) were enrolled by 2 CF care centers and assigned to 3 cohorts: CF, CFTR-related disorder (CFTR-RD) and healthy volunteers. Each participant was subjected to eight sweat tests in different conditions and time of the year. Data were analyzed using linear mixed effects models for repeated measures, taking also into account intra-individual correlations. We observed a high intra-individual variability of sweat Cl, with the lowest mean CV% values among CF patients (20.21 in CF, 29.74 in CFTR-RD, and 31.15 in healthy subjects). Gender and diet had no influence on sweat Cl variability, nor had pubertal age and menstrual phase. Results of this pilot study confirmed that sweat Cl variability is high in CF patients, although non-CF individuals displayed even higher mean CV% values. Season significantly influenced sweat test values only in CF patients, likely due to changes in their hydration status. © 2018 Wiley Periodicals, Inc.

Real-time Data Display System of the Korean Neonatal Network

PubMed Central

Lee, Byong Sop; Moon, Wi Hwan

2015-01-01

Real-time data reporting in clinical research networks can provide network members through interim analyses of the registered data, which can facilitate further studies and quality improvement activities. The aim of this report was to describe the building process of the data display system (DDS) of the Korean Neonatal Network (KNN) and its basic structure. After member verification at the KNN member's site, users can choose a variable of interest that is listed in the in-hospital data statistics (for 90 variables) or in the follow-up data statistics (for 54 variables). The statistical results of the outcome variables are displayed on the HyperText Markup Language 5-based chart graphs and tables. Participating hospitals can compare their performance to those of KNN as a whole and identify the trends over time. Ranking of each participating hospital is also displayed in terms of key outcome variables such as mortality and major neonatal morbidities with the names of other centers blinded. The most powerful function of the DDS is the ability to perform 'conditional filtering' which allows users to exclusively review the records of interest. Further collaboration is needed to upgrade the DDS to a more sophisticated analytical system and to provide a more user-friendly interface. PMID:26566352

The effect of a new lifetime-cardiovascular-risk display on patients' motivation to participate in shared decision-making.

PubMed

Jegan, Nikita Roman A; Kürwitz, Sarah Anna; Kramer, Lena Kathrin; Heinzel-Gutenbrunner, Monika; Adarkwah, Charles Christian; Popert, Uwe; Donner-Banzhoff, Norbert

2018-06-09

This study investigated the effects of three different risk displays used in a cardiovascular risk calculator on patients' motivation for shared decision-making (SDM). We compared a newly developed time-to-event (TTE) display with two established absolute risk displays (i.e. emoticons and bar charts). The accessibility, that is, how understandable, helpful, and trustworthy patients found each display, was also investigated. We analysed a sample of 353 patients recruited in general practices. After giving consent, patients were introduced to one of three fictional vignettes with low, medium or high cardiovascular risk. All three risk displays were shown in a randomized order. Patients were asked to rate each display with regard to motivation for SDM and accessibility. Two-factorial repeated measures analyses of variance were conducted to compare the displays and investigate possible interactions with age. Regarding motivation for SDM, the TTE elicited the highest motivation, followed by the emoticons and bar chart (p < .001). The displays had no differential influence on the age groups (p = .445). While the TTE was generally rated more accessible than the emoticons and bar chart (p < .001), the emoticons were only superior to the bar chart in the younger subsample. However, this was only to a small effect (interaction between display and age, p < .01, η 2  = 0.018). Using fictional case vignettes, the novel TTE display was superior regarding motivation for SDM and accessibility when compared to established displays using emoticons and a bar chart. If future research can replicate these results in real-life consultations, the TTE display will be a valuable addition to current risk calculators and decision aids by improving patients' participation.

Synthetic aperture radar operator tactical target acquisition research

NASA Technical Reports Server (NTRS)

Hershberger, M. L.; Craig, D. W.

1978-01-01

A radar target acquisition research study was conducted to access the effects of two levels of 13 radar sensor, display, and mission parameters on operator tactical target acquisition. A saturated fractional-factorial screening design was employed to examine these parameters. Data analysis computed ETA squared values for main and second-order effects for the variables tested. Ranking of the research parameters in terms of importance to system design revealed four variables (radar coverage, radar resolution/multiple looks, display resolution, and display size) accounted for 50 percent of the target acquisition probability variance.

Maxillary anterior papilla display during smiling: a clinical study of the interdental smile line.

PubMed

Hochman, Mark N; Chu, Stephen J; Tarnow, Dennis P

2012-08-01

The purpose of this research was to quantify the visual display (presence) or lack of display (absence) of interdental papillae during maximum smiling in a patient population aged 10 to 89 years. Four hundred twenty digital single-lens reflex photographs of patients were taken and examined for the visual display of interdental papillae between the maxillary anterior teeth during maximum smiling. Three digital photographs were taken per patient from the frontal, right frontal-lateral, and left frontal-lateral views. The data set of photographs was examined by two examiners for the presence or absence of the visual display of papillae. The visual display of interdental papillae during maximum smiling occurred in 380 of the 420 patients examined in this study, equivalent to a 91% occurrence rate. Eighty-seven percent of all patients categorized as having a low gingival smile line (n = 303) were found to display the interdental papillae upon smiling. Differences were noted for individual age groups according to the decade of life as well as a trend toward decreasing papillary display with increasing age. The importance of interdental papillae display during dynamic smiling should not be left undiagnosed since it is visible in over 91% of older patients and in 87% of patients with a low gingival smile line, representing a common and important esthetic element that needs to be assessed during smile analysis of the patient.

The relationship between nurse-patient interaction and meaning-in-life in cognitively intact nursing home patients.

PubMed

Haugan, Gørill

2014-01-01

To investigate the associations between nurse-patient interaction and meaning-in-life in a nursing home population. Meaning has been found to be a strong individual predictor of successful ageing and life satisfaction as well as an important psychological variable that promotes well-being. Meaning seems to serve as a mediating variable in both psychological and physical health. Connecting and communicating with others have been seen to facilitate meaning-in-life among older individuals. Cross-sectional descriptive study. The data were collected in 2008-2009 using the Nurse-Patient Interaction Scale and the Purpose-in-Life test. A total of 250 cognitively intact nursing home patients met the inclusion criteria and 202 (81%) participated. A structural equation model of the hypothesized relationship between nurse-patient interaction and meaning was tested by means of LISREL 8.8. The structural equation model fit well with the data. A significant direct relationship between nurse-patient interaction and meaning-in-life in cognitively intact nursing home patients was displayed. Nurse-patient interaction significantly relates to meaning and purpose-in-life among cognitively intact nursing home patients and might be an important resource in relation to the patient's mental health and global well-being. High-quality nurse-patient interaction and in-house activities aiming to increase patients' meaning might increase psychological and physical health, well-being and psycho-spiritual functioning in this vulnerable population. © 2013 John Wiley & Sons Ltd.

Cost-effectiveness analysis using data from multinational trials: The use of bivariate hierarchical modelling

PubMed Central

Manca, Andrea; Lambert, Paul C; Sculpher, Mark; Rice, Nigel

2008-01-01

Healthcare cost-effectiveness analysis (CEA) often uses individual patient data (IPD) from multinational randomised controlled trials. Although designed to account for between-patient sampling variability in the clinical and economic data, standard analytical approaches to CEA ignore the presence of between-location variability in the study results. This is a restrictive limitation given that countries often differ in factors that could affect the results of CEAs, such as the availability of healthcare resources, their unit costs, clinical practice, and patient case-mix. We advocate the use of Bayesian bivariate hierarchical modelling to analyse multinational cost-effectiveness data. This analytical framework explicitly recognises that patient-level costs and outcomes are nested within countries. Using real life data, we illustrate how the proposed methods can be applied to obtain (a) more appropriate estimates of overall cost-effectiveness and associated measure of sampling uncertainty compared to standard CEA; and (b) country-specific cost-effectiveness estimates which can be used to assess the between-location variability of the study results, while controlling for differences in country-specific and patient-specific characteristics. It is demonstrated that results from standard CEA using IPD from multinational trials display a large degree of variability across the 17 countries included in the analysis, producing potentially misleading results. In contrast, ‘shrinkage estimates’ obtained from the modelling approach proposed here facilitate the appropriate quantification of country-specific cost-effectiveness estimates, while weighting the results based on the level of information available within each country. We suggest that the methods presented here represent a general framework for the analysis of economic data collected from different locations. PMID:17641141

A novel de novo activating mutation in STAT3 identified in a patient with common variable immunodeficiency (CVID).

PubMed

Russell, Mark A; Pigors, Manuela; Houssen, Maha E; Manson, Ania; Kelsell, David; Longhurst, Hilary; Morgan, Noel G

2018-02-01

Common variable immunodeficiency (CVID) is characterised by repeated infection associated with primary acquired hypogammaglobulinemia. CVID frequently has a complex aetiology but, in certain cases, it has a monogenic cause. Recently, variants within the gene encoding the transcription factor STAT3 were implicated in monogenic CVID. Here, we describe a patient presenting with symptoms synonymous with CVID, who displayed reduced levels of IgG and IgA, repeated viral infections and multiple additional co-morbidities. Whole-exome sequencing revealed a de novo novel missense mutation in the coiled-coil domain of STAT3 (c.870A>T; p.K290N). Accordingly, the K290N variant of STAT3 was generated, and a STAT3 responsive dual-luciferase reporter assay revealed that the variant strongly enhances STAT3 transcriptional activity both under basal and stimulated (with IL-6) conditions. Overall, these data complement earlier studies in which CVID-associated STAT3 mutations are predicted to enhance transcriptional activity, suggesting that such patients may respond favourably to IL-6 receptor antagonists (e.g. tocilizumab). Copyright © 2017 Elsevier Inc. All rights reserved.

Alacrima as a Harbinger of Adrenal Insufficiency in a Child with Allgrove (AAA) Syndrome

PubMed Central

Brown, Brande; Agdere, Levon; Muntean, Cornelia; David, Karen

2016-01-01

Patient: Female, 6 Final Diagnosis: Allgrove syndrome Symptoms: Achalasia • adrenal insufficiency • alacrima Medication: — Clinical Procedure: — Specialty: Pediatrics and Neonatology Objective: Rare disease Background: Allgrove syndrome, or triple “A” syndrome (3A syndrome), is a rare autosomal recessive syndrome with variable phenotype, and an estimated prevalence of 1 per 1,000,000 individuals. Patients usually display the triad of achalasia, alacrima, and adrenocorticotropin (ACTH) insensitive adrenal insufficiency, though the presentation is inconsistent. Case Report: Here, the authors report a case of Allgrove syndrome in a pediatric patient with delayed diagnosis in order to raise awareness of this potentially fatal disease as a differential diagnosis of alacrima. Conclusions: The prevalence of Allgrove syndrome may be much higher as a result of underdiagnosis and missed diagnosis due to the variable presentation and sudden unexplained childhood death from adrenal crisis. The authors review the characteristic symptoms of Allgrove syndrome in relation to the case study in order to avoid missed or delayed diagnosis, potentially decreasing morbidity, and mortality in those affected by this disease. PMID:27698338

Patient portals and health apps: Pitfalls, promises, and what one might learn from the other.

PubMed

Baldwin, Jessica L; Singh, Hardeep; Sittig, Dean F; Giardina, Traber Davis

2017-09-01

Widespread use of health information technology (IT) could potentially increase patients' access to their health information and facilitate future goals of advancing patient-centered care. Despite having increased access to their health data, patients do not always understand this information or its implications, and digital health data can be difficult to navigate when displayed in a small-format, complex interface. In this paper, we discuss two forms of patient-facing health IT tools-patient portals and applications (apps)-and highlight how, despite several limitations of each, combining high-yield features of mobile health (mHealth) apps with portals could increase patient engagement and self-management and be more effective than either of them alone. Patient portal adoption is variable, and due to design and interface limitations and health literacy issues, many people find the portal difficult to use. Conversely, apps have experienced rapid adoption and traditionally have more consumer-friendly features with easy log-in access, real-time tracking, and simplified data display. These features make the applications more intuitive and easy-to-use than patient portals. While apps have their own limitations and might serve different purposes, patient portals could adopt some high-yield features and functions of apps that lead to engagement success with patients. We thus suggest that to improve user experience with future portals, developers could look towards mHealth apps in design, function, and user interface. Adding new features to portals may improve their use and empower patients to track their overall health and disease states. Nevertheless, both these health IT tools should be subjected to rigorous evaluation to ensure they meet their potential in improving patient outcomes. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Postural stability in patients with knee osteoarthritis: comparison with controls and evaluation of relationships between postural stability scores and International Classification of Functioning, Disability and Health components.

PubMed

Hsieh, Ru-Lan; Lee, Wen-Chung; Lo, Min-Tzu; Liao, Wei-Cheng

2013-02-01

To assess the differences in postural stability between patients with knee osteoarthritis and controls without knee osteoarthritis, and to evaluate possible relations between postural stability scores and International Classification of Functioning, Disability and Health (ICF) components. An age-matched, case-controlled trial with a cross-sectional design. A teaching hospital. Patients with knee osteoarthritis (n=73) and age-matched controls (n=60). Data on patients' postural stability and additional health-related variables were collected using various instruments. These included the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory, the World Health Organization Quality of Life Brief Version, the physical function test (chair-rising time), the Chinese version of the Western Ontario and McMaster Universities Osteoarthritis Index, the Chinese version of the Knee Injury and Osteoarthritis Outcome Score, and the Biodex Stability System. A comparison of postural stability in patients with knee osteoarthritis versus that of controls was performed. The relation between postural stability scores for patients with knee osteoarthritis and ICF components was evaluated. Pearson correlation tests were used to determine the variables that correlated with postural stability among these patients. Patients with knee osteoarthritis displayed lower overall postural stability than controls (scores of 0.7 vs. 0.5, P=.006) and scored lower on the environmental domain of the World Health Organization Quality of Life Brief Version (62.2 vs 66.8, P=.014). For patients with knee osteoarthritis, postural stability was weakly associated with the ICF components of body functions and structures, including pain (r=.33-.34, P=.004), physical fatigue (r=.28, P=.016), and reduced motivation (r=.30, P=.011). Weak to moderate associations between postural stability and the ICF components of activities and participation were found; the relevant ICF variables included reduced activity (r=.38, P=.001), physical domain and function (r=.34-.48, P=.001 to P<.004), activities of daily living (r=.51, P<.001), and sports and recreation (r=.35, P=.003). A moderate association between postural stability and the ICF components of personal and environmental factors was observed, including age (r=.52, P<.001) and quality of life (r=0.4, P=.001). Patients with knee osteoarthritis displayed lower postural stability and achieved lower scores in the environmental domain of quality-of-life measures than did controls. The postural stability of patients with knee osteoarthritis was weakly to moderately associated with the following ICF components: body functions and structures, activities and participation, and personal and environmental factors. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Usability Comparisons of Head-Mounted vs. Stereoscopic Desktop Displays in a Virtual Reality Environment with Pain Patients.

PubMed

Tong, Xin; Gromala, Diane; Gupta, Dimple; Squire, Pam

2016-01-01

Researchers have shown that immersive Virtual Reality (VR) can serve as an unusually powerful pain control technique. However, research assessing the reported symptoms and negative effects of VR systems indicate that it is important to ascertain if these symptoms arise from the use of particular VR display devices, particularly for users who are deemed "at risk," such as chronic pain patients Moreover, these patients have specific and often complex needs and requirements, and because basic issues such as 'comfort' may trigger anxiety or panic attacks, it is important to examine basic questions of the feasibility of using VR displays. Therefore, this repeated-measured experiment was conducted with two VR displays: the Oculus Rift's head-mounted display (HMD) and Firsthand Technologies' immersive desktop display, DeepStream3D. The characteristics of these immersive desktop displays differ: one is worn, enabling patients to move their heads, while the other is peered into, allowing less head movement. To assess the severity of physical discomforts, 20 chronic pain patients tried both displays while watching a VR pain management demo in clinical settings. Results indicated that participants experienced higher levels of Simulator Sickness using the Oculus Rift HMD. However, results also indicated other preferences of the two VR displays among patients, including physical comfort levels and a sense of immersion. Few studies have been conducted that compare usability of specific VR devices specifically with chronic pain patients using a therapeutic virtual environment in pain clinics. Thus, the results may help clinicians and researchers to choose the most appropriate VR displays for chronic pain patients and guide VR designers to enhance the usability of VR displays for long-term pain management interventions.

A novel approach to patient self-monitoring of sonographic examinations using a head-mounted display.

PubMed

Inoue, Masaharu; Kihara, Kazunori; Yoshida, Soichiro; Ito, Masaya; Takeshita, Hideki; Ishioka, Junichiro; Matsuoka, Yoh; Numao, Noboru; Saito, Kazutaka; Fujii, Yasuhisa

2015-01-01

Patients' use of a head-mounted display during their sonographic examinations could provide them with information about their diseases in real time and might help improve "patient-centered care." We conducted this prospective study to evaluate the feasibility of a modern head-mounted display for patient self-monitoring of sonographic examinations. In November and December 2013, 58 patients were enrolled. Patients wore a head-mounted display (HMZ-T2; Sony Corporation, Tokyo, Japan) during their sonographic examinations and watched their own images in real time. After the sonographic examinations, the patients completed a questionnaire, in which they evaluated the utility of the head-mounted display, their understanding of their diseases, their satisfaction with using the head-mounted display, and any adverse events. Until November 26, 2013, patients' names were requested on the questionnaire; after that date, the questionnaire was changed to be anonymous. Of the 58 patients, 56 (97%) elected to participate in this study. The head-mounted display was reported to have good image quality by 42 patients (75%) and good wearability by 39 (70%). Thirty-six patients (64%) reported they had deepened their understanding of their diseases. There were no major complications, and only 2 patients (4%) had mild eye fatigue. There was no significant association between questionnaire results and patient characteristics. None of the questionnaire results changed significantly after the questionnaire was made anonymous. The use of a modern head-mounted display by patients during sonographic examinations provided good image quality with acceptable wearability. It could deepen their understanding of their diseases and help develop patient-centered care. © 2015 by the American Institute of Ultrasound in Medicine.

Generalized anxiety disorder, comorbid major depression and heart rate variability: a case-control study in taiwan.

PubMed

Chang, Hsin-An; Chang, Chuan-Chia; Tzeng, Nian-Sheng; Kuo, Terry B J; Lu, Ru-Band; Huang, San-Yuan

2013-12-01

Decreased heart rate variability (HRV) has been reported in generalized anxiety disorder (GAD), but the results are mixed. Little is known about the impact of comorbid major depression (MD) on HRV in GAD patients. Both issues necessitate further investigation. Twenty unmedicated, physically healthy GAD patients, 20 GAD patients with a secondary diagnosis of MD, 40 MD patients and 60 matched controls were recruited. We used the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale to assess anxiety and depression severity, respectively. Cardiac autonomic function was evaluated by measuring HRV parameters. Frequency-domain indices of HRV were obtained. Three patient groups had more anxiety and depression symptoms than control subjects, but heart rates (HRs) were significantly elevated only in GAD patients with comorbid depression. Relative to controls, GAD patients had reduced HRV while GAD patients with comorbid depression displayed the greatest reductions in HRV among three patients groups. Correlation analyses revealed anxiety/depression severity significantly associated with HRs, variance, LF-HRV and HF-HRV. However, separately analyzing among individual groups and adjusting for HRV-associated covariables rendered the correlations non-significant. Our results suggest that reduction in HRV is a psychophysiological marker of GAD and individuals with comorbid GAD and MD may be distinguished based on psychophysiological correlates (for example, HF-HRV) from non-comorbid GAD patients. Taken into account that comorbid depression may confer increased risks for cardiovascular events in GAD patients, this subgroup of GAD patients may benefit better from cardiovascular risk reduction strategies.

New developments in flexible cholesteric liquid crystal displays

NASA Astrophysics Data System (ADS)

Schneider, Tod; Davis, Donald J.; Franklin, Sean; Venkataraman, Nithya; McDaniel, Diaz; Nicholson, Forrest; Montbach, Erica; Khan, Asad; Doane, J. William

2007-02-01

Flexible Cholesteric liquid crystal displays have been rapidly maturing into a strong contender in the flexible display market. Encapsulation of the Cholesteric liquid crystal permits the use of flexible plastic substrates and roll-to-roll production. Recent advances include ultra-thin displays, laser-cut segmented displays of variable geometry, and smart card applications. Exciting technologies such as simultaneous laser-edge sealing and singulation enable high volume production, excellent quality control and non-traditional display geometries and formats.

Losing dexterity: patterns of impaired coordination of finger movements in musician’s dystonia

PubMed Central

Furuya, Shinichi; Tominaga, Kenta; Miyazaki, Fumio; Altenmüller, Eckart

2015-01-01

Extensive training can bring about highly-skilled action, but may also impair motor dexterity by producing involuntary movements and muscular cramping, as seen in focal dystonia (FD) and tremor. To elucidate the underlying neuroplastic mechanisms of FD, the present study addressed the organization of finger movements during piano performance in pianists suffering from the condition. Principal component (PC) analysis identified three patterns of fundamental joint coordination constituting finger movements in both patients and controls. The first two coordination patterns described less individuated movements between the “dystonic” finger and key-striking fingers for patients compared to controls. The third coordination pattern, representing the individuation of movements between the middle and ring fingers, was evident during a sequence of strikes with these fingers in controls, which was absent in the patients. Consequently, rhythmic variability of keystrokes was more pronounced during this sequence of strikes for the patients. A stepwise multiple-regression analysis further identified greater variability of keystrokes for individuals displaying less individuated movements between the affected and striking fingers. The findings suggest that FD alters dexterous joint coordination so as to lower independent control of finger movements, and thereby degrades fine motor control. PMID:26289433

The effects of display variables and secondary loading on the dual axis critical task performance

NASA Technical Reports Server (NTRS)

Swisher, G. M.; Nataraj, S.

1973-01-01

The effects of scanning displays for separated instruments, separated versus combined displays, and the effects of secondary loading are investigated. An operator rating scale for handling qualities is established analogous to the Cooper Harper Scale.

Impact of marital status during diagnosis on cancer-caused specific survival in acute myeloid leukemia patients: a case-control and population-based study

PubMed Central

Zheng, Zhuojun; Zhu, Yuandong; Li, Xiaodong; Hu, Wenwei; Jiang, Jingting

2017-01-01

Objective This study investigated the impact of marital status on cancer-caused specific mortality among acute myeloid leukemia (AML) patients in the United States. Methods We used the Surveillance, Epidemiology and End Results program to identify 50,825 patients who had their clinical and follow-up information available and were diagnosed for AML between the years 1988 and 2015. The univariate and multivariable Cox regression models were used to analyze the patient data, and to minimize the group differences due to covariates between groups, a 1:1 propensity score matching was used in subsequent subgroup analysis. Results Our study demonstrated that married patients were less likely to die due to AML after adjusting for demographic and clinicopathological variables, than patients with variable unmarried status. Further analysis indicated that widowed, divorced and never married status correlated with poor cancer-cause specific survival than being married in almost all subgroups after being adjusted for the aforementioned variables (P<0.05). However, the difference between married and separated was not apparent. Moreover, similar survival analysis results were also observed in the 1:1 matched subgroups of marital status, but they displayed varied prognostic factors between them. The association of survival benefit with marriage in AML was consistent with the published survival benefit of conventional therapeutic approaches. Conclusion Overall, our study concluded that unmarried AML patients were at greater risk of cancer-specific mortality than married, and thus indicated that physicians should focus on health care strategies that target social support, in order to reduce the cancer-specific mortality in unmarried patients. PMID:28977979

Association between ratings of facial attractivess and patients' motivation for orthognathic surgery.

PubMed

Vargo, J K; Gladwin, M; Ngan, P

2003-02-01

To compare the judgments of facial esthetics, defects and treatment needs between laypersons and professionals (orthodontists and oral surgeons) as predictors of patient's motivation for orthognathic surgery. Two panels of expert and naïve raters were asked to evaluate photographs of orthognathic surgery patients for facial esthetics, defects and treatment needs. Results were correlated with patients' motivation for surgery. Fifty-seven patients (37 females and 20 males) with a mean age of 26.0 +/- 6.7 years were interviewed prior to orthognathic surgery treatment. Three color photographs of each patient were evaluated by a panel of 14 experts and panel of 18 laypersons. Each panel of raters were asked to evaluate the facial morphology, facial attractiveness and recommend surgical treatment (independent variables). The dependent variable was the patient's motivation for orthognathic surgery. Outcome measure--Reliability of raters were analyzed using an unweighted Kappa coefficient and a Cronbach alpha coefficient. Correlations and regression analyses were used to quantify the relationship between variables. Expert raters provided reliable ratings of certain morphological features such as excessive gingival display and classification of mandibular facial form and position. Based on the facial photographs both expert and naïve raters agreed on facial attractiveness of patients. The best predictors of patients' motivation for surgery were the naïve profile attractiveness rating and the patients' expected change in self-consciousness. Expert raters provide more reliable ratings on certain morphologic features. However, the layperson's profile attractiveness rating and the patients' expected change in self-consciousness were the best predictors for patients' motivation for surgery. These data suggest that patients' motives for treatment are not necessarily related to objectively determined need. Patients' decision to seek treatment was more correlated to laypersons' rating of attractiveness because they see what other laypersons see, and are directly or indirectly affected by others reactions to their appearance. These findings may provide useful information for clinicians in counseling patients who seek orthognathic surgery.

Internal Hydrolysis Indicator for Sample Specific Monitoring of β-Glucuronidase Activity.

PubMed

Taylor, Lacy L; Flint, Noah A; Ma, Vinh; Hill, Brandy M; Clark, Chantry J; Strathmann, Frederick G

2017-06-01

Metabolized forms of benzodiazepines (benzos) can cause issues with mass spectrometry identification. Benzodiazepines undergo a process called glucuronidation during metabolism that attaches a glucuronic acid for increased solubility. Often in clinical testing an enzymatic hydrolysis step is implemented to increase the sensitivity of benzodiazepines by hydrolyzing β-D-glucuronic acid from benzodiazepine-glucuronide conjugates in urine samples using the β-Glucuronidase enzyme. In this study resorufin β-D-glucuronide, a substrate of the β-Glucuronidase enzyme, was added to patient samples to determine if proper hydrolysis had occurred. The presence of resorufin as an Internal Hydrolysis Indicator (IHI) shows the activity and efficiency of the enzyme in each patient sample. Synthetic/patient urine samples were obtained and mixed with hydrolysis buffer containing resorufin β-D-glucuronide. The β-Glucuronidase enzyme was used to hydrolyze the benzodiazepine analytes as well as resorufin β-D-glucuronide. The enzymatic hydrolysis addition increased the positivity rate of benzodiazepines by 42.5%. The β-Glucuronidase substrate resorufin (IHI) displayed variability in area counts between patient samples. Comparative studies with internal standards and resorufin (IHI) showed no correlation between recovery and analyte variability. Hydrolysis reactions greatly improved the sensitivity of benzodiazepines by liquid chromatography time-of-flight mass spectrometry analysis. The large variation in resorufin (IHI) area counts amongst patient samples indicates possible variability in enzymatic hydrolysis activity. The enzymatic hydrolysis step is a part of the extraction procedure and should be controlled for in each patient sample. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Exploring High-D Spaces with Multiform Matrices and Small Multiples

PubMed Central

MacEachren, Alan; Dai, Xiping; Hardisty, Frank; Guo, Diansheng; Lengerich, Gene

2011-01-01

We introduce an approach to visual analysis of multivariate data that integrates several methods from information visualization, exploratory data analysis (EDA), and geovisualization. The approach leverages the component-based architecture implemented in GeoVISTA Studio to construct a flexible, multiview, tightly (but generically) coordinated, EDA toolkit. This toolkit builds upon traditional ideas behind both small multiples and scatterplot matrices in three fundamental ways. First, we develop a general, MultiForm, Bivariate Matrix and a complementary MultiForm, Bivariate Small Multiple plot in which different bivariate representation forms can be used in combination. We demonstrate the flexibility of this approach with matrices and small multiples that depict multivariate data through combinations of: scatterplots, bivariate maps, and space-filling displays. Second, we apply a measure of conditional entropy to (a) identify variables from a high-dimensional data set that are likely to display interesting relationships and (b) generate a default order of these variables in the matrix or small multiple display. Third, we add conditioning, a kind of dynamic query/filtering in which supplementary (undisplayed) variables are used to constrain the view onto variables that are displayed. Conditioning allows the effects of one or more well understood variables to be removed from the analysis, making relationships among remaining variables easier to explore. We illustrate the individual and combined functionality enabled by this approach through application to analysis of cancer diagnosis and mortality data and their associated covariates and risk factors. PMID:21947129

Variation of normal tissue complication probability (NTCP) estimates of radiation-induced hypothyroidism in relation to changes in delineation of the thyroid gland.

PubMed

Rønjom, Marianne F; Brink, Carsten; Lorenzen, Ebbe L; Hegedüs, Laszlo; Johansen, Jørgen

2015-01-01

To examine the variations of risk-estimates of radiation-induced hypothyroidism (HT) from our previously developed normal tissue complication probability (NTCP) model in patients with head and neck squamous cell carcinoma (HNSCC) in relation to variability of delineation of the thyroid gland. In a previous study for development of an NTCP model for HT, the thyroid gland was delineated in 246 treatment plans of patients with HNSCC. Fifty of these plans were randomly chosen for re-delineation for a study of the intra- and inter-observer variability of thyroid volume, Dmean and estimated risk of HT. Bland-Altman plots were used for assessment of the systematic (mean) and random [standard deviation (SD)] variability of the three parameters, and a method for displaying the spatial variation in delineation differences was developed. Intra-observer variability resulted in a mean difference in thyroid volume and Dmean of 0.4 cm(3) (SD ± 1.6) and -0.5 Gy (SD ± 1.0), respectively, and 0.3 cm(3) (SD ± 1.8) and 0.0 Gy (SD ± 1.3) for inter-observer variability. The corresponding mean differences of NTCP values for radiation-induced HT due to intra- and inter-observer variations were insignificantly small, -0.4% (SD ± 6.0) and -0.7% (SD ± 4.8), respectively, but as the SDs show, for some patients the difference in estimated NTCP was large. For the entire study population, the variation in predicted risk of radiation-induced HT in head and neck cancer was small and our NTCP model was robust against observer variations in delineation of the thyroid gland. However, for the individual patient, there may be large differences in estimated risk which calls for precise delineation of the thyroid gland to obtain correct dose and NTCP estimates for optimized treatment planning in the individual patient.

A comparison of plasma homovanillic acid in the deficit and nondeficit subtypes of schizophrenia.

PubMed

Ribeyre, J M; Lesieur, P; Varoquaux, O; Dollfus, S; Pays, M; Petit, M

1994-08-15

Plasma homovanillic acid (pHVA) was measured over a 13 hr-period in 16 DMS-III-R schizophrenic patients, all treated with neuroleptic drugs and in a stable clinical and therapeutic status for the preceeding 12 months. Patients were categorized into deficit (n = 9) and nondeficit (n = 7) forms of schizophrenia according to the Schedule for the Deficit Syndrome (SDS) criteria. As compared to the nondeficit group, deficit patients display significantly lower mean pHVA concentrations from 9 AM to 12 AM and a lack of diurnal variations. None of the demographic, clinical, and therapeutic variables can explain these biological differences. These data suggest a specific biochemical basis for the deficit syndrome of schizophrenia as defined by the SDS criteria, that is, primary, enduring, negative symptoms.

Data recording and trend display during anaesthesia using 'MacLab'.

PubMed

Kennedy, R R

1991-08-01

A single screen display of variables monitored during anaesthesia may be ergonomically superior to the 'stack' of monitors seen in many anaesthetising locations. A system based on a MacLab (Analogue Digital Instruments) analogue-to-digital convertor used in conjunction with a Macintosh computer was evaluated. The system was configured to provide trend displays of up to eight variables on a single screen. It was found to be a useful adjunct to monitoring during anaesthesia. Advantages of this system are low cost, flexibility, and the quality of the software and support provided. Limitations of this and other similar systems are discussed.

Fish Allergens at a Glance: Variable Allergenicity of Parvalbumins, the Major Fish Allergens

PubMed Central

Kuehn, Annette; Swoboda, Ines; Arumugam, Karthik; Hilger, Christiane; Hentges, François

2014-01-01

Fish is a common trigger of severe, food-allergic reactions. Only a limited number of proteins induce specific IgE-mediated immune reactions. The major fish allergens are the parvalbumins. They are members of the calcium-binding EF-hand protein family characterized by a conserved protein structure. They represent highly cross-reactive allergens for patients with specific IgE to conserved epitopes. These patients might experience clinical reactions with various fish species. On the other hand, some individuals have IgE antibodies directed against unique, species-specific parvalbumin epitopes, and these patients show clinical symptoms only with certain fish species. Furthermore, different parvalbumin isoforms and isoallergens are present in the same fish and might display variable allergenicity. This was shown for salmon homologs, where only a single parvalbumin (beta-1) isoform was identified as allergen in specific patients. In addition to the parvalbumins, several other fish proteins, enolases, aldolases, and fish gelatin, seem to be important allergens. New clinical and molecular insights advanced the knowledge and understanding of fish allergy in the last years. These findings were useful for the advancement of the IgE-based diagnosis and also for the management of fish allergies consisting of advice and treatment of fish-allergic patients. PMID:24795722

6-mercaptopurine influences TPMT gene transcription in a TPMT gene promoter variable number of tandem repeats-dependent manner.

PubMed

Kotur, Nikola; Stankovic, Biljana; Kassela, Katerina; Georgitsi, Marianthi; Vicha, Anna; Leontari, Iliana; Dokmanovic, Lidija; Janic, Dragana; Krstovski, Nada; Klaassen, Kristel; Radmilovic, Milena; Stojiljkovic, Maja; Nikcevic, Gordana; Simeonidis, Argiris; Sivolapenko, Gregory; Pavlovic, Sonja; Patrinos, George P; Zukic, Branka

2012-02-01

TPMT activity is characterized by a trimodal distribution, namely low, intermediate and high methylator. TPMT gene promoter contains a variable number of GC-rich tandem repeats (VNTRs), namely A, B and C, ranging from three to nine repeats in length in an A(n)B(m)C architecture. We have previously shown that the VNTR architecture in the TPMT gene promoter affects TPMT gene transcription. MATERIALS, METHODS & RESULTS: Here we demonstrate, using reporter assays, that 6-mercaptopurine (6-MP) treatment results in a VNTR architecture-dependent decrease of TPMT gene transcription, mediated by the binding of newly recruited protein complexes to the TPMT gene promoter, upon 6-MP treatment. We also show that acute lymphoblastic leukemia patients undergoing 6-MP treatment display a VNTR architecture-dependent response to 6-MP. These data suggest that the TPMT gene promoter VNTR architecture can be potentially used as a pharmacogenomic marker to predict toxicity due to 6-MP treatment in acute lymphoblastic leukemia patients.

The Viewing Geometry of Brown Dwarfs Influences Their Observed Colors and Variability Amplitudes

NASA Astrophysics Data System (ADS)

Vos, Johanna M.; Allers, Katelyn N.; Biller, Beth A.

2017-06-01

In this paper we study the full sample of known Spitzer [3.6 μm] and J-band variable brown dwarfs. We calculate the rotational velocities, v\\sin I, of 16 variable brown dwarfs using archival Keck NIRSPEC data and compute the inclination angles of 19 variable brown dwarfs. The results obtained show that all objects in the sample with mid-IR variability detections are inclined at an angle > 20^\\circ , while all objects in the sample displaying J-band variability have an inclination angle > 35^\\circ . J-band variability appears to be more affected by inclination than Spitzer [3.6 μm] variability, and is strongly attenuated at lower inclinations. Since J-band observations probe deeper into the atmosphere than mid-IR observations, this effect may be due to the increased atmospheric path length of J-band flux at lower inclinations. We find a statistically significant correlation between the color anomaly and inclination of our sample, where field objects viewed equator-on appear redder than objects viewed at lower inclinations. Considering the full sample of known variable L, T, and Y spectral type objects in the literature, we find that the variability properties of the two bands display notably different trends that are due to both intrinsic differences between bands and the sensitivity of ground-based versus space-based searches. However, in both bands we find that variability amplitude may reach a maximum at ˜7-9 hr periods. Finally, we find a strong correlation between color anomaly and variability amplitude for both the J-band and mid-IR variability detections, where redder objects display higher variability amplitudes.

Context-based electronic health record: toward patient specific healthcare.

PubMed

Hsu, William; Taira, Ricky K; El-Saden, Suzie; Kangarloo, Hooshang; Bui, Alex A T

2012-03-01

Due to the increasingly data-intensive clinical environment, physicians now have unprecedented access to detailed clinical information from a multitude of sources. However, applying this information to guide medical decisions for a specific patient case remains challenging. One issue is related to presenting information to the practitioner: displaying a large (irrelevant) amount of information often leads to information overload. Next-generation interfaces for the electronic health record (EHR) should not only make patient data easily searchable and accessible, but also synthesize fragments of evidence documented in the entire record to understand the etiology of a disease and its clinical manifestation in individual patients. In this paper, we describe our efforts toward creating a context-based EHR, which employs biomedical ontologies and (graphical) disease models as sources of domain knowledge to identify relevant parts of the record to display. We hypothesize that knowledge (e.g., variables, relationships) from these sources can be used to standardize, annotate, and contextualize information from the patient record, improving access to relevant parts of the record and informing medical decision making. To achieve this goal, we describe a framework that aggregates and extracts findings and attributes from free-text clinical reports, maps findings to concepts in available knowledge sources, and generates a tailored presentation of the record based on the information needs of the user. We have implemented this framework in a system called Adaptive EHR, demonstrating its capabilities to present and synthesize information from neurooncology patients. This paper highlights the challenges and potential applications of leveraging disease models to improve the access, integration, and interpretation of clinical patient data. © 2012 IEEE

Information presentation through a head-worn display (“smart glasses”) has a smaller influence on the temporal structure of gait variability during dual-task gait compared to handheld displays (paper-based system and smartphone)

PubMed Central

Sedighi, Alireza; Ulman, Sophia M.

2018-01-01

The need to complete multiple tasks concurrently is a common occurrence both daily life and in occupational activities, which can often include simultaneous cognitive and physical demands. As one example, there is increasing availability of head-worn display technologies that can be employed when a user is mobile (e.g., while walking). This new method of information presentation may, however, introduce risks of adverse outcomes such as a decrement to gait performance. The goal of this study was thus to quantify the effects of a head-worn display (i.e., smart glasses) on motor variability during gait and to compare these effects with those of other common information displays (i.e., smartphone and paper-based system). Twenty participants completed four walking conditions, as a single task and in three dual-task conditions (three information displays). In the dual-task conditions, the information display was used to present several cognitive tasks. Three different measures were used to quantify variability in gait parameters for each walking condition (using the cycle-to-cycle standard deviation, sample entropy, and the “goal-equivalent manifold” approach). Our results indicated that participants used less adaptable gait strategies in dual-task walking using the paper-based system and smartphone conditions compared with single-task walking. Gait performance, however, was less affected during dual-task walking with the smart glasses. We conclude that the risk of an adverse gait event (e.g., a fall) in head-down walking conditions (i.e., the paper-based system and smartphone conditions) were higher than in single-task walking, and that head-worn displays might help reduce the risk of such events during dual-task gait conditions. PMID:29630614

Esthetics: patients' perceptions of dental attractiveness.

PubMed

Dunn, W J; Murchison, D F; Broome, J C

1996-09-01

The importance of dentofacial attractiveness to the psychosocial well-being of an individual has been well established. Very little information is available regarding dental patient perceptions of a pleasing esthetic image. The purpose of this study was to identify factors distinctive to attractive smiles versus unattractive smiles, as perceived by patients. Standardized format photographs (5 x 7 in, matte finish, at f-32 and 1:2 magnification) of eight male and eight female smiles, framing only lips and teeth, were viewed by 297 subjects. The smiles exhibited differences in symmetry, tooth shade, number of teeth displayed, and height of maxillary lip line, and included both restored and unrestored teeth. Respondents ranked the photographs in order from most to least appealing appearance. Respondents viewed each series of photographs in a similar lighting and time period. A questionnaire identified the respondent's age, sex, race, education, income, and home town. Twenty-five demographic groups were established from the information in the questionnaire. Data were analyzed using stepwise discriminant analysis to determine the combination of smile characteristics that best predicted the ranking. The same female smile was chosen as the most attractive by 24 of the 25 demographic groups. This smile is characterized by natural teeth having light shade, high lip line, a large display of teeth, and radiating symmetry. Two female smiles typified by darker shade and asymmetry were rated by all groups as being least attractive. Two male smiles were judged equal as the most pleasing esthetically. Respondents favored those smiles characterized by light shade, a moderate display of teeth, moderate lip line, and a symmetrical arrangement of teeth. One male smile characterized by darker shade was rated as least attractive. In all cases, tooth shade was the most important factor, followed in sequence by unrestored natural teeth and number of teeth displayed. No correlation was found to exist between specific demographic groups and smile variables.

Fusobacterium nucleatum in endodontic flare-ups.

PubMed

Chávez de Paz Villanueva, Luis Eduardo

2002-02-01

The extent to which Fusobacterium nucleatum is recovered from root canals of teeth that present with an interappointment flare-up following endodontic instrumentation was investigated. Included in the study were 28 patients that sought emergency treatment after initiation of root canal therapy. Only non-painful teeth that had been treated because of a necrotic pulp and periapical inflammatory lesion were studied. Root canal samples for bacterial analysis were taken, transported to a bacteriological laboratory, and processed for a semiquantitative assessment of bacterial isolates. Bacterial findings were correlated with self-assessed pain intensity as recorded by means of a Visual Analogue Scale. Clinical presentation of swelling and presence of exudate in the treated root canals were also linked. Bacteria were recovered from all teeth examined. Gram-negative anaerobic coccoid rods (Prevotella species and Porphyromonas species) were frequent isolates. All teeth in patients who were reported to be in severe pain (Visual Analogue Scale > or = 6) displayed F nucleatum. Nine out of 10 of these teeth also had swelling and exudate in the root canals. Samples from the remaining patients that had teeth with less pain score showed a variable bacterial recovery. None of these teeth displayed F nucleatum. F nucleatum appears to be associated with the development of the most severe forms of interappointment endodontic flare-ups.

The Tell-Tale Tasks: A Review of Saccadic Research in Psychiatric Patient Populations

PubMed Central

Gooding, Diane C.; Basso, Michele A.

2008-01-01

This review focuses on saccade research with adult psychiatric patients. It begins with an introduction of the various types of saccades and the tasks used to evoke them. The functional significance of the different types of eye movements is briefly discussed. Research findings regarding the saccadic performance of different adult psychiatric patient populations are discussed in detail, with particular emphasis on findings regarding error rates, response latencies, and any specific task parameters that might affect those variables. Findings regarding the symptom, neurocognitive, and neural correlates of saccadic performance and the functional significance of patients’ saccadic deficits are also discussed. We also discuss the saccadic deficits displayed by various patient groups in terms of circuitry (e.g. cortical/basal ganglia circuits) that may be implicated in the underlying pathophysiology of several of these disorders. Future directions for research in this growing area are offered. PMID:18950927

Programming and execution of movement in Parkinson's disease.

PubMed

Sheridan, M R; Flowers, K A; Hurrell, J

1987-10-01

Programming and execution of arm movements in Parkinson's disease were investigated in choice and simple reaction time (RT) situations in which subjects made aimed movements at a target. A no-aiming condition was also studied. Reaction time was fractionated using surface EMG recording into premotor (central) and motor (peripheral) components. Premotor RT was found to be greater for parkinsonian patients than normal age-matched controls in the simple RT condition, but not in the choice condition. This effect did not depend on the parameters of the impending movement. Thus, paradoxically, parkinsonian patients were not inherently slower at initiating aiming movements from the starting position, but seemed unable to use advance information concerning motor task demands to speed up movement initiation. For both groups, low velocity movements took longer to initiate than high velocity ones. In the no-aiming condition parkinsonian RTs were markedly shorter than when aiming, but were still significantly longer than control RTs. Motor RT was constant across all conditions and was not different for patient and control subjects. In all conditions, parkinsonian movements were around 37% slower than control movements, and their movement times were more variable, the differences showing up early on in the movement, that is, during the initial ballistic phase. The within-subject variability of movement endpoints was also greater in patients. The motor dysfunction displayed in Parkinson's disease involves a number of components: (1) a basic central problem with simply initiating movements, even when minimal programming is required (no-aiming condition); (2) difficulty in maintaining computed forces for motor programs over time (simple RT condition); (3) a basic slowness of movement (bradykinesia) in all conditions; and (4) increased variability of movement in both time and space, presumably caused by inherent variability in force production.

Generalized Anxiety Disorder, Comorbid Major Depression and Heart Rate Variability: A Case-Control Study in Taiwan

PubMed Central

Chang, Hsin-An; Chang, Chuan-Chia; Tzeng, Nian-Sheng; Kuo, Terry B. J.; Lu, Ru-Band

2013-01-01

Objective Decreased heart rate variability (HRV) has been reported in generalized anxiety disorder (GAD), but the results are mixed. Little is known about the impact of comorbid major depression (MD) on HRV in GAD patients. Both issues necessitate further investigation. Methods Twenty unmedicated, physically healthy GAD patients, 20 GAD patients with a secondary diagnosis of MD, 40 MD patients and 60 matched controls were recruited. We used the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale to assess anxiety and depression severity, respectively. Cardiac autonomic function was evaluated by measuring HRV parameters. Frequency-domain indices of HRV were obtained. Results Three patient groups had more anxiety and depression symptoms than control subjects, but heart rates (HRs) were significantly elevated only in GAD patients with comorbid depression. Relative to controls, GAD patients had reduced HRV while GAD patients with comorbid depression displayed the greatest reductions in HRV among three patients groups. Correlation analyses revealed anxiety/depression severity significantly associated with HRs, variance, LF-HRV and HF-HRV. However, separately analyzing among individual groups and adjusting for HRV-associated covariables rendered the correlations non-significant. Conclusion Our results suggest that reduction in HRV is a psychophysiological marker of GAD and individuals with comorbid GAD and MD may be distinguished based on psychophysiological correlates (for example, HF-HRV) from non-comorbid GAD patients. Taken into account that comorbid depression may confer increased risks for cardiovascular events in GAD patients, this subgroup of GAD patients may benefit better from cardiovascular risk reduction strategies. PMID:24474980

Controlling motion sickness and spatial disorientation and enhancing vestibular rehabilitation with a user-worn see-through display.

PubMed

Krueger, Wesley W O

2011-01-01

An eyewear mounted visual display ("User-worn see-through display") projecting an artificial horizon aligned with the user's head and body position in space can prevent or lessen motion sickness in susceptible individuals when in a motion provocative environment as well as aid patients undergoing vestibular rehabilitation. In this project, a wearable display device, including software technology and hardware, was developed and a phase I feasibility study and phase II clinical trial for safety and efficacy were performed. Both phase I and phase II were prospective studies funded by the NIH. The phase II study used repeated measures for motion intolerant subjects and a randomized control group (display device/no display device) pre-posttest design for patients in vestibular rehabilitation. Following technology and display device development, 75 patients were evaluated by test and rating scales in the phase II study; 25 subjects with motion intolerance used the technology in the display device in provocative environments and completed subjective rating scales, whereas 50 patients were evaluated before and after vestibular rehabilitation (25 using the display device and 25 in a control group) using established test measures. All patients with motion intolerance rated the technology as helpful for nine symptoms assessed, and 96% rated the display device as simple and easy to use. Duration of symptoms significantly decreased with use of the technology displayed. In patients undergoing vestibular rehabilitation, there were no significant differences in amount of change from pre- to posttherapy on objective balance tests between display device users and controls. However, those using the technology required significantly fewer rehabilitation sessions to achieve those outcomes than the control group. A user-worn see-through display, utilizing a visual fixation target coupled with a stable artificial horizon and aligned with user movement, has demonstrated substantial benefit for individuals susceptible to motion intolerance and spatial disorientation and those undergoing vestibular rehabilitation. The technology developed has applications in any environment where motion sensitivity affects human performance.

Factors influencing adherence among Irish haemodialysis patients.

PubMed

Mellon, Lisa; Regan, Daniel; Curtis, Ruth

2013-07-01

Adherence to dietary and fluid restrictions among haemodialysis patients with end stage renal failure (ESRD) is a multi-factorial concept. This study seeks to assess the predictive value of demographic and psychological variables in non-adherence. A multi-centre cross sectional design assessed 50 haemodialysis patients on self reported adherence, attitudes towards dietary restrictions, quality of life, depression and anxiety. Adherence to fluid and dietary restrictions was measured objectively using potassium (K), phosphorus (PO4) and inter-dialytic weight gain (IDWG) parameters. 62% of patients were non-adherent with at least one aspect of the treatment regime. Regression analysis revealed age as significantly associated with adherence, in particular IDWG, with younger patients displaying poorer adherence. Younger patients may experience greater difficulty integrating complex treatment demands into their lifestyles, and non-adherence may be a consequence of the severe lifestyle limitations imposed by the haemodialysis treatment regime. Individualised interventions may be more effective than traditional methods of adherence monitoring in reducing the non-adherent behaviour. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

User Expectations for Media Sharing Practices in Open Display Networks

PubMed Central

Jose, Rui; Cardoso, Jorge C. S.; Hong, Jason

2015-01-01

Open Display Networks have the potential to allow many content creators to publish their media to an open-ended set of screen displays. However, this raises the issue of how to match that content to the right displays. In this study, we aim to understand how the perceived utility of particular media sharing scenarios is affected by three independent variables, more specifically: (a) the locativeness of the content being shared; (b) how personal that content is and (c) the scope in which it is being shared. To assess these effects, we composed a set of 24 media sharing scenarios embedded with different treatments of our three independent variables. We then asked 100 participants to express their perception of the relevance of those scenarios. The results suggest a clear preference for scenarios where content is both local and directly related to the person that is publishing it. This is in stark contrast to the types of content that are commonly found in public displays, and confirms the opportunity that open displays networks may represent a new media for self-expression. This novel understanding may inform the design of new publication paradigms that will enable people to share media across the display networks. PMID:26153770

Open-refrigerated retail display case temperature profile and its impact on product quality and microbiota of stored baby spinach

USDA-ARS?s Scientific Manuscript database

Open-refrigerated display cabinets are widely used in supermarkets and grocery chains around the globe. However, the temperature conditions in these display cases are variable which may impact product quality and safety. Therefore, we investigated the quality and microbiological populations of bagge...

When authenticity matters most: Physicians' regulation of emotional display and patient satisfaction.

PubMed

Yagil, Dana; Shnapper-Cohen, Moran

2016-10-01

The emotions expressed by physicians in medical encounters have significant impact on health outcomes and patient satisfaction. This study explored how physicians' regulation of displayed emotions affects patients' satisfaction, under low and high levels of patient distress and length of physician-patient acquaintance. Questionnaires were administered to 46 physicians and 230 of their patients (before and after the medical encounter) in outpatient clinics of two hospitals. Data were analyzed with hierarchical linear modeling which takes the nested data structure into account. We found a significant interaction effect of physician regulation of displayed emotions and patient distress on satisfaction: When distress was high, physician regulation of emotions was negatively related to patient satisfaction. The results also show a significant interaction effect of physician regulation of displayed emotions and length of physician-patient acquaintance: With a longer acquaintance, physician regulation of emotions was negatively related to patient satisfaction. The effect of the physicians' emotional display on patient satisfaction depends on contextual factors, such as patient distress and length of physician-patient acquaintance, which affect patients' emotional needs and expectations. When patients have high emotional involvement in the encounter it is suggested that physicians consider presenting genuine emotions to patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[PATHOGENETIC ASPECTS OF REHABILITATION OF PATIENTS AFTER CHOLECYSTECTOMY].

PubMed

Efendiyeva, M T; Abdurakhmanova, A Z

2015-01-01

Investigation of efficiency of liquid synbiotics and structure-resonance electric magnetic therapy (SRMT) among patients after cholecystectomy. 90 patients after cholecystectomy have been investigated (CE). Along with general clinical meth-ods of investigation, patients passed US investigation of abdomen, biochemical blood tests, bacteriological test of faeces, investigation of short-chain fatty acids (SCFA) by gas-liquid osteal chromatographic analysis. State of vegetative nervous system passed analysis according to variability of heart rhythm (VHR) by spectral analysis method using "Cardiac technic 4000 AD" cardiac monitor in frame of 24-hr ECG monitoring. Estimation of life quality (LQ) of patients after cholecystectomy has been conducted by "SF-36 Health status survey". Patients have been divided into 3 groups, comparable according to the main clinical and functional indicators. Patients of first group (30 people) passed correction of dysbiosis by liquid synbiotics. Patients of a second group (30 persons) passed complex treatment of SRMT and liquid synbiotics. Control group was composed by 30 patients after cholecystectomy who had been receiving diet therapy. In term of investigation 90% of patients have shown decrease of number and methabolic activity of microflora, change of activity of anaerobic microorganisms. Analysis of variability of heart rhythm have displayed relative prevalence of sympathetic modulation of a rhythm on the background of elevated ergotropic component of the total capacity of a spectrum; estimation of life quality (LQ) has shown that limitation of physical activity is a most considerable contribution to decrease of LQ among patients after cholecystectomy. After a course of liquid synbiotics and SMRT recovery and improvement of intestines and improvement of all indicator of life quality is observed.

Head and cervical spine postures in complete denture wearers.

PubMed

Salonen, M A; Raustia, A M; Huggare, J

1993-01-01

Signs and symptoms in the stomatognathic system and head and cervical spine postures were evaluated in 10 edentulous patients prior to renewal of their dentures, as well as immediately and six months after insertion of new dentures. Natural head posture was recorded using the fluid-level method and measured from the roentgen cephalograms. It was shown that the variables duration of edentulousness and free-way space displayed positive correlations with the dysfunction symptoms. In addition, the patients who needed oral rehabilitation the most, who received the greatest reduction in their free-way space, were seen to have raised their heads more than average. There was also an inverse correlation between the reduction of clinical dysfunction index score and cervical spine postures.

Spinal neurofibromatosis in a family with classical neurofibromatosis type 1 and a novel NF1 gene mutation.

PubMed

Nicita, Francesco; Torrente, Isabella; Spalice, Alberto; Bottillo, Irene; Papetti, Laura; Pinna, Valentina; Ursitti, Fabiana; Ruggieri, Martino

2014-02-01

Familial spinal neurofibromatosis (FSNF) is a rare form of neurofibromatosis type 1 (NF1) characterized by multiple, histologically proven neurofibromas of the spinal roots leaving no intact segments and associated neurofibromas of major peripheral nerves. It is sometimes associated with other NF1 stigmata. Most patients have NF1 gene mutations. We describe a patient who fulfilled the diagnostic criteria for spinal neurofibromatosis and belonged to a family in which other affected members exhibited classical NF1 stigmata. A novel missense (c.7109 T>A; p.Val2370Asp) mutation in exon 39 of the NF1 gene was present in the affected family members. The family displayed extreme phenotypic variability in the spectrum of NF1. To our knowledge, this is the first patient with spinal neurofibromatosis in the context of classical NF1 with an NF1 gene mutation. The term FSNF is inaccurate as this condition simply reflects the typical autosomal dominant pattern of NF1 inheritance with phenotypoc variability and does not encompass patients with sporadic disease or those in the context of a classical NF1 phenotype as reported in the present family. The term could be replaced by "spinal neurofibromatosis". Copyright © 2013 Elsevier Ltd. All rights reserved.

Monitoring risk-adjusted outcomes in congenital heart surgery: does the appropriateness of a risk model change with time?

PubMed

Tsang, Victor T; Brown, Katherine L; Synnergren, Mats Johanssen; Kang, Nicholas; de Leval, Marc R; Gallivan, Steve; Utley, Martin

2009-02-01

Risk adjustment of outcomes in pediatric congenital heart surgery is challenging due to the great diversity in diagnoses and procedures. We have previously shown that variable life-adjusted display (VLAD) charts provide an effective graphic display of risk-adjusted outcomes in this specialty. A question arises as to whether the risk model used remains appropriate over time. We used a recently developed graphic technique to evaluate the performance of an existing risk model among those patients at a single center during 2000 to 2003 originally used in model development. We then compared the distribution of predicted risk among these patients with that among patients in 2004 to 2006. Finally, we constructed a VLAD chart of risk-adjusted outcomes for the latter period. Among 1083 patients between April 2000 and March 2003, the risk model performed well at predicted risks above 3%, underestimated mortality at 2% to 3% predicted risk, and overestimated mortality below 2% predicted risk. There was little difference in the distribution of predicted risk among these patients and among 903 patients between June 2004 and October 2006. Outcomes for the more recent period were appreciably better than those expected according to the risk model. This finding cannot be explained by any apparent bias in the risk model combined with changes in case-mix. Risk models can, and hopefully do, become out of date. There is scope for complacency in the risk-adjusted audit if the risk model used is not regularly recalibrated to reflect changing standards and expectations.

Quantitative assessment of multiple sclerosis lesion load using CAD and expert input

NASA Astrophysics Data System (ADS)

Gertych, Arkadiusz; Wong, Alexis; Sangnil, Alan; Liu, Brent J.

2008-03-01

Multiple sclerosis (MS) is a frequently encountered neurological disease with a progressive but variable course affecting the central nervous system. Outline-based lesion quantification in the assessment of lesion load (LL) performed on magnetic resonance (MR) images is clinically useful and provides information about the development and change reflecting overall disease burden. Methods of LL assessment that rely on human input are tedious, have higher intra- and inter-observer variability and are more time-consuming than computerized automatic (CAD) techniques. At present it seems that methods based on human lesion identification preceded by non-interactive outlining by CAD are the best LL quantification strategies. We have developed a CAD that automatically quantifies MS lesions, displays 3-D lesion map and appends radiological findings to original images according to current DICOM standard. CAD is also capable to display and track changes and make comparison between patient's separate MRI studies to determine disease progression. The findings are exported to a separate imaging tool for review and final approval by expert. Capturing and standardized archiving of manual contours is also implemented. Similarity coefficients calculated from quantities of LL in collected exams show a good correlation of CAD-derived results vs. those incorporated as expert's reading. Combining the CAD approach with an expert interaction may impact to the diagnostic work-up of MS patients because of improved reproducibility in LL assessment and reduced time for single MR or comparative exams reading. Inclusion of CAD-generated outlines as DICOM-compliant overlays into the image data can serve as a better reference in MS progression tracking.

Highly conserved CDR3 region in circulating CD4+Vβ5+ T cells may be associated with cytotoxic activity in Chagas disease

PubMed Central

Menezes, C A S; Sullivan, A K; Falta, M T; Mack, D G; Freed, B M; Rocha, M O C; Gollob, K J; Fontenot, A P; Dutra, W O

2012-01-01

Human infection with Trypanosoma cruzi leads to Chagas disease, which presents as several different clinical conditions ranging from an asymptomatic form to a severe dilated cardiomyopathy. Several studies have demonstrated that T cells play a critical role in the development of cardiac pathology, as well as in immunoregulation during chronic disease. However, the mechanisms that drive protective or pathogenic T cell response are not known. We have shown that CD4+ T cells from chagasic patients preferentially express T cell receptor (TCR) β-chain variable region (Vβ) 5. The aim of this work was to determine whether T cells expressing this particular Vβ region displayed variable or restricted CDR3 sequences, as an indicator of the nature of the stimulus leading to the activation of these T cells in vivo. Additionally, we aimed to evaluate phenotypic characteristics of these cells that might be associated with pathology. CDR3 junctional region sequencing of Vβ5·1 expressing CD4+ T cells revealed the occurrence of a highly homologous CDR3 region with conserved TCR Jβ region usage among patients with cardiac, but not indeterminate, Chagas disease. Moreover, correlation analysis indicated that the frequency of CD4+Vβ5·1+ cells is associated with granzyme A expression, suggesting that these cells might display cytotoxic function. Together these results provide new insight into T cell recognition of antigens involved in Chagas disease and suggest that these cells may be implicated in the pathogenesis of chagasic cardiomyopathy. PMID:22774985

Associations between patterns of active commuting and socioeconomic factors in women with fibromyalgia: the al-Ándalus project.

PubMed

Herrador-Colmenero, Manuel; Álvarez-Gallardo, Inmaculada C; Segura-Jiménez, Víctor; Estévez-López, Fernando; Soriano-Maldonado, Alberto; Ruiz-Montero, Pedro J; Tercedor, Pablo; Girela-Rejón, María José; Delgado-Fernández, Manuel; Chillón, Palma

2016-01-01

The aims of this study were to know whether active commuting behaviour differs between fibromyalgia patients and controls, and to test whether active commuting is associated with socioeconomic factors in this population. This cross-sectional study included 459 women with fibromyalgia (52.2 years) and 214 female control participants (51.3 years) from Andalusia (southern Spain). Participants reported patterns of active commuting and socioeconomic factors (civil status, accompaniment at home, living with, educational level, and current occupational and professional status). On the age group <51 years, women with fibromyalgia revealed a significant higher percentage of active commuting for the variable active worker commuters than control group (p<0.05). On the age group ≥51 years, control group displayed a significant higher percentage of active commuting for commuting to local shops, super-market and active commuters variables (all, p<0.05). Women with fibromyalgia who lived alone were more active commuters in comparison to either those living accompanied, or living with both partner and children, only partner and only children (all, p<0.05). The prevalence of active commuting was similar in women with fibromyalgia and controls aged <51 years. However, fibromyalgia participants aged ≥51 years displayed differences: fibromyalgia women who lived alone were more active commuters than those living accompanied; family demands were inversely associated with commuting patterns. Policies focused on reducing family demands for fibromyalgia patients (i.e. social help on housework, childcare or overprotection) might facilitate the inclusion of daily active behaviours.

Effectiveness of enhanced pulse oximetry sonifications for conveying oxygen saturation ranges: a laboratory comparison of five auditory displays.

PubMed

Paterson, E; Sanderson, P M; Paterson, N A B; Loeb, R G

2017-12-01

Anaesthetists monitor auditory information about a patient's vital signs in an environment that can be noisy and while performing other cognitively demanding tasks. It can be difficult to identify oxygen saturation (SpO2) values using existing pulse oximeter auditory displays (sonifications). In a laboratory setting, we compared the ability of non-clinician participants to detect transitions into and out of an SpO2 target range using five different sonifications while they performed a secondary distractor arithmetic task in the presence of background noise. The control sonification was based on the auditory display of current pulse oximeters and comprised a variable pitch with an alarm. The four experimental conditions included an Alarm Only condition, a Variable pitch only condition, and two conditions using sonifications enhanced with additional sound dimensions. Accuracy to detect SpO2 target transitions was the primary outcome. We found that participants using the two sonifications enhanced with the additional sound dimensions of tremolo and brightness were significantly more accurate (83 and 96%, respectively) at detecting transitions to and from a target SpO2 range than participants using a pitch only sonification plus alarms (57%) as implemented in current pulse oximeters. Enhanced sonifications are more informative than conventional sonification. The implication is that they might allow anaesthetists to judge better when desaturation decreases below, or returns to, a target range. © The Author 2017. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com

The effect of a graphical interpretation of a statistic trend indicator (Trigg's Tracking Variable) on the detection of simulated changes.

PubMed

Kennedy, R R; Merry, A F

2011-09-01

Anaesthesia involves processing large amounts of information over time. One task of the anaesthetist is to detect substantive changes in physiological variables promptly and reliably. It has been previously demonstrated that a graphical trend display of historical data leads to more rapid detection of such changes. We examined the effect of a graphical indication of the magnitude of Trigg's Tracking Variable, a simple statistically based trend detection algorithm, on the accuracy and latency of the detection of changes in a micro-simulation. Ten anaesthetists each viewed 20 simulations with four variables displayed as the current value with a simple graphical trend display. Values for these variables were generated by a computer model, and updated every second; after a period of stability a change occurred to a new random value at least 10 units from baseline. In 50% of the simulations an indication of the rate of change was given by a five level graphical representation of the value of Trigg's Tracking Variable. Participants were asked to indicate when they thought a change was occurring. Changes were detected 10.9% faster with the trend indicator present (mean 13.1 [SD 3.1] cycles vs 14.6 [SD 3.4] cycles, 95% confidence interval 0.4 to 2.5 cycles, P = 0.013. There was no difference in accuracy of detection (median with trend detection 97% [interquartile range 95 to 100%], without trend detection 100% [98 to 100%]), P = 0.8. We conclude that simple statistical trend detection may speed detection of changes during routine anaesthesia, even when a graphical trend display is present.

Actigraphically assessed activity in unipolar depression: a comparison of inpatients with and without motor retardation.

PubMed

Krane-Gartiser, Karoline; Henriksen, Tone E G; Vaaler, Arne E; Fasmer, Ole Bernt; Morken, Gunnar

2015-09-01

To compare the activity patterns of inpatients with unipolar depression, who had been divided into groups with and without motor retardation prior to actigraphy monitoring. Twenty-four-hour actigraphy recordings from 52 consecutively, acutely admitted inpatients with unipolar depression (ICD-10) were compared to recordings from 28 healthy controls. The patients, admitted between September 2011 and April 2012, were separated into 2 groups: 25 with motor retardation and 27 without motor retardation. Twenty-eight healthy controls were also included. Twenty-four-hour recordings, 9-hour daytime sequences, and 64-minute periods of continuous motor activity in the morning and evening were analyzed for mean activity, variability, and complexity. Patients with motor retardation had a reduced mean activity level (P = .04) and higher intraindividual variability, as shown by increased standard deviation (SD) (P = .003) and root mean square successive difference (RMSSD) (P = .025), during 24 hours compared to the patients without motor retardation. Both patient groups demonstrated significantly lower mean activity compared to healthy controls (P < .001) as well as higher SD (P < .02) and RMSSD (P < .001) and a higher RMSSD/SD ratio (P = .04). In the active morning period, the patients without motor retardation displayed significantly increased complexity compared to motor-retarded patients (P = .006). The patients with and without motor retardation differ in activity patterns. Findings in depressed inpatients without motor retardation closely resemble those of inpatients with mania. © Copyright 2015 Physicians Postgraduate Press, Inc.

Reliability of serum creatinine-based formulae estimating renal function in non-critically ill surgery patients: Focus on augmented renal clearance.

PubMed

Declercq, Peter; Gijsen, Matthias; Meijers, Björn; Schetz, Marie; Nijs, Stefaan; D'Hoore, André; Wauters, Joost; Spriet, Isabel

2018-05-07

Formulae estimating glomerular filtration rate (GFR) are frequently used to guide drug dosing. The objectives of this prospective single-center study were to evaluate agreement between these equations and measured creatinine clearance (CrCl) in non-critically ill surgery patients with normal kidney function and augmented renal clearance (ARC, CrCl ≥ 130 mL/min/1.73 m²), to determine predictors for disagreement, define a GFR estimator cut-off value identifying ARC and determine the ARC prevalence and duration in non-critically ill surgical patients. Hospitalized adult non-critically ill abdominal and trauma surgery patients were eligible for inclusion. Measured CrCl based on an 8-hour urinary collection (CrCl 8h ) was used as the primary method for determining kidney function. Agreement between equations and measured CrCl 8h was assessed in terms of precision, defined as a bias within ±10 mL/min/1.73 m². Predictors for disagreement were identified for the most precise estimator using an ordinal logistic regression model with negative bias, agreement and positive bias as outcome variables. A receiver operating characteristic (ROC) analysis was performed to identify an estimator cut-off predicting ARC, which was subsequently applied for the daily proportion of patients displaying ARC and ARC duration. During the study period (14/11/2013 - 13/05/2014), in 232 adult non-critically ill abdominal and trauma surgery patients, all estimators tend to underestimate CrCl 8h (mean bias ranging from 17 to 22 mL/min/1.73 m²), especially in patients displaying ARC (mean bias ranging from 44 to 56 mL/min/1.73 m²). eGFR CKD-EPI performed the best. Younger age and low ASA score independently predicted underestimation of CrCl 8h . Three different eGFR CKD-EPI cut-offs with decreasing sensitivity and increasing specificity (84, 95 and 112 mL/min/1.73 m²) identified, respectively, 65%, 44% and 14% patients displaying ARC. The median ARC duration was 4, 4 and 3 days, respectively. In surgical patients, eGFR frequently underestimates measured CrCl, especially in young patients with low ASA score. eGFR cut-offs predicting ARC were identified. © 2018 John Wiley & Sons Ltd.

Evaluation of a pilot workload metric for simulated VTOL landing tasks

NASA Technical Reports Server (NTRS)

North, R. A.; Graffunder, K.

1979-01-01

A methodological approach to measuring workload was investigated for evaluation of new concepts in VTOL aircraft displays. Multivariate discriminant functions were formed from conventional flight performance and/or visual response variables to maximize detection of experimental differences. The flight performance variable discriminant showed maximum differentiation between crosswind conditions. The visual response measure discriminant maximized differences between fixed vs. motion base conditions and experimental displays. Physiological variables were used to attempt to predict the discriminant function values for each subject/condition/trial. The weights of the physiological variables in these equations showed agreement with previous studies. High muscle tension, light but irregular breathing patterns, and higher heart rate with low amplitude all produced higher scores on this scale and thus, represented higher workload levels.

SAMPLING OSCILLOSCOPE

DOEpatents

Sugarman, R.M.

1960-08-30

An oscilloscope is designed for displaying transient signal waveforms having random time and amplitude distributions. The oscilloscopc is a sampling device that selects for display a portion of only those waveforms having a particular range of amplitudes. For this purpose a pulse-height analyzer is provided to screen the pulses. A variable voltage-level shifter and a time-scale rampvoltage generator take the pulse height relative to the start of the waveform. The variable voltage shifter produces a voltage level raised one step for each sequential signal waveform to be sampled and this results in an unsmeared record of input signal waveforms. Appropriate delay devices permit each sample waveform to pass its peak amplitude before the circuit selects it for display.

Botulinum toxin type A (Botox) for the neuromuscular correction of excessive gingival display on smiling (gummy smile).

PubMed

Polo, Mario

2008-02-01

Previously, botulinum toxin type A (BTX-A) (Botox; Allergan, Irvine, Calif) was shown to be effective in reducing excessive gingival display in 5 patients with gummy smiles. This study was conducted to determine whether the doses and the primary injection sites used in the pilot study for the correction of gummy smiles provide consistent, statistically significant, and esthetically pleasing results. Thirty patients received BTX-A injections to reduce excessive gingival display. Gingival display was defined as the difference between the lower margin of the upper lip and the superior margin of the right incisor. Patients were followed at 2, 4, 8, 12, 16, 20, and 24 weeks postinjection, with changes documented by photographs and videos. At week 2, the patients rated the effects of BTX-A. A group of specialty clinicians also evaluated the effects of BTX-A. Preinjection gingival display averaged 5.2 +/- 1.4 mm in the 30 patients. At 2 weeks postinjection, mean gingival display had declined to 0.09 mm (+/- 1.06 mm) in 30 patients (t = 26.01, P <.00001). The average lip-drop at 2 weeks was 5.1 mm for 30 patients. Gingival display gradually increased from 2 weeks postinjection through 24 weeks, but, at 24 weeks, average gingival display had not returned to baseline values. Based on predictions from a third-order polynomial equation, the baseline average of 5.2 mm would not be reached until 30 to 32 weeks postinjection. Patients and specialty evaluators rated the effects of BTX-A as highly favorable. BTX-A injections for the neuromuscular correction of gummy smiles caused by hyperfunctional upper lip elevator muscles was effective and statistically superior to baseline smiles, although the effect is transitory.

Lack of efficacy for fluoxetine in PTSD: a placebo controlled trial in combat veterans.

PubMed

Hertzberg, M A; Feldman, M E; Beckham, J C; Kudler, H S; Davidson, J R

2000-06-01

Fluoxetine and placebo were studied in a population of combat veterans with severe, chronic PTSD. Twelve male veterans with PTSD were enrolled in a 12 week double-blind evaluation of fluoxetine and placebo. Mean fluoxetine dose at endpoint (week 12) was 48 mg/day with a range of 10 mg to 60 mg. One fluoxetine patient responded (17%) and two of the six placebo patients responded (33%). Fluoxetine patients did not show a greater response than placebo patients in this small sample of male combat veterans with severe, chronic PTSD. Fluoxetine has displayed an efficacious response in controlled studies of patients with PTSD who were predominantly female, suffered civilian (noncombat) traumas, and were overall experiencing less severe PTSD. The reasons for the low response rate to fluoxetine in our study is unknown and will await further study examining variables other than symptoms that might influence outcome, such as gender, comorbidity, prior treatment history, trauma type, severity and chronicity.

Assessment of Time and Frequency Domain Parameters of Heart Rate Variability and Interictal Cardiac Rhythm Abnormalities in Drug-naïve Patients with Idiopathic Generalized Epilepsy.

PubMed

Kilinc, Ozden; Cincin, Altug; Pehlivan, Aslihan; Midi, Ipek; Kepez, Alper; Agan, Kadriye

2016-06-01

Epilepsy is a disease known to occur with autonomous phenomenons. Earlier studies indicate decreased heart rate variability (HRV) during ictal and interictal periods among epilepsy patients. In this study, we aim to investigate cardiac rhythm abnormalities and HRV during interictal period between drug-naïve patients with idiopathic generalized epilepsy (IGE) and healthy control group. Twenty-six patients with IGE and 26 healthy individuals included in the study. In order to eliminate any structural cardiac pathology, transthoracic echocardiography was performed in all subjects and time and frequency domain parameters of HRV were evaluated after 24-hour rhythm holter monitoring. Between two groups, no significant difference was detected in terms of mean heart rate and maximum duration between the start of the Q waves and the end of the T waves (QT intervals). In the time domain analysis of HRV, no statically significant difference was detected for standard deviation of all R - R intervals and root-mean-square of successive differences between patient and control group (p = 0,070 and p = 0,104 respectively). In the frequency domain analysis of HRV, patients tended to display lower total power and very low frequency power than did healthy subjects, but the differences were not statistically significant. Our results suggest that there is no major effect of the epilepsy on HRV in patients with IGE. It should be emphasized that, in this study, HRV was evaluated only in patients with IGE and that the results are not proper to be generalized for patients with partial seizures.

The effect of patient anxiety and depression on motion during myocardial perfusion SPECT imaging.

PubMed

Lyra, Vassiliki; Kallergi, Maria; Rizos, Emmanouil; Lamprakopoulos, Georgios; Chatziioannou, Sofia N

2016-08-22

Patient motion during myocardial perfusion SPECT imaging (MPI) may be triggered by a patient's physical and/or psychological discomfort. The aim of this study was to investigate the impact of state anxiety (patient's reaction to exam-related stress), trait anxiety (patient's personality characteristic) and depression on patient motion during MPI. All patients that underwent MPI in our department in a six-month period were prospectively enrolled. One hundred eighty-three patients (45 females; 138 males) filled in the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI), along with a short questionnaire regarding their age, height and weight, level of education in years, occupation, and marital status. Cardiovascular and other co-morbidity factors were also evaluated. Through inspection of raw data on cinematic display, the presence or absence of patient motion was registered and classified into mild, moderate and severe, for both phases involved in image acquisition. The correlation of patient motion in the stress and delay phases of MPI and each of the other variables was investigated and the corresponding Pearson's coefficients of association were calculated. The anxiety-motion (r = 0.43, P < 0.0001) and depression-motion (r = 0.32, P < 0.0001) correlation results were moderately strong and statistically significant for the female but not the male patients. All the other variables did not demonstrate any association with motion in MPI, except a weak correlation between age and motion in females (r = 0.23, P < 0.001). The relationship between anxiety-motion and depression-motion identified in female patients represents the first supporting evidence of psychological discomfort as predisposing factor for patient motion during MPI.

Neutropenia in Patients with Common Variable Immunodeficiency: a Rare Event Associated with Severe Outcome.

PubMed

Guffroy, Aurélien; Mourot-Cottet, Rachel; Gérard, Laurence; Gies, Vincent; Lagresle, Chantal; Pouliet, Aurore; Nitschké, Patrick; Hanein, Sylvain; Bienvenu, Boris; Chanet, Valérie; Donadieu, Jean; Gardembas, Martine; Karmochkine, Marina; Nove-Josserand, Raphaele; Martin, Thierry; Poindron, Vincent; Soulas-Sprauel, Pauline; Rieux-Laucat, Fréderic; Fieschi, Claire; Oksenhendler, Eric; André-Schmutz, Isabelle; Korganow, Anne-Sophie

2017-10-01

Common variable immunodeficiency (CVID) is characterized by infections and hypogammaglobulinemia. Neutropenia is rare during CVID. The French DEFI study enrolled patients with primary hypogammaglobulinemia. Patients with CVID and neutropenia were retrospectively analyzed. Among 473 patients with CVID, 16 patients displayed neutropenia (lowest count [0-1400]*10 6 /L). Sex ratio (M/F) was 10/6. Five patients died during the follow-up (11 years) with an increased percentage of deaths compared to the whole DEFI group (31.3 vs 3.4%, P < 0.05). Neutropenia was diagnosed for 10 patients before 22 years old. The most frequent symptoms, except infections, were autoimmune cytopenia, i.e., thrombopenia or anemia (11/16). Ten patients were affected with lymphoproliferative diseases. Two patients were in the infection only group and the others belonged to one or several other CVID groups. The median level of IgG was 2.6 g/L [0.35-4.4]. Most patients presented increased numbers of CD21 low CD38 low B cell, as already described in CVID autoimmune cytopenia group. Neutropenia was considered autoimmune in 11 cases. NGS for 52 genes of interest was performed on 8 patients. No deleterious mutations were found in LRBA, CTLA4, and PIK3. More than one potentially damaging variant in other genes associated with CVID were present in most patients arguing for a multigene process. Neutropenia is generally associated with another cytopenia and presumably of autoimmune origin during CVID. In the DEFI study, neutropenia is coupled with more severe clinical outcomes. It appears as an "alarm bell" considering patients' presentation and the high rate of deaths. Whole exome sequencing diagnosis should improve management.

Depth-enhanced integral imaging display system with electrically variable image planes using polymer-dispersed liquid-crystal layers.

PubMed

Kim, Yunhee; Choi, Heejin; Kim, Joohwan; Cho, Seong-Woo; Kim, Youngmin; Park, Gilbae; Lee, Byoungho

2007-06-20

A depth-enhanced three-dimensional integral imaging system with electrically variable image planes is proposed. For implementing the variable image planes, polymer-dispersed liquid-crystal (PDLC) films and a projector are adopted as a new display system in the integral imaging. Since the transparencies of PDLC films are electrically controllable, we can make each film diffuse the projected light successively with a different depth from the lens array. As a result, the proposed method enables control of the location of image planes electrically and enhances the depth. The principle of the proposed method is described, and experimental results are also presented.

The Speed of Serial Attention Shifts in Visual Search: Evidence from the N2pc Component.

PubMed

Grubert, Anna; Eimer, Martin

2016-02-01

Finding target objects among distractors in visual search display is often assumed to be based on sequential movements of attention between different objects. However, the speed of such serial attention shifts is still under dispute. We employed a search task that encouraged the successive allocation of attention to two target objects in the same search display and measured N2pc components to determine how fast attention moved between these objects. Each display contained one digit in a known color (fixed-color target) and another digit whose color changed unpredictably across trials (variable-color target) together with two gray distractor digits. Participants' task was to find the fixed-color digit and compare its numerical value with that of the variable-color digit. N2pc components to fixed-color targets preceded N2pc components to variable-color digits, demonstrating that these two targets were indeed selected in a fixed serial order. The N2pc to variable-color digits emerged approximately 60 msec after the N2pc to fixed-color digits, which shows that attention can be reallocated very rapidly between different target objects in the visual field. When search display durations were increased, thereby relaxing the temporal demands on serial selection, the two N2pc components to fixed-color and variable-color targets were elicited within 90 msec of each other. Results demonstrate that sequential shifts of attention between different target locations can operate very rapidly at speeds that are in line with the assumptions of serial selection models of visual search.

An open label trial of folate receptor-targeted intraoperative molecular imaging to localize pulmonary squamous cell carcinomas

PubMed Central

Predina, Jarrod D.; Newton, Andrew D.; Xia, Leilei; Corbett, Christopher; Connolly, Courtney; Shin, Michael; Sulyok, Lydia Frezel; Litzky, Leslie; Deshpande, Charuhas; Nie, Shuming; Kularatne, Sumith A.; Low, Philip S.; Singhal, Sunil

2018-01-01

Background Clinical applicability of folate receptor-targeted intraoperative molecular imaging (FR-IMI) has been established for surgically resectable pulmonary adenocarcinoma. A role for FR-IMI in other lung cancer histologies has not been studied. In this study, we evaluate feasibility of FR-IMI in patients undergoing pulmonary resection for squamous cell carcinomas (SCCs). Methods In a human clinical trial (NCT02602119), twelve subjects with pulmonary SCCs underwent FR-IMI with a near-infrared contrast agent that targets the folate receptor-α (FRα), OTL38. Near-infrared signal from tumors and benign lung was quantified to calculate tumor-to-background ratios (TBR). Folate receptor-alpha expression was characterized, and histopathologic correlative analyses were performed to evaluate patterns of OTL38 accumulation. An exploratory analysis was performed to determine patient and histopathologic variables that predict tumor fluorescence. Results 9 of 13 SCCs (in 9 of 12 of subjects) displayed intraoperative fluorescence upon NIR evaluation (median TBR, 3.9). OTL38 accumulated within SCCs in a FRα-dependent manner. FR-IMI was reliable in localizing nodules as small as 1.1 cm, and prevented conversion to thoracotomy for nodule localization in three subjects. Upon evaluation of patient and histopathologic variables, in situ fluorescence was associated with distance from the pleural surface, and was independent of alternative variables including tumor size and metabolic activity. Conclusions This work demonstrates that FR-IMI is potentially feasible in 70% of SCC patients, and that molecular imaging can improve localization during minimally invasive pulmonary resection. These findings complement previous data demonstrating that ∼98% of pulmonary adenocarcinomas are localized during FR-IMI and suggest broad applicability for NSCLC patients undergoing resection. PMID:29568374

The Effect of Information Analysis Automation Display Content on Human Judgment Performance in Noisy Environments.

PubMed

Bass, Ellen J; Baumgart, Leigh A; Shepley, Kathryn Klein

2013-03-01

Displaying both the strategy that information analysis automation employs to makes its judgments and variability in the task environment may improve human judgment performance, especially in cases where this variability impacts the judgment performance of the information analysis automation. This work investigated the contribution of providing either information analysis automation strategy information, task environment information, or both, on human judgment performance in a domain where noisy sensor data are used by both the human and the information analysis automation to make judgments. In a simplified air traffic conflict prediction experiment, 32 participants made probability of horizontal conflict judgments under different display content conditions. After being exposed to the information analysis automation, judgment achievement significantly improved for all participants as compared to judgments without any of the automation's information. Participants provided with additional display content pertaining to cue variability in the task environment had significantly higher aided judgment achievement compared to those provided with only the automation's judgment of a probability of conflict. When designing information analysis automation for environments where the automation's judgment achievement is impacted by noisy environmental data, it may be beneficial to show additional task environment information to the human judge in order to improve judgment performance.

Advanced Transport Operating System (ATOPS) color displays software description microprocessor system

NASA Technical Reports Server (NTRS)

Slominski, Christopher J.; Plyler, Valerie E.; Dickson, Richard W.

1992-01-01

This document describes the software created for the Sperry Microprocessor Color Display System used for the Advanced Transport Operating Systems (ATOPS) project on the Transport Systems Research Vehicle (TSRV). The software delivery known as the 'baseline display system', is the one described in this document. Throughout this publication, module descriptions are presented in a standardized format which contains module purpose, calling sequence, detailed description, and global references. The global reference section includes procedures and common variables referenced by a particular module. The system described supports the Research Flight Deck (RFD) of the TSRV. The RFD contains eight cathode ray tubes (CRTs) which depict a Primary Flight Display, Navigation Display, System Warning Display, Takeoff Performance Monitoring System Display, and Engine Display.

Iconic Decay in Schizophrenia

PubMed Central

Hahn, Britta; Kappenman, Emily S.; Robinson, Benjamin M.; Fuller, Rebecca L.; Luck, Steven J.; Gold, James M.

2011-01-01

Working memory impairment is considered a core deficit in schizophrenia, but the precise nature of this deficit has not been determined. Multiple lines of evidence implicate deficits at the encoding stage. During encoding, information is held in a precategorical sensory store termed iconic memory, a literal image of the stimulus with high capacity but rapid decay. Pathologically increased iconic decay could reduce the number of items that can be transferred into working memory before the information is lost and could thus contribute to the working memory deficit seen in the illness. The current study used a partial report procedure to test the hypothesis that patients with schizophrenia (n = 37) display faster iconic memory decay than matched healthy control participants (n = 28). Six letters, arranged in a circle, were presented for 50 ms. Following a variable delay of 0–1000 ms, a central arrow cue indicated the item to be reported. In both patients and control subjects, recall accuracy decreased with increasing cue delay, reflecting decay of the iconic representation of the stimulus array. Patients displayed impaired memory performance across all cue delays, consistent with an impairment in working memory, but the rate of iconic memory decay did not differ between patients and controls. This provides clear evidence against faster loss of iconic memory representations in schizophrenia, ruling out iconic decay as an underlying source of the working memory impairment in this population. Thus, iconic decay rate can be added to a growing list of unimpaired cognitive building blocks in schizophrenia. PMID:20053864

Iconic decay in schizophrenia.

PubMed

Hahn, Britta; Kappenman, Emily S; Robinson, Benjamin M; Fuller, Rebecca L; Luck, Steven J; Gold, James M

2011-09-01

Working memory impairment is considered a core deficit in schizophrenia, but the precise nature of this deficit has not been determined. Multiple lines of evidence implicate deficits at the encoding stage. During encoding, information is held in a precategorical sensory store termed iconic memory, a literal image of the stimulus with high capacity but rapid decay. Pathologically increased iconic decay could reduce the number of items that can be transferred into working memory before the information is lost and could thus contribute to the working memory deficit seen in the illness. The current study used a partial report procedure to test the hypothesis that patients with schizophrenia (n = 37) display faster iconic memory decay than matched healthy control participants (n = 28). Six letters, arranged in a circle, were presented for 50 ms. Following a variable delay of 0-1000 ms, a central arrow cue indicated the item to be reported. In both patients and control subjects, recall accuracy decreased with increasing cue delay, reflecting decay of the iconic representation of the stimulus array. Patients displayed impaired memory performance across all cue delays, consistent with an impairment in working memory, but the rate of iconic memory decay did not differ between patients and controls. This provides clear evidence against faster loss of iconic memory representations in schizophrenia, ruling out iconic decay as an underlying source of the working memory impairment in this population. Thus, iconic decay rate can be added to a growing list of unimpaired cognitive building blocks in schizophrenia.

Effective color design for displays

NASA Astrophysics Data System (ADS)

MacDonald, Lindsay W.

2002-06-01

Visual communication is a key aspect of human-computer interaction, which contributes to the satisfaction of user and application needs. For effective design of presentations on computer displays, color should be used in conjunction with the other visual variables. The general needs of graphic user interfaces are discussed, followed by five specific tasks with differing criteria for display color specification - advertising, text, information, visualization and imaging.

Identifying Patient Attitudinal Clusters Associated with Asthma Control: The European REALISE Survey.

PubMed

van der Molen, Thys; Fletcher, Monica; Price, David

Asthma is a highly heterogeneous disease that can be classified into different clinical phenotypes, and treatment may be tailored accordingly. However, factors beyond purely clinical traits, such as patient attitudes and behaviors, can also have a marked impact on treatment outcomes. The objective of this study was to further analyze data from the REcognise Asthma and LInk to Symptoms and Experience (REALISE) Europe survey, to identify distinct patient groups sharing common attitudes toward asthma and its management. Factor analysis of respondent data (N = 7,930) from the REALISE Europe survey consolidated the 34 attitudinal variables provided by the study population into a set of 8 summary factors. Cluster analyses were used to identify patient clusters that showed similar attitudes and behaviors toward each of the 8 summary factors. Five distinct patient clusters were identified and named according to the key characteristics comprising that cluster: "Confident and self-managing," "Confident and accepting of their asthma," "Confident but dependent on others," "Concerned but confident in their health care professional (HCP)," and "Not confident in themselves or their HCP." Clusters showed clear variability in attributes such as degree of confidence in managing their asthma, use of reliever and preventer medication, and level of asthma control. The 5 patient clusters identified in this analysis displayed distinctly different personal attitudes that would require different approaches in the consultation room certainly for asthma but probably also for other chronic diseases. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Optical sensor feedback assistive technology to enable patients to play an active role in the management of their body dynamics during radiotherapy treatment

NASA Astrophysics Data System (ADS)

Parkhurst, J. M.; Price, G. J.; Sharrock, P. J.; Stratford, J.; Moore, C. J.

2013-04-01

Patient motion during treatment is well understood as a prime factor limiting radiotherapy success, with the risks most pronounced in modern safety critical therapies promising the greatest benefit. In this paper we describe a real-time visual feedback device designed to help patients to actively manage their body position, pose and motion. In addition to technical device details, we present preliminary trial results showing that its use enables volunteers to successfully manage their respiratory motion. The device enables patients to view their live body surface measurements relative to a prior reference, operating on the concept that co-operative engagement with patients will both improve geometric conformance and remove their perception of isolation, in turn easing stress related motion. The device is driven by a real-time wide field optical sensor system developed at The Christie. Feedback is delivered through three intuitive visualization modes of hierarchically increasing display complexity. The device can be used with any suitable display technology; in the presented study we use both personal video glasses and a standard LCD projector. The performance characteristics of the system were measured, with the frame rate, throughput and latency of the feedback device being 22.4 fps, 47.0 Mbps, 109.8 ms, and 13.7 fps, 86.4 Mbps, 119.1 ms for single and three-channel modes respectively. The pilot study, using ten healthy volunteers over three sessions, shows that the use of visual feedback resulted in both a reduction in the participants' respiratory amplitude, and a decrease in their overall body motion variability.

Plastics and cardiovascular health: phthalates may disrupt heart rate variability and cardiovascular reactivity.

PubMed

Jaimes, Rafael; Swiercz, Adam; Sherman, Meredith; Muselimyan, Narine; Marvar, Paul J; Posnack, Nikki Gillum

2017-11-01

Plastics have revolutionized medical device technology, transformed hematological care, and facilitated modern cardiology procedures. Despite these advances, studies have shown that phthalate chemicals migrate out of plastic products and that these chemicals are bioactive. Recent epidemiological and research studies have suggested that phthalate exposure adversely affects cardiovascular function. Our objective was to assess the safety and biocompatibility of phthalate chemicals and resolve the impact on cardiovascular and autonomic physiology. Adult mice were implanted with radiofrequency transmitters to monitor heart rate variability, blood pressure, and autonomic regulation in response to di-2-ethylhexyl-phthalate (DEHP) exposure. DEHP-treated animals displayed a decrease in heart rate variability (-17% SD of normal beat-to-beat intervals and -36% high-frequency power) and an exaggerated mean arterial pressure response to ganglionic blockade (31.5% via chlorisondamine). In response to a conditioned stressor, DEHP-treated animals displayed enhanced cardiovascular reactivity (-56% SD major axis Poincarè plot) and prolonged blood pressure recovery. Alterations in cardiac gene expression of endothelin-1, angiotensin-converting enzyme, and nitric oxide synthase may partly explain these cardiovascular alterations. This is the first study to show an association between phthalate chemicals that are used in medical devices with alterations in autonomic regulation, heart rate variability, and cardiovascular reactivity. Because changes in autonomic balance often precede clinical manifestations of hypertension, atherosclerosis, and conduction abnormalities, future studies are warranted to assess the downstream impact of plastic chemical exposure on end-organ function in sensitive patient populations. This study also highlights the importance of adopting safer biomaterials, chemicals, and/or surface coatings for use in medical devices. NEW & NOTEWORTHY Phthalates are widely used in the manufacturing of consumer and medical products. In the present study, di-2-ethylhexyl-phthalate exposure was associated with alterations in heart rate variability and cardiovascular reactivity. This highlights the importance of investigating the impact of phthalates on health and identifying suitable alternatives for medical device manufacturing. Copyright © 2017 the American Physiological Society.

Controlling Motion Sickness and Spatial Disorientation and Enhancing Vestibular Rehabilitation with a User-Worn See-Through Display

PubMed Central

Krueger, Wesley W.O.

2010-01-01

Objectives/Hypotheses An eyewear mounted visual display (“User-worn see-through display”) projecting an artificial horizon aligned with the user's head and body position in space can prevent or lessen motion sickness in susceptible individuals when in a motion provocative environment as well as aid patients undergoing vestibular rehabilitation. In this project, a wearable display device, including software technology and hardware, was developed and a phase I feasibility study and phase II clinical trial for safety and efficacy were performed. Study Design Both phase I and phase II were prospective studies funded by the NIH. The phase II study used repeated measures for motion intolerant subjects and a randomized control group (display device/no display device) pre-post test design for patients in vestibular rehabilitation. Methods Following technology and display device development, 75 patients were evaluated by test and rating scales in the phase II study; 25 subjects with motion intolerance used the technology in the display device in provocative environments and completed subjective rating scales while 50 patients were evaluated before and after vestibular rehabilitation (25 using the display device and 25 in a control group) using established test measures. Results All patients with motion intolerance rated the technology as helpful for nine symptoms assessed, and 96% rated the display device as simple and easy to use. Duration of symptoms significantly decreased with use of the technology displayed. In patients undergoing vestibular rehabilitation, there were no significant differences in amount of change from pre- to post-therapy on objective balance tests between display device users and controls. However, those using the technology required significantly fewer rehabilitation sessions to achieve those outcomes than the control group. Conclusions A user-worn see-through display, utilizing a visual fixation target coupled with a stable artificial horizon and aligned with user movement, has demonstrated substantial benefit for individuals susceptible to motion intolerance and spatial disorientation and those undergoing vestibular rehabilitation. The technology developed has applications in any environment where motion sensitivity affects human performance. PMID:21181963

Identifying at-risk states beyond positive symptoms: a brief task assessing how neurocognitive impairments impact on misrepresentation of the social world through blunted emotional appraisal.

PubMed

Galdos, Mariana; Simons, Claudia J P; Wichers, Marieke; Fernandez-Rivas, Aranzazu; Martinez-Azumendi, Oscar; Lataster, Tineke; Amer, Guillermo; Myin-Germeys, Inez; Gonzalez-Torres, Miguel Angel; van Os, Jim

2011-10-01

Neurocognitive impairments observed in psychotic disorder may impact on emotion recognition and theory of mind, resulting in altered understanding of the social world. Early intervention efforts would be served by further elucidation of this mechanism. Patients with a psychotic disorder (n=30) and a reference control group (n=310) were asked to offer emotional appraisals of images of social situations (EASS task). The degree to which case-control differences in appraisals were mediated by neurocognitive alterations was analyzed. The EASS task displayed convergent and discriminant validity. Compared to controls, patients displayed blunted emotional appraisal of social situations (B=0.52, 95% CI: 0.30, 0.74, P<0.001; adjusted for age, sex and number of years of education: B=0.44, 95% CI: 0.20, 0.68, P<0.001), a difference of 0.88 (adjusted: 0.75) standard deviation. After adjustment for neurocognitive variables, the case-control difference was reduced by nearly 75% and was non-significant (B=0.12, 95% CI: -0.14, 0.39, P=0.37). Neurocognitive impairments observed in patients with psychotic disorder may underlie misrepresentation of the social world, mediated by altered emotion recognition. A task assessing the social impact of cognitive alterations in clinical practice may be useful in detecting key alterations very early in the course of psychotic illness.

A novel somatic JAK2 kinase-domain mutation in pediatric acute lymphoblastic leukemia with rapid on-treatment development of LOH.

PubMed

Sadras, Teresa; Heatley, Susan L; Kok, Chung H; McClure, Barbara J; Yeung, David; Hughes, Timothy P; Sutton, Rosemary; Ziegler, David S; White, Deborah L

2017-10-01

We report a novel somatic mutation in the kinase domain of JAK2 (R938Q) in a high-risk pediatric case of B-cell acute lymphoblastic leukemia (ALL). The patient developed on-therapy relapse at 12 months, and interestingly, the JAK2 locus acquired loss of heterozygosity during treatment resulting in 100% mutation load. Furthermore, we show that primary ALL mononuclear cells harboring the JAK2 R938Q mutation display reduced sensitivity to the JAK1/2 ATP-competitive inhibitor ruxolitinib in vitro, compared to ALL cells that carry a more common JAK2 pseudokinase domain mutation. Our findings are in line with previous reports that demonstrate that mutations within the kinase domain of JAK2 are associated with resistance to type I JAK inhibitors. Importantly, given the recent inclusion of ruxolitinib in trial protocols for children with JAK pathway alterations, we predict that inter-patient genetic variability may result in suboptimal responses to JAK inhibitor therapy in a subset of cases. The need for alternate targeted and/or combination therapies for patients who display inherent or developed resistance to JAK inhibitor therapy will be warranted, and we propose that kinase-mutants less sensitive to type I JAK inhibitors may present a currently unexplored platform for investigation of improved therapies. Copyright © 2017. Published by Elsevier Inc.

Evaluation of the quality of patient information to support informed shared decision‐making

PubMed Central

Godolphin, William; Towle, Angela; McKendry, Rachael

2008-01-01

Objectives (a) To find out how much patient information material on display in family physicians’ offices refers to management choices, and hence may be useful to support informed and shared decision‐making (ISDM) by patients and (b) to evaluate the quality of print information materials exchanged during the consultation, i.e. brought in by patients or given out by family physicians. Design All print information available for patients and exchanged between physicians and patients was collected in a single complete day of the office practices of 21 family physicians. A published and validated instrument (DISCERN) was used to assess quality. Setting and participants Community office practices in the greater Vancouver area, British Columbia, Canada. The physicians were purposefully recruited by their association with the medical school Department of Family Practice, their interest in providing patients with print information and their representation of a range of practice types and location. Main variables studied The source of the pamphlets and these categories: available in the physicians’ offices; exchanged between physician and patient; and produced with the explicit or apparent intent to support evidence‐based patient choice. Main outcome measures The quality of the print information to support ISDM, as measured by DISCERN and the ease of use and reliability of the DISCERN tool. Results and conclusions Fewer than 50% of pamphlets available in these offices fulfilled our minimum criteria for ISDM (mentioned more than one management option). Offices varied widely in the proportion of pamphlets on display that supported ISDM and how particular the physician was in selecting materials. The DISCERN tool is quick, valid and reliable for the evaluation of patient information. The quality of patient information materials used in the consultation and available in these offices was below midpoint on the DISCERN score. Major deficiencies were with respect to the mention of choices, risks, effect of no treatment or uncertainty and reliability (source, evidence‐base). Good quality information can be produced; some is available locally. PMID:11703497

Variable acuity remote viewing system flight demonstration

NASA Technical Reports Server (NTRS)

Fisher, R. W.

1983-01-01

The Variable Acuity Remote Viewing System (VARVS), originally developed under contract to the Navy (ONR) as a laboratory brassboard, was modified for flight demonstration. The VARVS system was originally conceived as a technique which could circumvent the acuity/field of view/bandwidth tradeoffs that exists in remote viewing to provide a nearly eye limited display in both field of view (160 deg) and resolution (2 min arc) while utilizing conventional TV sensing, transmission, and display equipment. The modifications for flight demonstration consisted of modifying the sensor so it could be installed and flow in a Piper PA20 aircraft, equipped for remote control and modifying the display equipment so it could be integrated with the NASA Research RPB (RPRV) remote control cockpit.

CAVIAR: a serial ECG processing system for the comparative analysis of VCGs and their interpretation with auto-reference to the patient.

PubMed

Fayn, J; Rubel, P

1988-01-01

The authors present a new computer program for serial ECG analysis that allows a direct comparison of any couple of three-dimensional ECGs and quantitatively assesses the degree of evolution of the spatial loops as well as of their initial, central, or terminal sectors. Loops and sectors are superposed as best as possible, with the aim of overcoming tracing variability of nonpathological origin. As a result, optimal measures of evolution are computed and a tabular summary of measurements is dynamically configured with respect to the patient's history and is then printed. A multivariate classifier assigns each couple of tracings to one of four classes of evolution. Color graphic displays corresponding to several modes of representation may also be plotted.

What Faces Reveal: A Novel Method to Identify Patients at Risk of Deterioration Using Facial Expressions.

PubMed

Madrigal-Garcia, Maria Isabel; Rodrigues, Marcos; Shenfield, Alex; Singer, Mervyn; Moreno-Cuesta, Jeronimo

2018-07-01

To identify facial expressions occurring in patients at risk of deterioration in hospital wards. Prospective observational feasibility study. General ward patients in a London Community Hospital, United Kingdom. Thirty-four patients at risk of clinical deterioration. A 5-minute video (25 frames/s; 7,500 images) was recorded, encrypted, and subsequently analyzed for action units by a trained facial action coding system psychologist blinded to outcome. Action units of the upper face, head position, eyes position, lips and jaw position, and lower face were analyzed in conjunction with clinical measures collected within the National Early Warning Score. The most frequently detected action units were action unit 43 (73%) for upper face, action unit 51 (11.7%) for head position, action unit 62 (5.8%) for eyes position, action unit 25 (44.1%) for lips and jaw, and action unit 15 (67.6%) for lower face. The presence of certain combined face displays was increased in patients requiring admission to intensive care, namely, action units 43 + 15 + 25 (face display 1, p < 0.013), action units 43 + 15 + 51/52 (face display 2, p < 0.003), and action units 43 + 15 + 51 + 25 (face display 3, p < 0.002). Having face display 1, face display 2, and face display 3 increased the risk of being admitted to intensive care eight-fold, 18-fold, and as a sure event, respectively. A logistic regression model with face display 1, face display 2, face display 3, and National Early Warning Score as independent covariates described admission to intensive care with an average concordance statistic (C-index) of 0.71 (p = 0.009). Patterned facial expressions can be identified in deteriorating general ward patients. This tool may potentially augment risk prediction of current scoring systems.

Contourograph display system for monitoring electrocardiograms

NASA Technical Reports Server (NTRS)

Golden, D. P., Jr.; Maudlin, D. G.; Wolthuis, R. A.

1970-01-01

Electrocardiogram is displayed as a contourogram on the cathode ray tube of a variable-persistence oscilloscope. Each cycle is stacked below its predecessors giving a three dimensional effect. A major change in the signal is apparent as a change in the contourogram pattern.

The Impact of Pictorial Display on Operator Learning and Performance. M.S. Thesis

NASA Technical Reports Server (NTRS)

Miller, R. A.; Messing, L. J.; Jagacinski, R. J.

1984-01-01

The effects of pictorially displayed information on human learning and performance of a simple control task were investigated. The controlled system was a harmonic oscillator and the system response was displayed to subjects as either an animated pendulum or a horizontally moving dot. Results indicated that the pendulum display did not effect performance scores but did significantly effect the learning processes of individual operators. The subjects with the pendulum display demonstrated more vertical internal models early in the experiment and the manner in which their internal models were tuned with practice showed increased variability between subjects.

Evaluation of control and display configurations for helicopter shipboard operations

NASA Technical Reports Server (NTRS)

Paulk, C. H., Jr.; Donley, S. T.; Hollis, M. K.

1983-01-01

A simulation evaluation of several approach and landing flight-control configurations and of two out-of-the-cockpit display devices (a head-up display and a helmet-mounted display) was performed for the task of landing a helicopter on a destroyer in adverse weather. The results indicated that the ship airwake turbulence was the most significant environmental variable affecting hover performance. In addition, to achieve adequate landing performance, attitude-command control compensation was required for the pilot regardless of the display used. For improved performance with reduced pilot effort, a velocity-command, position-hold control system was desired.

Secondary forms of Takotsubo cardiomyopathy: A whole different prognosis.

PubMed

Núñez-Gil, Iván J; Almendro-Delia, Manuel; Andrés, Mireia; Sionis, Alessandro; Martin, Ana; Bastante, Teresa; Córdoba-Soriano, Juan G; Linares, José A; González Sucarrats, Silvia; Sánchez-Grande-Flecha, Alejandro; Fabregat-Andrés, Oscar; Pérez, Beatriz; Escudier-Villa, Juan M; Martin-Reyes, Roberto; Pérez-Castellanos, Alberto; Rueda Sobella, Ferrán; Cambeiro, Cristina; Piqueras-Flores, Jesús; Vidal-Perez, Rafael; Bodí, Vicente; García de la Villa, Bernardo; Corbí-Pascua, Miguel; Biagioni, Corina; Mejía-Rentería, Hernán D; Feltes, Gisela; Barrabés, José

2016-08-01

Takotsubo syndrome (TKS) usually mimics an acute coronary syndrome. However, several clinical forms have been reported. Our aim was to assess if different stressful triggers had prognostic influence on TKS, and to establish a working classification. We performed an analysis including patients with TKS between 2003-2013 from our prospective local database and the RETAKO National Registry, fulfilling Mayo criteria. Patients were divided in two groups regarding their potential triggers: (a) none/psychic stress as 'primary forms' and (b) physical factors (asthma, surgery, trauma, etc.) as 'secondary forms'. Finally, 328 patients were included, 90.2% women, with a mean age of 69.7 years. Patients were divided into primary TKS (n=265) and 63 secondary TKS groups. Age, gender, previous functional class and cardiovascular risk profile displayed no differences between groups before admission. However, primary-TKS patients suffered a main complaint of chest pain (89.4% vs 50.7%, p<0.0001) with frequent vegetative symptoms. Regarding treatment before admission, there were no differences either. During admission, differences were related to more intensive antithrombotic and anxiolytic drug use in the primary TKS group. Inotropic and mechanical ventilation use was higher in the secondary cohort. After discharge, a more frequent prescription of beta-blockers and statins in primary-TKS patients was seen. Secondary forms displayed more in-hospital stay and evolutive complications: death (hazard ratio (HR): 3.41; 95% confidence interval (CI): 1.14-10.16, p=0.02), combined event variable (MACE) (HR: 1.61; 95% CI: 1.01-2.6, p=0.04) and recurrences (HR: 1.85; 95% CI: 1.06-3.22, p=0.02). Secondary TKS could present or mark worse short and long-term prognoses in terms of mortality, recurrences and readmissions. We propose a simple working nomenclature for TKS. © The European Society of Cardiology 2015.

Advanced Transport Operating System (ATOPS) color displays software description: MicroVAX system

NASA Technical Reports Server (NTRS)

Slominski, Christopher J.; Plyler, Valerie E.; Dickson, Richard W.

1992-01-01

This document describes the software created for the Display MicroVAX computer used for the Advanced Transport Operating Systems (ATOPS) project on the Transport Systems Research Vehicle (TSRV). The software delivery of February 27, 1991, known as the 'baseline display system', is the one described in this document. Throughout this publication, module descriptions are presented in a standardized format which contains module purpose, calling sequence, detailed description, and global references. The global references section includes subroutines, functions, and common variables referenced by a particular module. The system described supports the Research Flight Deck (RFD) of the TSRV. The RFD contains eight Cathode Ray Tubes (CRTs) which depict a Primary Flight Display, Navigation Display, System Warning Display, Takeoff Performance Monitoring System Display, and Engine Display.

Marrow-Derived Antibody Library for Treatment of Neuroblastoma

DTIC Science & Technology

2013-09-01

to capture the auto-immune response reaction in neuroblastoma patients using phage display and B cell hybridoma technologies. The scope of this...project is to use NB patient-derived materials to create NB cell lines, xenograft models, NB specific phage display libraries and to identify and...the auto-immune response reaction in neuroblastoma patients using phage display and B cell hybridoma technologies. The scope of this project is to

Intention-to-treat survival benefit of liver transplantation in patients with hepatocellular cancer.

PubMed

Lai, Quirino; Vitale, Alessandro; Iesari, Samuele; Finkenstedt, Armin; Mennini, Gianluca; Spoletini, Gabriele; Hoppe-Lotichius, Maria; Vennarecci, Giovanni; Manzia, Tommaso M; Nicolini, Daniele; Avolio, Alfonso W; Frigo, Anna Chiara; Graziadei, Ivo; Rossi, Massimo; Tsochatzis, Emmanouil; Otto, Gerd; Ettorre, Giuseppe M; Tisone, Giuseppe; Vivarelli, Marco; Agnes, Salvatore; Cillo, Umberto; Lerut, Jan

2017-12-01

The debate about the best approach to select patients with hepatocellular cancer (HCC) waiting for liver transplantation (LT) is still ongoing. This study aims to identify the best variables allowing to discriminate between "high-" and "low-benefit" patients. To do so, the concept of intention-to-treat (ITT) survival benefit of LT has been created. Data of 2,103 adult HCC patients consecutively enlisted during the period 1987-2015 were analyzed. Three rigorous statistical steps were used in order to create the ITT survival benefit of LT: the development of an ITT LT and a non-LT survival model, and the individual prediction of the ITT survival benefit of LT defined as the difference between the median ITT survival with (based on the first model) and without LT (based on the second model) calculated for each enrolled patient. Four variables (Model for End-Stage Liver Disease, alpha-fetoprotein, Milan-Criteria status, and radiological response) displayed a high effect in terms of delta benefit. According to these risk factors, four benefit groups were identified. Patients with three to four factors ("no-benefit group"; n = 405 of 2,103; 19.2%) had no benefit of LT compared to alternative treatments. Conversely, patients without any risk factor ("large-benefit group"; n = 108; 5.1%) yielded the highest benefit from LT reaching 60 months. The ITT transplant survival benefit presented here allows physicians to better select HCC patients waiting for LT. The obtained stratification may lead to an improved and more equitable method of organ allocation. Patients without benefit should be de-listed, whereas patients with large benefit ratio should be prioritized for LT. (Hepatology 2017;66:1910-1919). © 2017 by the American Association for the Study of Liver Diseases.

Burden, perceived health status, and mood among caregivers of Parkinson's disease patients.

PubMed

Martinez-Martin, Pablo; Arroyo, Susana; Rojo-Abuin, Jose Manuel; Rodriguez-Blazquez, Carmen; Frades, Belen; de Pedro Cuesta, Jesus

2008-09-15

The objective of this study is to describe the characteristics of the caregivers of patients with Parkinson's disease (PD) and to analyze the association between these characteristics and caregiver burden, perceived health and mood status, and identify their predictors. A multicenter, nationwide, observational, cross-sectional study that included 289 patient-caregiver pairs was conducted. Caregiver self-assessments were the Hospital Anxiety and Depression Scale (HADS), EuroQol (EQ), and Zarit Caregiver Burden Inventory (ZCBI). Most caregivers in the study were women aged 60 years or thereabouts. Over two thirds were gainfully employed or housewives, 75% were patients' spouses, and the majority (96.5%) had been permanently taking care of the patient for 6 +/- 5.4 years. Less than 5% of patients were in the most advanced stages of disease, and direct costs were 6,350 euros per patient per year. Caregivers had more mood disorders and worse health-related quality of life (HRQol; EQ-Tariff) than did the general population. Caregiver HADS and EuroQol scores displayed a weak correlation (r(S) = 0.01-0.28) with patient-related variables (disease duration, HY, SCOPA-Motor, SCOPA-AUT, HADS, PPRS, and CISI-PD) whereas the ZCBI correlated moderately (r(S) = 0.27-0.47). Among caregivers, the EQ-Tariff was significantly lower and the HADS-Anxiety scores significantly higher for women. ZCBI and HADS-depression, though not EuroQol and HADS-anxiety, scores significantly increased with increasing PD severity levels. Caregivers' affective status proved the most important factor influencing their burden and perceived health, whereas patient-related variables influenced caregiver burden and mood but not health status. In PD, prevalence of affective disorders among patients' caregivers is high and influences both burden and HRQoL. (c) 2007 Movement Disorder Society.

A manual control theory analysis of vertical situation displays for STOL aircraft

NASA Technical Reports Server (NTRS)

Baron, S.; Levison, W. H.

1973-01-01

Pilot-vehicle-display systems theory is applied to the analysis of proposed vertical situation displays for manual control in approach-to-landing of a STOL aircraft. The effects of display variables on pilot workload and on total closed-loop system performance was calculated using an optimal-control model for the human operator. The steep approach of an augmentor wing jet STOL aircraft was analyzed. Both random turbulence and mean-wind shears were considered. Linearized perturbation equations were used to describe longitudinal and lateral dynamics of the aircraft. The basic display configuration was one that abstracted the essential status information (including glide-slope and localizer errors) of an EADI display. Proposed flight director displays for both longitudinal and lateral control were also investigated.

Variability of Cutaneous Leishmaniasis Lesions Is Not Associated with Genetic Diversity of Leishmania tropica in Khyber Pakhtunkhwa Province of Pakistan.

PubMed

Khan, Nazma Habib; Llewellyn, Martin S; Schönian, Gabriele; Sutherland, Colin J

2017-11-01

Leishmania tropica is the causative agent of cutaneous leishmaniasis in Pakistan. Here, intraspecific diversity of L. tropica from northern Pakistan was investigated using multilocus microsatellite typing. Fourteen polymorphic microsatellite markers were typed in 34 recently collected L. tropica isolates from Pakistan along with 158 archival strains of diverse Afro-Eurasian origins. Previously published profiles for 145 strains of L. tropica originating from different regions of Africa, Central Asia, Iran, and Middle East were included for comparison. Six consistently well-supported genetic groups were resolved: 1) Asia, 2) Morroco A, 3) Namibia and Kenya A, 4) Kenya B/Tunisia and Galilee, 5) Morocco B, and 6) Middle East. Strains from northern Pakistan were assigned to Asian cluster except for three that were placed in a geographically distant genetic group; Morocco A. Lesion variability among these Pakistani strains was not associated with specific L. tropica genetic profile. Pakistani strains showed little genetic differentiation from strains of Iraq, Afghanistan, and Syria (F ST = 0.00-0.06); displayed evidence of modest genetic flow with India (F ST = 0.14). Furthermore, genetic structuring within these isolates was not geographically defined. Pak-Afghan cluster was in significant linkage disequilibrium (I A = 1.43), had low genetic diversity, and displayed comparatively higher heterozygosity (F IS = -0.62). Patterns of genetic diversity observed suggest dominance of a minimally diverse clonal lineage within northern Pakistan. This is surprising as a wide clinical spectrum was observed in patients, suggesting the importance of host and other factors. Further genotyping studies of L. tropica isolates displaying different clinical phenotypes are required to validate this potentially important observation.

Reproducibility of the Carpet View system: a novel technical solution for display and off line analysis of OCT images.

PubMed

Gabriele, Alex; Marco, Valeria; Gatto, Laura; Paoletti, Giulia; Di Vito, Luca; Castriota, Fausto; Romagnoli, Enrico; Ricciardi, Andrea; Prati, Francesco

2014-10-01

The optical coherence tomography (OCT) evaluation of the stent anatomy requires the inspection of sequential cross section (CS). However stent coils cannot be appreciated in the conventional format as the OCT CS simply display stent struts, that are poorly representative of the stent architecture. The aim of the present study was to validate a new software (Carpet View), which unfolds the stented segment, reconstructing it as an open structure and displaying the stent meshwork. 21 patients were studied with frequency domain OCT after the deployment of different stents: seven bio-absorbable scaffolds (Dream), seven bare metal stent (Vision/Multilink8), seven drug eluting stent (Cre8). Conventional CS reconstructions were post-processed with the Carpet View software and analyzed by the same reader twice (intra-observer variability) and by two different readers (inter-observer variability). A small average difference in the number of all struts was obtained with the two methods (conventional vs carpet view reconstruction). Using the carpet view, high intra-observer and inter-observer correlations were found for the number of struts obtained in each coil. The Pearson correlation values were 0.98 (p = 0.0001) and 0.96 (p = 0.0001) respectively. The same number of coils was found when analyses were repeated by the same reader or by a different reader whilst mild differences in the count of stent junctions were reported. The Carpet View can be used to address the stent geometry with high reproducibility. This approach enables the matching of the same stent portion during serial time points and promises to improve the stent assessment.

Designing a system for patients controlling providers' access to their electronic health records: organizational and technical challenges.

PubMed

Leventhal, Jeremy C; Cummins, Jonathan A; Schwartz, Peter H; Martin, Douglas K; Tierney, William M

2015-01-01

Electronic health records (EHRs) are proliferating, and financial incentives encourage their use. Applying Fair Information Practice principles to EHRs necessitates balancing patients' rights to control their personal information with providers' data needs to deliver safe, high-quality care. We describe the technical and organizational challenges faced in capturing patients' preferences for patient-controlled EHR access and applying those preferences to an existing EHR. We established an online system for capturing patients' preferences for who could view their EHRs (listing all participating clinic providers individually and categorically-physicians, nurses, other staff) and what data to redact (none, all, or by specific categories of sensitive data or patient age). We then modified existing data-viewing software serving a state-wide health information exchange and a large urban health system and its primary care clinics to allow patients' preferences to guide data displays to providers. Patients could allow or restrict data displays to all clinicians and staff in a demonstration primary care clinic, categories of providers (physicians, nurses, others), or individual providers. They could also restrict access to all EHR data or any or all of five categories of sensitive data (mental and reproductive health, sexually transmitted diseases, HIV/AIDS, and substance abuse) and for specific patient ages. The EHR viewer displayed data via reports, data flowsheets, and coded and free text data displayed by Google-like searches. Unless patients recorded restrictions, by default all requested data were displayed to all providers. Data patients wanted restricted were not displayed, with no indication they were redacted. Technical barriers prevented redacting restricted information in free textnotes. The program allowed providers to hit a "Break the Glass" button to override patients' restrictions, recording the date, time, and next screen viewed. Establishing patient-control over EHR data displays was complex and required ethical, clinical, database, and programming expertise and difficult choices to overcome technical and health system constraints. Assessing patients' preferences for access to their EHRs and applying them in clinical practice requires wide-ranging technical, clinical, and bioethical expertise, to make tough choices to overcome significant technical and organization challenges.

Information transmission and detection thresholds in the vestibular nuclei: single neurons vs. population encoding

PubMed Central

Massot, Corentin; Chacron, Maurice J.

2011-01-01

Understanding how sensory neurons transmit information about relevant stimuli remains a major goal in neuroscience. Of particular relevance are the roles of neural variability and spike timing in neural coding. Peripheral vestibular afferents display differential variability that is correlated with the importance of spike timing; regular afferents display little variability and use a timing code to transmit information about sensory input. Irregular afferents, conversely, display greater variability and instead use a rate code. We studied how central neurons within the vestibular nuclei integrate information from both afferent classes by recording from a group of neurons termed vestibular only (VO) that are known to make contributions to vestibulospinal reflexes and project to higher-order centers. We found that, although individual central neurons had sensitivities that were greater than or equal to those of individual afferents, they transmitted less information. In addition, their velocity detection thresholds were significantly greater than those of individual afferents. This is because VO neurons display greater variability, which is detrimental to information transmission and signal detection. Combining activities from multiple VO neurons increased information transmission. However, the information rates were still much lower than those of equivalent afferent populations. Furthermore, combining responses from multiple VO neurons led to lower velocity detection threshold values approaching those measured from behavior (∼2.5 vs. 0.5–1°/s). Our results suggest that the detailed time course of vestibular stimuli encoded by afferents is not transmitted by VO neurons. Instead, they suggest that higher vestibular pathways must integrate information from central vestibular neuron populations to give rise to behaviorally observed detection thresholds. PMID:21307329

Inadequate consultation behavior modulates the relationship between type D personality and impaired health status in chronic heart failure.

PubMed

Pelle, Aline J; Schiffer, Angélique A; Smith, Otto R; Widdershoven, Jos W; Denollet, Johan

2010-06-25

Psychological risk factors for impaired health outcomes have been acknowledged in chronic heart failure (CHF), with Type D personality being such a risk factor. Inadequate consultation behavior, a specific aspect of self-management, might be one mechanism in explaining the adverse effect of Type D on health outcomes. In this study we examined the relationship between Type D personality, impaired disease-specific health status, and inadequate consultation behavior. CHF outpatients (n=313) completed the Type D Scale (DS14) at baseline, and the European Heart Failure Self-care Behaviour Scale (EHFScBS) and the Minnesota Living with Heart Failure Questionnaire (MLWHFQ) at 6-month follow-up. Type D personality independently predicted inadequate consultation behavior (OR=1.80, 95%CI [1.03-3.16], p=.04) and impaired health status (OR=3.61, 95%CI [1.93-6.74], p<.001) at 6-month follow-up, adjusting for demographic and clinical variables. Inadequate consultation behavior (OR=1.80, 95%CI [1.11-2.94], p=.02) and NYHA-class (OR=2.83, 95%CI [1.17-4.71], p<.001) were associated with impaired health status, after controlling for demographics, clinical variables, and Type D personality. Post-hoc multivariable analysis pointed out that Type D patients who displayed inadequate consultation behavior were at a 6-fold increased risk of reporting impaired health status, compared to the reference group of non-Type D patients who displayed adequate consultation behavior (OR=6.06, 95%CI [2.53-14.52], p<.001). These findings provide evidence for inadequate behavior as a mechanism that may explain the link between Type D personality and impaired health status. Future studies are warranted to elaborate on these findings. Copyright 2008 Elsevier Ireland Ltd. All rights reserved.

A variable-collimation display system

NASA Astrophysics Data System (ADS)

Batchko, Robert; Robinson, Sam; Schmidt, Jack; Graniela, Benito

2014-03-01

Two important human depth cues are accommodation and vergence. Normally, the eyes accommodate and converge or diverge in tandem; changes in viewing distance cause the eyes to simultaneously adjust both focus and orientation. However, ambiguity between accommodation and vergence cues is a well-known limitation in many stereoscopic display technologies. This limitation also arises in state-of-the-art full-flight simulator displays. In current full-flight simulators, the out-the-window (OTW) display (i.e., the front cockpit window display) employs a fixed collimated display technology which allows the pilot and copilot to perceive the OTW training scene without angular errors or distortions; however, accommodation and vergence cues are limited to fixed ranges (e.g., ~ 20 m). While this approach works well for long-range, the ambiguity of depth cues at shorter range hinders the pilot's ability to gauge distances in critical maneuvers such as vertical take-off and landing (VTOL). This is the first in a series of papers on a novel, variable-collimation display (VCD) technology that is being developed under NAVY SBIR Topic N121-041 funding. The proposed VCD will integrate with rotary-wing and vertical take-off and landing simulators and provide accurate accommodation and vergence cues for distances ranging from approximately 3 m outside the chin window to ~ 20 m. A display that offers dynamic accommodation and vergence could improve pilot safety and training, and impact other applications presently limited by lack of these depth cues.

A Systematic Search for Short-term Variability of EGRET Sources

NASA Technical Reports Server (NTRS)

Wallace, P. M.; Griffis, N. J.; Bertsch, D. L.; Hartman, R. C.; Thompson, D. J.; Kniffen, D. A.; Bloom, S. D.

2000-01-01

The 3rd EGRET Catalog of High-energy Gamma-ray Sources contains 170 unidentified sources, and there is great interest in the nature of these sources. One means of determining source class is the study of flux variability on time scales of days; pulsars are believed to be stable on these time scales while blazers are known to be highly variable. In addition, previous work has demonstrated that 3EG J0241-6103 and 3EG J1837-0606 are candidates for a new gamma-ray source class. These sources near the Galactic plane display transient behavior but cannot be associated with any known blazers. Although, many instances of flaring AGN have been reported, the EGRET database has not been systematically searched for occurrences of short-timescale (approximately 1 day) variability. These considerations have led us to conduct a systematic search for short-term variability in EGRET data, covering all viewing periods through proposal cycle 4. Six 3EG catalog sources are reported here to display variability on short time scales; four of them are unidentified. In addition, three non-catalog variable sources are discussed.

A Clinical Information Display System

PubMed Central

Blum, Bruce J.; Lenhard, Raymond E.; Braine, Hayden; Kammer, Anne

1977-01-01

A clinical information display system has been implemented as part of a prototype Oncology Clinical Information System for the Johns Hopkins Oncology Center. The information system has been developed to support the management of patient therapy. Capabilities in the prototype include a patient data system, a patient abstract, a tumor registry, an appointment system, a census system, and a clinical information display system. This paper describes the clinical information display component of the prototype. It has the capability of supporting up to 10,000 patient records with online data entry and editing. At the present time, the system is being used only in the Oncology Center. There are plans, however, for trial use by other departments, and the system represents a tool with a potential for more general application.

The Effect of Information Analysis Automation Display Content on Human Judgment Performance in Noisy Environments

PubMed Central

Bass, Ellen J.; Baumgart, Leigh A.; Shepley, Kathryn Klein

2014-01-01

Displaying both the strategy that information analysis automation employs to makes its judgments and variability in the task environment may improve human judgment performance, especially in cases where this variability impacts the judgment performance of the information analysis automation. This work investigated the contribution of providing either information analysis automation strategy information, task environment information, or both, on human judgment performance in a domain where noisy sensor data are used by both the human and the information analysis automation to make judgments. In a simplified air traffic conflict prediction experiment, 32 participants made probability of horizontal conflict judgments under different display content conditions. After being exposed to the information analysis automation, judgment achievement significantly improved for all participants as compared to judgments without any of the automation's information. Participants provided with additional display content pertaining to cue variability in the task environment had significantly higher aided judgment achievement compared to those provided with only the automation's judgment of a probability of conflict. When designing information analysis automation for environments where the automation's judgment achievement is impacted by noisy environmental data, it may be beneficial to show additional task environment information to the human judge in order to improve judgment performance. PMID:24847184

Serum Irisin Predicts Mortality Risk in Acute Heart Failure Patients.

PubMed

Shen, Shutong; Gao, Rongrong; Bei, Yihua; Li, Jin; Zhang, Haifeng; Zhou, Yanli; Yao, Wenming; Xu, Dongjie; Zhou, Fang; Jin, Mengchao; Wei, Siqi; Wang, Kai; Xu, Xuejuan; Li, Yongqin; Xiao, Junjie; Li, Xinli

2017-01-01

Irisin is a peptide hormone cleaved from a plasma membrane protein fibronectin type III domain containing protein 5 (FNDC5). Emerging studies have indicated association between serum irisin and many major chronic diseases including cardiovascular diseases. However, the role of serum irisin as a predictor for mortality risk in acute heart failure (AHF) patients is not clear. AHF patients were enrolled and serum was collected at the admission and all patients were followed up for 1 year. Enzyme-linked immunosorbent assay was used to measure serum irisin levels. To explore predictors for AHF mortality, the univariate and multivariate logistic regression analysis, and receiver-operator characteristic (ROC) curve analysis were used. To determine the role of serum irisin levels in predicting survival, Kaplan-Meier survival analysis was used. In this study, 161 AHF patients were enrolled and serum irisin level was found to be significantly higher in patients deceased in 1-year follow-up. The univariate logistic regression analysis identified 18 variables associated with all-cause mortality in AHF patients, while the multivariate logistic regression analysis identified 2 variables namely blood urea nitrogen and serum irisin. ROC curve analysis indicated that blood urea nitrogen and the most commonly used biomarker, NT-pro-BNP, displayed poor prognostic value for AHF (AUCs ≤ 0.700) compared to serum irisin (AUC = 0.753). Kaplan-Meier survival analysis demonstrated that AHF patients with higher serum irisin had significantly higher mortality (P<0.001). Collectively, our study identified serum irisin as a predictive biomarker for 1-year all-cause mortality in AHF patients though large multicenter studies are highly needed. © 2017 The Author(s). Published by S. Karger AG, Basel.

Assessment of Time and Frequency Domain Parameters of Heart Rate Variability and Interictal Cardiac Rhythm Abnormalities in Drug-naïve Patients with Idiopathic Generalized Epilepsy

PubMed Central

Kilinc, Ozden; Cincin, Altug; Pehlivan, Aslihan; Midi, Ipek; Kepez, Alper; Agan, Kadriye

2016-01-01

Background and Purpose: Epilepsy is a disease known to occur with autonomous phenomenons. Earlier studies indicate decreased heart rate variability (HRV) during ictal and interictal periods among epilepsy patients. In this study, we aim to investigate cardiac rhythm abnormalities and HRV during interictal period between drug-naïve patients with idiopathic generalized epilepsy (IGE) and healthy control group. Methods: Twenty-six patients with IGE and 26 healthy individuals included in the study. In order to eliminate any structural cardiac pathology, transthoracic echocardiography was performed in all subjects and time and frequency domain parameters of HRV were evaluated after 24-hour rhythm holter monitoring. Results: Between two groups, no significant difference was detected in terms of mean heart rate and maximum duration between the start of the Q waves and the end of the T waves (QT intervals). In the time domain analysis of HRV, no statically significant difference was detected for standard deviation of all R - R intervals and root-mean-square of successive differences between patient and control group (p = 0,070 and p = 0,104 respectively). In the frequency domain analysis of HRV, patients tended to display lower total power and very low frequency power than did healthy subjects, but the differences were not statistically significant. Conclusions: Our results suggest that there is no major effect of the epilepsy on HRV in patients with IGE. It should be emphasized that, in this study, HRV was evaluated only in patients with IGE and that the results are not proper to be generalized for patients with partial seizures. PMID:27390676

Cognitive deficits and predictors 3 years after diagnosis of a pilocytic astrocytoma in childhood.

PubMed

Aarsen, Femke K; Paquier, Philippe F; Arts, Willem-Frans; Van Veelen, Marie-Lise; Michiels, Erna; Lequin, Maarten; Catsman-Berrevoets, Coriene E

2009-07-20

PURPOSE To prospectively study cognitive deficits and predictors 3 years after diagnosis in a large series of pediatric patients treated for pilocytic astrocytoma (PA). PATIENTS AND METHODS Sixty-one of 67 children were grouped according to infratentorial, supratentorial midline, and supratentorial hemispheric site. Intelligence, memory, attention, language, visual-spatial, and executive functions were assessed. Included predictors were sex, age, relapse, diagnosis-assessment interval, hydrocephalus, kind of treatment, and tumor variables. Results All children with PA had problems with sustained attention and speed. In the infratentorial group, there also were deficits in verbal intelligence, visual-spatial memory, executive functioning, and naming. Verbal intelligence and verbal memory problems occurred in the brainstem tumor group. The supratentorial hemispheric tumor group had additional problems with selective attention and executive functioning, and the supratentorial midline tumor group displayed no extra impairments. More specifically, the dorsal supratentorial midline tumor group displayed problems with language and verbal memory. Predictors for lower cognitive functioning were hydrocephalus, radiotherapy, residual tumor size, and age; predictors for better functioning were chemotherapy or treatment of hydrocephalus. Almost 60% of children had problems with academic achievement, for which risk factors were relapse and younger age at diagnosis. CONCLUSION Despite normal intelligence at long-term follow-up, children treated for PA display invalidating cognitive impairments. Adequate treatment of hydrocephalus is important for a more favorable long-term cognitive outcome. Even children without initial severe deficits may develop cognitive impairments years after diagnosis, partly because of the phenomenon of growing into deficit, which has devastating implications for academic achievement and quality of life (QOL).

Variability of Sorafenib Toxicity and Exposure over Time: A Pharmacokinetic/Pharmacodynamic Analysis

PubMed Central

Ropert, Stanislas; Mir, Olivier; Coriat, Romain; Billemont, Bertrand; Tod, Michel; Cabanes, Laure; Franck, Nathalie; Blanchet, Benoit; Goldwasser, François

2012-01-01

Background. Sorafenib displays major interpatient pharmacokinetic variability. It is unknown whether the pharmacokinetics of sorafenib influence its toxicity. Methods. We analyzed the severity and kinetics of sorafenib-induced toxicities in unselected consecutive patients with cancer, as well as their relationship with biological, clinical, and pharmacokinetic parameters. Toxicity was recorded bimonthly. Sorafenib plasma concentrations were assessed by liquid chromatography. Results. For 83 patients (median age, 62 years; range, 21–84 years), median sorafenib 12-hour area under the curve (AUC0–12) was 52.8 mg · h/L (range: 11.8–199.6). A total of 51 patients (61%) experienced grade 3–4 toxicities, including hand-foot skin reactions (23%), asthenia (18%), and diarrhea (11%). Sorafenib AUC0–12 preceding grade 3–4 toxicities was significantly higher than that observed in the remaining population (61.9 mg · h/L vs. 53 mg · h/L). In 25 patients treated with fixed doses of sorafenib for the first 4 months, median dose-normalized AUC0–12 on day 120 was significantly lower than on day 15 (63 vs. 102 mg · h/L). The incidence of hypertension and hand-foot skin reactions significantly decreased over time. Conclusion. Sorafenib AUC0–12 decreases over time, similarly to the incidence of hypertension and hand-foot skin reactions. Monitoring of sorafenib plasma concentrations may help to prevent acute severe toxicities and detect patients with suboptimal exposure at disease progression. PMID:22752067

Which Factors Affect Dental Esthetics and Smile Attractiveness in Orthodontically Treated Patients?

PubMed

Ahrari, Farzaneh; Heravi, Farzin; Rashed, Roozbeh; Zarrabi, Mohammad Javad; Setayesh, Yasin

2015-07-01

This study aimed to find the factors that affect dental esthetics and smile attractiveness in orthodontically treated patients according to laypeople's judgment, and to determine whether there is any relationship between dental and smile esthetics. Using the Q-sort technique, 60 laypersons (30 males, 30 females) rated dental and smile photographs of 48 orthodontically treated patients based on their degree of attractiveness. Dental and smile parameters of each rated image were measured by Smile Analyzer software. The Student's t-test and chi-square test were used to compare dental and smile parameters between attractive and unattractive images. The logistic regression was used to assess which variables predicted dental and smile esthetics in treated individuals. The philtral to commissural height ratio and gingival display were significantly different in attractive and unattractive smiles (P=0.003 and P=0.02, respectively). None of the dental variables were found to be a determinant of dental esthetics at the end of the orthodontic treatment (P>0.05). According to the judgment of all raters (female and male) and the male raters' judgment, smile attractiveness could be predicted by philtral to commissural height ratio and buccal corridor ratio (P<0.05). There was no statistically significant relationship between dental esthetics and smile attractiveness in orthodontically treated patients (P>0.05). The philtral to commissural height ratio and buccal corridor ratio can be considered as predictors of smile attractiveness in orthodontically treated patients. Achieving dental esthetics at the end of orthodontic treatment does not guarantee smile attractiveness.

A timely reminder about stimulus display times and other presentation parameters on CRTs and newer technologies.

PubMed

Bauer, Ben

2015-09-01

Scientific experimentation requires specification and control of independent variables with accurate measurement of dependent variables. In Vision Sciences (here broadly including experimental psychology, cognitive neuroscience, psychophysics, and clinical vision), proper specification and control of stimulus rendering (already a thorny issue) may become more problematic as several newer display technologies replace cathode ray tubes (CRTs) in the lab. The present paper alerts researchers to spatiotemporal differences in display technologies and how these might affect various types of experiments. Parallels are drawn to similar challenges and solutions that arose during the change from cabinet-style tachistoscopes to computer driven CRT tachistoscopes. Technical papers outlining various strengths and limitations of several classes of display devices are introduced as a resource for the reader wanting to select appropriate displays for different presentation requirements. These papers emphasise the need to measure rather than assume display characteristics because manufacturers' specifications and software reports/settings may not correspond with actual performance. This is consistent with the call by several Vision Science and Psychological Science bodies to increase replications and increase detail in Method sections. Finally, several recent tachistoscope-based experiments, which focused on the same question but were implemented with different technologies, are compared for illustrative purposes. (c) 2015 APA, all rights reserved).

Heading perception in patients with advanced retinitis pigmentosa

NASA Technical Reports Server (NTRS)

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

2002-01-01

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

Heading perception in patients with advanced retinitis pigmentosa.

PubMed

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

2002-09-01

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

Visual Temporal Filtering and Intermittent Visual Displays.

DTIC Science & Technology

1986-08-08

suport Mud Kaplan, Associate Professor, 20% time and effort Michelangelo ROssetto, Research Associate, 20% time and m4pport Margo Greene, Research...reached and are described as follows. The variable raster rate display was designed and built by Michelangelo R0ssetto and Norman Milkman, Research

Feasibility of Population Health Analytics and Data Visualization for Decision Support in the Infectious Diseases Domain

PubMed Central

Del Fiol, Guilherme; Butler, Jorie; Livnat, Yarden; Mayer, Jeanmarie; Samore, Matthew; Jones, Makoto; Weir, Charlene

2016-01-01

Summary Objective Big data or population-based information has the potential to reduce uncertainty in medicine by informing clinicians about individual patient care. The objectives of this study were: 1) to explore the feasibility of extracting and displaying population-based information from an actual clinical population’s database records, 2) to explore specific design features for improving population display, 3) to explore perceptions of population information displays, and 4) to explore the impact of population information display on cognitive outcomes. Methods We used the Veteran’s Affairs (VA) database to identify similar complex patients based on a similar complex patient case. Study outcomes measures were 1) preferences for population information display 2) time looking at the population display, 3) time to read the chart, and 4) appropriateness of plans with pre- and post-presentation of population data. Finally, we redesigned the population information display based on our findings from this study. Results The qualitative data analysis for preferences of population information display resulted in four themes: 1) trusting the big/population data can be an issue, 2) embedded analytics is necessary to explore patient similarities, 3) need for tools to control the view (overview, zoom and filter), and 4) different presentations of the population display can be beneficial to improve the display. We found that appropriateness of plans was at 60% for both groups (t9=-1.9; p=0.08), and overall time looking at the population information display was 2.3 minutes versus 3.6 minutes with experts processing information faster than non-experts (t8= -2.3, p=0.04). Conclusion A population database has great potential for reducing complexity and uncertainty in medicine to improve clinical care. The preferences identified for the population information display will guide future health information technology system designers for better and more intuitive display. PMID:27437065

Moving beyond average values: assessing the night-to-night instability of sleep and arousal in DSM-IV-TR insomnia subtypes.

PubMed

Sánchez-Ortuño, M Montserrat; Carney, Colleen E; Edinger, Jack D; Wyatt, James K; Harris, Andrea

2011-04-01

We explored differences between individuals with DSM-IV-TR diagnoses of primary insomnia (PI) and insomnia related to a mental disorder (IMD) by using serial measurements of self-reported sleep variables (sleep onset latency, SOL; wake after sleep onset, WASO; total sleep time, TST; sleep efficiency, SE), and visual analogue scale ratings of 2 forms of bedtime arousal (cognitive and emotional). Furthermore, we sought to examine the relationship between sleep and arousal within each diagnostic subgroup. Between-group and within-group comparisons. Duke and Rush University Medical Centers, USA. One hundred eighty-seven insomnia sufferers (126 women, average age 47.15 years) diagnosed by sleep specialists at 2 sleep centers as PI patients (n=126) and IMD patients (n=61). N/A. Multilevel models for sleep measures indicated that IMD displayed significantly more instability across nights in their TST (i.e., larger changes) than did PI patients. With respect to pre-sleep arousal, IMD patients exhibited higher mean levels of emotional arousal, as well as more instability on the nightly ratings of this measure. Within the PI group, correlational analyses revealed a moderate relationship between the 2 arousal variables and SOL (r values 0.29 and 0.26), whereas the corresponding correlations were negligible and statistically nonsignificant in the IMD group. We found a number of differences on nighttime variables between those diagnosed with primary insomnia and those diagnosed with insomnia related to a mental disorder. These differences imply different perpetuating mechanisms involved in their ongoing sleep difficulties. Additionally, they support the categorical distinctiveness and the concurrent validity of these insomnia subtypes.

Effect of display update interval, update type, and background on perception of aircraft separation on a cockpit display on traffic information

NASA Technical Reports Server (NTRS)

Jago, S.; Baty, D.; Oconnor, S.; Palmer, E.

1981-01-01

The concept of a cockpit display of traffic information (CDTI) includes the integration of air traffic, navigation, and other pertinent information in a single electronic display in the cockpit. Concise display symbology was developed for use in later full-mission simulator evaluations of the CDTI concept. Experimental variables used included the update interval motion of the aircraft, the update type, (that is, whether the two aircraft were updated at the same update interval or not), the background (grid pattern or no background), and encounter type (straight or curved). Only the type of encounter affected performance.

Risks to infants from bites of the brown tree snake (Boiga irregularis)

USGS Publications Warehouse

Fritts, T.H.; McCoid, M.J.; Haddock, R.H.

1990-01-01

The brown tree snake, Boiga irregularis, is abundant on Guam and commonly invades human habitations. Data on emergency room visits on Guam document a high freguency of snakebites on Guam. Over 50% of the emergency room visits for snakebite involved children <4 years old. Records exist of 4 infants, 1, 2, 5, and 10 months old, who displayed significant symptoms after being bitten, while sleeping, by snakes. Two infants developed respiratory problems within a few hours and required medical treatment for asphyxiation. Lethargy, diminished sensory perceptions, drooping eyelids, swelling, discoloration, and bleb formation were variable in occurrence in the patients.

Risks to infants on Guam from bites of the Brown Tree Snake (Boiga irregularis)

USGS Publications Warehouse

Fritts, T.H.; McCoid, M.J.; Haddock, R.H.

1990-01-01

The brown tree snake, Boiga irregularis, is abundant on Guam and commonly invades human habitations. Data on emergency room visits on Guam document a high frequency of snakebites on Guam. Over 50% of the emergency room visits for snakebite involved children less than 4 years old. Records exist of 4 infants, 1, 2, 5, and 10 months old, who displayed significant symptoms after being bitten, while sleeping, by snakes. Two infants developed respiratory problems within a few hours and required medical treatment for asphyxiation. Lethargy, diminished sensory perceptions, drooping eyelids, swelling, discoloration, and bleb formation were variable in occurrence in the patients.

Hyperthyroidism hidden by congenital central hypoventilation syndrome.

PubMed

Fox, Danya A; Weese-Mayer, Debra E; Wensley, David F; Stewart, Laura L

2015-05-01

Congenital central hypoventilation syndrome (CCHS) is a rare neurocristopathy with severe central hypoventilation. CCHS results from a mutation in the paired-like homeobox 2B gene (PHOX2B). In addition to hypoventilation, patients with CCHS display a wide array of autonomic nervous system abnormalities, including decreased heart rate variability and abrupt sinus pauses, esophageal dysmotility, abnormal pupillary light response, and temperature dysregulation, to name a few. To date, there has been no documentation of a child with both CCHS and hyperthyroidism. We report the case of a young child with CCHS who presented with tachycardia, which was later found to be due to Grave's disease, after many months of investigation.

CRISPR correction of the PRKAG2 gene mutation in the patient's induced pluripotent stem cell-derived cardiomyocytes eliminates electrophysiological and structural abnormalities.

PubMed

Ben Jehuda, Ronen; Eisen, Binyamin; Shemer, Yuval; Mekies, Lucy N; Szantai, Agnes; Reiter, Irina; Cui, Huanhuan; Guan, Kaomei; Haron-Khun, Shiraz; Freimark, Dov; Sperling, Silke R; Gherghiceanu, Mihaela; Arad, Michael; Binah, Ofer

2018-02-01

Mutations in the PRKAG2 gene encoding the γ-subunit of adenosine monophosphate kinase (AMPK) cause hypertrophic cardiomyopathy (HCM) and familial Wolff-Parkinson-White (WPW) syndrome. Patients carrying the R302Q mutation in PRKAG2 present with sinus bradycardia, escape rhythms, ventricular preexcitation, supraventricular tachycardia, and atrioventricular block. This mutation affects AMPK activity and increases glycogen storage in cardiomyocytes. The link between glycogen storage, WPW syndrome, HCM, and arrhythmias remains unknown. The purpose of this study was to investigate the pathological changes caused by the PRKAG2 mutation. We tested the hypothesis that patient's induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) display clinical aspects of the disease. Using clustered regularly interspaced short palindromic repeats (CRISPR) technology, we corrected the mutation and then generated isogenic iPSC-CMs. Action potentials were recorded from spontaneously firing and paced cardiomyocytes using the patch clamp technique. Using a microelectrode array setup, we recorded electrograms from iPSC-CMs clusters. Transmission electron microscopy was used to detect ultrastructural abnormalities in the mutated iPSC-CMs. PRKAG2-mutated iPSC-CMs exhibited abnormal firing patterns, delayed afterdepolarizations, triggered arrhythmias, and augmented beat rate variability. Importantly, CRISPR correction eliminated the electrophysiological abnormalities, the augmented glycogen, storage, and cardiomyocyte hypertrophy. PRKAG2-mutated iPSC-CMs displayed functional and structural abnormalities, which were abolished by correcting the mutation in the patient's iPSCs using CRISPR technology. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

A novel tool for user-friendly estimation of natural, diagnostic and professional radiation risk: Radio-Risk software.

PubMed

Carpeggiani, Clara; Paterni, Marco; Caramella, Davide; Vano, Eliseo; Semelka, Richard C; Picano, Eugenio

2012-11-01

Awareness of radiological risk is low among doctors and patients. An educational/decision tool that considers each patient' s cumulative lifetime radiation exposure would facilitate provider-patient communication. The purpose of this work was to develop user-friendly software for simple estimation and communication of radiological risk to patients and doctors as a part of the SUIT-Heart (Stop Useless Imaging Testing in Heart disease) Project of the Tuscany Region. We developed a novel software program (PC-platform, Windows OS fully downloadable at http://suit-heart.ifc.cnr.it) considering reference dose estimates from American Heart Association Radiological Imaging 2009 guidelines and UK Royal College of Radiology 2007 guidelines. Cancer age and gender-weighted risk were derived from Biological Effects of Ionising Radiation VII Committee, 2006. With simple input functions (demographics, age, gender) the user selects from a predetermined menu variables relating to natural (e.g., airplane flights and geo-tracked background exposure), professional (e.g., cath lab workers) and medical (e.g., CT, cardiac scintigraphy, coronary stenting) sources. The program provides a simple numeric (cumulative effective dose in milliSievert, mSv, and equivalent number of chest X-rays) and graphic (cumulative temporal trends of exposure, cancer cases out of 100 exposed persons) display. A simple software program allows straightforward estimation of cumulative dose (in multiples of chest X-rays) and risk (in extra % lifetime cancer risk), with simple numbers quantifying lifetime extra cancer risk. Pictorial display of radiation risk may be valuable for increasing radiological awareness in cardiologists. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Format and basic geometry of a perspective display of air traffic for the cockpit

DOT National Transportation Integrated Search

1991-06-01

The design and implementation of a perspective display of air traffic for the cockpit is discussed. Parameters of the perspective are variable and interactive so that the appearance of the projected image can be widely varied. This approach makes all...

Psychopathology of EDNOS Patients: To Whom Do They Compare?

ERIC Educational Resources Information Center

Moor, Sasha; Vartanian, Lenny R.; Touyz, Stephen W.; Beumont, P. J. V.

2004-01-01

Do the levels of psychopathology displayed by patients with an eating disorder not otherwise specified (EDNOS) more closely resemble those displayed by full-criteria anorexia and bulimia nervosa patients than they do those of non-eating-disorder controls? Three groups of eating disorder patients (anorexia nervosa, n = 27; bulimia nervosa, n = 23;…

Drug utilisation study in patients receiving antiepileptic drugs in Colombia.

PubMed

Machado-Alba, J E; Calvo-Torres, L F; García-Betancur, S; Aguirre-Novoa, A; Bañol-Giraldo, A M

2016-03-01

This study examines the indications according to which antiepileptic drugs are prescribed and used in a population of patients enrolled in the Colombian national health system (SGSSS). Retrospective cross-sectional study. From the pool of individuals in 34 Colombian cities who used antiepileptic drugs between 18 July, 2013 and 31 August, 2014 during a period of no less than 12 months, we obtained a random sample stratified by city. Socio-demographic, pharmacological and comorbidity variables were analysed. Continuous and categorical variables were compared, and logistic regression models were used. Our patient total was 373 patients, with 197 women (52.1%) and a mean age of 41.9 ± 21.7 years; 65.4% of the patients were treated with monotherapy. The most frequently used drugs were valproic acid (53.1%) and carbamazepine (33.2%). Epilepsy was the most frequent indication (n=178; 47.7%); however, 52.3% of the patients were prescribed antiepileptics for different indications, especially neuropathic pain (26.8%), affective disorders (14.2%) and migraine prophylaxis (12.3%). A total of 81 patients with epilepsy (46.6%) displayed good seizure control while another 25 (14.4%) had drug-resistant epilepsy. In the multivariate analysis, medication adherence was associated with a lower risk of treatment failure in patients with epilepsy (OR: 0.27; 95%CI, 0.11-0.67). In Colombia, antiepileptic drugs are being used for indications other than those originally intended. Monotherapy is the most commonly used treatment approach, together with the use of classic antiepileptic drugs. Copyright © 2015 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

Treatment of chronic antibody mediated rejection with intravenous immunoglobulins and rituximab: A multicenter, prospective, randomized, double-blind clinical trial.

PubMed

Moreso, Francesc; Crespo, Marta; Ruiz, Juan C; Torres, Armando; Gutierrez-Dalmau, Alex; Osuna, Antonio; Perelló, Manel; Pascual, Julio; Torres, Irina B; Redondo-Pachón, Dolores; Rodrigo, Emilio; Lopez-Hoyos, Marcos; Seron, Daniel

2018-04-01

There are no approved treatments for chronic antibody mediated rejection (ABMR). We conducted a multicenter, prospective, randomized, placebo-controlled, double-blind clinical trial to evaluate efficacy and safety of intravenous immunoglobulins (IVIG) combined with rituximab (RTX) (EudraCT 2010-023746-67). Patients with transplant glomerulopathy and anti-HLA donor-specific antibodies (DSA) were eligible. Patients with estimated glomerular filtration rate (eGFR) <20 mL/min per 1.73m 2 and/or severe interstitial fibrosis/tubular atrophy were excluded. Patients were randomized to receive IVIG (4 doses of 0.5 g/kg) and RTX (375 mg/m 2 ) or a wrapped isovolumetric saline infusion. Primary efficacy variable was the decline of eGFR at one year. Secondary efficacy variables included evolution of proteinuria, renal lesions, and DSA at 1 year. The planned sample size was 25 patients per group. During 2012-2015, 25 patients were randomized (13 to the treatment and 12 to the placebo group). The planned patient enrollment was not achieved because of budgetary constraints and slow patient recruitment. There were no differences between the treatment and placebo groups in eGFR decline (-4.2 ± 14.4 vs. -6.6 ± 12.0 mL/min per 1.73 m 2 , P-value = .475), increase of proteinuria (+0.9 ± 2.1 vs. +0.9 ± 2.1 g/day, P-value = .378), Banff scores at one year and MFI of the immunodominant DSA. Safety was similar between groups. These data suggest that the combination of IVIG and RTX is not useful in patients displaying transplant glomerulopathy and DSA. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Gender Role Conflict, Emotional Approach Coping, Self-Compassion and Distress in Prostate Cancer Patients: A Model of Direct and Moderating Effects.

PubMed

Lennon, Jennifer; Hevey, David; Kinsella, Louise

2018-05-14

Gender role conflict or the negative consequences of male socialization may compromise men's adjustment to prostate cancer by shaping how patients perceive and cope with their illness. Given mixed findings regarding how gender role conflict interacts with emotional approach coping to regulate distress in prostate cancer patients, the present study examined the effects of emotional approach coping, when considered alongside self-compassion, the ability to be kind and understanding of oneself. 92 prostate cancer patients completed questionnaires measuring gender role conflict, emotional approach coping, self-compassion and distress. A moderated mediation model was tested, where emotional approach coping mediated the path between gender role conflict and distress and self compassion moderated paths between (a) gender role conflict and emotional approach coping, and (b) gender role conflict and distress. Results partially supported this model with all study variables predicting distress in the expected directions. Emotional approach coping did not mediate associations between gender role conflict and distress; however, self-compassion did moderate the pathway between these variables. Results indicated that higher levels of self-compassion might protect men from distress related to emasculating aspects of the cancer experience. Further investigation is required to understand how self-compassion interacts with emotionality and subsequently influences distress in prostate cancer patients. To better understand the effectiveness of emotional approach coping in reducing distress in prostate cancer patients, it is recommended that future research accounts for the receptiveness of social environments to men's emotional displays. This article is protected by copyright. All rights reserved.

Approximate Entropies for Stochastic Time Series and EKG Time Series of Patients with Epilepsy and Pseudoseizures

NASA Astrophysics Data System (ADS)

Vyhnalek, Brian; Zurcher, Ulrich; O'Dwyer, Rebecca; Kaufman, Miron

2009-10-01

A wide range of heart rate irregularities have been reported in small studies of patients with temporal lobe epilepsy [TLE]. We hypothesize that patients with TLE display cardiac dysautonomia in either a subclinical or clinical manner. In a small study, we have retrospectively identified (2003-8) two groups of patients from the epilepsy monitoring unit [EMU] at the Cleveland Clinic. No patients were diagnosed with cardiovascular morbidities. The control group consisted of patients with confirmed pseudoseizures and the experimental group had confirmed right temporal lobe epilepsy through a seizure free outcome after temporal lobectomy. We quantified the heart rate variability using the approximate entropy [ApEn]. We found similar values of the ApEn in all three states of consciousness (awake, sleep, and proceeding seizure onset). In the TLE group, there is some evidence for greater variability in the awake than in either the sleep or proceeding seizure onset. Here we present results for mathematically-generated time series: the heart rate fluctuations ξ follow the γ statistics i.e., p(ξ)=γ-1(k) ξ^k exp(-ξ). This probability function has well-known properties and its Shannon entropy can be expressed in terms of the γ-function. The parameter k allows us to generate a family of heart rate time series with different statistics. The ApEn calculated for the generated time series for different values of k mimic the properties found for the TLE and pseudoseizure group. Our results suggest that the ApEn is an effective tool to probe differences in statistics of heart rate fluctuations.

The effect of display movement angle, indicator type and display location on control/display stereotype strength.

PubMed

Hoffmann, Errol R; Chan, Alan H S

2017-08-01

Much research on stereotype strength relating display and control movements for displays moving in the vertical or horizontal directions has been reported. Here we report effects of display movement angle, where the display moves at angles (relative to the vertical) of between 0° and 180°. The experiment used six different controls, four display locations relative to the operator and three types of indicator. Indicator types were included because of the strong effects of the 'scale-side principle' that are variable with display angle. A directional indicator had higher stereotype strength than a neutral indicator, and showed an apparent reversal in control/display stereotype direction beyond an angle of 90°. However, with a neutral indicator this control reversal was not present. Practitioner Summary: The effects of display moving at angles other than the four cardinal directions, types of control, location of display and types of indicator are investigated. Indicator types (directional and neutral) have an effect on stereotype strength and may cause an apparent control reversal with change of display movement angle.

Evaluation of tactual displays for flight control

NASA Technical Reports Server (NTRS)

Levison, W. H.; Tanner, R. B.; Triggs, T. J.

1973-01-01

Manual tracking experiments were conducted to determine the suitability of tactual displays for presenting flight-control information in multitask situations. Although tracking error scores are considerably greater than scores obtained with a continuous visual display, preliminary results indicate that inter-task interference effects are substantially less with the tactual display in situations that impose high visual scanning workloads. The single-task performance degradation found with the tactual display appears to be a result of the coding scheme rather than the use of the tactual sensory mode per se. Analysis with the state-variable pilot/vehicle model shows that reliable predictions of tracking errors can be obtained for wide-band tracking systems once the pilot-related model parameters have been adjusted to reflect the pilot-display interaction.

Quantitative contrast enhanced magnetic resonance imaging for the evaluation of peripheral arterial disease: a comparative study versus standard digital angiography.

PubMed

Pavlovic, Chris; Futamatsu, Hideki; Angiolillo, Dominick J; Guzman, Luis A; Wilke, Norbert; Siragusa, Daniel; Wludyka, Peter; Percy, Robert; Northrup, Martin; Bass, Theodore A; Costa, Marco A

2007-04-01

The purpose of this study is to evaluate the accuracy of semiautomated analysis of contrast enhanced magnetic resonance angiography (MRA) in patients who have undergone standard angiographic evaluation for peripheral vascular disease (PVD). Magnetic resonance angiography is an important tool for evaluating PVD. Although this technique is both safe and noninvasive, the accuracy and reproducibility of quantitative measurements of disease severity using MRA in the clinical setting have not been fully investigated. 43 lesions in 13 patients who underwent both MRA and digital subtraction angiography (DSA) of iliac and common femoral arteries within 6 months were analyzed using quantitative magnetic resonance angiography (QMRA) and quantitative vascular analysis (QVA). Analysis was repeated by a second operator and by the same operator in approximately 1 month time. QMRA underestimated percent diameter stenosis (%DS) compared to measurements made with QVA by 2.47%. Limits of agreement between the two methods were +/- 9.14%. Interobserver variability in measurements of %DS were +/- 12.58% for QMRA and +/- 10.04% for QVA. Intraobserver variability of %DS for QMRA was +/- 4.6% and for QVA was +/- 8.46%. QMRA displays a high level of agreement to QVA when used to determine stenosis severity in iliac and common femoral arteries. Similar levels of interobserver and intraobserver variability are present with each method. Overall, QMRA represents a useful method to quantify severity of PVD.

The correlation between effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) with renal scintigraphy 99mTc-DTPA study

NASA Astrophysics Data System (ADS)

Ratnasari, D.; Nazir, F.; Toresano, L. O. H. Z.; Pawiro, S. A.; Soejoko, D. S.

2016-03-01

The prevalence of chronic renal diseases in Indonesia has an increasing annual trend, because it is frequently unrecognized and often co-exists with other disease. GFR and ERPF are parameters currently utilized to estimate renal function at routine renal scintigraphy 99m-Tc DTPA study. This study used 99m-Tc DTPA to measure GFR and ERPF. The purpose of this study was to find the correlation between ERPF and GFR, for ERPF analysis with Schlegel's method, and GFR analysis with Gate's method, as well as to find correction factor between both variables. Analysis of renal scintigraphy has been performed at Department of Nuclear Medicine Pertamina Center Hospital to thirty patient images acquired from 2014 to 2015 which were analyzed retrospectively data, using gamma camera dual head with counting method from renal scintigraphy 99m-Tc DTPA study. The calculation was executed by means of both display and manual calculation. Pearson's statistical analysis resulted on Positive Correlation for all data, with ERPF and GFR (display) showing Strongly Positive Correlation (r = 0.82; p- value < 0.05). Standard deviation was found to be 27.58 and 107.64 for GFR and ERPF (display), respectively. Our result indicated that the use of 99mTc-DTPA measure ERPF was not recommended.

A preliminary study of genetic diversity of MSP-1 types in Plasmodium falciparum in southern province of Sistan Baluchistan of Iran.

PubMed

Zahra, Zamani; Reza, Razavi Mohammad; Mehdi, Assmar; Sedigheh, Sadeghi; Fatemeh, Pourfallah; Nikoo, Nasoohi; Ashraf, Sheibani; Mohammad, Raisi

2007-02-01

Plasmodiumfalciparum merozoite surface protein-1 (MSP-1) shows extensive antigenic diversity. This is due to the presence of seven variable blocks, five semi-conserved and also five conserved blocks. The variable blocks in the MSP-1 gene are principally dimorphic, displaying either K1 or MAD20 type; except for the block 2 region which is represented by three alleles, an RO33 type in addition to the other two. Allelic diversity is reported to be generated by intra-genic recombination between the variable blocks. A study of allelic variation of MSP-1 gene in Plasmodium falciparum was carried out in the southern province of Sistan Baluchistan in Iran in 2001-2003. Samples were obtained from 30 febrile patients and DNA was extracted and association types between blocks 2 and 6 was identified on each block using specific primers and compared with those from Vietnam, Brazil and Africa. The association types obtained, were similar though less in number than the ones from Vietnam, but more than those from Africa and Brazil.

Effet de l'encombrement visuel de l'ecran primaire de vol sur la performance du pilote, la charge de travail et le parcours visuel

NASA Astrophysics Data System (ADS)

Doyon-Poulin, Philippe

Flight deck of 21st century commercial aircrafts does not look like the one the Wright brothers used for their first flight. The rapid growth of civilian aviation resulted in an increase in the number of flight deck instruments and of their complexity, in order to complete a safe and ontime flight. However, presenting an abundance of visual information using visually cluttered flight instruments might reduce the pilot's flight performance. Visual clutter has received an increased interest by the aerospace community to understand the effects of visual density and information overload on pilots' performance. Aerospace regulations demand to minimize visual clutter of flight deck displays. Past studies found a mixed effect of visual clutter of the primary flight display on pilots' technical flight performance. More research is needed to better understand this subject. In this thesis, we did an experimental study in a flight simulator to test the effects of visual clutter of the primary flight display on the pilot's technical flight performance, mental workload and gaze pattern. First, we identified a gap in existing definitions of visual clutter and we proposed a new definition relevant to the aerospace community that takes into account the context of use of the display. Then, we showed that past research on the effects of visual clutter of the primary flight display on pilots' performance did not manipulate the variable of visual clutter in a similar manner. Past research changed visual clutter at the same time than the flight guidance function. Using a different flight guidance function between displays might have masked the effect of visual clutter on pilots' performance. To solve this issue, we proposed three requirements that all tested displays must satisfy to assure that only the variable of visual clutter is changed during study while leaving other variables unaffected. Then, we designed three primary flight displays with a different visual clutter level (low, medium, high) but with the same flight guidance function, by respecting the previous requirements. Twelve pilots, with a mean experience of over 4000 total flight hours, completed an instrument landing in a flight simulator using all three displays for a total of nine repetitions. Our results showed that pilots reported lower workload level and had better lateral precision during the approach using the medium-clutter display compared to the low- and high-clutter displays. Also, pilots reported that the medium-clutter display was the most useful for the flight task compared to the two other displays. Eye tracker results showed that pilots' gaze pattern was less efficient for the high-clutter display compared to the low- and medium-clutter displays. Overall, these new experimental results emphasize the importance of optimizing visual clutter of flight displays as it affects both objective and subjective performance of experienced pilots in their flying task. This thesis ends with practical recommendations to help designers optimize visual clutter of displays used for man-machine interface.

The Effects of Data and Graph Type on Concepts and Visualizations of Variability

ERIC Educational Resources Information Center

Cooper, Linda L.; Shore, Felice S.

2010-01-01

Recognizing and interpreting variability in data lies at the heart of statistical reasoning. Since graphical displays should facilitate communication about data, statistical literacy should include an understanding of how variability in data can be gleaned from a graph. This paper identifies several types of graphs that students typically…

How do medical students form impressions of the effectiveness of classroom teachers?

PubMed

Rannelli, Luke; Coderre, Sylvain; Paget, Michael; Woloschuk, Wayne; Wright, Bruce; McLaughlin, Kevin

2014-08-01

Teaching effectiveness ratings (TERs) are used to provide feedback to teachers on their performance and to guide decisions on academic promotion. However, exactly how raters make decisions on teaching effectiveness is unclear. The objectives of this study were to identify variables that medical students appraise when rating the effectiveness of a classroom teacher, and to explore whether the relationships among these variables and TERs are modified by the physical attractiveness of the teacher. We asked 48 Year 1 medical students to listen to 2-minute audio clips of 10 teachers and to describe their impressions of these teachers and rate their teaching effectiveness. During each clip, we displayed either an attractive or an unattractive photograph of an unrelated third party. We used qualitative analysis followed by factor analysis to identify the principal components of teaching effectiveness, and multiple linear regression to study the associations among these components, type of photograph displayed, and TER. We identified two principal components of teaching effectiveness: charisma and intellect. There was no association between rating of intellect and TER. Rating of charisma and the display of an attractive photograph were both positively associated with TER and a significant interaction between these two variables was apparent (p < 0.001). The regression coefficient for the association between charisma and TER was 0.26 (95% confidence interval [CI] 0.10-0.41) when an attractive picture was displayed and 0.83 (95% CI 0.66-1.00) when an unattractive picture was displayed (p < 0.001). When medical students rate classroom teachers, they consider the degree to which the teacher is charismatic, although the relationship between this attribute and TER appears to be modified by the perceived physical attractiveness of the teacher. Further studies are needed to identify other variables that may influence subjective ratings of teaching effectiveness and to evaluate alternative strategies for rating teaching effectiveness. © 2014 John Wiley & Sons Ltd.

OHS Redecorates Exam Rooms to Educate Patients | Poster

Cancer.gov

Occupational Health Services interns are educating patients during their visits via updated exam rooms that now display health-related “themes” like cancer, general health, mental health, and travel safety. They hope the vibrant designs and intriguing facts they’ve displayed will attract attention and benefit patients.

Polyplanar optical display

NASA Astrophysics Data System (ADS)

Veligdan, James T.; Beiser, Leo; Biscardi, Cyrus; Brewster, Calvin; DeSanto, Leonard

1997-07-01

The polyplanar optical display (POD) is a unique display screen which can be use with any projection source. This display screen is 2 inches thick and has a matte black face which allows for high contrast images. The prototype being developed is a form, fit and functional replacement display for the B-52 aircraft which uses a monochrome ten-inch display. The new display uses a 100 milliwatt green solid state laser as its optical source. In order to produce real- time video, the laser light is being modulated by a digital light processing (DLP) chip manufactured by Texas Instruments, Inc. A variable astigmatic focusing system is used to produce a stigmatic image on the viewing face of the POD. In addition to the optical design, we discuss the electronic interfacing to the DLP chip, the opto-mechanical design and viewing angle characteristics.

Laser-driven polyplanar optic display

NASA Astrophysics Data System (ADS)

Veligdan, James T.; Beiser, Leo; Biscardi, Cyrus; Brewster, Calvin; DeSanto, Leonard

1998-05-01

The Polyplanar Optical Display (POD) is a unique display screen which can be used with any projection source. This display screen is 2 inches thick and has a matte-black face which allows for high contrast images. The prototype being developed is a form, fit and functional replacement display for the B-52 aircraft which uses a monochrome ten-inch display. The new display uses a 200 milliwatt green solid- state laser (532 nm) as its optical source. In order to produce real-time video, the laser light is being modulated by a Digital Light Processing (DLPTM) chip manufactured by Texas Instruments, Inc. A variable astigmatic focusing system is used to produce a stigmatic image on the viewing face of the POD. In addition to the optical design, we discuss the DLPTM chip, the opto-mechanical design and viewing angle characteristics.

CACDA Jiffy War Game Programmers Manual

DTIC Science & Technology

1977-03-01

variables for INDEX5. F-12 F-4. Program variables for LOSS. F-14 F-5. Program variables for DISPLAY. F- 16 G-I. Program variables for OVLY 1 (ROFA). G...variables for FASCAM. J-9 K-1. Program variables for OVLY 5 (AHAD). K-2 L-i. Program variables for CANNON. L-2 L-2. Program variables for CLGP. L- 16 M-i...flow diagram. 56 13. TANK (OVLY 2) flow diagram. 62 14. INFANT (OVLY 3) flow diagram. 69 15. MINE flow diagram. 74 16 . Subroutine FASCAM flow

Oral cancer associated with chronic mechanical irritation of the oral mucosa.

PubMed

Piemonte, E; Lazos, J; Belardinelli, P; Secchi, D; Brunotto, M; Lanfranchi-Tizeira, H

2018-03-01

Most of the studies dealing with Chronic Mechanical Irritation (CMI) and Oral Cancer (OC) only considered prosthetic and dental variables separately, and CMI functional factors are not registered. Thus, the aim of this study was to assess OC risk in individuals with dental, prosthetic and functional CMI. Also, we examined CMI presence in relation to tumor size. A case-control study was carried out from 2009 to 2013. Study group were squamous cell carcinoma cases; control group was patients seeking dental treatment in the same institution. 153 patients were studied (Study group n=53, Control group n=100). CMI reproducibility displayed a correlation coefficient of 1 (p<0.0001). Bivariate analysis showed statistically significant associations for all variables (age, gender, tobacco and alcohol consumption and CMI). Multivariate analysis exhibited statistical significance for age, alcohol, and CMI, but not for gender or tobacco. Relationship of CMI with tumor size showed no statistically significant differences. CMI could be regarded as a risk factor for oral cancer. In individuals with other OC risk factors, proper treatment of the mechanical injuring factors (dental, prosthetic and functional) could be an important measure to reduce the risk of oral cancer.

Sympatho-vagal balance, as quantified by ANSindex, predicts post spinal hypotension and vasopressor requirement in parturients undergoing lower segmental cesarean section: a single blinded prospective observational study.

PubMed

Prashanth, Anitha; Chakravarthy, Murali; George, Antony; Mayur, Rohini; Hosur, Rajathadri; Pargaonkar, Sumant

2017-08-01

Hypotension subsequent to spinal anesthesia occurs in a significant number of parturients undergoing lower segment caesarian section. Currently available methods to predict the incidence of hypotension, its severity and the outcome are sub-optimal. Many workers have used basal heart rate as one of the predictors. But using this method it is not possible to objectively analyze and predict the extent and severity of hypotension. We used an equipment measuring the level of sympatho-vagal balance, ANSiscope™, which derives these values from computed value of RR interval variability. We made a single measure of the value which was blinded to the patient and the anesthesiologist. We studied one hundred eight patients who underwent lower segment caesarian section under spinal anesthesia and found the variability of preoperative ANSindex (% activity displayed by the equipment) from 9 to 65 %. Higher ANSindex value was significantly associated with post spinal hypotension (p 0.017). A value of 24 % indicated the critical level above which hypotension appeared commonly. The ANSindex value might help anesthesiologist to anticipate and prepare for hypotension that is likely to ensue.

Format and basic geometry of a perspective display of air traffic for the cockpit

NASA Technical Reports Server (NTRS)

Mcgreevy, Michael Wallace; Ellis, Stephen R.

1991-01-01

The design and implementation of a perspective display of air traffic for the cockpit is discussed. Parameters of the perspective are variable and interactive so that the appearance of the projected image can be widely varied. This approach makes allowances for exploration of perspective parameters and their interactions. The display was initially used to study the cases of horizontal maneuver biases found in experiments involving a plan view air traffic display format. Experiments to determine the effect of perspective geometry on spatial judgements have evolved from the display program. Several scaling techniques and other adjustments to the perspective are used to tailor the geometry for effective presentation of 3-D traffic situations.

Alterations in sympathetic nerve traffic in genetic haemochromatosis before and after iron depletion therapy: a microneurographic study.

PubMed

Seravalle, Gino; Piperno, Alberto; Mariani, Raffaella; Pelloni, Irene; Facchetti, Rita; Dell'Oro, Raffaella; Cuspidi, Cesare; Mancia, Giuseppe; Grassi, Guido

2016-03-21

Haemochromatosis (HH) displays a number of circulatory alterations concurring at increase cardiovascular risk. Whether these include sympathetic abnormalities in unknown. In 18 males with primary HH (age: 42.3 ± 10.4 years, mean ± SD), clinic and beat-to-beat blood pressure (BP, Finapres), heart rate (HR, EKG), and muscle sympathetic nerve activity (MSNA, microneurography) traffic were measured in the iron overload state and after iron depletion therapy. Haemochromatosis patients displayed elevated serum iron indices while other haemodynamic and metabolic variables were superimposable to ones seen in 12 healthy subjects (C). Muscle sympathetic nerve activity was significantly greater in HH than C (64.8 ± 13.3 vs. 37.8 ± 6.7 bs/100 hb, P < 0.01). Iron depletion caused a significant reduction in serum ferritin, transferrin saturation, and MSNA (from 64.8 ± 13.3 to 39.2 ± 9.2 bs/100 hb, P < 0.01) and a significant improvement in baroreflex-MSNA modulation. This was paralleled by a significant increase in the high-frequency HR variability and by a significant reduction in the low-frequency systolic BP variability components. Before after iron depletion therapy, MSNA was significantly and directly related to transferrin saturation, liver iron concentration, and iron removed, while the MSNA reductions observed after the procedure were significantly and inversely related to the baroreflex-MSNA increases detected after iron depletion. In C, all variables remained unchanged following 1 month observation. These data provide the first evidence that in HH iron overload is associated with an hyperadrenergic state and a baroreflex alteration, which are reversed by iron depletion. These findings underline the importance of iron overload in modulating sympathetic activation, possibly participating at the elevated cardiovascular risk reported in HH. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Patterns of Cost for Patients Dying in the Intensive Care Unit and Implications for Cost Savings of Palliative Care Interventions

PubMed Central

Benkeser, David; Coe, Norma B.; Engelberg, Ruth A.; Teno, Joan M.; Curtis, J. Randall

2016-01-01

Abstract Background: Terminal intensive care unit (ICU) stays represent an important target to increase value of care. Objective: To characterize patterns of daily costs of ICU care at the end of life and, based on these patterns, examine the role for palliative care interventions in enhancing value. Design: Secondary analysis of an intervention study to improve quality of care for critically ill patients. Setting/Patients: 572 patients who died in the ICU between 2003 and 2005 at a Level-1 trauma center. Methods: Data were linked with hospital financial records. Costs were categorized into direct fixed, direct variable, and indirect costs. Patterns of daily costs were explored using generalized estimating equations stratified by length of stay, cause of death, ICU type, and insurance status. Estimates from the literature of effects of palliative care interventions on ICU utilization were used to simulate potential cost savings under different time horizons and reimbursement models. Main Results: Mean cost for a terminal ICU stay was 39.3K ± 45.1K. Direct fixed costs represented 45% of total hospital costs, direct variable costs 20%, and indirect costs 34%. Day of admission was most expensive (mean 9.6K ± 7.6K); average cost for subsequent days was 4.8K ± 3.4K and stable over time and patient characteristics. Conclusions: Terminal ICU stays display consistent cost patterns across patient characteristics. Savings can be realized with interventions that align care with patient preferences, helping to prevent unwanted ICU utilization at end of life. Cost modeling suggests that implications vary depending on time horizon and reimbursement models. PMID:27813724

Assessing the standards of online oral hygiene instructions for patients with fixed orthodontic appliances.

PubMed

Verhoef, Willem A; Livas, Christos; Delli, Konstantina; Ren, Yijin

2015-05-01

The authors conducted this study to assess the quality of the information available on the Web about oral hygiene for patients with fixed orthodontic appliances. The authors entered the search terms "cleaning braces," "brushing braces," and "oral hygiene and braces" into Google, Yahoo, and Bing search engines. They analyzed Web sites satisfying the inclusion criteria from the first 20 hits of each search for accessibility, usability, and reliability by using the LIDA instrument; for readability by using the Flesch Reading Ease (FRE) score; and for the completeness of oral hygiene instructions. Sixty-two Web sites met the inclusion criteria. The mean total LIDA score of 71.2 indicated the moderate quality of the design of the reviewed Web sites. The mean (standard deviation [SD]) values of LIDA scores for accessibility, usability, and reliability were 85.9 (7.0), 63.4 (16.1), and 48.0 (10.4), respectively. The mean (SD) FRE Score of 68.6 (9.7) applied to standard reading skills. The completeness of information (mean [SD] = 67.1 [27.8]) presented the highest variability. Overall, the authors found that the standards of online oral hygiene materials for orthodontic patients with fixed appliances exhibited modest scores. Readability appeared to be appropriate for young adolescents, whereas the comprehensiveness of the displayed information was highly variable. Further improvement of the infrastructure of electronic health information (that is, e-health) in orthodontics is necessary to meet patients' needs. Given the moderate quality of oral hygiene instruction available on the Web for patients with fixed appliances, orthodontic patients and caregivers should be cautious when browsing the Internet for relevant information. Dental professionals should refer patients to valid Web-based educational materials. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

Features of Turner syndrome among a group of Cameroonian patients.

PubMed

Wonkam, Ambroise; Veigne, Sandra W; Abass, Ali; Ngo Um, Suzanne; Noubiap, Jean Jacques N; Mbanya, Jean-Claude; Sobngwi, Eugene

2015-06-01

To describe the features of Turner syndrome among a group of Cameroonian patients. A descriptive cross-sectional study was conducted among patients with amenorrhea and/or short stature who attended the genetic unit of Yaoundé Gynecology, Obstetrics and Pediatric Hospital (Yaoundé, Cameroon) for a specialist consultation between July 1, 2007, and December 31, 2008. Sociodemographic, clinical, and cytogenetic data were collected. Turner syndrome was confirmed among 11 of the 14 participants (seven had monosomy of the X chromosome; four had mosaicism involving a structural abnormality of the second X chromosome). The mean age at diagnosis was 18.4±2.8years. The reasons for consultation were delayed puberty (n=10) and short stature (n=1). Nine patients had a short neck, nine had a forearm carrying-angle deformity, eight had a low hairline, and two had a webbed neck. Abdominal ultrasonography identified a horseshoe kidney in two patients and a rudimentary uterus in nine patients. None of the patients displayed cardiac abnormalities. Hypergonadotropic hypogonadism was reported among five patients. Eight patients did not receive hormonal treatment owing to advanced bone age or economic reasons. Late diagnosis and variable phenotypic expression were key features of Cameroonian patients with Turner syndrome. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Bracing of pectus carinatum: A quantitative analysis.

PubMed

Bugajski, Tomasz; Murari, Kartikeya; Lopushinsky, Steven; Schneider, Marc; Ronsky, Janet

2018-05-01

Primary treatment of pectus carinatum (PC) is performed with an external brace that compresses the protrusion. Patients are 'prescribed' a brace tightening force. However, no visual guides exist to display this force magnitude. The purpose of this study was to determine the repeatability of patients in applying their prescribed force over time and to determine whether the protrusion stiffness influences the patient-applied forces and the protrusion correction rate. Twenty-one male participants (12-17years) with chondrogladiolar PC were recruited at the time of brace fitting. Participants were evaluated on three visits: fitting, one month postfitting, and two months postfitting. Differences between prescribed force and patient-applied force were evaluated. Relationships of patient-applied force and correction rate with protrusion stiffness were assessed. Majority of individuals followed for two months (75%) had a significantly different patient-applied force (p<0.05) from their prescribed force. Protrusion stiffness had a positive relationship with patient-applied force, but no relationship with correction rate. Patients did not follow their prescribed force. Magnitudes of these differences require further investigation to determine clinical significance. Patient-applied forces were influenced by protrusion stiffness, but correction rate was not. Other factors may influence these variables, such as patient compliance. Treatment Study - Level IV. Copyright © 2018 Elsevier Inc. All rights reserved.

A wearable navigation display can improve attentiveness to the surgical field.

PubMed

Stewart, James; Billinghurst, Mark

2016-06-01

Surgical navigation is typically shown on a computer display that is distant from the patient, making it difficult for the surgeon to watch the patient while performing a guided task. We investigate whether a light-weight, untracked, wearable display (such as Google Glass, which has the same size and weight as corrective glasses) can improve attentiveness to the surgical field in a simulated surgical task. Three displays were tested: a computer monitor; a peripheral display above the eye; and a through-the-lens display in front of the eye. Twelve subjects performed a task to position and orient a tracked tool on a plastic femur. Both wearable displays were tested on the dominant and non-dominant eyes of each subject. Attentiveness during the task was measured by the time taken to respond to randomly illuminated LEDs on the femur. Attentiveness was improved with the wearable displays at the cost of a decrease in accuracy. The through-the-lens display performed better than the peripheral display. The peripheral display performed better when on the dominant eye, while the through-the-lens display performed better when on the non-dominant eye. Attentiveness to the surgical field can be improved with the use of a light-weight, untracked, wearable display. A through-the-lens display performs better than a peripheral display, and both perform better than a computer monitor. Eye dominance should be considered when positioning the display.

Immunoglobulin heavy chain V-D-J gene rearrangement and mutational status in Uruguayan patients with chronic lymphocytic leukemia.

PubMed

Bianchi, Sergio; Moreno, Pilar; Landoni, Ana Inés; Naya, Hugo; Oppezzo, Pablo; Dighiero, Guillermo; Gabús, Raúl; Pritsch, Otto

2010-11-01

B-cell chronic lymphocytic leukemia (CLL) is characterized by the accumulation of long-lived circulating clonal leukemic B-cells, although the etiopathogenesis remains unclear. The incidence of CLL is variable in different regions around the world. While it is the most frequent chronic leukemia in Western countries, it has a low incidence in Asia. In this work we have investigated the immunoglobulin heavy chain gene rearrangements and mutational status in 80 Uruguayan patients with CLL, and compared these results with those obtained in other geographic regions. Our results demonstrate that Uruguayan patients with CLL display an IGHV gene usage which resembles that observed in Mediterranean countries and exhibits certain differences compared with Brazilian and Asian series, as expected, considering the ethnic basis of the Uruguayan population. This suggests that genetic influences could be important in the development and etiopathogenesis of CLL, but larger studies are necessary to substantiate this possibility.

Age and Sex Differences in Intra-Individual Variability in a Simple Reaction Time Task

ERIC Educational Resources Information Center

Ghisletta, Paolo; Renaud, Olivier; Fagot, Delphine; Lecerf, Thierry; de Ribaupierre, Anik

2018-01-01

While age effects in reaction time (RT) tasks across the lifespan are well established for level of performance, analogous findings have started appearing also for indicators of intra-individual variability (IIV). Children are not only slower, but also display more variability than younger adults in RT. Yet, little is known about potential…

Resilience and active coping style: Effects on the self-reported quality of life in cancer patients.

PubMed

Popa-Velea, Ovidiu; Diaconescu, Liliana; Jidveian Popescu, Mara; Truţescu, Carmen

2017-03-01

Objective This study aimed to assess the association between resilience, active coping styles and the self-perceived quality of life in cancer patients. Additionally, we evaluated the contribution brought to quality of life by demographic variables (age, gender, occupational status) and medical ones (tumour, node and metastasis [TNM] stage, time from diagnosis, number of treatment lines). Methods The study design was cross-sectional. One hundred and seventy-eight patients (94 males, 84 females; mean age 56.20, SD = 7.81) consecutively admitted to two specialty hospitals in Bucharest and displaying TNM cancer stages II-IV were administered the Brief COPE Questionnaire, the RS-14 Resilience Scale and the Rotterdam symptom checklist. Hierarchical regression was used to analyze the relationship between the study variables and the quality of life components (physical distress, psychological distress, and the ability to remain active). Results The quality of life scores were within the average limits, despite 87.6% of patients being in an advanced cancer stage. Both resilience and active coping scores were in the higher range (resilience mean = 78.10, SD = 13.31, 95%CI = 76.14-80.06; active coping mean = 18.33, SD = 4.39, 95%CI = 17.68-18.98). Resilience correlated significantly with all quality of life components (global: p < .001, physical distress: p < .04, psychological distress: p < .0005, activity level: p < .03), whereas active coping did it only indirectly, via resilience. Among other variables, occupational status and time from diagnosis correlated inversely to two of quality of life components, and TNM stage to all. Conclusions This study points out the importance of resilience in influencing the self-perception of quality of life in cancer patients. Considering that resilience can be improved through psychological intervention, our findings may be useful for the design, adjustment, and implementation of future psychotherapeutic protocols.

Shaping Tourist LL: Language Display and the Sociolinguistic Background of an International Multilingual Readership

ERIC Educational Resources Information Center

Bruyèl-Olmedo, Antonio; Juan-Garau, Maria

2015-01-01

Linguistic landscape studies increasingly focus on the variables that intertwine to generate the meaning of texts on display. International tourist resorts, largely multilingual, reveal how languages in signage combine and respond to the sociolinguistic profile of their readership. However, these settings have received scant attention in the…

High-resolution multi-model projections of onshore wind resources over Portugal under a changing climate

NASA Astrophysics Data System (ADS)

Nogueira, Miguel; Soares, Pedro M. M.; Tomé, Ricardo; Cardoso, Rita M.

2018-05-01

We present a detailed evaluation of wind energy density (WED) over Portugal, based on the EURO-CORDEX database of high-resolution regional climate model (RCM) simulations. Most RCMs showed reasonable accuracy in reproducing the observed near-surface wind speed. The climatological patterns of WED displayed large sub-regional heterogeneity, with higher values over coastal regions and steep orography. Subsequently, we investigated the future changes of WED throughout the twenty-first century, considering mid- and end-century periods, and two emission scenarios (RCP4.5 and RCP8.5). On the yearly average, the multi-model ensemble WED changes were below 10% (15%) under RCP4.5 (RCP8.5). However, the projected WED anomalies displayed strong seasonality, dominated by low positive values in summer (< 10% for both scenarios), negative values in winter and spring (up to - 10% (- 20%) under RCP4.5 (RCP8.5)), and stronger negative anomalies in autumn (up to - 25% (- 35%) under RCP4.5 (RCP8.5)). These projected WED anomalies displayed large sub-regional variability. The largest reductions (and lowest increases) are linked to the northern and central-eastern elevated terrain, and the southwestern coast. In contrast, the largest increases (and lowest reductions) are linked to the central-western orographic features of moderate elevation. The projections also showed changes in inter-annual variability of WED, with small increases for annual averages, but with distinct behavior when considering year-to-year variability over a specific season: small increases in winter, larger increases in summer, slight decrease in autumn, and no relevant change in spring. The changes in inter-annual variability also displayed strong dependence on the underlying terrain. Finally, we found significant model spread in the magnitude of projected WED anomalies and inter-annual variability, affecting even the signal of the changes.

Display format, highlight validity, and highlight method: Their effects on search performance

NASA Technical Reports Server (NTRS)

Donner, Kimberly A.; Mckay, Tim D.; Obrien, Kevin M.; Rudisill, Marianne

1991-01-01

Display format and highlight validity were shown to affect visual display search performance; however, these studies were conducted on small, artificial displays of alphanumeric stimuli. A study manipulating these variables was conducted using realistic, complex Space Shuttle information displays. A 2x2x3 within-subjects analysis of variance found that search times were faster for items in reformatted displays than for current displays. Responses to valid applications of highlight were significantly faster than responses to non or invalidly highlighted applications. The significant format by highlight validity interaction showed that there was little difference in response time to both current and reformatted displays when the highlight validity was applied; however, under the non or invalid highlight conditions, search times were faster with reformatted displays. A separate within-subject analysis of variance of display format, highlight validity, and several highlight methods did not reveal a main effect of highlight method. In addition, observed display search times were compared to search time predicted by Tullis' Display Analysis Program. Benefits of highlighting and reformatting displays to enhance search and the necessity to consider highlight validity and format characteristics in tandem for predicting search performance are discussed.

Diagnosing and treatment planning inadequate tooth display.

PubMed

Spear, F

2016-10-21

Some of the most challenging patients to produce a pleasing smile for are those who present with inadequate tooth display (either due to tooth position, the patient has normal size teeth, but they aren't exposed adequately to fill out the smile) or due to tooth size (the teeth are small, often due to tooth wear). The key to understanding how to manage these patients is to learn to understand the possible aetiologies that could produce the condition, and learn how to diagnose which aetiologies exist for your patient. Potential aetiologies for inadequate tooth display in patients with normal length unworn anterior teeth: excessive lip length; inadequate lip mobility; inadequate vertical eruption of the anterior teeth; inadequate facial prominence of the maxillary anterior teeth; vertical maxillary deficiency; and anterior maxillary deficiency.This article, the first in a British Dental Journal series on the topic of aesthetic dentistry, reviews the clinical findings consistent with diagnosing each of the above etiologies, and then reviews the treatment options available for correcting the inadequate tooth display.

Metabolic networks in epilepsy by MR spectroscopic imaging.

PubMed

Pan, J W; Spencer, D D; Kuzniecky, R; Duckrow, R B; Hetherington, H; Spencer, S S

2012-12-01

The concept of an epileptic network has long been suggested from both animal and human studies of epilepsy. Based on the common observation that the MR spectroscopic imaging measure of NAA/Cr is sensitive to neuronal function and injury, we use this parameter to assess for the presence of a metabolic network in mesial temporal lobe epilepsy (MTLE) patients. A multivariate factor analysis is performed with controls and MTLE patients, using NAA/Cr measures from 12 loci: the bilateral hippocampi, thalami, basal ganglia, and insula. The factor analysis determines which and to what extent these loci are metabolically covarying. We extract two independent factors that explain the data's variability in control and MTLE patients. In controls, these factors characterize a 'thalamic' and 'dominant subcortical' function. The MTLE patients also exhibit a 'thalamic' factor, in addition to a second factor involving the ipsilateral insula and bilateral basal ganglia. These data suggest that MTLE patients demonstrate a metabolic network that involves the thalami, also seen in controls. The MTLE patients also display a second set of metabolically covarying regions that may be a manifestation of the epileptic network that characterizes limbic seizure propagation. © 2012 John Wiley & Sons A/S.

An exploratory study of clinical measures associated with subsyndromal pathological gambling in patients with binge eating disorder.

PubMed

Yip, Sarah W; White, Marney A; Grilo, Carlos M; Potenza, Marc N

2011-06-01

Both binge eating disorder (BED) and pathological gambling (PG) are characterized by impairments in impulse control. Subsyndromal levels of PG have been associated with measures of adverse health. The nature and significance of PG features in individuals with BED is unknown. Ninety-four patients with BED (28 men and 66 women) were classified by gambling group based on inclusionary criteria for Diagnostic and Statistical Manual-IV (DSM-IV) PG and compared on a range of behavioral, psychological and eating disorder (ED) psychopathology variables. One individual (1.1% of the sample) met criteria for PG, although 18.7% of patients with BED displayed one or more DSM-IV criteria for PG, hereafter referred to as problem gambling features. Men were more likely than women to have problem gambling features. BED patients with problem gambling features were distinguished by lower self-esteem and greater substance problem use. After controlling for gender, findings of reduced self-esteem and increased substance problem use among patients with problem gambling features remained significant. In patients with BED, problem gambling features are associated with a number of heightened clinical problems.

Which Factors Affect Dental Esthetics and Smile Attractiveness in Orthodontically Treated Patients?

PubMed Central

Heravi, Farzin; Rashed, Roozbeh; Zarrabi, Mohammad Javad; Setayesh, Yasin

2015-01-01

Objectives: This study aimed to find the factors that affect dental esthetics and smile attractiveness in orthodontically treated patients according to laypeople’s judgment, and to determine whether there is any relationship between dental and smile esthetics. Materials and Methods: Using the Q-sort technique, 60 laypersons (30 males, 30 females) rated dental and smile photographs of 48 orthodontically treated patients based on their degree of attractiveness. Dental and smile parameters of each rated image were measured by Smile Analyzer software. The Student’s t-test and chi-square test were used to compare dental and smile parameters between attractive and unattractive images. The logistic regression was used to assess which variables predicted dental and smile esthetics in treated individuals. Results: The philtral to commissural height ratio and gingival display were significantly different in attractive and unattractive smiles (P=0.003 and P=0.02, respectively). None of the dental variables were found to be a determinant of dental esthetics at the end of the orthodontic treatment (P>0.05). According to the judgment of all raters (female and male) and the male raters’ judgment, smile attractiveness could be predicted by philtral to commissural height ratio and buccal corridor ratio (P<0.05). There was no statistically significant relationship between dental esthetics and smile attractiveness in orthodontically treated patients (P>0.05). Conclusion: The philtral to commissural height ratio and buccal corridor ratio can be considered as predictors of smile attractiveness in orthodontically treated patients. Achieving dental esthetics at the end of orthodontic treatment does not guarantee smile attractiveness. PMID:26877739

Increasing recruitment rates in an inpatient clinical research study using quality improvement methods.

PubMed

Sauers, Hadley S; Beck, Andrew F; Kahn, Robert S; Simmons, Jeffrey M

2014-11-01

One important benefit of successful patient recruitment is increased generalizability of findings. We sought to optimize enrollment of children admitted with asthma as part of a population-based, prospective, observational cohort study with the goal of enrolling at least 60% of all eligible and staffed patients. Quality improvement methods were used to improve cohort recruitment. Weekly meetings with study staff and study leadership were held to plan and discuss how to maximize recruitment rates. Significant initial variability in recruitment success prompted the team to use small-scale tests of change to increase recruitment numbers. A number of tests were trialed, focusing primarily on reducing patient refusals and improving recruitment process efficiency. Recruitment rates were calculated by dividing eligible by enrolled patients and displayed using annotated Shewhart control charts. Control charts were used to illustrate week-to-week variability while also enabling differentiation of common-cause and special-cause variation. The study enrolled 774 patients, representing 54% of all eligible and 59% of those eligible for whom staff were available to enroll. Our mean weekly recruitment rate increased from 55% during the first 3 months of the study to a statistically significant sustained rate of 61%. This was sustained given numerous obstacles, such as departing and hiring of staff and adding a second recruitment location. Implementing quality improvement methods within a larger research study led to an increase in the rate of recruitment as well as the stability in recruitment rates from week-to-week. Copyright © 2014 by the American Academy of Pediatrics.

Paradoxical effect of dopamine medication on cognition in Parkinson's disease: relationship to side of motor onset.

PubMed

Hanna-Pladdy, Brenda; Pahwa, Rajesh; Lyons, Kelly E

2015-04-01

Parkinson's disease (PD) is characterized by asymmetric motor symptom onset attributed to greater degeneration of dopamine neurons contralateral to the affected side. However, whether motor asymmetries predict cognitive profiles in PD, and to what extent dopamine influences cognition remains controversial. This study evaluated cognitive variability in PD by measuring differential response to dopamine replacement therapy (DRT) based on hemispheric asymmetries. The influence of DRT on cognition was evaluated in mild PD patients (n = 36) with left or right motor onset symptoms. All subjects were evaluated on neuropsychological measures on and off DRT and compared to controls (n = 42). PD patients were impaired in executive, memory and motor domains irrespective of side of motor onset, although patients with left hemisphere deficit displayed greater cognitive impairment. Patients with right hemisphere deficit responded to DRT with significant improvement in sensorimotor deficits, and with corresponding improvement in attention and verbal memory functions. Conversely, patients with greater left hemisphere dopamine deficiency did not improve in attentional functions and declined in verbal memory recall following DRT. These findings support the presence of extensive mild cognitive deficits in early PD not fully explained by dopamine depletion alone. The paradoxical effects of levodopa on verbal memory were predicted by extent of fine motor impairment and sensorimotor response to levodopa, which reflects extent of dopamine depletion. The findings are discussed with respect to factors influencing variable cognitive profiles in early PD, including hemispheric asymmetries and differential response to levodopa based on dopamine levels predicting amelioration or overdosing.

A study of poor insight in social anxiety disorder.

PubMed

Vigne, Paula; de Menezes, Gabriela B; Harrison, Ben J; Fontenelle, Leonardo F

2014-11-30

We investigated levels of insight among patients with Social Anxiety Disorder (SAD) as compared to patients with Obsessive-Compulsive Disorder (OCD) and evaluated whether levels of insight in SAD were related to specific sociodemographic and/or clinical features. Thirty-seven SAD patients and 51 OCD patients attending a tertiary obsessive-compulsive and anxiety disorders clinic were assessed with a sociodemographic and clinical questionnaire, a structured diagnostic interview, the Brown Assessment of Beliefs Scale (BABS), the Social Phobia Inventory (SPIN), the Beck Depression Inventory (BDI), the Sheehan Disability Scale (SDS), and the Treatment Adherence Survey-patient version (TAS-P). According to the BABS, SAD patients exhibited insight levels that were as low as those exhibited by OCD patients, with up to 29.7% of them being described as "poor insight" SAD. Although poor insight SAD patients were more frequently married, less depressed and displayed a statistical trend towards greater rates of early drop-out from cognitive-behavioral therapy, their insight levels were not associated with other variables of interest, including sex, age, employment, age at onset, duration of illness, associated psychiatric disorders, SPIN and SDS scores. Patients with poor insight SAD might perceive their symptoms as being less distressful and thus report fewer depressive symptoms and high rates of treatment non-adherence. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Polyplanar optic display for cockpit application

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

Veligdan, J.; Biscardi, C.; Brewster, C.

1998-04-01

The Polyplanar Optical Display (POD) is a high contrast display screen being developed for cockpit applications. This display screen is 2 inches thick and has a matte black face which allows for high contrast images. The prototype being developed is a form, fit and functional replacement display for the B-52 aircraft which uses a monochrome ten-inch display. The new display uses a long lifetime, (10,000 hour), 200 mW green solid-state laser (532 nm) as its optical source. In order to produce real-time video, the laser light is being modulated by a Digital Light Processing (DLP{trademark}) chip manufactured by Texas Instruments,more » Inc. A variable astigmatic focusing system is used to produce a stigmatic image on the viewing face of the POD. In addition to the optical design and speckle reduction, the authors discuss the electronic interfacing to the DLP{trademark} chip, the opto-mechanical design and viewing angle characteristics.« less

Polyplanar optic display

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

Veligdan, J.; Biscardi, C.; Brewster, C.

1997-07-01

The Polyplanar Optical Display (POD) is a unique display screen which can be used with any projection source. This display screen is 2 inches thick and has a matte black face which allows for high contrast images. The prototype being developed is a form, fit and functional replacement display for the B-52 aircraft which uses a monochrome ten-inch display. The new display uses a 100 milliwatt green solid state laser (532 nm) as its optical source. In order to produce real-time video, the laser light is being modulated by a Digital Light Processing (DLP{trademark}) chip manufactured by Texas Instruments, Inc.more » A variable astigmatic focusing system is used to produce a stigmatic image on the viewing face of the POD. In addition to the optical design, the authors discuss the electronic interfacing to the DLP{trademark} chip, the opto-mechanical design and viewing angle characteristics.« less

Polyplanar optic display for cockpit application

NASA Astrophysics Data System (ADS)

Veligdan, James T.; Biscardi, Cyrus; Brewster, Calvin; DeSanto, Leonard; Freibott, William C.

1998-09-01

The Polyplanar Optical Display (POD) is a high contrast display screen being developed for cockpit applications. This display screen is 2 inches thick and has a matte black face which allows for high contrast images. The prototype being developed is a form, fit and functional replacement display for the B-52 aircraft which uses a monochrome ten-inch display. The new display uses a long lifetime, (10,000 hour), 200 mW green solid-state laser (532 nm) as its optical source. In order to produce real-time video, the laser light is being modulated by a Digital Light Processing (DLPTM) chip manufactured by Texas Instruments, Inc. A variable astigmatic focusing system is used to produce a stigmatic image on the viewing face of the POD. In addition to the optical design and speckle reduction, we discuss the electronic interfacing to the DLPTM chip, the opto-mechanical design and viewing angle characteristics.

Distinctive Resting State Network Disruptions Among Alzheimer's Disease, Subcortical Vascular Dementia, and Mixed Dementia Patients.

PubMed

Kim, Hee Jin; Cha, Jungho; Lee, Jong-Min; Shin, Ji Soo; Jung, Na-Yeon; Kim, Yeo Jin; Choe, Yearn Seong; Lee, Kyung Han; Kim, Sung Tae; Kim, Jae Seung; Lee, Jae Hong; Na, Duk L; Seo, Sang Won

2016-01-01

Recent advances in resting-state functional MRI have revealed altered functional networks in Alzheimer's disease (AD), especially those of the default mode network (DMN) and central executive network (CEN). However, few studies have evaluated whether small vessel disease (SVD) or combined amyloid and SVD burdens affect the DMN or CEN. The aim of this study was to evaluate whether SVD or combined amyloid and SVD burdens affect the DMN or CEN. In this cross-sectional study, we investigated the resting-state functional connectivity within DMN and CEN in 37 Pittsburgh compound-B (PiB)(+) AD, 37 PiB(-) subcortical vascular dementia (SVaD), 13 mixed dementia patients, and 65 normal controls. When the resting-state DMN of PiB(+) AD and PiB(-) SVaD patients were compared, the PiB(+) AD patients displayed lower functional connectivity in the inferior parietal lobule while the PiB(-) SVaD patients displayed lower functional connectivity in the medial frontal and superior frontal gyri. Compared to the PiB(-) SVaD or PiB(+) AD, the mixed dementia patients displayed lower functional connectivity within the DMN in the posterior cingulate gyrus. When the resting-state CEN connectivity of PiB(+) AD and PiB(-) SVaD patients were compared, the PiB(-) SVaD patients displayed lower functional connectivity in the anterior insular region. Compared to the PiB(-) SVaD or PiB(+) AD, the mixed dementia patients displayed lower functional connectivity within the CEN in the inferior frontal gyrus. Our findings suggest that in PiB(+) AD and PiB(-) SVaD, there is divergent disruptions in resting-state DMN and CEN. Furthermore, patients with combined amyloid and SVD burdens exhibited more disrupted resting-state DMN and CEN than patients with only amyloid or SVD burden.

Increasing the perceptual salience of relationships in parallel coordinate plots.

PubMed

Harter, Jonathan M; Wu, Xunlei; Alabi, Oluwafemi S; Phadke, Madhura; Pinto, Lifford; Dougherty, Daniel; Petersen, Hannah; Bass, Steffen; Taylor, Russell M

2012-01-01

We present three extensions to parallel coordinates that increase the perceptual salience of relationships between axes in multivariate data sets: (1) luminance modulation maintains the ability to preattentively detect patterns in the presence of overplotting, (2) adding a one-vs.-all variable display highlights relationships between one variable and all others, and (3) adding a scatter plot within the parallel-coordinates display preattentively highlights clusters and spatial layouts without strongly interfering with the parallel-coordinates display. These techniques can be combined with one another and with existing extensions to parallel coordinates, and two of them generalize beyond cases with known-important axes. We applied these techniques to two real-world data sets (relativistic heavy-ion collision hydrodynamics and weather observations with statistical principal component analysis) as well as the popular car data set. We present relationships discovered in the data sets using these methods.

Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis.

PubMed

Chalmers, John A; Quintana, Daniel S; Abbott, Maree J-Anne; Kemp, Andrew H

2014-01-01

Anxiety disorders increase risk of future cardiovascular disease (CVD) and mortality, even after controlling for confounds including smoking, lifestyle, and socioeconomic status, and irrespective of a history of medical disorders. While impaired vagal function, indicated by reductions in heart rate variability (HRV), may be one mechanism linking anxiety disorders to CVD, prior studies have reported inconsistent findings highlighting the need for meta-analysis. Studies comparing resting-state HRV recordings in patients with an anxiety disorder as a primary diagnosis and healthy controls were considered for meta-analysis. Meta-analyses were based on 36 articles, including 2086 patients with an anxiety disorder and 2294 controls. Overall, anxiety disorders were characterized by lower HRV [high frequency (HF): Hedges' g = -0.29. 95% CI: -0.41 to -0.17, p < 0.001; time domain: Hedges' g = -0.45, 95% CI: -0.57 to -0.33, p < 0.001] than controls. Panic disorder (n = 447), post-traumatic stress disorder (n = 192), generalized anxiety disorder (n = 68), and social anxiety disorder (n = 90), but not obsessive-compulsive disorder (n = 40), displayed reductions in HF HRV relative to controls (all ps < 0.001). Anxiety disorders are associated with reduced HRV, findings associated with a small-to-moderate effect size. Findings have important implications for future physical health and well-being of patients, highlighting a need for comprehensive cardiovascular risk reduction.

Variegated clonality and rapid emergence of new molecular lesions in xenografts of acute lymphoblastic leukemia are associated with drug resistance.

PubMed

Nowak, Daniel; Liem, Natalia L M; Mossner, Maximilian; Klaumünzer, Marion; Papa, Rachael A; Nowak, Verena; Jann, Johann C; Akagi, Tadayuki; Kawamata, Norihiko; Okamoto, Ryoko; Thoennissen, Nils H; Kato, Motohiro; Sanada, Masashi; Hofmann, Wolf-Karsten; Ogawa, Seishi; Marshall, Glenn M; Lock, Richard B; Koeffler, H Phillip

2015-01-01

The use of genome-wide copy-number analysis and massive parallel sequencing has revolutionized the understanding of the clonal architecture of pediatric acute lymphoblastic leukemia (ALL) by demonstrating that this disease is composed of highly variable clonal ancestries following the rules of Darwinian selection. The current study aimed to analyze the molecular composition of childhood ALL biopsies and patient-derived xenografts with particular emphasis on mechanisms associated with acquired chemoresistance. Genomic DNA from seven primary pediatric ALL patient samples, 29 serially passaged xenografts, and six in vivo selected chemoresistant xenografts were analyzed with 250K single-nucleotide polymorphism arrays. Copy-number analysis of non-drug-selected xenografts confirmed a highly variable molecular pattern of variegated subclones. Whereas primary patient samples from initial diagnosis displayed a mean of 5.7 copy-number alterations per sample, serially passaged xenografts contained a mean of 8.2 and chemoresistant xenografts a mean of 10.5 copy-number alterations per sample, respectively. Resistance to cytarabine was explained by a new homozygous deletion of the DCK gene, whereas methotrexate resistance was associated with monoallelic deletion of FPGS and mutation of the remaining allele. This study demonstrates that selecting for chemoresistance in xenografted human ALL cells can reveal novel mechanisms associated with drug resistance. Copyright © 2015 ISEH - International Society for Experimental Hematology. Published by Elsevier Inc. All rights reserved.

Gene transfer of Hodgkin cell lines via multivalent anti-CD30 scFv displaying bacteriophage.

PubMed

Chung, Yoon-Suk A; Sabel, Katja; Krönke, Martin; Klimka, Alexander

2008-04-16

The display of binding ligands, such as recombinant antibody fragments, on the surface of filamentous phage makes it possible to specifically attach these phage particles to target cells. After uptake of the phage, their internal single-stranded DNA is processed by the host cell, which allows transient expression of an encoded eukaryotic gene cassette. This opens the possibility to use bacteriophage as vectors for targeted gene therapy, although the transduction efficiency is very low. Here we demonstrate the display of an anti-CD30 single chain variable fragment fused to the major coat protein pVIII on the surface of bacteriophage. These phage particles showed an improved binding and transduction efficiency of CD30 positive Hodgkin-lymphoma cells, compared to bacteriophage with the anti-CD30 single chain variable fragment fused to the minor coat protein pIII. We can conclude from the results that the postulated multivalency of the anti-CD30-pVIII displaying bacteriophage combined with disseminated display of the anti-CD30 scFv on the whole particle surface is responsible for the improved gene transfer rate. These results mark an important step towards the use of phage particles as a cheap and safe gene transfer vehicle for the gene delivery of the desired target cells via their specific surface receptors.

Treatment Concept for a Patient with a High Smile Line and Gingival Pigmentation: A Case Report.

PubMed

Zarone, Fernando; Leone, Renato; Ferrari, Marco; Sorrentino, Roberto

Today, innovative restorative materials and techniques allow for minimally invasive prosthetic procedures, which are paramount to the preservation of hard and soft dental tissues. An integrated approach combining dental and esthetic medical therapies could be useful to improve the quality of life of patients, improving function, esthetics, and self-confidence. Oral esthetics depends on several variables, including tooth visibility and proportions as well as healthy gingival tissues. Proper integration between teeth and periodontal tissues plays an important role in esthetic success, which is mainly represented by an appealing smile. The present case report was aimed at describing the multidisciplinary treatment of a woman who was unsatisfied with the shape of her central incisors and the dark gingival pigmentation displayed by a high smile line. The patient was treated with minimally invasive combined periodontal, prosthetic, and esthetic medical techniques. The described multidisciplinary approach based on surgical gingival depigmentation, adhesive ceramic veneers, and selective botulinum toxin injection was effective in solving the undesired high smile line and achieving patient satisfaction.

An intersubject variable regional anesthesia simulator with a virtual patient architecture.

PubMed

Ullrich, Sebastian; Grottke, Oliver; Fried, Eduard; Frommen, Thorsten; Liao, Wei; Rossaint, Rolf; Kuhlen, Torsten; Deserno, Thomas M

2009-11-01

The main purpose is to provide an intuitive VR-based training environment for regional anesthesia (RA). The research question is how to process subject-specific datasets, organize them in a meaningful way and how to perform the simulation for peripheral regions. We propose a flexible virtual patient architecture and methods to process datasets. Image acquisition, image processing (especially segmentation), interactive nerve modeling and permutations (nerve instantiation) are described in detail. The simulation of electric impulse stimulation and according responses are essential for the training of peripheral RA and solved by an approach based on the electric distance. We have created an XML-based virtual patient database with several subjects. Prototypes of the simulation are implemented and run on multimodal VR hardware (e.g., stereoscopic display and haptic device). A first user pilot study has confirmed our approach. The virtual patient architecture enables support for arbitrary scenarios on different subjects. This concept can also be used for other simulators. In future work, we plan to extend the simulation and conduct further evaluations in order to provide a tool for routine training for RA.

Effect of 24-h continuous rotigotine treatment on stationary and non-stationary locomotion in de novo patients with Parkinson disease in an open-label uncontrolled study.

PubMed

Serrao, Mariano; Ranavolo, Alberto; Conte, Carmela; Davassi, Chiara; Mari, Silvia; Fasano, Alfonso; Chini, Giorgia; Coppola, Gianluca; Draicchio, Francesco; Pierelli, Francesco

2015-11-01

The aim of this study was to investigate the effect of a rotigotine transdermal patch on stationary and non-stationary locomotion in de novo Parkinson disease (PD) patients in an open-label uncontrolled study. A 3-D gait analysis system was used to investigate four different locomotor tasks: steady-state linear walking, gait initiation, gait termination and 180°-turning. A series of gait variables were measured for each locomotor task. PD patients who received rotigotine treatment (4-8 mg) displayed: (1) increased step length, gait speed, cadence and arm oscillations, and reduced double support duration and step asymmetry during steady-state linear gait; (2) increased initial step length during gait initiation; (3) increased final step length and gait speed, and decreased stability index during gait termination; (4) decreased duration of turning and head-pelvis delays during 180°-turning. The main finding that emerges from the present study is that the dopamine agonist rotigotine can improve various aspects of gait in de novo PD patients.

Expanding Dimensionality in Cinema Color: Impacting Observer Metamerism through Multiprimary Display

NASA Astrophysics Data System (ADS)

Long, David L.

Television and cinema display are both trending towards greater ranges and saturation of reproduced colors made possible by near-monochromatic RGB illumination technologies. Through current broadcast and digital cinema standards work, system designs employing laser light sources, narrow-band LED, quantum dots and others are being actively endorsed in promotion of Wide Color Gamut (WCG). Despite artistic benefits brought to creative content producers, spectrally selective excitations of naturally different human color response functions exacerbate variability of observer experience. An exaggerated variation in color-sensing is explicitly counter to the exhaustive controls and calibrations employed in modern motion picture pipelines. Further, singular standard observer summaries of human color vision such as found in the CIE's 1931 and 1964 color matching functions and used extensively in motion picture color management are deficient in recognizing expected human vision variability. Many researchers have confirmed the magnitude of observer metamerism in color matching in both uniform colors and imagery but few have shown explicit color management with an aim of minimized difference in observer perception variability. This research shows that not only can observer metamerism influences be quantitatively predicted and confirmed psychophysically but that intentionally engineered multiprimary displays employing more than three primaries can offer increased color gamut with drastically improved consistency of experience. To this end, a seven-channel prototype display has been constructed based on observer metamerism models and color difference indices derived from the latest color vision demographic research. This display has been further proven in forced-choice paired comparison tests to deliver superior color matching to reference stimuli versus both contemporary standard RGB cinema projection and recently ratified standard laser projection across a large population of color-normal observers.

The iMeteo is a web-based weather visualization tool

NASA Astrophysics Data System (ADS)

Tuni San-Martín, Max; San-Martín, Daniel; Cofiño, Antonio S.

2010-05-01

iMeteo is a web-based weather visualization tool. Designed with an extensible J2EE architecture, it is capable of displaying information from heterogeneous data sources such as gridded data from numerical models (in NetCDF format) or databases of local predictions. All this information is presented in a user-friendly way, being able to choose the specific tool to display data (maps, graphs, information tables) and customize it to desired locations. *Modular Display System* Visualization of the data is achieved through a set of mini tools called widgets. A user can add them at will and arrange them around the screen easily with a drag and drop movement. They can be of various types and each can be configured separately, forming a really powerful and configurable system. The "Map" is the most complex widget, since it can show several variables simultaneously (either gridded or point-based) through a layered display. Other useful widgets are the the "Histogram", which generates a graph with the frequency characteristics of a variable and the "Timeline" which shows the time evolution of a variable at a given location in an interactive way. *Customization and security* Following the trends in web development, the user can easily customize the way data is displayed. Due to programming in client side with technologies like AJAX, the interaction with the application is similar to the desktop ones because there are rapid respone times. If a user is registered then he could also save his settings in the database, allowing access from any system with Internet access with his particular setup. There is particular emphasis on application security. The administrator can define a set of user profiles, which may have associated restrictions on access to certain data sources, geographic areas or time intervals.

The effects of commercial electronic variable message signs (CEVMS) on driver attention and distraction : an update

DOT National Transportation Integrated Search

2009-02-01

The present report reviews research concerning the possible effects of Commercial Electronic Variable Message Signs (CEVMS) used for outdoor advertising on driver safety. Such CEVMS displays are alternatively known as Electronic Billboards (EBB) and ...

Analyticity in Time and Smoothing Effect of Solutions to Nonlinear Schrödinger Equations

NASA Astrophysics Data System (ADS)

Hayashi, Nakao; Kato, Keiichi

In this paper we consider analyticity in time and smoothing effect of solutions to nonlinear Schrödinger equations where . We prove that if φ satisfies then there exists a unique solution of (1) and positive constants T, C0, C1 such that is analytic in time and space variables for and and has an analytic continuation on and In the case the condition (2) can be relaxed as follows: where m= 0 if n= 1, p= 1, m= 1 if n= 2, and m= 1 if n= 3, p= 1.

Head-Mounted Display Technology for Low Vision Rehabilitation and Vision Enhancement

PubMed Central

Ehrlich, Joshua R.; Ojeda, Lauro V.; Wicker, Donna; Day, Sherry; Howson, Ashley; Lakshminarayanan, Vasudevan; Moroi, Sayoko E.

2017-01-01

Purpose To describe the various types of head-mounted display technology, their optical and human factors considerations, and their potential for use in low vision rehabilitation and vision enhancement. Design Expert perspective. Methods An overview of head-mounted display technology by an interdisciplinary team of experts drawing on key literature in the field. Results Head-mounted display technologies can be classified based on their display type and optical design. See-through displays such as retinal projection devices have the greatest potential for use as low vision aids. Devices vary by their relationship to the user’s eyes, field of view, illumination, resolution, color, stereopsis, effect on head motion and user interface. These optical and human factors considerations are important when selecting head-mounted displays for specific applications and patient groups. Conclusions Head-mounted display technologies may offer advantages over conventional low vision aids. Future research should compare head-mounted displays to commonly prescribed low vision aids in order to compare their effectiveness in addressing the impairments and rehabilitation goals of diverse patient populations. PMID:28048975

An introduction to the clinical phenomenology of Tourette syndrome.

PubMed

Martino, Davide; Madhusudan, Namrata; Zis, Panagiotis; Cavanna, Andrea E

2013-01-01

Tourette syndrome (TS) is the primary tic disorder that reaches most commonly medical attention and monitoring, with an estimated prevalence close to 1% between 5 and 18 years of age. Motor and phonic tics are the core features of TS. In addition to their well-characterized phenomenology, tics display a peculiar variability over time, which is strongly influenced by a variety of contextual factors. The sensory phenomena of TS are increasingly recognized as another crucial symptom of TS and consist of premonitory urges and somatic hypersensitivity. A relevant proportion of patients with TS display complex, tic-like, repetitive behaviors that include echophenomena, coprophenomena, and nonobscene socially inappropriate behaviors (NOSIBs). The burden of behavioral comorbidities is very important in determining the degree of disability of TS patients. Only a small minority of TS patients presents exclusively with a tic disorder. Obsessive-compulsive symptoms and related disorder (OCD) are common in TS, and the clinical distinction between compulsions and complex tics may be difficult in some cases. Probably, the presence of comorbid attention deficit hyperactivity disorder (ADHD) is the main determinant of cognitive dysfunction in TS patients and influences heavily also the risk of developing disruptive behaviors. Affective disorders, impulse control disorders, autism spectrum disorders, and personality disorders complete the wide psychopathological spectrum of this condition, but have been less investigated than OCD and ADHD. The complexity of the Tourette spectrum has been confirmed by cluster and factor analytical approaches, and is likely to inform the study of the genetic basis of this disorder, as well as future reappraisal of its nosography, with the development of novel clinical subtypes. © 2013 Elsevier Inc. All rights reserved.

Pupil-class determinants of aggressive and victim behaviour in pupils.

PubMed

Mooij, T

1998-09-01

Aggressive behaviour in pupils is expressed in, e.g., bullying, sexual harassment, and violence. Different kinds of variables could be relevant in explaining a pupil's aggressive or victim behaviour. To develop a multilevel theoretical and empirical explanation for different kinds of aggressive and victim behaviour displayed by pupils in a classroom and school environment. A national survey was carried out to identify different kinds of aggressive and victim behaviour displayed by pupils and to assess other variables related to pupils, classes, and schools. A total of 1998 pupils from 100 third and fourth year classes attending 71 different secondary schools took part in the research. Data were analysed by a series of secondary multilevel analyses using the MLA-program. Being a boy, being more extravert, being more disagreeable, coming across fewer teachers with positive teaching behaviour, and attending a lower type of secondary school, help explain why someone is a perpetrator as such. Being a boy, being more disagreeable, being more emotionally unstable, being open to new ideas, and seeing more teachers as being strict, function as explanatory pupil variables for victim behaviour. Other pupil level variables determine more specific aggressive and victim behaviour aspects. Various other class level and school level variables are relevant, too. Personal and environmental pupil variables are more important than class variables but class variables are in turn more important than school variables in explaining a pupil's aggressive and victim behaviour.

AMPS data management requirements study, appendix 1. [user manuals (computer programs)/display devices - computerized simulation/experimentation/ionosphere

NASA Technical Reports Server (NTRS)

1975-01-01

Flow charts and display formats for the simulation of five experiments are given. The experiments are: (1) electromagnetic wave transmission; (2) passive observations of ambient plasma; (3) ionospheric measurements with subsatellite; (4) electron accelerator beam measurements; and (5) measurement of acoustical gravity waves in the sodium layer using lasers. A detailed explanation of the simulation procedure, definition of variables, and an explanation of how the experimenter makes display choices is also presented. A functional description is included on each flow chart and the assumptions and definitions of terms and scope of the flow charts and displays are presented.

Human factors studies of control configurations for advanced transport aircraft

NASA Technical Reports Server (NTRS)

Snyder, Harry L.; Monty, Robert W.; Old, Joe

1985-01-01

This research investigated the threshold levels of display luminance contrast which were required to interpret static, achromatic, integrated displays of primary flight information. A four-factor within-subjects design was used to investigate the influences of type of flight variable information, the level of ambient illumination, the type of control input, and the size of the display symbology on the setting of these interpretability thresholds. A three-alternative forced choice paradigm was used in conjunction with the method of adjustments to obtain a measure of the upper limen of display luminance contrast needed to interpret a complex display of primary flight information. The pattern of results and the absolute magnitudes of the luminance contrast settings were found to be in good agreement with previously reported data from psychophysical investigations of display luminance contrast requirements.

The underlying structure of diagnostic systems of schizophrenia: a comprehensive polydiagnostic approach.

PubMed

Peralta, Victor; Cuesta, Manuel J

2005-11-15

The objective was to ascertain the underlying factor structure of alternative definitions of schizophrenia, and to examine the distribution of schizophrenia-related variables against the resulting factor solution. Twenty-three diagnostic schemes of schizophrenia were applied to 660 patients presenting with psychotic symptoms regardless of the specific diagnosis of psychotic disorder. Factor analysis of the 23 diagnostic schemes yielded three interpretable factors explaining 58% of the variance, the first factor (general schizophrenia factor) accounting for most of the variance (36%). On the basis of the general schizophrenia factor score, the sample was divided in quintile groups representing 5 levels of schizophrenia definition (absent, doubtful, very broad, broad and narrow) and the distribution of a number of schizophrenia-related variables was examined across the groups. This grouping procedure was used for examining the comparative validity of alternative levels of categorically defined schizophrenia and an ordinal (i.e. dimensional) definition. Overall, schizophrenia-related variables displayed a dose-response relationship with level of schizophrenia definition. Logistic regression analyses revealed that the dimensional definition explained more variance in the schizophrenia-related variables than the alternative levels for defining schizophrenia categorically. These results are consistent with a unitary and dimensional construct of schizophrenia with no clear "points of rarity" at its boundaries, thus supporting the continuum hypothesis of the psychotic illness.

Method and apparatus for non-invasive evaluation of diaphragmatic function

NASA Technical Reports Server (NTRS)

Yost, William T. (Inventor); Wait, Juliette L. (Inventor); Nahormek, Patricia A. (Inventor); Cantrell, John H. (Inventor); Hanna-Hawver, Pamela D. (Inventor)

1995-01-01

A method for non-invasive evaluation of diaphragmatic function in humans measures the thickness of the diaphragm in real time with an ultrasonic device, and displays the variations of diaphragm thickness versus time. Formulae are given for calculating a quantitative value for the reserve fatigue capacity of a patient's diaphragm from data obtained by measuring the time limits for maintaining a constant breathing pattern on the display at two different pressure differentials in series with the patient's airways. An apparatus for displaying the diaphragm thickness in real time is also described. The method can be used both on healthy patients and on patients with so severe breathing dysfunctions that they require breathing support from respirators.

Method and apparatus for non-invasive evaluation of diaphragmatic function

NASA Technical Reports Server (NTRS)

Yost, William T. (Inventor); Wait, Juliette L. (Inventor); Nahormek, Patricia A. (Inventor); Cantrell, John H. (Inventor); Hanna-Hawver, Pamela D. (Inventor)

1994-01-01

A method for non-invasive evaluation of diaphragmatic function in humans measures the thickness of the diaphragm in real time with an ultrasonic device, and displays the variations of diaphragm thickness versus time. Formulae are given for calculating a quantitative value for the reserve fatigue capacity of a patient's diaphragm from data obtained by measuring the time limits for maintaining a constant breathing pattern on the display at two different pressure differentials in series with the patient's airways. An apparatus for displaying the diaphragm thickness in real time is also described. The method can be used both on healthy patients and on patients with so severe breathing dysfunctions that they require breathing support from respirators.

Function and structure of the deep cervical extensor muscles in patients with neck pain.

PubMed

Schomacher, Jochen; Falla, Deborah

2013-10-01

The deep cervical extensors are anatomically able to control segmental movements of the cervical spine in concert with the deep cervical flexors. Several investigations have confirmed changes in cervical flexor muscle control in patients with neck pain and as a result, effective evidence-based therapeutic exercises have been developed to address such dysfunctions. However, knowledge on how the deep extensor muscles behave in patients with neck pain disorders is scare. Structural changes such as higher concentration of fat within the muscle, variable cross-sectional area and higher proportions of type II fibres have been observed in the deep cervical extensors of patients with neck pain compared to healthy controls. These findings suggest that the behaviour of the deep extensors may be altered in patients with neck pain. Consistent with this hypothesis, a recent series of studies confirm that patients display reduced activation of the deep cervical extensors as well as less defined activation patterns. This article provides an overview of the various different structural and functional changes in the deep neck extensor muscles documented in patients with neck pain. Relevant recommendations for the management of muscle dysfunction in patients with neck pain are presented. Copyright © 2013 Elsevier Ltd. All rights reserved.

Parents’ empathic perspective taking and altruistic behavior predicts infants’ arousal to others’ emotions

PubMed Central

Upshaw, Michaela B.; Kaiser, Cheryl R.; Sommerville, Jessica A.

2015-01-01

Empathy emerges in children’s overt behavior around the middle of the second year of life. Younger infants, however, exhibit arousal in response to others’ emotional displays, which is considered to be a precursor to fully developed empathy. The goal of the present study was to investigate individual variability in infants’ arousal toward others’ emotional displays, as indexed by 12- and 15-month-old infants’ (n = 49) pupillary changes in response to another infant’s emotions, and to determine whether such variability is linked to parental empathy and prosociality, as indexed via self-report questionnaires. We found that increases in infants’ pupil dilation in response to others’ emotional displays were associated with aspects of parental empathy and prosociality. Specifically, infants who exhibited the greatest arousal in response to others’ emotions had parents who scored highly on empathic perspective taking and self-reported altruism. These relations may have been found because arousal toward others’ emotions shares certain characteristics with empathic and prosocial dispositions. Together, these results demonstrate the presence of early variability in a precursor to mature empathic responding in infancy, which is meaningfully linked to parents’ empathic dispositions and prosocial behaviors. PMID:25883577

Sampling-Based Stochastic Sensitivity Analysis Using Score Functions for RBDO Problems with Correlated Random Variables

DTIC Science & Technology

2010-08-01

a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. a ...SECURITY CLASSIFICATION OF: This study presents a methodology for computing stochastic sensitivities with respect to the design variables, which are the...Random Variables Report Title ABSTRACT This study presents a methodology for computing stochastic sensitivities with respect to the design variables

Effect of dynamic temperature storage in retail display case on the quality and microbiota of packaged fresh-cut leafy greens

USDA-ARS?s Scientific Manuscript database

Commercial refrigeration equipment is projected to rise 5.2% annually to meet the consumer demand for fresh-cut produce items. The highly variable temperature conditions associated with storage of fresh-cuts in commercial open-refrigerated display cases dramatically affects the shelf-life and qualit...

Diversions: Writing the Alphabet Using Dots, Pixillated Alphanumerics, and Cross-Stitch

ERIC Educational Resources Information Center

Gough, John

2017-01-01

When computers started having screens (or monitors), as well as printers, a new alphanumeric display was created using dots. A crucial variable in designing alphabet letters and digits, using dots, is the height of the display, measured in dots. This article addresses the same design questions tackled by designers of typefaces or fonts, and shows…

Results of a simulator test comparing two display concepts for piloted flight-path-angle control

NASA Technical Reports Server (NTRS)

Kelley, W. W.

1978-01-01

Results of a simulator experiment which was conducted in order to compare pilot gamma-control performance using two display formats are reported. Pilots flew a variable flight path angle tracking task in the landing configuration. Pilot and airplane performance parameters were recorded and pilot comments noted for each case.

SU-E-T-41: Analysis of GI Dose Variability Due to Intrafraction Setup Variance

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

Phillips, J; Wolfgang, J

2014-06-01

Purpose: Proton SBRT (stereotactic body radiation therapy) can be an effective modality for treatment of gastrointestinal tumors, but limited in practice due to sensitivity with respect to variation in the RPL (radiological path length). Small, intrafractional shifts in patient anatomy can lead to significant changes in the dose distribution. This study describes a tool designed to visualize uncertainties in radiological depth in patient CT's and aid in treatment plan design. Methods: This project utilizes the Shadie toolkit, a GPU-based framework that allows for real-time interactive calculations for volume visualization. Current SBRT simulation practice consists of a serial CT acquisition formore » the assessment of inter- and intra-fractional motion utilizing patient specific immobilization systems. Shadie was used to visualize potential uncertainties, including RPL variance and changes in gastric content. Input for this procedure consisted of two patient CT sets, contours of the desired organ, and a pre-calculated dose. In this study, we performed rigid registrations between sets of 4DCT's obtained from a patient with varying setup conditions. Custom visualizations are written by the user in Shadie, permitting one to create color-coded displays derived from a calculation along each ray. Results: Serial CT data acquired on subsequent days was analyzed for variation in RPB and gastric content. Specific shaders were created to visualize clinically relevant features, including RPL (radiological path length) integrated up to organs of interest. Using pre-calculated dose distributions and utilizing segmentation masks as additional input allowed us to further refine the display output from Shadie and create tools suitable for clinical usage. Conclusion: We have demonstrated a method to visualize potential uncertainty for intrafractional proton radiotherapy. We believe this software could prove a useful tool to guide those looking to design treatment plans least insensitive to motion for patients undergoing proton SBRT in the GI tract.« less

A quantitative evaluation of the three dimensional reconstruction of patients' coronary arteries.

PubMed

Klein, J L; Hoff, J G; Peifer, J W; Folks, R; Cooke, C D; King, S B; Garcia, E V

1998-04-01

Through extensive training and experience angiographers learn to mentally reconstruct the three dimensional (3D) relationships of the coronary arterial branches. Graphic computer technology can assist angiographers to more quickly visualize the coronary 3D structure from limited initial views and then help to determine additional helpful views by predicting subsequent angiograms before they are obtained. A new computer method for facilitating 3D reconstruction and visualization of human coronary arteries was evaluated by reconstructing biplane left coronary angiograms from 30 patients. The accuracy of the reconstruction was assessed in two ways: 1) by comparing the vessel's centerlines of the actual angiograms with the centerlines of a 2D projection of the 3D model projected into the exact angle of the actual angiogram; and 2) by comparing two 3D models generated by different simultaneous pairs on angiograms. The inter- and intraobserver variability of reconstruction were evaluated by mathematically comparing the 3D model centerlines of repeated reconstructions. The average absolute corrected displacement of 14,662 vessel centerline points in 2D from 30 patients was 1.64 +/- 2.26 mm. The average corrected absolute displacement of 3D models generated from different biplane pairs was 7.08 +/- 3.21 mm. The intraobserver variability of absolute 3D corrected displacement was 5.22 +/- 3.39 mm. The interobserver variability was 6.6 +/- 3.1 mm. The centerline analyses show that the reconstruction algorithm is mathematically accurate and reproducible. The figures presented in this report put these measurement errors into clinical perspective showing that they yield an accurate representation of the clinically relevant information seen on the actual angiograms. These data show that this technique can be clinically useful by accurately displaying in three dimensions the complex relationships of the branches of the coronary arterial tree.

Autonomic cardiac regulation during spontaneous nocturnal hypoglycemia in patients with type 1 diabetes.

PubMed

Koivikko, Minna L; Tulppo, Mikko P; Kiviniemi, Antti M; Kallio, Mika A; Perkiömäki, Juha S; Salmela, Pasi I; Airaksinen, K E Juhani; Huikuri, Heikki V

2012-07-01

Experimental clamp studies have suggested that hypoglycemia evokes a reduction of cardiac vagal control in patients with type 1 diabetes. However, there are limited data on the influence of spontaneous nocturnal hypoglycemia on cardiac autonomic regulation. Adults with type 1 diabetes (n = 37) underwent continuous glucose monitoring via a subcutaneous sensor as well as recording of R-R interval or electrocardiogram for 3 nights. Heart rate (HR) variability was analyzed during periods of hypoglycemia (glucose <3.5 mmol/L) (minimum length of 20 min) and a control nonhypoglycemic period (glucose >3.9 mmol/L) of equal duration and at the same time of night. The duration of hypoglycemic and control episodes (n = 18) ranged from 20 to 190 min (mean 71 min). HR (62 ± 7 vs. 63 ± 9 beats per min; P = 0.30) or the high-frequency component of HR power spectrum (2,002 ± 1,965 vs. 1,336 ± 1,506 ms(2); P = 0.26) did not change during hypoglycemia. Hypoglycemia resulted in a significant decrease in the low-frequency component of HR variability (2,134 ± 1,635 vs. 1,169 ± 1,029 ms(2), respectively; P = 0.006). The decline in the glucose concentration displayed a significant positive correlation with the decrease of the low-frequency component of HR variability (r = 0.48; P = 0.04). The latter was closely related to an increase in muscle sympathetic nerve activity recorded in 10 subjects during controlled sympathetic activation. Spontaneous nocturnal hypoglycemia in patients with type 1 diabetes results in a reduction of the low-frequency component of HR, which is best explained by excessive sympathetic activation without a concomitant withdrawal of vagal outflow.

The cognitive effects of oxcarbazepine versus carbamazepine or valproate in newly diagnosed children with partial seizures.

PubMed

Donati, Filippo; Gobbi, Giuseppe; Campistol, Jaume; Rapatz, Guenter; Daehler, Maja; Sturm, Yvonne; Aldenkamp, Albert P

2007-12-01

To investigate the effect of oxcarbazepine against standard antiepileptic drug therapy (carbamazepine and valproate) on cognitive function in children and adolescents (aged 6 to <17 years) with newly diagnosed partial seizures. A multicentre, open-label, randomised, active-control, three-arm, parallel-group, 6-month study. The primary cognitive variable, the Computerized Visual Searching Task (CVST), assessed mental information processing speed and attention. Secondary variables included additional tests assessing psychomotor speed, alertness, memory and learning, and non-verbal intelligence. Of 112 patients randomised, 99 completed the study. The dropout rate was 11.6%; 13 patients discontinued due to adverse events (n=5) or unsatisfactory therapeutic effect (n=8). Mean CVST time decreased in all groups, indicating an improvement of mental processing speed and no cognitive impairment in any treatment group. No statistically significant difference was observed between oxcarbazepine and combined carbamazepine/valproate. Analysis of secondary variables did not show statistically significant differences between oxcarbazepine, carbamazepine and valproate. Analysis of intelligence test results showed that the number of correct answers increased at end point in all groups. The percentage of patients remaining seizure free throughout treatment was comparable across all groups (oxcarbazepine 58%; carbamazepine 46%; valproate 54%; carbamazepine/valproate 50%). The most common adverse events were fatigue and headache for oxcarbazepine, fatigue and rash for carbamazepine, and headache, increased appetite and alopecia for valproate. Oxcarbazepine treatment over 6 months does not display any differential effects on cognitive function and intelligence in children and adolescents with newly diagnosed partial seizures relative to standard antiepileptic drug therapy. No impairment in cognitive function was observed in any treatment group over a 6-month period.

Optimization of visual evoked potential (VEP) recording systems.

PubMed

Karanjia, Rustum; Brunet, Donald G; ten Hove, Martin W

2009-01-01

To explore the influence of environmental conditions on pattern visual evoked potential (VEP) recordings. Fourteen subjects with no known ocular pathology were recruited for the study. In an attempt to optimize the recording conditions, VEP recordings were performed in both the seated and recumbent positions. Comparisons were made between recordings using either LCD or CRT displays and recordings obtained in silence or with quiet background music. Paired recordings (in which only one variable was changed) were analyzed for changes in P100 latency, RMS noise, and variability. Baseline RMS noise demonstrated a significant decrease in the variability during the first 50msec accompanied by a 73% decrease in recording time for recumbent position when compared to the seated position (p<0.05). Visual evoked potentials recorded using LCD monitors demonstrated a significant increase in the P100 latency when compared to CRT recordings in the same subjects. The addition of background music did not affect the amount of RMS noise during the first 50msec of the recordings. This study demonstrates that the use of the recumbent position increases patient comfort and improves the signal to noise ratio. In contrast, the addition of background music to relax the patient did not improve the recording signal. Furthermore, the study illustrates the importance of avoiding low-contrast visual stimulation patterns obtained with LCD as they lead to higher latencies resulting in false positive recordings. These findings are important when establishing or modifying a pattern VEP recording protocol.

Highly Discriminatory Variable-Number Tandem-Repeat Markers for Genotyping of Trichophyton interdigitale Strains

PubMed Central

Drira, Ines; Hadrich, Ines; Neji, Sourour; Mahfouth, Nedia; Trabelsi, Houaida; Sellami, Hayet; Makni, Fattouma

2014-01-01

Trichophyton interdigitale is the second most frequent cause of superficial fungal infections of various parts of the human body. Studying the population structure and genotype differentiation of T. interdigitale strains may lead to significant improvements in clinical practice. The present study aimed to develop and select suitable variable-number tandem-repeat (VNTR) markers for 92 clinical strains of T. interdigitale. On the basis of an analysis of four VNTR markers, four to eight distinct alleles were detected for each marker. The marker with the highest discriminatory power had eight alleles and a D value of 0.802. The combination of all four markers yielded a D value of 0.969 with 29 distinct multilocus genotypes. VNTR typing revealed the genetic diversity of the strains, identifying three populations according to their colonization sites. A correlation between phenotypic characteristics and multilocus genotypes was observed. Seven patients harbored T. interdigitale strains with different genotypes. Typing of clinical T. interdigitale samples by VNTR markers displayed excellent discriminatory power and 100% reproducibility. PMID:24989614

From mild ataxia to huntington disease phenocopy: the multiple faces of spinocerebellar ataxia 17.

PubMed

Koutsis, Georgios; Panas, Marios; Paraskevas, George P; Bougea, Anastasia M; Kladi, Athina; Karadima, Georgia; Kapaki, Elisabeth

2014-01-01

Introduction. Spinocerebellar ataxia 17 (SCA 17) is a rare autosomal dominant cerebellar ataxia (ADCA) caused by a CAG/CAA expansion in the TBP gene, reported from a limited number of countries. It is a very heterogeneous ADCA characterized by ataxia, cognitive decline, psychiatric symptoms, and involuntary movements, with some patients presenting with Huntington disease (HD) phenocopies. The SCA 17 expansion is stable during parent-child transmission and intrafamilial phenotypic homogeneity has been reported. However, significant phenotypic variability within families has also been observed. Report of the Family. We presently report a Greek family with a pathological expansion of 54 repeats at the SCA 17 locus that displayed remarkable phenotypic variability. Among 3 affected members, one presented with HD phenocopy; one with progressive ataxia, dementia, chorea, dystonia, and seizures, and one with mild slowly progressive ataxia with minor cognitive and affective symptoms. Conclusions. This is the first family with SCA 17 identified in Greece and highlights the multiple faces of this rare disorder, even within the same family.

From Mild Ataxia to Huntington Disease Phenocopy: The Multiple Faces of Spinocerebellar Ataxia 17

PubMed Central

Panas, Marios; Paraskevas, George P.; Bougea, Anastasia M.; Karadima, Georgia; Kapaki, Elisabeth

2014-01-01

Introduction. Spinocerebellar ataxia 17 (SCA 17) is a rare autosomal dominant cerebellar ataxia (ADCA) caused by a CAG/CAA expansion in the TBP gene, reported from a limited number of countries. It is a very heterogeneous ADCA characterized by ataxia, cognitive decline, psychiatric symptoms, and involuntary movements, with some patients presenting with Huntington disease (HD) phenocopies. The SCA 17 expansion is stable during parent-child transmission and intrafamilial phenotypic homogeneity has been reported. However, significant phenotypic variability within families has also been observed. Report of the Family. We presently report a Greek family with a pathological expansion of 54 repeats at the SCA 17 locus that displayed remarkable phenotypic variability. Among 3 affected members, one presented with HD phenocopy; one with progressive ataxia, dementia, chorea, dystonia, and seizures, and one with mild slowly progressive ataxia with minor cognitive and affective symptoms. Conclusions. This is the first family with SCA 17 identified in Greece and highlights the multiple faces of this rare disorder, even within the same family. PMID:25349749

Non-verbal communication in meetings of psychiatrists and patients with schizophrenia.

PubMed

Lavelle, M; Dimic, S; Wildgrube, C; McCabe, R; Priebe, S

2015-03-01

Recent evidence found that patients with schizophrenia display non-verbal behaviour designed to avoid social engagement during the opening moments of their meetings with psychiatrists. This study aimed to replicate, and build on, this finding, assessing the non-verbal behaviour of patients and psychiatrists during meetings, exploring changes over time and its association with patients' symptoms and the quality of the therapeutic relationship. 40-videotaped routine out-patient consultations, involving patients with schizophrenia, were analysed. Non-verbal behaviour of patients and psychiatrists was assessed during three fixed, 2-min intervals using a modified Ethological Coding System for Interviews. Symptoms, satisfaction with communication and the quality of the therapeutic relationship were also measured. Over time, patients' non-verbal behaviour remained stable, whilst psychiatrists' flight behaviour decreased. Patients formed two groups based on their non-verbal profiles, one group (n = 25) displaying pro-social behaviour, inviting interaction and a second (n = 15) displaying flight behaviour, avoiding interaction. Psychiatrists interacting with pro-social patients displayed more pro-social behaviours (P < 0.001). Patients' pro-social profile was associated reduced symptom severity (P < 0.05), greater satisfaction with communication (P < 0.001) and positive therapeutic relationships (P < 0.05). Patients' non-verbal behaviour during routine psychiatric consultations remains unchanged, and is linked to both their psychiatrist's non-verbal behaviour and the quality of the therapeutic relationship. © 2014 The Authors. Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd.

Genotyping and antifungal susceptibility testing of multiple Malassezia pachydermatis isolates from otitis and dermatitis cases in pets: is it really worth the effort?

PubMed

Álvarez-Pérez, Sergio; García, Marta E; Peláez, Teresa; Blanco, José L

2016-01-01

A total of 216 colonies of Malassezia pachydermatis from 28 cases of fungal otitis or dermatitis in pets were genotyped by M13 fingerprinting and tested for antifungal susceptibility. A huge genetic diversity was found (157 M13 types in total), with all animals having a polyclonal pattern of infection (5.4 ± 1.5 genotypes/sample). Furthermore, analysis of molecular variance (AMOVA) revealed that most genetic diversity (44%) was found at the within sample level. In contrast, variability in antifungal susceptibility among isolates from the same sample was less important, with different M13 types displaying in most cases identical or very similar MIC results. Most isolates displayed high in vitro susceptibility to amphotericin B, terbinafine and all azoles tested except fluconazole, for which MIC values were always ≥4 μg/ml and a 26.9% of isolates displayed values ≥32 μg/ml. We conclude that although characterization of multiple yeast isolates results in a considerable increase in laboratory workload and expenses, it may help to get a better understanding of the epidemiology of M. pachydermatis in a given patient population. © The Author 2015. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Association of APOC3 polymorphisms with both dyslipidemia and lipoatrophy in HAART-receiving patients.

PubMed

Bonnet, Eric; Bernard, Jacques; Fauvel, Josette; Massip, Patrice; Ruidavets, Jean-Bernard; Perret, Bertrand

2008-02-01

The incidence and the magnitude of lipodystrophy and dyslipidemia in HIV-treated people reported in previous studies are very variable. Several predisposing factors have been identified, but there are few data on genetic factors. To search for a correlation between APOC3 polymorphisms and lipid disorders and lipodystrophy in HIV patients under d4T and protease inhibitors (PI)-containing HAART, we designed a monocenter, cross-sectional study in a University Hospital in Southern France during the period 2001-2004. Forty patients under HAART were included, with d4T for > or = 2 years and PI for > or = 1 year. We determined body mass composition by DXA, lipoprotein markers, and the -455/-482 apo C3 genotypes. Carriers of APOC3 variant alleles (-455 1/-482 1) displayed higher levels of triglycerides (3.72 vs. 2.57 mmol/liter), apo C3 (45.3 vs. 34.5 mg/liter), and apo E (130.2 vs. 66.5 mg/liter) and a lower fat mass (13.9 vs. 19.7%) than patients with nonvariant alleles (-455 0/-482 0). APOC3 polymorphisms might be associated with both dyslipidemia and lipoatrophy in HAART-treated patients.

Development of a risk-adjustment model for antimicrobial utilization data in 21 public hospitals in Queensland, Australia (2006-11).

PubMed

Rajmokan, M; Morton, A; Marquess, J; Playford, E G; Jones, M

2013-10-01

Making valid comparisons of antimicrobial utilization between hospitals requires risk adjustment for each hospital's case mix. Data on individual patients may be unavailable or difficult to process. Therefore, risk adjustment for antimicrobial usage frequently needs to be based on a hospital's services. This study evaluated such a strategy for hospital antimicrobial utilization. Data were obtained on five broad subclasses of antibiotics [carbapenems, β-lactam/β-lactamase inhibitor combinations (BLBLIs), fluoroquinolones, glycopeptides and third-generation cephalosporins] from the Queensland pharmacy database (MedTrx) for 21 acute public hospitals (2006-11). Eleven clinical services and a variable for hospitals from the tropical region were employed for risk adjustment. Multivariable regression models were used to identify risk and protective services for these antibiotics. Funnel plots were used to display hospitals' antimicrobial utilization. Total inpatient antibiotic utilization for these antibiotics increased from 130.6 defined daily doses (DDDs)/1000 patient-days in 2006 to 155.8 DDDs/1000 patient-days in 2011 (P < 0.0001). Except for third-generation cephalosporins, the average utilization rate was higher for intensive care, renal/nephrology, cardiac, burns/plastic surgery, neurosurgery, transplant and acute spinal services than for the respective reference group (no service). In addition, oncology, high-activity infectious disease and coronary care services were associated with higher utilization of carbapenems, BLBLIs and glycopeptides. Our model predicted antimicrobial utilization rates by hospital services. The funnel plots displayed hospital utilization data after adjustment for variation among the hospitals. However, the methodology needs to be validated in other populations, ideally using a larger group of hospitals.

Aberdeen polygons: computer displays of physiological profiles for intensive care.

PubMed

Green, C A; Logie, R H; Gilhooly, K J; Ross, D G; Ronald, A

1996-03-01

The clinician in an intensive therapy unit is presented regularly with a range of information about the current physiological state of the patients under care. This information typically comes from a variety of sources and in a variety of formats. A more integrated form of display incorporating several physiological parameters may be helpful therefore. Three experiments are reported that explored the potential use of analogue, polygon diagrams to display physiological data from patients undergoing intensive therapy. Experiment 1 demonstrated that information can be extracted readily from such diagrams comprising 8- or 10-sided polygons, but with an advantage for simpler polygons and for information displayed at the top of the diagram. Experiment 2 showed that colour coding removed these biases for simpler polygons and the top of the diagram, together with speeding the processing time. Experiment 3 used polygons displaying patterns of physiological data that were consistent with typical conditions observed in the intensive care unit. It was found that physicians can readily learn to recognize these patterns and to diagnose both the nature and severity of the patient's physiological state. These polygon diagrams appear to have some considerable potential for use in providing on-line summary information of a patient's physiological state.

Impact of Adding a Pictorial Display to Enhance Recall of Cancer Patient Histories: A Randomized Trial.

PubMed

Wolch, Gary; Ghosh, Sunita; Boyington, Curtiss; Watanabe, Sharon M; Fainsinger, Robin; Burton-Macleod, Sarah; Thai, Vincent; Thai, JoAnn; Fassbender, Konrad

2017-01-01

Current health care delivery models have increased the need for safe and concise patient handover. Handover interventions in the literature have focused on the use of structured tools but have not evaluated their ability to facilitate retention of patient information. In this study, mock pictorial displays were generated in an attempt to create a snapshot of each patient's medical and social circumstances. These pictorial displays contained the patient's photograph and other disease- and treatment-related images. The objective of this randomized trial was to assess the ability of these snapshots to enhance delayed information recall by care providers. Participating physicians were given four advanced cancer patient histories to review, two at a time over two weeks. Pictorial image displays, referred to as the Electronic Whiteboard (EWB) were added, in a randomized manner to half of the textual histories. The impact of the EWB on information recall was tested in immediate and delayed time frames. Overall, patient information recall declined significantly over time, with or without the EWB. Still, this trial demonstrates significantly higher test scores after 24 hours with the addition of pictures to textual patient information, compared with textual information alone (P = 0.0002). A more modest improvement was seen with the addition of the EWB for questionnaires administered immediately after history review (P = 0.008). Most participants agreed that the EWB was a useful enhancement and that seeing a patient's photograph improved their ability to retain information. Most studies examining the institution of handover protocols in the health care setting have failed to harness the power of pictures and other representative images. This study demonstrates the ability of pictorial displays to improve both immediate and delayed recall of patient histories without increasing review time. These types of displays may be amenable to generation by software programs and have the potential to enhance information transfer in various settings. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

A mouse model of high trait anxiety shows reduced heart rate variability that can be reversed by anxiolytic drug treatment.

PubMed

Gaburro, Stefano; Stiedl, Oliver; Giusti, Pietro; Sartori, Simone B; Landgraf, Rainer; Singewald, Nicolas

2011-11-01

Increasing evidence suggests that specific physiological measures may serve as biomarkers for successful treatment to alleviate symptoms of pathological anxiety. Studies of autonomic function investigating parameters such as heart rate (HR), HR variability and blood pressure (BP) indicated that HR variability is consistently reduced in anxious patients, whereas HR and BP data show inconsistent results. Therefore, HR and HR variability were measured under various emotionally challenging conditions in a mouse model of high innate anxiety (high anxiety behaviour; HAB) vs. control normal anxiety-like behaviour (NAB) mice. Baseline HR, HR variability and activity did not differ between mouse lines. However, after cued Pavlovian fear conditioning, both elevated tachycardia and increased fear responses were observed in HAB mice compared to NAB mice upon re-exposure to the conditioning stimulus serving as the emotional stressor. When retention of conditioned fear was tested in the home cage, HAB mice again displayed higher fear responses than NAB mice, while the HR responses were similar. Conversely, in both experimental settings HAB mice consistently exhibited reduced HR variability. Repeated administration of the anxiolytic NK1 receptor antagonist L-822429 lowered the conditioned fear response and shifted HR dynamics in HAB mice to a more regular pattern, similar to that in NAB mice. Additional receiver-operating characteristic (ROC) analysis demonstrated the high specificity and sensitivity of HR variability to distinguish between normal and high anxiety trait. These findings indicate that assessment of autonomic response in addition to freezing might be a useful indicator of the efficacy of novel anxiolytic treatments.

Ex-vivo sensitivity profiling to guide clinical decision making in acute myeloid leukemia: A pilot study.

PubMed

Swords, Ronan T; Azzam, Diana; Al-Ali, Hassan; Lohse, Ines; Volmar, Claude-Henry; Watts, Justin M; Perez, Aymee; Rodriguez, Ana; Vargas, Fernando; Elias, Roy; Vega, Francisco; Zelent, Arthur; Brothers, Shaun P; Abbasi, Taher; Trent, Jonathan; Rangwala, Shaukat; Deutsch, Yehuda; Conneally, Eibhlin; Drusbosky, Leylah; Cogle, Christopher R; Wahlestedt, Claes

2018-01-01

A precision medicine approach is appealing for use in AML due to ease of access to tumor samples and the significant variability in the patients' response to treatment. Attempts to establish a precision medicine platform for AML, however, have been unsuccessful, at least in part due to the use of small compound panels and having relatively slow turn over rates, which restricts the scope of treatment and delays its onset. For this pilot study, we evaluated a cohort of 12 patients with refractory AML using an ex vivo drug sensitivity testing (DST) platform. Purified AML blasts were screened with a panel of 215 FDA-approved compounds and treatment response was evaluated after 72h of exposure. Drug sensitivity scoring was reported to the treating physician, and patients were then treated with either DST- or non-DST guided therapy. We observed survival benefit of DST-guided therapy as compared to the survival of patients treated according to physician recommendation. Three out of four DST-treated patients displayed treatment response, while all of the non-DST-guided patients progressed during treatment. DST rapidly and effectively provides personalized treatment recommendations for patients with refractory AML. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Zeta Pegasi: An SPB Variable Star

NASA Technical Reports Server (NTRS)

Goebel, John H.

2007-01-01

Broadband photometric observations of the bright star Zeta Pegasi are presented that display brightness variability of 488.2 +/- 6.6 micromag (ppm) range with a period of 22.952 +/- 0.804 hr (f approx. equals 1.04566 c/d). The variation is monosinusoidal, so the star is recommended for membership in the class of small-amplitude Slowly Pulsating B-Stars (SPB) variables oscillating in a non-radial g-mode.

Effects of translational and rotational motions and display polarity on visual performance.

PubMed

Feng, Wen-Yang; Tseng, Feng-Yi; Chao, Chin-Jung; Lin, Chiuhsiang Joe

2008-10-01

This study investigated effects of both translational and rotational motion and display polarity on a visual identification task. Three different motion types--heave, roll, and pitch--were compared with the static (no motion) condition. The visual task was presented on two display polarities, black-on-white and white-on-black. The experiment was a 4 (motion conditions) x 2 (display polarities) within-subjects design with eight subjects (six men and two women; M age = 25.6 yr., SD = 3.2). The dependent variables used to assess the performance on the visual task were accuracy and reaction time. Motion environments, especially the roll condition, had statistically significant effects on the decrement of accuracy and reaction time. The display polarity was significant only in the static condition.

Sequential dynamics of culturally moderated facial expressions of emotion.

PubMed

Matsumoto, David; Willingham, Bob; Olide, Andres

2009-10-01

There is consensus that when emotions are aroused, the displays of those emotions are either universal or culture-specific. We investigated the idea that an individual's emotional displays in a given context can be both universal and culturally variable, as they change over time. We examined the emotional displays of Olympic athletes across time, classified their expressive styles, and tested the association between those styles and a number of characteristics associated with the countries the athletes represented. Athletes from relatively urban, individualistic cultures expressed their emotions more, whereas athletes from less urban, collectivistic cultures masked their emotions more. These culturally influenced expressions occurred within a few seconds after initial, immediate, and universal emotional displays. Thus, universal and culture-specific emotional displays can unfold across time in an individual in a single context.

Advanced Transport Operating System (ATOPS) control display unit software description

NASA Technical Reports Server (NTRS)

Slominski, Christopher J.; Parks, Mark A.; Debure, Kelly R.; Heaphy, William J.

1992-01-01

The software created for the Control Display Units (CDUs), used for the Advanced Transport Operating Systems (ATOPS) project, on the Transport Systems Research Vehicle (TSRV) is described. Module descriptions are presented in a standardized format which contains module purpose, calling sequence, a detailed description, and global references. The global reference section includes subroutines, functions, and common variables referenced by a particular module. The CDUs, one for the pilot and one for the copilot, are used for flight management purposes. Operations performed with the CDU affects the aircraft's guidance, navigation, and display software.

AOIPS water resources data management system

NASA Technical Reports Server (NTRS)

Vanwie, P.

1977-01-01

The text and computer-generated displays used to demonstrate the AOIPS (Atmospheric and Oceanographic Information Processing System) water resources data management system are investigated. The system was developed to assist hydrologists in analyzing the physical processes occurring in watersheds. It was designed to alleviate some of the problems encountered while investigating the complex interrelationships of variables such as land-cover type, topography, precipitation, snow melt, surface runoff, evapotranspiration, and streamflow rates. The system has an interactive image processing capability and a color video display to display results as they are obtained.

High-throughput sequencing enhanced phage display enables the identification of patient-specific epitope motifs in serum.

PubMed

Christiansen, Anders; Kringelum, Jens V; Hansen, Christian S; Bøgh, Katrine L; Sullivan, Eric; Patel, Jigar; Rigby, Neil M; Eiwegger, Thomas; Szépfalusi, Zsolt; de Masi, Federico; Nielsen, Morten; Lund, Ole; Dufva, Martin

2015-08-06

Phage display is a prominent screening technique with a multitude of applications including therapeutic antibody development and mapping of antigen epitopes. In this study, phages were selected based on their interaction with patient serum and exhaustively characterised by high-throughput sequencing. A bioinformatics approach was developed in order to identify peptide motifs of interest based on clustering and contrasting to control samples. Comparison of patient and control samples confirmed a major issue in phage display, namely the selection of unspecific peptides. The potential of the bioinformatic approach was demonstrated by identifying epitopes of a prominent peanut allergen, Ara h 1, in sera from patients with severe peanut allergy. The identified epitopes were confirmed by high-density peptide micro-arrays. The present study demonstrates that high-throughput sequencing can empower phage display by (i) enabling the analysis of complex biological samples, (ii) circumventing the traditional laborious picking and functional testing of individual phage clones and (iii) reducing the number of selection rounds.

“It Looks Like an Adult Sweetie Shop”: Point-of-Sale Tobacco Display Exposure and Brand Awareness in Scottish Secondary School Students

PubMed Central

van der Sluijs, Winfried; Miller, Martine; MacGregor, Andy; Sharp, Clare; Amos, Amanda; Best, Catherine; Stead, Martine; Eadie, Douglas; Pearce, Jamie; Frank, John; Haw, Sally

2016-01-01

Introduction: As further restrictions have been placed on tobacco advertising and promotions, point-of-sale (PoS) displays of cigarettes in shops have become an increasingly important source of young people’s exposure to tobacco products. This study explored the relationship between PoS displays of cigarettes and brand awareness among secondary school students in Scotland. Methods: Cross-sectional school surveys (n = 1406) and focus groups (n = 86) were conducted with S2 (13–14 years) and S4 (15–16 years) students in four schools of differing socioeconomic status in 2013, prior to the PoS display ban in large shops. Adjusted negative binomial regression analysis examined associations between brand awareness and exposure variables (visiting tobacco retailers, noticing displays of tobacco products). Results: Students visiting small shops more frequently (relative rate ratio [RRR] 1.19, 95% confidence interval [CI] 1.01–1.41) and those who noticed cigarette displays in small shops (RRR 1.24, 95% CI 1.03–1.51) and large supermarkets (RRR 1.15, 95% CI 1.01–1.30) had higher brand awareness. The focus groups supported these findings. Participants described PoS tobacco displays as being eye-catching, colorful and potentially attractive to young people. Conclusions: This mixed-methods study showed that higher cigarette brand awareness was significantly associated with regularly visiting small shops and noticing PoS displays in small and large shops, even when students’ smoking status, smoking in their social networks, leisure activities, and demographics were included as confounding variables. This highlights the importance of PoS displays of tobacco products in increasing brand awareness, which is known to increase youth smoking susceptibility, and thus the importance of implementing PoS display bans in all shops. Implications: As increasing restrictions have been placed on tobacco promotion in many countries, PoS displays of cigarettes in shops have become an important source of young people’s exposure to tobacco products and marketing. This mixed-methods study showed that prior to the PoS display ban in Scotland, and controlling for other factors, 13- and 15-year olds who regularly visited small shops and those who noticed PoS displays in small and large shops, had a higher awareness of cigarette brands. This highlights the importance of PoS displays in increasing youth brand awareness, which increases smoking susceptibility, and thus the need for comprehensive bans on PoS displays which cover all shops. PMID:26883750

"It Looks Like an Adult Sweetie Shop": Point-of-Sale Tobacco Display Exposure and Brand Awareness in Scottish Secondary School Students.

PubMed

van der Sluijs, Winfried; Haseen, Farhana; Miller, Martine; MacGregor, Andy; Sharp, Clare; Amos, Amanda; Best, Catherine; Stead, Martine; Eadie, Douglas; Pearce, Jamie; Frank, John; Haw, Sally

2016-10-01

As further restrictions have been placed on tobacco advertising and promotions, point-of-sale (PoS) displays of cigarettes in shops have become an increasingly important source of young people's exposure to tobacco products. This study explored the relationship between PoS displays of cigarettes and brand awareness among secondary school students in Scotland. Cross-sectional school surveys (n = 1406) and focus groups (n = 86) were conducted with S2 (13-14 years) and S4 (15-16 years) students in four schools of differing socioeconomic status in 2013, prior to the PoS display ban in large shops. Adjusted negative binomial regression analysis examined associations between brand awareness and exposure variables (visiting tobacco retailers, noticing displays of tobacco products). Students visiting small shops more frequently (relative rate ratio [RRR] 1.19, 95% confidence interval [CI] 1.01-1.41) and those who noticed cigarette displays in small shops (RRR 1.24, 95% CI 1.03-1.51) and large supermarkets (RRR 1.15, 95% CI 1.01-1.30) had higher brand awareness. The focus groups supported these findings. Participants described PoS tobacco displays as being eye-catching, colorful and potentially attractive to young people. This mixed-methods study showed that higher cigarette brand awareness was significantly associated with regularly visiting small shops and noticing PoS displays in small and large shops, even when students' smoking status, smoking in their social networks, leisure activities, and demographics were included as confounding variables. This highlights the importance of PoS displays of tobacco products in increasing brand awareness, which is known to increase youth smoking susceptibility, and thus the importance of implementing PoS display bans in all shops. As increasing restrictions have been placed on tobacco promotion in many countries, PoS displays of cigarettes in shops have become an important source of young people's exposure to tobacco products and marketing. This mixed-methods study showed that prior to the PoS display ban in Scotland, and controlling for other factors, 13- and 15-year olds who regularly visited small shops and those who noticed PoS displays in small and large shops, had a higher awareness of cigarette brands. This highlights the importance of PoS displays in increasing youth brand awareness, which increases smoking susceptibility, and thus the need for comprehensive bans on PoS displays which cover all shops. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

An Analysis of Attitudes toward the Vietnam War Displayed in Children's and Young Adult Literature Published after 1982.

ERIC Educational Resources Information Center

Verhoek, Nancy A.

A study involved the creation of a 20-variable checklist for children's and young adult war literature, to be utilized as a data-recording instrument for 24 examples of literature. The checklist components were based upon a combination of cognitive and affective attributes assisting in the formulation of attitudes toward war displayed by…

Use of an Antecedent Analysis and a Force Sensitive Platform to Compare Stereotyped Movements and Motor Tics

ERIC Educational Resources Information Center

Crosland, Kimberly A.; Zarcone, Jennifer R.; Schroeder, Stephen; Zarcane, Troy; Fowler, Stephen

2005-01-01

Stereotyped movements displayed by 6 participants and tics displayed by 6 children were evaluated using an antecedent behavioral analysis and a force sensitive platform. We found that tics occurred more often in an alone condition when compared to high preference toy and play conditions, whereas stereotyped movements were more variable across…

Standardization versus customization of glucose reporting.

PubMed

Rodbard, David

2013-05-01

Bergenstal et al. (Diabetes Technol Ther 2013;15:198-211) described an important approach toward standardization of reporting and analysis of continuous glucose monitoring and self-monitoring of blood glucose (SMBG) data. The ambulatory glucose profile (AGP), a composite display of glucose by time of day that superimposes data from multiple days, is perhaps the most informative and useful of the many graphical approaches to display glucose data. However, the AGP has limitations; some variations are desirable and useful. Synchronization with respect to meals, traditionally used in glucose profiles for SMBG data, can improve characterization of postprandial glucose excursions. Several other types of graphical display are available, and recently developed ones can augment the information provided by the AGP. There is a need to standardize the parameters describing glycemic variability and cross-validate the available computer programs that calculate glycemic variability. Clinical decision support software can identify and prioritize clinical problems, make recommendations for modifications of therapy, and explain its justification for those recommendations. The goal of standardization is challenging in view of the diversity of clinical situations and of computing and display platforms and software. Standardization is desirable but must be done in a manner that permits flexibility and fosters innovation.

Distribution of elements in individual blood cells in metabolic disorders at the cellular level

NASA Astrophysics Data System (ADS)

Johansson, Erland; Lindh, Ulf

1985-08-01

In comparison with controls neutrophil granulocytes from Rheumatoid arthritis (RA), Infantile Neuronal Ceroid Lipofuscinosis (INCL), Chronic Lymphatic Leukemia (L) and Aplastic Anemia (AA) displayed significant alterations in essential and non-essential elements which might be interpreted as fingerprints of these deseases. The neutrophils from RA patients displayed alterations in the concentrations of iron, calcium, strontium, manganese, zinc and copper. INCL displayed alterations in the concentrations of iron and copper but in the INCL disease the iron concentration was about 2 times higher than in RA. In leukemia, aluminium was observed but not in the controls (< 0.5 μg/ g). The zinc concentration was lowered in leukemia. Aplastic anemia displayed alterations in zirconium, arsenic, molybdenum, iron and zinc. The platelets from RA, INCL, L and AA patients also displayed alterations in the elemental profiles. The platelets from AA patients displayed a unique elemental distribution of arsenic, zirconium and molybdenum. The elemental profiles of the thrombocytes and neutrophils might be used as a complement in the diagnosis of the examined diseases and in therapy the elemental profile might be used to monitor drugs at the cellular level.

Production Function Geometry with "Knightian" Total Product

ERIC Educational Resources Information Center

Truett, Dale B.; Truett, Lila J.

2007-01-01

Authors of principles and price theory textbooks generally illustrate short-run production using a total product curve that displays first increasing and then diminishing marginal returns to employment of the variable input(s). Although it seems reasonable that a temporary range of increasing returns to variable inputs will likely occur as…

Artificial Intelligence Methods in Computer-Based Instructional Design. The Minnesota Adaptive Instructional System.

ERIC Educational Resources Information Center

Tennyson, Robert

1984-01-01

Reviews educational applications of artificial intelligence and presents empirically-based design variables for developing a computer-based instruction management system. Taken from a programmatic research effort based on the Minnesota Adaptive Instructional System, variables include amount and sequence of instruction, display time, advisement,…

Effects of magnification and visual accommodation on aimpoint estimation in simulated landings with real and virtual image displays

NASA Technical Reports Server (NTRS)

Randle, R. J.; Roscoe, S. N.; Petitt, J. C.

1980-01-01

Twenty professional pilots observed a computer-generated airport scene during simulated autopilot-coupled night landing approaches and at two points (20 sec and 10 sec before touchdown) judged whether the airplane would undershoot or overshoot the aimpoint. Visual accommodation was continuously measured using an automatic infrared optometer. Experimental variables included approach slope angle, display magnification, visual focus demand (using ophthalmic lenses), and presentation of the display as either a real (direct view) or a virtual (collimated) image. Aimpoint judgments shifted predictably with actual approach slope and display magnification. Both pilot judgments and measured accommodation interacted with focus demand with real-image displays but not with virtual-image displays. With either type of display, measured accommodation lagged far behind focus demand and was reliably less responsive to the virtual images. Pilot judgments shifted dramatically from an overwhelming perceived-overshoot bias 20 sec before touchdown to a reliable undershoot bias 10 sec later.

Raster graphics display library

NASA Technical Reports Server (NTRS)

Grimsrud, Anders; Stephenson, Michael B.

1987-01-01

The Raster Graphics Display Library (RGDL) is a high level subroutine package that give the advanced raster graphics display capabilities needed. The RGDL uses FORTRAN source code routines to build subroutines modular enough to use as stand-alone routines in a black box type of environment. Six examples are presented which will teach the use of RGDL in the fastest, most complete way possible. Routines within the display library that are used to produce raster graphics are presented in alphabetical order, each on a separate page. Each user-callable routine is described by function and calling parameters. All common blocks that are used in the display library are listed and the use of each variable within each common block is discussed. A reference on the include files that are necessary to compile the display library is contained. Each include file and its purpose are listed. The link map for MOVIE.BYU version 6, a general purpose computer graphics display system that uses RGDL software, is also contained.

Pharmacogenetic determinants of mercaptopurine disposition in children with acute lymphoblastic leukemia.

PubMed

Adam de Beaumais, Tiphaine; Jacqz-Aigrain, Evelyne

2012-09-01

The backbone of drug therapy used in acute lymphoblastic leukemia (ALL) in children includes 6-mercaptopurine (6-MP). Intracellular metabolism of this prodrug is a key component of the therapeutic response. Many metabolizing enzymes are involved in 6-MP disposition and active 6-MP metabolites are represented by 6-thioguanine nucleotides (6-TGN) and methylated metabolites primarily methylated by the thiopurine S-methyltransferase enzyme (TPMT). The genetic polymorphism affecting TPMT activity displays an important inter-subject variability in metabolites pharmacokinetics and influences the balance between 6-MP efficacy and toxicity: patients with high 6-TGN levels are at risk of myelosuppression while patients with high levels of methylated derivates are at hepatotoxic risk. However, the genetic TPMT polymorphism does not explain all 6-MP adverse events and some severe toxicities leading to life-threatening conditions remain unexplained. Additional single nucleotide polymorphisms (SNPs) in genes encoding enzymes involved in 6-MP metabolism and 6-MP transporters may also be responsible for this inter-individual 6-MP response variability. This review presents the pharmacogenetic aspects of 6-MP metabolism in great detail. We have focused on published data on ALL treatment supporting the great potential of 6-MP pharmacogenetics to improve efficacy, tolerance, and event-free survival rates in children with ALL.

Moving Beyond Average Values: Assessing the Night-To-Night Instability of Sleep and Arousal in DSM-IV-TR Insomnia Subtypes

PubMed Central

Sánchez-Ortuño, M. Montserrat; Carney, Colleen E.; Edinger, Jack D.; Wyatt, James K.; Harris, Andrea

2011-01-01

Study Objectives: We explored differences between individuals with DSM-IV-TR diagnoses of primary insomnia (PI) and insomnia related to a mental disorder (IMD) by using serial measurements of self-reported sleep variables (sleep onset latency, SOL; wake after sleep onset, WASO; total sleep time, TST; sleep efficiency, SE), and visual analogue scale ratings of 2 forms of bedtime arousal (cognitive and emotional). Furthermore, we sought to examine the relationship between sleep and arousal within each diagnostic subgroup. Design: Between-group and within-group comparisons. Setting: Duke and Rush University Medical Centers, USA. Participants: One hundred eighty-seven insomnia sufferers (126 women, average age 47.15 years) diagnosed by sleep specialists at 2 sleep centers as PI patients (n = 126) and IMD patients (n = 61). Interventions: N/A Measurements and Results: Multilevel models for sleep measures indicated that IMD displayed significantly more instability across nights in their TST (i.e., larger changes) than did PI patients. With respect to pre-sleep arousal, IMD patients exhibited higher mean levels of emotional arousal, as well as more instability on the nightly ratings of this measure. Within the PI group, correlational analyses revealed a moderate relationship between the 2 arousal variables and SOL (r values 0.29 and 0.26), whereas the corresponding correlations were negligible and statistically nonsignificant in the IMD group. Conclusions: We found a number of differences on nighttime variables between those diagnosed with primary insomnia and those diagnosed with insomnia related to a mental disorder. These differences imply different perpetuating mechanisms involved in their ongoing sleep difficulties. Additionally, they support the categorical distinctiveness and the concurrent validity of these insomnia subtypes. Citation: Sánchez-Ortuño MM; Carney CE; Edinger JD; Wyatt JK; Harris A. Moving beyond average values: assessing the night-to-night instability of sleep and arousal in DSM-IV-TR insomnia subtypes. SLEEP 2011;34(4):531-539 PMID:21461332

Potential Relationship between Season of Birth and Clinical Characteristics in Major Depressive Disorder in Koreans: Results from the CRESCEND Study.

PubMed

Park, Seon-Cheol; Sakong, Jeong-Kyu; Koo, Bon Hoon; Kim, Jae-Min; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jung-Bum; Yim, Hyeon-Woo; Park, Yong Chon

2016-05-01

We aimed to examine the potential relationship between season of birth (SOB) and clinical characteristics in Korean patients with unipolar non-psychotic major depressive disorder (MDD). Using data from the Clinical Research Center for Depression (CRESCEND) study in South Korea, 891 MDD patients were divided into two groups, those born in spring/summer (n=457) and those born in autumn/winter (n=434). Measurement tools comprising the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, Scale for Suicidal Ideation, Clinical Global Impression of severity, Social and Occupation Functional Assessment Scale, WHO Quality of Life assessment instrument-abbreviated version, Alcohol Use Disorder Identification Test, and Temperament and Character Inventory were used to evaluate depression, anxiety, overall symptoms, suicidal ideation, global severity, social function, quality of life, drinking, and temperament and character, respectively. Using independent t-tests for continuous variables and χ² tests for discrete variables, the clinical characteristics of the two groups were compared. MDD patients born in spring/summer were on average younger at onset of first depressive episode (t=2.084, p=0.038), had greater loss of concentration (χ²=4.589, p=0.032), and were more self-directed (t=2.256, p=0.025) than those born in autumn/winter. Clinically, there was a trend for the MDD patients born in spring/summer to display the contradictory characteristics of more severe clinical course and less illness burden; this may have been partly due to a paradoxical effect of the 5-HT system.

Heart rate variability is a trait marker of major depressive disorder: evidence from the sertraline vs. electric current therapy to treat depression clinical study.

PubMed

Brunoni, Andre Russowsky; Kemp, Andrew H; Dantas, Eduardo M; Goulart, Alessandra C; Nunes, Maria Angélica; Boggio, Paulo S; Mill, José Geraldo; Lotufo, Paulo A; Fregni, Felipe; Benseñor, Isabela M

2013-10-01

Decreased heart rate variability (HRV) is a cardiovascular predictor of mortality. Recent debate has focused on whether reductions in HRV in major depressive disorder (MDD) are a consequence of the disorder or a consequence of pharmacotherapy. Here we report on the impact of transcranial direct current stimulation (tDCS), a non-pharmacological intervention, vs. sertraline to further investigate this issue. The employed design was a double-blind, randomized, factorial, placebo-controlled trial. One hundred and eighteen moderate-to-severe, medication-free, low-cardiovascular risk depressed patients were recruited for this study and allocated to either active/sham tDCS (10 consecutive sessions plus two extra sessions every other week) or placebo/sertraline (50 mg/d) for 6 wk. Patients were age and gender-matched to healthy controls from a concurrent cohort study [the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)]. The impact of disorder, treatment and clinical response on HRV (root mean square of successive differences and high frequency) was examined. Our findings confirmed that patients displayed decreased HRV relative to controls. Furthermore, HRV scores did not change following treatment with either a non-pharmacological (tDCS) or pharmacological (sertraline) intervention, nor did HRV increase with clinical response to treatment. Based on these findings, we discuss whether reduced HRV is a trait-marker for MDD, which may predispose patients to a host of conditions and disease even after response to treatment. Our findings have important implications for our understanding of depression pathophysiology and the relationship between MDD, cardiovascular disorders and mortality.

Flexible Reporting of Clinical Data

PubMed Central

Andrews, Robert D.

1987-01-01

Two prototype methods have been developed to aid in the presentation of relevant clinical data: 1) an integrated report that displays results from a patient's computer-stored data and also allows manual entry of data, and 2) a graph program that plots results of multiple kinds of tests. These reports provide a flexible means of displaying data to help evaluate patient treatment. The two methods also explore ways of integrating the display of data from multiple components of the Veterans Administration's (VA) Decentralized Hospital Computer Program (DHCP) database.

Medical ozone increases methotrexate clinical response and improves cellular redox balance in patients with rheumatoid arthritis.

PubMed

León Fernández, Olga Sonia; Viebahn-Haensler, Renate; Cabreja, Gilberto López; Espinosa, Irainis Serrano; Matos, Yanet Hernández; Roche, Liván Delgado; Santos, Beatriz Tamargo; Oru, Gabriel Takon; Polo Vega, Juan Carlos

2016-10-15

Medical ozone reduced inflammation, IL-1β, TNF-α mRNA levels and oxidative stress in PG/PS-induced arthritis in rats. The aim of this study was to investigate the medical ozone effects in patients with rheumatoid arthritis treated with methotrexate and methotrexate+ozone, and to compare between them. A randomized clinical study with 60 patients was performed, who were divided into two groups: one (n=30) treated with methotrexate (MTX), folic acid and Ibuprophen (MTX group) and the second group (n=30) received the same as the MTX group+medical ozone by rectal insufflation of the gas (MTX+ozone group). The clinical response of the patients was evaluated by comparing Disease Activity Score 28 (DAS28), Health Assessment Questionnaire Disability Index (HAQ-DI), Anti-Cyclic Citrullinated (Anti-CCP) levels, reactants of acute phase and biochemical markers of oxidative stress before and after 20 days of treatment. MTX+ozone reduced the activity of the disease while MTX merely showed a tendency to decrease the variables. Reactants of acute phase displayed a similar picture. MTX+ozone reduced Anti-CCP levels as well as increased antioxidant system, and decreased oxidative damage whereas MTX did not change. Glutathione correlated with all clinical variables just after MTX+ozone. MTX+ozone increased the MTX clinical response in patients with rheumatoid arthritis. No side effects were observed. These results suggest that ozone can increase the efficacy of MTX probably because both share common therapeutic targets. Medical ozone treatment is capable of being a complementary therapy in the treatment of rheumatoid arthritis. Copyright © 2016 Elsevier B.V. All rights reserved.

Low Frequencies of Autoimmunity-Associated PTPN22 Polymorphisms in MODY Patients, Including Those Transiently Expressing Islet Cell Autoantibodies.

PubMed

Heneberg, Petr; Malá, Milena; Yorifuji, Tohru; Gat-Yablonski, Galia; Lebenthal, Yael; Tajima, Toshihiro; Nogaroto, Viviane; Rypáčková, Blanka; Kocková, Lucie; Urbanová, Jana; Anděl, Michal

2015-01-01

The protein tyrosine phosphatase nonreceptor type 22 (PTPN22) gene encodes lymphoid tyrosine phosphatase (LYP), which is expressed primarily in lymphoid tissues. The functional but geographically highly variable PTPN22 single-nucleotide polymorphisms (SNPs), particularly c.1858C>T, contribute to the onset and progression of autoimmunity-associated diseases and facilitate the expression of disease-associated autoantibodies. In Central Europe, 17-25% of patients with monogenic diabetes (maturity-onset diabetes of the young, MODY) transiently express islet cell autoantibodies. We addressed the links between the functional and geographically variable PTPN22 SNPs with MODY manifestation and the expression of islet cell autoantibodies in 276 MODY patients who originated from four regions (the Czech Republic, Israel, Japan and Brazil). The frequency of PTPN22 polymorphisms in the MODY patients was similar to those in geographically matched healthy populations, with the exception of c.788G>A, the minor allele frequency of which was significantly elevated in the Czech hepatocyte nuclear factor 1-α (HNF1A) MODY patients [odds ratio (OR) 4.8, 95% confidence interval (CI) 2.2-10.7] and the Brazilian MODY patients (OR 8.4, 95% CI 1.8-39.1). A barely significant increase in the c.788G>A minor allele was also detected in the islet cell autoantibody-positive Czech MODY patients. However, c.788A behaves as a loss-of-function mutant in T cells, and thus protects against autoimmunity. MODY patients (including islet cell autoantibody-positive cases) do not display any increase in autoimmunity-associated PTPN22 alleles. The absence of autoimmunity-associated PTPN22 alleles was also demonstrated in latent autoimmune diabetes in adults, which suggests that the slow kinetics of the onset of autoantibodies is subject to a regulation that is different from that experienced in type 1 diabetes and other autoimmune disorders. © 2015 S. Karger AG, Basel.

Normal Bone Mineral Density Associates with Duodenal Mucosa Healing in Adult Patients with Celiac Disease on a Gluten-Free Diet.

PubMed

Larussa, Tiziana; Suraci, Evelina; Imeneo, Maria; Marasco, Raffaella; Luzza, Francesco

2017-01-31

Impairment of bone mineral density (BMD) is frequent in celiac disease (CD) patients on a gluten-free diet (GFD). The normalization of intestinal mucosa is still difficult to predict. We aim to investigate the relationship between BMD and duodenal mucosa healing (DMH) in CD patients on a GFD. Sixty-four consecutive CD patients on a GFD were recruited. After a median period of a 6-year GFD (range 2-33 years), patients underwent repeat duodenal biopsy and dual-energy X-ray absorptiometry (DXA) scan. Twenty-four patients (38%) displayed normal and 40 (62%) low BMD, 47 (73%) DMH, and 17 (27%) duodenal mucosa lesions. All patients but one with normal BMD (23 of 24, 96%) showed DMH, while, among those with low BMD, 24 (60%) did and 16 (40%) did not. At multivariate analysis, being older (odds ratio (OR) 1.1, 95% confidence interval (CI) 1.03-1.18) and having diagnosis at an older age (OR 1.09, 95% CI 1.03-1.16) were associated with low BMD; in turn, having normal BMD was the only variable independently associated with DMH (OR 17.5, 95% CI 1.6-192). In older CD patients and with late onset disease, BMD recovery is not guaranteed, despite a GFD. A normal DXA scan identified CD patients with DMH; thus, it is a potential tool in planning endoscopic resampling.

VStar: Variable star data visualization and analysis tool

NASA Astrophysics Data System (ADS)

VStar Team

2014-07-01

VStar is a multi-platform, easy-to-use variable star data visualization and analysis tool. Data for a star can be read from the AAVSO (American Association of Variable Star Observers) database or from CSV and TSV files. VStar displays light curves and phase plots, can produce a mean curve, and analyzes time-frequency with Weighted Wavelet Z-Transform. It offers tools for period analysis, filtering, and other functions.

Team-level predictors of innovation at work: a comprehensive meta-analysis spanning three decades of research.

PubMed

Hülsheger, Ute R; Anderson, Neil; Salgado, Jesus F

2009-09-01

This article presents a meta-analysis of team-level antecedents of creativity and innovation in the workplace. Using a general input-process-output model, the authors examined 15 team-level variables researched in primary studies published over the last 30 years and their relation to creativity and innovation. An exhaustive search of the international innovation literature resulted in a final sample (k) of 104 independent studies. Results revealed that team process variables of support for innovation, vision, task orientation, and external communication displayed the strongest relationships with creativity and innovation (rhos between 0.4 and 0.5). Input variables (i.e., team composition and structure) showed weaker effect sizes. Moderator analyses confirmed that relationships differ substantially depending on measurement method (self-ratings vs. independent ratings of innovation) and measurement level (individual vs. team innovation). Team variables displayed considerably stronger relationships with self-report measures of innovation compared with independent ratings and objective criteria. Team process variables were more strongly related to creativity and innovation measured at the team than the individual level. Implications for future research and pragmatic ramifications for organizational practice are discussed in conclusion.

Display methods of electronic patient record screens: patient privacy concerns.

PubMed

Niimi, Yukari; Ota, Katsumasa

2013-01-01

To provide adequate care, medical professionals have to collect not only medical information but also information that may be related to private aspects of the patient's life. With patients' increasing awareness of information privacy, healthcare providers have to pay attention to the patients' right of privacy. This study aimed to clarify the requirements of the display method of electronic patient record (EPR) screens in consideration of both patients' information privacy concerns and health professionals' information needs. For this purpose, semi-structured group interviews were conducted of 78 medical professionals. They pointed out that partial concealment of information to meet patients' requests for privacy could result in challenges in (1) safety in healthcare, (2) information sharing, (3) collaboration, (4) hospital management, and (5) communication. They believed that EPRs should (1) meet the requirements of the therapeutic process, (2) have restricted access, (3) provide convenient access to necessary information, and (4) facilitate interprofessional collaboration. This study provides direction for the development of display methods that balance the sharing of vital information and protection of patient privacy.

Sympatric speciation by sexual selection alone is unlikely.

PubMed

Arnegard, Matthew E; Kondrashov, Alexey S

2004-02-01

According to Darwin, sympatric speciation is driven by disruptive, frequency-dependent natural selection caused by competition for diverse resources. Recently, several authors have argued that disruptive sexual selection can also cause sympatric speciation. Here, we use hypergeometric phenotypic and individual-based genotypic models to explore sympatric speciation by sexual selection under a broad range of conditions. If variabilities of preference and display traits are each caused by more than one or two polymorphic loci, sympatric speciation requires rather strong sexual selection when females exert preferences for extreme male phenotypes. Under this kind of mate choice, speciation can occur only if initial distributions of preference and display are close to symmetric. Otherwise, the population rapidly loses variability. Thus, unless allele replacements at very few loci are enough for reproductive isolation, female preferences for extreme male displays are unlikely to drive sympatric speciation. By contrast, similarity-based female preferences that do not cause sexual selection are less destabilizing to the maintenance of genetic variability and may result in sympatric speciation across a broader range of initial conditions. Certain groups of African cichlids have served as the exclusive motivation for the hypothesis of sympatric speciation by sexual selection. Mate choice in these fishes appears to be driven by female preferences for extreme male phenotypes rather than similarity-based preferences, and the evolution of premating reproductive isolation commonly involves at least several genes. Therefore, differences in female preferences and male display in cichlids and other species of sympatric origin are more likely to have evolved as isolating mechanisms under disruptive natural selection.

Cardiorespiratory interactions in patients with atrial flutter.

PubMed

Masè, Michela; Disertori, Marcello; Ravelli, Flavia

2009-01-01

Respiratory sinus arrhythmia (RSA) is generally known as the autonomically mediated modulation of the sinus node pacemaker frequency in synchrony with respiration. Cardiorespiratory interactions have been largely investigated during sinus rhythm, whereas little is known about interactions during reentrant arrhythmias. In this study, cardiorespiratory interactions at the atrial and ventricular level were investigated during atrial flutter (AFL), a supraventricular arrhythmia based on a reentry, by using cross-spectral analysis and computer modeling. The coherence and phase between respiration and atrial (gamma(AA)(2), phi(AA)) and ventricular (gamma(RR)(2), phi(RR)) interval series were estimated in 20 patients with typical AFL (68.0 +/- 8.8 yr) and some degree of atrioventricular (AV) conduction block. In all patients, atrial intervals displayed oscillations strongly coupled and in phase with respiration (gamma(AA)(2)= 0.97 +/- 0.05, phi(AA) = 0.71 +/- 0.31 rad), corresponding to a paradoxical lengthening of intervals during inspiration. The modulation pattern was frequency independent, with in-phase oscillations and short time delays (0.40 +/- 0.15 s) for respiratory frequencies in the range 0.1-0.4 Hz. Ventricular patterns were affected by AV conduction type. In patients with fixed AV conduction, ventricular intervals displayed oscillations strongly coupled (gamma(RR)(2)= 0.97 +/- 0.03) and in phase with respiration (phi(RR) = 1.08 +/- 0.80 rad). Differently, in patients with variable AV conduction, respiratory oscillations were secondary to Wencheback rhythmicity, resulting in a decreased level of coupling (gamma(RR)(2)= 0.50 +/- 0.21). Simulations with a simplified model of AV conduction showed ventricular patterns to originate from the combination of a respiratory modulated atrial input with the functional properties of the AV node. The paradoxical frequency-independent modulation pattern of atrial interval, the short time delays, and the complexity of ventricular rhythm characterize respiratory arrhythmia during AFL and distinguish it from normal RSA. These peculiar features can be explained by assuming a direct mechanical action of respiration on AFL reentrant circuit.

Comparison of volatile organic compounds from lung cancer patients and healthy controls-challenges and limitations of an observational study.

PubMed

Schallschmidt, Kristin; Becker, Roland; Jung, Christian; Bremser, Wolfram; Walles, Thorsten; Neudecker, Jens; Leschber, Gunda; Frese, Steffen; Nehls, Irene

2016-10-12

This paper outlines the design and performance of an observational study on the profiles of volatile organic compounds (VOCs) in the breath of 37 lung cancer patients and 23 healthy controls of similar age. The need to quantify each VOC considered as a potential disease marker on the basis of individual calibration is elaborated, and the quality control measures required to maintain reproducibility in breath sampling and subsequent instrumental trace VOC analysis using solid phase microextraction-gas chromatography-mass spectrometry over a study period of 14 months are described. Twenty-four VOCs were quantified on the basis of their previously suggested potential as cancer markers. The concentration of aromatic compounds in the breath was increased, as expected, in smokers, while lung cancer patients displayed significantly increased levels of oxygenated VOCs such as aldehydes, 2-butanone and 1-butanol. Although sets of selected oxygenated VOCs displayed sensitivities and specificities between 80% and 90% using linear discriminant analysis (LDA) with leave-one-out cross validation, the effective selectivity of the breath VOC approach with regard to cancer detection is clearly limited. Results are discussed against the background of the literature on volatile cancer marker investigations and the prospects of linking increased VOC levels in patients' breath with approaches that employ sniffer dogs. Experience from this study and the literature suggests that the currently available methodology is not able to use breath VOCs to reliably discriminate between cancer patients and healthy controls. Observational studies often tend to note significant differences in levels of certain oxygenated VOCs, but without the resolution required for practical application. Any step towards the exploitation of differences in VOC profiles for illness detection would have to solve current restrictions set by the low and variable VOC concentrations. Further challenges are the technical complexity of studies involving breath sampling and possibly the limited capability of current analytical procedures to detect unstable marker candidates.

Process and representation in graphical displays

NASA Technical Reports Server (NTRS)

Gillan, Douglas J.; Lewis, Robert; Rudisill, Marianne

1990-01-01

How people comprehend graphics is examined. Graphical comprehension involves the cognitive representation of information from a graphic display and the processing strategies that people apply to answer questions about graphics. Research on representation has examined both the features present in a graphic display and the cognitive representation of the graphic. The key features include the physical components of a graph, the relation between the figure and its axes, and the information in the graph. Tests of people's memory for graphs indicate that both the physical and informational aspect of a graph are important in the cognitive representation of a graph. However, the physical (or perceptual) features overshadow the information to a large degree. Processing strategies also involve a perception-information distinction. In order to answer simple questions (e.g., determining the value of a variable, comparing several variables, and determining the mean of a set of variables), people switch between two information processing strategies: (1) an arithmetic, look-up strategy in which they use a graph much like a table, looking up values and performing arithmetic calculations; and (2) a perceptual strategy in which they use the spatial characteristics of the graph to make comparisons and estimations. The user's choice of strategies depends on the task and the characteristics of the graph. A theory of graphic comprehension is presented.

Evaluation of Nurses' Acceptance of Screen Display Methods with Temporarily Non-Display for Privacy Protection.

PubMed

Niimi, Yukari; Ota, Katsumasa; Ikegami, Chikako

2018-01-01

The purpose of this study was to explore nurses' acceptance of a screen display method that temporarily hides patient information for privacy protection. Using a questionnaire, we asked nurses to evaluate the display method from the viewpoints of safety and efficiency with respect to 22 personal information items. The nurses were favorably interested in introducing the display method into their hospital system; however, their acceptance varied.

Flight evaluations of several hover control and display combinations for precise blind vertical landings

NASA Technical Reports Server (NTRS)

Schroeder, J. A.; Merrick, V. K.

1990-01-01

Several control and display concepts were evaluated on a variable-stability helicopter prior to future evaluations on a modified Harrier. The control and display concepts had been developed to enable precise hover maneuvers, station keeping, and vertical landings in simulated zero-visibility conditions and had been evaluated extensively in previous piloted simulations. Flight evaluations early in the program revealed several inadequacies in the display drive laws that were later corrected using an alternative design approach that integrated the control and display characteristics with the desired guidance law. While hooded, three pilots performed landing-pad captures followed by vertical landings with attitude-rate, attitude, and translation-velocity-command control systems. The latter control system incorporated a modified version of state-rate-feedback implicit-model following. Precise landing within 2 ft of the desired touchdown point were achieved.

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

Wehrschuetz, M., E-mail: martin.wehrschuetz@klinikum-graz.at; Aschauer, M.; Portugaller, H.

The purpose of this study was to assess interobserver variability and accuracy in the evaluation of renal artery stenosis (RAS) with gadolinium-enhanced MR angiography (MRA) and digital subtraction angiography (DSA) in patients with hypertension. The authors found that source images are more accurate than maximum intensity projection (MIP) for depicting renal artery stenosis. Two independent radiologists reviewed MRA and DSA from 38 patients with hypertension. Studies were postprocessed to display images in MIP and source images. DSA was the standard for comparison in each patient. For each main renal artery, percentage stenosis was estimated for any stenosis detected by themore » two radiologists. To calculate sensitivity, specificity and accuracy, MRA studies and stenoses were categorized as normal, mild (1-39%), moderate (40-69%) or severe ({>=}70%), or occluded. DSA stenosis estimates of 70% or greater were considered hemodynamically significant. Analysis of variance demonstrated that MIP estimates of stenosis were greater than source image estimates for both readers. Differences in estimates for MIP versus DSA reached significance in one reader. The interobserver variance for MIP, source images and DSA was excellent (0.80< {kappa}{<=} 0.90). The specificity of source images was high (97%) but less for MIP (87%); average accuracy was 92% for MIP and 98% for source images. In this study, source images are significantly more accurate than MIP images in one reader with a similar trend was observed in the second reader. The interobserver variability was excellent. When renal artery stenosis is a consideration, high accuracy can only be obtained when source images are examined.« less

Activity Parameters of Subthalamic Nucleus Neurons Selectively Predict Motor Symptom Severity in Parkinson's Disease

PubMed Central

Gulberti, Alessandro; Zittel, Simone; Tudor Jones, Adam A.; Fickel, Ulrich; Münchau, Alexander; Köppen, Johannes A.; Gerloff, Christian; Westphal, Manfred; Buhmann, Carsten; Hamel, Wolfgang; Engel, Andreas K.

2014-01-01

Parkinson's disease (PD) is a heterogeneous disorder that leads to variable expression of several different motor symptoms. While changes in firing rate, pattern, and oscillation of basal ganglia neurons have been observed in PD patients and experimental animals, there is limited evidence linking them to specific motor symptoms. Here we examined this relationship using extracellular recordings of subthalamic nucleus neurons from 19 PD patients undergoing surgery for deep brain stimulation. For each patient, ≥10 single units and/or multi-units were recorded in the OFF medication state. We correlated the proportion of neurons displaying different activities with preoperative Unified Parkinson's Disease Rating Scale subscores (OFF medication). The mean spectral power at sub-beta frequencies and percentage of units oscillating at beta frequencies were positively correlated with the axial and limb rigidity scores, respectively. The percentage of units oscillating at gamma frequency was negatively correlated with the bradykinesia scores. The mean intraburst rate was positively correlated with both bradykinesia and axial scores, while the related ratio of interspike intervals below/above 10 ms was positively correlated with these symptoms and limb rigidity. None of the activity parameters correlated with tremor. The grand average of all the significantly correlated subthalamic nucleus activities accounted for >60% of the variance of the combined bradykinetic-rigid and axial scores. Our results demonstrate that the occurrence of alterations in the rate and pattern of basal ganglia neurons could partly underlie the variability in parkinsonian phenotype. PMID:24790198

Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis

PubMed Central

Chalmers, John A.; Quintana, Daniel S.; Abbott, Maree J.-Anne; Kemp, Andrew H.

2014-01-01

Background: Anxiety disorders increase risk of future cardiovascular disease (CVD) and mortality, even after controlling for confounds including smoking, lifestyle, and socioeconomic status, and irrespective of a history of medical disorders. While impaired vagal function, indicated by reductions in heart rate variability (HRV), may be one mechanism linking anxiety disorders to CVD, prior studies have reported inconsistent findings highlighting the need for meta-analysis. Method: Studies comparing resting-state HRV recordings in patients with an anxiety disorder as a primary diagnosis and healthy controls were considered for meta-analysis. Results: Meta-analyses were based on 36 articles, including 2086 patients with an anxiety disorder and 2294 controls. Overall, anxiety disorders were characterized by lower HRV [high frequency (HF): Hedges’ g = −0.29. 95% CI: −0.41 to −0.17, p < 0.001; time domain: Hedges’ g = −0.45, 95% CI: −0.57 to −0.33, p < 0.001] than controls. Panic disorder (n = 447), post-traumatic stress disorder (n = 192), generalized anxiety disorder (n = 68), and social anxiety disorder (n = 90), but not obsessive–compulsive disorder (n = 40), displayed reductions in HF HRV relative to controls (all ps < 0.001). Conclusion: Anxiety disorders are associated with reduced HRV, findings associated with a small-to-moderate effect size. Findings have important implications for future physical health and well-being of patients, highlighting a need for comprehensive cardiovascular risk reduction. PMID:25071612

Use of modified lip repositioning technique associated with esthetic crown lengthening for treatment of excessive gingival display: A case report of multiple etiologies

PubMed Central

Mantovani, Matheus Bortoluzzi; Souza, Eduardo Clemente; Marson, Fabiano Carlos; Corrêa, Giovani Oliveira; Progiante, Patrícia Saram; Silva, Cléverson Oliveira

2016-01-01

Excessive gingival display during smile can result in compromised esthetics. This study aims to report a case of excessive gingival display with multiple etiologies treated by means of modified lip repositioning technique associated with esthetic crown lengthening. A 23-year-old female patient, with 5-mm gingival display during smile caused by altered passive eruption and hypermobility of the upper lip, underwent the modified lip repositioning technique associated with gingivectomy followed by flap elevation and ostectomy/osteoplasty. Seven months after the second procedure, the patient had her esthetic complaint solved appearing stable in the observation period. The modified lip repositioning technique is an effective procedure employed to reduce gingival display and when associated with esthetic clinical crown lengthening, can appropriately treat cases of gummy smile. PMID:27041845

Cultural diversity in patient participation: the influence of patients' characteristics and doctors' communicative behaviour.

PubMed

Schouten, Barbara C; Meeuwesen, Ludwien; Tromp, Fred; Harmsen, Hans A M

2007-07-01

The primary goal of this study was to examine the extent to which patient participation during medical visits is influenced by patients' ethnic background, patients' culture-related characteristics (e.g. acculturation, locus of control, cultural views) and features of doctors' communicative behaviour. Furthermore, the mutual influence between patients' participatory behaviour and doctors' communicative behaviour was investigated. An additional goal was to identify the independent contribution of these variables to the degree of patient satisfaction and mutual understanding between GP and patient. Communicative behaviour of patients (n=103) and GPs (n=29) was analysed with Roter's Interaction Analysis System, frequency of patient questions and patients' assertive utterances (e.g. making requests, suggesting alternative treatment options). Additional data were gathered using GP and patient questionnaires after the consultations. Results show that non-Western ethnic minority patients display less participatory behaviour during medical consultations than Dutch patients. GPs' affective verbal behaviour had most effect on degree of patient participation and patient satisfaction. Regression analyses indicate a significant mutual influence between patients' verbal behaviour and GPs' verbal behaviour. Overall, results of this study show some important differences between Dutch and non-Western ethnic minority patients in degree of patient participation. Furthermore, our results indicate that patient participation encompasses several aspects that are not necessarily interrelated. The necessity for continued education of GPs' communicative skills, particularly when dealing with non-Western ethnic minority patients, is reflected in the strong influence of GP's affective verbal behaviour on both patient participation and their satisfaction with the medical encounter.

An exploratory case study of the impact of ambient biographical displays on identity in a patient with Alzheimer's disease.

PubMed

Massimi, Michael; Berry, Emma; Browne, Georgina; Smyth, Gavin; Watson, Peter; Baecker, Ronald M

2008-01-01

One of the most troubling symptoms of Alzheimer's disease is the loss of the patient's sense of identity. This loss complicates relationships, increases apathy, and generally impedes quality of life for the patient. We describe a novel in-home ambient display called Biography Theatre that cycles through music, photographs, movies, and narratives drawn from the patient's past and current life. We conducted an exploratory case study with an 84-year-old male with moderate-stage Alzheimer's disease (Mr H). The study consisted of three phases: a baseline phase, a phase wherein autobiographical materials were collected and discussed, and a phase wherein the display was deployed in the home. The patient demonstrated improvement on standardised tests of apathy and positive self-identity, but did not improve on tests of autobiographical memory, anxiety, depression, and general cognition. We also report on caregiver reactions to the intervention and how the display helped them cope with and reinterpret their loved one's condition. This work suggests that interdisciplinary work involving "off the desktop" computing technologies may be a fruitful way to provide rehabilitative benefit for individuals with Alzheimer's disease.

Can electronic medical images replace hard-copy film? Defining and testing the equivalence of diagnostic tests.

PubMed

Obuchowski, N A

2001-10-15

Electronic medical images are an efficient and convenient format in which to display, store and transmit radiographic information. Before electronic images can be used routinely to screen and diagnose patients, however, it must be shown that readers have the same diagnostic performance with this new format as traditional hard-copy film. Currently, there exist no suitable definitions of diagnostic equivalence. In this paper we propose two criteria for diagnostic equivalence. The first criterion ('population equivalence') considers the variability between and within readers, as well as the mean reader performance. This criterion is useful for most applications. The second criterion ('individual equivalence') involves a comparison of the test results for individual patients and is necessary when patients are followed radiographically over time. We present methods for testing both individual and population equivalence. The properties of the proposed methods are assessed in a Monte Carlo simulation study. Data from a mammography screening study is used to illustrate the proposed methods and compare them with results from more conventional methods of assessing equivalence and inter-procedure agreement. Copyright 2001 John Wiley & Sons, Ltd.

The Instructional Effects of Matching or Mismatching Lesson and Posttest Screen Color

ERIC Educational Resources Information Center

Clariana, Roy B.

2004-01-01

This investigation considers the instructional effects of color as an over-arching context variable when learning from computer displays. The purpose of this investigation is to examine the posttest retrieval effects of color as a local, extra-item non-verbal lesson context variable for constructed-response versus multiple-choice posttest…

When Clerks Meet Customers: A Test of Variables Related to Emotional Expressions on the Job.

ERIC Educational Resources Information Center

Rafaeli, Anat

Although many modern occupations require employees to express particular types of emotions while doing their jobs, little empirical evidence exists about factors related to emotional behavior on the job. This study investigated the relationship between emotional displays (smiling, greeting, thanking, eye contact) of sales clerks and variables of…

Dynamic flashing yellow arrow (FYA): a study on variable left-turn mode operational and safety impacts phase II - model expansion and testing.

DOT National Transportation Integrated Search

2016-06-01

The flashing yellow arrow (FYA) signal display creates an opportunity to enhance the left-turn phase with a : variable mode that can be changed on demand. The previously developed decision support system (DSS) in : phase I facilitated the selection o...

Effect of Harm Anchors in Visual Displays of Test Results on Patient Perceptions of Urgency About Near-Normal Values: Experimental Study.

PubMed

Zikmund-Fisher, Brian J; Scherer, Aaron M; Witteman, Holly O; Solomon, Jacob B; Exe, Nicole L; Fagerlin, Angela

2018-03-26

Patient-facing displays of laboratory test results typically provide patients with one reference point (the "standard range"). To test the effect of including an additional harm anchor reference point in visual displays of laboratory test results, which indicates how far outside of the standard range values would need to be in order to suggest substantial patient risk. Using a demographically diverse, online sample, we compared the reactions of 1618 adults in the United States who viewed visual line displays that included both standard range and harm anchor reference points ("Many doctors are not concerned until here") to displays that included either (1) only a standard range, (2) standard range plus evaluative categories (eg, "borderline high"), or (3) a color gradient showing degree of deviation from the standard range. Providing the harm anchor reference point significantly reduced perceived urgency of close-to-normal alanine aminotransferase and creatinine results (P values <.001) but not generally for platelet count results. Notably, display type did not significantly alter perceptions of more extreme results in potentially harmful ranges. Harm anchors also substantially reduced the number of participants who wanted to contact their doctor urgently or go to the hospital about these test results. Presenting patients with evaluative cues regarding when test results become clinically concerning can reduce the perceived urgency of out-of-range results that do not require immediate clinical action. ©Brian J Zikmund-Fisher, Aaron M Scherer, Holly O Witteman, Jacob B Solomon, Nicole L Exe, Angela Fagerlin. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.03.2018.

Video-EEG study of psychogenic nonepileptic seizures: differential characteristics in patients with and without epilepsy.

PubMed

Mari, Francesco; Di Bonaventura, Carlo; Vanacore, Nicola; Fattouch, Jinane; Vaudano, Anna Elisabetta; Egeo, Gabriella; Berardelli, Alfredo; Manfredi, Mario; Prencipe, Massimiliano; Giallonardo, Anna Teresa

2006-01-01

Psychogenic nonepileptic seizures (PNES) are episodes that may resemble epileptic seizures (ES) but are not associated with abnormal electrical discharges in the brain. Video-EEG recording of a typical episode is considered the best diagnostic tool available. PNES are, however, also documented in patients with epilepsy (PNES/ES). The purpose of this study was to assess this comorbid population, focusing on the differences between patients with PNES/ES and patients with PNES alone. We reviewed 110 PNES episodes, occurring spontaneously or induced by means of suggestion techniques, recorded in our video-EEG laboratory over a period of eight years. We identified two subgroups of patients, consisting of 85 PNES cases and 25 PNES/ES cases, and assessed any differences in their characteristics by reviewing a number of variables (age, sex, clinical features, antiepileptic therapy, age of onset, time to diagnosis, pathological history, and length of follow-up). The comparison between the two subgroups revealed that PNES/ES patients displayed some statistically significant differences when compared with PNES alone patients, i.e., younger age, a higher percentage of spontaneously activated events, a shorter disease duration, a longer time to PNES diagnosis, and a lower percentage lost at follow-up. This study confirms that PNES is a common, though probably underestimated, occurrence in epilepsy services. Our results shed light on some different characteristics between PNES and PNES/ES patients.

Microarray-based mutation analysis of the ABCA4 (ABCR) gene in autosomal recessive cone-rod dystrophy and retinitis pigmentosa.

PubMed

Klevering, B Jeroen; Yzer, Suzanne; Rohrschneider, Klaus; Zonneveld, Marijke; Allikmets, Rando; van den Born, L Ingeborgh; Maugeri, Alessandra; Hoyng, Carel B; Cremers, Frans P M

2004-12-01

Mutations in the ABCA4 gene have been associated with autosomal recessive Stargardt disease (STGD1), cone-rod dystrophy (CRD), and retinitis pigmentosa (RP). We employed a recently developed genotyping microarray, the ABCR400-chip, to search for known ABCA4 mutations in patients with isolated or autosomal recessive CRD (54 cases) or RP (90 cases). We performed detailed ophthalmologic examinations and identified at least one ABCA4 mutation in 18 patients (33%) with CRD and in five patients (5.6%) with RP. Single-strand conformation polymorphism (SSCP) analysis and subsequent DNA sequencing revealed four novel missense mutations (R24C, E161K, P597S, G618E) and a novel 1-bp deletion (5888delG). Ophthalmoscopic abnormalities in CRD patients ranged from minor granular pigmentary changes in the posterior pole to widespread atrophy. In 12 patients with recordable electroretinogram (ERG) tracings, a cone-rod pattern was detected. Three patients demonstrated progression from a retinal dystrophy resembling STGD1 to a more widespread degeneration, and were subsequently diagnosed as CRD. In addition to a variable degree of atrophy, all RP patients displayed ophthalmologic characteristics of classic RP. When detectable, ERG recordings in these patients demonstrated rod-cone patterns of photoreceptor degeneration. In conclusion, in this study, we show that the ABCA4 mutation chip is an efficient first screening tool for arCRD.

Effects of induced anger in patients with antisocial personality disorder.

PubMed

Lobbestael, J; Arntz, A; Cima, M; Chakhssi, F

2009-04-01

Anger is the main deregulated emotion in patients with antisocial personality disorder (ASPD). The aim of this study was to examine emotional, cognitive and physiological correlates of anger and compare these between ASPD patients with varying degree of psychopathy (PP) and control groups. Assessment of the effect of anger induction on self-reported emotions and schema modes, psychophysiology and implicit reaction-time tasks measuring self-anger and aggressor-swearword associations. Participants (n=147) were patients with DSM-IV antisocial (n=21), borderline (n=45) and cluster C personality disorder (n=46) and non-patient controls (n=35). Groups did not differ in self-reported anger. ASPD patients displayed a decrease in heart rate and systolic blood pressure (SBP) and stronger implicit self-anger associations. ASPD patients scoring low on affective PP reported less negative emotions and displayed a greater decrease in diastolic blood pressure (DBP). ASPD patients did not display a deviant self-reported anger but physiological hyporesponsivity and cognitive hyper-responsivity. This ASPD anger response might reflect a controlled predatory-like fight preparation.

Characterizing the reflectivity of handheld display devices.

PubMed

Liu, Peter; Badano, Aldo

2014-08-01

With increased use of handheld and tablet display devices for viewing medical images, methods for consistently measuring reflectivity of the devices are needed. In this note, the authors report on the characterization of diffuse reflections for handheld display devices including mobile phones and tablets using methods recommended by the American Association of Physicists in Medicine Task Group 18 (TG18). The authors modified the diffuse reflectance coefficient measurement method outlined in the TG18 report. The authors measured seven handheld display devices (two phones and five tablets) and three workstation displays. The device was attached to a black panel with Velcro. To study the effect of the back surface on the diffuse reflectance coefficient, the authors created Styrofoam masks with different size square openings and placed it in front of the device. Overall, for each display device, measurements of illuminance and reflected luminance on the display screen were taken. The authors measured with no mask, with masks of varying size, and with display-size masks, and calculated the corresponding diffuse reflectance coefficient. For all handhelds, the diffuse reflectance coefficient measured with no back panel were lower than measurements performed with a mask. The authors found an overall increase in reflectivity as the size of the mask decreases. For workstations displays, diffuse reflectance coefficients were higher when no back panel was used, and higher than with masks. In all cases, as luminance increased, illuminance increased, but not at the same rate. Since the size of handheld displays is smaller than that of workstation devices, the TG18 method suffers from a dependency on illumination condition. The authors show that the diffuse reflection coefficients can vary depending on the nature of the back surface of the illuminating box. The variability in the diffuse coefficient can be as large as 20% depending on the size of the mask. For all measurements, both luminance and illuminance increased as the size of the display window decreased. The TG18 method does not account for this variability. The authors conclude that the method requires a definitive description of the back panel used in the light source setup. The methods described in the TG18 document may need to be improved to provide consistent comparisons of desktop monitors, phones, and tablets.

Concomitant occurrence of macroprolactin, exercise-induced amenorrhea, and a pituitary lesion: a diagnostic pitfall. Case report.

PubMed

Cattaneo, F A; Fahie-Wilson, M N

2001-08-01

The authors report the case of a 37-year-old woman who presented with amenorrhea and an increased level of serum prolactin. Magnetic resonance images of the pituitary revealed a lesion with characteristics consistent with those of a microadenoma. Transsphenoidal exploration was performed, but a prolactinoma was not found. After endocrinological review, the patient's hyperprolactinemia was found to be caused by the presence of macroprolactin and her amenorrhea was due to intense exercise and low body weight. Macroprolactin is an isoform of prolactin that is variably reactive in assays for prolactin, but displays minimum bioactivity in vivo. Patients with macroprolactin are mostly asymptomatic. This phenomenon may cause elevated prolactin values, which the authors view as apparent hyperprolactinemia. The presence of macroprolactin is an underrecognized problem, occurring in as many as 15 to 20% of patients with elevated prolactin values and often leading to unnecessary, expensive diagnostic procedures and inappropriate treatment. The presence of macroprolactin should always be suspected when the patient's clinical history or clinical or radiological data are incompatible with the prolactin value. Physicians dealing with diagnosis and treatment of hyperprolactinemia (general practitioners, gynecologists, neurosurgeons, endocrinologists, and biochemists) should be aware of the potentially misleading nature of macroprolactin.

The association of cigarette smoking with enhanced platelet inhibition by clopidogrel.

PubMed

Bliden, Kevin P; Dichiara, Joseph; Lawal, Lookman; Singla, Anand; Antonino, Mark J; Baker, Brian A; Bailey, William L; Tantry, Udaya S; Gurbel, Paul A

2008-08-12

The purpose of this study was to examine the effect of cigarette smoking on the platelet response to clopidogrel. Response variability to clopidogrel therapy has been demonstrated. Clopidogrel is metabolically activated by several hepatic cytochrome P450 (CYP) isoenzymes, including CYP1A2. Cigarette smoking induces CYP1A2 and may, therefore, enhance the conversion of clopidogrel to its active metabolite. Among 259 consecutive patients undergoing elective coronary stenting; 120 were on chronic clopidogrel therapy and were not loaded; and 139 were clopidogrel naïve and were loaded with 600 mg. There were 104 current smokers (CS) and 155 nonsmokers (NS). The adenosine diphosphate (ADP)-stimulated platelet aggregation (PA) was assessed by conventional aggregometry. The ADP-stimulated total and active glycoprotein (GP) IIb/IIIa expression were assessed with flow cytometry. Low PA was defined as the lowest quartile of 5 micromol/l ADP-induced post-treatment PA. Current smokers on chronic clopidogrel therapy displayed significantly lower PA and ADP-stimulated active GP IIb/IIIa expression compared with NS (p < or = 0.0008 for both). Similarly, CS treated with 600 mg of clopidogrel displayed greater platelet inhibition and lower active GP IIb/IIIa expression compared with NS (p < or = 0.05). In a multivariate Cox regression analysis, current smoking was an independent predictor of low PA (p = 0.0001). Clopidogrel therapy in CS is associated with increased platelet inhibition and lower aggregation as compared with NS. The mechanism of the smoking effect deserves further study and may be an important cause of response variability to clopidogrel therapy.

The unique contribution of elements of smile aesthetics to psychosocial well-being.

PubMed

Lukez, A; Pavlic, A; Trinajstic Zrinski, M; Spalj, S

2015-04-01

Pleasant smile aesthetics is an important contributory factor to psychosocial well-being. The aim of this study was to determine the psychosocial influence of smile aesthetics. The study was cross-sectional on a convenient sample that included patients, pupils, students and faculty staff. A total of 155 subjects (36% male) aged 12-39 (mean age 21, interquartile range 19-23) were included. Occlusal characteristics were recorded by the Index of Complexity, Outcome and Need, and smiling frontal view photographs were obtained. Fourteen variables were measured using photogrammetric analysis: smile width, visibility of buccal corridors, maximum teeth exposure, total gingival display, lip thickness, degree of occlusal cant and deviation from golden proportion of the teeth in maxillary intercanine sector. Psychometric instruments included the Psychosocial Impact of Dental Aesthetics Questionnaire and the Rosenberg Self-Esteem Scale. Statistical analysis comprised multiple linear regressions. Malocclusion severity is the most important predictor of psychosocial influence of smile aesthetics and self-esteem, the unique contribution of which accounts for a total of 4-27% of variability. Female gender is associated with higher psychological influence of dental aesthetics while male gender and older age with self-esteem. Malocclusions have higher psychosocial impact than parameters of mini- and micro-aesthetics of smile related to visibility of buccal corridors, amount of teeth exposure, gingival display, lip thickness, presence of occlusal cant and deviation from golden proportion of the teeth. It appears that people are not as focused on details of their smile as they are on distinctive malposition of teeth. © 2014 John Wiley & Sons Ltd.

A chimeric IgE that mimics IgE from patients allergic to acid-hydrolyzed wheat proteins is a novel tool for in vitro allergenicity assessment of functionalized glutens.

PubMed

Tranquet, Olivier; Gaudin, Jean-Charles; Patil, Sarita; Steinbrecher, Johanna; Matsunaga, Kayoko; Teshima, Reiko; Sakai, Shinobu; Larré, Colette; Denery-Papini, Sandra

2017-01-01

Acid-hydrolyzed wheat proteins (acid-HWPs) have been shown to provoke severe allergic reactions in Europe and Japan that are distinct from classical wheat allergies. Acid-HWPs were shown to contain neo-epitopes induced by the deamidation of gluten proteins. However, products with variable rates of deamidation can be found. In this work, we studied the effect of the extent of wheat proteins deamidation on its allergenicity. A recombinant chimeric IgE was produced and compared to patients' IgE for its capacity to assess the IgE-mediated triggering potential of acid-HWPs. Sera from acid-HWP allergic patients were analyzed via ELISA and a functional basophil assay for their IgE reactivity to wheat proteins with different deamidation levels. A chimeric mouse/human IgE (chIgE-DG1) specific for the main neo-epitope, QPEEPFPE, involved in allergy to acid-HWPs was characterized with respect to its functionality and its reactivity compared to that of patients' IgE. Acid-HWPs with medium (30%) and high (50-60%) deamidation levels displayed a markedly stronger IgE binding and capacity to activate basophils than those of samples with weak (15%) deamidation levels. The monoclonal chIgE-DG1 allowed basophil degranulation in the presence of deamidated wheat proteins. ChIgE-DG1 was found to mimic patients' IgE reactivity and displayed the same ability to rank acid-HWP products in a degranulation assay. Increasing the deamidation level of products from 15% to 60% resulted in an approximately 2-fold increase in their antigenicity and a 100-fold increase in their eliciting potential. The chimeric ChIgE-DG1 may be a useful tool to evaluate functionalized glutens for their allergenic potential. By mimicking patient sera reactivity, chIgE-DG1 also provided data on the patients' IgE repertoire and on the functionality of certain repeated epitopes in gluten proteins.

Clustering of samples and variables with mixed-type data

PubMed Central

Edelmann, Dominic; Kopp-Schneider, Annette

2017-01-01

Analysis of data measured on different scales is a relevant challenge. Biomedical studies often focus on high-throughput datasets of, e.g., quantitative measurements. However, the need for integration of other features possibly measured on different scales, e.g. clinical or cytogenetic factors, becomes increasingly important. The analysis results (e.g. a selection of relevant genes) are then visualized, while adding further information, like clinical factors, on top. However, a more integrative approach is desirable, where all available data are analyzed jointly, and where also in the visualization different data sources are combined in a more natural way. Here we specifically target integrative visualization and present a heatmap-style graphic display. To this end, we develop and explore methods for clustering mixed-type data, with special focus on clustering variables. Clustering of variables does not receive as much attention in the literature as does clustering of samples. We extend the variables clustering methodology by two new approaches, one based on the combination of different association measures and the other on distance correlation. With simulation studies we evaluate and compare different clustering strategies. Applying specific methods for mixed-type data proves to be comparable and in many cases beneficial as compared to standard approaches applied to corresponding quantitative or binarized data. Our two novel approaches for mixed-type variables show similar or better performance than the existing methods ClustOfVar and bias-corrected mutual information. Further, in contrast to ClustOfVar, our methods provide dissimilarity matrices, which is an advantage, especially for the purpose of visualization. Real data examples aim to give an impression of various kinds of potential applications for the integrative heatmap and other graphical displays based on dissimilarity matrices. We demonstrate that the presented integrative heatmap provides more information than common data displays about the relationship among variables and samples. The described clustering and visualization methods are implemented in our R package CluMix available from https://cran.r-project.org/web/packages/CluMix. PMID:29182671

Construction and characterization of a highly reactive chicken-derived single-chain variable fragment (scFv) antibody against Staphylococcus aureus developed with the T7 phage display system.

PubMed

Li, Jingquan; Xu, Yongping; Wang, Xitao; Li, Yuan; Wang, Lili; Li, Xiaoyu

2016-06-01

The purpose of this study was to construct a single-chain variable fragment (scFv) antibody from chicken egg yolk immunoglobulin (IgY) by means of genetic engineering and subsequent panning for a specific antibody against Staphylococcus aureus. We amplified the scFv using blood and spleen obtained from 100-day-old Roman chickens immunized with inactivated S. aureus and subsequently constructed a T7 phage display antibody library using phage display technology. Four non-repeated blood scFv and 6 spleen scFv were obtained following 3 rounds of panning of the T7 phage display antibody library, enzyme-linked immunosorbent assay and sequencing. These 10 scFv were cloned into the prokaryotic expression vector pCold I with expression induced at a low temperature. Four soluble proteins were obtained. Among them, soluble protein SFV6 derived from the spleen showed good reactivity against S. aureus using indirect ELISA and produced a particularly strong antibacterial effect in vitro. We were successful in isolating a highly specific scFv antibody against S. aureus from the spleen phage display library. This study provides a simple and rapid method for the quick preparation of a large number of antibodies against S. aureus and provides the foundation for the positioning of antibodies in the organism and the study of the antibacterial mechanism through which the antibody functions. Copyright © 2016 Elsevier B.V. All rights reserved.

Blood pressure measurement and display system

NASA Technical Reports Server (NTRS)

Farkas, A. J.

1972-01-01

System is described that employs solid state circuitry to transmit visual display of patient's blood pressure. Response of sphygmomanometer cuff and microphone provide input signals. Signals and their amplitudes, from turn-on time to turn-off time, are continuously fed to data transmitter which transmits to display device.

An anti-CD30 single-chain Fv selected by phage display and fused to Pseudomonas exotoxin A (Ki-4(scFv)-ETÁ) is a potent immunotoxin against a Hodgkin-derived cell line

PubMed Central

Klimka, A; Barth, S; Matthey, B; Roovers, R C; Lemke, H; Hansen, H; Arends, J-W; Diehl, V; Hoogenboom, H R; Engert, A

1999-01-01

The human CD30 receptor is highly overexpressed on the surface of Hodgkin Reed-Sternberg cells and has been shown to be an excellent target for selective immunotherapy using monoclonal antibody-based agents such as immunotoxins. To construct a new recombinant immunotoxin for possible clinical use in patients with Hodgkin's lymphoma, we have chosen the murine anti-CD30 hybridoma Ki-4 to generate a high-affinity Ki-4 single-chain variable fragment (scFv). Hybridoma V-genes were polymerase chain reaction-amplified, assembled, cloned and expressed as a mini-library for display on filamentous phage. Functional Ki-4 scFv were obtained by selection of binding phage on the Hodgkin lymphoma-derived, CD30-expressing cell line L540Cy. The selected recombinant Ki-4 scFv was shown to specifically bind to an overlapping epitope on the CD30 antigen with binding kinetics similar to those of the original antibody. The Ki-4 scFv was subsequently fused to a deletion mutant of Pseudomonas exotoxin A (ETÁ). The resulting immunotoxin Ki-4(scFv)-ETÁ specifically binds to CD30+ L540Cy cells and inhibits the protein synthesis by 50% at a concentration (IC50) of 43 pM. This recombinant immunotoxin is a promising candidate for further clinical evaluation in patients with Hodgkin's lymphoma or other CD30+ malignancies. © 1999 Cancer Research Campaign PMID:10376974

Collision judgment when viewing minified images through a HMD visual field expander

NASA Astrophysics Data System (ADS)

Luo, Gang; Lichtenstein, Lee; Peli, Eli

2007-02-01

Purpose: Patients with tunnel vision have great difficulties in mobility. We have developed an augmented vision head mounted device, which can provide patients 5x expanded field by superimposing minified edge images of a wider field captured by a miniature video camera over the natural view seen through the display. In the minified display, objects appear closer to the heading direction than they really are. This might cause users to overestimate collision risks, and therefore to perform unnecessary obstacle-avoidance maneuvers. A study was conducted in a virtual environment to test the impact of minified view on collision judgment. Methods: Simulated scenes were presented to subjects as if they were walking in a shopping mall corridor. Subjects reported whether they would make any contact with stationary obstacles that appeared at variable distances from their walking path. Perceived safe passing distance (PSPD) was calculated by finding the transition point from reports of yes to no. Decision uncertainty was quantified by the sharpness of the transition. Collision envelope (CE) size was calculated by summing up PSPD for left and right sides. Ten normally sighted subjects were tested (1) when not using the device and with one eye patched, and (2) when the see-through view of device was blocked and only minified images were visible. Results: The use of the 5x minification device caused only an 18% increase of CE (13cm, p=0.048). Significant impact of the device on judgment uncertainty was not found (p=0.089). Conclusion: Minification had only a small impact on collision judgment. This supports the use of such a minifying device as an effective field expander for patients with tunnel vision.

Dopamine replacement therapy and deep brain stimulation of the subthalamic nuclei induce modulation of emotional processes at different spatial frequencies in Parkinson's disease.

PubMed

Mermillod, Martial; Mondillon, Laurie; Rieu, Isabelle; Devaux, Damien; Chambres, Patrick; Auxiette, Catherine; Dalens, Hélène; Coulangeon, Louise Marie; Jalenques, Isabelle; Durif, Franck

2014-01-01

Deep brain stimulation of the subthalamic nuclei (STN-DBS) is an effective treatment for the most severe forms of Parkinson's disease (PD) and is intended to suppress these patients' motor symptoms. However, be it in association with Dopamine Replacement Therapy (DRT) or not, STN-DBS may in some cases induce addictive or emotional disorders. In the current study, we suggest that PD patients suffer from emotional deficits that have not been revealed in previous studies because in those experiments the stimuli were displayed for a time long enough to allow patients to have recourse to perceptual strategies in order to recognize the emotional facial expressions (EFE). The aim of the current article is to demonstrate the existence of emotional disorders in PD by using a rapid presentation of the visual stimuli (200-ms display time) which curtails their perceptual analysis, and to determine whether STN-DBS, either associated or not associated with DRT, has an impact on the recognition of emotions. The results show that EFE recognition performance depends on both STN-DBS ('on' vs. 'off') and medication ('on' vs. 'off'), but also that these variables have an interactive influence on EFE recognition performance. Moreover, we also reveal how these EFE impairments depend on different spatial frequencies perceptual channels (related to different cortical vs. subcortical neural structures). The effect of PD without therapy seems to be particularly acute for LSF emotional faces, possibly due to a subcortical dysfunction. However, our results indicate that the joint action of STN-DBS and DRT could also disrupt recognition of emotional expressions at the level of occipito-temporal cortical areas (processing HSF visual information) inducing broad global impairment of EFE at the level of HSF visual channels.

[A comparative study of the effectiveness and tolerability of a procedure involving slow dose-escalation of rivastigmine in patients with mild or moderate Alzheimer-type dementia: the SCALEX study].

PubMed

Agüera-Ortiz, L F; Ramos-García, M; Gobartt, A L

To determine and to compare the tolerability and effectiveness of a slow escalation of the dose of rivastigmine in patients with Alzheimer's disease with respect to using it with a faster escalation. We conducted a multi-centre, naturalistic, open-label, randomised trial with 429 hospital outpatients diagnosed with Alzheimer-type dementia (according to DSM-IV and NINCDS-ADRA criteria) and in whom treatment with rivastigmine was clinically indicated. Two study groups were established: slow escalation and fast escalation (in accordance with usual clinical practice); effectiveness and tolerability variables were analysed in the two groups, as was the proportion of patients who reached therapeutic doses (> 6 mg/day). The scores obtained on the CGI, MMSE, NPI and Barthel index scales were analysed, together with adverse events and reactions concerning spontaneous communication, and scores on the UKU scale. The slow escalation group displayed slightly higher percentages of sub-therapeutic anticipated interruptions than the fast escalation group (chi-square test; p < 0.05). On comparing the two treatment groups, no statistically significant differences were observed for the evolution of the scores on the different scales of effectiveness; no statistically significant differences were found between the two groups in the safety and tolerability analyses (chi-square test, exact test; p > 0.05) for most of the parameters that were studied (adverse reactions in spontaneous communication and the modified UKU scale). Slow escalation of the dose of rivastigmine did not display greater effectiveness or tolerability in comparison to an escalation applied in accordance with usual clinical practice.

Screening and identification of human ZnT8-specific single-chain variable fragment (scFv) from type 1 diabetes phage display library.

PubMed

Wu, Qian; Wang, Xiaodong; Gu, Yong; Zhang, Xiao; Qin, Yao; Chen, Heng; Xu, Xinyu; Yang, Tao; Zhang, Mei

2016-07-01

Zinc transporter 8 (ZnT8) is a major autoantigen and a predictive marker in type 1 diabetes (T1D). To investigate ZnT8-specific antibodies, a phage display library from T1D was constructed and single-chain antibodies against ZnT8 were screened and identified. Human T1D single-chain variable fragment (scFv) phage display library consists of approximately 1×10(8) clones. After four rounds of bio-panning, seven unique clones were positive by phage ELISA. Among them, C27 and C22, which demonstrated the highest affinity to ZnT8, were expressed in Escherichia coli Top10F' and then purified by affinity chromatography. C27 and C22 specifically bound ZnT8 N/C fusion protein and ZnT8 C terminal dimer with one Arg325Trp mutation. The specificity to human islet cells of these scFvs were further confirmed by immunohistochemistry. In conclusion, we have successfully constructed a T1D phage display antibody library and identified two ZnT8-specific scFv clones, C27 and C22. These ZnT8-specific scFvs are potential agents in immunodiagnostic and immunotherapy of T1D.

Structure, magnetic behavior, and anisotropy of homoleptic trinuclear lanthanoid 8-quinolinolate complexes.

PubMed

Chilton, Nicholas F; Deacon, Glen B; Gazukin, Olga; Junk, Peter C; Kersting, Berthold; Langley, Stuart K; Moubaraki, Boujemaa; Murray, Keith S; Schleife, Frederik; Shome, Mahasish; Turner, David R; Walker, Julia A

2014-03-03

Three complexes of the form [Ln(III)3(OQ)9] (Ln = Gd, Tb, Dy; OQ = 8-quinolinolate) have been synthesized and their magnetic properties studied. The trinuclear complexes adopt V-shaped geometries with three bridging 8-quinolinolate oxygen atoms between the central and peripheral eight-coordinate metal atoms. The magnetic properties of these three complexes differ greatly. Variable-temperature direct-current (dc) magnetic susceptibility measurements reveal that the gadolinium and terbium complexes display weak antiferromagnetic nearest-neighbor magnetic exchange interactions. This was quantified in the isotropic gadolinium case with an exchangecoupling parameter of J = -0.068(2) cm(-1). The dysprosium compound displays weak ferromagnetic exchange. Variable-frequency and -temperature alternating-current magnetic susceptibility measurements on the anisotropic cases reveal that the dysprosium complex displays single-molecule-magnet behavior, in zero dc field, with two distinct relaxation modes of differing time scales within the same molecule. Analysis of the data revealed anisotropy barriers of Ueff = 92 and 48 K for the two processes. The terbium complex, on the other hand, displays no such behavior in zero dc field, but upon application of a static dc field, slow magnetic relaxation can be observed. Ab initio and electrostatic calculations were used in an attempt to explain the origin of the experimentally observed slow relaxation of the magnetization for the dysprosium complex.

Isolation of a pH-Sensitive IgNAR Variable Domain from a Yeast-Displayed, Histidine-Doped Master Library.

PubMed

Könning, Doreen; Zielonka, Stefan; Sellmann, Carolin; Schröter, Christian; Grzeschik, Julius; Becker, Stefan; Kolmar, Harald

2016-04-01

In recent years, engineering of pH-sensitivity into antibodies as well as antibody-derived fragments has become more and more attractive for biomedical and biotechnological applications. Herein, we report the isolation of the first pH-sensitive IgNAR variable domain (vNAR), which was isolated from a yeast-displayed, semi-synthetic master library. This strategy enables the direct identification of pH-dependent binders from a histidine-enriched CDR3 library. Displayed vNAR variants contained two histidine substitutions on average at random positions in their 12-residue CDR3 loop. Upon screening of seven rounds against the proof-of-concept target EpCAM (selection for binding at pH 7.4 and decreased binding at pH 6.0), a single clone was obtained that showed specific and pH-dependent binding as characterized by yeast surface display and biolayer interferometry. Potential applications for such pH-dependent vNAR domains include their employment in tailored affinity chromatography, enabling mild elution protocols. Moreover, utilizing a master library for the isolation of pH-sensitive vNAR variants may be a generic strategy to obtain binding entities with prescribed characteristics for applications in biotechnology, diagnostics, and therapy.

The EPOS-CC Score: An Integration of Independent, Tumor- and Patient-Associated Risk Factors to Predict 5-years Overall Survival Following Colorectal Cancer Surgery.

PubMed

Haga, Yoshio; Ikejiri, Koji; Wada, Yasuo; Ikenaga, Masakazu; Koike, Shoichiro; Nakamura, Seiji; Koseki, Masato

2015-06-01

Surgical audit is an essential task for the estimation of postoperative outcome and comparison of quality of care. Previous studies on surgical audits focused on short-term outcomes, such as postoperative mortality. We propose a surgical audit evaluating long-term outcome following colorectal cancer surgery. The predictive model for this audit is designated as 'Estimation of Postoperative Overall Survival for Colorectal Cancer (EPOS-CC)'. Thirty-one tumor-related and physiological variables were prospectively collected in 889 patients undergoing elective resection for colorectal cancer between April 2005 and April 2007 in 16 Japanese hospitals. Postoperative overall survival was assessed over a 5-years period. The EPOS-CC score was established by selecting significant variables in a uni- and multivariate analysis and allocating a risk-adjusted multiplication factor to each variable using Cox regression analysis. For validation, the EPOS-CC score was compared to the predictive power of UICC stage. Inter-hospital variability of the observed-to-estimated 5-years survival was assessed to estimate quality of care. Among the 889 patients, 804 (90%) completed the 5-years follow-up. Univariate analysis displayed a significant correlation with 5-years survival for 14 physiological and nine tumor-related variables (p < 0.005). Highly significant p-values below 0.0001 were found for age, ASA score, severe pulmonary disease, respiratory history, performance status, hypoalbuminemia, alteration of hemoglobin, serum sodium level, and for all histological variables except tumor location. Age, TNM stage, lymphatic invasion, performance status, and serum sodium level were independent variables in the multivariate analysis and were entered the EPOS-CC model for the prediction of survival. Risk-adjusted multiplication factors between 1.5 (distant metastasis) and 0.16 (serum sodium level) were accorded to the different variables. The predictive power of EPOS-CC was superior to the one of UICC stage; area under the curve 0.87, 95% CI 0.85-0.90 for EPOS-CC, and 0.80, 0.76-0.83 for UICC stage, p < 0.001. Quality of care did not differ between hospitals. The EPOS-CC score including the independent variables age, performance status, serum sodium level, TNM stage, and lymphatic invasion is superior to the UICC stage in the prediction of 5-years overall survival. This higher accuracy might be explained by the inclusion of physiological factors, thus also taking non-tumor-associated deaths into account. Furthermore, EPOS-CC score may compare quality of care among different institutions. Future studies are necessary to further evaluate this score and help improving the prediction of long-term survival following colorectal cancer surgery.

The schedule of administration of canakinumab in cryopyrin associated periodic syndrome is driven by the phenotype severity rather than the age

PubMed Central

2013-01-01

Introduction Interleukin-1 (IL-1) blockade is the treatment of choice of cryopyrin associated periodic syndromes (CAPS). Anti-IL-1 monoclonal antibody (canakinumab) was recently registered. However no clear data are available on the optimal schedule of administration of this drug. The aim of the present study was to analyse the impact of canakinumab on CAPS patients in daily clinical practice and to identify the best schedule of administration according to age and phenotype. Methods 13 CAPS patients (10 children and 3 young adults) treated with canakinumab were followed for 12 months. Clinical and laboratory parameters were collected at each visit. Health-related quality of life (HRQoL) was recorded at month 12. Complete response was defined as absence of clinical manifestations and normal examinations. Clinical and laboratory variables at last follow-up were compared with those registered at the moment of anakinra discontinuation. Results seven patients with chronic infantile neurological cutaneous articular (CINCA) syndrome, four patients with Muckle-Wells syndrome (MWS) and two patients with an overlapping MWS/CINCA phenotype were analysed. CINCA patients experienced a higher number of modifications of the treatment (increased dosage or decreased dosing interval) in respect to MWS patients. At the end of the follow-up CINCA patients displayed a higher frequency of administration with a median dose of 3.7 mg/kg (2.1 mg/kg for MWS patients). Canakinumab was withdrawn in a patient with CINCA for incomplete response and poor compliance. The effect of canakinumab on HRQoL was similar to that observed during treatment with anakinra, with the exception of an improvement of the psychosocial concepts after the introduction of canakinumab. Conclusions The use of canakinumab in daily practice is associated with persistent satisfactory control of disease activity but needs progressive dose adjustments in more severe patients. The clinical phenotype, rather than the age, represents the main variable able to determine the need of more frequent administrations of the drug at higher dosage. PMID:23442610

The Influence of Environmental Consequences and Internalizing Symptoms on Children's Tic Severity.

PubMed

Eaton, Cyd K; Jones, Anna M; Gutierrez-Colina, Ana M; Ivey, Emily K; Carlson, Olivia; Melville, Lauren; Kardon, Patricia; Blount, Ronald L

2017-04-01

Although there is evidence that environmental consequences for displaying tics and internalizing symptoms are related to tic severity in children with TS, less is known about the inter-relationships of these variables or how these factors jointly contribute to tic severity. This study included 45 children with Tourette syndrome. Caregivers reported on children's environmental consequences for displaying tics, internalizing symptoms, and tic severity. Results indicated that children with higher levels of internalizing symptoms experienced significantly more environmental consequences for displaying tics. Children with higher levels of separation anxiety symptoms demonstrated significantly greater tic severity. Environmental consequences for displaying tics accounted for significantly more variance in predicting tic severity than anxiety symptoms. This preliminary evidence suggests that environmental consequences for displaying tics, such as receiving accommodations or attention from others, have a greater influence on children's tic severity than emotional factors.

Imprinting center analysis in Prader-Willi and Angelman syndrome patients with typical and atypical phenotypes.

PubMed

Camprubí, Cristina; Coll, Maria Dolors; Villatoro, Sergi; Gabau, Elisabeth; Kamli, Amine; Martínez, Maria Jesus; Poyatos, David; Guitart, Miriam

2007-01-01

Prader-Willi syndrome (PWS) and Angelman syndrome (AS) are genetic disorders caused by a deficiency of imprinted gene expression from the paternal or maternal chromosome 15, respectively. This deficiency is due to the deletion of the 15q11-q13 region, parental uniparental disomy of the chromosome 15, or imprinting defect (ID). Mutation of the UBE3A gene causes approximately 10% of AS cases. In this present study, we describe the molecular analysis and phenotypes of two PWS patients and four AS patients with ID. One of the PWS patients has a non-familial imprinting center (IC) deletion and displayed a severe phenotype with an atypical PWS appearance, hyperactivity and psychiatric vulnerability. The other PWS and AS patients did not present genetic abnormalities in the IC, suggesting an epimutation as the genetic cause. The methylation pattern of two AS patients showed a faint maternal band corresponding to a mosaic ID. One of these mosaic patients displayed a mild AS phenotype while the other displayed a PWS-like phenotype.

Factors influencing spatial variability in nitrogen processing in nitrogen-saturated soils

Treesearch

Frank S. Gilliam; Charles C. Somerville; Nikki L. Lyttle; Mary Beth Adams

2001-01-01

Nitrogen (N) saturation is an environmental concern for forests in the eastern U.S. Although several watersheds of the Fernow Experimental Forest (FEF), West Virginia exhibit symptoms of N saturation, many watersheds display a high degree of spatial variability in soil N processing. This study examined the effects of temperature on net N mineralization and...

Analyzing Disciplinary Punishments in High Schools in Terms of Different Variables in Turkish Education System

ERIC Educational Resources Information Center

Ergün, Muammer

2014-01-01

This study examined the disciplinary behaviors displayed at secondary education institutions located in Turkey and the disciplinary punishments imposed for those behaviors. The study made an attempt to reveal how disciplinary punishments imposed at high schools were distributed by different variables and whether those punishments varied by year,…

SAM syndrome is characterized by extensive phenotypic heterogeneity.

PubMed

Taiber, Shahar; Samuelov, Liat; Mohamad, Janan; Cohen Barak, Eran; Sarig, Ofer; Shalev, Stavit Allon; Lestringant, Gilles; Sprecher, Eli

2018-03-31

Severe skin dermatitis, multiple allergies and metabolic wasting (SAM) syndrome is a rare life-threatening inherited condition caused by bi-allelic mutations in DSG1 encoding desmoglein 1. The disease was initially reported to manifest with severe erythroderma, failure to thrive, atopic manifestations, recurrent infections, hypotrichosis and palmoplantar keratoderma. We present 3 new cases of SAM syndrome in 2 families and review the cases published so far. Whole exome and direct sequencing were used to identify SAM syndrome-causing mutations. Consistent with previous data, SAM syndrome was found in all 3 patients to result from homozygous mutations in DSG1 predicted to result in premature termination of translation. In contrast, as compared with patients previously reported, the present cases were found to display a wide range of clinical presentations of variable degrees of severity. The present data emphasizes the fact that SAM syndrome is characterized by extensive phenotypic heterogeneity, suggesting the existence of potent modifier traits. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Growth hormone-releasing hormone resistance in pseudohypoparathyroidism type ia: new evidence for imprinting of the Gs alpha gene.

PubMed

Mantovani, Giovanna; Maghnie, Mohamad; Weber, Giovanna; De Menis, Ernesto; Brunelli, Valeria; Cappa, Marco; Loli, Paola; Beck-Peccoz, Paolo; Spada, Anna

2003-09-01

Heterozygous inactivating mutations in the Gs alpha gene cause Albright's hereditary osteodystrophy. Consistent with the observation that only maternally inherited mutations lead to resistance to hormone action [pseudohypoparathyroidism type Ia (PHP Ia)], recent studies provided evidence for a predominant maternal origin of Gs alpha transcripts in endocrine organs, such as thyroid, gonad, and pituitary. The aim of this study was to investigate the presence of pituitary resistance to hypothalamic hormones acting via Gs alpha-coupled receptors in patients with PHP Ia. Six of nine patients showed an impaired GH responsiveness to GHRH plus arginine, consistent with a complete GH deficiency (GH peak from 2.6-8.6 microg/liter, normal > 16.5), and partial (GH peak 13.9 and 13.6 microg/liter) and normal responses were found in two and one patient, respectively. Accordingly, IGF-I levels were below and in the low-normal range in seven and two patients. All patients had a normal cortisol response to 1 microg ACTH test, suggesting a normal corticotroph function that was confirmed by a normal ACTH and cortisol response to CRH test in three patients. In conclusion, we report that in addition to PTH and TSH resistance, patients with PHP Ia display variable degrees of GHRH resistance, consistent with Gs alpha imprinting in human pituitary.

Extraocular Muscles in Patients With Infantile Nystagmus

PubMed Central

Berg, Kathleen T.; Hunter, David G.; Bothun, Erick D.; Antunes-Foschini, Rosalia; McLoon, Linda K.

2013-01-01

Objective To test the hypothesis that the extraocular muscles (EOMs) of patients with infantile nystagmus have muscular and innervational adaptations that may have a role in the involuntary oscillations of the eyes. Methods Specimens of EOMs from 10 patients with infantile nystagmus and postmortem specimens from 10 control subjects were prepared for histologic examination. The following variables were quantified: mean myofiber cross-sectional area, myofiber central nucleation, myelinated nerve density, nerve fiber density, and neuromuscular junction density. Results In contrast to control EOMs, infantile nystagmus EOMs had significantly more centrally nucleated myofibers, consistent with cycles of degeneration and regeneration. The EOMs of patients with nystagmus also had a greater degree of heterogeneity in myofiber size than did those of controls, with no difference in mean myofiber cross-sectional area. Mean myelinated nerve density, nerve fiber density, and neuromuscular junction density were also significantly decreased in infantile nystagmus EOMs. Conclusions The EOMs of patients with infantile nystagmus displayed a distinct hypoinnervated phenotype. This represents the first quantification of changes in central nucleation and myofiber size heterogeneity, as well as decreased myelinated nerve, nerve fiber, and neuromuscular junction density. These results suggest that deficits in motor innervation are a potential basis for the primary loss of motor control. Clinical Relevance Improved understanding of the etiology of nystagmus may direct future diagnostic and treatment strategies. PMID:22411664

Simulator evaluation of display concepts for pilot monitoring and control of space shuttle approach and landing. Phase 2: Manual flight control

NASA Technical Reports Server (NTRS)

Gartner, W. B.; Baldwin, K. M.

1973-01-01

A study of the display requirements for final approach management of the space shuttle orbiter vehicle is presented. An experimental display concept, providing a more direct, pictorial representation of the vehicle's movement relative to the selected approach path and aiming points, was developed and assessed as an aid to manual flight path control. Both head-up, windshield projections and head-down, panel mounted presentations of the experimental display were evaluated in a series of simulated orbiter approach sequence. Data obtained indicate that the experimental display would enable orbiter pilots to exercise greater flexibility in implementing alternative final approach control strategies. Touchdown position and airspeed dispersion criteria were satisfied on 91 percent of the approach sequences, representing various profile and wind effect conditions. Flight path control and airspeed management satisfied operationally-relevant criteria for the two-segment, power-off orbiter approach and were consistently more accurate and less variable when the full set of experimental display elements was available to the pilot. Approach control tended to be more precise when the head-up display was used; however, the data also indicate that the head-down display would provide adequate support for the manual control task.

Serum cytokine profile and clinicopathological findings in oral lichen planus, oral lichenoid lesions and stomatitis

PubMed Central

Johansen, Jeanne Duus; Reibel, Jesper; Zachariae, Claus; Pedersen, Anne Marie Lynge

2017-01-01

Abstract The objective of this study was to examine if clinical and histopathological variables in patients with oral lichen planus (OLP), oral lichenoid lesions (OLL), and generalized stomatitis display different cytokine profiles and if concomitant contact allergy influences this profile. Forty‐nine patients and 29 healthy age‐ and gender‐matched subjects were included. Demographic and clinical data immunohistochemical findings in mucosal specimens, results of contact allergy testing, and serum levels of tumor necrosis factor‐α, interferon‐γ, interleukin (IL)‐6, IL‐10, IL‐12p40, and IL‐12p70 were analyzed and compared between groups. Nineteen patients had OLP, primarily with ulcerative lesions on the buccal mucosa, 19 patients had OLL, and 11 patients had generalized stomatitis. All patients had oral symptoms, mainly stinging and burning. Nineteen patients and 10 healthy subjects had contact allergies, primarily to fragrance ingredients. Patient groups did not differ with regard to oral symptoms, clinical pattern of the lesions, or contact allergy. Serum cytokine levels did not differ between the different patient groups and were not related to histopathological findings. The patients had higher levels of IL‐6 than the healthy subjects. Interferon‐γ, IL‐12p40, and IL‐12p70 were below detection limit. Our findings indicate that OLP, OLL, and generalized stomatitis cannot be discriminated by means of the selected serum cytokines, and that the presence of concomitant contact allergy does not influence the cytokine expression. PMID:29744205

Impact and utilization studies of a PACS display station in an ICU setting

NASA Astrophysics Data System (ADS)

Andriole, Katherine P.; Storto, Maria L.; Gamsu, Gordon; Huang, H. K.

1996-05-01

An assessment of changes in health-care professional behavior as a result of the introduction of a PACS (picture archiving and communication system) display station to an adult medical- surgical intensive care unit (ICU) is investigated via pre- and post-PACs evaluations. ICU display station utilization and the impact on clinical operations are also examined. Parameters measured both pre- and post-PACS ICU display station placement include the number of films per patient day, the number of clinician reviews of a patient's images per day and the percentage of images on which the unit interacts with a radiologist. The elapsed times from the time of exposure to the time of: review by the referring physician, radiologist-unit interaction and clinical action based on image information are also measured. The results of this investigation suggest that the introduction of a PaCS display station in the ICU may reduce the number of exams per patient day, decrease the elapsed time from the time of exposure to the time of review by the unit clinician, and improve the time to clinical action. Note, however, that it does not appear to change the percentage of total images on which the unit interacts with a radiologist.

A multi-wavelength search for photometric variability in L dwarfs

NASA Astrophysics Data System (ADS)

Gelino, Christopher Ryan

Previous studies investigating L-dwarf variability have been conducted in the optical I filter. These studies have shown that some, but not all L dwarfs are variable in this filter. In this dissertation I increase the number of L dwarfs observed for variations in the I filter from 10 to 25, with another three from the original ten reexamined here. I find that at least 7 and possibly as many as 12 are variable. One of these variable objects has a puzzling saw-tooth pattern in part of its light curve and another displays a feature that could indicate the creation and dissipation of a large storm. There is no evidence for significant differences between the variable and non- variable objects in their colors, Hα emission, or Li I absorption. I argue that the lack of a correlation between Hα and variability, coupled with low magnetic Reynolds number and ionization fraction in the upper atmosphere, suggests a non-magnetic origin for the variations and favors non-uniform condensate coverage. Furthermore, the absence of significant periodicity in these objects could indicate that these clouds evolve rapidly on timescales of hours to days. In addition to the optical survey, I also present the first multi-wavelength near-infrared search for photometric variations in L dwarfs. I was unable to detect any definite variability in these eleven targets. The upper limits for the amplitude of possible variations suggest that L dwarfs display smaller variations in K than in J and H . The small number of objects on which this conclusion is based and the lack of variability detections underscores the importance of more work in this wavelength regime.

On the Importance of "Front-Side Mechanics" in Athletics Sprinting.

PubMed

Haugen, Thomas; Danielsen, Jørgen; Alnes, Leif Olav; McGhie, David; Sandbakk, Øyvind; Ettema, Gertjan

2018-05-16

Practitioners have, for many years, argued that athletic sprinters should optimize front-side mechanics (leg motions occurring in front of the extended line through the torso) and minimize back-side mechanics. This study aimed to investigate if variables related to front- and back-side mechanics can be distinguished from other previously highlighted kinematic variables (spatiotemporal variables and variables related to segment configuration and velocities at touchdown) in how they statistically predict performance. A total of 24 competitive sprinters (age: 23.1 [3.4] y, height: 1.81 [0.06] m, body mass: 75.7 [5.6] kg, and 100-m personal best: 10.86 [0.22] s) performed two 20-m starts from block and 2 to 3 flying sprints over 20 m. Kinematics were recorded in 3D using a motion tracking system with 21 cameras at a 250 Hz sampling rate. Several front- and back-side variables, including thigh (r = .64) and knee angle (r = .51) at lift-off and maximal thigh extension (r = .66), were largely correlated (P < .05) with accelerated running performance, and these variables displayed significantly higher correlations (P < .05) to accelerated running performance than nearly all the other analyzed variables. However, the relationship directions for most front- and back-side variables during accelerated running were opposite in comparison to how the theoretical concept has been described. Horizontal ankle velocity, contact time, and step rate displayed significantly higher correlation values to maximal velocity sprinting than the other variables (P < .05), and neither of the included front- and back-side variables were significantly associated with maximal velocity sprinting. Overall, the present findings did not support that front-side mechanics were crucial for sprint performance among the investigated sprinters.

16 CFR 437.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... use or operation of equipment, displays, vending machines, or similar devices, owned, leased... results based upon a combination of variables; and (2) Any statements from which a prospective purchaser...

16 CFR 437.1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... use or operation of equipment, displays, vending machines, or similar devices, owned, leased... results based upon a combination of variables; and (2) Any statements from which a prospective purchaser...

Characterization of a posed smile and evaluation of facial attractiveness by panel perception and its correlation with hard and soft tissue.

PubMed

Malhotra, Smriti; Sidhu, Maninder Singh; Prabhakar, Mona; Kochhar, Anuraj Singh

2012-01-01

To examine whether specific hard and soft tissue had any effect on smile characteristics and to ascertain the opinions of laypersons and clinicians in evaluating facial attractiveness among different occlusions. Photographs of posed smiles, along with profiles and full faces, of 76 patients with different occlusions were captured, and a lateral cephalogram of each subject was traced. These photographs were judged by a panel of 10 clinicians and 10 laypersons on a 5-point visual analog scale. Quantitative measurements were carried out on the smile images for 14 smile characteristics. The effect of hard and soft tissue on these characteristics was also examined. The upper vermilion lip thickness was affected by Pt.A-UI and E-line to upper lip, while the lower vermilion lip thickness was affected by lower anterior facial height. FMA had a significant positive effect on gingival display (P ≤ .05). This meant that an increase in FMA also caused the gingival display to increase. The nasolabial angle showed a significant positive effect on incisal display, while FMA showed a negative effect on intercanine width. Lower facial height and FMA had a significant negative effect on the smile index. A correlation was found between the judgments of clinicians and laypersons. Both judged Class I relationships to be the most attractive. FMA was found to have a positive effect on the amount of gingival display. It was also observed that patients with Class II Division 1 relationships had the thickest lips compared with patients having other types of occlusions. Class III patients exhibited no gingival display on smile. Patients with Class I showed the maximum smile width, while patients with Class III showed the least amount of buccal corridor.

Reanimating patients: cardio-respiratory CT and MR motion phantoms based on clinical CT patient data

NASA Astrophysics Data System (ADS)

Mayer, Johannes; Sauppe, Sebastian; Rank, Christopher M.; Sawall, Stefan; Kachelrieß, Marc

2017-03-01

Until today several algorithms have been developed that reduce or avoid artifacts caused by cardiac and respiratory motion in computed tomography (CT). The motion information is converted into so-called motion vector fields (MVFs) and used for motion compensation (MoCo) during the image reconstruction. To analyze these algorithms quantitatively there is the need for ground truth patient data displaying realistic motion. We developed a method to generate a digital ground truth displaying realistic cardiac and respiratory motion that can be used as a tool to assess MoCo algorithms. By the use of available MoCo methods we measured the motion in CT scans with high spatial and temporal resolution and transferred the motion information onto patient data with different anatomy or imaging modality, thereby reanimating the patient virtually. In addition to these images the ground truth motion information in the form of MVFs is available and can be used to benchmark the MVF estimation of MoCo algorithms. We here applied the method to generate 20 CT volumes displaying detailed cardiac motion that can be used for cone-beam CT (CBCT) simulations and a set of 8 MR volumes displaying respiratory motion. Our method is able to reanimate patient data virtually. In combination with the MVFs it serves as a digital ground truth and provides an improved framework to assess MoCo algorithms.

Selection and characterization of naturally occurring single-domain (IgNAR) antibody fragments from immunized sharks by phage display.

PubMed

Dooley, Helen; Flajnik, Martin F; Porter, Andrew J

2003-09-01

The novel immunoglobulin isotype novel antigen receptor (IgNAR) is found in cartilaginous fish and is composed of a heavy-chain homodimer that does not associate with light chains. The variable regions of IgNAR function as independent domains similar to those found in the heavy-chain immunoglobulins of Camelids. Here, we describe the successful cloning and generation of a phage-displayed, single-domain library based upon the variable domain of IgNAR. Selection of such a library generated from nurse sharks (Ginglymostoma cirratum) immunized with the model antigen hen egg-white lysozyme (HEL) enabled the successful isolation of intact antigen-specific binders matured in vivo. The selected variable domains were shown to be functionally expressed in Escherichia coli, extremely stable, and bind to antigen specifically with an affinity in the nanomolar range. This approach can therefore be considered as an alternative route for the isolation of minimal antigen-binding fragments with favorable characteristics.

Reorganization of Retinotopic Maps After Occipital Lobe Infarction

PubMed Central

Vaina, Lucia M.; Soloviev, Sergei; Calabro, Finnegan J.; Buonanno, Ferdinando; Passingham, Richard; Cowey, Alan

2015-01-01

We studied patient JS who had a right occipital infarct that encroached on visual areas V1, V2v and VP. When tested psychophysically, he was very impaired at detecting the direction of motion in random dot displays where a variable proportion of dots moving in one direction (signal) were embedded in masking motion noise (noise dots). The impairment on this Motion Coherence task was especially marked when the display was presented to the upper left (affected) visual quadrant, contralateral to his lesion. However, with extensive training, by 11 months his threshold fell to the level of healthy subjects. Training on the Motion Coherence task generalized to another motion task, the Motion Discontinuity task, on which he had to detect the presence of an edge that was defined by the difference in the direction of the coherently moving dots (signal) within the display. He was much better at this task at 8 than 3 months, and this improvement was associated with an increase in the activation of the human MT complex (hMT+) and in the kinetic occipital region (KO) as shown by repeated fMRI scans. We also used fMRI to perform retinotopic mapping at 3, 8 and 11 months after the infarct. We quantified the retinotopy and areal shifts by measuring the distances between the center of mass of functionally defined areas, computed in spherical surface-based coordinates. The functionally defined retinotopic areas V1, V2v, V2d and VP were initially smaller in the lesioned right hemisphere, but they increased in size between 3 and 11 months. This change was not found in the normal, left hemisphere, of the patient or in either hemispheres of the healthy control subjects. We were interested in whether practice on the motion coherence task promoted the changes in the retinotopic maps. We compared the results for patient JS with those from another patient (PF) who had a comparable lesion but had not been given such practice. We found similar changes in the maps in the lesioned hemisphere of PF. However, PF was only scanned at 3 and 7 months, and the biggest shifts in patient JS were found between 8 and 11 months. Thus, it is important to carry out a prospective study with a trained and untrained group so as to determine whether the patterns of reorganization that we have observed can be further promoted by training. PMID:24345177

Population Pharmacokinetics of Cladribine in Patients with Multiple Sclerosis.

PubMed

Savic, Radojka M; Novakovic, Ana M; Ekblom, Marianne; Munafo, Alain; Karlsson, Mats O

2017-10-01

The aims of this study were to characterize the concentration-time course of cladribine (CdA) and its main metabolite 2-chloroadenine (CAde), estimate interindividual variability in pharmacokinetics (PK), and identify covariates explaining variability in the PK of CdA. This population PK analysis was based on the combined dataset from four clinical studies in patients with multiple sclerosis (MS): three phase I studies, including one food and one drug-drug interaction study, and one phase III clinical study. Plasma and urine concentration data of CdA and CAde were modeled simultaneously. The analysis comprised a total of 2619 CdA and CAde plasma and urine concentration observations from 173 patients with MS who received an intravenous infusion or oral tablet doses of CdA as a single agent or in combination with interferon (IFN) β-1a. CdA PK data were best described by a three-compartment model, while a one-compartment model best described the PK of CAde. CdA renal clearance (CL R ) was correlated with creatinine clearance (CL CR ), predicting a decrease in the total clearance of 19%, 30% and 40% for patients with mild (CL CR  = 65 ml/min), moderate (CL CR  = 40 ml/min) and severe (CL CR  = 20 ml/min) renal impairment, respectively. Food decreased the extent of CdA absorption by 11.2% and caused an absorption delay. Coadministration with IFNβ-1a was found to increase non-CL R (CL NR ) by 21%, resulting in an increase of 11% in total clearance. Both CdA and CAde displayed linear PK after intravenous and oral administration of CdA, with CdA renal function depending on CL CR . Trial registration number for study 25643: NCT00213135.

Isogenic blood-brain barrier models based on patient-derived stem cells display inter-individual differences in cell maturation and functionality.

PubMed

Patel, Ronak; Page, Shyanne; Al-Ahmad, Abraham Jacob

2017-07-01

The blood-brain barrier (BBB) constitutes an important component of the neurovascular unit formed by specialized brain microvascular endothelial cells (BMECs) surrounded by astrocytes, pericytes, and neurons. Recently, isogenic in vitro models of the BBB based on human pluripotent stem cells have been documented, yet the impact of inter-individual variability on the yield and phenotype of such models remains to be documented. In this study, we investigated the impact of inter-individual variability on the yield and phenotype of isogenic models of the BBB, using patient-derived induced pluripotent stem cells (iPSCs). Astrocytes, BMECs, and neurons were differentiated from four asymptomatic patient-derived iPSCs (two males, two females). We differentiated such cells using existing differentiation protocols and quantified expression of cell lineage markers, as well as BBB phenotype, barrier induction, and formation of neurite processes. iPSC-derived BMECs showed barrier properties better than hCMEC/D3 monolayers; however, we noted differences in the expression and activity among iPSC lines. In addition, we noted differences in the differentiation efficiency of these cells into neural stem cells and progenitor cells (as noted by differences in expression of cell lineage markers). Such differences were reflected later in the terminal differentiation, as seen as ability to induce barrier function and to form neurite processes. Although we demonstrated our ability to obtain an isogenic model of the BBB with different patients' iPSCs, we also noted subtle differences in the expression of cell lineage markers and cell maturation processes, suggesting the presence of inter-individual polymorphisms. © 2017 International Society for Neurochemistry.

PHOSPHATE BINDER USE AND MORTALITY AMONG HEMODIALYSIS PATIENTS IN THE DOPPS: EVALUATION OF POSSIBLE CONFOUNDING BY NUTRITIONAL STATUS

PubMed Central

Lopes, Antonio Alberto; Tong, Lin; Thumma, Jyothi; Li, Yun; Fuller, Douglas S.; Morgenstern, Hal; Bommer, Jürgen; Kerr, Peter G; Tentori, Francesca; Akiba, Takashi; Gillespie, Brenda; Robinson, Bruce M.; Port, Friedrich K; Pisoni, Ronald L.

2014-01-01

Background Poor nutritional status and both hyperphosphatemia and hypophosphatemia are associated with increased mortality in maintenance hemodialysis (MHD) patients. We assessed associations of PB prescription with survival and indicators of nutritional status among (MHD) patients. Study Design Prospective cohort study (DOPPS) 1996 to 2008. Setting and Participants 23,898 MHD patients at 923 facilities in 12 countries. Predictors Patient-level PB prescription; and case-mix-adjusted facility percentage PB prescription using an instrumental-variable analysis. Outcome All-cause mortality. Results Overall, 88% of patients were prescribed PBs. The distributions of age, comorbidities and other characteristics showed small differences between facilities with higher and lower percentage PB prescription. Patient-level PB prescription was strongly associated at baseline with indicators of better nutrition, i.e., higher serum creatinine, albumin, normalized protein-catabolic rate, BMI and absence of cachectic appearance. Overall, patients prescribed PBs displayed 25% lower mortality (hazard ratio [HR] = 0.75, 95% confidence interval [CI] = 0.68–0.83) when adjusted for serum phosphorus and other covariates; further adjustment for nutritional indicators attenuated this association (HR = 0.88, 95% CI = 0.80–0.97). This inverse association, however, was observed only for patients with serum phosphorus ≥3.5mg/dL. In the instrumental-variable analysis, case-mix-adjusted facility percentage PB prescription (range: 23–100%) was positively associated with better nutritional status and inversely associated with mortality (HR for 10% more PB = 0.93, 95% CI = 0.89–0.96). Further adjustment for nutritional indicators reduced this association to HR = 0.95 (95% CI = 0.92–0.99). Limitations Results were based on PB prescription; PB and nutritional data were cross-sectional; dietary restriction was not assessed; observational design limits causal inference due to possible residual confounding. Conclusions Longer survival and better nutritional status were observed for MHD patients prescribed PBs and in facilities with greater percentage PB prescription. Understanding the mechanisms for explaining this effect and ruling out possible residual confounding require additional research. PMID:22385781

Some Causes of the Variable Shape of Flocks of Birds

PubMed Central

Hemelrijk, Charlotte K.; Hildenbrandt, Hanno

2011-01-01

Flocks of birds are highly variable in shape in all contexts (while travelling, avoiding predation, wheeling above the roost). Particularly amazing in this respect are the aerial displays of huge flocks of starlings (Sturnus vulgaris) above the sleeping site at dawn. The causes of this variability are hardly known, however. Here we hypothesise that variability of shape increases when there are larger local differences in movement behaviour in the flock. We investigate this hypothesis with the help of a model of the self-organisation of travelling groups, called StarDisplay, since such a model has also increased our understanding of what causes the oblong shape of schools of fish. The flocking patterns in the model prove to resemble those of real birds, in particular of starlings and rock doves. As to shape, we measure the relative proportions of the flock in several ways, which either depend on the direction of movement or do not. We confirm that flock shape is usually more variable when local differences in movement in the flock are larger. This happens when a) flock size is larger, b) interacting partners are fewer, c) the flock turnings are stronger, and d) individuals roll into the turn. In contrast to our expectations, when variability of speed in the flock is higher, flock shape and the positions of members in the flock are more static. We explain this and indicate the adaptive value of low variability of speed and spatial restriction of interaction and develop testable hypotheses. PMID:21829627

Reward modulation of contextual cueing: Repeated context overshadows repeated target location.

PubMed

Sharifian, Fariba; Contier, Oliver; Preuschhof, Claudia; Pollmann, Stefan

2017-10-01

Contextual cueing can be enhanced by reward. However, there is a debate if reward is associated with the repeated target-distractor configurations or with the repeated target locations that occur in both repeated and new displays. Based on neuroimaging evidence, we hypothesized that reward becomes associated with the target location only in new displays, but not in repeated displays, where the repeated target location is overshadowed by the more salient repeated target-distractor configuration. To test this hypothesis, we varied the reward value associated with the same target location in repeated and new displays. The results confirmed the overshadowing hypothesis in that search facilitation in repeated target-distractor configurations was modulated by the variable value associated with the target location. This effect was observed mainly in early learning.

Graduated profiling: enumerating and generating perceptual colormaps for uncalibrated computer displays

NASA Astrophysics Data System (ADS)

Kalvin, Alan D.

2002-06-01

The importance of using perceptual colormaps for visualizing numerical data is well established in the fields of scientific visualization, computer graphics and color science and related areas of research. In practice however, the use of perceptual colormaps tends to be the exception rather than the rule. In general it is difficult for end-users to find suitable colormaps. In addition, even when such colormaps are available, the inherent variability in color reproduction among computer displays makes it very difficult for the users to verify that these colormaps do indeed preserve their perceptual characteristics when used on different displays. Generally, verification requires display profiling (evaluating the display's color reproduction characteristics), using a colorimeter or a similar type of measuring device. With the growth of the Internet, and the resulting proliferation of remote, client-based displays, the profiling problem has become even more difficult, and in many cases, impossible. We present a method for enumerating and generating perceptual colormaps in such a way that ensures that the perceptual characteristics of the colormaps are maintained for over a wide range of different displays. This method constructs colormaps that are guaranteed to be 'perceptually correct' for a given display by using whatever partial profile information of the display is available. We use the term 'graduated profiling' to describe this method of partial profiling.

Experimental characterization of the imaging properties of multifocal intraocular lenses

NASA Astrophysics Data System (ADS)

Gobbi, Pier Giorgio; Fasce, Francesco; Bozza, Stefano; Brancato, Rosario

2003-07-01

Many different types of intraocular lenses (IOL) are currently available for implantation, both as crystalline lens replacements and as phakic refractive elements. Their optical design is increasingly sophisticated, including aspherical surface profiles and multi-zone multifocal structures, however a quantitative and comparative characterization of their imaging properties is lacking. Also a qualitative visualization of their properties would be very useful for patients in the lens choice process. To this end an experimental eye model has been developed to allow for simulated in-vivo testing of IOLs. The model cornea is made of PMMA with a dioptric power of 43 D, and it has an aspherical profile designed to minimize spherical aberration across the visible spectrum. The eye model has a variable iris and a mechanical support to accomodate IOLs, immersed in physiological solution. The eye length is variable and the retina is replaced by a glass plate. The image formed on this "retina" is optically conjugated to a CCD camera, with a suitable magnification in order to mimic the human fovea resolution, and displayed onto a monitor. With such an opto-mechanical eye model, two types of images have been used to characterize IOLs: letter charts and variable contrast gratings, in order to directly simulate human visual acuity and contrast sensitivity.

TOWARD QUANTITATIVE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY: Visualizing Blood Flow Speeds in Ocular Pathology Using Variable Interscan Time Analysis.

PubMed

Ploner, Stefan B; Moult, Eric M; Choi, WooJhon; Waheed, Nadia K; Lee, ByungKun; Novais, Eduardo A; Cole, Emily D; Potsaid, Benjamin; Husvogt, Lennart; Schottenhamml, Julia; Maier, Andreas; Rosenfeld, Philip J; Duker, Jay S; Hornegger, Joachim; Fujimoto, James G

2016-12-01

Currently available optical coherence tomography angiography systems provide information about blood flux but only limited information about blood flow speed. The authors develop a method for mapping the previously proposed variable interscan time analysis (VISTA) algorithm into a color display that encodes relative blood flow speed. Optical coherence tomography angiography was performed with a 1,050 nm, 400 kHz A-scan rate, swept source optical coherence tomography system using a 5 repeated B-scan protocol. Variable interscan time analysis was used to compute the optical coherence tomography angiography signal from B-scan pairs having 1.5 millisecond and 3.0 milliseconds interscan times. The resulting VISTA data were then mapped to a color space for display. The authors evaluated the VISTA visualization algorithm in normal eyes (n = 2), nonproliferative diabetic retinopathy eyes (n = 6), proliferative diabetic retinopathy eyes (n = 3), geographic atrophy eyes (n = 4), and exudative age-related macular degeneration eyes (n = 2). All eyes showed blood flow speed variations, and all eyes with pathology showed abnormal blood flow speeds compared with controls. The authors developed a novel method for mapping VISTA into a color display, allowing visualization of relative blood flow speeds. The method was found useful, in a small case series, for visualizing blood flow speeds in a variety of ocular diseases and serves as a step toward quantitative optical coherence tomography angiography.

Production of Recombinant Human scFv Against Tetanus Toxin Heavy Chain by Phage Display Technology.

PubMed

Khalili, Ehsan; Lakzaei, Mostafa; Rasaee, Mohhamad Javad; Aminian, Mahdi

2015-10-01

Tetanus, as a major cause of death in developing countries, is caused by tetanus neurotoxin. Recombinant antibodies against tetanus neurotoxin can be useful in tetanus management. Phage display of antibody fragments from immune human antibody libraries with single chain constructs combining the variable fragments (scFv) has been one of the most prominent technologies in antibody engineering. The aim of this study was the generation of a single chain fragment of variable region (scFv) library and selection of specific antibodies with high affinity against tetanus toxin. Immune human single chain fragment variable (HuscFv) antibody phagemid library was displayed on pIII of filamentous bacteriophage. Selection of scFv clones was performed against tetanus toxin antigens after three rounds of panning. The selected scFv clones were analyzed for inhibition of tetanus toxin binding to ganglioside GT1b. After the third round of panning, over 35 HuscFv phages specific for tetanus toxin were isolated from this library of which 15 clones were found to bind specifically to tetanus toxin. The selected HuscFv phages expressed as a soluble HuscFv peptide and some clones showed positive signals against tetanus toxin. We found that six HuscFv clones inhibit toxin binding to ganglioside GT1b. These selected antibodies can be used in the management of tetanus.

Frequency of Behavior Witnessed and Conformity in an Everyday Social Context

PubMed Central

Claidière, Nicolas; Bowler, Mark; Brookes, Sarah; Brown, Rebecca; Whiten, Andrew

2014-01-01

Conformity is thought to be an important force in human evolution because it has the potential to stabilize cultural homogeneity within groups and cultural diversity between groups. However, the effects of such conformity on cultural and biological evolution will depend much on the particular way in which individuals are influenced by the frequency of alternative behavioral options they witness. In a previous study we found that in a natural situation people displayed a tendency to be ‘linear-conformist’. When visitors to a Zoo exhibit were invited to write or draw answers to questions on cards to win a small prize and we manipulated the proportion of text versus drawings on display, we found a strong and significant effect of the proportion of text displayed on the proportion of text in the answers, a conformist effect that was largely linear with a small non-linear component. However, although this overall effect is important to understand cultural evolution, it might mask a greater diversity of behavioral responses shaped by variables such as age, sex, social environment and attention of the participants. Accordingly we performed a further study explicitly to analyze the effects of these variables, together with the quality of the information participants' responses made available to further visitors. Results again showed a largely linear conformity effect that varied little with the variables analyzed. PMID:24950212

Capacity of dental equipment to interfere with cardiac implantable electrical devices.

PubMed

Lahor-Soler, Eduard; Miranda-Rius, Jaume; Brunet-Llobet, Lluís; Sabaté de la Cruz, Xavier

2015-06-01

Patients with cardiac implantable electrical devices should take precautions when exposed to electromagnetic fields. Possible interference as a result of proximity to electromagnets or electricity flow from electronic tools employed in clinical odontology remains controversial. The objective of this study was to examine in vitro the capacity of dental equipment to provoke electromagnetic interference in pacemakers and implantable cardioverter defibrillators. Six electronic dental instruments were tested on three implantable cardioverter defibrillators and three pacemakers from different manufacturers. A simulator model, submerged in physiological saline, with elements that reproduced life-size anatomic structures was used. The instruments were analyzed at differing distances and for different time periods of application. The dental instruments studied displayed significant differences in their capacity to trigger electromagnetic interference. Significant differences in the quantity of registered interference were observed with respect to the variables manufacturer, type of cardiac implant, and application distance but not with the variable time of application. The electronic dental equipment tested at a clinical application distance (20 cm) provoked only slight interference in the pacemakers and implantable cardioverter defibrillators employed, irrespective of manufacturer. © 2015 Eur J Oral Sci.

Assessing the Association Between Asthma and Air Quality in the Presence of Wildfires

NASA Technical Reports Server (NTRS)

Young, L. J.; Lopiano, K. K.; Xu, X.; Holt, N. M.; Leary, E.; Al-Hamdan, M. Z.; Crosson, W. L.; Estes, M. G.; Luvall, J. C.; Estes, S. M.;

Identification of antibiotics using small molecule variable ligand display on gold nanoparticles.

PubMed

Bresee, Jamee; Maier, Keith E; Melander, Christian; Feldheim, Daniel L

2010-10-28

Here we describe the use of simple 1-pot thiol exchange reactions to generate a library of mixed ligand-coated gold nanoparticles that was screened for antibiotic activity. A library of 120 nanoparticle conjugates was assembled and antibiotic activity toward E. coli was determined and found to depend upon the combination of thiols assembled onto the nanoparticles. The most active conjugate displayed 99.9% growth inhibition at 0.5 μM.

3D display for enhanced tele-operation and other applications

NASA Astrophysics Data System (ADS)

Edmondson, Richard; Pezzaniti, J. Larry; Vaden, Justin; Hyatt, Brian; Morris, James; Chenault, David; Bodenhamer, Andrew; Pettijohn, Bradley; Tchon, Joe; Barnidge, Tracy; Kaufman, Seth; Kingston, David; Newell, Scott

2010-04-01

In this paper, we report on the use of a 3D vision field upgrade kit for TALON robot consisting of a replacement flat panel stereoscopic display, and multiple stereo camera systems. An assessment of the system's use for robotic driving, manipulation, and surveillance operations was conducted. A replacement display, replacement mast camera with zoom, auto-focus, and variable convergence, and a replacement gripper camera with fixed focus and zoom comprise the upgrade kit. The stereo mast camera allows for improved driving and situational awareness as well as scene survey. The stereo gripper camera allows for improved manipulation in typical TALON missions.

Molar intercuspal dimensions: genetic input to phenotypic variation.

PubMed

Townsend, G; Richards, L; Hughes, T

2003-05-01

Molecular studies indicate that epigenetic events are important in determining how the internal enamel epithelium folds during odontogenesis. Since this process of folding leads to the subsequent arrangement of cusps on molar teeth, we hypothesized that intercuspal distances of human molar teeth would display greater phenotypic variation but lower heritabilities than overall crown diameters. Intercuspal distances and maximum crown diameters were recorded from digitized images of dental casts in 100 monozygotic and 74 dizygotic twin pairs. Intercuspal distances displayed less sexual dimorphism in mean values but greater relative variability and fluctuating asymmetry than overall crown measures. Correlations between intercuspal distances and overall crown measures were low. Models incorporating only environmental effects accounted for observed variation in several intercuspal measures. For those intercuspal variables displaying significant additive genetic variance, estimates of heritability ranged from 43 to 79%, whereas those for overall crown size were higher generally, ranging from 60 to 82%. Our finding of high phenotypic variation in intercuspal distances with only moderate genetic contribution is consistent with substantial epigenetic influence on the progressive folding of the internal enamel epithelium, following formation of the primary and secondary enamel knots.

Determination of critical levels of residual oxygen to minimize discoloration of sliced packaged Norwegian salami under light display.

PubMed

Sørheim, Oddvin; Måge, Ingrid; Larsen, Hanne

2017-07-01

Discoloration of sliced packaged salami is contributing to rejection of the product, food waste and economical loss. A combination of residual O 2 in the headspace of packages and light is causing photooxidation and deterioration of colour. The aim of this study was to establish maximum tolerable concentrations of residual O 2 in packages of salami slices with 100% N 2 under light display at 4 and 20°C. Salami sausages had variable inherent O 2 consumption rate. Storage of salami in 1% O 2 in darkness did not induce discoloration. The upper limits for O 2 for avoiding discoloration under light were variable in the range 0.1-1.0%, depending on temperature and type of salami. Display at 20°C increased the rate of O 2 depletion compared to 4°C. To minimize discoloration, sliced and packaged salami should be stored in darkness at approximately 20°C until the level of residual O 2 is reduced below a critical limit. Copyright © 2017 Elsevier Ltd. All rights reserved.

Relationship of sleep abnormalities to patient genotypes in Prader-Willi syndrome

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

Vgontzas, A.N.; Kales, A.; Bixler, E.O.

To assess whether sleep abnormalities are related to the genetic abnormalities in Prader-Willi Syndrome (PWS), we performed polysomnographic studies (nighttime and daytime) and determined the chromosome 15 genotypes in eight patients with PWS. Four patients demonstrated sleep onset REM periods (SOREM), and five met the objective polysomnographic criteria for severe or moderate excessive daytime sleepiness (EDS). Three of the four patients with SOREM displayed a paternally derived deletion of chromosome 15q11-q13, whereas the fourth exhibited maternal uniparental heterodisomy in this chromosomal region (UPD). Two of the four patients that did not display SOREM carried paternally derived deletions; the remaining twomore » demonstrated UPD. Four of the five patients with EDS displayed paternal deletions, and the fifth exhibited UPD. One of three patients without evidence of EDS demonstrated paternal deletion; the remaining two showed UPD. Although neither EDS nor SOREM was not consistently associated with a specific genetic abnormality, these phenotypes may be more common in patients with paternal deletions than in those with UPD. Sleep abnormalities in PWS cannot be explained by a single genetic model. 32 refs., 1 tab.« less

At-a-glance monitoring: covert observations of anesthesiologists in the operating room.

PubMed

Ford, Simon; Birmingham, Elina; King, Ashlee; Lim, Joanne; Ansermino, J Mark

2010-09-01

Patient monitoring displays are designed to improve patient safety, and yet little is known about how anesthesiologists interact with these displays. Previous studies of clinician behavior used an observer in the operating room, which may have altered behavior. We describe a covert observation technique to determine how often and for how long anesthesiologists actually look at the monitoring display during different segments of the maintenance phase of anesthesia, and to determine whether this changed with more than 1 anesthesia provider or during concomitant activities such as reading. Five staff anesthesiologists, 2 anesthesia fellows, 3 anesthesia residents, and 2 medical students were covertly videotaped across 10 dual anesthesia provider cases and 10 solo cases. Videotapes were later segmented (5 minutes postinduction [early maintenance], mid-maintenance, and immediately before the drapes came down [late maintenance]) and coded for looking behavior at the patient monitor, anesthesia chart, and other reading material. Anesthesiologists looked at the monitor in 1- to 2-second glances, performed frequently throughout the 3 segments of maintenance anesthesia. Overall, the patient monitor was looked at only 5 of the analyzed time, which is less than has previously been reported. Monitoring behavior was constant across the segments of maintenance anesthesia and was not significantly affected by the number of anesthesia providers or role (trainee vs. senior). In contrast, charting behavior and other reading material viewing changed significantly over the analyzed segments of maintenance anesthesia. The presence of "at-a-glance monitoring" has implications for the design of patient monitoring displays. Displays should be developed to optimize the information obtained from brief glances at the monitor.

Grouping and trajectories of neuropsychiatric symptoms in patients with Alzheimer's disease. Part II: two-year patient trajectories.

PubMed

Garre-Olmo, Josep; López-Pousa, Secundino; Vilalta-Franch, Joan; de Gracia Blanco, Manuel; Vilarrasa, Antoni Bulbena

2010-01-01

Behavioral and psychological symptoms of dementia (BPSD) are characterized by fluctuations in their frequency and severity as well as by differences in the concurrent presentation of different symptoms. The goal of the current study was to identify groups of patients with Alzheimer's disease (AD) that had similar trajectories in the expression of BPSD. Over a 24-month period, an observational study was conducted using a population of ambulatory patients with AD of mild or moderate severity. The Neuropsychiatric Inventory (NPI) was administered every 6 months to the patient's caregiver. To classify patients according to changes in the frequency and severity of BPSD, growth mixture models were fitted to the applied to the grouping of NPI subscales in the following three categories: psychotic syndrome (hallucinations and delusions), affective syndrome (depression, anxiety, irritability, and agitation), and behavioral syndrome (disinhibition, euphoria, apathy, and aberrant motor behavior). The sample population consisted of 491 patients (70.9% women) that had an average age of 75.2 years (SD=6.6). Different trajectory patterns were identified based on differences in changes over the time in the frequency (stable, increasing, decreasing, or fluctuating in course) and severity (low, moderate, or elevated severity) for psychotic syndrome, emotional syndrome, and behavior syndrome. Patients with AD display a high degree of variability in the evolutionary course of BPSD. It is possible to identify groups of patients with similar evolutionary trajectories in terms of changes in the frequency and severity of BPSD.

Physicians' perception of alternative displays of clinical research evidence for clinical decision support - A study with case vignettes.

PubMed

Slager, Stacey L; Weir, Charlene R; Kim, Heejun; Mostafa, Javed; Del Fiol, Guilherme

2017-07-01

To design alternate information displays that present summaries of clinical trial results to clinicians to support decision-making; and to compare the displays according to efficacy and acceptability. A 6-between (information display presentation order) by 3-within (display type) factorial design. Two alternate displays were designed based on Information Foraging theory: a narrative summary that reduces the content to a few sentences; and a table format that structures the display according to the PICO (Population, Intervention, Comparison, Outcome) framework. The designs were compared with the summary display format available in PubMed. Physicians were asked to review five clinical studies retrieved for a case vignette; and were presented with the three display formats. Participants were asked to rate their experience with each of the information displays according to a Likert scale questionnaire. Twenty physicians completed the study. Overall, participants rated the table display more highly than either the text summary or PubMed's summary format (5.9vs. 5.4vs. 3.9 on a scale between 1 [strongly disagree] and 7 [strongly agree]). Usefulness ratings of seven pieces of information, i.e. patient population, patient age range, sample size, study arm, primary outcome, results of primary outcome, and conclusion, were high (average across all items=4.71 on a 1 to 5 scale, with 1=not at all useful and 5=very useful). Study arm, primary outcome, and conclusion scored the highest (4.9, 4.85, and 4.85 respectively). Participants suggested additional details such as rate of adverse effects. The table format reduced physicians' perceived cognitive effort when quickly reviewing clinical trial information and was more favorably received by physicians than the narrative summary or PubMed's summary format display. Copyright © 2017 Elsevier Inc. All rights reserved.

Outcome of papillary versus clear cell renal cell carcinoma varies significantly in non-metastatic disease

PubMed Central

Edelmann, Dominic; Benner, Axel; Zigeuner, Richard; Borgmann, Hendrik; Wolff, Ingmar; Krabbe, Laura M.; Musquera, Mireia; Dell’Oglio, Paolo; Capitanio, Umberto; Klatte, Tobias; Cindolo, Luca; May, Matthias; Brookman-May, Sabine D.

2017-01-01

Renal cell carcinoma (RCC) comprises a heterogenous group of tumors. Traditionally, papillary RCC (pRCC) is associated with a favorable outcome compared to clear cell RCC (ccRCC), while other series report equivalent or worse prognosis. In this paper we comparatively evaluate outcome of pRCC versus ccRCC in two large multi-institutional databases (cohort study), including distribution of pRCC subtypes 1 and 2. Retrospective data of 1,943 surgically treated pRCC patients from 17 European/ North American centers between 1984–2015 were compared to 5,600 ccRCC patients from a database comprising 11 European/ North American centers (1984–2011). Median follow-up was 64.6 months. Differences between pRCC, subtypes, and ccRCC were compared with t-tests, Chi^2-tests, and exact Fisher tests. Cancer-specific mortality was analyzed with cumulative incidence curves and Cox cause-specific hazard models. The robustness of our results was examined with sensitivity analyses. We present that cancer-specific mortality rates and variables as stage, lymph node, and distant metastasis differ significantly between groups. Furthermore, we demonstrate that patients with non-metastatic pRCC had a significantly better cancer-specific mortality (HR 0.76, p = 0.007), when compared to ccRCC. Additionally, pRCC type 2 versus ccRCC exhibited no difference in cancer-specific mortality (HR 0.9, p = 0.722), whereas pRCC type 1 versus ccRCC displayed a risk of death reduced by 69% (p = 0.044). Taken together, outcome of pRCC versus ccRCC varies significantly in non-metastatic disease. Furthermore, pRCC type 2 exhibited no difference in cancer-specific mortality, whereas pRCC type 1 displayed a significantly reduced risk of death. Consequently, there is urgent need to respect histopathological entities and their subtypes, when assigning follow-up or targeted therapy to RCC patients. PMID:28934212

HIV-1 V3 loop crown epitope-focused mimotope selection by patient serum from random phage display libraries: implications for the epitope structural features.

PubMed

Gazarian, Karlen G; Palacios-Rodríguez, Yadira; Gazarian, Tatiana G; Huerta, Leonor

2013-06-01

The crown region of the V3 loop in HIV-1 that contains the conserved amino acid sequence GPGR/G is known as the principal neutralizing determinant due to the extraordinary ability of antibodies to this region to neutralize the virus. To complement the existing peptide models of this epitope, we describe a family of 18 phage-displayed peptides, which include linear 12mer and constrained 7mer peptides that was selected by screening random libraries with serum from HIV-1 subtype B-infected patients. The 7mer constrained peptides presented two conserved amino acid sequences: PR-L in N-terminus and GPG in the C-terminus. On the basis of these peptides we propose a mimotope model of the V3 crown epitope in which the PR-L and GPG sequences represent the two known epitope binding sites. The GPG, has the same function as the V3 crown GPGR sequence but without the involvement of the "R" despite its being considered as the signature of the epitope in B-subtype viruses. The PR-L contains a proline not existing in the epitope that is postulated to induce kinks in the backbones of all peptides and create a spatial element mimicking the N-terminal conformationally variable binding site. Rabbit serum to these mimotopes recognized the V3 peptides and moderately decreased the fusion between HIV-1 Env- and CD4-expressing Jurkat cells. This study proposes the efficient generation by means of patient sera of V3 epitope mimics validated by interaction with the antibodies to contemporary viruses induced in patients. The serum antibody-selectable mimotopes are sources of novel information on the fine structure-function properties of HIV-1 principal neutralizing domain and candidate anti-HIV-1 immunogens. Copyright © 2012 Elsevier Ltd. All rights reserved.

Patient monitoring in the operating theatre.

PubMed

Forrest, A L; Douglas, D M; Rimmer, A R

1976-09-01

Anaesthetised patients are monitored to ensure their safety. Simple clinical observations must not be replaced by electronic instruments--these provide an extension of the clinical senses. The choice of parameters for monitoring is discussed. The design of the Ninewells main operating theatre suite is described. An 8-channel bourne in the base of the theatre table conveys patient signals to a 4-channel recorder in a monitoring laboratory. Outputs are displayed on a wall mounted display in theatre. Two-way speech intercommunication exists with monitoring technician and students.

A novel non-sense mutation in the SLC2A10 gene of an arterial tortuosity syndrome patient of Kurdish origin.

PubMed

Zaidi, Syed H E; Meyer, Sascha; Peltekova, Vanya D; Lindinger, Angelika; Teebi, Ahmad S; Faiyaz-Ul-Haque, Muhammad

2009-07-01

Arterial tortuosity syndrome (ATS) is a rare autosomal recessive disorder in which patients display tortuosity of arteries in addition to hyperextensible skin, joint laxity, and other connective tissue features. This syndrome is caused by mutations in the SLC2A10 gene. In this article we describe an ATS girl of Kurdish origin who, in addition to arterial tortuosity and connective tissue features, displays stomach displacement within the thorax and bilateral hip dislocation. Clinical details of this patient have been reported previously. Sequencing of the SLC2A10 gene identified a novel homozygous non-sense c.756C>A mutation in this patient's DNA. This mutation in the SLC2A10 gene replaces a cysteine encoding codon with a stop signal. This is believed to cause a premature truncation of GLUT10 protein in this patient. We conclude that patients of Kurdish origin who display arterial tortuosity associated with skin hyperextensibility, joint hypermobility, and characteristic facial features may carry mutations in the SLC2A10 gene.

Effects of Typographic Variables on Eye-Movement Measures in Reading Chinese from a Screen

ERIC Educational Resources Information Center

Yen, Nai-Shing; Tsai, Jie-Li; Chen, Pei-Ling; Lin, Hsuan-Yu; Chen, Arbee L. P.

2011-01-01

To investigate the most efficient way to represent text in reading Chinese on computer displays, three typographic variables, character size (41[feet] arc/24 pixels and 60[feet] arc/32 pixels), character spacing (1/4 and 1/8 character width) and font type (Kai and Ming), were manipulated. Results showed that the reading speed for Chinese…

Convergence of leaf display and photosynthetic characteristics of understory Abies amabilis and Tsuga Heterophylla in an old-growth forest in southwestern Washington State, USA

Treesearch

Hiroaki Ishii; Ken-Ichi Yoshimura; Akira Mori

2009-01-01

The branching pattern of A. amabilis was regular (normal shoot-length distribution, less variable branching angle and bifurcation ratio), whereas that of T. heterophylla was more plastic (positively skewed shoot-length distribution, more variable branching angle and bifurcation ratio). The two species had similar shoot...

Designing a better weather display

NASA Astrophysics Data System (ADS)

Ware, Colin; Plumlee, Matthew

2012-01-01

The variables most commonly displayed on weather maps are atmospheric pressure, wind speed and direction, and surface temperature. But they are usually shown separately, not together on a single map. As a design exercise, we set the goal of finding out if it is possible to show all three variables (two 2D scalar fields and a 2D vector field) simultaneously such that values can be accurately read using keys for all variables, a reasonable level of detail is shown, and important meteorological features stand out clearly. Our solution involves employing three perceptual "channels", a color channel, a texture channel, and a motion channel in order to perceptually separate the variables and make them independently readable. We conducted an experiment to evaluate our new design both against a conventional solution, and against a glyph-based solution. The evaluation tested the abilities of novice subjects both to read values using a key, and to see meteorological patterns in the data. Our new scheme was superior especially in the representation of wind patterns using the motion channel, and it also performed well enough in the representation of pressure using the texture channel to suggest it as a viable design alternative.

Panoramic ECG display versus conventional ECG: ischaemia detection by critical care nurses.

PubMed

Wilson, Nick; Hassani, Aimen; Gibson, Vanessa; Lightfoot, Timothy; Zizzo, Claudio

2012-01-01

To compare accuracy and certainty of diagnosis of cardiac ischaemia using the Panoramic ECG display tool plus conventional 12-lead electrocardiogram (ECG) versus 12-lead ECG alone by UK critical care nurses who were members of the British Association of Critical Care Nurses (BACCN). Critically ill patients are prone to myocardial ischaemia. Symptoms may be masked by sedation or analgesia, and ECG changes may be the only sign. Critical care nurses have an essential role in detecting ECG changes promptly. Despite this, critical care nurses may lack expertise in interpreting ECGs and myocardial ischaemia often goes undetected by critical care staff. British Association of Critical Care Nurses (BACCN) members were invited to complete an online survey to evaluate the analysis of two sets of eight ECGs displayed alone and with the new display device. Data from 82 participants showed diagnostic accuracy improved from 67·1% reading ECG traces alone, to 96·0% reading ECG plus Panoramic ECG display tool (P < 0·01, significance level α = 0·05). Participants' diagnostic certainty score rose from 41·7% reading ECG alone to 66·8% reading ECG plus Panoramic ECG display tool (P < 0·01, α = 0·05). The Panoramic ECG display tool improves both accuracy and certainty of detecting ST segment changes among critical care nurses, when compared to conventional 12-lead ECG alone. This benefit was greatest with early ischaemic changes. Critical care nurses who are least confident in reading conventional ECGs benefit the most from the new display. Critical care nurses have an essential role in the monitoring of critically ill patients. However, nurses do not always have the expertise to detect subtle ischaemic ECG changes promptly. Introduction of the Panoramic ECG display tool into clinical practice could lead to patients receiving treatment for myocardial ischaemia sooner with the potential for reduction in morbidity and mortality. © 2012 The Authors. Nursing in Critical Care © 2012 British Association of Critical Care Nurses.

Studies of the Vector Field in Shallow Water and in the Presence of 3-D Variability

DTIC Science & Technology

2015-09-30

1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Studies of the Vector Field in Shallow Water and in the...including noise variability in shallow water and the influence of three-dimensional environmental variability on the propagation of acoustic energy...issue, known to be a problem in SSF algorithms in shallow water . Figure 1 displays results of TL traces at a depth of 100m for a 100Hz source

Image Quality Characteristics of Handheld Display Devices for Medical Imaging

PubMed Central

Yamazaki, Asumi; Liu, Peter; Cheng, Wei-Chung; Badano, Aldo

2013-01-01

Handheld devices such as mobile phones and tablet computers have become widespread with thousands of available software applications. Recently, handhelds are being proposed as part of medical imaging solutions, especially in emergency medicine, where immediate consultation is required. However, handheld devices differ significantly from medical workstation displays in terms of display characteristics. Moreover, the characteristics vary significantly among device types. We investigate the image quality characteristics of various handheld devices with respect to luminance response, spatial resolution, spatial noise, and reflectance. We show that the luminance characteristics of the handheld displays are different from those of workstation displays complying with grayscale standard target response suggesting that luminance calibration might be needed. Our results also demonstrate that the spatial characteristics of handhelds can surpass those of medical workstation displays particularly for recent generation devices. While a 5 mega-pixel monochrome workstation display has horizontal and vertical modulation transfer factors of 0.52 and 0.47 at the Nyquist frequency, the handheld displays released after 2011 can have values higher than 0.63 at the respective Nyquist frequencies. The noise power spectra for workstation displays are higher than 1.2×10−5 mm2 at 1 mm−1, while handheld displays have values lower than 3.7×10−6 mm2. Reflectance measurements on some of the handheld displays are consistent with measurements for workstation displays with, in some cases, low specular and diffuse reflectance coefficients. The variability of the characterization results among devices due to the different technological features indicates that image quality varies greatly among handheld display devices. PMID:24236113

Improving Communication During Cardiac ICU Multidisciplinary Rounds Through Visual Display of Patient Daily Goals.

PubMed

Justice, Lindsey B; Cooper, David S; Henderson, Carla; Brown, James; Simon, Katherine; Clark, Lindsey; Fleckenstein, Elizabeth; Benscoter, Alexis; Nelson, David P

2016-07-01

To improve communication during daily cardiac ICU multidisciplinary rounds. Quality improvement methodology. Twenty-five-bed cardiac ICUs in an academic free-standing pediatric hospital. All patients admitted to the cardiac ICU. Implementation of visual display of patient daily goals through a write-down and read-back process. The Rounds Effectiveness Assessment and Communication Tool was developed based on the previously validated Patient Knowledge Assessment Tool to evaluate comprehension of patient daily goals. Rounds were assessed for each patient by the bedside nurse, nurse practitioner or fellow, and attending physician, and answers were compared to determine percent agreement per day. At baseline, percent agreement for patient goals was only 62%. After initial implementation of the daily goal write-down/read-back process, which was written on paper by the bedside nurse, the Rounds Effectiveness Assessment and Communication Tool survey revealed no improvement. With adaptation of the intervention so goals were written on whiteboards for visual display during rounds, the percent agreement improved to 85%. Families were also asked to complete a survey (1-6 Likert scale) of their satisfaction with rounds and understanding of daily goals before and after the intervention. Family survey results improved from a mean of 4.6-5.7. Parent selection of the best possible score for each question was 19% at baseline and 75% after the intervention. Visual display of patient daily goals via a write-down/read-back process improves comprehension of goals by all team members and improves parent satisfaction. The daily goal whiteboard facilitates consistent development of a comprehensive plan of care for each patient, fosters goal-directed care, and provides a checklist for providers and parents to review throughout the day.

Novel use of video glasses during binocular microscopy in the otolaryngology clinic.

PubMed

Fastenberg, Judd H; Fang, Christina H; Akbar, Nadeem A; Abuzeid, Waleed M; Moskowitz, Howard S

2018-06-06

The development of portable, high resolution video displays such as video glasses allows clinicians the opportunity to offer patients an increased ability to visualize aspects of their physical examination in an ergonomic and cost-effective manner. The objective of this pilot study is to trial the use of video glasses for patients undergoing binocular microscopy as well as to better understand some of the potential benefits of the enhanced display option. This study was comprised of a single treatment group. Patients seen in the otolaryngology clinic who required binocular microscopy for diagnosis and treatment were recruited. All patients wore video glasses during their otoscopic examination. An additional cohort of patients who required binocular microscopy were also recruited, but did not use the video glasses during their examination. Patients subsequently completed a 10-point Likert scale survey that assessed their comfort, anxiety, and satisfaction with the examination as well as their general understanding of their otologic condition. A total of 29 patients who used the video glasses were recruited, including those with normal examinations, cerumen impaction, or chronic ear disease. Based on the survey results, patients reported a high level of satisfaction and comfort during their exam with video glasses. Patients who used the video glasses did not exhibit any increased anxiety with their examination. Patients reported that video glasses improved their understanding and they expressed a desire to wear the glasses again during repeat exams. This pilot study demonstrates that video glasses may represent a viable alternative display option in the otolaryngology clinic. The results show that the use of video glasses is associated with high patient comfort and satisfaction during binocular microscopy. Further investigation is warranted to determine the potential for this display option in other facets of patient care as well as in expanding patient understanding of disease and anatomy. Copyright © 2018 Elsevier Inc. All rights reserved.

Description and prediction of time-to-attainment of excellent recovery for borderline patients followed prospectively for 20 years.

PubMed

Zanarini, Mary C; Temes, Christina M; Frankenburg, Frances R; Reich, D Bradford; Fitzmaurice, Garrett M

2018-04-01

One purpose of this study was to determine the cumulative rates of excellent recovery for borderline patients and axis II comparison subjects followed prospectively for 20 years. Another purpose was to find the best set of baseline predictors of excellent recovery for borderline patients. A total of 290 inpatients meeting rigorous criteria for borderline personality disorder and 72 axis II comparison subjects completed semistructured interviews and self-report measures during their index admission. Subjects were reassessed prospectively over 10 contiguous two-year waves of follow-up. Thirty-nine percent of borderline patients and 73% of personality-disordered comparison subjects met our operationalized definition of excellent recovery (concurrent remission of borderline or another primary personality disorder, good social and full-time vocational functioning, and absence of an axis I disorder associated decreased social and/or vocational functioning). Five variables formed our multivariate predictive model of excellent recovery for borderline patients: higher IQ, good childhood work history, good adult vocational record, lower trait neuroticism, and higher trait agreeableness. The results of this study suggest that complete recovery is difficult for borderline patients to achieve even over long periods of time. They also suggest that competence displayed in both childhood and adulthood is the best predictor of this important outcome. Copyright © 2018 Elsevier B.V. All rights reserved.

Interactional difficulties as a resource for patient participation in prenatal screening consultations in Hong Kong.

PubMed

Kang, M Agnes; Zayts, Olga A

2013-07-01

In this paper, we examine the interactional means by which non-native English speaking patients in Hong Kong participate in prenatal screening sessions. Using interactional sociolinguistics as the theoretical framework, we apply the concept of contextualization cues to illustrate that patients indicate their participation in the consultation through verbal and non-verbal modes. We find that non-native English speaking patients participate: (1) by displaying the interactional difficulties they are encountering and (2) by coordinating their displays of interactional difficulties with the activities of the healthcare provider. We conclude that the notion of patient participation must be expanded to take into account non-native speaking contexts; in particular, that collaborative displays of knowledge (or lack thereof) must be included as part of the definition of patient participation. While verbal contributions represent an important mode of participation in consultations, patients also participate by contextualizing their lack of understanding, which then can serve as a resource to healthcare providers in pursuing meaningful consultations. Our analysis illustrates how health care professionals' awareness of the modes of patient participation and what these modes may signal in non-native consultations can help to establish what the patient knows in the consultation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Phenotypic variability and selection of lipid-producing microalgae in a microfluidic centrifuge

NASA Astrophysics Data System (ADS)

Estévez-Torres, André.; Mestler, Troy; Austin, Robert H.

2010-03-01

Isogenic cells are known to display various expression levels that may result in different phenotypes within a population. Here we focus on the phenotypic variability of a species of unicellular algae that produce neutral lipids. Lipid-producing algae are one of the most promising sources of biofuel. We have implemented a simple microfluidic method to assess lipid-production variability in a population of algae that relays on density differences. We will discuss the reasons of this variability and address the promising avenues of this technique for directing the evolution of algae towards high lipid productivity.

Preoperative Cleft Lip Measurements and Maxillary Growth in Patients With Unilateral Cleft Lip and Palate.

PubMed

Antonarakis, Gregory S; Tompson, Bryan D; Fisher, David M

2016-11-01

Maxillary growth in patients with cleft lip and palate is highly variable. The authors' aim was to investigate associations between preoperative cleft lip measurements and maxillary growth determined cephalometrically in patients with complete unilateral cleft lip and palate (cUCLP). Retrospective cross-sectional study. Children with cUCLP. Preoperative cleft lip measurements were made at the time of primary cheiloplasty and available for each patient. Maxillary growth was evaluated on lateral cephalometric radiographs taken prior to any orthodontic treatment and alveolar bone grafting (8.5 ± 0.7 years). The presence of associations between preoperative cleft lip measurements and cephalometric measures of maxillary growth was determined using regression analyses. In the 58 patients included in the study, the cleft lateral lip element was deficient in height in 90% and in transverse width in 81% of patients. There was an inverse correlation between cleft lateral lip height and transverse width with a β coefficient of -0.382 (P = .003). Patients with a more deficient cleft lateral lip height displayed a shorter maxillary length (β coefficient = 0.336; P = .010), a less protruded maxilla (β coefficient = .334; P = .008), and a shorter anterior maxillary height (β coefficient = 0.306; P = .020) than those with a less deficient cleft lateral lip height. Patients with cUCLP present with varying degrees of lateral lip hypoplasia. Preoperative measures of lateral lip deficiency are related to later observed deficiencies of maxillary length, protrusion, and height.

Displaying uncertainty: investigating the effects of display format and specificity.

PubMed

Bisantz, Ann M; Marsiglio, Stephanie Schinzing; Munch, Jessica

2005-01-01

We conducted four studies regarding the representation of probabilistic information. Experiments 1 through 3 compared performance on a simulated stock purchase task, in which information regarding stock profitability was probabilistic. Two variables were manipulated: display format for probabilistic information (blurred and colored icons, linguistic phrases, numeric expressions, and combinations) and specificity level (in which the number and size of discrete steps into which the probabilistic information was mapped differed). Results indicated few performance differences attributable to display format; however, performance did improve with greater specificity. Experiment 4, in which participants generated membership functions corresponding to three display formats, found a high degree of similarity in functions across formats and participants and a strong relationship between the shape of the membership function and the intended meaning of the representation. These results indicate that participants can successfully interpret nonnumeric representations of uncertainty and can use such representations in a manner similar to the way numeric expressions are used in a decision-making task. Actual or potential applications of this research include the use of graphical representations of uncertainty in systems such as command and control and situation displays.

Social variables exert selective pressures in the evolution and form of primate mimetic musculature.

PubMed

Burrows, Anne M; Li, Ly; Waller, Bridget M; Micheletta, Jerome

2016-04-01

Mammals use their faces in social interactions more so than any other vertebrates. Primates are an extreme among most mammals in their complex, direct, lifelong social interactions and their frequent use of facial displays is a means of proximate visual communication with conspecifics. The available repertoire of facial displays is primarily controlled by mimetic musculature, the muscles that move the face. The form of these muscles is, in turn, limited by and influenced by phylogenetic inertia but here we use examples, both morphological and physiological, to illustrate the influence that social variables may exert on the evolution and form of mimetic musculature among primates. Ecomorphology is concerned with the adaptive responses of morphology to various ecological variables such as diet, foliage density, predation pressures, and time of day activity. We present evidence that social variables also exert selective pressures on morphology, specifically using mimetic muscles among primates as an example. Social variables include group size, dominance 'style', and mating systems. We present two case studies to illustrate the potential influence of social behavior on adaptive morphology of mimetic musculature in primates: (1) gross morphology of the mimetic muscles around the external ear in closely related species of macaque (Macaca mulatta and Macaca nigra) characterized by varying dominance styles and (2) comparative physiology of the orbicularis oris muscle among select ape species. This muscle is used in both facial displays/expressions and in vocalizations/human speech. We present qualitative observations of myosin fiber-type distribution in this muscle of siamang (Symphalangus syndactylus), chimpanzee (Pan troglodytes), and human to demonstrate the potential influence of visual and auditory communication on muscle physiology. In sum, ecomorphologists should be aware of social selective pressures as well as ecological ones, and that observed morphology might reflect a compromise between the demands of the physical and the social environments. © 2016 Anatomical Society.

Crystal structure of the anti-(carcinoembryonic antigen) single-chain Fv antibody MFE-23 and a model for antigen binding based on intermolecular contacts.

PubMed

Boehm, M K; Corper, A L; Wan, T; Sohi, M K; Sutton, B J; Thornton, J D; Keep, P A; Chester, K A; Begent, R H; Perkins, S J

2000-03-01

MFE-23 is the first single-chain Fv antibody molecule to be used in patients and is used to target colorectal cancer through its high affinity for carcinoembryonic antigen (CEA), a cell-surface member of the immunoglobulin superfamily. MFE-23 contains an N-terminal variable heavy-chain domain joined by a (Gly(4)Ser)(3) linker to a variable light-chain (V(L)) domain (kappa chain) with an 11-residue C-terminal Myc-tag. Its crystal structure was determined at 2.4 A resolution by molecular replacement with an R(cryst) of 19.0%. Five of the six antigen-binding loops, L1, L2, L3, H1 and H2, conformed to known canonical structures. The sixth loop, H3, displayed a unique structure, with a beta-hairpin loop and a bifurcated apex characterized by a buried Thr residue. In the crystal lattice, two MFE-23 molecules were associated back-to-back in a manner not seen before. The antigen-binding site displayed a large acidic region located mainly within the H2 loop and a large hydrophobic region within the H3 loop. Even though this structure is unliganded within the crystal, there is an unusually large region of contact between the H1, H2 and H3 loops and the beta-sheet of the V(L) domain of an adjacent molecule (strands DEBA) as a result of intermolecular packing. These interactions exhibited remarkably high surface and electrostatic complementarity. Of seven MFE-23 residues predicted to make contact with antigen, five participated in these lattice contacts, and this model for antigen binding is consistent with previously reported site-specific mutagenesis of MFE-23 and its effect on CEA binding.

Human factors flight trial analysis for 3D SVS: part II

NASA Astrophysics Data System (ADS)

Schiefele, Jens; Howland, Duncan; Maris, John; Pschierer, Christian; Wipplinger, Patrick; Meuter, Michael

2005-05-01

This paper describes flight trials performed in Centennial, CO using a Piper Cheyenne owned and operated by Marinvent. The goal of the flight trial was to evaluate the objective performance of pilots using conventional paper charts or a 3D SVS display. Six pilots flew thirty-six approaches to the Colorado Springs airport to accomplish this goal. As dependent variables, positional accuracy and situational awareness probe (SAP) statistics were measured while analysis was conducted by an ANOVA test. In parallel, all pilots answered subjective Cooper-Harper, NASA TLX, situation awareness rating technique (SART), Display Readability Rating, Display Flyability Rating and debriefing questionnaires. Three different settings (paper chart, electronic navigation chart, 3D SVS display) were evaluated in a totally randomized manner. This paper describes the comparison between the conventional paper chart and the 3D SVS display. The 3D SVS primary flight display provides a depiction of primary flight data as well as a 3D depiction of airports, terrain and obstacles. In addition, a 3D dynamic channel visualizing the selected approach procedure can be displayed. The result shows that pilots flying the 3D SVS display perform no worse than pilots with the conventional paper chart. Flight technical error and workload are lower, situational awareness is equivalent with conventional paper charts.

The ergonomic evaluation of eye movement and mental workload in aircraft pilots.

PubMed

Itoh, Y; Hayashi, Y; Tsukui, I; Saito, S

1990-06-01

This paper presents an experiment which examines characteristics of pilots' scanning behaviour when using integrated CRT displays, and the changes in characteristics when pilots face abnormal situations. The subjects were five experienced pilots. They performed two modes of flight tasks, under normal and abnormal situations, in flight simulators with standard settings. The flight simulators were for a Boeing 747-300 (B747), which made use of electromechanical displays, and for a Boeing 767 (B767), equipped with integrated CRT displays. The results showed that the B767 pilots tended to gaze at the attitude director indicator which was displayed in the integrated CRT display. It was assumed that 'gaze-type scanning' might be one of the characteristics of pilots' scanning behaviour in cockpits which use the integrated display. By employing subjective ratings and heart rate variability to measure mental workload, no differences in mental workload between the B767 pilots and the B747 pilots were observed. However, in abnormal situations, the changes in scanning pattern for B767 pilots were found to be smaller than those of the B747 pilots. It is concluded that the application of integrated displays helps pilots to obtain sufficient information more easily than electromechanical displays do, even under abnormal situations.

The Validity of the Multi-Informant Approach to Assessing Child and Adolescent Mental Health

PubMed Central

De Los Reyes, Andres; Augenstein, Tara M.; Wang, Mo; Thomas, Sarah A.; Drabick, Deborah A.G.; Burgers, Darcy E.; Rabinowitz, Jill

2015-01-01

Child and adolescent patients may display mental health concerns within some contexts and not others (e.g., home vs. school). Thus, understanding the specific contexts in which patients display concerns may assist mental health professionals in tailoring treatments to patients' needs. Consequently, clinical assessments often include reports from multiple informants who vary in the contexts in which they observe patients' behavior (e.g., patients, parents, teachers). Previous meta-analyses indicate that informants' reports correlate at low-to-moderate magnitudes. However, is it valid to interpret low correspondence among reports as indicating that patients display concerns in some contexts and not others? We meta-analyzed 341 studies published between 1989 and 2014 that reported cross-informant correspondence estimates, and observed low-to-moderate correspondence (mean internalizing: r = .25; mean externalizing: r = .30; mean overall: r = .28). Informant pair, mental health domain, and measurement method moderated magnitudes of correspondence. These robust findings have informed the development of concepts for interpreting multi-informant assessments, allowing researchers to draw specific predictions about the incremental and construct validity of these assessments. In turn, we critically evaluated research on the incremental and construct validity of the multi-informant approach to clinical child and adolescent assessment. In so doing, we identify crucial gaps in knowledge for future research, and provide recommendations for “best practices” in using and interpreting multi-informant assessments in clinical work and research. This paper has important implications for developing personalized approaches to clinical assessment, with the goal of informing techniques for tailoring treatments to target the specific contexts where patients display concerns. PMID:25915035

Usability Evaluation and Implementation of a Health Information Technology Dashboard of Evidence-Based Quality Indicators.

PubMed

Schall, Mark Christopher; Cullen, Laura; Pennathur, Priyadarshini; Chen, Howard; Burrell, Keith; Matthews, Grace

2017-06-01

Health information technology dashboards that integrate evidence-based quality indicators can efficiently and accurately display patient risk information to promote early intervention and improve overall quality of patient care. We describe the process of developing, evaluating, and implementing a dashboard designed to promote quality care through display of evidence-based quality indicators within an electronic health record. Clinician feedback was sought throughout the process. Usability evaluations were provided by three nurse pairs and one physician from medical-surgical areas. Task completion times, error rates, and ratings of system usability were collected to compare the use of quality indicators displayed on the dashboard to the indicators displayed in a conventional electronic health record across eight experimental scenarios. Participants rated the dashboard as "highly usable" following System Usability Scale (mean, 87.5 [SD, 9.6]) and Poststudy System Usability Questionnaire (mean, 1.7 [SD, 0.5]) criteria. Use of the dashboard led to reduced task completion times and error rates in comparison to the conventional electronic health record for quality indicator-related tasks. Clinician responses to the dashboard display capabilities were positive, and a multifaceted implementation plan has been used. Results suggest application of the dashboard in the care environment may lead to improved patient care.

Intra- and inter-radiation therapist reproducibility of daily isocenter verification using prostatic fiducial markers

PubMed Central

Ullman, Karen L; Ning, Holly; Susil, Robert C; Ayele, Asna; Jocelyn, Lucresse; Havelos, Jan; Guion, Peter; Xie, Huchen; Li, Guang; Arora, Barbara C; Cannon, Angela; Miller, Robert W; Norman Coleman, C; Camphausen, Kevin; Ménard, Cynthia

2006-01-01

Background We sought to determine the intra- and inter-radiation therapist reproducibility of a previously established matching technique for daily verification and correction of isocenter position relative to intraprostatic fiducial markers (FM). Materials and methods With the patient in the treatment position, anterior-posterior and left lateral electronic images are acquired on an amorphous silicon flat panel electronic portal imaging device. After each portal image is acquired, the therapist manually translates and aligns the fiducial markers in the image to the marker contours on the digitally reconstructed radiograph. The distances between the planned and actual isocenter location is displayed. In order to determine the reproducibility of this technique, four therapists repeated and recorded this operation two separate times on 20 previously acquired portal image datasets from two patients. The data were analyzed to obtain the mean variability in the distances measured between and within observers. Results The mean and median intra-observer variability ranged from 0.4 to 0.7 mm and 0.3 to 0.6 mm respectively with a standard deviation of 0.4 to 1.0 mm. Inter-observer results were similar with a mean variability of 0.9 mm, a median of 0.6 mm, and a standard deviation of 0.7 mm. When using a 5 mm threshold, only 0.5% of treatments will undergo a table shift due to intra or inter-observer error, increasing to an error rate of 2.4% if this threshold were reduced to 3 mm. Conclusion We have found high reproducibility with a previously established method for daily verification and correction of isocenter position relative to prostatic fiducial markers using electronic portal imaging. PMID:16722575

Enhanced Combined Tomography and Biomechanics Data for Distinguishing Forme Fruste Keratoconus.

PubMed

Luz, Allan; Lopes, Bernardo; Hallahan, Katie M; Valbon, Bruno; Ramos, Isaac; Faria-Correia, Fernando; Schor, Paulo; Dupps, William J; Ambrósio, Renato

2016-07-01

To evaluate the performance of the Ocular Response Analyzer (ORA) (Reichert Ophthalmic Instruments, Depew, NY) variables and Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany) tomographic parameters in differentiating forme fruste keratoconus (FFKC) from normal corneas, and to assess a combined biomechanical and tomographic parameter to improve outcomes. Seventy-six eyes of 76 normal patients and 21 eyes of 21 patients with FFKC were included in the study. Fifteen variables were derived from exported ORA signals to characterize putative indicators of biomechanical behavior and 37 ORA waveform parameters were tested. Sixteen tomographic parameters from Pentacam HR were tested. Logistic regression was used to produce a combined biomechanical and tomography linear model. Differences between groups were assessed by the Mann-Whitney U test. The area under the receiver operating characteristics curve (AUROC) was used to compare diagnostic performance. No statistically significant differences were found in age, thinnest point, central corneal thickness, and maximum keratometry between groups. Twenty-one parameters showed significant differences between the FFKC and control groups. Among the ORA waveform measurements, the best parameters were those related to the area under the first peak, p1area1 (AUROC, 0.717 ± 0.065). Among the investigator ORA variables, a measure incorporating the pressure-deformation relationship of the entire response cycle was the best predictor (hysteresis loop area, AUROC, 0.688 ± 0.068). Among tomographic parameters, Belin/Ambrósio display showed the highest predictive value (AUROC, 0.91 ± 0.057). A combination of parameters showed the best result (AUROC, 0.953 ± 0.024) outperforming individual parameters. Tomographic and biomechanical parameters demonstrated the ability to differentiate FFKC from normal eyes. A combination of both types of information further improved predictive value. [J Refract Surg. 2016;32(7):479-485.]. Copyright 2016, SLACK Incorporated.

Pictorial communication in virtual and real environments

NASA Technical Reports Server (NTRS)

Ellis, Stephen R. (Editor)

1991-01-01

Papers about the communication between human users and machines in real and synthetic environments are presented. Individual topics addressed include: pictorial communication, distortions in memory for visual displays, cartography and map displays, efficiency of graphical perception, volumetric visualization of 3D data, spatial displays to increase pilot situational awareness, teleoperation of land vehicles, computer graphics system for visualizing spacecraft in orbit, visual display aid for orbital maneuvering, multiaxis control in telemanipulation and vehicle guidance, visual enhancements in pick-and-place tasks, target axis effects under transformed visual-motor mappings, adapting to variable prismatic displacement. Also discussed are: spatial vision within egocentric and exocentric frames of reference, sensory conflict in motion sickness, interactions of form and orientation, perception of geometrical structure from congruence, prediction of three-dimensionality across continuous surfaces, effects of viewpoint in the virtual space of pictures, visual slant underestimation, spatial constraints of stereopsis in video displays, stereoscopic stance perception, paradoxical monocular stereopsis and perspective vergence. (No individual items are abstracted in this volume)

A comparative evaluation of in-vehicle side view displays layouts in critical lane changing situation.

PubMed

Beck, Donghyun; Lee, Minho; Park, Woojin

2017-12-01

This study conducted a driving simulator experiment to comparatively evaluate three in-vehicle side view displays layouts for camera monitor systems (CMS) and the traditional side view mirror arrangement. The three layouts placed two electronic side view displays near the traditional mirrors positions, on the dashboard at each side of the steering wheel and on the centre fascia with the two displays joined side-by-side, respectively. Twenty-two participants performed a time- and safety-critical driving task that required rapidly gaining situation awareness through the side view displays/mirrors and making a lane change to avoid collision. The dependent variables were eye-off-the-road time, response time, and, ratings of perceived workload, preference and perceived safety. Overall, the layout placing the side view displays on the dashboard at each side of the steering wheel was found to be the best. The results indicated that reducing eye gaze travel distance and maintaining compatibility were both important for the design of CMS displays layout. Practitioner Summary: A driving simulator study was conducted to comparatively evaluate three in-vehicle side view displays layouts for camera monitor systems (CMS) and the traditional side view mirror arrangement in critical lane changing situation. Reducing eye movement and maintaining compatibility were found to be both important for the ergonomics design of CMS displays layout.

18-year variability of ultraviolet radiation penetration in the mid-latitude coastal waters of the western boundary Pacific

NASA Astrophysics Data System (ADS)

Kuwahara, Victor S.; Nozaki, Sena; Nakano, Junji; Toda, Tatsuki; Kikuchi, Tomohiko; Taguchi, Satoru

2015-07-01

The 18-year time-series shows in situ ultraviolet radiation (UVR) and photosynthetically active radiation (PAR) diffuse attenuation coefficient Kd(λ) have recurrent seasonal variability of high/low attenuation during summer/winter months, respectively, dependent on variability in water column stratification and concentrations of bio-optical properties. The mid-latitude coastal survey station displayed significant seasonality of the mixed layer depth (MLD) between 12 and 82 m which modified the distribution of chlorophyll a (4.6-24.9 mg m-2) and absorption of colored dissolved organic matter [aCDOM(320 nm) 0.043-1.34 m-1]. The median Kd(320 nm) displayed significant seasonality at 0.19-0.74 m-1 (C.V. = 44.1%) and seasonal variability within the euphotic layer [Z10%(320 nm) = 7-20%]. High attenuation of UVR with relatively moderate attenuation of PAR was consistently observed during the summer months when increased concentrations of terrestrially derived CDOM coupled with a shallow MLD were present. The winter season showed the opposite of low UVR and PAR attenuation due to a relatively deeper MLD coupled with low concentrations of bio-optical properties. Although the long term Kd(λ) did not vary significantly during the time-series, analysis of the interannual variability suggests there are positive and negative phases following the Pacific Decadal Oscillation (PDO) vis-a-vis variability in bio-optical properties (p < 0.001).

Treatment intensification using long-acting insulin -predictors of future basal insulin supported oral therapy in the DIVE registry.

PubMed

Danne, Thomas; Bluhmki, Tobias; Seufert, Jochen; Kaltheuner, Matthias; Rathmann, Wolfgang; Beyersmann, Jan; Bramlage, Peter

2015-10-07

In patients with type-2 diabetes receiving oral antidiabetic drugs (OADs), the addition of insulin is frequently required to achieve sufficient control over blood glucose levels. It is, however, difficult to predict if, when and in which patients insulin therapy will be needed. We aimed to identify patient related variables associated with the addition of basal insulin to oral therapy resulting in a basal supported oral therapy (BOT). DIVE (DIabetes Versorgungs-Evaluation) is a prospective, observational, multi-centre diabetes registry established in Germany in 2011. For the present explorative analysis, 31,008 patients with type-2 diabetes prescribed at least one OAD were included. Patients who had previously received insulin and those over 90 years old were excluded. The event of interest was defined as the initiation of BOT during the observational period. Cause-specific Cox proportional hazards models based on a competing risk framework were applied for risk quantification. Multivariable adjusted hazard ratios demonstrated that longer diabetes duration, higher BMI, poorer glycaemic control, documentation of any micro- or macrovascular comorbidity, the presence of concomitant non-antidiabetic pharmacotherapies, and greater numbers of prescribed OADs increased the likelihood of BOT initiation. On the other hand BOT initiation was less likely in patients with older age and female gender. Analysing the likelihood of OAD termination without initiation of BOT provided supportive evidence for the variables predictive of BOT initiation. Analysis of the DIVE registry has resulted in the identification of a number of factors that may be predictive for the initiation of BOT for type-2 diabetes patients initially prescribed one or more OADs. Poor glycaemic control, the presence of vascular comorbidities and concomitant medications, and a greater number of OADs were all detected to increase the risk of a switch to BOT. Female gender and younger age showed protective properties. The close monitoring of patients displaying these characteristics may help to identify individuals who might benefit from early addition of insulin therapy to their oral treatment regimen.

Evaluation of third molar development in the estimation of chronological age.

PubMed

Soares, Caio Belém Rodrigues Barros; Figueiroa, José Natal; Dantas, Renata Moura Xavier; Kurita, Lúcio Mitsuo; Pontual, Andréa dos Anjos; Ramos-Perez, Flávia Maria de Moraes; Perez, Danyel Elias da Cruz; Pontual, Maria Luiza dos Anjos

2015-09-01

The purpose of this study was to evaluate the correlation between chronological age and the degree of third molar mineralization by Demirjian's developmental stages (Demirjian et al., 1973) using panoramic radiography. From a total of 11.396 digital panoramic radiographs of patients from three oral radiology private clinics from the northeast region of Brazil, obtained from January to June 2009, 2097 radiographic images from patients aged between 6 and 22 years were selected. The images were analyzed individually by two obsevers using a 21-inch computer screen and Windows Picture and Fax Viewer. Reliability was achieved by intra- and interobserver evaluation, using the Kappa test. Chronological age, calcification stage, gender and third molar were interrelated using a multiple linear regression model, considering age as a response variable. There was reliability with Demirjian et al.'s developmental stage assesment, displaying a significant relationship between mineralization stages and patients' age (P<0.05). There was no significant difference between the average age and the calcification stage taking gender and localization of the third molar into consideration. It is possible to estimate chronological age based on Demirjian's stage of a third molar, regardless of gender and location. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

CVID-associated TACI mutations affect autoreactive B cell selection and activation

PubMed Central

Romberg, Neil; Chamberlain, Nicolas; Saadoun, David; Gentile, Maurizio; Kinnunen, Tuure; Ng, Yen Shing; Virdee, Manmeet; Menard, Laurence; Cantaert, Tineke; Morbach, Henner; Rachid, Rima; Martinez-Pomar, Natalia; Matamoros, Nuria; Geha, Raif; Grimbacher, Bodo; Cerutti, Andrea; Cunningham-Rundles, Charlotte; Meffre, Eric

2013-01-01

Common variable immune deficiency (CVID) is an assorted group of primary diseases that clinically manifest with antibody deficiency, infection susceptibility, and autoimmunity. Heterozygous mutations in the gene encoding the tumor necrosis factor receptor superfamily member TACI are associated with CVID and autoimmune manifestations, whereas two mutated alleles prevent autoimmunity. To assess how the number of TACI mutations affects B cell activation and tolerance checkpoints, we analyzed healthy individuals and CVID patients carrying one or two TACI mutations. We found that TACI interacts with the cleaved, mature forms of TLR7 and TLR9 and plays an important role during B cell activation and the central removal of autoreactive B cells in healthy donors and CVID patients. However, only subjects with a single TACI mutation displayed a breached immune tolerance and secreted antinuclear antibodies (ANAs). These antibodies were associated with the presence of circulating B cell lymphoma 6–expressing T follicular helper (Tfh) cells, likely stimulating autoreactive B cells. Thus, TACI mutations may favor CVID by altering B cell activation with coincident impairment of central B cell tolerance, whereas residual B cell responsiveness in patients with one, but not two, TACI mutations enables autoimmune complications. PMID:24051380

Hereditary Xerocytosis due to Mutations in PIEZO1 Gene Associated with Heterozygous Pyruvate Kinase Deficiency and Beta-Thalassemia Trait in Two Unrelated Families.

PubMed

Fermo, Elisa; Vercellati, Cristina; Marcello, Anna Paola; Zaninoni, Anna; van Wijk, Richard; Mirra, Nadia; Curcio, Cristina; Cortelezzi, Agostino; Zanella, Alberto; Barcellini, Wilma; Bianchi, Paola

2017-01-01

Hereditary xerocytosis (HX) is a rare disorder caused by defects of RBC permeability, associated with haemolytic anaemia of variable degree and iron overload. It is sometimes misdiagnosed as hereditary spherocytosis or other congenital haemolytic anaemia. Splenectomy is contraindicated due to increased risk of thromboembolic complications. We report the clinical, haematological, and molecular characteristics of four patients from two unrelated Italian families affected by HX, associated with beta-thalassemia trait and heterozygous pyruvate kinase deficiency, respectively. Two patients had been splenectomised and displayed thrombotic episodes. All patients had iron overload in the absence of transfusion, two of them requiring iron chelation. The diagnosis of HX was confirmed by LoRRca Osmoscan analysis showing a left-shifted curve. PIEZO1 gene sequencing revealed the presence of mutation p.E2496ELE, showing that this is one of the most frequent mutations in this disease. The concomitant defects did not aggravate the clinical phenotype; however, in one patient, the initial diagnosis of pyruvate kinase deficiency delayed the correct diagnosis of HX for many years and resulted in splenectomy followed by thrombotic complications. The study underlines the importance of a precise diagnosis in HX, particularly in view of splenectomy, and the need of a molecular confirmation of suspected RBC enzymopathy.

Hereditary Xerocytosis due to Mutations in PIEZO1 Gene Associated with Heterozygous Pyruvate Kinase Deficiency and Beta-Thalassemia Trait in Two Unrelated Families

PubMed Central

Vercellati, Cristina; Marcello, Anna Paola; Zaninoni, Anna; van Wijk, Richard; Mirra, Nadia; Curcio, Cristina; Cortelezzi, Agostino; Zanella, Alberto; Barcellini, Wilma; Bianchi, Paola

2017-01-01

Hereditary xerocytosis (HX) is a rare disorder caused by defects of RBC permeability, associated with haemolytic anaemia of variable degree and iron overload. It is sometimes misdiagnosed as hereditary spherocytosis or other congenital haemolytic anaemia. Splenectomy is contraindicated due to increased risk of thromboembolic complications. We report the clinical, haematological, and molecular characteristics of four patients from two unrelated Italian families affected by HX, associated with beta-thalassemia trait and heterozygous pyruvate kinase deficiency, respectively. Two patients had been splenectomised and displayed thrombotic episodes. All patients had iron overload in the absence of transfusion, two of them requiring iron chelation. The diagnosis of HX was confirmed by LoRRca Osmoscan analysis showing a left-shifted curve. PIEZO1 gene sequencing revealed the presence of mutation p.E2496ELE, showing that this is one of the most frequent mutations in this disease. The concomitant defects did not aggravate the clinical phenotype; however, in one patient, the initial diagnosis of pyruvate kinase deficiency delayed the correct diagnosis of HX for many years and resulted in splenectomy followed by thrombotic complications. The study underlines the importance of a precise diagnosis in HX, particularly in view of splenectomy, and the need of a molecular confirmation of suspected RBC enzymopathy. PMID:28367341

Brain structural network topological alterations of the left prefrontal and limbic cortex in psychogenic erectile dysfunction.

PubMed

Chen, Jianhuai; Chen, Yun; Gao, Qingqiang; Chen, Guotao; Dai, Yutian; Yao, Zhijian; Lu, Qing

2018-05-01

Despite increasing understanding of the cerebral functional changes and structural abnormalities in erectile dysfunction, alterations in the topological organization of brain networks underlying psychogenic erectile dysfunction remain unclear. Here, based on the diffusion tensor image data of 25 patients and 26 healthy controls, we investigated the topological organization of brain structural networks and its correlations with the clinical variables using the graph theoretical analysis. Patients displayed a preserved overall small-world organization and exhibited a less connectivity strength in the left inferior frontal gyrus, amygdale and the right inferior temporal gyrus. Moreover, an abnormal hub pattern was observed in patients, which might disturb the information interactions of the remaining brain network. Additionally, the clustering coefficient of the left hippocampus was positively correlated with the duration of patients and the normalized betweenness centrality of the right anterior cingulate gyrus and the left calcarine fissure were negatively correlated with the sum scores of the 17-item Hamilton Depression Rating Scale. These findings suggested that the damaged white matter and the abnormal hub distribution of the left prefrontal and limbic cortex might contribute to the pathogenesis of psychogenic erectile dysfunction and provided new insights into the understanding of the pathophysiological mechanisms of psychogenic erectile dysfunction.

A general theoretical framework for interpreting patient-reported outcomes estimated from ordinally scaled item responses.

PubMed

Massof, Robert W

2014-10-01

A simple theoretical framework explains patient responses to items in rating scale questionnaires. Fixed latent variables position each patient and each item on the same linear scale. Item responses are governed by a set of fixed category thresholds, one for each ordinal response category. A patient's item responses are magnitude estimates of the difference between the patient variable and the patient's estimate of the item variable, relative to his/her personally defined response category thresholds. Differences between patients in their personal estimates of the item variable and in their personal choices of category thresholds are represented by random variables added to the corresponding fixed variables. Effects of intervention correspond to changes in the patient variable, the patient's response bias, and/or latent item variables for a subset of items. Intervention effects on patients' item responses were simulated by assuming the random variables are normally distributed with a constant scalar covariance matrix. Rasch analysis was used to estimate latent variables from the simulated responses. The simulations demonstrate that changes in the patient variable and changes in response bias produce indistinguishable effects on item responses and manifest as changes only in the estimated patient variable. Changes in a subset of item variables manifest as intervention-specific differential item functioning and as changes in the estimated person variable that equals the average of changes in the item variables. Simulations demonstrate that intervention-specific differential item functioning produces inefficiencies and inaccuracies in computer adaptive testing. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Real-time display of flow-pressure-volume loops.

PubMed

Morozoff, P E; Evans, R W

1992-01-01

Graphic display of respiratory waveforms can be valuable for monitoring the progress of ventilated patients. A system has been developed that can display flow-pressure-volume loops as derived from a patient's respiratory circuit in real time. It can also display, store, print, and retrieve ventilatory waveforms. Five loops can be displayed at once: current, previous, reference, "ideal," and previously saved. Two components, the data-display device (DDD) and the data-collection device (DCD), comprise the system. An IBM 286/386 computer with a graphics card (VGA) and bidirectional parallel port is used for the DDD; an eight-bit microprocessor card and an A/D convertor card make up the DCD. A real-time multitasking operating system was written to control the DDD, while the DCD operates from in-line assembly code. The DCD samples the pressure and flow sensors at 100 Hz and looks for a complete flow waveform pattern based on flow slope. These waveforms are then passed to the DDD via the mutual parallel port. Within the DDD a process integrates the flow to create a volume signal and performs a multilinear regression on the pressure, flow, and volume data to calculate the elastance, resistance, pressure offset, and coefficient of determination. Elastance, resistance, and offset are used to calculate Pr and Pc where: Pr[k] = P[k]-offset-(elastance.V[k]) and Pc[k] = P[k]-offset-(resistance.F[k]). Volume vs. Pc and flow vs. Pr can be displayed in real time. Patient data from previous clinical tests were loaded into the device to verify the software calculations. An analog waveform generator was used to simulate flow and pressure waveforms that validated the system.(ABSTRACT TRUNCATED AT 250 WORDS)

Mid-infrared interferometric variability of DG Tau: implications for the inner-disk structure .

NASA Astrophysics Data System (ADS)

Ábrahám, P.; Varga, J.; Gabányi, K. É.; Chen, L.; Kóspál, Á.; Ratzka, Th.; van Boekel, R.; Mosoni, L.; Henning, Th.

DG Tau is a low-mass young star whose strongly accreting disk shows a variable 10 mu m silicate feature, that may even turn temporarily from emission to absorption. Aiming to find the physical reason of this variability, we analysed multiepoch VLTI/MIDI interferometric observations. We found that the inner disk within 3 au radius exhibits a 10 mu m absorption feature related to amorphous silicate grains, while the outer disk displays a variable crystalline feature in emission, similar in shape to the spectrum of comet Hale-Bopp. The variability may be related to a fluctuating amount of dusty material above the disk surface, possibly due to turbulence.

Do Children and Adolescents with Anorexia Nervosa Display an Inefficient Cognitive Processing Style?

PubMed

Lang, Katie; Lloyd, Samantha; Khondoker, Mizanur; Simic, Mima; Treasure, Janet; Tchanturia, Kate

2015-01-01

This study aimed to examine neuropsychological processing in children and adolescents with Anorexia Nervosa (AN). The relationship of clinical and demographic variables to neuropsychological functioning within the AN group was also explored. The performance of 41 children and adolescents with a diagnosis of AN were compared to 43 healthy control (HC) participants on a number of neuropsychological measures. There were no differences in IQ between AN and HC groups. However, children and adolescents with AN displayed significantly more perseverative errors on the Wisconsin Card Sorting Test, and lower Style and Central Coherence scores on the Rey Osterrieth Complex Figure Test relative to HCs. Inefficient cognitive processing in the AN group was independent of clinical and demographic variables, suggesting it might represent an underlying trait for AN. The implications of these findings are discussed.

Reliable cloning of functional antibody variable domains from hybridomas and spleen cell repertoires employing a reengineered phage display system.

PubMed

Krebber, A; Bornhauser, S; Burmester, J; Honegger, A; Willuda, J; Bosshard, H R; Plückthun, A

1997-02-14

A prerequisite for the use of recombinant antibody technologies starting from hybridomas or immune repertoires is the reliable cloning of functional immunoglobulin genes. For this purpose, a standard phage display system was optimized for robustness, vector stability, tight control of scFv-delta geneIII expression, primer usage for PCR amplification of variable region genes, scFv assembly strategy and subsequent directional cloning using a single rare cutting restriction enzyme. This integrated cloning, screening and selection system allowed us to rapidly obtain antigen binding scFvs derived from spleen-cell repertoires of mice immunized with ampicillin as well as from all hybridoma cell lines tested to date. As representative examples, cloning of monoclonal antibodies against a his tag, leucine zippers, the tumor marker EGP-2 and the insecticide DDT is presented. Several hybridomas whose genes could not be cloned in previous experimental setups, but were successfully obtained with the present system, expressed high amounts of aberrant heavy and light chain mRNAs, which were amplified by PCR and greatly exceeded the amount of binding antibody sequences. These contaminating variable region genes were successfully eliminated by employing the optimized phage display system, thus avoiding time consuming sequencing of non-binding scFv genes. To maximize soluble expression of functional scFvs subsequent to cloning, a compatible vector series to simplify modification, detection, multimerization and rapid purification of recombinant antibody fragments was constructed.

Countermovement Jump Performance with Increased Training Loads in Elite Female Rugby Athletes.

PubMed

Gathercole, R; Sporer, B; Stellingwerff, T

2015-08-01

Countermovement jump (CMJ) performance is typically analyzed through single-point concentric-based variables (e. g., peak power or force and height). However, methodological approaches examining movement strategies may be more sensitive to neuromuscular fatigue. 12 elite female rugby sevens athletes undertook weekly CMJ testing throughout a 6-week training block involving progressively increased training loads. Athletes self-reported training load (TRIMP) and wellness daily. 22 CMJ variables were assessed, incorporating analyses of force, velocity, power and time measured during eccentric and concentric jump phases. Differences over time were examined using the magnitude of change (effect sizes; ES) compared to baseline. Pearson correlations examined relationships between CMJ variables, wellness and TRIMP. TRIMP displayed large increases (mean ES; weeks 2-6: 2.47). Wellness decreased in week 3 (-0.41), with small reductions following (weeks 4-6: -0.34). Flight time (weeks 3-6: -1.84), peak displacement (weeks 2-6: -2.24), time to peak force (weeks 3-6: 2.58), force at zero velocity (F@0V) (weeks 5-6: -1.28) displayed multiple changes indicative of diminished neuromuscular function. Wellness scores and max rate of force development (mean; r=0.32), F@0V (r=0.28) and flight time (r=0.34) displayed positive correlations. Intensified training decreased CMJ output and altered CMJ mechanics. Longitudinal neuromuscular fatigue monitoring of team-sport athletes appears improved through CMJ mechanics analysis. © Georg Thieme Verlag KG Stuttgart · New York.

Phage and Yeast Display.

PubMed

Sheehan, Jared; Marasco, Wayne A

2015-02-01

Despite the availability of antimicrobial drugs, the continued development of microbial resistance--established through escape mutations and the emergence of resistant strains--limits their clinical utility. The discovery of novel, therapeutic, monoclonal antibodies (mAbs) offers viable clinical alternatives in the treatment and prophylaxis of infectious diseases. Human mAb-based therapies are typically nontoxic in patients and demonstrate high specificity for the intended microbial target. This specificity prevents negative impacts on the patient microbiome and avoids driving the resistance of nontarget species. The in vitro selection of human antibody fragment libraries displayed on phage or yeast surfaces represents a group of well-established technologies capable of generating human mAbs. The advantage of these forms of microbial display is the large repertoire of human antibody fragments present during a single selection campaign. Furthermore, the in vitro selection environments of microbial surface display allow for the rapid isolation of antibodies--and their encoding genes--against infectious pathogens and their toxins that are impractical within in vivo systems, such as murine hybridomas. This article focuses on the technologies of phage display and yeast display, as these strategies relate to the discovery of human mAbs for the treatment and vaccine development of infectious diseases.

Depression, comorbid anxiety disorders, and heart rate variability in physically healthy, unmedicated patients: implications for cardiovascular risk.

PubMed

Kemp, Andrew H; Quintana, Daniel S; Felmingham, Kim L; Matthews, Slade; Jelinek, Herbert F

2012-01-01

There is evidence that heart rate variability (HRV) is reduced in major depressive disorder (MDD), although there is debate about whether this effect is caused by medication or the disorder per se. MDD is associated with a two to fourfold increase in the risk of cardiac mortality, and HRV is a robust predictor of cardiac mortality; determining a direct link between HRV and not only MDD, but common comorbid anxiety disorders, will point to psychiatric indicators for cardiovascular risk reduction. To determine in physically healthy, unmedicated patients whether (1) HRV is reduced in MDD relative to controls, and (2) HRV reductions are driven by MDD alone, comorbid generalized anxiety disorder (GAD, characterized by anxious anticipation), or comorbid panic and posttraumatic stress disorders (PD/PTSD, characterized by anxious arousal). A case-control study in 2006 and 2007 on 73 MDD patients, including 24 without anxiety comorbidity, 24 with GAD, and 14 with PD/PTSD. Seventy-three MDD and 94 healthy age- and sex-matched control participants were recruited from the general community. Participants had no history of drug addiction, alcoholism, brain injury, loss of consciousness, stroke, neurological disorder, or serious medical conditions. There were no significant differences between the four groups in age, gender, BMI, or alcohol use. HRV was calculated from electrocardiography under a standardized short-term resting state condition. HRV was reduced in MDD relative to controls, an effect associated with a medium effect size. MDD participants with comorbid generalized anxiety disorder displayed the greatest reductions in HRV relative to controls, an effect associated with a large effect size. Unmedicated, physically healthy MDD patients with and without comorbid anxiety had reduced HRV. Those with comorbid GAD showed the greatest reductions. Implications for cardiovascular risk reduction strategies in otherwise healthy patients with psychiatric illness are discussed.

Somatic mutation dynamics in MDS patients treated with azacitidine indicate clonal selection in patients-responders

PubMed Central

Polgarova, Kamila; Vargova, Karina; Kulvait, Vojtech; Dusilkova, Nina; Minarik, Lubomir; Zemanova, Zuzana; Pesta, Michal; Jonasova, Anna; Stopka, Tomas

2017-01-01

Azacitidine (AZA) for higher risk MDS patients is a standard therapy with limited durability. To monitor mutation dynamics during AZA therapy we utilized massive parallel sequencing of 54 genes previously associated with MDS/AML pathogenesis. Serial sampling before and during AZA therapy of 38 patients (reaching median overall survival 24 months (Mo) with 60% clinical responses) identified 116 somatic pathogenic variants with allele frequency (VAF) exceeding 5%. High accuracy of data was achieved via duplicate libraries from myeloid cells and T-cell controls. We observed that nearly half of the variants were stable while other variants were highly dynamic. Patients with marked decrease of allelic burden upon AZA therapy achieved clinical responses. In contrast, early-progressing patients on AZA displayed minimal changes of the mutation pattern. We modeled the VAF dynamics on AZA and utilized a joint model for the overall survival and response duration. While the presence of certain variants associated with clinical outcomes, such as the mutations of CDKN2A were adverse predictors while KDM6A mutations yield lower risk of dying, the data also indicate that allelic burden volatility represents additional important prognostic variable. In addition, preceding 5q- syndrome represents strong positive predictor of longer overall survival and response duration in high risk MDS patients treated with AZA. In conclusion, variants dynamics detected via serial sampling represents another parameter to consider when evaluating AZA efficacy and predicting outcome. PMID:29340104

Recognition, prevention, and proactive management of hypoglycemia in patients with type 1 diabetes mellitus.

PubMed

Unger, Jeff; Parkin, Christopher

2011-07-01

Hypoglycemia is the key barrier that prevents patients from optimizing glycemic control with the use of pharmacotherapeutic interventions. Optimal glycemic control for patients with type 1 diabetes (T1DM) includes methods that provide glucose-regulated physiologic insulin replacement or secretion in association with glucose monitoring methods designed to predict and prevent acute extreme changes in glycemic variability. Patients with T1DM experience an average of 2 episodes of symptomatic hypoglycemia each week and at least 1 episode of severe, disabling hypoglycemia annually. Asymptomatic hypoglycemia is common, as shown in studies using continuous glucose monitoring (CGM). Episodes of hypoglycemia (symptomatic and asymptomatic) impair counterregulatory defenses against subsequent events, resulting in the inability to respond to and recover from serious hypoglycemia. This defective counterregulation is known as hypoglycemic-associated autonomic failure. When patients are prescribed a more intensive medication regimen or reinforcing lifestyle interventions, such as medical nutrition therapy and exercise therapy, providers should also assess their ability to proactively identify and manage hypoglycemia. Although self-monitoring of blood glucose regimens, such as pre- and post-meal and periodic middle-of-the-night glucose testing, can help predict the risk of developing hypoglycemia, CGM technology allows patients to receive real-time notification of impending events either through preset alarms or simply by looking at the device display. This review explores the utility of initiating CGM within the primary care setting for patients at high risk for developing hypoglycemia.

Pituitary dysfunction and its association with quality of life in traumatic brain injury.

PubMed

Izzo, Giulia; Tirelli, Assunta; Angrisani, Elisabetta; Cannaviello, Giovanni; Cannaviello, Lucio; Puzziello, Alessandro; Vatrella, Alessandro; Vitale, Mario

2016-04-01

Traumatic brain injury (TBI) is a major cause of death and disability and may cause transient or persistent, isolated or multiple hypopituitarism in a variable percentage of cases. The primary aim of this study was to determine the incidence of isolated and multiple anterior pituitary hormone deficiency in subjects with TBI in a single institution. The secondary aim was to determine a correlation between pituitary deficiency and quality of life (QOL) after TBI. Thirty-five patients, aged between 18 and 63 years, were evaluated 6months to 5 years after TBI. We evaluated the QOL by SF-12(®) questionnaire and measured serum basal GH, IGF1, LH, FSH, testosterone (in males), 17-β-estradiol (in women), PRL, fT4 and TSH. In patients with low IGF1, a GHRH + Arginine test was performed. Single or multiple pituitary failure was found in 13 patients (37%). Low testosterone was found in 7 males, low FSH and/or LH in 4, low IGF1 in 7 patients. Hypogonadotropic hypogonadism and GH insufficiency assessed by GHRH + Arginine test were found respectively in 3 and 2 patients. One patient displayed a concomitant GH insufficiency and low TSH level. Twenty six patients showed a reduction in QOL. A correlations between altered QOL and hormonal deficiency was not observed. Isolated or multiple hypopituitarism resulting from TBI are frequent. Alterations in QOL and pituitary function resulting from TBI are not associated. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Nonverbal behavior during face-to-face social interaction in schizophrenia: a review.

PubMed

Lavelle, Mary; Healey, Patrick G T; McCabe, Rosemarie

2014-01-01

Patients with a diagnosis of schizophrenia display social cognitive deficits. However, little is known about patients' nonverbal communication during their social encounters with others. This review identified 17 studies investigating nonverbal communication in patients' unscripted face-to-face interactions, addressing a) nonverbal differences between patients and others, b) nonverbal behavior of the patients' partners, c) the association between nonverbal behavior and symptoms, and d) the association between nonverbal behavior and social outcomes. Patients displayed fewer nonverbal behaviors inviting interaction, with negative symptoms exacerbating this pattern. Positive symptoms were associated with heightened nonverbal behavior. Patients' partners changed their own nonverbal behavior in response to the patient. Reduced prosocial behaviors, inviting interaction, were associated with poorer social outcomes. The evidence suggests that patients' nonverbal behavior, during face-to-face interaction, is influenced by patients symptoms and impacts the success of their social interactions.

Using a Sequence of Earcons to Monitor Multiple Simulated Patients.

PubMed

Hickling, Anna; Brecknell, Birgit; Loeb, Robert G; Sanderson, Penelope

2017-03-01

The aim of this study was to determine whether a sequence of earcons can effectively convey the status of multiple processes, such as the status of multiple patients in a clinical setting. Clinicians often monitor multiple patients. An auditory display that intermittently conveys the status of multiple patients may help. Nonclinician participants listened to sequences of 500-ms earcons that each represented the heart rate (HR) and oxygen saturation (SpO 2 ) levels of a different simulated patient. In each sequence, one, two, or three patients had an abnormal level of HR and/or SpO 2 . In Experiment 1, participants reported which of nine patients in a sequence were abnormal. In Experiment 2, participants identified the vital signs of one, two, or three abnormal patients in sequences of one, five, or nine patients, where the interstimulus interval (ISI) between earcons was 150 ms. Experiment 3 used the five-sequence condition of Experiment 2, but the ISI was either 150 ms or 800 ms. Participants reported which patient(s) were abnormal with median 95% accuracy. Identification accuracy for vital signs decreased as the number of abnormal patients increased from one to three, p < .001, but accuracy was unaffected by number of patients in a sequence. Overall, identification accuracy was significantly higher with an ISI of 800 ms (89%) compared with an ISI of 150 ms (83%), p < .001. A multiple-patient display can be created by cycling through earcons that represent individual patients. The principles underlying the multiple-patient display can be extended to other vital signs, designs, and domains.

Two Eyes, 3D: A New Project to Study Stereoscopy in Astronomy Education

NASA Astrophysics Data System (ADS)

Price, Aaron; SubbaRao, M.; Wyatt, R.

2012-01-01

"Two Eyes, 3D" is a 3-year NSF funded research project to study the educational impacts of using stereoscopic representations in informal settings. The project funds two experimental studies. The first is focused on how children perceive various spatial qualities of scientific objects displayed in static 2D and 3D formats. The second is focused on how adults perceive various spatial qualities of scientific objects and processes displayed in 2D and 3D movie formats. As part of the project, two brief high-definition films about variable stars will be developed. Both studies will be mixed-method and look at prior spatial ability and other demographic variables as covariates. The project is run by the American Association of Variable Star Observers, Boston Museum of Science and the Adler Planetarium and Astronomy Museum with consulting from the California Academy of Sciences. Early pilot results will be presented. All films will be released into the public domain, as will the assessment software designed to run on tablet computers (iOS or Android).

[Comorbidity in people with depression seeking help at primary health care centers in Santiago, Chile].

PubMed

Martínez, Pablo; Rojas, Graciela; Fritsch, Rosemarie; Martínez, Vania; Vöhringer, Paul A; Castro, Ariel

2017-01-01

International evidence has shown the complex interaction between depression and chronic physical diseases. Depression in scenarios involving multiple comorbidities has not received enough attention in Chile. To characterize the depressed people who consult at Primary Health Care Centers (PHCCs), taking into account the presence of chronic physical or psychiatric comorbidity. A secondary analysis of databases used in a clinical trial. Two hundred fifty six adults seeking professional help were recruited in four PHCCs located in the Metropolitan Region. These people had a major depressive episode, identified with a structured psychiatric interview (MINI), and gave their informed consent to participate. Socio-demographic information was collected, depressive symptomatology was measured with the patient health questionnaire 9 (PHQ-9), psychiatric morbidity was assessed using the Mini International Neuropsychiatric Interview (MINI), and chronic physical diseases were self-reported by the patients. Descriptive analyses of all the variables were conducted. Seventy percent of patients had a history of depression, with a median of two prior depressive episodes. Depressive symptoms were mostly considered as moderate to severe and severe and 31% of the patients had high suicide risk. Seventy eight percent displayed a physical or psychiatric comorbidity. Of these patients, 29% only had a chronic physical comorbidity, while 46% suffered from an additional psychiatric disorder. Depressed individuals who seek help at PHCCs constitute an especially complex population that must be treated taking into account multiple comorbidities.

Long-stay in short-stay inpatient facilities: risk factors and barriers to discharge

PubMed Central

Gigantesco, Antonella; de Girolamo, Giovanni; Santone, Giovanni; Miglio, Rossella; Picardi, Angelo

2009-01-01

Background The aim of the present study was to assess the characteristics of long-stay inpatients in public and private Italian acute inpatient facilities, to identify risk factors and correlates of the long duration of hospital stay in these patients, and to identify possible barriers to alternative placements. Methods All patients in 130 Italian public and private psychiatric inpatient units who had been hospitalized for more than 3 months during a specific index period were assessed with standardized assessment instruments and compared to patients discharged during the same index period, but staying in hospital for less than 3 months (short-stay inpatients). Assessed domains included demographic, clinical, and treatment characteristics, as well as process of care. Logistic regression analysis was used to identify specific variables predicting inpatient long-stay status. Reasons for delaying patient discharge, as reported by treatment teams, were also analyzed. Results No overall differences between long-stay and short-stay patients emerged in terms of symptom severity or diagnostic status. Admission to a private inpatient facility and display of violent behavior during hospital stay were the most powerful predictors of long-stay. Lack of housing and a shortage of community support were the reasons most commonly cited by treatment teams as barriers to discharge. Conclusion Extra-clinical factors are important determinants of prolonged hospitalization in acute inpatient settings. PMID:19698136

Pulmonary hypertension in sickle cell disease children under 10 years of age.

PubMed

Colombatti, Raffaella; Maschietto, Nicola; Varotto, Elena; Grison, Alessandra; Grazzina, Nicoletta; Meneghello, Linda; Teso, Simone; Carli, Modesto; Milanesi, Ornella; Sainati, Laura

2010-09-01

Despite the finding of elevated Tricuspid Regurgitant Velocity (TRV) in children below 5 years of age, the prevalence and evolution of Pulmonary Hypertension (PH) in young children with sickle cell disease (SCD) are unclear. In order to identify predictive factors of precocious PH development, SCD children > or =3 years old, at steady state, underwent annual echocardiography and Tissue Doppler Imaging (TDI). Patients receiving chronic transfusion were excluded. Thirty-seven of seventy-five patients were > or =3 years, with measurable TRV. In our young population (mean age 6.2 years) of mainly African, HbS/HbS patients, 8/37 (21.6%) had TRV > or =2.5 m/s, 8% being only 3 years old. Significant correlation was found between precocious TRV elevation and high platelet and reticulocyte counts and frequent acute chest syndromes (ACS). In multivariate analysis, ACS was the only variable predicting TRV > or =2.5 m/s. TDI of the 37 patients showed signs of diastolic dysfunction of the left ventricle. At follow-up all eight patients with high TRV displayed further increase and seven more developed TRV > or =2.5 m/s. PH seems to begin in children earlier than expected. Factors involved in its early onset might be different from the ones causing its development in older children or adults. African children might benefit from early screening and re-assessment once a year.

Development, reliability and use of a food environment assessment tool in supermarkets of four neighbourhoods in Montréal, Canada.

PubMed

Jalbert-Arsenault, Élise; Robitaille, Éric; Paquette, Marie-Claude

2017-09-01

The food environment is a promising arena in which to influence people's dietary habits. This study aimed to develop a comprehensive food environment assessment tool for businesses and characterize the food environment of a low-tomedium income area of Montréal, Canada. We developed a tool, Mesure de l'environnement alimentaire du consommateur dans les supermarchés (MEAC-S), and tested it for reliability. We used the MEAC-S to assess the consumer food environment of 17 supermarkets in four neighbourhoods of Montréal. We measured the shelf length, variety, price, display counts and in-store positions of fruits and vegetables (FV) and ultra-processed food products (UPFPs). We also assessed fresh FV for quality. Store size was estimated using the total measured shelf length for all food categories. We conducted Spearman correlations between these indicators of the food environment. Reliability analyses revealed satisfactory results for most indicators. Characterization of the food environment revealed high variability in shelf length, variety and price of FV between supermarkets and suggested a disproportionate promotion of UPFPs. Display counts of UPFPs outside their normal display location ranged from 7 to 26, and they occupied 8 to 33 strategic in-store positions, whereas the number of display counts of fresh FV outside their normal display location exceeded 1 in only 2 of the 17 stores surveyed, and they occupied a maximum of 2 strategic in-store positions per supermarket. Price of UPFPs was inversely associated with their prominence (p < .005) and promotion (p < .003). Store size was associated with display counts and strategic in-store positioning of UPFPs (p < .001), but not FV, and was inversely associated with the price of soft drinks (p < .003). This study illustrates the variability of the food environment between supermarkets and underscores the importance of measuring in-store characteristics to adequately picture the consumer food environment.

Development, reliability and use of a food environment assessment tool in supermarkets of four neighbourhoods in Montréal, Canada

PubMed Central

Élise, Jalbert-Arsenault; Éric, Robitaille; Marie-Claude, Paquette

2017-01-01

Abstract Introduction: The food environment is a promising arena in which to influence people’s dietary habits. This study aimed to develop a comprehensive food environment assessment tool for businesses and characterize the food environment of a low-tomedium income area of Montréal, Canada. Methods: We developed a tool, Mesure de l’environnement alimentaire du consommateur dans les supermarchés (MEAC-S), and tested it for reliability. We used the MEAC-S to assess the consumer food environment of 17 supermarkets in four neighbourhoods of Montréal. We measured the shelf length, variety, price, display counts and in-store positions of fruits and vegetables (FV) and ultra-processed food products (UPFPs). We also assessed fresh FV for quality. Store size was estimated using the total measured shelf length for all food categories. We conducted Spearman correlations between these indicators of the food environment. Results: Reliability analyses revealed satisfactory results for most indicators. Characterization of the food environment revealed high variability in shelf length, variety and price of FV between supermarkets and suggested a disproportionate promotion of UPFPs. Display counts of UPFPs outside their normal display location ranged from 7 to 26, and they occupied 8 to 33 strategic in-store positions, whereas the number of display counts of fresh FV outside their normal display location exceeded 1 in only 2 of the 17 stores surveyed, and they occupied a maximum of 2 strategic in-store positions per supermarket. Price of UPFPs was inversely associated with their prominence (p < .005) and promotion (p < .003). Store size was associated with display counts and strategic in-store positioning of UPFPs (p < .001), but not FV, and was inversely associated with the price of soft drinks (p < .003). Conclusion: This study illustrates the variability of the food environment between supermarkets and underscores the importance of measuring in-store characteristics to adequately picture the consumer food environment. PMID:28902478

Data Images and Other Graphical Displays for Directional Data

NASA Technical Reports Server (NTRS)

Morphet, Bill; Symanzik, Juergen

2005-01-01

Vectors, axes, and periodic phenomena have direction. Directional variation can be expressed as points on a unit circle and is the subject of circular statistics, a relatively new application of statistics. An overview of existing methods for the display of directional data is given. The data image for linear variables is reviewed, then extended to directional variables by displaying direction using a color scale composed of a sequence of four or more color gradients with continuity between sequences and ordered intuitively in a color wheel such that the color of the 0deg angle is the same as the color of the 360deg angle. Cross over, which arose in automating the summarization of historical wind data, and color discontinuity resulting from the use a single color gradient in computational fluid dynamics visualization are eliminated. The new method provides for simultaneous resolution of detail on a small scale and overall structure on a large scale. Example circular data images are given of a global view of average wind direction of El Nino periods, computed rocket motor internal combustion flow, a global view of direction of the horizontal component of earth's main magnetic field on 9/15/2004, and Space Shuttle solid rocket motor nozzle vectoring.

High Resolution Displays Using NCAP Liquid Crystals

NASA Astrophysics Data System (ADS)

Macknick, A. Brian; Jones, Phil; White, Larry

1989-07-01

Nematic curvilinear aligned phase (NCAP) liquid crystals have been found useful for high information content video displays. NCAP materials are liquid crystals which have been encapsulated in a polymer matrix and which have a light transmission which is variable with applied electric fields. Because NCAP materials do not require polarizers, their on-state transmission is substantially better than twisted nematic cells. All dimensional tolerances are locked in during the encapsulation process and hence there are no critical sealing or spacing issues. By controlling the polymer/liquid crystal morphology, switching speeds of NCAP materials have been significantly improved over twisted nematic systems. Recent work has combined active matrix addressing with NCAP materials. Active matrices, such as thin film transistors, have given displays of high resolution. The paper will discuss the advantages of NCAP materials specifically designed for operation at video rates on transistor arrays; applications for both backlit and projection displays will be discussed.

Evaluation of the monitor cursor-line method for measuring pulmonary artery and central venous pressures.

PubMed

Pasion, Editha; Good, Levell; Tizon, Jisebelle; Krieger, Staci; O'Kier, Catherine; Taylor, Nicole; Johnson, Jennifer; Horton, Carrie M; Peterson, Mary

2010-11-01

To determine if the monitor cursor-line feature on bedside monitors is accurate for measuring central venous and pulmonary artery pressures in cardiac surgery patients. Central venous and pulmonary artery pressures were measured via 3 methods (end-expiratory graphic recording, monitor cursor-line display, and monitor digital display) in a convenience sample of postoperative cardiac surgery patients. Pressures were measured twice during both mechanical ventilation and spontaneous breathing. Analysis of variance was used to determine differences between measurement methods and the percentage of monitor pressures that differed by 4 mm Hg or more from the measurement obtained from the graphic recording. Significance level was set at P less than .05. Twenty-five patients were studied during mechanical ventilation (50 measurements) and 21 patients during spontaneous breathing (42 measurements). Measurements obtained via the 3 methods did not differ significantly for either type of pressure (P > .05). Graphically recorded pressures and measurements obtained via the monitor cursor-line or digital display methods differed by 4 mm Hg or more in 4% and 6% of measurements, respectively, during mechanical ventilation and 4% and 11%, respectively, during spontaneous breathing. The monitor cursor-line method for measuring central venous and pulmonary artery pressures may be a reasonable alternative to the end-expiratory graphic recording method in hemodynamically stable, postoperative cardiac surgery patients. Use of the digital display on the bedside monitor may result in larger discrepancies from the graphically recorded pressures than when the cursor-line method is used, particularly in spontaneously breathing patients.

The Stanford-Ames portable echocardioscope - A case study in technology transfer

NASA Technical Reports Server (NTRS)

Schmidt, G.; Miller, H.

1975-01-01

The paper describes a lightweight portable battery-powered echocardioscope fabricated largely from readily available components. The transducer contains a piezoelectric crystal which acts as both an ultrasound pulse emitter and echo receiver, and the oscilloscope is of modular construction. The oscilloscope display can be produced in any of three different modes: A-mode, B-mode, and M-mode (time-motion) by sweeping the intensified points of light of the B-mode display vertically along the oscilloscope face. The resulting display can be photographed in a time exposure, thus providing a hardcopy record for the patient's chart or physician's records. The device is clinically validated on both normal subjects and patients by experienced echocardiographers.

The validity of the multi-informant approach to assessing child and adolescent mental health.

PubMed

De Los Reyes, Andres; Augenstein, Tara M; Wang, Mo; Thomas, Sarah A; Drabick, Deborah A G; Burgers, Darcy E; Rabinowitz, Jill

2015-07-01

Child and adolescent patients may display mental health concerns within some contexts and not others (e.g., home vs. school). Thus, understanding the specific contexts in which patients display concerns may assist mental health professionals in tailoring treatments to patients' needs. Consequently, clinical assessments often include reports from multiple informants who vary in the contexts in which they observe patients' behavior (e.g., patients, parents, teachers). Previous meta-analyses indicate that informants' reports correlate at low-to-moderate magnitudes. However, is it valid to interpret low correspondence among reports as indicating that patients display concerns in some contexts and not others? We meta-analyzed 341 studies published between 1989 and 2014 that reported cross-informant correspondence estimates, and observed low-to-moderate correspondence (mean internalizing: r = .25; mean externalizing: r = .30; mean overall: r = .28). Informant pair, mental health domain, and measurement method moderated magnitudes of correspondence. These robust findings have informed the development of concepts for interpreting multi-informant assessments, allowing researchers to draw specific predictions about the incremental and construct validity of these assessments. In turn, we critically evaluated research on the incremental and construct validity of the multi-informant approach to clinical child and adolescent assessment. In so doing, we identify crucial gaps in knowledge for future research, and provide recommendations for "best practices" in using and interpreting multi-informant assessments in clinical work and research. This article has important implications for developing personalized approaches to clinical assessment, with the goal of informing techniques for tailoring treatments to target the specific contexts where patients display concerns. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Prevalence and clinical correlation of dysphagia in Parkinson disease: a study on Chinese patients.

PubMed

Ding, X; Gao, J; Xie, C; Xiong, B; Wu, S; Cen, Z; Lou, Y; Lou, D; Xie, F; Luo, W

2018-01-01

Dysphagia is relatively common in patients with Parkinson disease (PD) and can have a negative impact on their quality of life; therefore, it is imperative that its prevalence in PD patients is studied. The aim of this study was to explore the prevalence and clinical correlation of dysphagia in Chinese PD patients. We recruited 116 Chinese PD patients. A videofluoroscopic study of swallowing (VFSS) was used to identify dysphagia. Assessments, including water drinking test, relative motor symptoms, non-motor symptoms (NMS) and quality of life, were performed to analyze the risks of dysphagia. The prevalence of dysphagia was 87.1%. The comparison of demographic and clinical features between patients with and without dysphagia included sex, education level, disease course, Mini-mental State Examination (MMSE), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Question 6, 7 of the Unified Parkinson Disease Rating Scale (UPDRS Part II), Hoehn-Yahr stage (H&Y), water drinking test, 39-item Parkinson Disease Questionnaire (PDQ-39) and Non-Motor Symptoms Quest (NMSQ). We found significant correlations between dysphagia and age. Using age, disease course, and H&Y stage as the independent variable in our regression analysis for assessing the risk factors of dysphagia in PD patients, age and H&Y stage displayed a strong correlation as the risk factors. The risk of dysphagia in elderly PD patients is 1.078 times greater than that of younger PD patients. Also, the risk of dysphagia in PD patients of a greater H&Y staging is 3.260 times greater than that of lower staging PD patients. Our results suggest that dysphagia is common in Chinese PD patients. Older patients or those in higher H&Y stages are more likely to experience dysphagia. There is no correlation between dysphagia and PD duration.

Travelers with cutaneous leishmaniasis cured without systemic therapy.

PubMed

Morizot, G; Kendjo, E; Mouri, O; Thellier, M; Pérignon, A; Foulet, F; Cordoliani, F; Bourrat, E; Laffitte, E; Alcaraz, I; Bodak, N; Ravel, C; Vray, M; Grogl, M; Mazier, D; Caumes, E; Lachaud, L; Buffet, P A

2013-08-01

Cutaneous leishmaniasis (CL) is a disfiguring but not life-threatening disease. Because antileishmanial drugs are potentially toxic, the World Health Organization (WHO) recommends simple wound care or local therapy as first-line treatment, followed or replaced by systemic therapy if local therapy fails or cannot be performed. To determine the feasibility and impact of the recommended approach, we analyzed the results of a centralized referral treatment program in 135 patients with parasitologically proven CL. Infections involved 10 Leishmania species and were contracted in 29 different countries. Eighty-four of 135 patients (62%) were initially treated without systemic therapy. Of 109 patients with evaluable charts, 23 of 25 (92%) treated with simple wound care and 37 of 47 (79%) treated with local antileishmanial therapy were cured by days 42-60. In 37 patients with large or complex lesions, or preexisting morbidities, or who had not been cured with local therapy, the cure rate with systemic antileishmanial agents was 60%. Systemic adverse events were observed in 15 patients, all receiving systemic therapy. In this population of CL patients displaying variable degrees of complexity and severity, almost two-thirds of patients could be initially managed without systemic therapy. Of these, 60 were cured before day 60. The WHO-recommended stepwise approach favoring initial local therapy therefore resulted in at least 44% of all patients being cured without exposure to the risk of systemic adverse events. Efforts are needed to further simplify local therapy of CL and to improve the management of patients with complex lesions and/or preexisting comorbidities.

Managing patients' wait time in specialist out-patient clinic using real-time data from existing queue management and ADT systems.

PubMed

Ju, John Chen; Gan, Soon Ann; Tan Siew Wee, Justine; Huang Yuchi, Peter; Mei Mei, Chan; Wong Mei Mei, Sharon; Fong, Kam Weng

2013-01-01

In major cancer centers, heavy patients load and multiple registration stations could cause significant wait time, and can be result in patient complains. Real-time patient journey data and visual display are useful tools in hospital patient queue management. This paper demonstrates how we capture patient queue data without deploying any tracing devices; and how to convert data into useful patient journey information to understand where interventions are likely to be most effective. During our system development, remarkable effort has been spent on resolving data discrepancy and balancing between accuracy and system performances. A web-based dashboard to display real-time information and a framework for data analysis were also developed to facilitate our clinics' operation. Result shows our system could eliminate more than 95% of data capturing errors and has improved patient wait time data accuracy since it was deployed.

Surface display of a massively variable lipoprotein by a Legionella diversity-generating retroelement.

PubMed

Arambula, Diego; Wong, Wenge; Medhekar, Bob A; Guo, Huatao; Gingery, Mari; Czornyj, Elizabeth; Liu, Minghsun; Dey, Sanghamitra; Ghosh, Partho; Miller, Jeff F

2013-05-14

Diversity-generating retroelements (DGRs) are a unique family of retroelements that confer selective advantages to their hosts by facilitating localized DNA sequence evolution through a specialized error-prone reverse transcription process. We characterized a DGR in Legionella pneumophila, an opportunistic human pathogen that causes Legionnaires disease. The L. pneumophila DGR is found within a horizontally acquired genomic island, and it can theoretically generate 10(26) unique nucleotide sequences in its target gene, legionella determinent target A (ldtA), creating a repertoire of 10(19) distinct proteins. Expression of the L. pneumophila DGR resulted in transfer of DNA sequence information from a template repeat to a variable repeat (VR) accompanied by adenine-specific mutagenesis of progeny VRs at the 3'end of ldtA. ldtA encodes a twin-arginine translocated lipoprotein that is anchored in the outer leaflet of the outer membrane, with its C-terminal variable region surface exposed. Related DGRs were identified in L. pneumophila clinical isolates that encode unique target proteins with homologous VRs, demonstrating the adaptability of DGR components. This work characterizes a DGR that diversifies a bacterial protein and confirms the hypothesis that DGR-mediated mutagenic homing occurs through a conserved mechanism. Comparative bioinformatics predicts that surface display of massively variable proteins is a defining feature of a subset of bacterial DGRs.

Design and verification of a hybrid nonlinear MRE vibration absorber for controllable broadband performance

NASA Astrophysics Data System (ADS)

Sun, S. S.; Yildirim, T.; Wu, Jichu; Yang, J.; Du, H.; Zhang, S. W.; Li, W. H.

2017-09-01

In this work, a hybrid nonlinear magnetorheological elastomer (MRE) vibration absorber has been designed, theoretically investigated and experimentally verified. The proposed nonlinear MRE absorber has the dual advantages of a nonlinear force-displacement relationship and variable stiffness technology; the purpose for coupling these two technologies is to achieve a large broadband vibration absorber with controllable capability. To achieve a nonlinear stiffness in the device, two pairs of magnets move at a rotary angle against each other, and the theoretical nonlinear force-displacement relationship has been theoretically calculated. For the experimental investigation, the effects of base excitation, variable currents applied to the device (i.e. variable stiffness of the MRE) and semi-active control have been conducted to determine the enhanced broadband performance of the designed device. It was observed the device was able to change resonance frequency with the applied current; moreover, the hybrid nonlinear MRE absorber displayed a softening-type nonlinear response with clear discontinuous bifurcations observed. Furthermore, the performance of the device under a semi-active control algorithm displayed the optimal performance in attenuating the vibration from a primary system to the absorber over a large frequency bandwidth from 4 to 12 Hz. By coupling nonlinear stiffness attributes with variable stiffness MRE technology, the performance of a vibration absorber is substantially improved.

Perceived Discrimination and Mexican-Origin Young Adults' Sleep Duration and Variability: The Moderating Role of Cultural Orientations.

PubMed

Zeiders, Katharine H; Updegraff, Kimberly A; Kuo, Sally I-Chun; Umaña-Taylor, Adriana J; McHale, Susan M

2017-08-01

Perceived ethnic discrimination is central to the experiences of Latino young adults, yet we know little about the ways in which and the conditions under which ethnic discrimination relates to Latino young adults' sleep patterns. Using a sample of 246 Mexican-origin young adults (M age  = 21.11, SD = 1.54; 50 % female), the current study investigated the longitudinal links between perceived ethnic discrimination and both sleep duration and night-to-night variability in duration, while also examining the moderating roles of Anglo and Mexican orientations in the associations. The results revealed that perceived discrimination predicted greater sleep variability, and this link was not moderated by cultural orientations. The relation between perceived discrimination and hours of sleep, however, was moderated by Anglo and Mexican orientations. Individuals with high Anglo and Mexican orientations (bicultural) and those with only high Mexican orientations (enculturated), showed no association between discrimination and hours of sleep. Individuals with low Anglo and Mexican orientations (marginalized) displayed a positive association, whereas those with high Anglo and low Mexican orientations (acculturated) displayed a negative association. The results suggest that discrimination has long term effects on sleep variability of Mexican-origin young adults, regardless of cultural orientations; however, for sleep duration, bicultural and enculturated orientations are protective.

Ceiling art in a radiation therapy department: its effect on patient treatment experience

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

Bonett, Jotham

A new initiative has been implemented at the Sunshine Hospital Radiation Therapy Centre, to provide a calming and comforting environment for patients attending radiation therapy treatment. As part of this initiative, the department's computed tomography (CT) room and radiation therapy bunkers were designed to incorporate ceiling art that replicates a number of different visual scenes. The study was undertaken to determine if ceiling art in the radiation therapy treatment CT and treatment bunkers had an effect on a patient's experience during treatment at the department. Additionally, the study aimed to identify which of the visuals in the ceiling art weremore » most preferred by patients. Patients were requested to complete a 12-question survey. The survey solicited a patient's opinion/perception on the unit's unique ceiling display with emphasis on aesthetic appeal, patient treatment experience and the patient's engagement due to the ceiling display. The responses were dichotomised to ‘positive’ or ‘negative’. Every sixth patient who completed the survey was invited to have a general face-to-face discussion to provide further information about their thoughts on the displays. The results demonstrate that the ceiling artwork solicited a positive reaction in 89.8% of patients surveyed. This score indicates that ceiling artwork contributed positively to patients’ experiences during radiation therapy treatment. The study suggests that ceiling artwork in the department has a positive effect on patient experience during their radiation therapy treatment at the department.« less

Simplifying the use of prognostic information in traumatic brain injury. Part 2: Graphical presentation of probabilities.

PubMed

Murray, Gordon D; Brennan, Paul M; Teasdale, Graham M

2018-06-01

OBJECTIVE Clinical features such as those included in the Glasgow Coma Scale (GCS) score, pupil reactivity, and patient age, as well as CT findings, have clear established relationships with patient outcomes due to neurotrauma. Nevertheless, predictions made from combining these features in probabilistic models have not found a role in clinical practice. In this study, the authors aimed to develop a method of displaying probabilities graphically that would be simple and easy to use, thus improving the usefulness of prognostic information in neurotrauma. This work builds on a companion paper describing the GCS-Pupils score (GCS-P) as a tool for assessing the clinical severity of neurotrauma. METHODS Information about early GCS score, pupil response, patient age, CT findings, late outcome according to the Glasgow Outcome Scale, and mortality were obtained at the individual adult patient level from the CRASH (Corticosteroid Randomisation After Significant Head Injury; n = 9045) and IMPACT (International Mission for Prognosis and Clinical Trials in TBI; n = 6855) databases. These data were combined into a pooled data set for the main analysis. Logistic regression was first used to model the combined association between the GCS-P and patient age and outcome, following which CT findings were added to the models. The proportion of variability in outcomes "explained" by each model was assessed using Nagelkerke's R 2 . RESULTS The authors observed that patient age and GCS-P have an additive effect on outcome. The probability of mortality 6 months after neurotrauma is greater with increasing age, and for all age groups the probability of death is greater with decreasing GCS-P. Conversely, the probability of favorable recovery becomes lower with increasing age and lessens with decreasing GCS-P. The effect of combining the GCS-P with patient age was substantially more informative than the GCS-P, age, GCS score, or pupil reactivity alone. Two-dimensional charts were produced displaying outcome probabilities, as percentages, for 5-year increments in age between 15 and 85 years, and for GCS-Ps ranging from 1 to 15; it is readily seen that the movement toward combinations at the top right of the charts reflects a decreasing likelihood of mortality and an increasing likelihood of favorable outcome. Analysis of CT findings showed that differences in outcome are very similar between patients with or without a hematoma, absent cisterns, or subarachnoid hemorrhage. Taken in combination, there is a gradation in risk that aligns with increasing numbers of any of these abnormalities. This information provides added value over age and GCS-P alone, supporting a simple extension of the earlier prognostic charts by stratifying the original charts in the following 3 CT groupings: none, only 1, and 2 or more CT abnormalities. CONCLUSIONS The important prognostic features in neurotrauma can be brought together to display graphically their combined effects on risks of death or on prospects for independent recovery. This approach can support decision making and improve communication of risk among health care professionals, patients, and their relatives. These charts will not replace clinical judgment, but they will reduce the risk of influences from biases.

Finger displacement in Parkinson disease: up? down? sideways?

PubMed

Lieberman, Abraham; Dhall, Rohit; Salins, Naomi; Sadreddin, Arshia; Moguel-Cobos, Guillermo; Karis, John; Krishnamurthi, Narayanan

2014-05-01

We previously reported that patients with tremor preponderant Parkinson disease (PD) displayed upward or lateral displacement of their more tremulous finger when they pointed both their index fingers at a target and closed their eyes for 15 seconds. In this study, we examined the phenomenon in 104 PD patients: 72 patients without tremor and 32 with minimal tremor to see if the displacement is related to the disease or the tremor. Sixty-eight of the 72 patients without tremor, 94%, exhibited finger displacement suggesting the phenomenon is related to the disease. None of the 104 patients were demented: mini-mental status examination (MMSE) score 29.0 ± 0. 75. Ninety patients displayed upward displacement (56 patients) or lateral or medial displacement (34 patients). MMSE score of the 90 patients: 29.2 ± 0.74 with no score < 28. Eight patients (6 without tremor) displayed downward displacement. MMSE score of the 8 patients: 27.5 ± 0.35 with 5 having MMSE score of 27. Although not significant the results suggest that patients with downward displacement and lower MMSE score may be evolving a dementia. Upward displacement with eyes closed for 15 seconds requires an ability to "remember" the position of the finger in space and to alter tone to overcome gravity. Downward displacement implies an inability to "remember" the position of the finger in space an inability to overcome the effects of gravity. This may be more likely in patients who are evolving a dementia. Two patients, with PD-like symptoms, and specific anatomical abnormalities are also presented as they illustrate the anatomy of finger displacement.

High-throughput screening of T7 phage display and protein microarrays as a methodological approach for the identification of IgE-reactive components.

PubMed

San Segundo-Acosta, Pablo; Garranzo-Asensio, María; Oeo-Santos, Carmen; Montero-Calle, Ana; Quiralte, Joaquín; Cuesta-Herranz, Javier; Villalba, Mayte; Barderas, Rodrigo

2018-05-01

Olive pollen and yellow mustard seeds are major allergenic sources with high clinical relevance. To aid with the identification of IgE-reactive components, the development of sensitive methodological approaches is required. Here, we have combined T7 phage display and protein microarrays for the identification of allergenic peptides and mimotopes from olive pollen and mustard seeds. The identification of these allergenic sequences involved the construction and biopanning of T7 phage display libraries of mustard seeds and olive pollen using sera from allergic patients to both biological sources together with the construction of phage microarrays printed with 1536 monoclonal phages from the third/four rounds of biopanning. The screening of the phage microarrays with individual sera from allergic patients enabled the identification of 10 and 9 IgE-reactive unique amino acid sequences from olive pollen and mustard seeds, respectively. Five immunoreactive amino acid sequences displayed on phages were selected for their expression as His6-GST tag fusion proteins and validation. After immunological characterization, we assessed the IgE-reactivity of the constructs. Our results show that protein microarrays printed with T7 phages displaying peptides from allergenic sources might be used to identify allergenic components -peptides, proteins or mimotopes- through their screening with specific IgE antibodies from allergic patients. Copyright © 2018 Elsevier B.V. All rights reserved.

Construction of a patient observation system using KINECTTM

NASA Astrophysics Data System (ADS)

Miyaura, Kazunori; Kumazaki, Yu; Fukushima, Chika; Kato, Shingo; Saitoh, Hidetoshi

2014-03-01

Improvement in the positional accuracy of irradiation is expected by capturing patient motion (intra-fractional error) during irradiation. The present study reports the construction of a patient observation system using Microsoft® KINECTTM. By tracking movement, we made it possible to add a depth component to the acquired position coordinates and to display three-axis (X, Y, and Z) movement. Moreover, the developed system can be displayed in a graph which is constructed from the coordinate position at each time interval. Using the developed system, an observer can easily visualize patient movement. When the body phantom was moved a known distance in the X, Y, and Z directions, good coincidence was shown with each axis. We built a patient observation system which captures a patient's motion using KINECTTM.

Color dependence with horizontal-viewing angle and colorimetric characterization of two displays using different backlighting

NASA Astrophysics Data System (ADS)

Castro, José J.; Pozo, Antonio M.; Rubiño, Manuel

2013-11-01

In this work we studied the color dependence with a horizontal-viewing angle and colorimetric characterization of two liquid-crystal displays (LCD) using two different backlighting: Cold Cathode Fluorescent Lamps (CCFLs) and light-emitting diodes (LEDs). The LCDs studied had identical resolution, size, and technology (TFT - thin film transistor). The colorimetric measurements were made with the spectroradiometer SpectraScan PR-650 following the procedure recommended in the European guideline EN 61747-6. For each display, we measured at the centre of the screen the chromaticity coordinates at horizontal viewing angles of 0, 20, 40, 60 and 80 degrees for the achromatic (A), red (R), green (G) and blue (B) channels. Results showed a greater color-gamut area for the display with LED backlight, compared with the CCFL backlight, showing a greater range of colors perceptible by human vision. This color-gamut area diminished with viewing angle for both displays. Higher differences between trends for viewing angles were observed in the LED-backlight, especially for the R- and G-channels, demonstrating a higher variability of the chromaticity coordinates with viewing angle. The best additivity was reached by the LED-backlight display (a lower error percentage). LED-backlight display provided better color performance of visualization.

A high-throughput platform for population reformatting and mammalian expression of phage display libraries to enable functional screening as full-length IgG.

PubMed

Xiao, Xiaodong; Douthwaite, Julie A; Chen, Yan; Kemp, Ben; Kidd, Sara; Percival-Alwyn, Jennifer; Smith, Alison; Goode, Kate; Swerdlow, Bonnie; Lowe, David; Wu, Herren; Dall'Acqua, William F; Chowdhury, Partha S

Phage display antibody libraries are a rich resource for discovery of potential therapeutic antibodies. Single-chain variable fragment (scFv) libraries are the most common format due to the efficient display of scFv by phage particles and the ease by which soluble scFv antibodies can be expressed for high-throughput screening. Typically, a cascade of screening and triaging activities are performed, beginning with the assessment of large numbers of E. coli-expressed scFv, and progressing through additional assays with individual reformatting of the most promising scFv to full-length IgG. However, use of high-throughput screening of scFv for the discovery of full-length IgG is not ideal because of the differences between these molecules. Furthermore, the reformatting step represents a bottle neck in the process because each antibody has to be handled individually to preserve the unique VH and VL pairing. These problems could be resolved if populations of scFv could be reformatted to full-length IgG before screening without disrupting the variable region pairing. Here, we describe a novel strategy that allows the reformatting of diverse populations of scFv from phage selections to full-length IgG in a batch format. The reformatting process maintains the diversity and variable region pairing with high fidelity, and the resulted IgG pool enables high-throughput expression of IgG in mammalian cells and cell-based functional screening. The improved process led to the discovery of potent candidates that are comparable or better than those obtained by traditional methods. This strategy should also be readily applicable to Fab-based phage libraries. Our approach, Screening in Product Format (SiPF), represents a substantial improvement in the field of antibody discovery using phage display.

False memories and memory confidence in borderline patients.

PubMed

Schilling, Lisa; Wingenfeld, Katja; Spitzer, Carsten; Nagel, Matthias; Moritz, Steffen

2013-12-01

Mixed results have been obtained regarding memory in patients with borderline personality disorder (BPD). Prior reports and anecdotal evidence suggests that patients with BPD are prone to false memories but this assumption has to been put to firm empirical test, yet. Memory accuracy and confidence was assessed in 20 BPD patients and 22 healthy controls using a visual variant of the false memory (Deese-Roediger-McDermott) paradigm which involved a negative and a positive-valenced picture. Groups did not differ regarding veridical item recognition. Importantly, patients did not display more false memories than controls. At trend level, borderline patients rated more items as new with high confidence compared to healthy controls. The results tentatively suggest that borderline patients show uncompromised visual memory functions and display no increased susceptibility for distorted memories. Copyright © 2013 Elsevier Ltd. All rights reserved.

SEXUAL SELECTION THROUGH FEMALE CHOICE IN LAWES' PAROTIA, A LEK-MATING BIRD OF PARADISE.

PubMed

Pruett-Jones, S G; Pruett-Jones, M A

1990-05-01

We studied sexual selection in Lawes' Parotia, a lek-mating bird of paradise, during 1981-1983 in Papua New Guinea. There was a high variance in mating success among males, with fewer than half of the individuals mating in any one year. This variance was independent of male-male interactions and disruptions. A role of female choice in sexual selection was suggested by the patterns of female visitation to courts and statistical correlations across males between phenotypic traits and mating success. Females repeatedly visited most males in their home ranges and began visiting males up to six weeks before mating. In one or more years, six aspects of male behavior and one morphological variable were positively correlated with mating success, but the probability values were not significant using a simultaneous inference test. Calculation of combined probability values across all three years revealed that one aspect of male display behavior, the probability of display, positively and significantly influenced mating status. The probability of display was also significantly correlated with relative mating success among males. Females showed strong fidelity to mates, both within and between seasons. Display sites of male Lawes' Parotia are variably dispersed, but mating success did not differ for grouped and solitary males. These data confirm an important role of female choice in sexual selection in birds of paradise but also suggest that female choice may be unrelated to the process of lek-initiation in this species. © 1990 The Society for the Study of Evolution.

A comparison of clinicians' racial biases in the United States and France.

PubMed

Khosla, Natalia N; Perry, Sylvia P; Moss-Racusin, Corinne A; Burke, Sara E; Dovidio, John F

2018-06-01

Clinician bias contributes to racial disparities in healthcare, but its effects may be indirect and culturally specific. The present work aims to investigate clinicians' perceptions of Black versus White patients' personal responsibility for their health, whether this variable predicts racial bias against Black patients, and whether this effect differs between the U.S. and France. American (N = 83) and French (N = 81) clinicians were randomly assigned to report their impressions of an identical Black or White male patient based on a physician's notes. We measured clinicians' views of the patient's anticipated improvement and adherence to treatment and their perceptions concerning how personally responsible the patient was for his health. Whereas French clinicians did not exhibit significant racial bias on the measures of interest, American clinicians rated a hypothetical White patient, compared to an identical Black patient, as significantly more likely to improve, adhere to treatment, and be personally responsible for his health. Moreover, in the U.S., personal responsibility mediated the racial difference in expected improvement, such that as the White patient was seen as more personally responsible for his health, he was also viewed as more likely to improve. The present work indicates that American clinicians displayed less optimistic expectations for the medical treatment and health of a Black male patient, relative to a White male patient, and that this racial bias was related to their view of the Black patient as being less personally responsible for his health relative to the White patient. French clinicians did not show this pattern of racial bias, suggesting the importance of considering cultural influences for understanding racial biases in healthcare and health. Copyright © 2018 Elsevier Ltd. All rights reserved.

Plasma D-dimer levels and ischaemic lesions in multiple vascular regions can predict occult cancer in patients with cryptogenic stroke.

PubMed

Gon, Y; Sakaguchi, M; Takasugi, J; Kawano, T; Kanki, H; Watanabe, A; Oyama, N; Terasaki, Y; Sasaki, T; Mochizuki, H

2017-03-01

Cancer patients with cryptogenic stroke often have high plasma D-dimer levels and lesions in multiple vascular regions. Hence, if patients with cryptogenic stroke display such characteristics, occult cancer could be predicted. This study aimed to investigate the clinical characteristics of cryptogenic stroke as the first manifestation of occult cancer and to determine whether plasma D-dimer levels and lesions in multiple vascular regions can predict occult cancer in patients with cryptogenic stroke. Between January 2006 and October 2015, data on 1225 patients with acute ischaemic stroke were extracted from the stroke database of Osaka University Hospital. Among them, 184 patients were classified as having cryptogenic stroke, and 120 patients without a diagnosis of cancer at stroke onset were identified. Clinical variables were analyzed between cryptogenic stroke patients with and without occult cancer. Among 120 cryptogenic stroke patients without a diagnosis of cancer, 12 patients had occult cancer. The body mass index, hemoglobin levels and albumin levels were lower; plasma D-dimer and high-sensitivity C-reactive protein levels were higher; and lesions in multiple vascular regions were more common in patients with than in those without occult cancer. Multiple logistic regression analysis revealed that plasma D-dimer levels (odds ratio, 3.48; 95% confidence interval, 1.68-8.33; P = 0.002) and lesions in multiple vascular regions (odds ratio, 7.40; 95% confidence interval, 1.70-39.45; P = 0.01) independently predicted occult cancer. High plasma D-dimer levels and lesions in multiple vascular regions can be used to predict occult cancer in patients with cryptogenic stroke. © 2016 EAN.

Reduced activation in the ventral striatum during probabilistic decision-making in patients in an at-risk mental state

PubMed Central

Rausch, Franziska; Mier, Daniela; Eifler, Sarah; Fenske, Sabrina; Schirmbeck, Frederike; Englisch, Susanne; Schilling, Claudia; Meyer-Lindenberg, Andreas; Kirsch, Peter; Zink, Mathias

2015-01-01

Background Patients with schizophrenia display metacognitive impairments, such as hasty decision-making during probabilistic reasoning — the “jumping to conclusion” bias (JTC). Our recent fMRI study revealed reduced activations in the right ventral striatum (VS) and the ventral tegmental area (VTA) to be associated with decision-making in patients with schizophrenia. It is unclear whether these functional alterations occur in the at-risk mental state (ARMS). Methods We administered the classical beads task and fMRI among ARMS patients and healthy controls matched for age, sex, education and premorbid verbal intelligence. None of the ARMS patients was treated with antipsychotics. Both tasks request probabilistic decisions after a variable amount of stimuli. We evaluated activation during decision-making under certainty versus uncertainty and the process of final decision-making. Results We included 24 AMRS patients and 24 controls in our study. Compared with controls, ARMS patients tended to draw fewer beads and showed significantly more JTC bias in the classical beads task, mirroring findings in patients with schizophrenia. During fMRI, ARMS patients did not demonstrate JTC bias on the behavioural level, but showed a significant hypoactivation in the right VS during the decision stage. Limitations Owing to the cross-sectional design of the study, results are constrained to a better insight into the neurobiology of risk constellations, but not pre-psychotic stages. Nine of the ARMS patients were treated with antidepressants and/or lorazepam. Conclusion As in patients with schizophrenia, a striatal hypoactivation was found in ARMS patients. Confounding effects of antipsychotic medication can be excluded. Our findings indicate that error prediction signalling and reward anticipation may be linked to striatal dysfunction during prodromal stages and should be examined for their utility in predicting transition risk. PMID:25622039

Reduced activation in the ventral striatum during probabilistic decision-making in patients in an at-risk mental state.

PubMed

Rausch, Franziska; Mier, Daniela; Eifler, Sarah; Fenske, Sabrina; Schirmbeck, Frederike; Englisch, Susanne; Schilling, Claudia; Meyer-Lindenberg, Andreas; Kirsch, Peter; Zink, Mathias

2015-05-01

Patients with schizophrenia display metacognitive impairments, such as hasty decision-making during probabilistic reasoning - the "jumping to conclusion" bias (JTC). Our recent fMRI study revealed reduced activations in the right ventral striatum (VS) and the ventral tegmental area (VTA) to be associated with decision-making in patients with schizophrenia. It is unclear whether these functional alterations occur in the at-risk mental state (ARMS). We administered the classical beads task and fMRI among ARMS patients and healthy controls matched for age, sex, education and premorbid verbal intelligence. None of the ARMS patients was treated with antipsychotics. Both tasks request probabilistic decisions after a variable amount of stimuli. We evaluated activation during decision-making under certainty versus uncertainty and the process of final decision-making. We included 24 AMRS patients and 24 controls in our study. Compared with controls, ARMS patients tended to draw fewer beads and showed significantly more JTC bias in the classical beads task, mirroring findings in patients with schizophrenia. During fMRI, ARMS patients did not demonstrate JTC bias on the behavioural level, but showed a significant hypoactivation in the right VS during the decision stage. Owing to the cross-sectional design of the study, results are constrained to a better insight into the neurobiology of risk constellations, but not prepsychotic stages. Nine of the ARMS patients were treated with antidepressants and/or lorazepam. As in patients with schizophrenia, a striatal hypoactivation was found in ARMS patients. Confounding effects of antipsychotic medication can be excluded. Our findings indicate that error prediction signalling and reward anticipation may be linked to striatal dysfunction during prodromal stages and should be examined for their utility in predicting transition risk.

Functionality predictors in acquired brain damage.

PubMed

Huertas Hoyas, E; Pedrero Pérez, E J; Águila Maturana, A M; García López-Alberca, S; González Alted, C

2015-01-01

Most individuals who have survived an acquired brain injury present consequences affecting the sensorimotor, cognitive, affective or behavioural components. These deficits affect the proper performance of daily living activities. The aim of this study is to identify functional differences between individuals with unilateral acquired brain injury using functional independence, capacity, and performance of daily activities. Descriptive cross-sectional design with a sample of 58 people, with right-sided injury (n=14 TBI; n=15 stroke) or left-sided injury (n = 14 TBI, n = 15 stroke), right handed, and with a mean age of 47 years and time since onset of 4 ± 3.65 years. The functional assessment/functional independence measure (FIM/FAM) and the International Classification of Functioning (ICF) were used for the study. The data showed significant differences (P<.000), and a large size effect (dr=0.78) in the cross-sectional estimates, and point to fewer restrictions for patients with a lesion on their right side. The major differences were in the variables 'speaking' and 'receiving spoken messages' (ICF variables), and 'Expression', 'Writing' and 'intelligible speech' (FIM/FAM variables). In the linear regression analysis, the results showed that only 4 FIM/FAM variables, taken together, predict 44% of the ICF variance, which measures the ability of the individual, and up to 52% of the ICF, which measures the individual's performance. Gait alone predicts a 28% of the variance. It seems that individuals with acquired brain injury in the left hemisphere display important differences regarding functional and communication variables. The motor aspects are an important prognostic factor in functional rehabilitation. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

Failure to pop out: Feature singletons do not capture attention under low signal-to-noise ratio conditions.

PubMed

Rangelov, Dragan; Müller, Hermann J; Zehetleitner, Michael

2017-05-01

Pop-out search implies that the target is always the first item selected, no matter how many distractors are presented. However, increasing evidence indicates that search is not entirely independent of display density even for pop-out targets: search is slower with sparse (few distractors) than with dense displays (many distractors). Despite its significance, the cause of this anomaly remains unclear. We investigated several mechanisms that could slow down search for pop-out targets. Consistent with the assumption that pop-out targets frequently fail to pop out in sparse displays, we observed greater variability of search duration for sparse displays relative to dense. Computational modeling of the response time distributions also supported the view that pop-out targets fail to pop out in sparse displays. Our findings strongly question the classical assumption that early processing of pop-out targets is independent of the distractors. Rather, the density of distractors critically influences whether or not a stimulus pops out. These results call for new, more reliable measures of pop-out search and potentially a reinterpretation of studies that used relatively sparse displays. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Simulation Test of a Head-Worn Display with Ambient Vision Display for Unusual Attitude Recovery

NASA Technical Reports Server (NTRS)

Arthur, Jarvis (Trey) J., III; Nicholas, Stephanie N.; Shelton, Kevin J.; Ballard, Kathryn; Prinzel, Lawrence J., III; Ellis, Kyle E.; Bailey, Randall E.; Williams, Steven P.

2017-01-01

Head-Worn Displays (HWDs) are envisioned as a possible equivalent to a Head-Up Display (HUD) in commercial and general aviation. A simulation experiment was conducted to evaluate whether the HWD can provide an equivalent or better level of performance to a HUD in terms of unusual attitude recognition and recovery. A prototype HWD was tested with ambient vision capability which were varied (on/off) as an independent variable in the experiment testing for attitude awareness. The simulation experiment was conducted in two parts: 1) short unusual attitude recovery scenarios where the aircraft is placed in an unusual attitude and a single-pilot crew recovered the aircraft; and, 2) a two-pilot crew operating in a realistic flight environment with "off-nominal" events to induce unusual attitudes. The data showed few differences in unusual attitude recognition and recovery performance between the tested head-down, head-up, and head-worn display concepts. The presence and absence of ambient vision stimulation was inconclusive. The ergonomic influences of the head-worn display, necessary to implement the ambient vision experimentation, may have influenced the pilot ratings and acceptance of the concepts.

Synthetic Vision Enhances Situation Awareness and RNP Capabilities for Terrain-Challenged Approaches

NASA Technical Reports Server (NTRS)

Kramer, Lynda J.; Prinzel, Lawrence J., III; Bailey, Randall E.; Arthur, Jarvis J., III

2003-01-01

The Synthetic Vision Systems (SVS) Project of Aviation Safety Program is striving to eliminate poor visibility as a causal factor in aircraft accidents as well as enhance operational capabilities of all aircraft through the display of computer generated imagery derived from an onboard database of terrain, obstacle, and airport information. To achieve these objectives, NASA 757 flight test research was conducted at the Eagle-Vail, Colorado airport to evaluate three SVS display types (Head-Up Display, Head-Down Size A, Head-Down Size X) and two terrain texture methods (photo-realistic, generic) in comparison to the simulated Baseline Boeing-757 Electronic Attitude Direction Indicator and Navigation / Terrain Awareness and Warning System displays. These independent variables were evaluated for situation awareness, path error, and workload while making approaches to Runway 25 and 07 and during simulated engine-out Cottonwood 2 and KREMM departures. The results of the experiment showed significantly improved situation awareness, performance, and workload for SVS concepts compared to the Baseline displays and confirmed the retrofit capability of the Head-Up Display and Size A SVS concepts. The research also demonstrated that the pathway and pursuit guidance used within the SVS concepts achieved required navigation performance (RNP) criteria.

R package PRIMsrc: Bump Hunting by Patient Rule Induction Method for Survival, Regression and Classification

PubMed Central

Dazard, Jean-Eudes; Choe, Michael; LeBlanc, Michael; Rao, J. Sunil

2015-01-01

PRIMsrc is a novel implementation of a non-parametric bump hunting procedure, based on the Patient Rule Induction Method (PRIM), offering a unified treatment of outcome variables, including censored time-to-event (Survival), continuous (Regression) and discrete (Classification) responses. To fit the model, it uses a recursive peeling procedure with specific peeling criteria and stopping rules depending on the response. To validate the model, it provides an objective function based on prediction-error or other specific statistic, as well as two alternative cross-validation techniques, adapted to the task of decision-rule making and estimation in the three types of settings. PRIMsrc comes as an open source R package, including at this point: (i) a main function for fitting a Survival Bump Hunting model with various options allowing cross-validated model selection to control model size (#covariates) and model complexity (#peeling steps) and generation of cross-validated end-point estimates; (ii) parallel computing; (iii) various S3-generic and specific plotting functions for data visualization, diagnostic, prediction, summary and display of results. It is available on CRAN and GitHub. PMID:26798326

Suppression of TFT leakage current effect on active matrix displays by employing a new circular switch

NASA Astrophysics Data System (ADS)

Lee, Jae-Hoon; Park, Hyun-Sang; Jeon, Jae-Hong; Han, Min-Koo

2008-03-01

We have proposed a new poly-Si TFT pixel, which can suppress TFT leakage current effect on active matrix organic diode (AMOLED) displays, by employing a new circular switching TFT and additional signal line for compensating the leakage current. When the leakage current of switching TFT is increased, the VGS of the current driving TFT in the proposed pixel is not altered by the variable data voltages due to the circular switching TFT. Our simulation results show that OLED current variation of the proposed pixel can be suppressed less than 3%, while that of conventional pixel exceeds 30%. The proposed pixel may be suitable to suppress the leakage current effect on AMOLED display.

The importance of a high rectal pressure on strain in constipated patients: implications for biofeedback therapy.

PubMed

Mazor, Y; Hansen, R; Prott, G; Kellow, J; Malcolm, A

2017-03-01

A subset of patients with chronic constipation display a relatively high manometric rectal pressure on strain. We hypothesized that these patients represent a unique phenotype of functional defecatory disorder (FDD) and would benefit from undergoing anorectal biofeedback (BF). Of 138 consecutive patients with chronic constipation and symptoms of FDD, 19 were defined as having a high rectal pressure on strain, using a statistically derived cut-off of 78 mm Hg. This subset was compared with remaining patients in regard to baseline clinical profile and physiology, and outcome of BF. There was a greater representation of males in the high rectal pressure group. Their constipation score, impact of bowel dysfunction on quality of life and satisfaction with bowel habits did not differ from the remaining patients. Eighty-four percent of patients in the high group successfully expelled the rectal balloon and 95% displayed paradoxical anal contraction on strain (P<.05 compared with the remaining patients). Following BF, 89% of patients in the high group reduced their rectal pressure to normal. End of BF treatment outcomes improved significantly, and to a similar degree, in both groups. We have identified a subgroup of patients with dyssynergic symptoms but without a formal Rome III diagnosis of FDD, who were characterized by a high straining rectal pressure. Although these patients displayed some physiological differences to the patients with lower straining rectal pressure, they suffer similarly. Importantly, we have shown that these patients can respond favorably to anorectal BF. © 2016 John Wiley & Sons Ltd.

Optical Polarization and Spectral Variability in the M87 Jet

NASA Technical Reports Server (NTRS)

Perlman, Eric S.; Adams, Steven C.; Cara, Mihai; Bourque, Matthew; Harris, D. E.; Madrid, Juan P.; Simons, Raymond C.; Clausen-Brown, Eric; Cheung, C. C.; Stawarz, Lukasz;

The relationship between sleep-wake cycle and cognitive functioning in young people with affective disorders.

PubMed

Carpenter, Joanne S; Robillard, Rébecca; Lee, Rico S C; Hermens, Daniel F; Naismith, Sharon L; White, Django; Whitwell, Bradley; Scott, Elizabeth M; Hickie, Ian B

2015-01-01

Although early-stage affective disorders are associated with both cognitive dysfunction and sleep-wake disruptions, relationships between these factors have not been specifically examined in young adults. Sleep and circadian rhythm disturbances in those with affective disorders are considerably heterogeneous, and may not relate to cognitive dysfunction in a simple linear fashion. This study aimed to characterise profiles of sleep and circadian disturbance in young people with affective disorders and examine associations between these profiles and cognitive performance. Actigraphy monitoring was completed in 152 young people (16-30 years; 66% female) with primary diagnoses of affective disorders, and 69 healthy controls (18-30 years; 57% female). Patients also underwent detailed neuropsychological assessment. Actigraphy data were processed to estimate both sleep and circadian parameters. Overall neuropsychological performance in patients was poor on tasks relating to mental flexibility and visual memory. Two hierarchical cluster analyses identified three distinct patient groups based on sleep variables and three based on circadian variables. Sleep clusters included a 'long sleep' cluster, a 'disrupted sleep' cluster, and a 'delayed and disrupted sleep' cluster. Circadian clusters included a 'strong circadian' cluster, a 'weak circadian' cluster, and a 'delayed circadian' cluster. Medication use differed between clusters. The 'long sleep' cluster displayed significantly worse visual memory performance compared to the 'disrupted sleep' cluster. No other cognitive functions differed between clusters. These results highlight the heterogeneity of sleep and circadian profiles in young people with affective disorders, and provide preliminary evidence in support of a relationship between sleep and visual memory, which may be mediated by use of antipsychotic medication. These findings have implications for the personalisation of treatments and improvement of functioning in young adults early in the course of affective illness.

Clinical and neurocognitive course in early-onset psychosis: a longitudinal study of adolescents with schizophrenia-spectrum disorders*

PubMed Central

Wozniak, Jeffrey R.; Block, Erin E.; White, Tonya; Jensen, Jonathan B.; Schulz, S. Charles

2017-01-01

Aim Adolescents with psychotic disorders show deficits in IQ, attention, learning and memory, executive functioning, and processing speed that are related to important clinical variables including negative symptoms, adaptive functioning and academics. Previous studies have reported relatively consistent deficits with varying relationships to illness status and symptoms. The goals of this study were to examine these relationships in a larger sample at baseline, and also to examine the longitudinal course of these deficits in a smaller subset of adolescents. Method Thirty-six subjects, aged 10 to 17 years, were included at baseline. All had Diagnostic and Statistical Manual-Fourth Edition diagnoses of schizophrenia, schizoaffective disorder, schizophreniform disorder and psychosis – not otherwise specified, as determined by Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children structured interviews. Patients were administered a neuropsychological battery, and Positive and Negative Syndrome Scale ratings were completed at baseline and again at 1 year (n = 14). Most participants were inpatients at baseline, and 13 of 14were on atypical antipsychotic medication during both sessions. Results At baseline, the patients demonstrated impairments in working memory, processing speed, executive function and verbal learning. No significant cognitive change was detected at 1-year follow-up. In contrast, clinical symptoms were variable across 1 year, with an improvement in positive symptoms at 1 year. No relationships between clinical and cognitive symptoms were observed, with the exception of baseline IQ predicting negative symptoms at 1 year. Conclusions Young patients with schizophrenia-spectrum disorders displayed neurocognitive impairments at baseline. Despite measurable fluctuations in clinical symptoms over the year, no significant changes were measured in cognition. Lower IQ at baseline was predictive of more negative symptoms at 1 year. PMID:21352150

Validations of a portable home sleep study with twelve-lead polysomnography: comparisons and insights into a variable gold standard.

PubMed

Michaelson, Peter G; Allan, Patrick; Chaney, John; Mair, Eric A

2006-11-01

Accurate and timely diagnosis for patients with obstructive sleep apnea (OSA) is imperative. Unfortunately, growing interest in this diagnosis has resulted in increased requests and waiting times for polysomnography (PSG), as well as a potential delay in diagnosis and treatment. This study evaluated the accuracy and viability of utilizing SNAP (SNAP Laboratories, LLC, Wheeling, Illinois), a portable home sleep test, as an alternative to traditional PSG in diagnosing OSA. This prospective clinical trial included 59 patients evaluated at our institution's sleep laboratory. Concurrent PSG and SNAP testing was performed for 1 night on each patient. Independent, blinded readers at our institution and at an outside-accredited institution read the PSG data, and 2 independent, blinded readers interpreted the SNAP data at SNAP laboratories. The apnea-hypopnea index (AHI) was used to compare the 2 testing modalities. The correlation coefficient, receiver operating characteristic curve analysis, and the Bland-Altman curves, as well as sensitivity, specificity, inter-reader variability, positive predictive value, and negative predictive value, were used to compare SNAP and PSG. There is a definitive, statistically sound correlation between the AHIs determined from both PSG and SNAP. This relationship holds true for all measures of comparison, while displaying a concerning, weaker correlation between the different PSG interpretations. There is a convincing correlation between the study-determined AHIs of both PSG and SNAP. This finding supports SNAP as a suitable alternative to PSG in identifying OSA, while accentuating the inherent variation present in a PSG-derived AHI. This test expands the diagnostic and therapeutic prowess of the practicing otolaryngologist by offering an alternative OSA testing modality that is associated with not only less expense, decreased waiting time, and increased convenience, but also statistically proven accuracy.

Collision judgment when using an augmented-vision head-mounted display device

PubMed Central

Luo, Gang; Woods, Russell L; Peli, Eli

2016-01-01

Purpose We have developed a device to provide an expanded visual field to patients with tunnel vision by superimposing minified edge images of the wide scene, in which objects appear closer to the heading direction than they really are. We conducted experiments in a virtual environment to determine if users would overestimate collision risks. Methods Given simulated scenes of walking or standing with intention to walk towards a given direction (intended walking) in a shopping mall corridor, participants (12 normally sighted and 7 with tunnel vision) reported whether they would collide with obstacles appearing at different offsets from variable walking paths (or intended directions), with and without the device. The collision envelope (CE), a personal space based on perceived collision judgments, and judgment uncertainty (variability of response) were measured. When the device was used, combinations of two image scales (5× minified and 1:1) and two image types (grayscale or edge images) were tested. Results Image type did not significantly alter collision judgment (p>0.7). Compared to the without-device baseline, minification did not significantly change the CE of normally sighted subjects for simulated walking (p=0.12), but increased CE by 30% for intended walking (p<0.001). Their uncertainty was not affected by minification (p>0.25). For the patients, neither CE nor uncertainty was affected by minification (p>0.13) in both walking conditions. Baseline CE and uncertainty were greater for patients than normally-sighted subjects in simulated walking (p=0.03), but the two groups were not significantly different in all other conditions. Conclusion Users did not substantially overestimate collision risk, as the 5× minified images had only limited impact on collision judgments either during walking or before starting to walk. PMID:19458339

Clinical characteristics and treatment outcomes of patients with major depressive disorder and comorbid anxiety disorders - results from a European multicenter study.

PubMed

Dold, Markus; Bartova, Lucie; Souery, Daniel; Mendlewicz, Julien; Serretti, Alessandro; Porcelli, Stefano; Zohar, Joseph; Montgomery, Stuart; Kasper, Siegfried

2017-08-01

This naturalistic European multicenter study aimed to elucidate the association between major depressive disorder (MDD) and comorbid anxiety disorders. Demographic and clinical information of 1346 MDD patients were compared between those with and without concurrent anxiety disorders. The association between explanatory variables and the presence of comorbid anxiety disorders was examined using binary logistic regression analyses. 286 (21.2%) of the participants exhibited comorbid anxiety disorders, 10.8% generalized anxiety disorder (GAD), 8.3% panic disorder, 8.1% agoraphobia, and 3.3% social phobia. MDD patients with comorbid anxiety disorders were characterized by younger age (social phobia), outpatient status (agoraphobia), suicide risk (any anxiety disorder, panic disorder, agoraphobia, social phobia), higher depressive symptom severity (GAD), polypsychopharmacy (panic disorder, agoraphobia), and a higher proportion receiving augmentation treatment with benzodiazepines (any anxiety disorder, GAD, panic disorder, agoraphobia, social phobia) and pregabalin (any anxiety disorder, GAD, panic disorder). The results in terms of treatment response were conflicting (better response for panic disorder and poorer for GAD). The logistic regression analyses revealed younger age (any anxiety disorder, social phobia), outpatient status (agoraphobia), suicide risk (agoraphobia), severe depressive symptoms (any anxiety disorder, GAD, social phobia), poorer treatment response (GAD), and increased administration of benzodiazepines (any anxiety disorder, agoraphobia, social phobia) and pregabalin (any anxiety disorder, GAD, panic disorder) to be associated with comorbid anxiety disorders. Our findings suggest that the various anxiety disorders subtypes display divergent clinical characteristics and are associated with different variables. Especially comorbid GAD appears to be characterized by high symptom severity and poor treatment response. Copyright © 2017 Elsevier Ltd. All rights reserved.

Collision judgment when using an augmented-vision head-mounted display device.

PubMed

Luo, Gang; Woods, Russell L; Peli, Eli

2009-09-01

A device was developed to provide an expanded visual field to patients with tunnel vision by superimposing minified edge images of the wide scene, in which objects appear closer to the heading direction than they really are. Experiments were conducted in a virtual environment to determine whether users would overestimate collision risks. Given simulated scenes of walking or standing with intention to walk toward a given direction (intended walking) in a shopping mall corridor, participants (12 normally sighted and 7 with tunnel vision) reported whether they would collide with obstacles appearing at different offsets from variable walking paths (or intended directions), with and without the device. The collision envelope (CE), a personal space based on perceived collision judgments, and judgment uncertainty (variability of response) were measured. When the device was used, combinations of two image scales (5x minified and 1:1) and two image types (grayscale or edge images) were tested. Image type did not significantly alter collision judgment (P > 0.7). Compared to the without-device baseline, minification did not significantly change the CE of normally sighted subjects for simulated walking (P = 0.12), but increased CE by 30% for intended walking (P < 0.001). Their uncertainty was not affected by minification (P > 0.25). For the patients, neither CE nor uncertainty was affected by minification (P > 0.13) in both walking conditions. Baseline CE and uncertainty were greater for patients than normally sighted subjects in simulated walking (P = 0.03), but the two groups were not significantly different in all other conditions. Users did not substantially overestimate collision risk, as the x5 minified images had only limited impact on collision judgments either during walking or before starting to walk.

Autoimmune Lymphoproliferative Syndrome-FAS Patients Have an Abnormal Regulatory T Cell (Treg) Phenotype but Display Normal Natural Treg-Suppressive Function on T Cell Proliferation.

PubMed

Mazerolles, Fabienne; Stolzenberg, Marie-Claude; Pelle, Olivier; Picard, Capucine; Neven, Benedicte; Fischer, Alain; Magerus-Chatinet, Aude; Rieux-Laucat, Frederic

2018-01-01

Autoimmune lymphoproliferative syndrome (ALPS) with FAS mutation (ALPS-FAS) is a nonmalignant, noninfectious, lymphoproliferative disease with autoimmunity. Given the central role of natural regulatory T cells (nTregs) in the control of lymphoproliferation and autoimmunity, we assessed nTreg-suppressive function in 16 patients with ALPS-FAS. The proportion of CD25 high CD127 low Tregs was lower in ALPS-FAS patients than in healthy controls. This subset was correlated with a reduced CD25 expression in CD3 + CD4 + T cells from ALPS patients and thus an abnormally low proportion of CD25 high FOXP3 + Helios + T cells. The ALPS patients also displayed a high proportion of naïve Treg (FOXP3 low CD45RA + ) and an unusual subpopulation (CD4 + CD127 low CD15s + CD45RA + ). Despite this abnormal phenotype, the CD25 high CD127 low Tregs' suppressive function was unaffected. Furthermore, conventional T cells from FAS -mutated patients showed normal levels of sensitivity to Treg suppression. An abnormal Treg phenotype is observed in circulating lymphocytes of ALPS patients. However, these Tregs displayed a normal suppressive function on T effector proliferation in vitro . This is suggesting that lymphoproliferation observed in ALPS patients does not result from Tregs functional defect or T effector cells insensitivity to Tregs suppression.

Clinical and biochemical heterogeneity between patients with glycogen storage disease type IA: the added value of CUSUM for metabolic control.

PubMed

Peeks, Fabian; Steunenberg, Thomas A H; de Boer, Foekje; Rubio-Gozalbo, M Estela; Williams, Monique; Burghard, Rob; Rajas, Fabienne; Oosterveer, Maaike H; Weinstein, David A; Derks, Terry G J

2017-09-01

To study heterogeneity between patients with glycogen storage disease type Ia (GSD Ia), a rare inherited disorder of carbohydrate metabolism caused by the deficiency of glucose-6-phosphatase (G6Pase). Descriptive retrospective study of longitudinal clinical and biochemical data and long-term complications in 20 GSD Ia patients. We included 11 patients with homozygous G6PC mutations and siblings from four families carrying identical G6PC genotypes. To display subtle variations for repeated triglyceride measurements with respect to time for individual patients, CUSUM-analysis graphs were constructed. Patients with different homozygous G6PC mutations showed important differences in height, BMI, and biochemical parameters (i.e., lactate, uric acid, triglyceride, and cholesterol concentrations). Furthermore, CUSUM-analysis predicts and displays subtle changes in longitudinal blood triglyceride concentrations. Siblings in families also displayed important differences in biochemical parameters (i.e., lactate, uric acid, triglycerides, and cholesterol concentrations) and long-term complications (i.e., liver adenomas, nephropathy, and osteopenia/osteoporosis). Differences between GSD Ia patients reflect large clinical and biochemical heterogeneity. Heterogeneity between GSD Ia patients with homozygous G6PC mutations indicate an important role of the G6PC genotype/mutations. Differences between affected siblings suggest an additional role (genetic and/or environmental) of modifying factors defining the GSD Ia phenotype. CUSUM-analysis can facilitate single-patient monitoring of metabolic control and future application of this method may improve precision medicine for patients both with GSD and remaining inherited metabolic diseases.

Gonadotrophic status in adolescents with pituitary stalk interruption syndrome.

PubMed

Rottembourg, Diane; Linglart, Agnès; Adamsbaum, Catherine; Lahlou, Najiba; Teinturier, Cécile; Bougnères, Pierre; Carel, Jean-Claude

2008-07-01

Pituitary stalk interruption syndrome (PSIS) is a frequent cause of GH deficiency (GHD) and is commonly associated with other PH deficiencies (PHDs). Although previous reports have correlated multiple PHDs with severe anatomical lesions, the status of the gonadotrophic axis has not yet been thoroughly analysed. We retrospectively reviewed the medical records of 27 patients (15 males, 12 females) with GHD and PSIS defined by MRI findings. The status of the gonadotrophic axis was evaluated in children who were at least 14.5 years (boys) or 13 years (girls). Out of 27 patients, five displayed spontaneous full pubertal development with normal hormonal values at the final evaluation, whereas 22 of 27 patients (81%) had complete (n = 18) or partial pubertal deficiency. Three girls had primary amenorrhoea with normal gonadotrophin values, raising the possibility of subtle disturbances of gonadotrophin pulsatility. Of the 21 patients with TSH or ACTH deficiency, 17 (81%) had complete gonadotrophin deficiency. Two of our six patients with apparently isolated GHD during childhood had gonadotrophin deficiency. Cryptorchidism was present at birth in six boys (40%). Of these six boys, one had normal pubertal development. Ten of 11 boys with micropenis at birth had gonadotrophin deficiency. Gonadotrophin deficiency is a common finding in adolescents with PSIS and is frequently associated with other PHDs. However its severity is variable, ranging from complete gonadotrophin deficiency to normogonadotrophic amenorrhoea. The occurrence of gonadotrophin deficiency in 33% of children with apparently isolated GHD and PSIS has important implications for the counselling and follow-up of these patients.

Internet design preferences of patients with cancer.

PubMed

Chernecky, Cynthia; Macklin, Denise; Walter, Jennifer

2006-07-01

To describe computer experience and preferences for multimedia design. Prospective, descriptive. Physician office and outpatient cancer centers in an urban area in the southeastern United States. Convenience sample of 22 volunteer patients with cancer from four racial groups. A questionnaire on computer experiences was followed by a hands-on computer session with questions regarding preferences for seven interface items. Data termination occurred when sample size was obtained. Design of Internet education site for patients. Variables include preferences, computer, cancer, multimedia, and education. Eighty-two percent had personal computers, 41% used a computer daily, and 95% believed that computers would be a good avenue for learning about cancer care. Preferences included display colors in blue and green hues; colored buttons; easy-to-read text; graphics with a simple design and large, clear pictures; serif font in dark type; light-colored background; and larger photo size in a rectangle shape. Most popular graphic icons as metaphors were 911 for emergency, picture of skull and crossbones for danger, and a picture of a string on an index finger representing reminder. The simple layout most preferred for appearances was one that included text and pictures, read from left to right, and was symmetrical in its placement of pictures and text on the page. Preferences are necessary to maintain interest and support navigation through computer designs to enhance the translation of knowledge to patients. Development of multimedia based on patient preferences will enhance education, learning, and, ultimately, quality patient care.

Local Stability of the Trunk in Patients with Degenerative Cerebellar Ataxia During Walking.

PubMed

Chini, Giorgia; Ranavolo, Alberto; Draicchio, Francesco; Casali, Carlo; Conte, Carmela; Martino, Giovanni; Leonardi, Luca; Padua, Luca; Coppola, Gianluca; Pierelli, Francesco; Serrao, Mariano

2017-02-01

This study aims to evaluate trunk local stability in a group of patients with degenerative primary cerebellar ataxia and to correlate it with spatio-temporal parameters, clinical variables, and history of falls. Sixteen patients affected by degenerative cerebellar ataxia and 16 gender- and age-matched healthy adults were studied by means of an inertial sensor to measure trunk kinematics and spatio-temporal parameters during over-ground walking. Trunk local dynamic stability was quantified by the maximum Lyapunov exponent with short data series of the acceleration data. According to this index, low values indicate more stable trunk dynamics, while high values denote less stable trunk dynamics. Disease severity was assessed by means of International Cooperative Ataxia Rating Scale (ICARS) according to which higher values correspond to more severe disease, while lower values correspond to less severe disease.Patients displayed a higher short-term maximum Lyapunov exponent than controls in all three spatial planes, which was correlated with the age, onset of the disease, and history of falls. Furthermore, the maximum Lyapunov exponent was negatively correlated with ICARS balance, ICARS posture, and ICARS total scores.These findings indicate that trunk local stability during gait is lower in patients with cerebellar degenerative ataxia than that in healthy controls and that this may increase the risk of falls. Local dynamic stability of the trunk seems to be an important aspect in patients with ataxia and could be a useful tool in the evaluation of rehabilitative and pharmacological treatment outcomes.

Selection of specific interactors from phage display library based on sea lamprey variable lymphocyte receptor sequences.

PubMed

Wezner-Ptasinska, Magdalena; Otlewski, Jacek

2015-12-01

Variable lymphocyte receptors (VLRs) are non-immunoglobulin components of adaptive immunity in jawless vertebrates. These proteins composed of leucine-rich repeat modules offer some advantages over antibodies in target binding and therefore are attractive candidates for biotechnological applications. In this paper we report the design and characterization of a phage display library based on a previously proposed dVLR scaffold containing six LRR modules [Wezner-Ptasinska et al., 2011]. Our library was designed based on a consensus approach in which the randomization scheme reflects the frequencies of amino acids naturally occurring in respective positions responsible for antigen recognition. We demonstrate general applicability of the scaffold by selecting dVLRs specific for lysozyme and S100A7 protein with KD values in the micromolar range. The dVLR library could be used as a convenient alternative to antibodies for effective isolation of high affinity binders.

Circatrigintan instead of lunar periodicity of larval release in a brooding coral species.

PubMed

Linden, Bart; Huisman, Jef; Rinkevich, Baruch

2018-04-04

Larval release by brooding corals is often assumed to display lunar periodicity. Here, we show that larval release of individual Stylophora pistillata colonies does not comply with the assumed tight entrainment by the lunar cycle, and can better be classified as a circatrigintan pattern. The colonies exhibited three distinct reproductive patterns, characterized by short intervals, long intervals and no periodicity between reproductive peaks, respectively. Cross correlation between the lunar cycle and larval release of the periodic colonies revealed an approximately 30-day periodicity with a variable lag of 5 to 10 days after full moon. The observed variability indicates that the lunar cycle does not provide a strict zeitgeber. Other factors such as water temperature and solar radiation did not correlate significantly with the larval release. The circatrigintan patterns displayed by S. pistillata supports the plasticity of corals and sheds new light on discussions on the fecundity of brooding coral species.

Psychophysical evaluation of a variable friction tactile interface

NASA Astrophysics Data System (ADS)

Samur, Evren; Colgate, J. Edward; Peshkin, Michael A.

2009-02-01

This study explores the haptic rendering capabilities of a variable friction tactile interface through psychophysical experiments. In order to obtain a deeper understanding of the sensory resolution associated with the Tactile Pattern Display (TPaD), friction discrimination experiments are conducted. During the experiments, subjects are asked to explore the glass surface of the TPaD using their bare index fingers, to feel the friction on the surface, and to compare the slipperiness of two stimuli, displayed in sequential order. The fingertip position data is collected by an infrared frame and normal and translational forces applied by the finger are measured by force sensors attached to the TPaD. The recorded data is used to calculate the coefficient of friction between the fingertip and the TPaD. The experiments determine the just noticeable difference (JND) of friction coefficient for humans interacting with the TPaD.

Do Children and Adolescents with Anorexia Nervosa Display an Inefficient Cognitive Processing Style?

PubMed Central

Lang, Katie; Lloyd, Samantha; Khondoker, Mizanur; Simic, Mima; Treasure, Janet; Tchanturia, Kate

2015-01-01

Objective This study aimed to examine neuropsychological processing in children and adolescents with Anorexia Nervosa (AN). The relationship of clinical and demographic variables to neuropsychological functioning within the AN group was also explored. Method The performance of 41 children and adolescents with a diagnosis of AN were compared to 43 healthy control (HC) participants on a number of neuropsychological measures. Results There were no differences in IQ between AN and HC groups. However, children and adolescents with AN displayed significantly more perseverative errors on the Wisconsin Card Sorting Test, and lower Style and Central Coherence scores on the Rey Osterrieth Complex Figure Test relative to HCs. Conclusion Inefficient cognitive processing in the AN group was independent of clinical and demographic variables, suggesting it might represent an underlying trait for AN. The implications of these findings are discussed. PMID:26133552

B cell gene signature with massive intrahepatic production of antibodies to hepatitis B core antigen in hepatitis B virus-associated acute liver failure.

PubMed

Farci, Patrizia; Diaz, Giacomo; Chen, Zhaochun; Govindarajan, Sugantha; Tice, Ashley; Agulto, Liane; Pittaluga, Stefania; Boon, Denali; Yu, Claro; Engle, Ronald E; Haas, Mark; Simon, Richard; Purcell, Robert H; Zamboni, Fausto

2010-05-11

Hepatitis B virus (HBV)-associated acute liver failure (ALF) is a dramatic clinical syndrome due to a sudden loss of hepatic cells leading to multiorgan failure. The mechanisms whereby HBV induces ALF are unknown. Here, we show that liver tissue collected at the time of liver transplantation in two patients with HBV-associated ALF is characterized by an overwhelming B cell response apparently centered in the liver with massive accumulation of plasma cells secreting IgG and IgM, accompanied by complement deposition. We demonstrate that the molecular target of these antibodies is the hepatitis B core antigen (HBcAg); that these anti-bodies display a restricted variable heavy chain (V(H)) repertoire and lack somatic mutations; and that these two unrelated individuals with ALF use an identical predominant V(H) gene with unmutated variable domain (IGHV1-3) for both IgG and IgM anti-HBc antibodies, indicating that HBcAg is the target of a germline human V(H) gene. These data suggest that humoral immunity may exert a primary role in the pathogenesis of HBV-associated ALF.

Temporal Variability of Antibiotics Fluxes in Wastewater and Contribution from Hospitals

PubMed Central

Coutu, Sylvain; Rossi, Luca; Barry, D. A.; Rudaz, Serge; Vernaz, Nathalie

2013-01-01

Significant quantities of antibiotics are used in all parts of the globe to treat diseases with bacterial origins. After ingestion, antibiotics are excreted by the patient and transmitted in due course to the aquatic environment. This study examined temporal fluctuations (monthly time scale) in antibiotic sources (ambulatory sales and data from a hospital dispensary) for Lausanne, Switzerland. Source variability (i.e., antibiotic consumption, monthly data for 2006–2010) were examined in detail for nine antibiotics – azithromycin, ciprofloxacin, clarithromycin, clindamycin, metronidazole, norfloxacin, ofloxacin, sulfamethoxazole and trimethoprim, from which two main conclusions were reached. First, some substances – azithromycin, clarithromycin, ciprofloxacin – displayed high seasonality in their consumption, with the winter peak being up to three times higher than the summer minimum. This seasonality in consumption resulted in seasonality in Predicted Environmental Concentrations (PECs). In addition, the seasonality in PECs was also influenced by that in the base wastewater flow. Second, the contribution of hospitals to the total load of antibiotics reaching the Lausanne Wastewater Treatment Plant (WTP) fluctuated markedly on a monthly time scale, but with no seasonal pattern detected. That is, there was no connection between fluctuations in ambulatory and hospital consumption for the substances investigated. PMID:23320096

Suicidal ideation, suicide attempts, and psychological distress among intoxicated adolescents in the pediatric emergency department.

PubMed

Puuskari, Varpu; Aalto-Setälä, Terhi; Komulainen, Erkki; Marttunen, Mauri

2018-02-01

Studies have emphasized screening for psychiatric disorders, especially suicide risk in emergency departments. Psychiatric disorders and experimentation with alcohol increase in adolescence and intoxications among patients challenge the staff in emergency departments. This study examined the degree of suicidal ideation (SI) and suicidal behavior in adolescents, and the extent to which they differed from non-suicidal patients in terms of alcohol use, psychological distress, self-esteem, and perceived social support. The study comprised 120 adolescents, a mean age of 14.2 years. Of them 60% were females. We collected data on the clinical characteristics and assessed the patient's psychiatric status using self-report scales and analyzed blood samples for alcohol. A consulting psychiatrist interviewed each patient before discharge to evaluate potential SI or suicide attempt (SA) using structured and semi-structured scales. Of the 120 patients 20% had SI or had made a SA. High psychological distress in girls, low blood alcohol levels (BALs), as well as low scores on self-esteem, on social support and on familial support were associated with patients with SI/SA. Logistic regression showed that the most significant variables with suicidal patients included low BAL and low self-esteem and high alcohol consumption. Psychological distress had a direct and mediational role in the suicidal patients. Adolescents referred to the pediatric emergency department with intoxication displaying high psychological distress and low self-esteem represent a high-risk group of teens. In this group, careful assessment of mental health status, screening for suicidal ideation, and SAs seems warranted.

Long-term results of oxybutynin use in treating facial hyperhidrosis.

PubMed

Wolosker, Nelson; Teivelis, Marcelo Passos; Krutman, Mariana; Campbell, Taiz Pereira Dozono de Almeida; Kauffman, Paulo; Campos, José Ribas de; Puech-Leão, Pedro

2014-01-01

Facial hyperhidrosis can lead to serious emotional distress. Video-assisted thoracic sympathectomy resolves symptoms effectively, though it may be associated with compensatory hyperhidrosis, which may be more common in patients undergoing resection of the second thoracic ganglion. Oxybutynin has been used as a pharmacological approach to facial hyperhidrosis but the long-term results of this treatment are unclear. To evaluate the use of low oxybutynin doses in facial hyperhidrosis patients for at least six months. 61 patients were monitored for over six months and assessed according to the following variables: impact of hyperhidrosis on quality of life (QOL) before treatment and after six weeks, evolution of facial hyperhidrosis after six weeks and at the last consultation, complaints of dry mouth after six weeks and on last return visit, and improvement at other hyperhidrosis sites. Patients were monitored for 6 to 61 months (median=17 months). Thirty-six (59%) were female. Age ranged from 17-74 (median:45). Pre-treatment QOL was poor/very poor in 96.72%. After six weeks, 100% of patients improved QOL. Comparing results after six weeks and on the last visit, 91.8% of patients maintained the same category of improvement in facial hyperhidrosis, 3.3% worsened and 4.9% improved. Dry mouth complaints were common but not consistent throughout treatment. More than 90% of patients presented moderate/great improvement at other hyperhidrosis sites. Patients who had a good initial response to treatment maintained a good response long-term, did not display tachiphylaxis and experienced improvement on other hyperhidrosis sites.

Long-term results of oxybutynin use in treating facial hyperhidrosis*

PubMed Central

Wolosker, Nelson; Teivelis, Marcelo Passos; Krutman, Mariana; Campbell, Taiz Pereira Dozono de Almeida; Kauffman, Paulo; de Campos, José Ribas; Puech-Leão, Pedro

2014-01-01

BACKGROUND Facial hyperhidrosis can lead to serious emotional distress. Video-assisted thoracic sympathectomy resolves symptoms effectively, though it may be associated with compensatory hyperhidrosis, which may be more common in patients undergoing resection of the second thoracic ganglion. Oxybutynin has been used as a pharmacological approach to facial hyperhidrosis but the long-term results of this treatment are unclear. OBJECTIVE To evaluate the use of low oxybutynin doses in facial hyperhidrosis patients for at least six months. METHODS 61 patients were monitored for over six months and assessed according to the following variables: impact of hyperhidrosis on quality of life (QOL) before treatment and after six weeks, evolution of facial hyperhidrosis after six weeks and at the last consultation, complaints of dry mouth after six weeks and on last return visit, and improvement at other hyperhidrosis sites. RESULTS Patients were monitored for 6 to 61 months (median=17 months). Thirty-six (59%) were female. Age ranged from 17-74 (median:45). Pre-treatment QOL was poor/very poor in 96.72%. After six weeks, 100% of patients improved QOL. Comparing results after six weeks and on the last visit, 91.8% of patients maintained the same category of improvement in facial hyperhidrosis, 3.3% worsened and 4.9% improved. Dry mouth complaints were common but not consistent throughout treatment. More than 90% of patients presented moderate/great improvement at other hyperhidrosis sites. CONCLUSION Patients who had a good initial response to treatment maintained a good response long-term, did not display tachiphylaxis and experienced improvement on other hyperhidrosis sites. PMID:25387496

[Perceived satisfaction and usefulness of suicide prevention information for patients and relatives].

PubMed

Triñanes, Y; Senra-Rivera, C; Seoane-Pesqueira, G; González-García, A; Álvarez-Ariza, M; de-Las-Heras-Liñero, E; Atienza, G

2014-01-01

To assess the satisfaction of persons with suicidal behaviour and their relatives using patient information material included in the Clinical Practice Guidelines on Prevention and Treatment of Suicidal Behaviour. The sample was made up of 57 patients with suicidal ideation or behaviour, and 52 relatives. The participants were recruited through a suicide prevention programme (Programa de intervención intensiva en conducta suicida [PII] - Suicidal Behaviour Intensive Intervention Programme) and a family association (Federación de Asociaciones de Familiares y Personas con enfermedad mental de Galicia [FEAFES] - Galician Federation of Associations of Relatives and Persons with mental diseases). An ad-hoc questionnaire was designed to ascertain the degree of perceived satisfaction and usefulness of using the information included in the guidelines. The descriptive data of the sample is presented, along with an exploratory factorial analysis of the questionnaire that yielded two dimensions, i.e., format and usefulness. Patients scored significantly lower than the relatives in two dimensions; nevertheless, no significant differences were found between the two groups in the level of general satisfaction. The socio-demographic variables did not influence the results. Similarly, no differences were observed between patients with and without history of suicidal behaviour. Participants stressed that Primary Care was the setting best suited for dissemination of this type of information. In general, both patients and relatives displayed a high level of satisfaction with the patient information material assessed. Furnishing information of this type to patients with suicidal ideation and/or behaviour could act as a preventive-educational tool. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

Polychromatic plots: graphical display of multidimensional data.

PubMed

Roederer, Mario; Moody, M Anthony

2008-09-01

Limitations of graphical displays as well as human perception make the presentation and analysis of multidimensional data challenging. Graphical display of information on paper or by current projectors is perforce limited to two dimensions; the encoding of information from other dimensions must be overloaded into the two physical dimensions. A number of alternative means of encoding this information have been implemented, such as offsetting data points at an angle (e.g., three-dimensional projections onto a two-dimensional surface) or generating derived parameters that are combinations of other variables (e.g., principal components). Here, we explore the use of color to encode additional dimensions of data. PolyChromatic Plots are standard dot plots, where the color of each event is defined by the values of one, two, or three of the measurements for that event. The measurements for these parameters are mapped onto an intensity value for each primary color (red, green, or blue) based on different functions. In addition, differential weighting of the priority with which overlapping events are displayed can be defined by these same measurements. PolyChromatic Plots can encode up to five independent dimensions of data in a single display. By altering the color mapping function and the priority function, very different displays that highlight or de-emphasize populations of events can be generated. As for standard black-and-white dot plots, frequency information can be significantly biased by this display; care must be taken to ensure appropriate interpretation of the displays. PolyChromatic Plots are a powerful display type that enables rapid data exploration. By virtue of encoding as many as five dimensions of data independently, an enormous amount of information can be gleaned from the displays. In many ways, the display performs somewhat like an unsupervised cluster algorithm, by highlighting events of similar distributions in multivariate space.

Efficacy of monitoring patient's position during neurosurgical procedures: introduction of real-time display and record.

PubMed

Hasegawa, Mitsuhiro; Nouri, Mohsen; Fujisawa, Hironori; Hayashi, Yutaka; Inamasu, Joji; Hirose, Yuichi; Yamashita, Junkoh

2015-01-01

There are many reports on position-related complications in neurosurgical literature but so far, continuous quantification of the patient's position during the surgery has not been reported. This study aims to explore the utility of a new surgical table system and its software in displaying the patient's body positions during surgery on real-time basis. More than 200 neurosurgical cases were monitored for their positions intra-operatively. The position was digitally recorded and could be seen by all the members in the operating team. It also displayed the three-dimensional relationship between the head and the heart positions. No position-related complications were observed during the study. The system was able to serve as an excellent indicator for monitoring the patient's position. The recordings were analyzed and even used to reproduce or improve the position in the subsequent operations. The novel technique of monitoring the position of the head and the heart of the patients and the operating table planes are considered to be useful during delicate neurosurgical procedures thereby, preventing inadvertent procedural errors. This can be used to quantify various surgical positions in the future and define safety measures accordingly.

Evaluating Approaches to Rendering Braille Text on a High-Density Pin Display.

PubMed

Morash, Valerie S; Russomanno, Alexander; Gillespie, R Brent; OModhrain, Sile

2017-10-13

Refreshable displays for tactile graphics are typically composed of pins that have smaller diameters and spacing than standard braille dots. We investigated configurations of high-density pins to form braille text on such displays using non-refreshable stimuli produced with a 3D printer. Normal dot braille (diameter 1.5 mm) was compared to high-density dot braille (diameter 0.75 mm) wherein each normal dot was rendered by high-density simulated pins alone or in a cluster of pins configured in a diamond, X, or square; and to "blobs" that could result from covering normal braille and high-density multi-pin configurations with a thin membrane. Twelve blind participants read MNREAD sentences displayed in these conditions. For high-density simulated pins, single pins were as quickly and easily read as normal braille, but diamond, X, and square multi-pin configurations were slower and/or harder to read than normal braille. We therefore conclude that as long as center-to-center dot spacing and dot placement is maintained, the dot diameter may be open to variability for rendering braille on a high density tactile display.

Meat quality of lamb frozen stored up to 21 months: instrumental analyses on thawed meat during display.

PubMed

Muela, E; Monge, P; Sañudo, C; Campo, M M; Beltrán, J A

2015-04-01

The study analysed the effect of frozen storage duration (FSD: 0, 1, 9, 15 or 21 months) and display duration (DD: 0-24 h post-slaughter-, 3 and 6 days) in modified atmosphere packaging (MAP) on lamb quality. pH, colour, lipid oxidation, water holding capacity and instrumental texture were performed on Longissimus muscle in displayed fresh and thawed meat. FSD affected all the variables showing lower differences between fresh and 1 month storage than among them and longer FSD. Only cooking losses were not affected by DD in thawed meats. It was observed a general decrease in quality (lower redness and water holding capacity; higher yellowness and lipid oxidation) as FSD or DD increased and only texture was improved over DD being thawed meat more tender. In conclusion, lamb storage at -18°C should not exceed 1 month if thawed meat would be later displayed in MAP while meat would have an acceptable quality up to 21 months without subsequent display. Copyright © 2015 Elsevier Ltd. All rights reserved.

The XMM deep survey in the CDF-S. X. X-ray variability of bright sources

NASA Astrophysics Data System (ADS)

Falocco, S.; Paolillo, M.; Comastri, A.; Carrera, F. J.; Ranalli, P.; Iwasawa, K.; Georgantopoulos, I.; Vignali, C.; Gilli, R.

2017-12-01

Aims: We aim to study the variability properties of bright hard X-ray selected active galactic nuclei (AGN) in the redshift range between 0.3 and 1.6 detected in the Chandra Deep Field South (XMM-CDFS) by a long ( 3 Ms) XMM observation. Methods: Taking advantage of the good count statistics in the XMM CDFS, we search for flux and spectral variability using the hardness ratio (HR) techniques. We also investigate the spectral variability of different spectral components (photon index of the power law, column density of the local absorber, and reflection intensity). The spectra were merged in six epochs (defined as adjacent observations) and in high and low flux states to understand whether the flux transitions are accompanied by spectral changes. Results: The flux variability is significant in all the sources investigated. The HRs in general are not as variable as the fluxes, in line with previous results on deep fields. Only one source displays a variable HR, anti-correlated with the flux (source 337). The spectral analysis in the available epochs confirms the steeper when brighter trend consistent with Comptonisation models only in this source at 99% confidence level. Finding this trend in one out of seven unabsorbed sources is consistent, within the statistical limits, with the 15% of unabsorbed AGN in previous deep surveys. No significant variability in the column densities, nor in the Compton reflection component, has been detected across the epochs considered. The high and low states display in general different normalisations but consistent spectral properties. Conclusions: X-ray flux fluctuations are ubiquitous in AGN, though in some cases the data quality does not allow for their detection. In general, the significant flux variations are not associated with spectral variability: photon index and column densities are not significantly variable in nine out of the ten AGN over long timescales (from three to six and a half years). Photon index variability is found only in one source (which is steeper when brighter) out of seven unabsorbed AGN. The percentage of spectrally variable objects is consistent, within the limited statistics of sources studied here, with previous deep samples.

Improving Team Performance and Participation via Computer-mediated Turn Taking and Informational Prompts.

DTIC Science & Technology

1981-03-01

Abstract (continued) that time. A second independent variable studied was the use of informational prompts consisting of periodic computer displays of...resolved by allowing the person to speak first who had spoken least up to that time. A second independent variable studied was the use of...beneficial in a team which interacts repeatedly over an extended period of time. In the study to be presented here, a specially designed electronic

3-D surface reconstruction of patient specific anatomic data using a pre-specified number of polygons.

PubMed

Aharon, S; Robb, R A

1997-01-01

Virtual reality environments provide highly interactive, natural control of the visualization process, significantly enhancing the scientific value of the data produced by medical imaging systems. Due to the computational and real time display update requirements of virtual reality interfaces, however, the complexity of organ and tissue surfaces which can be displayed is limited. In this paper, we present a new algorithm for the production of a polygonal surface containing a pre-specified number of polygons from patient or subject specific volumetric image data. The advantage of this new algorithm is that it effectively tiles complex structures with a specified number of polygons selected to optimize the trade-off between surface detail and real-time display rates.

Visual search performance among persons with schizophrenia as a function of target eccentricity.

PubMed

Elahipanah, Ava; Christensen, Bruce K; Reingold, Eyal M

2010-03-01

The current study investigated one possible mechanism of impaired visual attention among patients with schizophrenia: a reduced visual span. Visual span is the region of the visual field from which one can extract information during a single eye fixation. This study hypothesized that schizophrenia-related visual search impairment is mediated, in part, by a smaller visual span. To test this hypothesis, 23 patients with schizophrenia and 22 healthy controls completed a visual search task where the target was pseudorandomly presented at different distances from the center of the display. Response times were analyzed as a function of search condition (feature vs. conjunctive), display size, and target eccentricity. Consistent with previous reports, patient search times were more adversely affected as the number of search items increased in the conjunctive search condition. It was important however, that patients' conjunctive search times were also impacted to a greater degree by target eccentricity. Moreover, a significant impairment in patients' visual search performance was only evident when targets were more eccentric and their performance was more similar to healthy controls when the target was located closer to the center of the search display. These results support the hypothesis that a narrower visual span may underlie impaired visual search performance among patients with schizophrenia. Copyright 2010 APA, all rights reserved

A Multisite Survey Study of EMR Review Habits, Information Needs, and Display Preferences among Medical ICU Clinicians Evaluating New Patients.

PubMed

Nolan, Matthew E; Cartin-Ceba, Rodrigo; Moreno-Franco, Pablo; Pickering, Brian; Herasevich, Vitaly

2017-10-01

The electronic chart review habits of intensive care unit (ICU) clinicians admitting new patients are largely unknown but necessary to inform the design of existing and future critical care information systems. We conducted a survey study to assess the electronic chart review practices, information needs, workflow, and data display preferences among medical ICU clinicians admitting new patients. We surveyed rotating residents, critical care fellows, advanced practice providers, and attending physicians at three Mayo Clinic sites (Minnesota, Florida, and Arizona) via email with a single follow-up reminder message. Of 234 clinicians invited, 156 completed the full survey (67% response rate). Ninety-two percent of medical ICU clinicians performed electronic chart review for the majority of new patients. Clinicians estimated spending a median (interquartile range (IQR)) of 15 (10-20) minutes for a typical case, and 25 (15-40) minutes for complex cases, with no difference across training levels. Chart review spans 3 or more years for two-thirds of clinicians, with the most relevant categories being imaging, laboratory studies, diagnostic studies, microbiology reports, and clinical notes, although most time is spent reviewing notes. Most clinicians (77%) worry about overlooking important information due to the volume of data (74%) and inadequate display/organization (63%). Potential solutions are chronologic ordering of disparate data types, color coding, and explicit data filtering techniques. The ability to dynamically customize information display for different users and varying clinical scenarios is paramount. Electronic chart review of historical data is an important, prevalent, and potentially time-consuming activity among medical ICU clinicians who would benefit from improved information display systems. Schattauer GmbH Stuttgart.

P08.13 Pattern of care and outcome in elderly glioblastoma patients: a multicenter retrospective study on 151 patientsi from 3 hospitals in Lombardia

PubMed Central

Silvani, A.; Rigamonti, A.; Imbesi, F.; Legnani, F.; Grimod, G.; Arienti, V.; Prone, V.; Soatti, C.; Fariselli, L.; Salmaggi, A.

2016-01-01

Abstract Pending the results of the 26062 EORTC trial, no standard of care exists for elderly patients with glioblastoma. Randomized controlled trials have provided evidence of a slight survival benefit for radiotherapy versus best supportive care (Keime-Guibert) and of lack of substantial benefit from single post-surgical treatment over each other. Treatment is still largely variable according to local practice. In this study we investigated the pattern of care and outcome in patients older than 65 diagnosed with glioblatoma in 3 hospitals in Lombardia and analyzed factors with impact on survival. 151 patients were included in this study, enrolled in Lecco Hospital, Niguarda Hospital and Neurooncology Unit of Fondazione IRCCS Istituto Neurologico Besta and undergoing surgery from 2004 to 2014. 91 were male, 60 female. Age range was 65 to 83, with a median value of 72. Concerning clinical variables, KPS was 70 or higher in 109 patients and lower in 42. 19 patients underwent biopsy, 14 partial resection and 118 total/subtotal resection as evaluated by the neurosurgeon. 114 patients were treated with radiotherapy and 97 with chemotherapy (all these 97 also received radiotherapy). 32 patients displayed seizures at disease onset. 22 patients did not receive antiepileptic treatment, while 129 were treated with antiepileptic drugs despite absence of seizures in 48. 40% of patients treated with antiepileptic drugs received enzyme-inducing drugs, 60% were treated with either VPA or levetiracetam. At disease progression, 22 patients received further treatment, including repeat surgery and/or second-line chemotherapy. In only 36 patients were molecular biology tests performed (IDH1 mutation). At univariate analysis, survival was longer in patients with higher KPS (p=0.02), those receiving partial/total surgery vs biopsy (p=0.03), those receiving total resection (p=0.003), those treated with radiotherapy (p<0.0001), chemotherapy (p<0.0001), those being treated at Istituto Besta (p=0.003). No signficant differences were detected in survival according to presence of seizures at onset or type of antiepipeptic treatment. At multivariate analysis, radiotherapy, surgery other than biopsy, and lack of antiepileptic treatment emerged as factors associated with longer survival, while age classes were not and KPS showed just a trend to prognostic value. Older patients with glioblastoma continue to be undertreated; fit elderly patients can receive multimodal therapy with benefit. Undue treatment with antiepileptic drugs (especially EIADS) may negatively impact on survival in this age group.

TRIM28 and β-Actin Identified via Nanobody-Based Reverse Proteomics Approach as Possible Human Glioblastoma Biomarkers

PubMed Central

Jovčevska, Ivana; Zupanec, Neja; Kočevar, Nina; Cesselli, Daniela; Podergajs, Neža; Stokin, Clara Limbaeck; Myers, Michael P.; Muyldermans, Serge; Ghassabeh, Gholamreza Hassanzadeh; Motaln, Helena; Ruaro, Maria Elisabetta; Bourkoula, Evgenia; Turnšek, Tamara Lah; Komel, Radovan

2014-01-01

Malignant gliomas are among the rarest brain tumours, and they have the worst prognosis. Grade IV astrocytoma, known as glioblastoma multiforme (GBM), is a highly lethal disease where the standard therapies of surgery, followed by radiation and chemotherapy, cannot significantly prolong the life expectancy of the patients. Tumour recurrence shows more aggressive form compared to the primary tumour, and results in patient survival from 12 to 15 months only. Although still controversial, the cancer stem cell hypothesis postulates that cancer stem cells are responsible for early relapse of the disease after surgical intervention due to their high resistance to therapy. Alternative strategies for GBM therapy are thus urgently needed. Nanobodies are single-domain antigen-binding fragments of heavy-chain antibodies, and together with classical antibodies, they are part of the camelid immune system. Nanobodies are small and stable, and they share a high degree of sequence identity to the human heavy chain variable domain, and these characteristics offer them advantages over classical antibodies or antibody fragments. We first immunised an alpaca with a human GBM stem-like cell line prepared from primary GBM cultures. Next, a nanobody library was constructed in a phage-display vector. Using nanobody phage-display technology, we selected specific GBM stem-like cell binders through a number of affinity selections, using whole cell protein extracts and membrane protein-enriched extracts from eight different GBM patients, and membrane protein-enriched extracts from two established GBM stem-like cell lines (NCH644 and NCH421K cells). After the enrichment, periplasmic extract ELISA was used to screen for specific clones. These nanobody clones were recloned into the pHEN6 vector, expressed in Escherichia coli WK6, and purified using immobilised metal affinity chromatography and size-exclusion chromatography. Specific nanobody:antigen pairs were obtained and mass spectrometry analysis revealed two proteins, TRIM28 and β-actin, that were up-regulated in the GBM stem-like cells compared to the controls. PMID:25419715

Two Japanese patients with Leigh syndrome caused by novel SURF1 mutations.

PubMed

Tanigawa, Junpei; Kaneko, Kaori; Honda, Masakazu; Harashima, Hiroko; Murayama, Kei; Wada, Takahito; Takano, Kyoko; Iai, Mizue; Yamashita, Sumimasa; Shimbo, Hiroko; Aida, Noriko; Ohtake, Akira; Osaka, Hitoshi

2012-11-01

We report two patients with Leigh syndrome that showed a combination of facial dysmorphism and MRI imaging indicating an SURF1 deficiency, which was confirmed by sequence analysis. Case 1 is a 3-year-old girl with failure to thrive and developmental delay. She presented with tachypnea at rest and displayed facial dysmorphism including frontal bossing, lateral displacement of inner canthi, esotropia, maxillary hypoplasia, slightly upturned nostril, and hypertrichosis dominant on the forehead and extremities. Case 2 is an 8-year-old boy with respiratory failure. He had been diagnosed as selective complex IV deficiency. Case 2 displayed facial dysmorphism and hypertrichosis. Since both patients displayed characteristic facial dysmorphism and MRI findings, we sequenced the SURF1 gene and identified two heterozygous mutations; c.49+1 G>T and c.752_753del in Case 1, and homozygous c.743 C>A in Case 2. For patients with Leigh syndrome showing these facial dysmorphism and hypertrichosis, sequence analysis of the SURF1 gene may be useful. Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Automated objective characterization of visual field defects in 3D

NASA Technical Reports Server (NTRS)

Fink, Wolfgang (Inventor)

2006-01-01

A method and apparatus for electronically performing a visual field test for a patient. A visual field test pattern is displayed to the patient on an electronic display device and the patient's responses to the visual field test pattern are recorded. A visual field representation is generated from the patient's responses. The visual field representation is then used as an input into a variety of automated diagnostic processes. In one process, the visual field representation is used to generate a statistical description of the rapidity of change of a patient's visual field at the boundary of a visual field defect. In another process, the area of a visual field defect is calculated using the visual field representation. In another process, the visual field representation is used to generate a statistical description of the volume of a patient's visual field defect.

Astigmatism at nearpoint: adventitious, purposeful, and environmental influences.

PubMed

Nicholson, S B; Garzia, R P

1988-12-01

Previous studies indicate that a number of individuals display significant differences between astigmatism measured at farpoint and nearpoint. Adventitious effects, purposeful lenticular changes and adaptations in response to environmental forces are reviewed as possible sources of this astigmatic variability.

Macrophages of multiple sclerosis patients display deficient SHP-1 expression and enhanced inflammatory phenotype.

PubMed

Christophi, George P; Panos, Michael; Hudson, Chad A; Christophi, Rebecca L; Gruber, Ross C; Mersich, Akos T; Blystone, Scott D; Jubelt, Burk; Massa, Paul T

2009-07-01

Recent studies in mice have demonstrated that the protein tyrosine phosphatase SHP-1 is a crucial negative regulator of proinflammatory cytokine signaling, TLR signaling, and inflammatory gene expression. Furthermore, mice genetically lacking SHP-1 (me/me) display a profound susceptibility to inflammatory CNS demyelination relative to wild-type mice. In particular, SHP-1 deficiency may act predominantly in inflammatory macrophages to increase CNS demyelination as SHP-1-deficient macrophages display coexpression of inflammatory effector molecules and increased demyelinating activity in me/me mice. Recently, we reported that PBMCs of multiple sclerosis (MS) patients have a deficiency in SHP-1 expression relative to normal control subjects indicating that SHP-1 deficiency may play a similar role in MS as to that seen in mice. Therefore, it became essential to examine the specific expression and function of SHP-1 in macrophages from MS patients. Herein, we document that macrophages of MS patients have deficient SHP-1 protein and mRNA expression relative to those of normal control subjects. To examine functional consequences of the lower SHP-1, the activation of STAT6, STAT1, and NF-kappaB was quantified and macrophages of MS patients showed increased activation of these transcription factors. In accordance with this observation, several STAT6-, STAT1-, and NF-kappaB-responsive genes that mediate inflammatory demyelination were increased in macrophages of MS patients following cytokine and TLR agonist stimulation. Supporting a direct role of SHP-1 deficiency in altered macrophage function, experimental depletion of SHP-1 in normal subject macrophages resulted in an increased STAT/NF-kappaB activation and increased inflammatory gene expression to levels seen in macrophages of MS patients. In conclusion, macrophages of MS patients display a deficiency of SHP-1 expression, heightened activation of STAT6, STAT1, and NF-kappaB and a corresponding inflammatory profile that may be important in controlling macrophage-mediated demyelination in MS.

An unsupervised classification method for inferring original case locations from low-resolution disease maps.

PubMed

Brownstein, John S; Cassa, Christopher A; Kohane, Isaac S; Mandl, Kenneth D

2006-12-08

Widespread availability of geographic information systems software has facilitated the use of disease mapping in academia, government and private sector. Maps that display the address of affected patients are often exchanged in public forums, and published in peer-reviewed journal articles. As previously reported, a search of figure legends in five major medical journals found 19 articles from 1994-2004 that identify over 19,000 patient addresses. In this report, a method is presented to evaluate whether patient privacy is being breached in the publication of low-resolution disease maps. To demonstrate the effect, a hypothetical low-resolution map of geocoded patient addresses was created and the accuracy with which patient addresses can be resolved is described. Through georeferencing and unsupervised classification of the original image, the method precisely re-identified 26% (144/550) of the patient addresses from a presentation quality map and 79% (432/550) from a publication quality map. For the presentation quality map, 99.8% of the addresses were within 70 meters (approximately one city block length) of the predicted patient location, 51.6% of addresses were identified within five buildings, 70.7% within ten buildings and 93% within twenty buildings. For the publication quality map, all addresses were within 14 meters and 11 buildings of the predicted patient location. This study demonstrates that lowering the resolution of a map displaying geocoded patient addresses does not sufficiently protect patient addresses from re-identification. Guidelines to protect patient privacy, including those of medical journals, should reflect policies that ensure privacy protection when spatial data are displayed or published.

Pain-related avoidance versus endurance in primary care patients with subacute back pain: psychological characteristics and outcome at a 6-month follow-up.

PubMed

Hasenbring, Monika I; Hallner, Dirk; Klasen, Bernhard; Streitlein-Böhme, Irmgard; Willburger, Roland; Rusche, Herbert

2012-01-01

Recent research has found individual differences in back pain patients due to behavioral avoidance vs persistence. However, there is a lack of prospective studies of nonspecific low back pain patients. The avoidance-endurance model (AEM) suggests at least 3 pathways leading to chronic pain: fear-avoidance response, distress-endurance response, and eustress-endurance response. We sought to compare these 3 maladaptive subgroups with an adaptive group using a classification tool that included the following scales: the thought suppression and behavioral endurance subscale of the Avoidance-Endurance Questionnaire and the Beck Depression Inventory. The psychological characteristics, and pain and disability of the AEM subgroups were investigated. We report results from 177 patients with subacute nonspecific low back pain at the start of outpatient treatment and at follow-up after 6 months. At baseline, a multivariate analysis of variance found that the fear-avoidance patients scored higher in pain catastrophizing than the other groups. The distress-endurance patients displayed elevated anxiety/depression and helplessness/hopelessness accompanied with the highest scores in the classification variables thought suppression and persistence behavior. The eustress-endurance patients had the highest humor/distraction scores, pain persistence, and positive mood despite pain. All 3 maladaptive groups revealed a higher pain intensity than the adaptive patients at follow-up after 6 months; however, disability at follow-up was elevated only in the fear-avoidance and distress-endurance patients. The study provides preliminary evidence for the construct and prospective validity of AEM-based subgroups of subacute, nonspecific back pain patients. The results suggest the need for individually targeted cognitive behavioral treatments in the maladaptive groups. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Impact of an Acceptance Facilitating Intervention on Patients' Acceptance of Internet-based Pain Interventions: A Randomized Controlled Trial.

PubMed

Baumeister, Harald; Seifferth, Holger; Lin, Jiaxi; Nowoczin, Lisa; Lüking, Marianne; Ebert, David

2015-06-01

Results from clinical trials indicate that Internet-based psychological pain interventions are effective in treating chronic pain. However, little is known about patients' acceptance of these programs and how to positively influence patients' intention to engage in them. Therefore, the present study aimed (1) to assess patients' acceptance of Internet-based interventions, and (2) to examine whether patients' acceptance can be increased by an acceptance facilitating intervention. A total of 104 patients with chronic pain from 2 pain units were randomly allocated to an intervention group (IG) and a no-intervention control group (CG). The IG was shown a short informational video about Internet-based psychological pain interventions before receiving a questionnaire on patients' acceptance of Internet-based psychological pain interventions and predictors of acceptance (performance expectancy, effort expectancy, social influence, facilitating conditions, Internet usage, and Internet anxiety). The CG filled out the questionnaire immediately. Patients' acceptance was measured with a 4-item scale (sum score ranging from 4 to 20). Baseline acceptance of Internet-based interventions was reported as low (sum-score:4-9) by 53.8%, moderate (10 to 15) by 42.3%, and high (16 to 20) by 3.9% of the patients with chronic pain in the CG. The IG showed a significantly higher acceptance (M = 12.17, SD = 4.22) than the CG (M = 8.94, SD = 3.71) with a standardized mean difference of d = 0.81 (95% CI, 0.41, 1.21). All predictor variables were significantly improved in the IG compared with the CG, except for Internet usage. Patients with chronic pain display a relatively low acceptance of Internet-based psychological pain interventions, which can be substantially increased by a short informational video.

ORFeome Phage Display.

PubMed

Zantow, Jonas; Moreira, Gustavo Marçal Schmidt Garcia; Dübel, Stefan; Hust, Michael

2018-01-01

ORFeome phage display allows the efficient functional screening of entire proteomes or even metaproteomes to identify immunogenic proteins. For this purpose, randomly fragmented, whole genomes or metagenomes are cloned into a phage-display vector allowing positive selection for open reading frames (ORF) to improve the library quality. These libraries display all possible proteins encoded by a pathogen or a microbiome on the phage surface. Consequently, immunogenic proteins can be selected from these libraries using disease-related immunoglobulins from patient serum. ORFeome phage display in particular allows the identification of immunogenic proteins that are only expressed in the host-pathogen interaction but not in cultivation, as well as the detection of very low expressed and very small immunogens and immunogenic proteins of non-cultivable organisms. The identified immunogenic proteins are potential biomarkers for the development of diagnostic assays or vaccines. These articles will give an introduction to ORFeome phage-display technology and give detailed protocols to identify immunogenic proteins by phage display.

Real-time, high frequency QRS electrocardiograph

NASA Technical Reports Server (NTRS)

Schlegel, Todd T. (Inventor); DePalma, Jude L. (Inventor); Moradi, Saeed (Inventor)

2006-01-01

Real time cardiac electrical data are received from a patient, manipulated to determine various useful aspects of the ECG signal, and displayed in real time in a useful form on a computer screen or monitor. The monitor displays the high frequency data from the QRS complex in units of microvolts, juxtaposed with a display of conventional ECG data in units of millivolts or microvolts. The high frequency data are analyzed for their root mean square (RMS) voltage values and the discrete RMS values and related parameters are displayed in real time. The high frequency data from the QRS complex are analyzed with imbedded algorithms to determine the presence or absence of reduced amplitude zones, referred to herein as RAZs. RAZs are displayed as go, no-go signals on the computer monitor. The RMS and related values of the high frequency components are displayed as time varying signals, and the presence or absence of RAZs may be similarly displayed over time.

Elevated plasma macrophage migration inhibitor factor as a risk factor for the development of post-stroke depression in ischemic stroke.

PubMed

Xu, Tingting; Pu, Shuang; Ni, Ying; Gao, Mingqing; Li, Xuemei; Zeng, Xianwei

2018-07-15

Macrophage migration inhibitory factor (MIF), a central cytokine of the innate immunity and inflammatory responses, has been reported to link to the pathophysiology of cardiovascular disease and depression. The aim of this study was to test the possible association between plasma MIF and the development of post-stroke depression (PSD) in Chinese patients with acute ischemic stroke (AIS). The first-ever AIS patients who were hospitalized at Affiliated Hospital of Weifang Medical College during the period from November 2015 to September 2017 were included. Neurological and neuropsychological evaluations were conducted at the 3-month follow-up. Plasma concentrations of MIF were tested by Quantikine Human MIF Immunoassay. Plasma levels of homocysteine (HCY), C-reactive protein (CRP) and Interleukin 6 (IL-6) were also tested. Results were expressed as percentages for categorical variables and as medians (Interquartile range-IQR) for the continuous variables. Finally, 333 stroke patients were included, and 95 out of those patients (28.5%) were classified as major depression. In the patients with major depression, plasma levels of MIF were higher compared with those in patients free-depression [27.3(IQR, 23.5-34.9) ng/ml vs. 20.9(IQR, 17.0-24.8) ng/ml; Z = 8.369, P < 0.001]. For each 1unit increase of MIF, the unadjusted and adjusted risk of PSD increased by 18% (odds ratios [OR]: 1.18; 95% confidence interval [CI], 1.13-1.23, P < 0.001) and 11% (1.11; 1.02-1.16, P = 0.001), respectively. In a multivariate model using the elevated levels of MIF (≥median) vs. normal (

Augmented virtuality for arthroscopic knee surgery.

PubMed

Li, John M; Bardana, Davide D; Stewart, A James

2011-01-01

This paper describes a computer system to visualize the location and alignment of an arthroscope using augmented virtuality. A 3D computer model of the patient's joint (from CT) is shown, along with a model of the tracked arthroscopic probe and the projection of the camera image onto the virtual joint. A user study, using plastic bones instead of live patients, was made to determine the effectiveness of this navigated display; the study showed that the navigated display improves target localization in novice residents.

Individual differences in the day-to-day variability of pain, fatigue, and well-being in patients with rheumatic disease: Associations with psychological variables

PubMed Central

Schneider, Stefan; Junghaenel, Doerte U.; Keefe, Francis J.; Schwartz, Joseph E.; Stone, Arthur A.; Broderick, Joan E.

2012-01-01

This paper examines day-to-day variability in rheumatology patients' ratings of pain and related quality-of-life variables as well as predictors of that variability. Data from two studies were used. The hypothesis was that greater psychological distress (i.e., depression and anxiety) and poorer coping appraisals (i.e., higher pain catastrophizing and lower self-efficacy) are associated with more variability. Electronic daily diary ratings were collected from 106 patients from a community rheumatology practice across 28 days (Study 1), and from 194 osteoarthritis patients across 7 days (Study 2). In multilevel modeling analyses, substantial day-to-day variability was evident for all variables in both studies, andindividual patients differed considerably and somewhat reliably in the magnitude of their variability. Higher levels of depression significantly predicted greater variability in pain, as well as in happiness and frustration (Study 1). Lower self-efficacy was associated with more variability in patients' daily satisfaction with accomplishments and in the quality of their day (Study 2). Greater pain catastrophizing and higher depression predicted more variability in interference with social relationships (Study 2). Anxiety was not significantly associated with day-to-day variability. The results of these studies suggest that individual differences in the magnitude of symptom fluctuation may play a vital role in understanding patients' adjustment to pain. Future research will be needed to examine the clinical utility of measuring variability in patients' pain and well being, and to understand whether reducing variability may be an important treatment target. PMID:22349917

What they say versus what we see: "hidden" distress and impaired quality of life in heart transplant recipients.

PubMed

Ross, Heather; Abbey, Susan; De Luca, Enza; Mauthner, Oliver; McKeever, Patricia; Shildrick, Margrit; Poole, Jennifer

2010-10-01

Quality of life (QoL) studies in heart transplant recipients generally rely on quantifiable self-report questionnaires and have shown that approximately 20% of patients undergo distress and poor QoL not clearly related to medical variables. Building on existing qualitative research, we used a phenomenologically informed audiovisual method to explore the nature of "distress" in heart transplant recipients. Focused open-ended interviews were conducted in non-clinical settings with 27 medically stable heart transplant recipients (70% male, mean age 53 ± 13 years, range 18 to 72 years; mean time since transplant 4.1 ± 2.4 years). Interviews were audio/videotaped and transcribed verbatim. A qualitative software program (NVIVO8) was used to code interview transcripts and videotaped bodily gestures and "expressive artifacts" as well as vocal tone and volume. Distress was displayed by 88% of patients during the interview, and 52% displayed a profound disjunct between the words they used to describe their quality of life (e.g., "wonderful") and their embodied expressions of the same (e.g., protective body posturing, distressed facial expression). Most also expressed significant distress when discussing issues such as the donor and their "gift of life," as well as a disrupted sense of bodily integrity and identity that they felt could only be appreciated by fellow heart recipients. Increased awareness of this distress and disruption related to bodily integrity and identity after heart transplant may allow transplant professionals and researchers to see beyond "words" to more effectively reduce distress and improve quality of life. Copyright © 2010 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.