A computerized decision support system for depression in primary care.

PubMed

Kurian, Benji T; Trivedi, Madhukar H; Grannemann, Bruce D; Claassen, Cynthia A; Daly, Ella J; Sunderajan, Prabha

2009-01-01

In 2004, results from The Texas Medication Algorithm Project (TMAP) showed better clinical outcomes for patients whose physicians adhered to a paper-and-pencil algorithm compared to patients who received standard clinical treatment for major depressive disorder (MDD). However, implementation of and fidelity to the treatment algorithm among various providers was observed to be inadequate. A computerized decision support system (CDSS) for the implementation of the TMAP algorithm for depression has since been developed to improve fidelity and adherence to the algorithm. This was a 2-group, parallel design, clinical trial (one patient group receiving MDD treatment from physicians using the CDSS and the other patient group receiving usual care) conducted at 2 separate primary care clinics in Texas from March 2005 through June 2006. Fifty-five patients with MDD (DSM-IV criteria) with no significant difference in disease characteristics were enrolled, 32 of whom were treated by physicians using CDSS and 23 were treated by physicians using usual care. The study's objective was to evaluate the feasibility and efficacy of implementing a CDSS to assist physicians acutely treating patients with MDD compared to usual care in primary care. Primary efficacy outcomes for depression symptom severity were based on the 17-item Hamilton Depression Rating Scale (HDRS(17)) evaluated by an independent rater. Patients treated by physicians employing CDSS had significantly greater symptom reduction, based on the HDRS(17), than patients treated with usual care (P < .001). The CDSS algorithm, utilizing measurement-based care, was superior to usual care for patients with MDD in primary care settings. Larger randomized controlled trials are needed to confirm these findings. clinicaltrials.gov Identifier: NCT00551083.

A Study to Evaluate the Organization and the Operating Procedures of the Patient Assistance Function at Brooke Army Medical Center, Fort Sam Houston, Texas

DTIC Science & Technology

1979-08-01

15 March 1979. 59Interview with Wendy L. Farace , Head Nurse, Obstetrics/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas, 8...6 February 1979. Farace , Wendy L. Head Nurse, Obstetrica/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas. Interview, 8 January

Veterans Affairs and Academic Medical Center Affiliations: The North Texas Experience

ERIC Educational Resources Information Center

Mohl, Paul Cecil; Hendrickse, William; Orsak, Catherine; Vermette, Heidi

2009-01-01

Objective: The authors review the more than 30-year history of the academic affiliation between the Department of Psychiatry at the University of Texas Southwestern Medical Center in Dallas and the Mental Health Service at the Veterans Affairs North Texas Health Care System. Methods: The authors interviewed individuals involved at various stages…

Preventing Exertional Death in Military Trainees: Recommendations and Treatment Algorithms From a Multidisciplinary Working Group.

PubMed

Webber, Bryant J; Casa, Douglas J; Beutler, Anthony I; Nye, Nathaniel S; Trueblood, Wesley E; O'Connor, Francis G

2016-04-01

Despite aggressive prevention programs and strategies, nontraumatic exertional sudden death events in military training continue to prove a difficult challenge for the Department of Defense. In November 2014, the 559th Medical Group at Joint Base San Antonio-Lackland, Texas, hosted a working group on sudden exertional death in military training. Their objectives were three-fold: (1) determine best practices to prevent sudden exertional death of military trainees, (2) determine best practices to establish safe and ethical training environments for military trainees with sickle cell trait, and (3) develop field-ready algorithms for managing military trainees who collapse during exertion. This article summarizes the major findings and recommendations of the working group. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

High performance 3D adaptive filtering for DSP based portable medical imaging systems

NASA Astrophysics Data System (ADS)

Bockenbach, Olivier; Ali, Murtaza; Wainwright, Ian; Nadeski, Mark

2015-03-01

Portable medical imaging devices have proven valuable for emergency medical services both in the field and hospital environments and are becoming more prevalent in clinical settings where the use of larger imaging machines is impractical. Despite their constraints on power, size and cost, portable imaging devices must still deliver high quality images. 3D adaptive filtering is one of the most advanced techniques aimed at noise reduction and feature enhancement, but is computationally very demanding and hence often cannot be run with sufficient performance on a portable platform. In recent years, advanced multicore digital signal processors (DSP) have been developed that attain high processing performance while maintaining low levels of power dissipation. These processors enable the implementation of complex algorithms on a portable platform. In this study, the performance of a 3D adaptive filtering algorithm on a DSP is investigated. The performance is assessed by filtering a volume of size 512x256x128 voxels sampled at a pace of 10 MVoxels/sec with an Ultrasound 3D probe. Relative performance and power is addressed between a reference PC (Quad Core CPU) and a TMS320C6678 DSP from Texas Instruments.

Looking to the Future: Health Professions Education in Texas.

ERIC Educational Resources Information Center

Rettig, Richard

This report analyzes how the Texas higher education system will meet the needs of future health care professionals. The report examines: (1) medical education needs (physician supply, physician distribution, medical schools' responses to physician distribution, and distribution of medical schools and regional academic health centers); (2) national…

Serum Antibody Biomarkers for ASD

DTIC Science & Technology

2014-10-01

INVESTIGATOR: Dwight German, Ph.D. CONTRACTING ORGANIZATION: Univ. of Texas Southwestern Medical Center Dallas TX 75390 REPORT DATE: October...2014 TYPE OF REPORT: Annual PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick...ADDRESS(ES) University of Texas Southwestern Medical School 8. PERFORMING ORGANIZATION REPORT NUMBER Dallas TX 75390 9

Serum Antibody Biomarkers for ASD

DTIC Science & Technology

2013-10-01

PRINCIPAL INVESTIGATOR: Dwight German, Ph.D. CONTRACTING ORGANIZATION: Univ of Texas Southwestern Medical Center, Dallas TX 75390...REPORT DATE: TYPE OF REPORT: Annual Report PREPARED FOR: U.S. Army Medical Research and Materiel Command...7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Univ. of Texas Southwestern Medical School, Dallas TX 75390 8. PERFORMING ORGANIZATION REPORT

The Integrative Studies of Genetic and Environmental Factors in Systemic Sclerosis

DTIC Science & Technology

2009-05-01

University of Texas Health Science Center Houston, Texas 77030-3900 REPORT DATE...May 2009 TYPE OF REPORT: Annual PREPARED FOR: U.S. Army Medical Research and Materiel Command... Texas Health Science Center Houston, Texas 77030-3900 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR

Texas two-step: a framework for optimal multi-input single-output deconvolution.

PubMed

Neelamani, Ramesh; Deffenbaugh, Max; Baraniuk, Richard G

2007-11-01

Multi-input single-output deconvolution (MISO-D) aims to extract a deblurred estimate of a target signal from several blurred and noisy observations. This paper develops a new two step framework--Texas Two-Step--to solve MISO-D problems with known blurs. Texas Two-Step first reduces the MISO-D problem to a related single-input single-output deconvolution (SISO-D) problem by invoking the concept of sufficient statistics (SSs) and then solves the simpler SISO-D problem using an appropriate technique. The two-step framework enables new MISO-D techniques (both optimal and suboptimal) based on the rich suite of existing SISO-D techniques. In fact, the properties of SSs imply that a MISO-D algorithm is mean-squared-error optimal if and only if it can be rearranged to conform to the Texas Two-Step framework. Using this insight, we construct new wavelet- and curvelet-based MISO-D algorithms with asymptotically optimal performance. Simulated and real data experiments verify that the framework is indeed effective.

A feasibility study for an emergency medical services system to serve the Permian basin in the state of Texas

NASA Technical Reports Server (NTRS)

1975-01-01

The development of an Emergency Medical Services System grant application for the Permian Basin Region of West Texas is described along with the application of NASA-developed technology. Conclusions and recommendations are included.

The Joint Admission Medical Program: a statewide approach to expanding medical education and career opportunities for disadvantaged students.

PubMed

Dalley, Bernell; Podawiltz, Alan; Castro, Robert; Fallon, Kathleen; Kott, Marylee; Rabek, Jeffrey; Richardson, James; Thomson, William; Ferry, Pamela; Mabry, Budge; Hermesmeyer, Paul; Smith, Quentin

2009-10-01

In 2003, Texas initiated an experiment to address enrollment disparities in its medical schools. With bipartisan support from key Texas legislators, funding was allocated in 2002 to establish the Joint Admission Medical Program (JAMP). Texas' then eight medical schools created, through JAMP, a partnership with the state's 31 public and 34 private undergraduate colleges and universities. Cognizant of legal prohibitions against reliance solely on race or ethnicity in promoting diversity, JAMP is designed to enhance opportunities for economically disadvantaged students from across the state, including those from (1) rural and remote areas of the state, and (2) institutions that have historically sent few students to medical school. Now in its seventh year of operation, JAMP is overseen by a council with representatives from all nine Texas medical schools. For the six years-2003 to 2008-for which data are available, indicators of JAMP performance can be seen in (1) the numbers of applicants to JAMP (1,230 applicants in the first six years), (2) levels of JAMP participation (480 participants), and (3) matriculation of JAMP participants into medical schools (164 of 288 of those accepted into the program in the years 2003-2006).The authors provide a brief history of JAMP, describe its structure and operation, summarize objective performance data, and identify some of the challenges still faced. These include increasing the participation of students from underrepresented minority groups within the legal structure for the program, and fostering substantive participation in JAMP by all of Texas' undergraduate institutions. A focused effort is under way to strengthen the evaluative aspects of JAMP so that more comprehensive data, including subjective evaluation data from participants, can be shared with colleagues in the future.

DOE Center of Excellence in Medical Laser Applications. Final report

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

Jacques, S.L.

1998-01-01

An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland, OR, Houston, TX, and Galveston, TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several newmore » video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulation of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.« less

DOE Center of Excellence in Medical Laser Applications. Final report, December 1, 1994--November 30, 1997

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

Jacques, S.L.

1998-01-01

An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland OR, Houston TX, and Galveston TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several newmore » video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulant of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.« less

Leading medical causes of mortality among male prisoners in Texas, 1992--2003.

PubMed

Harzke, Amy J; Baillargeon, Jacques G; Kelley, Michael F; Pruitt, Sandi L; Pulvino, John S; Paar, David P

2011-07-01

Data from the Texas prison system and the Texas Vital Statistics Bureau were used to identify and assess the leading medical causes of death from 1992 to 2003 among male prisoners in Texas (N = 4,026). The leading medical causes of death were infection, cancer, cardiovascular disease (CVD), liver disease, and respiratory disease. Of these, only cancer showed a significant average annual increase in crude death rates (2.5% [0.2% to 4.9%]). Among prisoners aged 55 to 84 years, crude average annual death rates due to cancer and CVD were high and substantially exceeded death rates due to other causes. Among prisoners aged 25 to 44 years, crude average annual death rates due to infection exceeded death rates due to other causes. Continued improvements in the prevention, screening, and treatment of these conditions are warranted in correctional health care settings.

CSHCN in Texas: meeting the need for specialist care.

PubMed

Young, M Cherilyn; Drayton, Vonna L C; Menon, Ramdas; Walker, Lesa R; Parker, Colleen M; Cooper, Sam B; Bultman, Linda L

2005-06-01

Assuring the sufficiency and suitability of systems of care and services for children with special health care needs (CSHCN) presents a challenge to Texas providers, agencies, and state Title V programs. To meet the need for specialist care, referrals from primary care doctors are often necessary. The objective of this study was to describe the factors associated with the need for specialist care and problems associated with obtaining referrals in Texas. Bivariate and multivariate analyses were performed using the National Survey of Children with Special Health Care Needs (NS-CSHCN) weighted sample for Texas (n = 719,014) to identify variables associated with the need for specialist care and problems obtaining referrals for specialist care. Medical need of the CSHCN and sensitivity to family values/customs was associated with greater need for specialist care, and Hispanic ethnicity and lower maternal education were associated with less need. Medical need, amount of time spent with doctors and sensitivity to values/customs, living in a large metropolitan statistical area, and lack of medical information were associated with problems obtaining a specialist care referral. Findings revealed some similarities and differences with meeting the need for specialist care when comparing Texas results to other studies. In Texas, aspects of customer satisfaction variables, especially doctors' sensitivity to family values/customs and parents' not receiving enough information on medical problems, were significantly associated with problems obtaining specialist referrals. Findings indicate a need to further research relationships and communication among doctors, CSHCN, and their families.

Evaluation of algorithms for estimating wheat acreage from multispectral scanner data. [Kansas and Texas

NASA Technical Reports Server (NTRS)

Nalepka, R. F. (Principal Investigator); Richardson, W.; Pentland, A. P.

1976-01-01

The author has identified the following significant results. Fourteen different classification algorithms were tested for their ability to estimate the proportion of wheat in an area. For some algorithms, accuracy of classification in field centers was observed. The data base consisted of ground truth and LANDSAT data from 55 sections (1 x 1 mile) from five LACIE intensive test sites in Kansas and Texas. Signatures obtained from training fields selected at random from the ground truth were generally representative of the data distribution patterns. LIMMIX, an algorithm that chooses a pure signature when the data point is close enough to a signature mean and otherwise chooses the best mixture of a pair of signatures, reduced the average absolute error to 6.1% and the bias to 1.0%. QRULE run with a null test achieved a similar reduction.

Computer Algorithms and Architectures for Three-Dimensional Eddy-Current Nondestructive Evaluation. Volume 3. Chapters 6-11

DTIC Science & Technology

1989-01-20

addressable memory can be loaded or off- loaded as the number crunching continues. Modem VLSI processors can often process data faster than today’s...Available DSP Chips Texas Instruments was one of the first serious manufacturers of DSP chips. With the Texas Instruments TMS310 DSP chip, modem , voice...Can handle double presicion data types. Texas Instruments TMS32010 T’s first-generation DSP design: a fixed-point DSP that has found its way into modem

Implementing practice guidelines: lessons from public mental health settings.

PubMed

Parks, Joseph J

2007-01-01

There is evidence that state-of-the-art psychiatric treatments are not being translated into community settings, resulting in the de facto denial of up-to-date psychiatric care for many Americans with mental illness. Although multiple models of evidence-based care exist, little is known about how to disseminate information regarding these models to clinicians in real-world practice. Suggested solutions have included the use of published practice guidelines, such as the American Psychiatric Association Practice Guidelines and the Expert Consensus Guidelines, or algorithm-based programs, such as the Texas Medication Algorithm Project. Unfortunately, the real-world utility of practice guidelines tends to be limited, because their implementation depends entirely on practitioner self-motivation. Similarly, the use of algorithm-based programs may be limited by their pervasive high specificity, practitioner resistance, and various patient misperceptions. Another solution is the implementation of evidence-based practices (EBPs), such as the Substance Abuse and Mental Health Services Administration (SAMHSA) EBPs. However, states' use of the SAMHSA EBPs has been hampered by misalignment of the funding structure, lack of information regarding EBPs, high costs to train and supervise staff, staff turnover, and a lack of resources. As a result, federal and clinical/professional agencies have called for a change in the nation's mental health care delivery system, supplying persuasive arguments for the economic and clinical superiority of integrated care models. One such model, the Missouri Medical Risk Management (MRM) Program for Medicaid Recipients with Schizophrenia, currently assists patients identified as being at high risk for adverse medical and behavioral outcomes. Preliminary results from the Missouri MRM Program are described.

Artificial Intelligence Project

DTIC Science & Technology

1990-01-01

Artifcial Intelligence Project at The University of Texas at Austin, University of Texas at Austin, Artificial Intelligence Laboratory AITR84-01. Novak...Texas at Austin, Artificial Intelligence Laboratory A187-52, April 1987. Novak, G. "GLISP: A Lisp-Based Programming System with Data Abstraction...of Texas at Austin, Artificial Intelligence Laboratory AITR85-14.) Rim, Hae-Chang, and Simmons, R. F. "Extracting Data Base Knowledge from Medical

The impact of tort reform and quality improvements on medical liability claims: a tale of 2 States.

PubMed

Illingworth, Kenneth D; Shaha, Steven H; Tzeng, Tony H; Sinha, Michael S; Saleh, Khaled J

2015-05-01

The purpose of this study was to determine the effect of tort reform and quality improvement measures on medical liability claims in 2 groups of hospitals within the same multihospital organization: one in Texas, which implemented medical liability tort reform caps on noneconomic damages in 2003, and one in Louisiana, which did not undergo significant tort reform during the same time period. Significant reduction in medical liability claims per quarter in Texas was found after tort reform implementation (7.27 to 1.4; P<.05). A significant correlation was found between the increase in mean Centers for Medicare & Medicaid Services performance score and the decrease in the frequency of claims observed in Louisiana (P<.05). Although tort reform caps on noneconomic damages in Texas caused the largest initial decrease, increasing quality improvement measures without increasing financial burden also decreased liability claims in Louisiana. Uniquely, this study showed that increasing patient quality resulted in decreased medical liability claims. © 2014 by the American College of Medical Quality.

Annual Progress Report of the Coastal Bend Migrant Council Health Project, San Patricio Migrant Health Center (Texas), 1973-1974.

ERIC Educational Resources Information Center

Coastal Bend Migrant Council, Mathis, TX. San Patricio Migrant Health Center.

The annual medical progress report covers migrant health services in San Patricio County, Texas, from February 1, 1973 to January 31, 1974. The report discusses: staff, administration, cardiology, dental services, health services, medical services, outreach and environmental health services, prescription services, registration and identification,…

A Model for Health Professional Education in South Texas

ERIC Educational Resources Information Center

Ramirez, Amelie; Vela, Leonel; Cigarroa, Francisco G.

2008-01-01

In 1997, The University of Texas Health Science Center at San Antonio established the Regional Academic Health Center (RAHC) for the Lower Rio Grande Valley in south Texas. Through medical education programs, research facilities, and partnerships with health-care providers, the RAHC aims to improve the health status and access to health services…

A Reference Handbook of the Texas Health Professions and their Support Personnel; The Health Professions in Texas.

ERIC Educational Resources Information Center

Texas Nurses Association.

The fields of dentistry, dietetics, medicine, medical technology, nursing, occupational therapy, pharmacy, physical therapy, and social work are defined in the handbook. The entrance requirements, educational institutions, and licensure regulations in Texas are treated for each major and allied support field. The functions or types of…

MO-E-BRD-01: Adapt-A-Thon - Texas Hold’em Invitational

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

Kessler, M; Brock, K; Pouliot, J

2014-06-15

Software tools for image-based adaptive radiotherapy such as deformable image registration, contour propagation and dose mapping have progressed beyond the research setting and are now commercial products available as part of both treatment planning systems and stand-alone applications. These software tools are used together to create clinical workflows to detect, track and evaluate changes in the patient and to accumulate dose. Deviations uncovered in this process are used to guide decisions about replanning/adaptation with the goal of keeping the delivery of prescribed dose “on target” throughout the entire course of radiotherapy. Since the output from one step of the adaptivemore » process is used as an input for another, it is essential to understand and document the uncertainty associated with each of the step and how these uncertainties are propagated. This in turn requires an understanding how the underlying tools work. Unfortunately, important details about the algorithms used to implement these tools are scarce or incomplete, too often for competitive reasons. This is in contrast to the situation involving other basic treatment planning algorithms such as dose calculations, where the medical physics community essentially requires vendors to provide physically important details about their underlying theory and clinical implementation. Vendors should adopt this same level of information sharing when it comes to the tools and techniques for image guided adaptive radiotherapy. The goal of this session is to start this process by inviting vendors and medical physicists to discuss and demonstrate the available tools and describe how they are intended to be used in clinical practice. The format of the session will involve a combination of formal presentations, interactive demonstrations, audience participation and some friendly “Texas style” competition. Learning Objectives: Understand the components of the image-based adaptive radiotherapy process. Understand the how these components are implemented in various commercial systems. Understand the different use cases and workflows currently supported these tools.« less

Development of a medical humanities and ethics certificate program in Texas.

PubMed

Erwin, Cheryl J

2014-12-01

Education in the medical humanities and ethics is an integral part of the formation of future physicians. This article reports on an innovative approach to incorporating the medical humanities and ethics into the four-year curriculum in a Certificate Program spanning all four years of the medical school experience. The faculty of the McGovern Center for Humanities and Ethics at the University of Texas Medical School at Houston conceived and implemented this program to teach medical students a range of scholarly topics in the medical humanities and to engage the full human experience into the process of becoming a physician. This study follows six years of experience, and we report student experiences and learning in their own words.

Measurement-based care for refractory depression: a clinical decision support model for clinical research and practice.

PubMed

Trivedi, Madhukar H; Daly, Ella J

2007-05-01

Despite years of antidepressant drug development and patient and provider education, suboptimal medication dosing and duration of exposure resulting in incomplete remission of symptoms remains the norm in the treatment of depression. Additionally, since no one treatment is effective for all patients, optimal implementation focusing on the measurement of symptoms, side effects, and function is essential to determine effective sequential treatment approaches. There is a need for a paradigm shift in how clinical decision making is incorporated into clinical practice and for a move away from the trial-and-error approach that currently determines the "next best" treatment. This paper describes how our experience with the Texas Medication Algorithm Project (TMAP) and the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial has confirmed the need for easy-to-use clinical support systems to ensure fidelity to guidelines. To further enhance guideline fidelity, we have developed an electronic decision support system that provides critical feedback and guidance at the point of patient care. We believe that a measurement-based care (MBC) approach is essential to any decision support system, allowing physicians to individualize and adapt decisions about patient care based on symptom progress, tolerability of medication, and dose optimization. We also believe that successful integration of sequential algorithms with MBC into real-world clinics will facilitate change that will endure and improve patient outcomes. Although we use major depression to illustrate our approach, the issues addressed are applicable to other chronic psychiatric conditions including comorbid depression and substance use disorder as well as other medical illnesses.

Measurement-Based Care for Refractory Depression: A Clinical Decision Support Model for Clinical Research and Practice

PubMed Central

Trivedi, Madhukar H.; Daly, Ella J.

2009-01-01

Despite years of antidepressant drug development and patient and provider education, suboptimal medication dosing and duration of exposure resulting in incomplete remission of symptoms remains the norm in the treatment of depression. Additionally, since no one treatment is effective for all patients, optimal implementation focusing on the measurement of symptoms, side effects, and function is essential to determine effective sequential treatment approaches. There is a need for a paradigm shift in how clinical decision making is incorporated into clinical practice and for a move away from the trial-and-error approach that currently determines the “next best” treatment. This paper describes how our experience with the Texas Medication Algorithm Project (TMAP) and the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial has confirmed the need for easy-to-use clinical support systems to ensure fidelity to guidelines. To further enhance guideline fidelity, we have developed an electronic decision support system that provides critical feedback and guidance at the point of patient care. We believe that a measurement-based care (MBC) approach is essential to any decision support system, allowing physicians to individualize and adapt decisions about patient care based on symptom progress, tolerability of medication, and dose optimization. We also believe that successful integration of sequential algorithms with MBC into real-world clinics will facilitate change that will endure and improve patient outcomes. Although we use major depression to illustrate our approach, the issues addressed are applicable to other chronic psychiatric conditions including comorbid depression and substance use disorder as well as other medical illnesses. PMID:17320312

Superhuman AI for heads-up no-limit poker: Libratus beats top professionals.

PubMed

Brown, Noam; Sandholm, Tuomas

2018-01-26

No-limit Texas hold'em is the most popular form of poker. Despite artificial intelligence (AI) successes in perfect-information games, the private information and massive game tree have made no-limit poker difficult to tackle. We present Libratus, an AI that, in a 120,000-hand competition, defeated four top human specialist professionals in heads-up no-limit Texas hold'em, the leading benchmark and long-standing challenge problem in imperfect-information game solving. Our game-theoretic approach features application-independent techniques: an algorithm for computing a blueprint for the overall strategy, an algorithm that fleshes out the details of the strategy for subgames that are reached during play, and a self-improver algorithm that fixes potential weaknesses that opponents have identified in the blueprint strategy. Copyright © 2018, The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Tort reform is associated with more medical board complaints and disciplinary actions.

PubMed

Stewart, Ronald M; Love, Joseph D; Rocheleau, Lisa A; Sirinek, Kenneth R

2012-04-01

Previous reports have confirmed that comprehensive tort reform in Texas (enacted in 2003) was associated with fewer lawsuits and less litigation-associated cost. We hypothesized that complaints to the Texas Medical Board (TMB) increased after tort reform. To test this hypothesis, we compared complaints, investigations, disciplinary actions, and penalties against physicians before and after comprehensive state tort reform measures were adopted. Data were obtained from the TMB for a 15-year period (1996 to 2010). When comparing the period before tort reform (1996 to 2002) with the period after tort reform (2004 to 2010), TMB complaints increased 13%; investigations opened increased 33%, disciplinary actions increased 96%, license revocations or surrenders increased 47%, and financial penalties increased 367%. All of these increases were statistically significant (p ≤ 0.01). After tort reform in Texas, the total number of complaints, investigations, disciplinary decisions, license revocations or surrenders, and financial penalties from the TMB significantly increased. In Texas, tort reform was accompanied by legislatively directed, enhanced oversight and activity of the authority (TMB) charged with regulation of the medical profession. Copyright © 2012. Published by Elsevier Inc.

Telemedicine: the slow revolution.

PubMed

Moncrief, Jack W

2014-01-01

The use of interactive video has been recognized as a means of delivering medical support to isolated areas since the 1950s. The Department of Defense recognized early the capacity of telemedicine to deliver medical care and support to front-line military personnel. In 1989, the Texas Telemedicine Project received grants and support from the then American Telephone and Telegraph Company (now AT&T) and the Meadows Foundation of Dallas, Texas, to establish and evaluate telemedicine delivery in central Texas. That project had 6 connected telemedicine sites: 3 in Austin, Texas, and 3 in Giddings, Texas (a small community 55 miles to the southeast of Austin). The sites in Giddings included a chronic outpatient dialysis facility, an inpatient psychiatric hospital, and the emergency department at Giddings Hospital. Patient contact began in April 1991 and continued through March 1993. During that period, data on the 1500 patient contacts made were recorded. After termination of the Texas Telemedicine Project, AT&T continued to provide the transmission lines, and between 1993 and 1996, another 12,000 patient contacts were made. Approximately 80% were dialysis evaluations and 20% were non-dialysis primary care contacts. The original cost of materials and equipment in the Texas Telemedicine Project exceeded $50,000 per site. Today, a secure Internet connection with full-motion video and wireless data transfer to almost any location in the world is achievable with an iPad. Multiple inexpensive applications with connections for electrocardiogram, otoscope, and stethoscope, among others, make this technology extremely inexpensive and user-friendly. The revolution now is rapidly moving forward, with Medicare reimbursing telemedicine contacts in medically underserved areas. Multiple bills are before Congress to expand Medicare and therefore private insurance payment for this service.

DLP-based 3D metrology by structured light or projected fringe technology for life sciences and industrial metrology

NASA Astrophysics Data System (ADS)

Frankowski, G.; Hainich, R.

2009-02-01

Since the mid-eighties, a fundamental idea for achieving measuring accuracy in projected fringe technology was to consider the projected fringe pattern as an interferogram and evaluate it on the basis of advanced algorithms widely used for phase measuring in real-time interferometry. A fundamental requirement for obtaining a sufficiently high degree of measuring accuracy with this so-called "phase measuring projected fringe technology" is that the projected fringes, analogous to interference fringes, must have a cos2-shaped intensity distribution. Until the mid-nineties, this requirement for the projected fringe pattern measurement technology presented a basic handicap for its wide application in 3D metrology. This situation changed abruptly, when in the nineties Texas Instruments introduced to the market advanced digital light projection on the basis of micro mirror based projection systems, socalled DLP technology, which also facilitated the generation and projection of cos2-shaped intensity and/or fringe patterns. With this DLP technology, which from its original approach was actually oriented towards completely different applications such as multimedia projection, Texas Instruments boosted phase-measuring fringe projection in optical 3D metrology to a worldwide breakthrough both for medical as well as industrial applications. A subject matter of the lecture will be to present the fundamental principles and the resulting advantages of optical 3D metrology based on phase-measuring fringe projection using DLP technology. Further will be presented and discussed applications of the measurement technology in medical engineering and industrial metrology.

Improving Learning of Markov Logic Networks using Transfer and Bottom-Up Induction

DTIC Science & Technology

2007-05-01

Texas at Austin Austin, TX 78712 lilyanam@cs.utexas.edu Doctoral Dissertation Proposal Supervising Professor: Raymond J. Mooney Abstract Statistical...maxima and plateaus. It is therefore an important research problem to develop learning algorithms that improve the speed and accuracy of this process. The...of Texas at Austin,Department of Computer Sciences,Austin,TX,78712 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S

Exploring e-readers to support clinical medical education: two case studies*†

PubMed Central

von Isenburg, Megan

2011-01-01

Question: Can e-readers loaded with medical textbooks and other relevant material benefit medical students, residents, and preceptors in clinical settings? Settings: The settings are North Carolina community clinics served by Duke University Medical Center and St. Joseph's Hospital in Bryan, Texas, and Scott and White Memorial Hospital in Temple, Texas. Methods: Duke University: Twenty second-year medical students and fourteen family medicine clerkship preceptors used Kindle e-readers in clinics during eight months of rotations. Students and preceptors provided feedback through an anonymous online survey. Texas A&M University: Nine fourth-year medical students in an elective compared medical textbooks in print, online, and on a Kindle. Six residents at a local hospital completed an anonymous online survey after a three-week loan of a Kindle loaded with medical textbooks. Results: The e-reader's major advantages in clinical settings are portability and searchability. The selected e-reader's limitations include connection speed, navigation, and display. User preferences varied, but online resources were preferred. Participants suggested additional uses for Kindles in medical education. Conclusions: The selected e-reader's limitations may be resolved with further development of the device. Investigation of other e-readers is needed. Criteria for evaluating e-readers in clinical settings should include portability, searchability, speed, navigation, and display. Research comparing e-readers and mobile devices in clinical education is also warranted. PMID:21464848

Early Detection of Peak Demand Days of Chronic Respiratory Diseases Emergency Department Visits Using Artificial Neural Networks.

PubMed

Khatri, Krishan L; Tamil, Lakshman S

2018-01-01

Chronic respiratory diseases, mainly asthma and chronic obstructive pulmonary disease (COPD), affect the lives of people by limiting their activities in various aspects. Overcrowding of hospital emergency departments (EDs) due to respiratory diseases in certain weather and environmental pollution conditions results in the degradation of quality of medical care, and even limits its availability. A useful tool for ED managers would be to forecast peak demand days so that they can take steps to improve the availability of medical care. In this paper, we developed an artificial neural network based classifier using multilayer perceptron with back propagation algorithm that predicts peak event (peak demand days) of patients with respiratory diseases, mainly asthma and COPD visiting EDs in Dallas County of Texas in the United States. The precision and recall for peak event class were 77.1% and 78.0%, respectively, and those for nonpeak events were 83.9% and 83.2%, respectively. The overall accuracy of the system is 81.0%.

Emergency Communications Console

NASA Technical Reports Server (NTRS)

1978-01-01

NASA has applied its communications equipment expertise to development of a communications console that provides, in a compact package only slightly larger than an electric typewriter, all the emergency medical services communications functions needed for a regional hospital. A prototype unit, built by Johnson Space Center, has been installed in the Odessa (Texas) Medical Center Hospital. The hospital is the medical control center for the 17-county Permian Basin Emergency Medical System in west Texas. The console project originated in response to a request to NASA from the Texas governor's office, which sought a better way of providing emergency medical care in rural areas. Because ambulance travel time is frequently long in remote areas of west Texas, it is important that treatment begin at the scene of the emergency rather than at the hospital emergency room. A radio and telephone system linking ambulance emergency technicians and hospital staff makes this possible. But earlier equipment was complex, requiring specialized operators. A highly reliable system was needed to minimize breakdowns and provide controls of utmost simplicity, so that the system could be operated by physicians and nurses rather than by communications specialists. The resulting console has both radio and telephone sections. With the radio equipment, hospital personnel can communicate with ambulance drivers and paramedics, receive incoming electrocardiagrams, consult with other hospitals, page hospital staff and set up a radio-to-telephone "patch." The telephone portion of the system includes a hotline from the Permian Basin Emergency Medical Service's resource control center, an automatic dialer for contacting special care facilities in the Permian Basin network, a hospital intercom terminal and a means of relaying cardioscope displays and other data between hospitals. The integrated system also provides links with local disaster and civil defense organizations and with emergency "Dial 911" control points.

Telepsychiatrists' Medication Treatment Strategies in the Children's Attention-Deficit/Hyperactivity Disorder Telemental Health Treatment Study

PubMed Central

Tse, Yuet Juhn; Fesinmeyer, Megan D.; Garcia, Jessica; Myers, Kathleen

2016-01-01

Abstract Objective: The purpose of this study was to examine the prescribing strategies that telepsychiatrists used to provide pharmacologic treatment in the Children's Attention-Deficit/Hyperactivity Disorder (ADHD) Telemental Health Treatment Study (CATTS). Methods: CATTS was a randomized controlled trial that demonstrated the superiority of a telehealth service delivery model for the treatment of ADHD with combined pharmacotherapy and behavior training (n=111), compared with management in primary care augmented with a telepsychiatry consultation (n=112). A diagnosis of ADHD was established with the Computerized Diagnostic Interview Schedule for Children (CDISC), and comorbidity for oppositional defiant disorder (ODD) and anxiety disorders (AD) was established using the CDISC and the Child Behavior Checklist. Telepsychiatrists used the Texas Children's Medication Algorithm Project (TCMAP) for ADHD to guide pharmacotherapy and the treat-to-target model to encourage their assertive medication management to a predetermined goal of 50% reduction in ADHD-related symptoms. We assessed whether telepsychiatrists' decision making about making medication changes was associated with baseline ADHD symptom severity, comorbidity, and attainment of the treat-to-target goal. Results: Telepsychiatrists showed high fidelity (91%) to their chosen algorithms in medication management. At the end of the trial, the CATTS intervention showed 46.0% attainment of the treat-to-target goal compared with 13.6% for the augmented primary care condition, and significantly greater attainment of the goal by comorbidity status for the ADHD with one and ADHD with two comorbidities groups. Telepsychiatrists' were more likely to decide to make medication adjustments for youth with higher baseline ADHD severity and the presence of disorders comorbid with ADHD. Multiple mixed methods regression analyses controlling for baseline ADHD severity and comorbidity status indicated that the telepsychiatrists also based their decision making session to session on attainment of the treat-to-target goal. Conclusions: Telepsychiatry is an effective service delivery model for providing pharmacotherapy for ADHD, and the CATTS telepsychiatrists showed high fidelity to evidence-based protocols. PMID:26258927

The Osler Student Societies of the University of Texas medical branch: a medical professionalism translational tool.

PubMed

Malloy, Michael H

2012-12-01

This essay reviews some of the issues associated with the challenge of integrating the concepts of medical professionalism into the socialization and identity formation of the undergraduate medical student. A narrative-based approach to the integration of professionalism in medical education proposed by Coulehan (Acad Med 80(10):892-898, 2005) offers an appealing method to accomplish the task in a less didactic format and in a way that promotes more personal growth. In this essay, I review how the Osler Student Societies of the University of Texas Medical Branch developed and how they offer a convenient vehicle to carry out this narrative-based approach to professionalism. Through mentor-modeled professional behavior, opportunities for student self-reflection, the development of narrative skills through reflection on great literature, and opportunities for community service, the Osler Student Societies provide a ready-made narrative-based approach to medical professionalism education.

Medical devices in dermatology using DLP technology from Texas Instruments

NASA Astrophysics Data System (ADS)

Kock, M.; Lüllau, F.

2012-03-01

The market of medical devices is growing continuously worldwide. With the DLP™ technology from Texas Instruments Lüllau Engineering GmbH in Germany has realized different applications in the medical discipline of dermatology. Especially a new digital phototherapy device named skintrek™ PT5 is revolutionizing the treatment of skin diseases like psoriasis , Vitiligo and other Eczema. The functions of the new phototherapy device can only be realized through DLP™ technology which is not only be used for the selective irradiation process. In combination with other optical systems DLP™ technology undertakes also other functionalities like 3D-topology calculation und patient movement compensation.

Improving patient outcomes by pooling resources (the Texas Heart Care Partnership experience).

PubMed

Hillert, B; Remonte, S; Rodgers, G; Yancy, C W; Kaul, A F

2000-02-10

The morbidity and mortality associated with cardiovascular disease presents an enormous humanistic and economic burden in the United States. In Texas, cardiovascular disease has been the leading cause of death since 1950. Risk-factor modification has been targeted in the secondary prevention of cardiovascular disease, including lipid management, smoking cessation, improved control of blood pressure, physical activity, weight management, the use of antiplatelet agents/anticoagulants, angiotensin-converting enzyme (ACE) inhibitors in congestive heart failure, beta blockers after myocardial infarction, and estrogen replacement therapy. The Heart Care Partnership (HCP) is a multifaceted interactive program designed to improve risk-factor management in the secondary prevention of cardiovascular disease through physician education, participation, and consensus development in addition to practice improvement processes and patient education. Development and implementation of the Texas HCP was a joint effort of the Texas Medical Association, the Texas Affiliate of the American Heart Association, and Merck & Co. This program helps hospitals improve the quality of care and outcomes for patients with heart disease. Program resources include educational workshops, quality improvement processes, and patient educational materials. HCP workshops address the treatment gap, define optimal care, and help define institution-specific plans for treating heart disease. Quality-improvement processes provide hospitals with baseline data and tools to improve and measure outcomes over time. The HCP workshops are provided as a combination of lectures, interactive discussions, and small group planning sessions designed to encourage audience participation. Upon completing the HCP program, participants are able to (1) describe the evidence-based medicine supporting secondary prevention of cardiovascular disease; (2) identify and prioritize cardiovascular disease risk factors for secondary prevention; (3) identify barriers to and solutions for implementing secondary prevention; and (4) develop site-based plans for cardiovascular risk-factor modification with definite time lines for implementation ("care maps"). The HCP's initial audit of medical practices indicates that Texas appears to share the same deficiencies in the secondary prevention of cardiovascular disease as the rest of the country. However, improvements can be demonstrated in both the hospital and physician office settings through the HCP. The HCP facilitated the cooperation of the medical community in the state of Texas to work together in a synchronized, communicative manner to decrease coronary events. This partnership represents a watershed event in the history of Texas medicine. It is the first time that such a statewide team approach to address a public health issue has been initiated. In the past, medical organizations within the state have had disparate goals and multiple strategies for achieving them.

Neurosurgical Defensive Medicine in Texas and Illinois: A Tale of 2 States.

PubMed

Cote, David J; Karhade, Aditya V; Larsen, Alexandra M G; Castlen, Joseph P; Smith, Timothy R

2016-05-01

To compare the self-reported liability characteristics and defensive medicine practices of neurosurgeons in Texas with neurosurgeons in Illinois in an effort to describe the effect of medicolegal environment on defensive behavior. An online survey was sent to 3344 members of the American Board of Neurological Surgery. Respondents were asked questions in 8 domains, and responses were compared between Illinois, the state with the highest reported average malpractice insurance premium, and Texas, a state with a relatively low average malpractice insurance premium. In Illinois, 85 of 146 (58.2%) neurosurgeons surveyed responded to the survey. In Texas, 65 of 265 (24.5%) neurosurgeons surveyed responded. In Illinois, neurosurgeons were more likely to rate the overall burden of liability insurance premiums to be an extreme/major burden (odds ratio [OR] = 7.398, P < 0.001) and to have >$2 million in total coverage (OR = 9.814, P < 0.001) than neurosurgeons from Texas. Annual malpractice insurance premiums in Illinois were more likely to be higher than $50,000 than in Texas (OR = 9.936, P < 0.001), and survey respondents from Illinois were more likely to believe that there is an ongoing medical liability crisis in the United States (OR = 9.505, P < 0.001). Neurosurgeons from Illinois were more likely to report that they very often/always order additional imaging (OR = 2.514, P = 0.011) or very often/always request additional consultations (OR = 2.385, P = 0.014) compared with neurosurgeons in Texas. Neurosurgeons in Illinois are more likely to believe that there is an ongoing medical liability crisis and more likely to practice defensively than neurosurgeons in Texas. Copyright © 2016 Elsevier Inc. All rights reserved.

Proof Checking the RSA (Rivest, Shamir and Adleman) Public Key Encryption Algorithm.

DTIC Science & Technology

1982-09-01

Pt- R136 626 PROOF CHECKING THE RSA (RIVEST SNAMIR AND ADLENRN) 1/i PUBLIC KEY ENCRYPTION.. (U) TEXAS UNIV AT AUSTIN INST FOR COMPUTING SCIENCE AND...Austin, Texas 78712 Ir t1 CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE - Software Systems Science Office of Naval Research September. 1982...properties are proved in [11. The third property is not proved; instead the authors of [li) argue that "all the obvious approaches to breaking our system are

Introduction and Mission Response Team (MRT)

NASA Technical Reports Server (NTRS)

Pool, Sam

2005-01-01

On February 1, 2003 the Space Shuttle Columbia, returning to Earth with a crew of seven astronauts, disintegrated along a track extending from California to Louisiana. Observers on the ground filmed breakup of the spacecraft. Debris fell along a 567 statute mile track from Littlefield, Texas to Fort Polk, Louisiana; the largest ever recorded debris field. At the time of the accident the National Aeronautics and Space Administration (NASA) flight surgeon on-duty at the Mission Control Center (MCC) in Houston, Texas initiated the medical contingency response. The DOD surgeon at Patrick Air Force Base was notified, NASA medical personnel were recalled and the services of Armed Forces Institute of Pathology (AFIP) were requested. Subsequent to the accident the NASA flight surgeons that had supported the crew on orbit now provided medical support to the crewmember s families. Federal Emergency Management Agency (FEMA), the National Transportation Safety Board (NTSB), the Federal Bureau of Investigation (FBI) and numerous other federal, state and local agencies along with the citizens of Texas and Louisiana responded to the disaster. Search and recovery was managed from a Disaster Field Office (DFO) established in Lufkin, Texas. Mishap Investigation Team (MIT) medical operations were managed from Barksdale Air Force Base, Louisiana. Accident investigation teams (Columbia Accident Investigation Task Force (CAITF) and Columbia Accident Investigation Board (CAIB)) appointed immediately after the disaster included current and former authorities in space medicine. In August 2003, the CAIB concluded its investigation and released its findings in a report published in February 2004.

Development of the Brief Bipolar Disorder Symptom Scale for patients with bipolar disorder.

PubMed

Dennehy, Ellen B; Suppes, Trisha; Crismon, M Lynn; Toprac, Marcia; Carmody, Thomas J; Rush, A John

2004-06-30

The Brief Bipolar Disorder Symptom Scale (BDSS) is a 10-item measure of symptom severity that was derived from the 24-item Brief Psychiatric Rating Scale (BPRS24). It was developed for clinical use in settings where systematic evaluation is desired within the constraints of a brief visit. The psychometric properties of the BDSS were evaluated in 409 adult outpatients recruited from 19 clinics within the public mental health system of Texas, as part of the Texas Medication Algorithm Project (TMAP). The selection process for individual items is discussed in detail, and was based on multiple analyses, including principal components analysis with varimax rotation. Selection of the final items considered the statistical strength and factor loading of items within each of those factors as well as the need for comprehensive coverage of critical symptoms of bipolar disorder. The BDSS demonstrated good psychometric properties in this preliminary investigation. It demonstrated a strong association with the BPRS24 and performed similarly to the BPRS24 in its relationship to other symptom measures. The BDSS demonstrated superior sensitivity to symptom change, and an excellent level of agreement for classification of patients as either responders or non-responders with the BPRS24. Copyright 2004 Elsevier Ireland Ltd.

Simulation of nonlinear propagation of biomedical ultrasound using PZFlex and the KZK Texas code

NASA Astrophysics Data System (ADS)

Qiao, Shan; Jackson, Edward; Coussios, Constantin-C.; Cleveland, Robin

2015-10-01

In biomedical ultrasound nonlinear acoustics can be important in both diagnostic and therapeutic applications and robust simulations tools are needed in the design process but also for day-to-day use such as treatment planning. For most biomedical application the ultrasound sources generate focused sound beams of finite amplitude. The KZK equation is a common model as it accounts for nonlinearity, absorption and paraxial diffraction and there are a number of solvers available, primarily developed by research groups. We compare the predictions of the KZK Texas code (a finite-difference time-domain algorithm) to an FEM-based commercial software, PZFlex. PZFlex solves the continuity equation and momentum conservation equation with a correction for nonlinearity in the equation of state incorporated using an incrementally linear, 2nd order accurate, explicit algorithm in time domain. Nonlinear ultrasound beams from two transducers driven at 1 MHz and 3.3 MHz respectively were simulated by both the KZK Texas code and PZFlex, and the pressure field was also measured by a fibre-optic hydrophone to validate the models. Further simulations were carried out a wide range of frequencies. The comparisons showed good agreement for the fundamental frequency for PZFlex, the KZK Texas code and the experiments. For the harmonic components, the KZK Texas code was in good agreement with measurements but PZFlex underestimated the amplitude: 32% for the 2nd harmonic and 66% for the 3rd harmonic. The underestimation of harmonics by PZFlex was more significant when the fundamental frequency increased. Furthermore non-physical oscillations in the axial profile of harmonics occurred in the PZFlex results when the amplitudes were relatively low. These results suggest that careful benchmarking of nonlinear simulations is important.

Simulation of nonlinear propagation of biomedical ultrasound using PZFlex and the KZK Texas code

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

Qiao, Shan, E-mail: shan.qiao@eng.ox.ac.uk; Jackson, Edward; Coussios, Constantin-C

In biomedical ultrasound nonlinear acoustics can be important in both diagnostic and therapeutic applications and robust simulations tools are needed in the design process but also for day-to-day use such as treatment planning. For most biomedical application the ultrasound sources generate focused sound beams of finite amplitude. The KZK equation is a common model as it accounts for nonlinearity, absorption and paraxial diffraction and there are a number of solvers available, primarily developed by research groups. We compare the predictions of the KZK Texas code (a finite-difference time-domain algorithm) to an FEM-based commercial software, PZFlex. PZFlex solves the continuity equationmore » and momentum conservation equation with a correction for nonlinearity in the equation of state incorporated using an incrementally linear, 2nd order accurate, explicit algorithm in time domain. Nonlinear ultrasound beams from two transducers driven at 1 MHz and 3.3 MHz respectively were simulated by both the KZK Texas code and PZFlex, and the pressure field was also measured by a fibre-optic hydrophone to validate the models. Further simulations were carried out a wide range of frequencies. The comparisons showed good agreement for the fundamental frequency for PZFlex, the KZK Texas code and the experiments. For the harmonic components, the KZK Texas code was in good agreement with measurements but PZFlex underestimated the amplitude: 32% for the 2nd harmonic and 66% for the 3rd harmonic. The underestimation of harmonics by PZFlex was more significant when the fundamental frequency increased. Furthermore non-physical oscillations in the axial profile of harmonics occurred in the PZFlex results when the amplitudes were relatively low. These results suggest that careful benchmarking of nonlinear simulations is important.« less

The Texas Plan to Combat Mental Retardation.

ERIC Educational Resources Information Center

Governor's Advisory Committee on Mental Retardation Planning, Austin, TX.

The Texas state plan of action against mental retardation is presented. Aspects considered include the evolution of the plan, the role of the health services, medical aspects of retardation, education and training, vocational rehabilitation and employment, and social welfare. Also surveyed are the following: residential and day care, manpower,…

Utilizing Machine Learning for Analysis of Tiara for Texas

NASA Astrophysics Data System (ADS)

van Slycke, Jacqueline; Christian, Greg, , Dr.

2017-09-01

The Tiara for Texas detector at Texas A&M University consists of a target chamber housing an array of silicon detectors and surrounded by four high purity germanium clovers that generate voltage pulses proportional to detected gamma ray energies. While some radiation is fully absorbed in one photopeak, others undergo Compton scattering between detectors. This process is thoroughly simulated in GEANT4. Machine learning with scikit-learn allows for the reconstruction of scattered photons to the original energy of the incident gamma ray. In a given simulation, a defined number of rays are emitted from the source. Each ray is marked as an event and its path is tracked. Scikit-learn uses the events' paths to train an algorithm, which recognizes which events should be summed to reconstruct the full gamma ray energy and additional events to test the algorithm. These predictions are not exact, but were analyzed to further understand any discrepancies and increase the effectiveness of the simulation. The results from this research project compare various machine learning techniques to determine which methods should be expanded on in the future. National Science Foundation Grant PHY-1659847 and United States Department of Energy Grant DE-FG02-93ER40773.

An Energy-Efficient Algorithm for Wearable Electrocardiogram Signal Processing in Ubiquitous Healthcare Applications

PubMed Central

Sodhro, Ali Hassan; Sodhro, Gul Hassan; Lohano, Sonia; Pirbhulal, Sandeep

2018-01-01

Rapid progress and emerging trends in miniaturized medical devices have enabled the un-obtrusive monitoring of physiological signals and daily activities of everyone’s life in a prominent and pervasive manner. Due to the power-constrained nature of conventional wearable sensor devices during ubiquitous sensing (US), energy-efficiency has become one of the highly demanding and debatable issues in healthcare. This paper develops a single chip-based wearable wireless electrocardiogram (ECG) monitoring system by adopting analog front end (AFE) chip model ADS1292R from Texas Instruments. The developed chip collects real-time ECG data with two adopted channels for continuous monitoring of human heart activity. Then, these two channels and the AFE are built into a right leg drive right leg drive (RLD) driver circuit with lead-off detection and medical graded test signal. Human ECG data was collected at 60 beats per minute (BPM) to 120 BPM with 60 Hz noise and considered throughout the experimental set-up. Moreover, notch filter (cutoff frequency 60 Hz), high-pass filter (cutoff frequency 0.67 Hz), and low-pass filter (cutoff frequency 100 Hz) with cut-off frequencies of 60 Hz, 0.67 Hz, and 100 Hz, respectively, were designed with bilinear transformation for rectifying the power-line noise and artifacts while extracting real-time ECG signals. Finally, a transmission power control-based energy-efficient (ETPC) algorithm is proposed, implemented on the hardware and then compared with the several conventional TPC methods. Experimental results reveal that our developed chip collects real-time ECG data efficiently, and the proposed ETPC algorithm achieves higher energy savings of 35.5% with a slightly larger packet loss ratio (PLR) as compared to conventional TPC (e.g., constant TPC, Gao’s, and Xiao’s methods). PMID:29558433

An Energy-Efficient Algorithm for Wearable Electrocardiogram Signal Processing in Ubiquitous Healthcare Applications.

PubMed

Sodhro, Ali Hassan; Sangaiah, Arun Kumar; Sodhro, Gul Hassan; Lohano, Sonia; Pirbhulal, Sandeep

2018-03-20

Rapid progress and emerging trends in miniaturized medical devices have enabled the un-obtrusive monitoring of physiological signals and daily activities of everyone's life in a prominent and pervasive manner. Due to the power-constrained nature of conventional wearable sensor devices during ubiquitous sensing (US), energy-efficiency has become one of the highly demanding and debatable issues in healthcare. This paper develops a single chip-based wearable wireless electrocardiogram (ECG) monitoring system by adopting analog front end (AFE) chip model ADS1292R from Texas Instruments. The developed chip collects real-time ECG data with two adopted channels for continuous monitoring of human heart activity. Then, these two channels and the AFE are built into a right leg drive right leg drive (RLD) driver circuit with lead-off detection and medical graded test signal. Human ECG data was collected at 60 beats per minute (BPM) to 120 BPM with 60 Hz noise and considered throughout the experimental set-up. Moreover, notch filter (cutoff frequency 60 Hz), high-pass filter (cutoff frequency 0.67 Hz), and low-pass filter (cutoff frequency 100 Hz) with cut-off frequencies of 60 Hz, 0.67 Hz, and 100 Hz, respectively, were designed with bilinear transformation for rectifying the power-line noise and artifacts while extracting real-time ECG signals. Finally, a transmission power control-based energy-efficient (ETPC) algorithm is proposed, implemented on the hardware and then compared with the several conventional TPC methods. Experimental results reveal that our developed chip collects real-time ECG data efficiently, and the proposed ETPC algorithm achieves higher energy savings of 35.5% with a slightly larger packet loss ratio (PLR) as compared to conventional TPC (e.g., constant TPC, Gao's, and Xiao's methods).

Rural Health Care in Texas: The Facts-1980.

ERIC Educational Resources Information Center

Arabzadegan, Lupe, Comp.; Walker, Mary, Comp.

Although rural Texas residents have some access to medical care, it is often limited by poverty, lack of health insurance or coverage under public programs, cultural barriers, racial discrimination, and limited education. It is inaccurate to say that rural residents receive health care if health is defined in terms of environmental, physical,…

Screening for mental illness: the merger of eugenics and the drug industry.

PubMed

Sharav, Vera Hassner

2005-01-01

The implementation of a recommendation by the President's New Freedom Commission (NFC) to screen the entire United States population--children first--for presumed, undetected, mental illness is an ill-conceived policy destined for disastrous consequences. The "pseudoscientific" methods used to screen for mental and behavioral abnormalities are a legacy from the discredited ideology of eugenics. Both eugenics and psychiatry suffer from a common philosophical fallacy that undermines the validity of their theories and prescriptions. Both are wed to a faith-based ideological assumption that mental and behavioral manifestations are biologically determined, and are, therefore, ameliorated by biological interventions. NFC promoted the Texas Medication Algorithm Project (TMAP) as a "model" medication treatment plan. The impact of TMAP is evident in the skyrocketing increase in psychotropic drug prescriptions for children and adults, and in the disproportionate expenditure for psychotropic drugs. The New Freedom Commission's screening for mental illness initiative is, therefore, but the first step toward prescribing drugs. The escalating expenditure for psychotropic drugs since TMAP leaves little doubt about who the beneficiaries of TMAP are. Screening for mental illness will increase their use.

A ’Multiple Pivoting’ Algorithm for Goal-Interval Programming Formulations.

DTIC Science & Technology

1980-03-01

jotso _P- ,- Research Report CCS 355 A "MULTIPLE PIVOTING" ALGORITHM FOR GOAL-INTERVAL PROGRAMMING FORMULATIONS by R. Armstrong* A. Charnes*W. Cook...J. Godfrey*** March 1980 *The University of Texas at Austin **York University, Downsview, Ontario, Canada ***Washington, DC This research was partly...areas. However, the main direction of goal programing research has been in formulating models instead of seeking procedures that would provide

Newly Recognized Pediatric Cases of Typhus Group Rickettsiosis, Houston, Texas, USA

PubMed Central

Erickson, Timothy; da Silva, Juliana; Nolan, Melissa S.; Marquez, Lucila; Munoz, Flor M.

2017-01-01

An increase in typhus group rickettsiosis and an expanding geographic range occurred in Texas, USA, over a decade. Because this illness commonly affects children, we retrospectively examined medical records from 2008–2016 at a large Houston-area pediatric hospital and identified 36 cases. The earliest known cases were diagnosed in 2011. PMID:29148369

Overweight and Perceived Health in Mexican American Children: A Pilot Study in a Central Texas Community

ERIC Educational Resources Information Center

Tyler, Diane O.

2004-01-01

This study assessed actual and perceived health status of overweight Mexican American clients at a central Texas school-based health center in a predominately Hispanic school district. It also explored the participants' interest in making lifestyle changes to promote a healthy weight. A medical records review indicated that of the Hispanic…

When "Promotoras" and Technology Meet: A Qualitative Analysis of "Promotoras'" Use of Small Media to Increase Cancer Screening among South Texas Latinos

ERIC Educational Resources Information Center

Arvey, Sarah R.; Fernandez, Maria E.; LaRue, Denise M.; Bartholomew, L. Kay

2012-01-01

Computer-based multimedia technologies can be used to tailor health messages, but "promotoras" (Spanish-speaking community health workers) rarely use these tools. "Promotoras" delivered health messages about colorectal cancer screening to medically underserved Latinos in South Texas using two small media formats: a…

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

Khosrow Behbehani

The goal of this project was to create state-of-the-art optical medical imaging laboratories for the Biomedical Engineering faculty and student researchers of the University of Texas at Arlington (UTA) on the campus of the University of Texas Southwestern Medical Center (UTSW). This has been successfully achieved. These laboratories provide an unprecedented opportunity for the bioengineers (from UTA) to bring about new breakthroughs in medical imaging using optics. Specifically, three major laboratories have been successfully established and state-of-the-art scientific instruments have been placed in the labs. As a result of this grant, numerous journal and conference publications have been generated, patentsmore » for new inventions have been filed and received, and many additional grants for the continuation of the research has been received.« less

University of Texas Southwestern Medical Center: High-Throughput siRNA Screening of a Non-Small Cell Lung Cancer (NSCLC) Cell Line Panel | Office of Cancer Genomics

Cancer.gov

The goal of this project is to use siRNA screens to identify NSCLC-selective siRNAs from two genome-wide libraries that will allow us to functionally define genetic dependencies of subtypes of NSCLC. Using bioinformatics tools, the CTD2 center at the University of Texas Southwestern Medical Center are discovering associations between this functional data (siRNAs) and NSCLC mutational status, methylation arrays, gene expression arrays, and copy number variation data that will help us identify new targets and enrollment biomarkers. 

University of Texas Southwestern Medical Center (UTSW): High-Throughput siRNA Screening of a Non-Small Cell Lung Cancer (NSCLC) Cell Line Panel | Office of Cancer Genomics

Cancer.gov

The goal of this project is to use siRNA screens to identify NSCLC-selective siRNAs from two genome-wide libraries that will allow us to functionally define genetic dependencies of subtypes of NSCLC. Using bioinformatics tools, the CTD2 center at the University of Texas Southwestern Medical Center are discovering associations between this functional data (siRNAs) and NSCLC mutational status, methylation arrays, gene expression arrays, and copy number variation data that will help us identify new targets and enrollment biomarkers. 

Medical review practices for driver licensing volume 2: case studies of medical referrals and licensing outcomes in Maine, Ohio, Oregon, Texas, Washington, and Wisconsin.

DOT National Transportation Integrated Search

2017-03-01

This is the second of three reports examining driver medical review practices in the United States and how : they fulfill the basic functions of identifying, assessing, and rendering licensing decisions on medically at-risk : drivers. This volume pre...

[The study of medical supplies automation replenishment algorithm in hospital on medical supplies supplying chain].

PubMed

Sheng, Xi

2012-07-01

The thesis aims to study the automation replenishment algorithm in hospital on medical supplies supplying chain. The mathematical model and algorithm of medical supplies automation replenishment are designed through referring to practical data form hospital on the basis of applying inventory theory, greedy algorithm and partition algorithm. The automation replenishment algorithm is proved to realize automatic calculation of the medical supplies distribution amount and optimize medical supplies distribution scheme. A conclusion could be arrived that the model and algorithm of inventory theory, if applied in medical supplies circulation field, could provide theoretical and technological support for realizing medical supplies automation replenishment of hospital on medical supplies supplying chain.

Commercial Tanning Bed Use as a Medical Therapy.

PubMed

Acosta, K Alexandra; Hunter-Ellul, Lindsey; Wilkerson, Michael G

2015-06-01

An anonymous 9-question survey was composed and distributed to members of the Texas Dermatological Society to evaluate dermatologists' prescription of commercial tanning beds for treatment of certain dermatologic and other medical conditions and to seek opinions on whether commercial tanning beds are a legitimate medical therapy. Results show that although dermatologists agree recreational tanning should always be discouraged, some Texas dermatologists do occasionally recommend commercial tanning bed use for some conditions in patients who cannot afford traditional in-office phototherapy because they lack insurance or have high copays or for those patients who live in regions with limited access to in-office phototherapy or have significant barriers to coming into the clinic. Conditions for which patients are referred to commercial tanning beds include psoriasis, renal prurigo, atopic dermatitis, and mycosis fungoides.

Lifting the veil.

PubMed

Sorrel, Amy Lynn

2014-07-01

As governments and employers look for ways to curb growing health care costs, and as patients bear a higher share of their medical bills, policymakers in Texas and beyond increasingly target physicians in their efforts to unveil health care prices. They couch such "price transparency" as a way to help patients make more informed health care decisions. But Texas Medical Association's Board of Trustees member Gary W. Floyd, MD, of Fort Worth, cautions that for a complex health care payment system, coupled with individual patients' complex needs, coming up with a so-called "sticker price" is not as simple as it seems.

Human exposures to tilmicosin reported to poison centres, Texas, 1998-2003.

PubMed

Forrester, Mathias B

2005-05-01

Tilmicosin, or 20-deoxo-20-(3,5-dimethylpiperidin-1-yl)-desmycosin, is a macrolide antibiotic primarily utilized in livestock. This study examined 46 human exposure calls involving tilmicosin received by Texas poison centres during 1998-2003. The majority (91%) of the calls were received from northern and central Texas. All of the cases were unintentional exposures. The most frequent route of exposure was parenteral (48%). The majority of the patients were males (80%) and adults (84%). Only 46% of the patients were managed outside of health care facilities. Some sort of adverse medical outcome was reported in 93% of parenteral exposures and 54% of other-route exposures. However, only 21% of parenteral exposures and 15% of other-route exposures involved medical outcomes that were judged to be moderate or worse. No deaths were reported. The most frequently reported clinical effects among parenteral cases were dermal (79%), while only 9% of other-route exposures had dermal effects. Cardiovascular clinical effects were observed in a single case of parenteral exposure and a single case of other-route exposure. Although the majority of cases were managed with the assistance of health care facilities, the medical outcomes were usually not serious. Outcome depended on the route of exposure.

Factors influencing the development of area health education centers with Texas-Mexico border populations.

PubMed

Fowkes, V K; Fowkes, W C; Walters, E G; Gamel, N

1990-12-01

Area Health Education Centers (AHECs) have been viewed as an appropriate vehicle for implementing new initiatives for training health professionals who will work along the U.S.-Mexico border. Perceptions about this program in Texas were evaluated from July 1988 to June 1989 to identify problems and formulate suggestions that might be of use to academic health science centers (HSCs)--and in particular medical schools--working with Hispanic populations. Interviews were conducted with 116 people: the presidents and/or deans of all eight Texas HSCs and/or medical schools, other deans and faculty, community leaders in five border counties, and state officials. The school and community perspectives about past and present AHEC activities were compared. Some of the barriers were: insufficient components of the health care delivery system to support medical education in severely underserved areas; differing school and community priorities; cultural differences between the school faculty and the community; and feeling among community physicians and dentists that AHECs were a source of competition. The school and community respondents agreed that the AHEC program needs more cooperative planning and training that emphasizes public health education for future AHEC-like activities with border populations.

Ear surgery - slideshow

MedlinePlus

... Otolaryngology – Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Related MedlinePlus Health Topics Ear Disorders ...

Facelift - slideshow

MedlinePlus

... Otolaryngology – Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Related MedlinePlus Health Topics Plastic and ...

An Exploratory Study of the Comprehension, Retention and Action of the Denton County Older Population in Regards to Disaster Preparedness Education

ERIC Educational Resources Information Center

Knight, Rebekah P.

2012-01-01

The purpose of this exploratory study was to operationalize the responses from a sample of the community dwelling older population from Denton County, Texas on disaster preparedness education given by Denton County Health Department (DCHD) personnel. The goals and objectives were drawn from the Texas Public Health and Medical Emergency Management…

Deadly distractions.

PubMed

Zuzek, Crystal

2013-04-01

In 2011, the National Transportation Safety Board urged all states to ban the use of portable electronic devices while driving, including hand-held and hands-free devices. Texting while driving concerns several Texas legislators, who have filed bills, backed by the Texas Medical Association, to ban the practice. TMA physicians recognize that the use of hand-held and hands-free devices and other factors associated with distracted driving affect their patients' safety.

Annual Medical Report of the Coastal Bend Migrant Council Health Project, San Patricio Migrant Health Center (Texas), 1973-1974.

ERIC Educational Resources Information Center

Krebethe, William F.

The primary goal of the migrant health project in San Patricio County, Texas was to establish out-patient family health care for migrant and seasonal farmworkers. Several accomplishments were made. By using a physician assistant, the clinic was able to add an additional work without the necessity of extending their hours. The dental services have…

Cosmonauts and astronauts during medical operations training

NASA Image and Video Library

1994-06-11

Cosmonaut Gennadiy M. Strekalov (right), Mir-18 flight engineer, is briefed on medical supplies by Ezra D. Kucharz, medical operations trainer for Krug Life Sciences, Incorporated. Strekalov and a number of other cosmonauts and astronauts participating in joint Russia - United States space missions are in Houston, Texas, to prepare for their upcoming missions.

A Study to Determine the Best Approach for Conducting a Formal Ambulatory Surgery Program at William Beaumont Army Medical Center, El Paso, Texas

DTIC Science & Technology

1982-05-01

and sex of the patient, but also scheduled time of surgery. It is not advisable to mix pre-operative and post-operative patients in the same area...Texas 79920 Haim4-=IC 18 January 1982 SUDJECT: pwequet for Surgical Workload Data 6. 1 certainly app-eciate your valuablOe sevice . 2 Incl HNRM C

Leishmaniasis in Texas: Isolation of Leishmania mexicana from Neotoma Micropus

DTIC Science & Technology

1990-01-01

leishmaniasis cases in Texas, 2) Lutzomyia anthophora, a sand fly which has transmitted Leishmania mexicana under laboratory conditions (Endris et al., 1984...Addis, 1945). Other vertebrates such as opossums, hispid cotton rats, and armadillos and other sand flies such as Lutzomyia diabolica and Lutzomyia texana...Leishmania mexicana by a North American sand fly, Lutzomyia anthophora (Diptera: Psychodidae). Journal of Medical Entomology 24: 243- 247. GRIMALDI, G. Jr

Oncogenic LINE 1 Retroelements Sustain Prostate Tumor Cells and Promote Metastatic Progression

DTIC Science & Technology

2016-12-01

Tillotson University in Austin , Texas and provides a summer research experience for them where they learn about prostate cancer research , as well as...PRINCIPAL INVESTIGATOR: Denise S. O’Keefe, Ph.D. CONTRACTING ORGANIZATION: UNIVERSITY OF TEXAS , San Antonio SAN ANTONIO TX 78229-3901 REPORT DATE...December 2016 TYPE OF REPORT: Final PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012

Family Studies of Sensorimotor and Neurocognitive Heterogeneity in Autism Spectrum Disorders (ASD)

DTIC Science & Technology

2013-09-01

Autism Spectrum Disorders (ASD) PRINCIPAL INVESTIGATOR: John Sweeney, Ph.D. CONTRACTING ORGANIZATION: University of Texas...in Autism Spectrum Disorders (ASD) 5b. GRANT NUMBER W81XWH-11-1-0738 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) John A. Sweeney, Ph.D.; Matthew W...Southwestern Medical Center Center for Autism and Developmental Disabilities 5323 Harry Hinds Boulevard, MC9086 Dallas, Texas 75390-9086

Methods for Functional Connectivity Analyses

DTIC Science & Technology

2012-12-13

motor , or hand motor function (green, red, or blue shading, respectively). Thus, this work produced the first comprehensive analysis of ECoG...Computer Engineering, University of Texas at El Paso , TX, USA 3Department of Neurology, Albany Medical College, Albany, NY, USA 4Department of Computer...Department of Health, Albany, NY, USA bDepartment of Electrical and Computer Engineering, University of Texas at El Paso , TX, USA cDepartment of Neurology

Global Surveillance of Emerging Influenza Virus Genotypes by Mass Spectrometry

DTIC Science & Technology

2007-05-30

Intercontinental circulation of human influenza A( H1N2 ) reassortant viruses during the 2001–2002 influenza season. J Infect Dis 186: 1490–1493. 6. Taubenberger...Global Surveillance of Emerging Influenza Virus Genotypes by Mass Spectrometry Rangarajan Sampath1*, Kevin L. Russell2, Christian Massire1, Mark W...Infections and Immunity, University of Texas Medical Branch, Galveston, Texas, United States of America Background. Effective influenza surveillance requires

Some queuing network models of computer systems

NASA Technical Reports Server (NTRS)

Herndon, E. S.

1980-01-01

Queuing network models of a computer system operating with a single workload type are presented. Program algorithms are adapted for use on the Texas Instruments SR-52 programmable calculator. By slightly altering the algorithm to process the G and H matrices row by row instead of column by column, six devices and an unlimited job/terminal population could be handled on the SR-52. Techniques are also introduced for handling a simple load dependent server and for studying interactive systems with fixed multiprogramming limits.

Cosmonauts and astronauts during medical operations training

NASA Image and Video Library

1994-06-11

Cosmonaut Alexandr F. Poleshchuk (right) inventories medical supplies with Ezra D. Kucharz, medical operations trainer for Krug Life Sciences, Incorporated. Poleshchuk, a Mir reserve crew member, and a number of other cosmonauts and astronauts participating in the joint Russia - United States program were in Houston, Texas, to prepare for upcoming missions which involve crew members from the two nations.

Addressing medical school diversity through an undergraduate partnership at Texas A&M Health Science Center: a blueprint for success.

PubMed

Parrish, Alan R; Daniels, Dennis E; Hester, R Kelly; Colenda, Christopher C

2008-05-01

Imperative to increasing diversity in the physician workforce is increasing the pool of qualified underrepresented minority applicants to medical schools. With this goal in mind, the Texas A&M Health Science Center College of Medicine (A&M College of Medicine) has partnered with Prairie View A&M University (PVAMU), a historically black college and university that is a component of the Texas A&M university system, to develop the undergraduate medical academy (UMA). The UMA was established by legislative mandate in 2003 and is a state-funded program. The authors describe the development of partnership between the A&M College of Medicine and PVAMU, focusing on the key attributes that have been identified for success. The administrative structure of the UMA ensures that the presidents of the two institutions collaborate to address issues of program oversight and facilitates a direct relationship between the dean and associate dean for academic affairs of A&M College of Medicine and the director of the UMA to define the program objectives and structure. The authors delineate the admission process to the UMA, as well as the academic requirements of the program. Students attend lecture series during the academic year and participate in summer programs on the A&M College of Medicine campus in addition to receiving intensive academic counseling and opportunities for tutoring in several subjects. The authors also describe the initial success in medical school admissions for UMA students. This partnership provides a model blueprint that can be adopted and adapted by other medical schools focused on increasing diversity in medicine.

Fuzzy logic applications to control engineering

NASA Astrophysics Data System (ADS)

Langari, Reza

1993-12-01

This paper presents the results of a project presently under way at Texas A&M which focuses on the use of fuzzy logic in integrated control of manufacturing systems. The specific problems investigated here include diagnosis of critical tool wear in machining of metals via a neuro-fuzzy algorithm, as well as compensation of friction in mechanical positioning systems via an adaptive fuzzy logic algorithm. The results indicate that fuzzy logic in conjunction with conventional algorithmic based approaches or neural nets can prove useful in dealing with the intricacies of control/monitoring of manufacturing systems and can potentially play an active role in multi-modal integrated control systems of the future.

The relationship between tort reform and medical utilization.

PubMed

Kavanagh, Kevin T; Calderon, Lindsay E; Saman, Daniel M

2014-12-01

The hidden cost of defensive medicine has been cited by policymakers as a significant driving force in the increase of our nation's health-care costs. If this hypothesis is correct, one would expect that states with higher levels of tort reform will have a decrease in Medicare utilization and that medical utilization will decrease after tort reform is enacted. State-level reimbursement data for years 1999 to 2010 (the last year available) was obtained from the Dartmouth Atlas of Health Care. Medical tort rankings for the 50 states were obtained from the Pacific Research Institute (PRI) and correlated with state medical utilization for the year 2010. In 3 states, Mississippi, Nevada, and Texas, data were available to make pretort and posttort reform comparisons. Data analysis between total state Medicare Reimbursements and the PRI's tort rankings showed no significant observed correlation. In 6 Medicare utilization categories (total Medicare, hospital and skilled nursing facility, physician, home health agency, hospice, and durable medical equipment), a negative trend was observed when correlated with PRI tort rankings. This trend does not support the hypothesis that defensive medicine is a major driver of health-care expenditures. Tracking expenditures in the states of Texas, Nevada, and Mississippi, before and after passage of comprehensive medical tort reform gave inconsistent results and did not demonstrate substantial or meaningful total Medicare savings. In Mississippi, there was a trend of decreased expenditures after medical tort reform was passed. However, in Texas, where 80% of the analyzed enrollees resided, there was a trend of progressive increasing expenditures after tort reform was passed. The comparison of the Dartmouth Atlas Medicare Reimbursement Data with Malpractice Reform State Rankings, which are used by the PRI, did not support the hypothesis that defensive medicine is a driver of rising health-care costs. Additionally, comparing Medicare reimbursements, premedical and postmedical tort reform, we found no consistent effect on health-care expenditures. Together, these data indicate that medical tort reform seems to have little to no effect on overall Medicare cost savings.

Innovations in Teaching on Aging: Integrative and Interactive Approaches.

ERIC Educational Resources Information Center

Timiras, Paola S.

1981-01-01

Presents summaries of current programs on aging and gerontology at these five institutions: University of Texas Health Science Center (San Antonio), Michigan State University (East Lansing), University of California (Berkeley), University of Colorado Medical Center (Denver), and University of Kentucky Medical Center (Lexington). (CS)

Data fusion and machine learning to identify threat vectors for the Zika virus and classify vulnerability

NASA Astrophysics Data System (ADS)

Gentle, J. N., Jr.; Kahn, A.; Pierce, S. A.; Wang, S.; Wade, C.; Moran, S.

2016-12-01

With the continued spread of the zika virus in the United States in both Florida and Virginia, increased public awareness, prevention and targeted prediction is necessary to effectively mitigate further infection and propagation of the virus throughout the human population. The goal of this project is to utilize publicly accessible data and HPC resources coupled with machine learning algorithms to identify potential threat vectors for the spread of the zika virus in Texas, the United States and globally by correlating available zika case data collected from incident reports in medical databases (e.g., CDC, Florida Department of Health) with known bodies of water in various earth science databases (e.g., USGS NAQWA Data, NASA ASTER Data, TWDB Data) and by using known mosquito population centers as a proxy for trends in population distribution (e.g., WHO, European CDC, Texas Data) while correlating historical trends in the spread of other mosquito borne diseases (e.g., chikungunya, malaria, dengue, yellow fever, west nile, etc.). The resulting analysis should refine the identification of the specific threat vectors for the spread of the virus which will correspondingly increase the effectiveness of the limited resources allocated towards combating the disease through better strategic implementation of defense measures. The minimal outcome of this research is a better understanding of the factors involved in the spread of the zika virus, with the greater potential to save additional lives through more effective resource utilization and public outreach.

Surface Energy Balance System for Estimating Daily Evapotranspiration Rates in the Texas High Plains

USDA-ARS?s Scientific Manuscript database

Numerous energy balance (EB) algorithms have been developed to use remote sensing data for mapping evapotranspiration (ET) on a regional basis. Adopting any single or a combination of these models for an operational ET remote sensing program requires thorough evaluation. The Surface Energy Balance S...

Returning Fourth-Year Students to the Classroom/Laboratory.

ERIC Educational Resources Information Center

Markert, Ronald J.; Ogilvie, Charles D.

1980-01-01

The Eighth Semester Program of the Texas College of Osteopathic Medicine reintroduces classroom-laboratory activities into the medical students' clinical years in an attempt to "round out" students' education. Topics include development of a medical practice, government and the physician, counseling skills, and nutrition inpatient care.…

Proportion of White-tailed deer using medicated bait sites in Southern Texas

USDA-ARS?s Scientific Manuscript database

Cattle fever ticks, Rhipicephalus (Boophilus) microplus and R. (B.) annulatus, have been found on white-tailed deer (Odocoileus virginianus) complicating eradication efforts of the USDA’s Cattle Fever Tick Eradication Program. Our objective was to assess patterns of deer visitation to medicated bait...

Proceedings of the World Congress on Medical Physics and Biomedical Engineering (San Antonio, Texas, August 6-12, 1988).

ERIC Educational Resources Information Center

Clark, John W., Ed.; And Others

1988-01-01

This document contains the proceedings of a joint meeting of the International Federation for Medical and Biological Engineering and the International Organization for Medical Physics. Participants from over 50 countries were in attendance. The theme of the program, "Challenges for the Year 2000," was a reminder of the challenges which confront…

Travels with Gates - May 3-4, 2007 - U.S. Department of Defense Official

Science.gov Websites

dozens of wounded warriors for their service and sacrifice during a visit to Brooke Army Medical Center with each servicemember, most times bedside, asking about their medical care, hometowns and future Staff Sgt. Randal C. Young at Brooke Army Medical Center on Fort Sam Houston, Texas, May 4, 2007. U.S

Telemedicine Program

NASA Technical Reports Server (NTRS)

1996-01-01

Since the 1970s, NASA has been involved in the research and demonstration of telemedicine for its potential in the care of astronauts in flight and Earth-bound applications. A combination of NASA funding, expertise and off-the-shelf computer and networking systems made telemedicine possible for a medically underserved hospital in Texas. Through two-way audio/video relay, the program links pediatric oncology specialists at the University of Texas Health Science Center in San Antonio to South Texas Hospital in Harlingen, providing easier access and better care to children with cancer. Additionally, the hospital is receiving teleclinics on pediatric oncology nursing, family counseling and tuberculosis treatment. VTEL Corporation, Sprint, and the Healthcare Open Systems and Trials Consortium also contributed staff and hardware.

Regional Estimates of Drought-Induced Tree Canopy Loss across Texas

NASA Astrophysics Data System (ADS)

Schwantes, A.; Swenson, J. J.; González-Roglich, M.; Johnson, D. M.; Domec, J. C.; Jackson, R. B.

2015-12-01

The severe drought of 2011 killed millions of trees across the state of Texas. Drought-induced tree-mortality can have significant impacts to carbon cycling, regional biophysics, and community composition. We quantified canopy cover loss across the state using remotely sensed imagery from before and after the drought at multiple scales. First, we classified ~200 orthophotos (1-m spatial resolution) from the National Agriculture Imagery Program, using a supervised maximum likelihood classification. Area of canopy cover loss in these classifications was highly correlated (R2 = 0.8) with ground estimates of canopy cover loss, measured in 74 plots across 15 different sites in Texas. These 1-m orthophoto classifications were then used to calibrate and validate coarser scale (30-m) Landsat imagery to create wall-to-wall tree canopy cover loss maps across the state of Texas. We quantified percent dead and live canopy within each pixel of Landsat to create continuous maps of dead and live tree cover, using two approaches: (1) a zero-inflated beta distribution model and (2) a random forest algorithm. Widespread canopy loss occurred across all the major natural systems of Texas, with the Edwards Plateau region most affected. In this region, on average, 10% of the forested area was lost due to the 2011 drought. We also identified climatic thresholds that controlled the spatial distribution of tree canopy loss across the state. However, surprisingly, there were many local hot spots of canopy loss, suggesting that not only climatic factors could explain the spatial patterns of canopy loss, but rather other factors related to soil, landscape, management, and stand density also likely played a role. As increases in extreme droughts are predicted to occur with climate change, it will become important to define methods that can detect associated drought-induced tree mortality across large regions. These maps could then be used (1) to quantify impacts to carbon cycling and regional biophysics, (2) to better understand the spatiotemporal dynamics of tree mortality, and (3) to calibrate and/or validate mortality algorithms in regional models.

University of Texas M.D. Anderson Cancer Center

MedlinePlus

... Clinical Trials Cancer Genomics Laboratory Cancer Prevention and ... Shot is revolutionizing the conventional medical research approach to rapidly translate findings into patient treatment options ...

Print campaign. Branding through print for Corpus Christi (TX) Medical Center.

PubMed

2007-01-01

Corpus Christi Medical Center, a 582-bed healthcare system consisting of four hospitals throughout south Texas, launched a print branding effort at the beginning of the year featuring its own doctors. The print ads promote several of the various service lines offered at the hospitals, including cardiac care.

Prime Contractors | Division of Cancer Prevention

Cancer.gov

2015-2018 Efficacy and Intermediate Endpoint Biomarkers: The Research Institute of Fox Chase Cancer Center SRI International IIT Research Institute University of Texas MD Anderson Cancer Center University of Alabama at Birmingham Medical College of Wisconsin University of Oklahoma Health Sciences Center Weill Medical College of Cornell University Toxicology and Pharmacology

White-tailed Deer Visitation Rates at Medicated Bait Sites in Southern Texas

USDA-ARS?s Scientific Manuscript database

The cattle fever tick, Rhipicephalus (Boophilus) microplus, has been found on white-tailed deer (Odocoileus virginianus) complicating eradication efforts of the USDA’s Cattle Fever Tick Eradication Program. Our objective was to assess patterns of deer visitation to medicated bait sites used to treat...

Treatment-Based Classification versus Usual Care for Management of Low Back Pain

DTIC Science & Technology

2014-08-01

Doctoral Fellowship in Orthopaedic Manual Physical Therapy , San Antonio Military Medical Center, Fort Sam Hous- ton, Texas. N.W. Gill, PT, DSc, OCS, FAAOMPT...US Army–Baylor Uni- versity Doctor of Physical Therapy Program, Fort Sam Houston, Texas. [Rhon DI, Deyle GD, Gill NW. Clin- ical reasoning and...1234–1243.] © 2013 American Physical Therapy Association Published Ahead of Print: February 7, 2013 Accepted: February 4, 2013 Submitted: March 30, 2012

Methodology of quality improvement projects for the Texas Medicare population.

PubMed

Pendergrass, P W; Abel, R L; Bing, M; Vaughn, R; McCauley, C

1998-07-01

The Texas Medical Foundation, the quality improvement organization for the state of Texas, develops local quality improvement projects for the Medicare population. These projects are developed as part of the Health Care Quality Improvement Program undertaken by the Health Care Financing Administration. The goal of a local quality improvement project is to collaborate with providers to identify and reduce the incidence of unintentional variations in the delivery of care that negatively impact outcomes. Two factors are critical to the success of a quality improvement project. First, as opposed to peer review that is based on implicit criteria, quality improvement must be based on explicit criteria. These criteria represent key steps in the delivery of care that have been shown to improve outcomes for a specific disease. Second, quality improvement must be performed in partnership with the health care community. As such, the health care community must play an integral role in the design and evaluation of a quality improvement project and in the design and implementation of the resulting quality improvement plan. Specifically, this article provides a historical perspective for the transition from peer review to quality improvement. It discusses key steps used in developing and implementing local quality improvement projects including topic selection, quality indicator development, collaborator recruitment, and measurement of performance/improvement. Two Texas Medical Foundation projects are described to highlight the current methodology and to illustrate the impact of quality improvement projects.

Three-dimensional representations of salt-dome margins at four active strategic petroleum reserve sites.

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

Rautman, Christopher Arthur; Stein, Joshua S.

2003-01-01

Existing paper-based site characterization models of salt domes at the four active U.S. Strategic Petroleum Reserve sites have been converted to digital format and visualized using modern computer software. The four sites are the Bayou Choctaw dome in Iberville Parish, Louisiana; the Big Hill dome in Jefferson County, Texas; the Bryan Mound dome in Brazoria County, Texas; and the West Hackberry dome in Cameron Parish, Louisiana. A new modeling algorithm has been developed to overcome limitations of many standard geological modeling software packages in order to deal with structurally overhanging salt margins that are typical of many salt domes. Thismore » algorithm, and the implementing computer program, make use of the existing interpretive modeling conducted manually using professional geological judgement and presented in two dimensions in the original site characterization reports as structure contour maps on the top of salt. The algorithm makes use of concepts of finite-element meshes of general engineering usage. Although the specific implementation of the algorithm described in this report and the resulting output files are tailored to the modeling and visualization software used to construct the figures contained herein, the algorithm itself is generic and other implementations and output formats are possible. The graphical visualizations of the salt domes at the four Strategic Petroleum Reserve sites are believed to be major improvements over the previously available two-dimensional representations of the domes via conventional geologic drawings (cross sections and contour maps). Additionally, the numerical mesh files produced by this modeling activity are available for import into and display by other software routines. The mesh data are not explicitly tabulated in this report; however an electronic version in simple ASCII format is included on a PC-based compact disk.« less

Validation of an association rule mining-based method to infer associations between medications and problems.

PubMed

Wright, A; McCoy, A; Henkin, S; Flaherty, M; Sittig, D

2013-01-01

In a prior study, we developed methods for automatically identifying associations between medications and problems using association rule mining on a large clinical data warehouse and validated these methods at a single site which used a self-developed electronic health record. To demonstrate the generalizability of these methods by validating them at an external site. We received data on medications and problems for 263,597 patients from the University of Texas Health Science Center at Houston Faculty Practice, an ambulatory practice that uses the Allscripts Enterprise commercial electronic health record product. We then conducted association rule mining to identify associated pairs of medications and problems and characterized these associations with five measures of interestingness: support, confidence, chi-square, interest and conviction and compared the top-ranked pairs to a gold standard. 25,088 medication-problem pairs were identified that exceeded our confidence and support thresholds. An analysis of the top 500 pairs according to each measure of interestingness showed a high degree of accuracy for highly-ranked pairs. The same technique was successfully employed at the University of Texas and accuracy was comparable to our previous results. Top associations included many medications that are highly specific for a particular problem as well as a large number of common, accurate medication-problem pairs that reflect practice patterns.

Increasing the Accessibility of Sexual Assault Forensic Examinations: Evaluation of Texas Law SB 1191.

PubMed

Davis, Robert C; Auchter, Bernard; Howley, Susan; Camp, Torie; Knecht, Ilse; Wells, William

Texas SB 1191 was enacted in 2013 with the intent of increasing access to medical forensic examinations for sexual assault victims by requiring every hospital with an emergency department to be prepared to provide a medical forensic examination if requested by a sexual assault victim. To realize that goal, the law also required basic forensic training for medical professionals before conducting a medical forensic examination as well as a requirement that hospitals develop a "plan to train personnel on sexual assault forensic evidence collection." Interviews were conducted in 18 healthcare facilities (five with sexual assault nurse examiner [SANE] programs and 13 without SANE programs) in Dallas, Lubbock, and Austin to determine their awareness and compliance with SB 1191. The data suggest that the law had a little effect on actual practice, and sexual assault survivors still sought a SANE program for a medical forensic examination. Although SB 1191 is an important state level effort to make forensic examinations more readily available, it did not fully account for the challenges faced by smaller hospitals that do not see enough sexual assault victims to justify training staff to SANE standards and did not adequately address the training required by medical professionals to feel prepared to conduct a medical forensic examination.

Racial Diversity in the Medical Profession: The Impact of Affirmative Action Bans on Underrepresented Student of Color Matriculation in Medical Schools

ERIC Educational Resources Information Center

Garces, Liliana M.; Mickey-Pabello, David

2015-01-01

This study examines the impact of affirmative action bans in six states (California, Washington, Florida, Texas, Michigan, and Nebraska) on the matriculation rates of historically underrepresented students of color in public medical schools in these states. Findings show that affirmative action bans have led to about a 17% decline (from 18.5% to…

A Simple Algorithm for Obtaining Nearly Optimal Quadrature Rules for NURBS-based Isogeometric Analysis

DTIC Science & Technology

2012-01-05

Università degli Studi di Pavia bIstituto di Matematica Applicata e Tecnologie Informatiche “E. Magenes” del CNR, Pavia cDAEIMI, Università degli Studi di...Cassino d Institute for Computational Engineering and Sciences, University of Texas at Austin eDipartimento di Matematica , Università degli Studi di

Some practical aspects of prestack waveform inversion using a genetic algorithm: An example from the east Texas Woodbine gas sand

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

Mallick, S.

1999-03-01

In this paper, a prestack inversion method using a genetic algorithm (GA) is presented, and issues relating to the implementation of prestack GA inversion in practice are discussed. GA is a Monte-Carlo type inversion, using a natural analogy to the biological evolution process. When GA is cast into a Bayesian framework, a priori information of the model parameters and the physics of the forward problem are used to compute synthetic data. These synthetic data can then be matched with observations to obtain approximate estimates of the marginal a posteriori probability density (PPD) functions in the model space. Plots of thesemore » PPD functions allow an interpreter to choose models which best describe the specific geologic setting and lead to an accurate prediction of seismic lithology. Poststack inversion and prestack GA inversion were applied to a Woodbine gas sand data set from East Texas. A comparison of prestack inversion with poststack inversion demonstrates that prestack inversion shows detailed stratigraphic features of the subsurface which are not visible on the poststack inversion.« less

Comparing the financial condition of Texas hospitals using a novel definition for the safety net.

PubMed

Stauffer, Brett D; Amarasingham, Ruben; Pickens, Sue; Anderson, Ron J

2008-08-01

Lack of health insurance is more prevalent in the state of Texas than in the rest of the country. To get necessary medical care, uninsured Texans must rely on safety net hospitals. Economic turmoil and fluctuating public support routinely threaten the financial stability of these hospitals. Safety net hospitals must be identified to craft public policy solutions that ensure their viability. In this paper, we propose a new method to identify these hospitals by incorporating criteria established previously by economists with additional measures of community value. Our data indicate that safety net hospitals continue to face financial challenges. Texas will need to move forward along several policy fronts to preserve this vital system of care.

University of Texas Southwestern Medical Center: U01 Natural Products Screening | Office of Cancer Genomics

Cancer.gov

The goal of this project was to enlarge the chemical space probed by Project 1 (High-Throughput siRNA Screening of a Non-Small Cell Lung Cancer Cell Line Panel) by screening an expanded natural products library (~40,000) in an effort to further define vulnerabilities and therapeutic targets in non-small cell lung cancer. This new library is derived from a diverse collection of marine bacteria (prepared by Dr. John MacMillan, University of Texas Southwestern).

University of Texas Southwestern Medical Center (UTSW): U01 Natural Products Screening | Office of Cancer Genomics

Cancer.gov

The goal of this project was to enlarge the chemical space probed by Project 1 (High-Throughput siRNA Screening of a Non-Small Cell Lung Cancer Cell Line Panel) by screening an expanded natural products library (~40,000) in an effort to further define vulnerabilities and therapeutic targets in non-small cell lung cancer. This new library is derived from a diverse collection of marine bacteria (prepared by Dr. John MacMillan, University of Texas Southwestern).

Medical Surveillance Monthly Report (MSMR). Volume 7, Number 7, August 2001

DTIC Science & Technology

2001-08-01

to 1995. The highest numbers of deaths were in Florida and Texas, while the highest rates were in New Mexico , Arizona, Arkansas, and Mississippi4...Hepatitis B Varicella 2. Events reported by August 7, 2000 and 2001. Shigella Sentinel reportable events for all beneficiaries1at US Army medical

Comparison of Two Educational Strategies in Teaching Preventive Cardiology.

ERIC Educational Resources Information Center

Stroup-Benham, Christine A.; And Others

This study assessed the impact of two educational strategies: text only versus text plus small group discussion, among two groups of third-year internal medicine clerkship students in a preventive cardiology course. The course was a required, 12-week Internal Medical clerkship at the University of Texas Medical Branch. The first group reviewed…

Prevalence of nontyphoidal Salmonella and Salmonella strains with conjugative antimicrobial-resistant serovars contaminating animal feed in Texas

USDA-ARS?s Scientific Manuscript database

The objective of this study was to characterize 365 nontyphoidal Salmonella enterica isolates from animal feed. Among the 365 isolates, 78 serovars were identified. Twenty-four isolates (7.0%) were recovered from three of six medicated feed types. Three of these isolates derived from the medicate...

Instruction in Renal Physiology on a Minicomputer-Based Educational System.

ERIC Educational Resources Information Center

Wells, C. H.; And Others

A prototypical minicomputer-based educational system was designed at the University of Texas Medical Branch to determine if it is possible to evolve complex educational programs which are effective and also flexible and of low cost. Freshman medical students using the minicomputer program substantially improved their problem-solving abilities in…

University of Texas Medical Branch telemedicine disaster response and recovery: lessons learned from hurricane Ike.

PubMed

Vo, Alexander H; Brooks, George B; Bourdeau, Michael; Farr, Ralph; Raimer, Ben G

2010-06-01

Despite previous efforts and expenditure of tremendous resources on creating and simulating disaster response scenarios, true disaster response, specifically for healthcare, has been inadequate. In addition, none of the >200 local and statewide telemedicine programs in the United States has ever responded to a large-scale disaster, let alone, experienced one directly. Based on its experience with hurricanes Rita and, most recently, Ike, the University of Texas Medical Branch (UTMB) experienced its most challenging trials. Although there were significant disruptions to a majority of UTMB's physical and operational infrastructures, its telemedicine services were able to resume near normal activities within the first week of the post-Ike recovery period, an unimaginable feat in the face of such remarkable devastation. This was primarily due in part to the flexibility of its data network, the rapid response, and plasticity of its telemedicine program. UTMB's experiences in providing rapid and effective medical services in the face of such a disaster offer valuable lessons for local, state, and national disaster preparations, policy, and remote medical delivery models and programs.

Development of a computerized assessment of clinician adherence to a treatment guideline for patients with bipolar disorder.

PubMed

Dennehy, Ellen B; Suppes, Trisha; John Rush, A; Lynn Crismon, M; Witte, B; Webster, J

2004-01-01

The adoption of treatment guidelines for complex psychiatric illness is increasing. Treatment decisions in psychiatry depend on a number of variables, including severity of symptoms, past treatment history, patient preferences, medication tolerability, and clinical response. While patient outcomes may be improved by the use of treatment guidelines, there is no agreed upon standard by which to assess the degree to which clinician behavior corresponds to those recommendations. This report presents a method to assess clinician adherence to the complex multidimensional treatment guideline for bipolar disorder utilized in the Texas Medication Algorithm Project. The steps involved in the development of this system are presented, including the reliance on standardized documentation, defining core variables of interest, selecting criteria for operationalization of those variables, and computerization of the assessment of adherence. The computerized assessment represents an improvement over other assessment methods, which have relied on laborious and costly chart reviews to extract clinical information and to analyze provider behavior. However, it is limited by the specificity of decisions that guided the adherence scoring process. Preliminary findings using this system with 2035 clinical visits conducted for the bipolar disorder module of TMAP Phase 3 are presented. These data indicate that this system of guideline adherence monitoring is feasible.

Attitudes Toward Medications and the Relationship to Outcomes in Patients with Schizophrenia.

PubMed

Campbell, Angela H; Scalo, Julieta F; Crismon, M Lynn; Barner, Jamie C; Argo, Tami R; Lawson, Kenneth A; Miller, Alexander

The determinants of attitudes toward medication (ATM) are not well elucidated. In particular, literature remains equivocal regarding the influence of cognition, adverse events, and psychiatric symptomatology. This study evaluated relationships between those outcomes in schizophrenia and ATM. This is a retrospective analysis of data collected during the Texas Medication Algorithm Project (TMAP, n=307 with schizophrenia-related diagnoses), in outpatient clinics at baseline and every 3 months for ≥1 year (for cognition: 3rd and 9th month only). The Drug Attitude Inventory (DAI-30) measured ATM, and independent variables were: cognition (Trail Making Test [TMT], Verbal Fluency Test, Hopkins Verbal Learning Test), adverse events (Systematic Assessment for Treatment-Emergent Adverse Events, Barnes Akathisia Rating Scale), psychiatric symptomatology (Brief Psychiatric Rating Scale, Scale for Assessment of Negative Symptoms [SANS]), and medication adherence (Medication Compliance Scale). Analyses included binary logistic regression (cognition, psychiatric symptoms) and chi-square (adverse events, adherence) for baseline comparisons, and linear regression (cognition) or ANOVA (adverse events, adherence) for changes over time. Mean DAI-30 scores did not change over 12 months. Odds of positive ATM increased with higher TMT Part B scores (p=0.03) and lower SANS scores (p=0.02). Worsening of general psychopathology (p<0.001), positive symptoms (p<0.001), and negative symptoms (p=0.007) correlated with negative changes in DAI-30 scores. Relationships between cognition, negative symptoms, and ATM warrant further investigation. Studies evaluating therapies for cognitive deficits and negative symptoms should consider including ATM measures as endpoints. Patterns and inconsistencies in findings across studies raise questions about whether some factors thought to influence ATM have nonlinear relationships.

Needs Assessment and Telecommunications Cost Benefit Analysis for Army Medical Department Continuing Clinical Education Requirements.

DTIC Science & Technology

1985-04-01

Dentistry 5 0 Medical Teaching Techniques 5 0 Medical Proficiency Training S 5 0 Amalgam Filling Mercury Poisoning Scare Future Trends in Health Care...May). Contemporary Topics For Dieticians and Nutritionists . 1984 Dietary Uptakes. Teleconference Network of Texas. (1984, May-June). Eight contact hours... Teaching Techniques 5 Increaseiig Dental Productivity 5 Amalgam Filling Mercury Poisoning Scare 5 oci’ijitionau Preventive Dentistrv 5 Osseo

Identification and Validation of Established and Novel Biomarkers for Infections in Burns

DTIC Science & Technology

2016-10-01

INVESTIGATOR: Celeste C. Finnerty, PhD RECIPIENT: The University of Texas Medical Branch at Galveston Galveston, TX 77555 REPORT DATE: October 2016...TYPE OF REPORT: Annual PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION STATEMENT...Boulevard Galveston, TX 77555-5302 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) U.S. Army Medical

Pathology and medical malpractice. Academic and trainee empirical review of cases by State of Texas physicians.

PubMed

Allen, Timothy Craig; Stafford, Mehary; Liang, Bryan A

2014-04-01

This study examines whether the assumptions that pathologists understand the medical malpractice negligence rule and have a clear single standard of care are reasonable. Two hundred eighty-one Texas academic pathologists and trainees were presented 10 actual pathology malpractice cases from publicly available sources, representing the tort system's signal. Of the respondents, 55.52% were trainees, and 44.48% were pathology faculty. Only in two cases did more than 50% of respondents correctly identify the behavior of pathologists as defined by legal outcomes. In only half of the cases did more than 50% of pathologists concur with the jury verdict. This study provides further evidence that physicians do not understand the legal rule of negligence. Pathologists have a poor understanding of negligence and cannot accurately predict a jury verdict. There is significant divergence from the single standard of care assumption. Alternative methods to provide appropriate compensation and to establish physician accountability should be explored. Additional education about medical negligence is needed.

Photometry of Standard Stars and Open Star Clusters

NASA Astrophysics Data System (ADS)

Jefferies, Amanda; Frinchaboy, Peter

2010-10-01

Photometric CCD observations of open star clusters and standard stars were carried out at the McDonald Observatory in Fort Davis, Texas. This data was analyzed using aperture photometry algorithms (DAOPHOT II and ALLSTAR) and the IRAF software package. Color-magnitude diagrams of these clusters were produced, showing the evolution of each cluster along the main sequence.

Nitrogen dioxide observations from the Geostationary Trace gas and Aerosol Sensor Optimization (GeoTASO) airborne instrument: Retrieval algorithm and measurements during DISCOVER-AQ Texas 2013

EPA Science Inventory

The Geostationary Trace gas and Aerosol Sensor Optimization (GeoTASO) airborne instrument is a test bed for upcoming air quality satellite instruments that will measure backscattered ultraviolet, visible and near-infrared light from geostationary orbit. GeoTASO flew on the NASA F...

Immigration and Its Effect on the College-Going Outcomes of Natives

ERIC Educational Resources Information Center

Neymotin, Florence

2009-01-01

In this paper, I analyze immigration's effect on the SAT-scores and college application patterns of high school students in California and Texas. The student-level dataset used is longitudinal in nature and is matched via a unique algorithm to the Census 2000 summary tabulation files to determine immigration at the local census-place level. The…

Outpatient Nonavailability Statement Procedures, Health Services Command Catchment Areas. Second Quarter, FY 1994 with Comparisons to First Quarter, FY 1994

DTIC Science & Technology

1994-05-01

Commander, U.S. Army Medical Department Activity, Fort Carson, CO 80913-5101 (1) Commander, U.S. Army Medical Department Activity, Fort Devens , MA 01433...Medical Department Activity, Fort Carson, CO 80913-5101 (1) Director, Coordinated Care, U.S. Army Medical Department Activity, Fort Devens , MA 01433...016 * MAY 1994 I UNITED STATES ARMY HEALTH SERVICES COMMAND.I N FORT SAM HOUSTON, TEXAS 78234-6000 ’I I i TRI-SERVICE CHAMPUS STATISTICAL DATABASE

A computerized clinical decision support system as a means of implementing depression guidelines.

PubMed

Trivedi, Madhukar H; Kern, Janet K; Grannemann, Bruce D; Altshuler, Kenneth Z; Sunderajan, Prabha

2004-08-01

The authors describe the history and current use of computerized systems for implementing treatment guidelines in general medicine as well as the development, testing, and early use of a computerized decision support system for depression treatment among "real-world" clinical settings in Texas. In 1999 health care experts from Europe and the United States met to confront the well-documented challenges of implementing treatment guidelines and to identify strategies for improvement. They suggested the integration of guidelines into computer systems that is incorporated into clinical workflow. Several studies have demonstrated improvements in physicians' adherence to guidelines when such guidelines are provided in a computerized format. Although computerized decision support systems are being used in many areas of medicine and have demonstrated improved patient outcomes, their use in psychiatric illness is limited. The authors designed and developed a computerized decision support system for the treatment of major depressive disorder by using evidence-based guidelines, transferring the knowledge gained from the Texas Medication Algorithm Project (TMAP). This computerized decision support system (CompTMAP) provides support in diagnosis, treatment, follow-up, and preventive care and can be incorporated into the clinical setting. CompTMAP has gone through extensive testing to ensure accuracy and reliability. Physician surveys have indicated a positive response to CompTMAP, although the sample was insufficient for statistical testing. CompTMAP is part of a new era of comprehensive computerized decision support systems that take advantage of advances in automation and provide more complete clinical support to physicians in clinical practice.

A novel clinical decision support algorithm for constructing complete medication histories.

PubMed

Long, Ju; Yuan, Michael Juntao

2017-07-01

A patient's complete medication history is a crucial element for physicians to develop a full understanding of the patient's medical conditions and treatment options. However, due to the fragmented nature of medical data, this process can be very time-consuming and often impossible for physicians to construct a complete medication history for complex patients. In this paper, we describe an accurate, computationally efficient and scalable algorithm to construct a medication history timeline. The algorithm is developed and validated based on 1 million random prescription records from a large national prescription data aggregator. Our evaluation shows that the algorithm can be scaled horizontally on-demand, making it suitable for future delivery in a cloud-computing environment. We also propose that this cloud-based medication history computation algorithm could be integrated into Electronic Medical Records, enabling informed clinical decision-making at the point of care. Copyright © 2017 Elsevier B.V. All rights reserved.

The artificial organ museum in Cleveland (1979-1999) moved to Houston, Texas, and named in 2002 as the ICMT Museum for Artificial Organs.

PubMed

Nosé, Yukihiko

2003-09-01

The artificial organ museum established in Cleveland, Ohio, in 1979 organized by the International Center for Artificial Organs and Transplantation (ICAOT), was moved to Houston, Texas, in 1999. The museum with expanded and renewed artificial organ exhibits was officially opened on the 8th and 9th of November, 2002, at the Cullen Pavilion of the original Memorial Hermann Hospital. This building is the oldest in the Texas Medical Center, which was built in 1922. The ICMT (International Center for Medical Technologies) Museum for Artificial Organs (Museum) was completed after phase I, II, and III expansions of the exhibit booths, which were made over the last two years. Approximately 250 historically important and currently widely used artificial organs are exhibited in the Museum. The official opening of the Museum was coordinated with the "Symposium on Artificial Organs: Past, Present, and Future" during two days in November. There were approximately 225 participants at these events, and approximately 40 pioneers and clinical experts in the development and practice of various types of artificial organs contributed. During these programs, a proposal to maintain human resources in addition to artificial organ hardware and software was made in addition to the Museum. This new organization would be called the International Academy of Artificial Organ Pioneers (Academy). All contributors to the symposium were invited to be members of the Academy. The attendants of the symposium accepted this proposal unanimously. An additional 40 individuals, who were recognized as contributors to artificial organ technologies, were later added to the original Academy members. Later, the effective utilization of the Museum and Academy was encompassed in the International Faculty for Health and Medical Technologies (Faculty), a new addition to the activities of the ICMT. Dr. Michael DeBakey was elected as Dean of the Faculty. This is considered a "university without walls," a "university linked to the world," and a "university providing simultaneous teaching at multiple sites"--a completely new concept in teaching tools for medical technologies. All of these subsidiary organizations of the ICMT were legally included as nonprofit, nontaxable charity organizations of the state of Texas.

A Mobile Phone HIV Medication Adherence Intervention: Care4Today™ Mobile Health Manager

ERIC Educational Resources Information Center

Martin, C. Andrew

2016-01-01

This paper presents the findings of a qualitative study designed to describe the experience of HIV medication adherence using a mobile phone application. For the purpose of this qualitative study, nine semi-structured focus group discussions were conducted over a three-month period at an AIDS service organization in Central Texas. The data were…

Treating your own.

PubMed

Conde, Crystal

2011-10-01

Giving a staff member a flu shot or writing your spouse a prescription for pain medication may not seem like a big deal. But if you fail to maintain a medical record for the employee, or if your spouse gets hooked on a controlled substance, you could be in hot water. Texas Medical Board Executive Director Mari Robinson, JD, says it's not illegal for physicians to treat family members, friends, and employees, but doing so poses risks.

Medical Library Association

MedlinePlus

... CST, Fri Nov 10th, 2017 Harlingen, Texas Metadata Transformation Librarian Updated 9:27AM CDT, Wed Nov 1st, ... 05 PM Characteristics of multi-institutional health sciences education research: a systematic review Posted on: October 2, ...

The role of forensic anthropology in the recovery and analysis of Branch Davidian Compound victims: recovery procedures and characteristics of the victims.

PubMed

Ubelaker, D H; Owsley, D W; Houck, M M; Craig, E; Grant, W; Woltanski, T; Fram, R; Sandness, K; Peerwani, N

1995-05-01

Anthropological contributions to the investigation of the events at the Branch Davidian Compound near Waco, Texas in early 1993, were of two major types: the recovery of human remains from the site and the analysis of most of those individuals at the Medical Examiner's Office in Fort Worth, Texas. This paper describes the role of forensic anthropology in the recovery and analysis of Branch Davidian Compound victims and the recovery procedures and characteristics of the victims.

Use of Nondisclosure Agreements in Medical Malpractice Settlements by a Large Academic Health Care System.

PubMed

Sage, William M; Jablonski, Joseph S; Thomas, Eric J

2015-07-01

Honesty and transparency are essential aspects of health care, including in physicians' and hospitals' responses to medical error. Biases and habits associated with medical malpractice litigation, however, may work at cross-purposes with compassion in clinical care and with efforts to improve patient safety. To determine the frequency of nondisclosure agreements in medical malpractice settlements and the extent to which the restrictions in these agreements seem incompatible with good patient care. We performed a retrospective review of medical malpractice claim files, including settlement agreements, for claims closed before (fiscal year 2001-2002), during (fiscal year 2006-2007), and after (fiscal years 2009-2012) the implementation of tort reform in Texas. We studied The University of Texas System, which self-insures malpractice claims that involve 6000 physicians at 6 medical campuses in 5 cities. Nondisclosure provisions in medical malpractice settlements. During the 5 study years, The University of Texas System closed 715 malpractice claims and made 150 settlement payments. For the 124 cases that met our selection criteria, the median compensation paid by the university was $100,000 (range, $500-$1.25 million), and the mean compensation was $185,372. A total of 110 settlement agreements (88.7%) included nondisclosure provisions. All the nondisclosure clauses prohibited disclosure of the settlement terms and amount, 61 (55.5%) prohibited disclosure that the settlement had been reached, 51 (46.4%) prohibited disclosure of the facts of the claim, 29 (26.4%) prohibited reporting to regulatory agencies, and 10 (9.1%) prohibited disclosure by the settling physicians and hospitals, not only by the claimant. Three agreements (2.7%) included specific language that prohibited the claimant from disparaging the physicians or hospitals. The 50 settlement agreements signed after tort reform took full effect in Texas (2009-2012) had stricter nondisclosure provisions than the 60 signed in earlier years: settlements after tort reform were more likely to prohibit disclosure of the event of settlement (36 [72.0%] vs 25 [41.7%]; P < .001), to prohibit disclosure of the facts of the claims (31 [62.0%] vs 20 [33.3%]; P = .003), and to prohibit reporting to regulatory bodies (25 [50.0%] vs 4 [6.7%]; P < .001). An academic health system with a declared commitment to patient safety and transparency used nondisclosure clauses in most malpractice settlement agreements but with little standardization or consistency. The scope of nondisclosure was often broader than seemed needed to protect physicians and hospitals from disparagement by the plaintiff or to avoid publicizing settlement amounts that might attract other claimants. Some agreements prohibited reporting to regulatory agencies, a practice that the health system changed in response to our findings.

Water Mapping Technology Rebuilds Lives in Arid Regions

NASA Technical Reports Server (NTRS)

2015-01-01

Using NASA Landsat satellite and other remote sensing topographical data, Radar Technologies International developed an algorithm-based software program that can locate underground water sources. Working with international organizations and governments, the firm, which maintains an office in New Braunfels, Texas, is helping to provide water for refugees and other people in drought-stricken regions such as Kenya, Sudan, and Afghanistan.

The impact of drought on ozone dry deposition over eastern Texas

NASA Astrophysics Data System (ADS)

Huang, Ling; McDonald-Buller, Elena C.; McGaughey, Gary; Kimura, Yosuke; Allen, David T.

2016-02-01

Dry deposition represents a critical pathway through which ground-level ozone is removed from the atmosphere. Understanding the effects of drought on ozone dry deposition is essential for air quality modeling and management in regions of the world with recurring droughts. This work applied the widely used Zhang dry deposition algorithm to examine seasonal and interannual changes in estimated ozone dry deposition velocities and component resistances/conductances over eastern Texas during years with drought (2006 and 2011) as well as a year with slightly cooler temperatures and above average rainfall (2007). Simulated area-averaged daytime ozone dry deposition velocities ranged between 0.26 and 0.47 cm/s. Seasonal patterns reflected the combined seasonal variations in non-stomatal and stomatal deposition pathways. Daytime ozone dry deposition velocities during the growing season were consistently larger during 2007 compared to 2006 and 2011. These differences were associated with differences in stomatal conductances and were most pronounced in forested areas. Reductions in stomatal conductances under drought conditions were highly sensitive to increases in vapor pressure deficit and warmer temperatures in Zhang's algorithm. Reductions in daytime ozone deposition velocities and deposition mass during drought years were associated with estimates of higher surface ozone concentrations.

Automatic Detection of Diabetic Retinopathy and Age-Related Macular Degeneration in Digital Fundus Images

PubMed Central

Barriga, E. Simon; Murray, Victor; Nemeth, Sheila; Crammer, Robert; Bauman, Wendall; Zamora, Gilberto; Pattichis, Marios S.; Soliz, Peter

2011-01-01

Purpose. To describe and evaluate the performance of an algorithm that automatically classifies images with pathologic features commonly found in diabetic retinopathy (DR) and age-related macular degeneration (AMD). Methods. Retinal digital photographs (N = 2247) of three fields of view (FOV) were obtained of the eyes of 822 patients at two centers: The Retina Institute of South Texas (RIST, San Antonio, TX) and The University of Texas Health Science Center San Antonio (UTHSCSA). Ground truth was provided for the presence of pathologic conditions, including microaneurysms, hemorrhages, exudates, neovascularization in the optic disc and elsewhere, drusen, abnormal pigmentation, and geographic atrophy. The algorithm was used to report on the presence or absence of disease. A detection threshold was applied to obtain different values of sensitivity and specificity with respect to ground truth and to construct a receiver operating characteristic (ROC) curve. Results. The system achieved an average area under the ROC curve (AUC) of 0.89 for detection of DR and of 0.92 for detection of sight-threatening DR (STDR). With a fixed specificity of 0.50, the system's sensitivity ranged from 0.92 for all DR cases to 1.00 for clinically significant macular edema (CSME). Conclusions. A computer-aided algorithm was trained to detect different types of pathologic retinal conditions. The cases of hard exudates within 1 disc diameter (DD) of the fovea (surrogate for CSME) were detected with very high accuracy (sensitivity = 1, specificity = 0.50), whereas mild nonproliferative DR was the most challenging condition (sensitivity= 0.92, specificity = 0.50). The algorithm was also tested on images with signs of AMD, achieving a performance of AUC of 0.84 (sensitivity = 0.94, specificity = 0.50). PMID:21666234

Automatic detection of diabetic retinopathy and age-related macular degeneration in digital fundus images.

PubMed

Agurto, Carla; Barriga, E Simon; Murray, Victor; Nemeth, Sheila; Crammer, Robert; Bauman, Wendall; Zamora, Gilberto; Pattichis, Marios S; Soliz, Peter

2011-07-29

To describe and evaluate the performance of an algorithm that automatically classifies images with pathologic features commonly found in diabetic retinopathy (DR) and age-related macular degeneration (AMD). Retinal digital photographs (N = 2247) of three fields of view (FOV) were obtained of the eyes of 822 patients at two centers: The Retina Institute of South Texas (RIST, San Antonio, TX) and The University of Texas Health Science Center San Antonio (UTHSCSA). Ground truth was provided for the presence of pathologic conditions, including microaneurysms, hemorrhages, exudates, neovascularization in the optic disc and elsewhere, drusen, abnormal pigmentation, and geographic atrophy. The algorithm was used to report on the presence or absence of disease. A detection threshold was applied to obtain different values of sensitivity and specificity with respect to ground truth and to construct a receiver operating characteristic (ROC) curve. The system achieved an average area under the ROC curve (AUC) of 0.89 for detection of DR and of 0.92 for detection of sight-threatening DR (STDR). With a fixed specificity of 0.50, the system's sensitivity ranged from 0.92 for all DR cases to 1.00 for clinically significant macular edema (CSME). A computer-aided algorithm was trained to detect different types of pathologic retinal conditions. The cases of hard exudates within 1 disc diameter (DD) of the fovea (surrogate for CSME) were detected with very high accuracy (sensitivity = 1, specificity = 0.50), whereas mild nonproliferative DR was the most challenging condition (sensitivity = 0.92, specificity = 0.50). The algorithm was also tested on images with signs of AMD, achieving a performance of AUC of 0.84 (sensitivity = 0.94, specificity = 0.50).

The BADER Consortium

DTIC Science & Technology

2012-10-01

Reed National Military Medical Center; C-Motion Inc . in Germantown, Md.; and the University of Michigan. Funding for this Orthopaedic...IRB of record outside the MTFs (Davis) • Initiated the development of partnership with Nike , USA (Davis) • Development and implementation of an...Christiana Care Health Systems Walter Reed National Military Medical Center University of Texas – Austin C-Motion, Inc Department of Veteran’s

Marketing Is Not a Luxury - Marketing Is a Necessity.

PubMed

Price, Sean

2017-10-01

Physicians who work in small practices constantly face a basic marketing question: What's the best way to sell myself and my business to the community? Because few physicians studied business principles, many won't know the answer. That's why the Texas Medical Association is publishing a book titled Marketing Smart: A Guide for Medical Practices.

Prevalence of chronic medical conditions among inmates in the Texas prison system.

PubMed

Harzke, Amy J; Baillargeon, Jacques G; Pruitt, Sandi L; Pulvino, John S; Paar, David P; Kelley, Michael F

2010-05-01

Given the rapid growth and aging of the US prison population in recent years, the disease profile and health care needs of inmates portend to have far-reaching public health implications. Although numerous studies have examined infectious disease prevalence and treatment in incarcerated populations, little is known about the prevalence of non-infectious chronic medical conditions in US prison populations. The purpose of this study was to estimate the prevalence of selected non-infectious chronic medical conditions among inmates in the Texas prison system. The study population consisted of the total census of inmates who were incarcerated in the Texas Department of Criminal Justice for any duration from September 1, 2006 through August 31, 2007 (N=234,031). Information on medical diagnoses was obtained from a system-wide electronic medical record system. Overall crude prevalence estimates for the selected conditions were as follows: hypertension, 18.8%; asthma, 5.4%; diabetes, 4.2%; ischemic heart disease, 1.7%; chronic obstructive pulmonary disease, 0.96%; and cerebrovascular disease, 0.23%. Nearly one quarter (24.5%) of the study population had at least one of the selected conditions. Except for asthma, crude prevalence estimates of the selected conditions increased monotonically with age. Nearly two thirds (64.6%) of inmates who were >or=55 years of age had at least one of the selected conditions. Except for diabetes, crude prevalence estimates for the selected conditions were lower among Hispanic inmates than among non-Hispanic White inmates and African American inmates. Although age-standardized prevalence estimates for the selected conditions did not appear to exceed age-standardized estimates from the US general population, a large number of inmates were affected by one or more of these conditions. As the prison population continues to grow and to age, the burden of these conditions on correctional and community health care systems can be expected to increase.

Tracheitis

MedlinePlus

... Otolaryngology – Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. team. Staphylococcal Infections Read more Tracheal ...

Advanced MHD Algorithm for Solar and Space Science: lst Year Semi Annual Progress Report

NASA Technical Reports Server (NTRS)

Schnack, Dalton D.; Lionello, Roberto

2003-01-01

We report progress for the development of MH4D for the first and second quarters of FY2004, December 29, 2002 - June 6, 2003. The present version of MH4D can now solve the full viscous and resistive MHD equations using either an explicit or a semi-implicit time advancement algorithm. In this report we describe progress in the following areas. During the two last quarters we have presented poster at the EGS-AGU-EUG Joint Assembly in Nice, France, April 6-11, 2003, and a poster at the 2003 International Sherwood Theory Conference in Corpus Christi, Texas, April 28-30 2003. In the area of code development, we have implemented the MHD equations and the semi-implicit algorithm. The new features have been tested.

Texas Medicaid Payment Reform: Fewer Early Elective Deliveries And Increased Gestational Age And Birthweight.

PubMed

Dahlen, Heather M; McCullough, J Mac; Fertig, Angela R; Dowd, Bryan E; Riley, William J

2017-03-01

Infants born at full term have better health outcomes. However, one in ten babies in the United States are born via a medically unnecessary early elective delivery: induction of labor, a cesarean section, or both before thirty-nine weeks gestation. In 2011 the Texas Medicaid program sought to reduce the rate of early elective deliveries by denying payment to providers for the procedure. We examined the impact of this policy on clinical care practice and perinatal outcomes by comparing the changes in Texas relative to comparison states. We found that early elective delivery rates fell by as much as 14 percent in Texas after this payment policy change, which led to gains of almost five days in gestational age and six ounces in birthweight among births affected by the policy. The impact on early elective delivery was larger in magnitude for minority patients. Other states may look to this Medicaid payment reform as a model for reducing early elective deliveries and disparities in infant health. Project HOPE—The People-to-People Health Foundation, Inc.

Primary Disaster Field Office (DFO), Lufkin, Texas

NASA Technical Reports Server (NTRS)

Wetherbee, James D.

2005-01-01

On February 1, 2003, the Space Shuttle Columbia broke apart during atmospheric re-entry on mission STS-107; the complexity of such an event cannot be underestimated. The Lufkin Disaster Field Office (DFO) served as the primary DFO for all operations, including staging assets and deploying field teams for search, recovery and security. There were many organizations that had operational experience with disaster recovery. Offers to help came from many groups including the White House Liaison Office, the Department of Defense (DOD), branches of local, state and federal government, the Federal Bureau of Investigation (FBI), the Federal Emergency Management Agency (FEMA), the Environmental Protection Agency (EPA), state police, fire departments, the Texas Forestry Service, the Texas Army National Guard, medical groups, various rescue forces, contractor companies, the Salvation Army, local businesses, and citizens of our country and especially East Texas. The challenge was to know how much help to accept and how to efficiently incorporate their valuable assistance into a comprehensive and cohesive operational plan. There were more than 2,000 people involved with search and recovery.

A vagabond education: UTMB students, residents still feel Ike's impact.

PubMed

Ortolon, Ken

2009-06-01

Hurricane Ike played havoc with students and residents at The University of Texas Medical Branch at Galveston. Their education was disrupted, they lost many of their possessions, and some were forced to train elsewhere.

42 CFR 421.210 - Designations of regional carriers to process claims for durable medical equipment, prosthetics...

Code of Federal Regulations, 2011 CFR

2011-10-01

..., Mississippi, Louisiana, Texas, Arkansas, Oklahoma, New Mexico, Colorado, Puerto Rico, and the Virgin Islands... criteria— (1) Timeliness of claim processing; (2) Cost per claim; (3) Claim processing quality; (4...

42 CFR 421.210 - Designations of regional carriers to process claims for durable medical equipment, prosthetics...

Code of Federal Regulations, 2010 CFR

2010-10-01

..., Mississippi, Louisiana, Texas, Arkansas, Oklahoma, New Mexico, Colorado, Puerto Rico, and the Virgin Islands... criteria— (1) Timeliness of claim processing; (2) Cost per claim; (3) Claim processing quality; (4...

Upper airway biopsy

MedlinePlus

... Otolaryngology – Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Biopsy Read more Cancer Read more ...

The Patient Protection and Affordable Care Act's provisions regarding medical loss ratios and quality: evidence from Texas.

PubMed

Quast, Troy

2013-01-01

The Patient Protection and Affordable Care Act (PPACA) includes a provision that penalizes insurance companies if their Medical Loss Ratio (MLR) falls below a specified threshold. The MLR is roughly measured as the ratio of health care expenses to premiums paid by enrollees. I investigate whether there is a relationship between MLRs and the quality of care provided by insurance companies. I employ a ten-year sample of market-level financial data and quality variables for Texas insurers, as well as relevant control variables, in regression analyses that utilize insurer and market fixed effects. Of the 15 quality measures, only one has a statistically significant relationship with the MLR. For this measure, the relationship is negative. Although the MLR provision may provide incentives for insurance companies to lower premiums, this sample does not suggest that there is likely to be a beneficial effect on quality.

The Houston Academy of Medicine--Texas Medical Center Library management information system.

PubMed Central

Camille, D; Chadha, S; Lyders, R A

1993-01-01

A management information system (MIS) provides a means for collecting, reporting, and analyzing data from all segments of an organization. Such systems are common in business but rare in libraries. The Houston Academy of Medicine-Texas Medical Center Library developed an MIS that operates on a system of networked IBM PCs and Paradox, a commercial database software package. The data collected in the system include monthly reports, client profile information, and data collected at the time of service requests. The MIS assists with enforcement of library policies, ensures that correct information is recorded, and provides reports for library managers. It also can be used to help answer a variety of ad hoc questions. Future plans call for the development of an MIS that could be adapted to other libraries' needs, and a decision-support interface that would facilitate access to the data contained in the MIS databases. PMID:8251972

Countermeasures and Functional Testing in Head-Down Tilt Bed Rest (CFT 70)

NASA Technical Reports Server (NTRS)

Cromwell, Ronita L.

2013-01-01

This 70-day bed rest campaign was comprised of 6 integrated studies and conducted at the NASA Flight Analogs Research Unit (FARU). The FARU is located at the University of Texas Medical Branch, Galveston, Texas and is a satellite unit of the Institute for Translational Sciences - Clinical Research Center. This presentation will describe the FARU, discuss the utility of the bed rest platform for use in these studies, and introduce the studies that participated in the CFT 70 bed rest campaign. Information in this presentation will serve as the background for subsequent talks from each individual study. Individual study presentations will discuss preliminary results from completed subjects. Studies included in CFT70 were: ? Physiological Factors Contributing to Post Flight Changes in Functional Performance. J. Bloomberg, NASA ? Integrated Resistance and Aerobic Training Study. L. Ploutz-Snyder, USRA ? Testosterone Supplementation as a Countermeasure Against Musculoskeletal losses during Space Exploration. R. Urban, University of Texas Medical Branch ? Effects of Retronasal Smelling, Variety and Choice on Appetite & Satiety. J. Hunter, Cornell University ? AD ASTRA: Automated Detection of Attitudes and States through Transaction Recordings Analysis. C. Miller, Smart Information Flow Technologies, LLC ? Bed Rest as a Spaceflight Analog to Study Neuro-cognitive Changes: Extent, Longevity, and Neural Bases. R. Seidler, University of Michigan

A bill to name the Department of Veterans Affairs medical center in Waco, Texas, as the "Doris Miller Department of Veterans Affairs Medical Center".

THOMAS, 113th Congress

Sen. Cornyn, John [R-TX

2014-03-13

Senate - 03/13/2014 Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Notes: For further action, see H.R.4199, which became Public Law 113-256 on 12/18/2014. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Theranostics Targeting Metastatic Breast Cancer

DTIC Science & Technology

2016-10-01

2000) in Chemistry from University of Cambridge, UK. She conducted Postdoc research in Prof Kevin Burgess’ group in TAMU. She is currently Senior...ORGANIZATION: Texas A&M University College Station, TX 77845 REPORT DATE: October 2016 TYPE OF REPORT: Annual PREPARED FOR: U.S. Army Medical Research ...Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 11. SPONSOR/MONITOR’S REPORT NUMBER(S) 12. DISTRIBUTION / AVAILABILITY

A Survey of Texas HIV, Sexually Transmitted Disease, Tuberculosis, and Viral Hepatitis Providers’ Billing and Reimbursement Capabilities

PubMed Central

Atwood, Robin; Greenberg, Jennifer B.; Ray, Tara; Harris, Karol Kaye

2015-01-01

The Affordable Care Act presents financial challenges and opportunities for publicly funded service providers. We assessed billing practices and anticipated barriers to third-party billing among organizations in Texas that provide publicly funded HIV, sexually transmitted diseases, tuberculosis, and viral hepatitis services. One third to one half of the organizations did not bill for medical services. The most common barrier to third-party billing was lack of staff knowledge about billing and coding. Future research must evaluate options for organizations and communities to maintain access to infectious disease services for vulnerable populations. PMID:26447911

Development of MODIS data-based algorithm for retrieving sea surface temperature in coastal waters.

PubMed

Wang, Jiao; Deng, Zhiqiang

2017-06-01

A new algorithm was developed for retrieving sea surface temperature (SST) in coastal waters using satellite remote sensing data from Moderate Resolution Imaging Spectroradiometer (MODIS) aboard Aqua platform. The new SST algorithm was trained using the Artificial Neural Network (ANN) method and tested using 8 years of remote sensing data from MODIS Aqua sensor and in situ sensing data from the US coastal waters in Louisiana, Texas, Florida, California, and New Jersey. The ANN algorithm could be utilized to map SST in both deep offshore and particularly shallow nearshore waters at the high spatial resolution of 1 km, greatly expanding the coverage of remote sensing-based SST data from offshore waters to nearshore waters. Applications of the ANN algorithm require only the remotely sensed reflectance values from the two MODIS Aqua thermal bands 31 and 32 as input data. Application results indicated that the ANN algorithm was able to explaining 82-90% variations in observed SST in US coastal waters. While the algorithm is generally applicable to the retrieval of SST, it works best for nearshore waters where important coastal resources are located and existing algorithms are either not applicable or do not work well, making the new ANN-based SST algorithm unique and particularly useful to coastal resource management.

Chagas disease risk in Texas.

PubMed

Sarkar, Sahotra; Strutz, Stavana E; Frank, David M; Rivaldi, Chissa-Louise; Sissel, Blake; Sánchez-Cordero, Victor

2010-10-05

Chagas disease, caused by Trypanosoma cruzi, remains a serious public health concern in many areas of Latin America, including México. It is also endemic in Texas with an autochthonous canine cycle, abundant vectors (Triatoma species) in many counties, and established domestic and peridomestic cycles which make competent reservoirs available throughout the state. Yet, Chagas disease is not reportable in Texas, blood donor screening is not mandatory, and the serological profiles of human and canine populations remain unknown. The purpose of this analysis was to provide a formal risk assessment, including risk maps, which recommends the removal of these lacunae. The spatial relative risk of the establishment of autochthonous Chagas disease cycles in Texas was assessed using a five-stage analysis. 1. Ecological risk for Chagas disease was established at a fine spatial resolution using a maximum entropy algorithm that takes as input occurrence points of vectors and environmental layers. The analysis was restricted to triatomine vector species for which new data were generated through field collection and through collation of post-1960 museum records in both México and the United States with sufficiently low georeferenced error to be admissible given the spatial resolution of the analysis (1 arc-minute). The new data extended the distribution of vector species to 10 new Texas counties. The models predicted that Triatoma gerstaeckeri has a large region of contiguous suitable habitat in the southern United States and México, T. lecticularia has a diffuse suitable habitat distribution along both coasts of the same region, and T. sanguisuga has a disjoint suitable habitat distribution along the coasts of the United States. The ecological risk is highest in south Texas. 2. Incidence-based relative risk was computed at the county level using the Bayesian Besag-York-Mollié model and post-1960 T. cruzi incidence data. This risk is concentrated in south Texas. 3. The ecological and incidence-based risks were analyzed together in a multi-criteria dominance analysis of all counties and those counties in which there were as yet no reports of parasite incidence. Both analyses picked out counties in south Texas as those at highest risk. 4. As an alternative to the multi-criteria analysis, the ecological and incidence-based risks were compounded in a multiplicative composite risk model. Counties in south Texas emerged as those with the highest risk. 5. Risk as the relative expected exposure rate was computed using a multiplicative model for the composite risk and a scaled population county map for Texas. Counties with highest risk were those in south Texas and a few counties with high human populations in north, east, and central Texas showing that, though Chagas disease risk is concentrated in south Texas, it is not restricted to it. For all of Texas, Chagas disease should be designated as reportable, as it is in Arizona and Massachusetts. At least for south Texas, lower than N, blood donor screening should be mandatory, and the serological profiles of human and canine populations should be established. It is also recommended that a joint initiative be undertaken by the United States and México to combat Chagas disease in the trans-border region. The methodology developed for this analysis can be easily exported to other geographical and disease contexts in which risk assessment is of potential value.

Prevalence of psychiatric disorders in the Texas juvenile correctional system.

PubMed

Harzke, Amy Jo; Baillargeon, Jacques; Baillargeon, Gwen; Henry, Judith; Olvera, Rene L; Torrealday, Ohiana; Penn, Joseph V; Parikh, Rajendra

2012-04-01

Most studies assessing the burden of psychiatric disorders in juvenile correctional facilities have been based on small or male-only samples or have focused on a single disorder. Using electronic data routinely collected by the Texas juvenile correctional system and its contracted medical provider organization, we estimated the prevalence of selected psychiatric disorders among youths committed to Texas juvenile correctional facilities between January 1, 2004, and December 31, 2008 (N = 11,603). Ninety-eight percent were diagnosed with at least one of the disorders. Highest estimated prevalence was for conduct disorder (83.2%), followed by any substance use disorder (75.6%), any bipolar disorder (19.4%), attention-deficit/hyperactivity disorder (18.3%), and any depressive disorder (12.6%). The estimated prevalence of psychiatric disorders among these youths was exceptionally high and showed patterns by sex, race/ethnicity, and age that were both consistent and inconsistent with other juvenile justice samples.

Implementation of a rational pharmacotherapy intervention for inpatients at a psychiatric department.

PubMed

Sorensen, Lene; Nielsen, Bent; Stage, Kurt B; Brøsen, Kim; Damkier, Per

2008-01-01

The objective of the study was to develop, implement and evaluate two treatment algorithms for schizophrenia and depression at a psychiatric hospital department. The treatment algorithms were based on available literature and developed in collaboration between psychiatrists, clinical pharmacologists and a clinical pharmacist. The treatment algorithms were introduced at a meeting for all psychiatrists, reinforced by the project psychiatrists in the daily routine and used for educational purposes of young doctors and medical students. A quantitative pre-post evaluation was conducted using data from medical charts, and qualitative information was collected by interviews. In general, no significant differences were found when comparing outcomes from 104 charts from the baseline period with 96 charts from the post-intervention period. Most of the patients (65% in the post-intervention period) admitted during the data collection periods did not receive any medication changes. Of the patients undergoing medication changes in the post-intervention period, 56% followed the algorithms, and 70% of the patients admitted to the psychiatric hospital department for the first time had their medications changed according to the algorithms. All of the 10 interviewed doctors found the algorithms useful. The treatment algorithms were successfully implemented with a high degree of satisfaction among the interviewed doctors. The majority of patients admitted to the psychiatric hospital department for the first time had their medications changed according to the algorithms.

Factors associated with high-severity disciplinary action by a state medical board: a Texas study of medical license revocation.

PubMed

Cardarelli, Roberto; Licciardone, John C

2006-03-01

There has been an increase in research evaluating factors associated with disciplinary action of physicians by state medical boards. However, factors related to the severity of disciplinary action are lacking. By investigating these factors while controlling for the type of violation, the authors sought to determine whether physician characteristics influenced the process of disciplinary action by state medical boards. Physicians disciplined by the Texas Medical Board between January 1, 1989, and December 31, 1998, were included in this case-controlled study (N=1129). Multivariate logistic regression analysis was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with license revocation, the most severe disciplinary action, compared with all other forms of disciplinary action combined. Anesthesiologists (OR, 2.45; 95% CI, 1.05-5.74), general practitioners (OR, 1.80; 95% CI, 1.01-3.19), and psychiatrists (OR, 2.68; 95% CI, 1.41-5.13), as well as those with multiple disciplinary actions (OR, 1.91; 95% CI, 1.29-2.83) were most susceptible to license revocation. The more years a disciplined physician was in practice, the greater risk he or she had of license revocation (OR, 1.05; 95% CI, 1.04-1.07). Factors associated with a greater likelihood of license revocation for physicians are: primary medical specialty, number of years in practice, and a history of multiple disciplinary actions.

Predicting daily PM2.5 concentrations in Texas using high-resolution satellite aerosol optical depth.

PubMed

Zhang, Xueying; Chu, Yiyi; Wang, Yuxuan; Zhang, Kai

2018-08-01

The regulatory monitoring data of particulate matter with an aerodynamic diameter <2.5μm (PM 2.5 ) in Texas have limited spatial and temporal coverage. The purpose of this study is to estimate the ground-level PM 2.5 concentrations on a daily basis using satellite-retrieved Aerosol Optical Depth (AOD) in the state of Texas. We obtained the AOD values at 1-km resolution generated through the Multi-Angle Implementation of Atmospheric Correction (MAIAC) algorithm based on the images retrieved from the Moderate Resolution Imaging Spectroradiometer (MODIS) satellites. We then developed mixed-effects models based on AODs, land use features, geographic characteristics, and weather conditions, and the day-specific as well as site-specific random effects to estimate the PM 2.5 concentrations (μg/m 3 ) in the state of Texas during the period 2008-2013. The mixed-effects models' performance was evaluated using the coefficient of determination (R 2 ) and square root of the mean squared prediction error (RMSPE) from ten-fold cross-validation, which randomly selected 90% of the observations for training purpose and 10% of the observations for assessing the models' true prediction ability. Mixed-effects regression models showed good prediction performance (R 2 values from 10-fold cross validation: 0.63-0.69). The model performance varied by regions and study years, and the East region of Texas, and year of 2009 presented relatively higher prediction precision (R 2 : 0.62 for the East region; R 2 : 0.69 for the year of 2009). The PM 2.5 concentrations generated through our developed models at 1-km grid cells in the state of Texas showed a decreasing trend from 2008 to 2013 and a higher reduction of predicted PM 2.5 in more polluted areas. Our findings suggest that mixed-effects regression models developed based on MAIAC AOD are a feasible approach to predict ground-level PM 2.5 in Texas. Predicted PM 2.5 concentrations at the 1-km resolution on a daily basis can be used for epidemiological studies to investigate short- and long-term health impact of PM 2.5 in Texas. Copyright © 2017 Elsevier B.V. All rights reserved.

United States Travelers' Concern about Zika Infection and Willingness to Receive a Hypothetical Zika Vaccine.

PubMed

Vielot, Nadja A; Stamm, Lola; Herrington, James; Squiers, Linda; Kelly, Bridget; McCormack, Lauren; Becker-Dreps, Sylvia

2018-06-01

The ongoing Zika pandemic has affected many countries that are common travel destinations. We assessed the willingness to receive a prophylactic Zika virus (ZIKV) vaccine, currently under development, among travelers to areas with reported autochthonous ZIKV transmission. We surveyed United States (U.S.) residents aged 18-44 years who had ever heard of ZIKV and planned to travel to Florida and/or Texas ( N = 420) or a U.S. territory or foreign country ( N = 415) in 2017, using a nationally representative internet panel. Travelers to Florida and/or Texas reported less concern about ZIKV infection than travelers to other destinations (27% versus 36%, P = 0.01). Female sex, Hispanic ethnicity, discussing ZIKV with medical professionals, ZIKV risk perception, and self-efficacy for ZIKV prevention predicted concern about ZIKV infection in both groups. Travelers to Florida and/or Texas (43%) and other destinations (44%) were equally willing to receive a ZIKV vaccine. Hispanic ethnicity, discussing ZIKV with medical professionals, and concern about ZIKV infection predicted vaccine willingness in both groups. Likelihood of using existing ZIKV prevention methods, confidence in the U.S. government to prevent ZIKV spread, self-efficacy for ZIKV prevention, and knowledge about ZIKV symptoms further predicted vaccine willingness in travelers to other destinations. In multivariable analyses, only concern about ZIKV infection was associated with vaccine willingness in both groups (prevalence ratio [95% confidence interval]: Florida and/or Texas: 1.34 [1.06, 1.69]; other: 1.82 [1.44, 2.29]). Targeted communications can educate travelers, particularly travelers who are pregnant or may become pregnant, about ZIKV risk to generate ZIKV vaccine demand.

Development of visible/infrared/microwave agriculture classification and biomass estimation algorithms, volume 2. [Oklahoma and Texas

NASA Technical Reports Server (NTRS)

Rosenthal, W. D.; Mcfarland, M. J.; Theis, S. W.; Jones, C. L. (Principal Investigator)

1982-01-01

Agricultural crop classification models using two or more spectral regions (visible through microwave) were developed and tested and biomass was estimated by including microwave with visible and infrared data. The study was conducted at Guymon, Oklahoma and Dalhart, Texas utilizing aircraft multispectral data and ground truth soil moisture and biomass information. Results indicate that inclusion of C, L, and P band active microwave data from look angles greater than 35 deg from nadir with visible and infrared data improved crop discrimination and biomass estimates compared to results using only visible and infrared data. The active microwave frequencies were sensitive to different biomass levels. In addition, two indices, one using only active microwave data and the other using data from the middle and near infrared bands, were well correlated to total biomass.

International air cargo operations and gateways : their emerging importance to the state of Texas.

DOT National Transportation Integrated Search

2011-07-01

Air cargo transport has become particularly important in todays expanding global : economy for the movement of high-value goods such as electronics, computer components, : precision equipment, medical supplies, auto parts, and perishables. Air car...

76 FR 35475 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-17

... received a certification of eligibility to apply for trade adjustment assistance benefits and such supply... Medical, Hagameyer, T&K, Zachary, Rockdale, Texas: March 24, 2010. TA-W-80,134; Premier Pet Products, Inc...

Women of Valor in the American Civil War

DTIC Science & Technology

1999-04-01

Newcomb and Agnes Scott. Coeducational universities were Cornell, Michigan, Wisconsin, Kansas, Missouri, California, Texas and Kentucky. To meet the...courses separate from men. By the 1890’s Syracuse, California, Iowa and Howard Universities were among the dozen coeducational medical colleges

Using medication list--problem list mismatches as markers of potential error.

PubMed Central

Carpenter, James D.; Gorman, Paul N.

2002-01-01

The goal of this project was to specify and develop an algorithm that will check for drug and problem list mismatches in an electronic medical record (EMR). The algorithm is based on the premise that a patient's problem list and medication list should agree, and a mismatch may indicate medication error. Successful development of this algorithm could mean detection of some errors, such as medication orders entered into a wrong patient record, or drug therapy omissions, that are not otherwise detected via automated means. Additionally, mismatches may identify opportunities to improve problem list integrity. To assess the concept's feasibility, this study compared medications listed in a pharmacy information system with findings in an online nursing adult admission assessment, serving as a proxy for the problem list. Where drug and problem list mismatches were discovered, examination of the patient record confirmed the mismatch, and identified any potential causes. Evaluation of the algorithm in diabetes treatment indicates that it successfully detects both potential medication error and opportunities to improve problem list completeness. This algorithm, once fully developed and deployed, could prove a valuable way to improve the patient problem list, and could decrease the risk of medication error. PMID:12463796

Unmitigated numerical solution to the diffraction term in the parabolic nonlinear ultrasound wave equation.

PubMed

Hasani, Mojtaba H; Gharibzadeh, Shahriar; Farjami, Yaghoub; Tavakkoli, Jahan

2013-09-01

Various numerical algorithms have been developed to solve the Khokhlov-Kuznetsov-Zabolotskaya (KZK) parabolic nonlinear wave equation. In this work, a generalized time-domain numerical algorithm is proposed to solve the diffraction term of the KZK equation. This algorithm solves the transverse Laplacian operator of the KZK equation in three-dimensional (3D) Cartesian coordinates using a finite-difference method based on the five-point implicit backward finite difference and the five-point Crank-Nicolson finite difference discretization techniques. This leads to a more uniform discretization of the Laplacian operator which in turn results in fewer calculation gridding nodes without compromising accuracy in the diffraction term. In addition, a new empirical algorithm based on the LU decomposition technique is proposed to solve the system of linear equations obtained from this discretization. The proposed empirical algorithm improves the calculation speed and memory usage, while the order of computational complexity remains linear in calculation of the diffraction term in the KZK equation. For evaluating the accuracy of the proposed algorithm, two previously published algorithms are used as comparison references: the conventional 2D Texas code and its generalization for 3D geometries. The results show that the accuracy/efficiency performance of the proposed algorithm is comparable with the established time-domain methods.

Baylor College of Medicine's support of Tulane University School of Medicine following Hurricane Katrina.

PubMed

Searle, Nancy S

2007-08-01

The authors describe how Baylor College of Medicine (BCM), with three other Texas medical schools, "adopted" virtually all the 620 medical students and 526 house officers of Tulane University School of Medicine and continued their education for eight months after most of New Orleans, including Tulane, was flooded on August 29, 2005, after Hurricane Katrina. Soon after, BCM's president asked all senior staff to take whatever actions were necessary to sustain Tulane, and on September 7, leaders from BCM and three other Texas medical schools met to plan the relocation of Tulane's students and programs. The authors explain how problems were overcome (e.g., locating the scattered Tulane students and staff, finding them lodging, obtaining their records, and providing financial aid and counseling), and how high-quality educational experiences were maintained for both Tulane's and BCM's students and residents while assisting Tulane's faculty in numerous ways, helping Tulane plan the enrollment of its following year's students, and undergoing Liaison Committee for Medical Education and Accreditation Council on Graduate Medical Education site visits to BCM. After the BCM-Tulane experience, BCM developed a disaster-management plan (available online) that could help other schools as they plan for disasters. The authors also offer lessons learned in the areas of communication, cooperation, curriculum, collaboration, contact with accrediting bodies, and compassion. They close by stating that when BCM faculty are asked "how could you take Tulane's medical school in?" their response is, "how could we not?" They continue: "In medical education, a frequent discussion is how to teach humanism and professionalism; we teach it best by modeling it."

Toward cognitive pipelines of medical assistance algorithms.

PubMed

Philipp, Patrick; Maleshkova, Maria; Katic, Darko; Weber, Christian; Götz, Michael; Rettinger, Achim; Speidel, Stefanie; Kämpgen, Benedikt; Nolden, Marco; Wekerle, Anna-Laura; Dillmann, Rüdiger; Kenngott, Hannes; Müller, Beat; Studer, Rudi

2016-09-01

Assistance algorithms for medical tasks have great potential to support physicians with their daily work. However, medicine is also one of the most demanding domains for computer-based support systems, since medical assistance tasks are complex and the practical experience of the physician is crucial. Recent developments in the area of cognitive computing appear to be well suited to tackle medicine as an application domain. We propose a system based on the idea of cognitive computing and consisting of auto-configurable medical assistance algorithms and their self-adapting combination. The system enables automatic execution of new algorithms, given they are made available as Medical Cognitive Apps and are registered in a central semantic repository. Learning components can be added to the system to optimize the results in the cases when numerous Medical Cognitive Apps are available for the same task. Our prototypical implementation is applied to the areas of surgical phase recognition based on sensor data and image progressing for tumor progression mappings. Our results suggest that such assistance algorithms can be automatically configured in execution pipelines, candidate results can be automatically scored and combined, and the system can learn from experience. Furthermore, our evaluation shows that the Medical Cognitive Apps are providing the correct results as they did for local execution and run in a reasonable amount of time. The proposed solution is applicable to a variety of medical use cases and effectively supports the automated and self-adaptive configuration of cognitive pipelines based on medical interpretation algorithms.

Proceedings of the Second Joint Technology Workshop on Neural Networks and Fuzzy Logic, volume 2

NASA Technical Reports Server (NTRS)

Lea, Robert N. (Editor); Villarreal, James A. (Editor)

1991-01-01

Documented here are papers presented at the Neural Networks and Fuzzy Logic Workshop sponsored by NASA and the University of Texas, Houston. Topics addressed included adaptive systems, learning algorithms, network architectures, vision, robotics, neurobiological connections, speech recognition and synthesis, fuzzy set theory and application, control and dynamics processing, space applications, fuzzy logic and neural network computers, approximate reasoning, and multiobject decision making.

An Investigation of Run-Time Operations in a Heterogeneous Desktop Grid Environment: The Texas Tech University Desktop Grid Case Study

ERIC Educational Resources Information Center

Perez, Jerry F.

2013-01-01

The goal of the dissertation study was to evaluate the existing DG scheduling algorithm. The evaluation was developed through previously explored simulated analyses of DGs performed by researchers in the field of DG scheduling optimization and to improve the current RT framework of the DG at TTU. The author analyzed the RT of an actual DG, thereby…

Lysimetric evaluation of simplified surface energy balance approach in the Texas high plains

USGS Publications Warehouse

Gowda, P.H.; Senay, G.B.; Howell, T.A.; Marek, T.H.

2009-01-01

Numerous energy balance (EB) algorithms have been developed to make use of remote sensing data to estimate evapotranspiration (ET) regionally. However, most EB models are complex to use and efforts are being made to simplify procedures mainly through the scaling of reference ET. The Simplified Surface Energy Balance (SSEB) is one such method. This approach has never been evaluated using measured ET data. In this study, the SSEB approach was applied to 14 Landsat TM images covering a major portion of the Southern High Plains that were acquired during 2006 and 2007 cropping seasons. Performance of the SSEB was evaluated by comparing estimated ET with measured daily ET from four large monolithic lysimeters at the USDA-ARS Conservation and Production Research Laboratory, Bushland, Texas. Statistical evaluation of results indicated that the SSEB accounted for 84% of the variability in the measured ET values with a slope and intercept of 0.75 and 1.1 mm d-1, respectively. Considering the minimal amount of ancillary data required and excellent performance in predicting daily ET, the SSEB approach is a promising tool for mapping ET in the semiarid Texas High Plains and in other parts of the world with similar hydro-climatic conditions.

Lysimetric Evaluation of Simplified Surface Energy Balance Approach in the Texas High Plains

USGS Publications Warehouse

Senay, Gabriel B.; Gowda, P.H.; Howell, T.A.; Marek, T.H.

2009-01-01

Numerous energy balance (EB) algorithms have been developed to make use of remote sensing data to estimate evapotranspiration (ET) regionally. However, most EB models are complex to use and efforts are being made to simplify procedures mainly through the scaling of reference ET. The Simplified Surface Energy Balance (SSEB) is one such method. This approach has never been evaluated using measured ET data. In this study, the SSEB approach was applied to fourteen Landsat TM images covering a major portion of the Southern High Plains that were acquired during 2006 and 2007 cropping seasons. Performance of the SSEB was evaluated by comparing estimated ET with measured daily ET from four large monolithic lysimeters at the USDA-ARS Conservation and Production Research Laboratory, Bushland, Texas. Statistical evaluation of results indicated that the SSEB accounted for 84% of the variability in the measured ET values with a slope and intercept of 0.75 and 1.1 mm d-1, respectively. Considering the minimal amount of ancillary data required and excellent performance in predicting daily ET, the SSEB approach is a promising tool for mapping ET in the semiarid Texas High Plains and in other parts of the world with similar hydro-climatic conditions.

Mass and Volume Optimization of Space Flight Medical Kits

NASA Technical Reports Server (NTRS)

Keenan, A. B.; Foy, Millennia Hope; Myers, Jerry

2014-01-01

Resource allocation is a critical aspect of space mission planning. All resources, including medical resources, are subject to a number of mission constraints such a maximum mass and volume. However, unlike many resources, there is often limited understanding in how to optimize medical resources for a mission. The Integrated Medical Model (IMM) is a probabilistic model that estimates medical event occurrences and mission outcomes for different mission profiles. IMM simulates outcomes and describes the impact of medical events in terms of lost crew time, medical resource usage, and the potential for medically required evacuation. Previously published work describes an approach that uses the IMM to generate optimized medical kits that maximize benefit to the crew subject to mass and volume constraints. We improve upon the results obtained previously and extend our approach to minimize mass and volume while meeting some benefit threshold. METHODS We frame the medical kit optimization problem as a modified knapsack problem and implement an algorithm utilizing dynamic programming. Using this algorithm, optimized medical kits were generated for 3 mission scenarios with the goal of minimizing the medical kit mass and volume for a specified likelihood of evacuation or Crew Health Index (CHI) threshold. The algorithm was expanded to generate medical kits that maximize likelihood of evacuation or CHI subject to mass and volume constraints. RESULTS AND CONCLUSIONS In maximizing benefit to crew health subject to certain constraints, our algorithm generates medical kits that more closely resemble the unlimited-resource scenario than previous approaches which leverage medical risk information generated by the IMM. Our work here demonstrates that this algorithm provides an efficient and effective means to objectively allocate medical resources for spaceflight missions and provides an effective means of addressing tradeoffs in medical resource allocations and crew mission success parameters.

Production of a small-circulation medical journal using desktop publishing methods.

PubMed

Peters, B A

1994-07-01

Since its inception in January 1988, the Baylor University Medical Center Proceedings, a quarterly medical journal, has been published by the few staff of the Scientific Publications Office (Baylor Research Institute, Dallas, Texas, USA) using microcomputers and page-makeup software in conjunction with a commercial printing company. This article outlines the establishment of the journal; the steps used in the publication process; the software and hardware used; and the changes in design, content, and circulation that have taken place as the journal and the technology used to create it have evolved.

Insurance Status Is a Greater Barrier Than Income or Acculturation to Chronic Disease Screening in the Mexican Origin Population in El Paso, Texas.

PubMed

Salinas, Jennifer J; de Heer, Hendrik D; Lapeyrouse, Lisa M; Heyman, Josiah M; Balcázar, Hector Guillermo

2015-01-01

The purpose of this study was to determine the association between income, insurance status, acculturation, and preventive screening for diabetes, high blood pressure, and cholesterol in Mexican American adults living in El Paso, Texas. This is a secondary data analysis using data from El Paso, Texas, that was collected between November 2007 and May 2009. Bivariate and stepwise regression analysis was used to determine the relationships between income, insurance, and acculturation factors on preventive screenings. Findings indicate that insurance status was associated with blood pressure check, blood sugar check, cholesterol screening, and any preventive screening. The association for income $40,000 + was explained by insurance. The only significant acculturation variable was language use for cholesterol. Disparities in preventive health screening in Mexican Americans were associated with primary insurance coverage in El Paso, Texas. With the border region being among the most medically underserved and underinsured areas in the United States, the results from this study suggest policy efforts are essential to ensure equal access to resources to maintain good health. Intervention efforts may include increasing awareness of enrollment information for insurance programs through the Affordable Care Act.

Pharmacologic behavior management of pediatric dental patients diagnosed with attention deficit disorder/attention deficit hyperactivity disorder.

PubMed

Kerins, Carolyn A; McWhorter, Alton G; Seale, N Sue

2007-01-01

The purpose of this study was to conduct a survey of Texas pediatric dentists to determine: (1) the percentage of patients they treat with attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD); (2) the behavior management techniques that are utilized to treat their patients who suffer from ADD/ADHD; and (3) the relative success rates of these techniques in their practices. A 17-question, single-answer, multiple choice survey was mailed to 343 Texas pediatric dentists. The mailing list was obtained from American Academy of Pediatric Dentistry and Texas Academy of Pediatric Dentistry member rosters. One mailing was sent, including a self-addressed stomped envelope, for returned responses. A 54% response rate (186 surveys) revealed that nitrous oxide was the most frequently used pharmacologic behavior management technique; however, demerol/promethazine/nitrous oxide was rated as effective most often for treating ADD/ADHD patients. Practitioners believe the incidence of attention deficit disorder/attention deficit hyperactivity disorder is increasing, and they are familiar with the medications used to treat the conditions. Texas pediatric dentists are using a variety of sedation techniques and are interested in developing guidelines for sedation of these patients.

A clustering method of Chinese medicine prescriptions based on modified firefly algorithm.

PubMed

Yuan, Feng; Liu, Hong; Chen, Shou-Qiang; Xu, Liang

2016-12-01

This paper is aimed to study the clustering method for Chinese medicine (CM) medical cases. The traditional K-means clustering algorithm had shortcomings such as dependence of results on the selection of initial value, trapping in local optimum when processing prescriptions form CM medical cases. Therefore, a new clustering method based on the collaboration of firefly algorithm and simulated annealing algorithm was proposed. This algorithm dynamically determined the iteration of firefly algorithm and simulates sampling of annealing algorithm by fitness changes, and increased the diversity of swarm through expansion of the scope of the sudden jump, thereby effectively avoiding premature problem. The results from confirmatory experiments for CM medical cases suggested that, comparing with traditional K-means clustering algorithms, this method was greatly improved in the individual diversity and the obtained clustering results, the computing results from this method had a certain reference value for cluster analysis on CM prescriptions.

Utility of an Algorithm to Increase the Accuracy of Medication History in an Obstetrical Setting.

PubMed

Corbel, Aline; Baud, David; Chaouch, Aziz; Beney, Johnny; Csajka, Chantal; Panchaud, Alice

2016-01-01

In an obstetrical setting, inaccurate medication histories at hospital admission may result in failure to identify potentially harmful treatments for patients and/or their fetus(es). This prospective study was conducted to assess average concordance rates between (1) a medication list obtained with a one-page structured medication history algorithm developed for the obstetrical setting and (2) the medication list reported in medical records and obtained by open-ended questions based on standard procedures. Both lists were converted into concordance rate using a best possible medication history approach as the reference (information obtained by patients, prescribers and community pharmacists' interviews). The algorithm-based method obtained a higher average concordance rate than the standard method, with respectively 90.2% [CI95% 85.8-94.3] versus 24.6% [CI95%15.3-34.4] concordance rates (p<0.01). Our algorithm-based method strongly enhanced the accuracy of the medication history in our obstetric population, without using substantial resources. Its implementation is an effective first step to the medication reconciliation process, which has been recognized as a very important component of patients' drug safety.

Single-dose volume regulation algorithm for a gas-compensated intrathecal infusion pump.

PubMed

Nam, Kyoung Won; Kim, Kwang Gi; Sung, Mun Hyun; Choi, Seong Wook; Kim, Dae Hyun; Jo, Yung Ho

2011-01-01

The internal pressures of medication reservoirs of gas-compensated intrathecal medication infusion pumps decrease when medication is discharged, and these discharge-induced pressure drops can decrease the volume of medication discharged. To prevent these reductions, the volumes discharged must be adjusted to maintain the required dosage levels. In this study, the authors developed an automatic control algorithm for an intrathecal infusion pump developed by the Korean National Cancer Center that regulates single-dose volumes. The proposed algorithm estimates the amount of medication remaining and adjusts control parameters automatically to maintain single-dose volumes at predetermined levels. Experimental results demonstrated that the proposed algorithm can regulate mean single-dose volumes with a variation of <3% and estimate the remaining medication volume with an accuracy of >98%. © 2010, Copyright the Authors. Artificial Organs © 2010, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Glycemic Control in the Burn Intensive Care Unit: Focus on the Role of Anemia in Glucose Measurement

DTIC Science & Technology

2009-11-01

Aeronautics and Space Administration, the Juvenile Diabetes Research Foundation, and the Combat Casualty Care Division of the U.S. Army Medical Research...Research, Brooke Army Medical Center, San Antonio, Texas Abbreviations: (ABA) American Burn Association, (ADA) American Diabetes Association, (BG) blood...6315; email address Elizabeth.Mann@us.army.mil Journal of Diabetes Science and Technology Volume 3, Issue 6, November 2009 © Diabetes Technology

Automation of a high risk medication regime algorithm in a home health care population.

PubMed

Olson, Catherine H; Dierich, Mary; Westra, Bonnie L

2014-10-01

Create an automated algorithm for predicting elderly patients' medication-related risks for readmission and validate it by comparing results with a manual analysis of the same patient population. Outcome and Assessment Information Set (OASIS) and medication data were reused from a previous, manual study of 911 patients from 15 Medicare-certified home health care agencies. The medication data was converted into standardized drug codes using APIs managed by the National Library of Medicine (NLM), and then integrated in an automated algorithm that calculates patients' high risk medication regime scores (HRMRs). A comparison of the results between algorithm and manual process was conducted to determine how frequently the HRMR scores were derived which are predictive of readmission. HRMR scores are composed of polypharmacy (number of drugs), Potentially Inappropriate Medications (PIM) (drugs risky to the elderly), and Medication Regimen Complexity Index (MRCI) (complex dose forms, instructions or administration). The algorithm produced polypharmacy, PIM, and MRCI scores that matched with 99%, 87% and 99% of the scores, respectively, from the manual analysis. Imperfect match rates resulted from discrepancies in how drugs were classified and coded by the manual analysis vs. the automated algorithm. HRMR rules lack clarity, resulting in clinical judgments for manual coding that were difficult to replicate in the automated analysis. The high comparison rates for the three measures suggest that an automated clinical tool could use patients' medication records to predict their risks of avoidable readmissions. Copyright © 2014 Elsevier Inc. All rights reserved.

Historical ties between otolaryngology-head and neck surgery and aviation and space medicine.

PubMed

Alford, B R; Atkins, J H

1998-03-01

Otolaryngology-head and neck surgeons have been involved in the development of aviation and space medicine since the beginning of this century. More than 75 years ago, otolaryngologists revised the physical examination for pilots, organized "boards of medical examiners" to test pilot applicants, coined the term "flight surgeon," and helped organize the first medical research laboratories at Hazelhurst Field in New York. These laboratories were transformed in 1922 into the School of Aviation Medicine at Brooks Field, Texas, which in turn subsequently was relocated to Randolph Field, Texas. During World War II the Director of Research at the school was Colonel Paul A. Campbell, MD, an otolaryngologist. In 1959, the school moved back to Brooks Air Force Base and was renamed the Aerospace Medical Center. Since manned space flight began in the 1960s there have been many joint research efforts between principal investigators in otolaryngology-head and neck surgery and NASA. Several otolaryngology-head and neck surgeons have served or currently serve as consultants and advisors to many of NASA's standing committees. The space environment offers a new frontier for development and research in the specialty and for better understanding of vestibular function and related disorders.

How a disaster preparedness rotation helps teach the seven NAVMEC professional competencies: the Texas A&M University Experience.

PubMed

Bissett, Wesley T; Zoran, Debra L; Clendenin, Angela; Espitia, Noberto F; Moyer, William; Rogers, Kenita S

2013-01-01

Changing societal expectations provide new challenges and opportunities for the veterinary medical profession. These changing expectations and approaches to the education of veterinary students in the future are reflected in the North American Veterinary Medical Education Consortium's report "Roadmap for Veterinary Medical Education in the 21st Century: Responsive, Collaborative, Flexible." They are also reflected in the expectations of the populace, who no longer find it acceptable that animals are not included in both planning for and responding to natural or manmade disasters. In response to the changing needs of society and the veterinary profession, Texas A&M University College of Veterinary Medicine has developed a required rotation in the fourth-year curriculum on emergency planning and response. The unique requirements of emergency preparedness and response and the design of the rotation provide an ideal platform for providing this valued public service while simultaneously addressing the seven professional competencies outlined in the NAVMEC roadmap. This article describes an overview of the rotation and its content and identifies opportunities for students to practice these important professional competencies using the tools introduced in this new rotation.

The Applications of Genetic Algorithms in Medicine.

PubMed

Ghaheri, Ali; Shoar, Saeed; Naderan, Mohammad; Hoseini, Sayed Shahabuddin

2015-11-01

A great wealth of information is hidden amid medical research data that in some cases cannot be easily analyzed, if at all, using classical statistical methods. Inspired by nature, metaheuristic algorithms have been developed to offer optimal or near-optimal solutions to complex data analysis and decision-making tasks in a reasonable time. Due to their powerful features, metaheuristic algorithms have frequently been used in other fields of sciences. In medicine, however, the use of these algorithms are not known by physicians who may well benefit by applying them to solve complex medical problems. Therefore, in this paper, we introduce the genetic algorithm and its applications in medicine. The use of the genetic algorithm has promising implications in various medical specialties including radiology, radiotherapy, oncology, pediatrics, cardiology, endocrinology, surgery, obstetrics and gynecology, pulmonology, infectious diseases, orthopedics, rehabilitation medicine, neurology, pharmacotherapy, and health care management. This review introduces the applications of the genetic algorithm in disease screening, diagnosis, treatment planning, pharmacovigilance, prognosis, and health care management, and enables physicians to envision possible applications of this metaheuristic method in their medical career.].

The Applications of Genetic Algorithms in Medicine

PubMed Central

Ghaheri, Ali; Shoar, Saeed; Naderan, Mohammad; Hoseini, Sayed Shahabuddin

2015-01-01

A great wealth of information is hidden amid medical research data that in some cases cannot be easily analyzed, if at all, using classical statistical methods. Inspired by nature, metaheuristic algorithms have been developed to offer optimal or near-optimal solutions to complex data analysis and decision-making tasks in a reasonable time. Due to their powerful features, metaheuristic algorithms have frequently been used in other fields of sciences. In medicine, however, the use of these algorithms are not known by physicians who may well benefit by applying them to solve complex medical problems. Therefore, in this paper, we introduce the genetic algorithm and its applications in medicine. The use of the genetic algorithm has promising implications in various medical specialties including radiology, radiotherapy, oncology, pediatrics, cardiology, endocrinology, surgery, obstetrics and gynecology, pulmonology, infectious diseases, orthopedics, rehabilitation medicine, neurology, pharmacotherapy, and health care management. This review introduces the applications of the genetic algorithm in disease screening, diagnosis, treatment planning, pharmacovigilance, prognosis, and health care management, and enables physicians to envision possible applications of this metaheuristic method in their medical career.] PMID:26676060

Algorithmic and user study of an autocompletion algorithm on a large medical vocabulary.

PubMed

Sevenster, Merlijn; van Ommering, Rob; Qian, Yuechen

2012-02-01

Autocompletion supports human-computer interaction in software applications that let users enter textual data. We will be inspired by the use case in which medical professionals enter ontology concepts, catering the ongoing demand for structured and standardized data in medicine. Goal is to give an algorithmic analysis of one particular autocompletion algorithm, called multi-prefix matching algorithm, which suggests terms whose words' prefixes contain all words in the string typed by the user, e.g., in this sense, opt ner me matches optic nerve meningioma. Second we aim to investigate how well it supports users entering concepts from a large and comprehensive medical vocabulary (snomed ct). We give a concise description of the multi-prefix algorithm, and sketch how it can be optimized to meet required response time. Performance will be compared to a baseline algorithm, which gives suggestions that extend the string typed by the user to the right, e.g. optic nerve m gives optic nerve meningioma, but opt ner me does not. We conduct a user experiment in which 12 participants are invited to complete 40 snomed ct terms with the baseline algorithm and another set of 40 snomed ct terms with the multi-prefix algorithm. Our results show that users need significantly fewer keystrokes when supported by the multi-prefix algorithm than when supported by the baseline algorithm. The proposed algorithm is a competitive candidate for searching and retrieving terms from a large medical ontology. Copyright © 2011 Elsevier Inc. All rights reserved.

Comparative Analysis of the Public Health Role of Two Types of Death Investigation Systems in Texas: Application of Essential Services.

PubMed

Drake, Stacy A; Cron, Stanley G; Giardino, Angelo; Trevino, Vanessa; Nolte, Kurt B

2015-07-01

The purpose of this research was to assess the practices of death investigation agencies in Texas and to investigate the differences between justices of the peace (JPs) and medical examiner perceptions of their role and responsibilities. A survey was conducted in which justices of the peace and medical examiners (MEs) were questioned on their agency's policies and practices in regard to essential services provided using a recently published 50-item instrument subdivided into 10 essential services areas. The study used a quantitative descriptive cross-sectional design in which nonparametric analysis was used to ascertain differences between groups. The sample size for analysis was composed of 10 (83%) ME offices and 112 (15.5%) JPs. This statewide study found significant differences between MEs and JPs. These differences reflect the variation in educational background, understanding and implementation of essential services, and the appreciation of the needs of a system to be both collaborative and independent. © 2015 American Academy of Forensic Sciences.

[An improved medical image fusion algorithm and quality evaluation].

PubMed

Chen, Meiling; Tao, Ling; Qian, Zhiyu

2009-08-01

Medical image fusion is of very important value for application in medical image analysis and diagnosis. In this paper, the conventional method of wavelet fusion is improved,so a new algorithm of medical image fusion is presented and the high frequency and low frequency coefficients are studied respectively. When high frequency coefficients are chosen, the regional edge intensities of each sub-image are calculated to realize adaptive fusion. The choice of low frequency coefficient is based on the edges of images, so that the fused image preserves all useful information and appears more distinctly. We apply the conventional and the improved fusion algorithms based on wavelet transform to fuse two images of human body and also evaluate the fusion results through a quality evaluation method. Experimental results show that this algorithm can effectively retain the details of information on original images and enhance their edge and texture features. This new algorithm is better than the conventional fusion algorithm based on wavelet transform.

Logic Programming as an Inference Engine for Non-Monotonic Reasoning

DTIC Science & Technology

1991-11-11

Mathematical Sciences . ... University of Texas at El Paso AdI!ar, El Pazo , TX 79968-0514 [ A , (teodor math.ep.utexas.edu) Dist November 11, 1991 Title...Przymusinska, L. Pereira and D.S. Warren. Significant progress has been made towards both theoretical and algorithmic foundations of a non-monotonic...reasoning system based on logic programming. An implementation of such a system, limited to circumscrip- tive thoories, has been also completed. 14

Use of the internet for health information among primary care patients in rural West Texas.

PubMed

Zhang, Yan; Jones, Betsy; Spalding, Mary; Young, Rodney; Ragain, Mike

2009-06-01

Little is known about how primary care patients in rural, remote or border areas use the internet for their health information. This study examined the factors related to internet use for medical information among primary care clinic patients in such areas of West Texas. A convenience sample was drawn from nine clinics that serve low-income rural area populations. Surveys were distributed to the patients during a 6-week period in the winter of 2006. The analytical sample included 1890 participants. Logistic regressions were conducted. Of 1890 subjects, 699 (37%) reported having used the internet for medical information. Among those who reported using the internet for health information, respondents' primary usage pattern was to request more health information (29.9%), followed by the purchase of health supplies (13.4%). Most internet users (78.8%) agreed that the online medical/health information had improved their understanding of a specific condition, disease, or treatment. Almost 60% of the internet users thought the information was reliable. The correlates of internet use included health insurance, self-rated health, health confidence, and number of worried days as well as age, education level, ethnicity, and language. Our findings showed a much lower rate of internet use for medical/health information compared with a 2006 nationwide survey. This finding suggests that promoting health/medical information through websites or other on-line resources might not be the most effective way to reach a majority of patients in remote, rural or border areas.

Evaluation of active mortality surveillance system data for monitoring hurricane-related deaths-Texas, 2008.

PubMed

Choudhary, Ekta; Zane, David F; Beasley, Crystal; Jones, Russell; Rey, Araceli; Noe, Rebecca S; Martin, Colleen; Wolkin, Amy F; Bayleyegn, Tesfaye M

2012-08-01

The Texas Department of State Health Services (DSHS) implemented an active mortality surveillance system to enumerate and characterize hurricane-related deaths during Hurricane Ike in 2008. This surveillance system used established guidelines and case definitions to categorize deaths as directly, indirectly, and possibly related to Hurricane Ike. The objective of this study was to evaluate Texas DSHS' active mortality surveillance system using US Centers for Disease Control and Prevention's (CDC) surveillance system evaluation guidelines. Using CDC's Updated Guidelines for Surveillance System Evaluation, the active mortality surveillance system of the Texas DSHS was evaluated. Data from the active mortality surveillance system were compared with Texas vital statistics data for the same time period to estimate the completeness of reported disaster-related deaths. From September 8 through October 13, 2008, medical examiners (MEs) and Justices of the Peace (JPs) in 44 affected counties reported deaths daily by using a one-page, standardized mortality form. The active mortality surveillance system identified 74 hurricane-related deaths, whereas a review of vital statistics data revealed only four deaths that were hurricane-related. The average time of reporting a death by active mortality surveillance and vital statistics was 14 days and 16 days, respectively. Texas's active mortality surveillance system successfully identified hurricane-related deaths. Evaluation of the active mortality surveillance system suggested that it is necessary to collect detailed and representative mortality data during a hurricane because vital statistics do not capture sufficient information to identify whether deaths are hurricane-related. The results from this evaluation will help improve active mortality surveillance during hurricanes which, in turn, will enhance preparedness and response plans and identify public health interventions to reduce future hurricane-related mortality rates.

An improved wavelet neural network medical image segmentation algorithm with combined maximum entropy

NASA Astrophysics Data System (ADS)

Hu, Xiaoqian; Tao, Jinxu; Ye, Zhongfu; Qiu, Bensheng; Xu, Jinzhang

2018-05-01

In order to solve the problem of medical image segmentation, a wavelet neural network medical image segmentation algorithm based on combined maximum entropy criterion is proposed. Firstly, we use bee colony algorithm to optimize the network parameters of wavelet neural network, get the parameters of network structure, initial weights and threshold values, and so on, we can quickly converge to higher precision when training, and avoid to falling into relative extremum; then the optimal number of iterations is obtained by calculating the maximum entropy of the segmented image, so as to achieve the automatic and accurate segmentation effect. Medical image segmentation experiments show that the proposed algorithm can reduce sample training time effectively and improve convergence precision, and segmentation effect is more accurate and effective than traditional BP neural network (back propagation neural network : a multilayer feed forward neural network which trained according to the error backward propagation algorithm.

The algorithm stitching for medical imaging

NASA Astrophysics Data System (ADS)

Semenishchev, E.; Marchuk, V.; Voronin, V.; Pismenskova, M.; Tolstova, I.; Svirin, I.

2016-05-01

In this paper we propose a stitching algorithm of medical images into one. The algorithm is designed to stitching the medical x-ray imaging, biological particles in microscopic images, medical microscopic images and other. Such image can improve the diagnosis accuracy and quality for minimally invasive studies (e.g., laparoscopy, ophthalmology and other). The proposed algorithm is based on the following steps: the searching and selection areas with overlap boundaries; the keypoint and feature detection; the preliminary stitching images and transformation to reduce the visible distortion; the search a single unified borders in overlap area; brightness, contrast and white balance converting; the superimposition into a one image. Experimental results demonstrate the effectiveness of the proposed method in the task of image stitching.

[Research on non-rigid registration of multi-modal medical image based on Demons algorithm].

PubMed

Hao, Peibo; Chen, Zhen; Jiang, Shaofeng; Wang, Yang

2014-02-01

Non-rigid medical image registration is a popular subject in the research areas of the medical image and has an important clinical value. In this paper we put forward an improved algorithm of Demons, together with the conservation of gray model and local structure tensor conservation model, to construct a new energy function processing multi-modal registration problem. We then applied the L-BFGS algorithm to optimize the energy function and solve complex three-dimensional data optimization problem. And finally we used the multi-scale hierarchical refinement ideas to solve large deformation registration. The experimental results showed that the proposed algorithm for large de formation and multi-modal three-dimensional medical image registration had good effects.

A Study of the Emergency Medical Service System at Womack Army Hospital, Fort Bragg, North Carolina.

DTIC Science & Technology

1978-04-01

SECURITY CLASSIFICATION OF THIS PAGE ACKNOWLEDGEMENTS Special thanks must be given to Colonel Llewellyn Legters , Colonel Joseph E. Brannock, and Major James...DEPARTMENT OF THE ARMY HEADQUARTERS. UNITED STATES ARMY HEALTH SERVICES COMMAND FORT SAIA HOUSTON. TEXAS 78234 HSPA 2 2 .0 7 Colonel Llewellyn J. Legters ...Commander US Army Medical Department Activity Fort Bragg, NC 28307 Dear Colonel Legters : The continuing military physician shortage is the most

Proceedings of the Current Trends in Army Medical Department Psychology Held at San Antonio, Texas on 8-12 November 1976.

DTIC Science & Technology

1976-12-01

the faculty of several medical schools and universities. He is a 4 noted authority, lecturer, and author in the field of clinical hypnosis and has...a Fellow in the American Psychological Association and a Diplomate in Psychological Hypnosis . 0 .. ’..........- 1976 Current Trends in AMEDD...clinical neuropsychology, including the relationship of this field to medicine and various forensic concerns. Subsequent to this introduction by Dr

Entrance into Registered Nursing--Issues and Problems.

ERIC Educational Resources Information Center

Herd, Ruby H.

Following a description of the facilities, programs, and students of El Centro College (Texas), this paper reviews the conflicts arising between the mandates of external certifying boards, the expectations of hospital administrators and other medical personnel, and the realities of community college philosophy, planning, staffing and budgeting for…

Expert Systems Based Clinical Assessment and Tutorial Project.

ERIC Educational Resources Information Center

Papa, Frank; Shores, Jay

This project at the Texas College of Osteopathic Medicine (Fort Worth) evaluated the use of an artificial-intelligence-derived measure, "Knowledge-Based Inference Tool" (KBIT), as the basis for assessing medical students' diagnostic capabilities and designing instruction to improve diagnostic skills. The instrument was designed to…

Counties Without a Physician.

ERIC Educational Resources Information Center

Getz, Virginia

1982-01-01

Uses a budgeting technique to determine if free-market incentives or forces would provide an economic base sufficient to support medical professionals who might practice in the approximately 140 U.S. counties that lack a physician (located mainly in a narrow band from west Texas north through South Dakota). (AH)

Changes and challenges: managing ADHD in a fast-paced world.

PubMed

Manos, Michael J; Tom-Revzon, Catherine; Bukstein, Oscar G; Crismon, M Lynn

2007-11-01

Attention-deficit/hyperactivity disorder (ADHD) impairs the lives of both children and adults. Undiagnosed and untreated, ADHD may have serious lifelong consequences. Research has identified diagnostic clues, neurotransmitter pathways, and psychiatric comorbidities related to ADHD, as well as effective pharmacologic, behavioral, and psychosocial interventions. Stimulant agents have been the foundation of ADHD therapy for more than 50 years. Availability of new extended-release (XR or ER) and longer-acting (LA) formulations and novel agents allows for wider and more individualized treatment choices. Side effects of stimulants are generally mild, short lived, and responsive to adjustments in dosage or timing. Outcomes in ADHD treatment can be improved with the use of clear treatment guidelines and tools to aid clinicians in implementing them efficiently and effectively. The Texas Children's Medication Algorithm Project (CMAP) provides a system of algorithm-driven treatment decisions that is evidence based and easy to implement. To (1) review the psychological components of attention, the neurotransmitter pathways associated with ADHD, and the array of therapeutic options for ADHD, with an emphasis on the most recent introductions to the therapeutic armamentarium; (2) discuss the rare psychiatric and cardiovascular side effects associated with stimulants; (3) review abuse liability, comorbidities, and suggested approaches to these issues; and (4) review the development and use of CMAP and offer resources for its implementation in clinical practice. The pathophysiology of ADHD is linked to dysfunction of fronto-subcortical networks and dysregulation of dopaminergic, noradrenergic, and nicotinic neurotransmitter systems. An additive effect of multiple genes as well as environmental influences contributes to the clinical picture. Treatment with stimulants and nonstimulants has proven effective in different subgroups, with the effectiveness of specific agents most likely related to the primary neurotransmitter involved. Availability of XR, ER, LA, and transdermal stimulant formulations, as well as alternative nonstimulant agents, offers new options for the pharmacotherapy of ADHD. Major concerns associated with abuse liability of stimulants have been allayed by the availability of ER formulations, which have reduced reinforcing effects associated with short-acting preparations. Medication outcomes in ADHD can be enhanced by the use of evidence-based algorithms such as CMAP. Keys to success are adequate initial assessment and diagnosis, the use of sustained-release products, sufficient dose titration, and the use of clinical rating scales with feedback from caregivers and teachers. Optimal treatment outcomes can be achieved by appropriate pharmacotherapy combined with psychosocial interventions.

Optimizing Medical Kits for Spaceflight

NASA Technical Reports Server (NTRS)

Keenan, A. B,; Foy, Millennia; Myers, G.

2014-01-01

The Integrated Medical Model (IMM) is a probabilistic model that estimates medical event occurrences and mission outcomes for different mission profiles. IMM simulation outcomes describing the impact of medical events on the mission may be used to optimize the allocation of resources in medical kits. Efficient allocation of medical resources, subject to certain mass and volume constraints, is crucial to ensuring the best outcomes of in-flight medical events. We implement a new approach to this medical kit optimization problem. METHODS We frame medical kit optimization as a modified knapsack problem and implement an algorithm utilizing a dynamic programming technique. Using this algorithm, optimized medical kits were generated for 3 different mission scenarios with the goal of minimizing the probability of evacuation and maximizing the Crew Health Index (CHI) for each mission subject to mass and volume constraints. Simulation outcomes using these kits were also compared to outcomes using kits optimized..RESULTS The optimized medical kits generated by the algorithm described here resulted in predicted mission outcomes more closely approached the unlimited-resource scenario for Crew Health Index (CHI) than the implementation in under all optimization priorities. Furthermore, the approach described here improves upon in reducing evacuation when the optimization priority is minimizing the probability of evacuation. CONCLUSIONS This algorithm provides an efficient, effective means to objectively allocate medical resources for spaceflight missions using the Integrated Medical Model.

A Remote Sensing and GIS Approach for State to Aquifer Scale Mapping of Groundwater Dependent Ecosystems

NASA Astrophysics Data System (ADS)

Gonzalez, S.; Gou, S.; Miller, G. R.

2012-12-01

Ecosystems which rely on either the surface expression or subsurface presence of groundwater are known as groundwater dependent ecosystems (GDEs). A comprehensive inventory of GDE locations at a management scale is a necessary first-step for sustainable management of effected aquifers; however, this information is unavailable for most areas of concern. To address this gap, this study derives algorithms to identify the spatial distribution of GDEs at the state and aquifer scales and to generate an example geospatial database of potential GDEs located throughout Texas. We first constructed a geospatial information system (GIS) database with current climate, topography, hydrology, and ecology data, synthesized from both existing feature sets and sets created with information from published documents. The created features included potential groundwater dependent vegetation types in Texas and gaining and loosing streams produces with data from flow measuring stations. The resulting state-scale GIS database was used to delineate the areas where conditions are favorable for GDEs. Next, an aquifer-scale remote sensing based algorithm was created to identify the ecosystems that exhibit the physiological hallmarks groundwater dependence. This algorithm used Landsat 7 and MODIS images to calculate the seasonal and inter-annual changes of NDVI for each vegetation pixel. The NDVI dynamics were used to identify the vegetation with high potential to use groundwater—such plants remain mostly green and physiologically active during extended dry periods of the year and also exhibit low inter-annual leaf area changes between dry and wet years. Combining the results of GIS and remote sensing methods, we group the vegetated areas into five levels from "very high" to "very low" potential to use groundwater. The product of this research, a state-level GIS database of potential GDEs in Texas, indicates that the vegetation with highest groundwater use possibility is around the springs, along the gaining streams, or within the shallow water table areas. It also reveals that the Edwards aquifer region has the highest density of potential GDEs. Out of a total area of 105 km2 in this region, 24% was found to have a high or very high probability of having GDEs. In addition, we highlight the significance of GDE identification to sustainable groundwater management and demonstrate the necessity of unconfined groundwater table monitoring.

Crypto-Watermarking of Transmitted Medical Images.

PubMed

Al-Haj, Ali; Mohammad, Ahmad; Amer, Alaa'

2017-02-01

Telemedicine is a booming healthcare practice that has facilitated the exchange of medical data and expertise between healthcare entities. However, the widespread use of telemedicine applications requires a secured scheme to guarantee confidentiality and verify authenticity and integrity of exchanged medical data. In this paper, we describe a region-based, crypto-watermarking algorithm capable of providing confidentiality, authenticity, and integrity for medical images of different modalities. The proposed algorithm provides authenticity by embedding robust watermarks in images' region of non-interest using SVD in the DWT domain. Integrity is provided in two levels: strict integrity implemented by a cryptographic hash watermark, and content-based integrity implemented by a symmetric encryption-based tamper localization scheme. Confidentiality is achieved as a byproduct of hiding patient's data in the image. Performance of the algorithm was evaluated with respect to imperceptibility, robustness, capacity, and tamper localization, using different medical images. The results showed the effectiveness of the algorithm in providing security for telemedicine applications.

A Nonlinear Digital Control Solution for a DC/DC Power Converter

NASA Technical Reports Server (NTRS)

Zhu, Minshao

2002-01-01

A digital Nonlinear Proportional-Integral-Derivative (NPID) control algorithm was proposed to control a 1-kW, PWM, DC/DC, switching power converter. The NPID methodology is introduced and a practical hardware control solution is obtained. The design of the controller was completed using Matlab (trademark) Simulink, while the hardware-in-the-loop testing was performed using both the dSPACE (trademark) rapid prototyping system, and a stand-alone Texas Instruments (trademark) Digital Signal Processor (DSP)-based system. The final Nonlinear digital control algorithm was implemented and tested using the ED408043-1 Westinghouse DC-DC switching power converter. The NPID test results are discussed and compared to the results of a standard Proportional-Integral (PI) controller.

Medical Image Encryption: An Application for Improved Padding Based GGH Encryption Algorithm

PubMed Central

Sokouti, Massoud; Zakerolhosseini, Ali; Sokouti, Babak

2016-01-01

Medical images are regarded as important and sensitive data in the medical informatics systems. For transferring medical images over an insecure network, developing a secure encryption algorithm is necessary. Among the three main properties of security services (i.e., confidentiality, integrity, and availability), the confidentiality is the most essential feature for exchanging medical images among physicians. The Goldreich Goldwasser Halevi (GGH) algorithm can be a good choice for encrypting medical images as both the algorithm and sensitive data are represented by numeric matrices. Additionally, the GGH algorithm does not increase the size of the image and hence, its complexity will remain as simple as O(n2). However, one of the disadvantages of using the GGH algorithm is the Chosen Cipher Text attack. In our strategy, this shortcoming of GGH algorithm has been taken in to consideration and has been improved by applying the padding (i.e., snail tour XORing), before the GGH encryption process. For evaluating their performances, three measurement criteria are considered including (i) Number of Pixels Change Rate (NPCR), (ii) Unified Average Changing Intensity (UACI), and (iii) Avalanche effect. The results on three different sizes of images showed that padding GGH approach has improved UACI, NPCR, and Avalanche by almost 100%, 35%, and 45%, respectively, in comparison to the standard GGH algorithm. Also, the outcomes will make the padding GGH resist against the cipher text, the chosen cipher text, and the statistical attacks. Furthermore, increasing the avalanche effect of more than 50% is a promising achievement in comparison to the increased complexities of the proposed method in terms of encryption and decryption processes. PMID:27857824

Department of the Army Health Services Command, CHAMPUS Catastrophic Payments for Second Quarter, Fiscal Year 1993. Gateway Catchment Areas

DTIC Science & Technology

1993-04-01

Carson, I CO 80913-5000 (1) Commander, U.S. Army Medical Department Activity, Fort Devens , MA 01433-5000 (1) Commander, U.S. Army Medical Department...Director, Coordinated Care, U.S. Army Medical Department Activity, Fort Devens , MA 01433-5000 (1) 7 I I Director, Coordinated Care, U.S. Army...ThNITED STATES ARMY 8 HEALTH SERVICES COMMAND * FORT SAM HOUSTON, TEXAS 78234 i 93-10539 I g 3 5 1 1 2 0 I i IIIlllllllHItli • I I NOTICE I The findings in

Statistical Report. Fiscal Year 1990: September 1, 1989-August 3, 1990.

ERIC Educational Resources Information Center

Texas Higher Education Coordinating Board, Austin.

Statistical data are presented from Texas institutions of higher education, including both public and independent universities; medical, dental, and allied health units; junior colleges; and technical institutes. The scope of the data includes: (1) student enrollments from 1985-1989, enrollment by ethnic origin and sex, resident and nonresident…

Contemplating Katrina's Chaos

ERIC Educational Resources Information Center

Roach, Ronald

2005-01-01

To get some notion of how deeply scholars have been affected by Hurricane Katrina, one might look to someone like Dr. Erma Lawson, a medical sociologist from the University of North Texas. Lawson, who has coordinated the assistance efforts for the Association of Black Sociologists, has not hesitated to call on colleagues, graduate students, civil…

Engineering Light: Quantum Cascade Lasers

ScienceCinema

Claire Gmachl

2017-12-09

Quantum cascade lasers are ideal for environmental sensing and medical diagnostic applications. Gmachl discusses how these lasers work, and their applications, including their use as chemical trace gas sensors. As examples of these applications, she briefly presents results from her field campaign at the Beijing Olympics, and ongoing campaigns in Texas, Maryland, and Ghana.

Faculty Development Manual for the School of Allied Health Sciences, University of Texas Medical Branch at Galveston.

ERIC Educational Resources Information Center

Texas Univ., Galveston. Medical Branch.

The contents of this guide, adopted for a one-year pilot study, include: standard operating procedures for the faculty development/effectiveness document (performance and evaluation contract); instructions and forms for evaluating effectiveness in teaching, administrative duties, and professional activities; and a faculty…

78 FR 44972 - George R. Smith, M.D.; Decision and Order

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-25

... administrative hearing. [ALJ Exh. 5; Tr. 6]. B. Respondent's History 1. Respondent's Education and Training Respondent received a Bachelor of Science degree from East Texas State University, majoring in Molecular... Southwestern Medical School, where he later graduated in the top 10% of his class. [Tr. 78-79]. After...

Progressive Reduction in Central Blood Volume is not Detected by Sublingual Capnography

DTIC Science & Technology

2012-01-01

Sam Houston; †Department of Health and Kinesiology , University of Texas at San Antonio, San Antonio, and ‡San Antonio Military Medical Center, Fort...of hypovolaemia with gastrointestinal tonometry. Intensive Care Med 23(3):276 281, 1997. 13. Santoso JT, Wisner DH, Battistella FD, Owings JT

Levels of Organization: A Model of Morphologic Interrelationships

ERIC Educational Resources Information Center

Shively, Michael Jay

1977-01-01

A one-hour presentation given to veterinary medical students at Texas A&M University during their first week of professional school is summarized. It helps the students place some of their subjects and disciplines in perspective, emphasizing the overall morphologic organizational scheme of the higher vertebrate body. (LBH)

Hypomyelination Associated with Bovine Viral Diarrhea Virus Type 2 Infection in a Longhorn Calf

USDA-ARS?s Scientific Manuscript database

A newborn Longhorn heifer calf presented to the Veterinary Medical Teaching Hospital at Texas A&M University with generalized tremors, muscle fasciculations, ataxia, and nystagmus. At necropsy, gross central nervous system lesions were not observed. Histopathologic evaluation of the brain and spin...

Variation in inpatient hospital prices and outpatient service quantities drive geographic differences in private spending in Texas.

PubMed

Franzini, Luisa; White, Chapin; Taychakhoonavudh, Suthira; Parikh, Rohan; Zezza, Mark; Mikhail, Osama

2014-12-01

To measure the contribution of market-level prices, utilization, and health risk to medical spending variation among the Blue Cross Blue Shield of Texas (BCBSTX) privately insured population and the Texas Medicare population. Claims data for all BCBSTX members and publicly available CMS data for Texas in 2011. We used observational data and decomposed overall and service-specific spending into health status and health status adjusted utilization and input prices and input prices adjusted for the BCBSTX and Medicare populations. Variation in overall BCBSTX spending across HRRs appeared driven by price variation, whereas utilization variation factored more prominently in Medicare. The contribution of price to spending variation differed by service category. Price drove inpatient spending variation, while utilization drove outpatient and professional spending variation in BCBSTX. The context in which negotiations occur may help explain the patterns across services. The conventional wisdom that Medicare does a better job of controlling prices and private plans do a better job of controlling volume is an oversimplification. BCBSTX does a good job of controlling outpatient and professional prices, but not at controlling inpatient prices. Strategies to manage the variation in spending may need to differ substantially depending on the service and payer. © Health Research and Educational Trust.

Cross-Border Utilization of Health Care: Evidence from a Population-Based Study in South Texas

PubMed Central

Su, Dejun; Richardson, Chad; Wen, Ming; Pagán, José A

2011-01-01

Objective To assess the prevalence of health care utilization in Mexico by Texas border residents and to identify the main contributing factors to their cross-border utilization of health care services. Data and Methods This study used primary data from a population-based telephone survey that was conducted in the whole Texas border area in 2008. The survey included responses from 1,405 adults. Multivariate logistic regression models were estimated to determine predictors of utilizing a wide range of health care services in Mexico. Principal Findings Forty-nine percent of the sample reported having ever purchased medications in Mexico, followed by 41 percent for dentist visits, 37.3 percent for doctor visits, and 6.7 percent for inpatient care. The most significant predictors of health care utilization in Mexico were lack of U.S. health insurance coverage, dissatisfaction with the quality of U.S. health care, and poor self-rated health status. Conclusions The high prevalence of use of health care services in Mexico by Texas border residents is suggestive of unmet needs in health care on the U.S. side of the border. Addressing these unmet needs calls for a binational approach to improve the affordability, accessibility, and quality of health care in the U.S.–Mexico border region. PMID:21158855

Variation in Inpatient Hospital Prices and Outpatient Service Quantities Drive Geographic Differences in Private Spending in Texas

PubMed Central

Franzini, Luisa; White, Chapin; Taychakhoonavudh, Suthira; Parikh, Rohan; Zezza, Mark; Mikhail, Osama

2014-01-01

Objective To measure the contribution of market-level prices, utilization, and health risk to medical spending variation among the Blue Cross Blue Shield of Texas (BCBSTX) privately insured population and the Texas Medicare population. Data Sources Claims data for all BCBSTX members and publicly available CMS data for Texas in 2011. Study Design We used observational data and decomposed overall and service-specific spending into health status and health status adjusted utilization and input prices and input prices adjusted for the BCBSTX and Medicare populations. Principal Findings Variation in overall BCBSTX spending across HRRs appeared driven by price variation, whereas utilization variation factored more prominently in Medicare. The contribution of price to spending variation differed by service category. Price drove inpatient spending variation, while utilization drove outpatient and professional spending variation in BCBSTX. The context in which negotiations occur may help explain the patterns across services. Conclusions The conventional wisdom that Medicare does a better job of controlling prices and private plans do a better job of controlling volume is an oversimplification. BCBSTX does a good job of controlling outpatient and professional prices, but not at controlling inpatient prices. Strategies to manage the variation in spending may need to differ substantially depending on the service and payer. PMID:24919408

Block-suffix shifting: fast, simultaneous medical concept set identification in large medical record corpora.

PubMed

Liu, Ying; Lita, Lucian Vlad; Niculescu, Radu Stefan; Mitra, Prasenjit; Giles, C Lee

2008-11-06

Owing to new advances in computer hardware, large text databases have become more prevalent than ever.Automatically mining information from these databases proves to be a challenge due to slow pattern/string matching techniques. In this paper we present a new, fast multi-string pattern matching method based on the well known Aho-Chorasick algorithm. Advantages of our algorithm include:the ability to exploit the natural structure of text, the ability to perform significant character shifting, avoiding backtracking jumps that are not useful, efficiency in terms of matching time and avoiding the typical "sub-string" false positive errors.Our algorithm is applicable to many fields with free text, such as the health care domain and the scientific document field. In this paper, we apply the BSS algorithm to health care data and mine hundreds of thousands of medical concepts from a large Electronic Medical Record (EMR) corpora simultaneously and efficiently. Experimental results show the superiority of our algorithm when compared with the top of the line multi-string matching algorithms.

US-USSR telemedicine consultation spacebridge to Armenia and Ufa

NASA Technical Reports Server (NTRS)

1991-01-01

The Final Report on the U.S.-U.S.S.R. Telemedicine Consultation Spacebride to Armenia and Ufa is presented. The goal of this activity was to provide expert medical consultation to the Armenian medical personnel in the areas of plastic and reconstructive surgery, physical and psychological rehabilitation, public health, and epidemiology following the devastating earthquake in Dec. 1988. The U.S. and U.S.S.R. implementation teams developed new standards for medical information transmittal as well as protocols and schedules on how to conduct medical consultations. The consultations were provided to the Republic Diagnostic Center in Yerevan, U.S.S.R. by four U.S. medical centers: University of Utah/LDS Hospital, University of Texas, Maryland Institute for Emergency Medical Service Systems, and Uniformed Services University of the Health Sciences.

Proceedings of a Symposium - Consequences of Wearing the Chemical Protective Ensemble: Illustrative Assessment Approaches (33rd) Held in San Antonio, Texas on October 31, 1991

DTIC Science & Technology

1992-03-01

marksmanship. Proceedings of the 1989 Medical Defense Bioscience Review (pp. 823-826). Aberdeen Proving Ground , MD: US Army Medical Research Institute of...MILITARY PERSONNEL PERFORM THEIR MOS IN MOPP4 William K. Blewett Chemical Research, Development and Engineering Center Aberdeen Proving Ground , MD 21010...approximately the same evaporation rate, surface tension, solubility, and detectability as the agent mustard . The MS is detectable by use of the Chemical

AMEDD Clinical Psychology Short Course Held at Brooke Army Medical Center, San Antonio, Texas, 5-9 June 1991

DTIC Science & Technology

1991-06-01

off after a while, as the triage and surgical teams can only pretend to start the IV’s and insert the nasogastric and chest tubes , and only get to...clinical psychology; -- To examine AMEDD clinical psychology’s support of the Gulf War; and -- To provide a forum for continuing education , exchange of...also provide actual preventive consultation, education and case evaluations to the medical company and all other nearby units. In some FTXs, when

International Conference on Positron Annihilation (6th) held at the University of Texas at Arlington, April 3-7, 1982. Program and Collected Abstracts.

DTIC Science & Technology

1983-02-23

Annihilation Techniques SONIA MIIAN S., R. ZANA , J.CH. ABBE, and G. DUPLATRE - xxviii P-80 Study of Microemulsion Systems by Positron Annihilation...California, Berkeley CA 94720, U.S.A. Primary considerations for the design of positron emission tomographs for medical studies in humans are high...imaging system for medical applications is to produce an image in as short as time as possible which represents as accurately Ias possible the

Forty-Year Anniversary of Louisiana's Medical Malpractice Act, Act 817 of 1975.

PubMed

Palmisano, Donald J

2015-01-01

Here we are at the 40th anniversary of the passage of the 1975 Medical Malpractice Act, Act 817.2 How time flies! Act 817 of 1975 lives and the Louisiana State Supreme Court has ruled the current law, a total cap on all damages with its 1984 amendment for unlimited future medical payments as incurred (La. Act 435 of 19843), constitutional in the Butler case previously cited in the 20-year anniversary article (reprinted in this issue of the Journal). Louisiana's law was voted into law prior to California's famous medical liability law.4 For another great triumph, see Texas and its success in 2003.5 Three different laws; three proven long-term successes.

Algorithmic Approach With Clinical Pathology Consultation Improves Access to Specialty Care for Patients With Systemic Lupus Erythematosus.

PubMed

Chen, Lei; Welsh, Kerry J; Chang, Brian; Kidd, Laura; Kott, Marylee; Zare, Mohammad; Carroll, Kelley; Nguyen, Andy; Wahed, Amer; Tholpady, Ashok; Pung, Norin; McKee, Donna; Risin, Semyon A; Hunter, Robert L

2016-09-01

Harris Health System (HHS) is a safety net system providing health care to the underserved of Harris County, Texas. There was a 6-month waiting period for a rheumatologist consult for patients with suspected systemic lupus erythematosus (SLE). The objective of the intervention was to improve access to specialty care. An algorithmic approach to testing for SLE was implemented initially through the HHS referral center. The algorithm was further offered as a "one-click" order for physicians, with automated reflex testing, interpretation, and case triaging by clinical pathology. Data review revealed that prior to the intervention, 80% of patients did not have complete laboratory workups available at the first rheumatology visit. Implementation of algorithmic testing and triaging of referrals by pathologists resulted in decreasing the waiting time for a rheumatologist by 50%. Clinical pathology intervention and case triaging can improve access to care in a county health care system. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Three-dimensional comparison of facial morphology in white populations in Budapest, Hungary, and Houston, Texas.

PubMed

Gor, Troy; Kau, Chung How; English, Jeryl D; Lee, Robert P; Borbely, Peter

2010-03-01

The aim of this study was to assess the use of 3-dimensional facial averages in determining facial morphologic differences in 2 white population groups. Three-dimensional images were obtained in a reproducible and controlled environment from a commercially available stereo-photogrammetric camera capture system. The 3dMDface system (3dMD, Atlanta, Ga) photographed 200 subjects from 2 population groups (Budapest, Hungary, and Houston, Tex); each group included 50 men and 50 women, aged 18 to 30 years. Each face was obtained as a facial mesh and orientated along a triangulated axis. All faces were overlaid, one on top of the other, and a complex mathematical algorithm was used until an average composite face of 1 man and 1 woman was obtained for each subgroup (Hungarian men, Hungarian women, Texas men, and Texas women). These average facial composites were superimposed (men and women) based on a previously validated superimposition method, and the facial differences were quantified. Distinct facial differences were observed between the population groups. These differences could be seen in the nasal, malar, lips, and lower facial regions. In general, the mean facial differences were 0.55 +/- 0.60 mm between the Hungarian and Texas women, and 0.44 +/- 0.42 mm between the Hungarian and Texas men. The ranges of differences were -2.02 to 3.77 and -2.05 to 1.94 mm for the female and male pairings, respectively. Three-dimensional facial averages representing the facial soft-tissue morphology of adults can be used to assess diagnostic and treatment regimens for patients by population. Each population is different with respect to their soft-tissue structures, and traditional soft-tissue normative data (eg, white norms) should be altered and used for specific groups. American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Measuring the cost implications of the Collaborative Accountable Care initiative in Texas.

PubMed

Ho, Vivian; Allen, Timothy K; Kim, Urie; Keenan, William P; Ku-Goto, Meei-Hsiang; Sanderson, Mark

2016-09-01

We analyzed changes in healthcare spending associated with the implementation of Cigna's Collaborative Accountable Care (CAC) initiative in a large multi-clinic physician practice. We compared claims from 2009, prior to the CAC initiative, against claims for 2010 to 2011, contrasting the patients covered by Cigna's CAC initiative with patients in other practices in the same geographic area covered by Cigna's medical plan. We used a propensity weighted difference-in-differences approach, adjusting for age, sex, health status, and secular trends to isolate the treatment effect of the CAC. The CAC initiative resulted in a 5.7% reduction in net spending per patient for 2010 to 2011, relative to what spending would have been without the initiative. This reduced spending was evident in multiple service categories: evaluation and management, procedures, imaging, tests, and durable medical equipment. Professional payments, inpatient facility, and outpatient facility payments for Medical Clinic of North Texas enrollees all experienced significant cost savings relative to the control group. About half of the savings resulted from using lower-priced sources. The CAC initiative, which includes an embedded care coordinator and a list of recommended providers, was associated with cost savings similar to those reported by other initiatives, such as global budgets and risk-based contracts.

Implementation of health information technology to maximize efficiency of resource utilization in a geographically dispersed prenatal care delivery system.

PubMed

Cochran, Marlo Baker; Snyder, Russell R; Thomas, Elizabeth; Freeman, Daniel H; Hankins, Gary D V

2012-04-01

This study investigated the utilization of health information technology (HIT) to enhance resource utilization in a geographically dispersed tertiary care system with extensive outpatient and delivery services. It was initiated as a result of a systems change implemented after Hurricane Ike devastated southeast Texas. A retrospective database and electronic medical record review was performed, which included data collection from all patients evaluated 18 months prior (epoch I) and 18 months following (epoch II) the landfall of Hurricane Ike. The months immediately following the storm were omitted from the analysis, allowing time to establish a new baseline. We analyzed a total of 21,201 patients evaluated in triage at the University of Texas Medical Branch. Epoch I consisted of 11,280 patients and epoch II consisted of 9922 patients. Using HIT, we were able to decrease the number of visits to triage while simultaneously managing more complex patients in the outpatient setting with no clinically significant change in maternal or fetal outcome. This study developed an innovated model of care using constrained resources while providing quality and safety to our patients without additional cost to the health care delivery system. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Admission Control Over Internet of Vehicles Attached With Medical Sensors for Ubiquitous Healthcare Applications.

PubMed

Lin, Di; Labeau, Fabrice; Yao, Yuanzhe; Vasilakos, Athanasios V; Tang, Yu

2016-07-01

Wireless technologies and vehicle-mounted or wearable medical sensors are pervasive to support ubiquitous healthcare applications. However, a critical issue of using wireless communications under a healthcare scenario rests at the electromagnetic interference (EMI) caused by radio frequency transmission. A high level of EMI may lead to a critical malfunction of medical sensors, and in such a scenario, a few users who are not transmitting emergency data could be required to reduce their transmit power or even temporarily disconnect from the network in order to guarantee the normal operation of medical sensors as well as the transmission of emergency data. In this paper, we propose a joint power and admission control algorithm to schedule the users' transmission of medical data. The objective of this algorithm is to minimize the number of users who are forced to disconnect from the network while keeping the EMI on medical sensors at an acceptable level. We show that a fixed point of proposed algorithm always exists, and at the fixed point, our proposed algorithm can minimize the number of low-priority users who are required to disconnect from the network. Numerical results illustrate that the proposed algorithm can achieve robust performance against the variations of mobile hospital environments.

Texas Bull Nettle (Cnidoscolus texanus) Exposures Reported to Texas Poison Centers.

PubMed

Forrester, Mathias B

2017-06-01

Texas bull nettle (Cnidoscolus texanus) is covered in bristly hairs similar to stinging nettle. Contact with the plant may result in intense dermal pain, burning, itching, cellulitis, and allergic reaction. This study characterizes C texanus exposures reported to a large state-wide poison center system. Cases were C texanus exposures reported to Texas poison centers during 2000-2015. The distribution of cases was determined for patient demographics, exposure circumstances, and patient outcome. A total of 140 C texanus exposures were identified. Twenty percent of the patients were aged ≤5 years, 21% were 6 to 12 years, 5% were 13 to 19 years, and 51% were ≥20years; and 51% of the patients were male. Eighty-one percent of the exposures occurred at the patient's own residence, 11% in a public area, 2% at another residence, and 1% at school. Seventy-eight percent of the patients were managed on site, 13% were already at or en route to a health care facility, and 6% were referred to a health care facility. Eighty-eight percent of the exposures resulted in dermal effects: irritation or pain (56%), erythema or flushing (31%), edema (27%), pruritus (24%), rash (19%), puncture or wound (19%), and hives or welts (11%). C texanus exposures reported to Texas poison centers were most likely to be unintentional and occur at the patient's own residence. The outcomes of the exposures tended not to be serious and could be managed successfully outside of health care facilities. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Using Pill Identification Calls to Poison Centers as a Marker of Drug Abuse at Three Texas Military Bases.

PubMed

Ng, Patrick C; Maddry, Joseph K; Sessions, Daniel; Borys, Douglas J; Bebarta, Vikhyat S

2017-11-01

Opioid abuse is a growing problem in civilian communities, and it has developed in the military as well. Telephone calls to poison centers requesting pill identification (ID) is a marker of drug abuse. This study identifies the number of pill ID calls made to the poison centers from areas containing and surrounding three Texas military bases during an 8-year period. We performed a retrospective observational study identifying calls to certified poison centers in Texas from 2002 to 2009 that identified hydrocodone tablets and other pain medications. We noted the calls made from ZIP codes containing and surrounding the three largest military bases in Texas. We reviewed 75,537 drug ID calls for any drug from the ZIP codes of interest. Total drug ID calls increased 105% and the number of calls for hydrocodone increased 463%. In our study most of the drug ID calls from military communities in Texas were for hydrocodone. The rate of calls for hydrocodone increased more than the rate of calls for other analgesics from 2002 to 2009. Using drug ID calls as a surrogate of drug abuse, our results suggest that hydrocodone abuse has increased within military communities and that poison center data can be a reliable surrogate for prescription drug abuse near military bases. Future studies are needed to further understand the extent of this problem in military and civilian communities. We can use this information to heighten awareness, influence prescription practices, establish practice guidelines, and develop educational programs to mitigate the increasing rate of prescription analgesic abuse in the United States.

A Parallel Nonrigid Registration Algorithm Based on B-Spline for Medical Images.

PubMed

Du, Xiaogang; Dang, Jianwu; Wang, Yangping; Wang, Song; Lei, Tao

2016-01-01

The nonrigid registration algorithm based on B-spline Free-Form Deformation (FFD) plays a key role and is widely applied in medical image processing due to the good flexibility and robustness. However, it requires a tremendous amount of computing time to obtain more accurate registration results especially for a large amount of medical image data. To address the issue, a parallel nonrigid registration algorithm based on B-spline is proposed in this paper. First, the Logarithm Squared Difference (LSD) is considered as the similarity metric in the B-spline registration algorithm to improve registration precision. After that, we create a parallel computing strategy and lookup tables (LUTs) to reduce the complexity of the B-spline registration algorithm. As a result, the computing time of three time-consuming steps including B-splines interpolation, LSD computation, and the analytic gradient computation of LSD, is efficiently reduced, for the B-spline registration algorithm employs the Nonlinear Conjugate Gradient (NCG) optimization method. Experimental results of registration quality and execution efficiency on the large amount of medical images show that our algorithm achieves a better registration accuracy in terms of the differences between the best deformation fields and ground truth and a speedup of 17 times over the single-threaded CPU implementation due to the powerful parallel computing ability of Graphics Processing Unit (GPU).

Reducing noise component on medical images

NASA Astrophysics Data System (ADS)

Semenishchev, Evgeny; Voronin, Viacheslav; Dub, Vladimir; Balabaeva, Oksana

2018-04-01

Medical visualization and analysis of medical data is an actual direction. Medical images are used in microbiology, genetics, roentgenology, oncology, surgery, ophthalmology, etc. Initial data processing is a major step towards obtaining a good diagnostic result. The paper considers the approach allows an image filtering with preservation of objects borders. The algorithm proposed in this paper is based on sequential data processing. At the first stage, local areas are determined, for this purpose the method of threshold processing, as well as the classical ICI algorithm, is applied. The second stage uses a method based on based on two criteria, namely, L2 norm and the first order square difference. To preserve the boundaries of objects, we will process the transition boundary and local neighborhood the filtering algorithm with a fixed-coefficient. For example, reconstructed images of CT, x-ray, and microbiological studies are shown. The test images show the effectiveness of the proposed algorithm. This shows the applicability of analysis many medical imaging applications.

Outcomes of a Rotational Dissection System in Gross Anatomy

ERIC Educational Resources Information Center

Marshak, David W.; Oakes, Joanne; Hsieh, Pei-Hsuan; Chuang, Alice Z.; Cleary, Leonard J.

2015-01-01

At the University of Texas Houston Medical School, a rotational dissection system was introduced to improve coordination between the Gross Anatomy and the Introduction to Clinical Medicine (ICM) courses. Six students were assigned to each cadaver and divided into two teams. For each laboratory, one team was assigned to dissect and the other to…

Statistical Report. Fiscal Year 1991: September 1, 1990-August 31, 1991.

ERIC Educational Resources Information Center

Texas Higher Education Coordinating Board, Austin.

This is a statistical report for the fiscal year 1991 for Texas public and independent institutions of higher education. Listed first are all institutions in the system: public universities; public medical, dental and allied health units; public community junior colleges; public technical institutes; independent senior colleges and universities;…

Virtual Worlds Turn Therapeutic for Autistic Disorders

ERIC Educational Resources Information Center

Mangan, Katherine

2008-01-01

Asperger's patients have been treated by role-playing with real-life therapists. The virtual-reality town at the medical center is a new twist. The University of Texas at Dallas uses a platform from Second Life, the popular virtual world, in which patients go to an "island" customized for therapeutic purposes. The island was built by…

Adult Day Care--Extended Family.

ERIC Educational Resources Information Center

Smith, Bert Kruger

This pamphlet describes a multi-purpose day-care center for the elderly in Abilene, Texas which is intended to fill the "extended family" role of offering companionship, medical attention, and other aspects of concern to older persons in the community. The goals of the program are as follows: (1) to keep individuals out of institutions…

Winning performance improvement strategies--linking documentation and accounts receivable.

PubMed

Braden, J H; Swadley, D

1996-01-01

When the HIM department at The University of Texas Medical Branch set out to improve documentation and accounts receivable management, it established a plan that encompassed a broad spectrum of data management process changes. The department examined and acknowledged the deficiencies in data management processes and used performance improvement tools to achieve successful results.

Novel Plant-Derived Recombinant Human Interferons with Broad Spectrum Antiviral Activity

DTIC Science & Technology

2011-10-14

Ikegami et al., 2006) virus was kindly provided by Dr. Shinji Makino of the University of Texas Medical Branch at Galveston. The GFP-tagged Zaire...Arch. Virol. 156, 1877–1881. Ikegami , T., Won, S., Peters, C.J., Makino, S., 2006. Rescue of infectious rift valley fever virus entirely from cDNA

A Model for the Inclusion of a Physical Fitness and Health Promotion Component in a Chemical Abuse Treatment Program.

ERIC Educational Resources Information Center

Fridinger, Fred; Dehart, Beverly

1993-01-01

Describes treatment program at Charter Hospital in Fort Worth, Texas, which incorporates comprehensive medical examination, fitness and nutritional screenings, and appropriate exercise activities into alcohol and other substance abuse treatment. Notes that educational sessions are offered on health fitness, risk reduction, stress management,…

Psychiatric disorders, HIV infection and HIV/hepatitis co-infection in the correctional setting.

PubMed

Baillargeon, J G; Paar, D P; Wu, H; Giordano, T P; Murray, O; Raimer, B G; Avery, E N; Diamond, P M; Pulvino, J S

2008-01-01

Psychiatric disorders such as bipolar disorder, schizophrenia and depression have long been associated with risk behaviors for HIV, hepatitis C virus (HCV) and hepatitis B virus (HBV). The US prison population is reported to have elevated rates of HIV, hepatitis and most psychiatric disorders. This study examined the association of six major psychiatric disorders with HIV mono-infection, HIV/HCV co-infection and HIV/HBV co-infection in one of the nation's largest prison populations. The study population consisted of 370,511 Texas Department of Criminal Justice inmates who were incarcerated for any duration between January 1, 2003 and July 1, 2006. Information on medical conditions and sociodemographic factors was obtained from an institution-wide electronic medical information system. Offenders diagnosed with HIV mono-infection, HIV/HCV, HIV/HBV and all HIV combined exhibited elevated rates of major depression, bipolar disorder, schizophrenia, schizoaffective disorder, non-schizophrenic psychotic disorder and any psychiatric disorder. In comparison to offenders with HIV mono-infection, those with HIV/HCV co-infection had an elevated prevalence of any psychiatric disorder. This cross-sectional study's finding of positive associations between psychiatric disease and both HIV infection and hepatitis co-infection among Texas prison inmates holds both clinical and public health relevance. It will be important for future investigations to examine the extent to which psychiatric disorders serve as a barrier to medical care, communication with clinicians and adherence to prescribed medical regimens among both HIV-mono-infected and HIV/hepatitis-co-infected inmates.

Physical Examination Reporting System

PubMed Central

Rowley, B.A.; Cameron, J.M.; Anderson, D.E.; Nicholas, T.A.; Hogue, R.L.; Hutcheson, J.L.; Peralta, V.H.; Johansen, B.; Walston, D.

1978-01-01

The following is a description of a Physical Examination Reporting System which was developed in cooperation with physicians from the Department of Family Practice and the Department of Preventive Medicine, Texas Tech University School of Medicine, Lubbock, Texas. This system was designed to evaluate what effect such a report would have on the practice of medicine in underserved areas with regard to health benefit, medical impact, and economic impact. The set of observations was assembled over a three month period by utilizing techniques previously developed in this area as well as the expertise of the TTUSM faculty. This system was developed for impact evaluation purposes. Its actual daily use may require changes in the form, in method of entry, and in format of the report.

The Sepsis Early Recognition and Response Initiative (SERRI)

PubMed Central

Jones, Stephen L.; Ashton, Carol M.; Kiehne, Lisa; Gigliotti, Elizabeth; Bell-Gordon, Charyl; Pinn, Teresa T.; Tran, Shirley K.; Nicolas, Juan C.; Rose, Alexis L.; Shirkey, Beverly A.; Disbot, Maureen; Masud, Faisal; Wray, Nelda P.

2016-01-01

Duration of Initiative 48 months and currently ongoing. Setting The Houston Methodist Hospital System and affiliated hospitals (3 facilities with 2 hospital-run skilled nursing facilities in and around Houston), St. Joseph’s Regional Health Center (1 acute care hospital and 2 skilled nursing facilities in Bryan, Texas), Hospital Corporation of America (2 acute care facilities in Houston, 1 acute care facility in McAllen, Texas [Rio Grande Valley]), Kindred Healthcare (2 long term acute care facilities in Houston), Select Medical Specialty Hospitals (2 long term acute care facilities in Houston). Whom This Should Concern Hospital administrators, quality and safety officers, performance improvement and patient safety professionals, clinic managers, infection control and prevention staff, and other physicians, nurses, and clinical staff. PMID:26892701

A novel strategy for load balancing of distributed medical applications.

PubMed

Logeswaran, Rajasvaran; Chen, Li-Choo

2012-04-01

Current trends in medicine, specifically in the electronic handling of medical applications, ranging from digital imaging, paperless hospital administration and electronic medical records, telemedicine, to computer-aided diagnosis, creates a burden on the network. Distributed Service Architectures, such as Intelligent Network (IN), Telecommunication Information Networking Architecture (TINA) and Open Service Access (OSA), are able to meet this new challenge. Distribution enables computational tasks to be spread among multiple processors; hence, performance is an important issue. This paper proposes a novel approach in load balancing, the Random Sender Initiated Algorithm, for distribution of tasks among several nodes sharing the same computational object (CO) instances in Distributed Service Architectures. Simulations illustrate that the proposed algorithm produces better network performance than the benchmark load balancing algorithms-the Random Node Selection Algorithm and the Shortest Queue Algorithm, especially under medium and heavily loaded conditions.

Medical management of hyperglycaemia in type 2 diabetes mellitus: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes.

PubMed

Nathan, D M; Buse, J B; Davidson, M B; Ferrannini, E; Holman, R R; Sherwin, R; Zinman, B

2009-01-01

The consensus algorithm for the medical management of type 2 diabetes was published in August 2006 with the expectation that it would be updated, based on the availability of new interventions and new evidence to establish their clinical role. The authors continue to endorse the principles used to develop the algorithm and its major features. We are sensitive to the risks of changing the algorithm cavalierly or too frequently, without compelling new information. An update to the consensus algorithm published in January 2008 specifically addressed safety issues surrounding the thiazolidinediones. In this revision, we focus on the new classes of medications that now have more clinical data and experience.

[A study on medical image fusion].

PubMed

Zhang, Er-hu; Bian, Zheng-zhong

2002-09-01

Five algorithms with its advantages and disadvantage for medical image fusion are analyzed. Four kinds of quantitative evaluation criteria for the quality of image fusion algorithms are proposed and these will give us some guidance for future research.

Comparison of hospitalizations, emergency department visits, and costs in a historical cohort of Texas Medicaid patients with chronic obstructive pulmonary disease, by initial medication regimen.

PubMed

Rascati, Karen L; Akazawa, Manabu; Johnsrud, Michael; Stanford, Richard H; Blanchette, Christopher M

2007-06-01

Limited information is available on the relative outcomes and treatment costs of various pharmacotherapies for chronic obstructive pulmonary disease (COPD) in a Medicaid population. This study compared the effects of initial medication regimens for COPD on COPD-related and all-cause events (hospitalizations and/or emergency department [ED] visits) and COPD-related and all-cause costs. The study population was a historical cohort of Texas Medicaid beneficiaries aged 40 to 64 years with COPD-related medical costs (International Classification of Diseases, Ninth Revision, Clinical Modification codes 491.xx, 492.xx, 496.xx), 24 months of continuous Medicaid enrollment (12 months before and after the index prescription), and at least 1 prescription claim (index) for a combination product containing fluticasone propionate + salmeterol, an inhaled corticosteroid, salmeterol, or ipratropium between April 1, 2001, and March 31, 2003. The analyses of events employed Cox proportional hazards regression, controlling for baseline factors and preindex events. The analyses of costs used a 2-part model with logistic regression and generalized linear model to adjust for baseline characteristics and preindex utilization and costs. The study population included 6793 patients (1211 combination therapy, 968 inhaled corticosteroid, 401 salmeterol, and 4213 ipratropium). Only combination therapy was associated with a significantly lower risk for any COPD-related event (hazard ratio [HR] = 0.733; 95% CI, 0.650-0.826) and any all-cause event (HR = 0.906; 95% CI, 0.844-0.972) compared with ipratropium. COPD-related prescription costs were higher in all cohorts compared with the ipratropium cohort, but COPD-related medical costs were lower, offsetting the increase in prescription costs. For all-cause costs, prescription costs were higher in the combination-therapy cohort (+$415; P < 0.05) and the salmeterol cohort (+$247; P < 0.05) compared with the ipratropium cohort, but significant reductions in all-cause medical costs in the combination-therapy cohort (-$1735; P < 0.05) and salmeterol cohort (-$1547; P < 0.05) more than offset the increase in prescription costs. In this historical population of Texas Medicaid beneficiaries, the combination-therapy cohort was 27% less likely to have a COPD-related event than the ipratropium cohort, 10% less likely to have any all-cause event, had similar COPD-related costs, and had reduced all-cause costs. Thus, compared with the ipratropium cohort, the combination-therapy cohort had an improvement in outcomes (based on the decreased time to a hospitalization or ED visit), with similar or decreased direct medical costs. Future research is needed in other patient groups.

Pesticide-related poison center exposures in children and adolescents aged ≤19 years in Texas, 2000-2013.

PubMed

Trueblood, Amber B; Forrester, Mathias B; Han, Daikwon; Shipp, Eva M; Cizmas, Leslie H

2016-11-01

Although national poison center data show that pesticides were the 8th most commonly reported substance category (3.27%) for children aged ≤5 years in 2014, there is limited information on childhood and adolescent pesticide exposures. This study assessed pesticide-related poison center exposures in children and adolescents aged ≤19 years from 2000-2013 in Texas to characterize the potential burden of pesticides. Pesticide-related poison center exposures among children and adolescents aged ≤19 years reported to Texas poison centers were identified. The distribution of exposures was estimated by gender, age category, medical outcome, management site, exposure route, and pesticide category. From 2000 to 2013, there were 61,147 pesticide-related poison center exposures in children and adolescents aged ≤19 years. The prevalence was highest among males at 864.24 per 100,000 population. The prevalence of unintentional exposures was highest among children aged ≤5 years at 2310.69 per 100,000 population, whereas the prevalence of intentional exposures was highest among adolescents aged 13-19 years at 13.82 per 100,000 population. A majority of medical outcomes reported were classified as having no effect (30.24%) and not followed, but minimal clinical effects possible (42.74%). Of all the exposures, 81.24% were managed on site. However, 57% of intentional exposures were referred to or treated at a health-care facility. The most common routes of exposure were ingestion (80.83%) and dermal (17.21%). The most common pesticide categories included rodenticides (30.02%), pyrethrins/pyrethroids (20.69%), and other and unspecified insecticides (18.14%). The study found differences in the frequency of exposures by intent for sex and age categories, and identified the most common medical outcomes, management site, exposure route, and pesticide category. Through characterizing pesticide-related poison center exposures, future interventions can be designed to address groups with higher prevalence of exposure.

Medical image segmentation using genetic algorithms.

PubMed

Maulik, Ujjwal

2009-03-01

Genetic algorithms (GAs) have been found to be effective in the domain of medical image segmentation, since the problem can often be mapped to one of search in a complex and multimodal landscape. The challenges in medical image segmentation arise due to poor image contrast and artifacts that result in missing or diffuse organ/tissue boundaries. The resulting search space is therefore often noisy with a multitude of local optima. Not only does the genetic algorithmic framework prove to be effective in coming out of local optima, it also brings considerable flexibility into the segmentation procedure. In this paper, an attempt has been made to review the major applications of GAs to the domain of medical image segmentation.

Rates of abnormalities and infectious agents in cervical smears from female inmates in Texas: comparison with private and university clinic patients.

PubMed

Logrono, R; Wong, J Y

1999-09-01

Inmates are generally considered a high-risk population for gynecologic neoplasia and sexually transmitted diseases. Cervical smears from prisoners of the Texas Department of Corrections (TDC) were expected initially to have higher rates of cellular abnormalities and infectious agents than do smears from the general population. The cytologic findings from 25,522 TDC gynecologic smears were compared with those of 6883 cases from The University of Texas Medical Branch (UTMB) affiliated physician private clinics, and with 56,178 from the UTMB hospital clinics. The period of study was from September 1995 to February 1998. This study revealed a 5.23% higher rate of abnormalities for TDC gynecologic smears as compared with that for the private clinic smears. However, the TDC rate of abnormalities was unexpectedly 1.08% lower than that for the UTMB clinic smears. These unexpected findings were probably the result of a more selected high-risk population referred to the UTMB clinics. The TDC smears showed also the highest incidence of trichomoniasis.

Cardiac surgery for inmates in the Texas Department of Corrections.

PubMed

Bilfinger, T V; Conti, V R

1990-10-01

All Texas prison inmates requiring hospitalization since 1983 have been transferred to a separate prison hospital adjacent to a tertiary care university hospital. We reviewed and analyzed the data regarding one major tertiary care service, namely cardiac surgery, to describe the rate of utilization of this service and its results. From January 1, 1984, to June 30, 1988, 73 inmates underwent 74 cardiac operations, 50 of which were coronary revascularizations. The age-adjusted rates of utilization for coronary artery bypass grafting were substantially higher for inmates over age 45 than for that described for the general population, whereas the utilization rates for valve surgery were comparable. There were no perioperative or late deaths, and 86% of the inmate patients are currently employed within the Texas Department of Corrections system or were employed at the time of their release. The utilization rates and the results of this representative tertiary medical care service for the state's prison population are comparable to those achieved in the private sector, and may have a substantial beneficial effect on inmate rehabilitation.

Medical image classification based on multi-scale non-negative sparse coding.

PubMed

Zhang, Ruijie; Shen, Jian; Wei, Fushan; Li, Xiong; Sangaiah, Arun Kumar

2017-11-01

With the rapid development of modern medical imaging technology, medical image classification has become more and more important in medical diagnosis and clinical practice. Conventional medical image classification algorithms usually neglect the semantic gap problem between low-level features and high-level image semantic, which will largely degrade the classification performance. To solve this problem, we propose a multi-scale non-negative sparse coding based medical image classification algorithm. Firstly, Medical images are decomposed into multiple scale layers, thus diverse visual details can be extracted from different scale layers. Secondly, for each scale layer, the non-negative sparse coding model with fisher discriminative analysis is constructed to obtain the discriminative sparse representation of medical images. Then, the obtained multi-scale non-negative sparse coding features are combined to form a multi-scale feature histogram as the final representation for a medical image. Finally, SVM classifier is combined to conduct medical image classification. The experimental results demonstrate that our proposed algorithm can effectively utilize multi-scale and contextual spatial information of medical images, reduce the semantic gap in a large degree and improve medical image classification performance. Copyright © 2017 Elsevier B.V. All rights reserved.

Validation of electronic medical record-based phenotyping algorithms: results and lessons learned from the eMERGE network.

PubMed

Newton, Katherine M; Peissig, Peggy L; Kho, Abel Ngo; Bielinski, Suzette J; Berg, Richard L; Choudhary, Vidhu; Basford, Melissa; Chute, Christopher G; Kullo, Iftikhar J; Li, Rongling; Pacheco, Jennifer A; Rasmussen, Luke V; Spangler, Leslie; Denny, Joshua C

2013-06-01

Genetic studies require precise phenotype definitions, but electronic medical record (EMR) phenotype data are recorded inconsistently and in a variety of formats. To present lessons learned about validation of EMR-based phenotypes from the Electronic Medical Records and Genomics (eMERGE) studies. The eMERGE network created and validated 13 EMR-derived phenotype algorithms. Network sites are Group Health, Marshfield Clinic, Mayo Clinic, Northwestern University, and Vanderbilt University. By validating EMR-derived phenotypes we learned that: (1) multisite validation improves phenotype algorithm accuracy; (2) targets for validation should be carefully considered and defined; (3) specifying time frames for review of variables eases validation time and improves accuracy; (4) using repeated measures requires defining the relevant time period and specifying the most meaningful value to be studied; (5) patient movement in and out of the health plan (transience) can result in incomplete or fragmented data; (6) the review scope should be defined carefully; (7) particular care is required in combining EMR and research data; (8) medication data can be assessed using claims, medications dispensed, or medications prescribed; (9) algorithm development and validation work best as an iterative process; and (10) validation by content experts or structured chart review can provide accurate results. Despite the diverse structure of the five EMRs of the eMERGE sites, we developed, validated, and successfully deployed 13 electronic phenotype algorithms. Validation is a worthwhile process that not only measures phenotype performance but also strengthens phenotype algorithm definitions and enhances their inter-institutional sharing.

Development of visible/infrared/microwave agriculture classification and biomass estimation algorithms. [Guyton, Oklahoma and Dalhart, Texas

NASA Technical Reports Server (NTRS)

Rosenthal, W. D.; Mcfarland, M. J.; Theis, S. W.; Jones, C. L. (Principal Investigator)

1982-01-01

Agricultural crop classification models using two or more spectral regions (visible through microwave) are considered in an effort to estimate biomass at Guymon, Oklahoma Dalhart, Texas. Both grounds truth and aerial data were used. Results indicate that inclusion of C, L, and P band active microwave data, from look angles greater than 35 deg from nadir, with visible and infrared data improve crop discrimination and biomass estimates compared to results using only visible and infrared data. The microwave frequencies were sensitive to different biomass levels. The K and C band were sensitive to differences at low biomass levels, while P band was sensitive to differences at high biomass levels. Two indices, one using only active microwave data and the other using data from the middle and near infrared bands, were well correlated to total biomass. It is implied that inclusion of active microwave sensors with visible and infrared sensors on future satellites could aid in crop discrimination and biomass estimation.

Phenotyping for patient safety: algorithm development for electronic health record based automated adverse event and medical error detection in neonatal intensive care.

PubMed

Li, Qi; Melton, Kristin; Lingren, Todd; Kirkendall, Eric S; Hall, Eric; Zhai, Haijun; Ni, Yizhao; Kaiser, Megan; Stoutenborough, Laura; Solti, Imre

2014-01-01

Although electronic health records (EHRs) have the potential to provide a foundation for quality and safety algorithms, few studies have measured their impact on automated adverse event (AE) and medical error (ME) detection within the neonatal intensive care unit (NICU) environment. This paper presents two phenotyping AE and ME detection algorithms (ie, IV infiltrations, narcotic medication oversedation and dosing errors) and describes manual annotation of airway management and medication/fluid AEs from NICU EHRs. From 753 NICU patient EHRs from 2011, we developed two automatic AE/ME detection algorithms, and manually annotated 11 classes of AEs in 3263 clinical notes. Performance of the automatic AE/ME detection algorithms was compared to trigger tool and voluntary incident reporting results. AEs in clinical notes were double annotated and consensus achieved under neonatologist supervision. Sensitivity, positive predictive value (PPV), and specificity are reported. Twelve severe IV infiltrates were detected. The algorithm identified one more infiltrate than the trigger tool and eight more than incident reporting. One narcotic oversedation was detected demonstrating 100% agreement with the trigger tool. Additionally, 17 narcotic medication MEs were detected, an increase of 16 cases over voluntary incident reporting. Automated AE/ME detection algorithms provide higher sensitivity and PPV than currently used trigger tools or voluntary incident-reporting systems, including identification of potential dosing and frequency errors that current methods are unequipped to detect. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Improving Brain Magnetic Resonance Image (MRI) Segmentation via a Novel Algorithm based on Genetic and Regional Growth

PubMed Central

A., Javadpour; A., Mohammadi

2016-01-01

Background Regarding the importance of right diagnosis in medical applications, various methods have been exploited for processing medical images solar. The method of segmentation is used to analyze anal to miscall structures in medical imaging. Objective This study describes a new method for brain Magnetic Resonance Image (MRI) segmentation via a novel algorithm based on genetic and regional growth. Methods Among medical imaging methods, brains MRI segmentation is important due to high contrast of non-intrusive soft tissue and high spatial resolution. Size variations of brain tissues are often accompanied by various diseases such as Alzheimer’s disease. As our knowledge about the relation between various brain diseases and deviation of brain anatomy increases, MRI segmentation is exploited as the first step in early diagnosis. In this paper, regional growth method and auto-mate selection of initial points by genetic algorithm is used to introduce a new method for MRI segmentation. Primary pixels and similarity criterion are automatically by genetic algorithms to maximize the accuracy and validity in image segmentation. Results By using genetic algorithms and defining the fixed function of image segmentation, the initial points for the algorithm were found. The proposed algorithms are applied to the images and results are manually selected by regional growth in which the initial points were compared. The results showed that the proposed algorithm could reduce segmentation error effectively. Conclusion The study concluded that the proposed algorithm could reduce segmentation error effectively and help us to diagnose brain diseases. PMID:27672629

Identifying individuals with physician-diagnosed chronic obstructive pulmonary disease in primary care electronic medical records: a retrospective chart abstraction study.

PubMed

Lee, Theresa M; Tu, Karen; Wing, Laura L; Gershon, Andrea S

2017-05-15

Little is known about using electronic medical records to identify patients with chronic obstructive pulmonary disease to improve quality of care. Our objective was to develop electronic medical record algorithms that can accurately identify patients with obstructive pulmonary disease. A retrospective chart abstraction study was conducted on data from the Electronic Medical Record Administrative data Linked Database (EMRALD ® ) housed at the Institute for Clinical Evaluative Sciences. Abstracted charts provided the reference standard based on available physician-diagnoses, chronic obstructive pulmonary disease-specific medications, smoking history and pulmonary function testing. Chronic obstructive pulmonary disease electronic medical record algorithms using combinations of terminology in the cumulative patient profile (CPP; problem list/past medical history), physician billing codes (chronic bronchitis/emphysema/other chronic obstructive pulmonary disease), and prescriptions, were tested against the reference standard. Sensitivity, specificity, and positive/negative predictive values (PPV/NPV) were calculated. There were 364 patients with chronic obstructive pulmonary disease identified in a 5889 randomly sampled cohort aged ≥ 35 years (prevalence = 6.2%). The electronic medical record algorithm consisting of ≥ 3 physician billing codes for chronic obstructive pulmonary disease per year; documentation in the CPP; tiotropium prescription; or ipratropium (or its formulations) prescription and a chronic obstructive pulmonary disease billing code had sensitivity of 76.9% (95% CI:72.2-81.2), specificity of 99.7% (99.5-99.8), PPV of 93.6% (90.3-96.1), and NPV of 98.5% (98.1-98.8). Electronic medical record algorithms can accurately identify patients with chronic obstructive pulmonary disease in primary care records. They can be used to enable further studies in practice patterns and chronic obstructive pulmonary disease management in primary care. NOVEL ALGORITHM SEARCH TECHNIQUE: Researchers develop an algorithm that can accurately search through electronic health records to find patients with chronic lung disease. Mining population-wide data for information on patients diagnosed and treated with chronic obstructive pulmonary disease (COPD) in primary care could help inform future healthcare and spending practices. Theresa Lee at the University of Toronto, Canada, and colleagues used an algorithm to search electronic medical records and identify patients with COPD from doctors' notes, prescriptions and symptom histories. They carefully adjusted the algorithm to improve sensitivity and predictive value by adding details such as specific medications, physician codes related to COPD, and different combinations of terminology in doctors' notes. The team accurately identified 364 patients with COPD in a randomly-selected cohort of 5889 people. Their results suggest opportunities for broader, informative studies of COPD in wider populations.

Multi-label classification of chronically ill patients with bag of words and supervised dimensionality reduction algorithms.

PubMed

Bromuri, Stefano; Zufferey, Damien; Hennebert, Jean; Schumacher, Michael

2014-10-01

This research is motivated by the issue of classifying illnesses of chronically ill patients for decision support in clinical settings. Our main objective is to propose multi-label classification of multivariate time series contained in medical records of chronically ill patients, by means of quantization methods, such as bag of words (BoW), and multi-label classification algorithms. Our second objective is to compare supervised dimensionality reduction techniques to state-of-the-art multi-label classification algorithms. The hypothesis is that kernel methods and locality preserving projections make such algorithms good candidates to study multi-label medical time series. We combine BoW and supervised dimensionality reduction algorithms to perform multi-label classification on health records of chronically ill patients. The considered algorithms are compared with state-of-the-art multi-label classifiers in two real world datasets. Portavita dataset contains 525 diabetes type 2 (DT2) patients, with co-morbidities of DT2 such as hypertension, dyslipidemia, and microvascular or macrovascular issues. MIMIC II dataset contains 2635 patients affected by thyroid disease, diabetes mellitus, lipoid metabolism disease, fluid electrolyte disease, hypertensive disease, thrombosis, hypotension, chronic obstructive pulmonary disease (COPD), liver disease and kidney disease. The algorithms are evaluated using multi-label evaluation metrics such as hamming loss, one error, coverage, ranking loss, and average precision. Non-linear dimensionality reduction approaches behave well on medical time series quantized using the BoW algorithm, with results comparable to state-of-the-art multi-label classification algorithms. Chaining the projected features has a positive impact on the performance of the algorithm with respect to pure binary relevance approaches. The evaluation highlights the feasibility of representing medical health records using the BoW for multi-label classification tasks. The study also highlights that dimensionality reduction algorithms based on kernel methods, locality preserving projections or both are good candidates to deal with multi-label classification tasks in medical time series with many missing values and high label density. Copyright © 2014 Elsevier Inc. All rights reserved.

A university system's approach to enhancing the educational mission of health science schools and institutions: the University of Texas Academy of Health Science Education

PubMed Central

Buja, L. Maximilian; Cox, Susan M.; Lieberman, Steven A.; MacClements, Jonathan; Williams, Janet F.; Esterl, Robert M.; Shine, Kenneth I.

2013-01-01

Background The academy movement developed in the United States as an important approach to enhance the educational mission and facilitate the recognition and work of educators at medical schools and health science institutions. Objectives Academies initially formed at individual medical schools. Educators and leaders in The University of Texas System (the UT System, UTS) recognized the academy movement as a means both to address special challenges and pursue opportunities for advancing the educational mission of academic health sciences institutions. Methods The UTS academy process was started by the appointment of a Chancellor's Health Fellow for Education in 2004. Subsequently, the University of Texas Academy of Health Science Education (UTAHSE) was formed by bringing together esteemed faculty educators from the six UTS health science institutions. Results Currently, the UTAHSE has 132 voting members who were selected through a rigorous, system-wide peer review and who represent multiple professional backgrounds and all six campuses. With support from the UTS, the UTAHSE has developed and sustained an annual Innovations in Health Science Education conference, a small grants program and an Innovations in Health Science Education Award, among other UTS health science educational activities. The UTAHSE represents one university system's innovative approach to enhancing its educational mission through multi- and interdisciplinary as well as inter-institutional collaboration. Conclusions The UTAHSE is presented as a model for the development of other consortia-type academies that could involve several components of a university system or coalitions of several institutions. PMID:23490406

Algorithm of first-aid management of dental trauma for medics and corpsmen.

PubMed

Zadik, Yehuda

2008-12-01

In order to fill the discrepancy between the necessity of providing prompt and proper treatment to dental trauma patients, and the inadequate knowledge among medics and corpsmen, as well as the lack of instructions in first-aid textbook and manuals, and after reviewing the dental literature, a simple algorithm for non-professional first-aid management for various injuries to hard (teeth) and soft oral tissues, is presented. The recommended management of tooth avulsion, subluxation and luxation, crown fracture and lip, tongue or gingival laceration included in the algorithm. Along with a list of after-hour dental clinics, this symptoms- and clinical-appearance-based algorithm is suited to tuck easily into a pocket for quick utilization by medics/corpsmen in an emergency situation. Although the algorithm was developed for the usage of military non-dental health-care providers, this method could be adjusted and employed in the civilian environment as well.

Medical image registration by combining global and local information: a chain-type diffeomorphic demons algorithm.

PubMed

Liu, Xiaozheng; Yuan, Zhenming; Zhu, Junming; Xu, Dongrong

2013-12-07

The demons algorithm is a popular algorithm for non-rigid image registration because of its computational efficiency and simple implementation. The deformation forces of the classic demons algorithm were derived from image gradients by considering the deformation to decrease the intensity dissimilarity between images. However, the methods using the difference of image intensity for medical image registration are easily affected by image artifacts, such as image noise, non-uniform imaging and partial volume effects. The gradient magnitude image is constructed from the local information of an image, so the difference in a gradient magnitude image can be regarded as more reliable and robust for these artifacts. Then, registering medical images by considering the differences in both image intensity and gradient magnitude is a straightforward selection. In this paper, based on a diffeomorphic demons algorithm, we propose a chain-type diffeomorphic demons algorithm by combining the differences in both image intensity and gradient magnitude for medical image registration. Previous work had shown that the classic demons algorithm can be considered as an approximation of a second order gradient descent on the sum of the squared intensity differences. By optimizing the new dissimilarity criteria, we also present a set of new demons forces which were derived from the gradients of the image and gradient magnitude image. We show that, in controlled experiments, this advantage is confirmed, and yields a fast convergence.

A Parallel Nonrigid Registration Algorithm Based on B-Spline for Medical Images

PubMed Central

Wang, Yangping; Wang, Song

2016-01-01

The nonrigid registration algorithm based on B-spline Free-Form Deformation (FFD) plays a key role and is widely applied in medical image processing due to the good flexibility and robustness. However, it requires a tremendous amount of computing time to obtain more accurate registration results especially for a large amount of medical image data. To address the issue, a parallel nonrigid registration algorithm based on B-spline is proposed in this paper. First, the Logarithm Squared Difference (LSD) is considered as the similarity metric in the B-spline registration algorithm to improve registration precision. After that, we create a parallel computing strategy and lookup tables (LUTs) to reduce the complexity of the B-spline registration algorithm. As a result, the computing time of three time-consuming steps including B-splines interpolation, LSD computation, and the analytic gradient computation of LSD, is efficiently reduced, for the B-spline registration algorithm employs the Nonlinear Conjugate Gradient (NCG) optimization method. Experimental results of registration quality and execution efficiency on the large amount of medical images show that our algorithm achieves a better registration accuracy in terms of the differences between the best deformation fields and ground truth and a speedup of 17 times over the single-threaded CPU implementation due to the powerful parallel computing ability of Graphics Processing Unit (GPU). PMID:28053653

Specificity and Sensitivity of Claims-Based Algorithms for Identifying Members of Medicare+Choice Health Plans That Have Chronic Medical Conditions

PubMed Central

Rector, Thomas S; Wickstrom, Steven L; Shah, Mona; Thomas Greeenlee, N; Rheault, Paula; Rogowski, Jeannette; Freedman, Vicki; Adams, John; Escarce, José J

2004-01-01

Objective To examine the effects of varying diagnostic and pharmaceutical criteria on the performance of claims-based algorithms for identifying beneficiaries with hypertension, heart failure, chronic lung disease, arthritis, glaucoma, and diabetes. Study Setting Secondary 1999–2000 data from two Medicare+Choice health plans. Study Design Retrospective analysis of algorithm specificity and sensitivity. Data Collection Physician, facility, and pharmacy claims data were extracted from electronic records for a sample of 3,633 continuously enrolled beneficiaries who responded to an independent survey that included questions about chronic diseases. Principal Findings Compared to an algorithm that required a single medical claim in a one-year period that listed the diagnosis, either requiring that the diagnosis be listed on two separate claims or that the diagnosis to be listed on one claim for a face-to-face encounter with a health care provider significantly increased specificity for the conditions studied by 0.03 to 0.11. Specificity of algorithms was significantly improved by 0.03 to 0.17 when both a medical claim with a diagnosis and a pharmacy claim for a medication commonly used to treat the condition were required. Sensitivity improved significantly by 0.01 to 0.20 when the algorithm relied on a medical claim with a diagnosis or a pharmacy claim, and by 0.05 to 0.17 when two years rather than one year of claims data were analyzed. Algorithms that had specificity more than 0.95 were found for all six conditions. Sensitivity above 0.90 was not achieved all conditions. Conclusions Varying claims criteria improved the performance of case-finding algorithms for six chronic conditions. Highly specific, and sometimes sensitive, algorithms for identifying members of health plans with several chronic conditions can be developed using claims data. PMID:15533190

Interactive algorithms for teaching and learning acute medicine in the network of medical faculties MEFANET.

PubMed

Schwarz, Daniel; Štourač, Petr; Komenda, Martin; Harazim, Hana; Kosinová, Martina; Gregor, Jakub; Hůlek, Richard; Smékalová, Olga; Křikava, Ivo; Štoudek, Roman; Dušek, Ladislav

2013-07-08

Medical Faculties Network (MEFANET) has established itself as the authority for setting standards for medical educators in the Czech Republic and Slovakia, 2 independent countries with similar languages that once comprised a federation and that still retain the same curricular structure for medical education. One of the basic goals of the network is to advance medical teaching and learning with the use of modern information and communication technologies. We present the education portal AKUTNE.CZ as an important part of the MEFANET's content. Our focus is primarily on simulation-based tools for teaching and learning acute medicine issues. Three fundamental elements of the MEFANET e-publishing system are described: (1) medical disciplines linker, (2) authentication/authorization framework, and (3) multidimensional quality assessment. A new set of tools for technology-enhanced learning have been introduced recently: Sandbox (works in progress), WikiLectures (collaborative content authoring), Moodle-MEFANET (central learning management system), and Serious Games (virtual casuistics and interactive algorithms). The latest development in MEFANET is designed for indexing metadata about simulation-based learning objects, also known as electronic virtual patients or virtual clinical cases. The simulations assume the form of interactive algorithms for teaching and learning acute medicine. An anonymous questionnaire of 10 items was used to explore students' attitudes and interests in using the interactive algorithms as part of their medical or health care studies. Data collection was conducted over 10 days in February 2013. In total, 25 interactive algorithms in the Czech and English languages have been developed and published on the AKUTNE.CZ education portal to allow the users to test and improve their knowledge and skills in the field of acute medicine. In the feedback survey, 62 participants completed the online questionnaire (13.5%) from the total 460 addressed. Positive attitudes toward the interactive algorithms outnumbered negative trends. The peer-reviewed algorithms were used for conducting problem-based learning sessions in general medicine (first aid, anesthesiology and pain management, emergency medicine) and in nursing (emergency medicine for midwives, obstetric analgesia, and anesthesia for midwifes). The feedback from the survey suggests that the students found the interactive algorithms as effective learning tools, facilitating enhanced knowledge in the field of acute medicine. The interactive algorithms, as a software platform, are open to academic use worldwide. The existing algorithms, in the form of simulation-based learning objects, can be incorporated into any educational website (subject to the approval of the authors).

Interactive Algorithms for Teaching and Learning Acute Medicine in the Network of Medical Faculties MEFANET

PubMed Central

Štourač, Petr; Komenda, Martin; Harazim, Hana; Kosinová, Martina; Gregor, Jakub; Hůlek, Richard; Smékalová, Olga; Křikava, Ivo; Štoudek, Roman; Dušek, Ladislav

2013-01-01

Background Medical Faculties Network (MEFANET) has established itself as the authority for setting standards for medical educators in the Czech Republic and Slovakia, 2 independent countries with similar languages that once comprised a federation and that still retain the same curricular structure for medical education. One of the basic goals of the network is to advance medical teaching and learning with the use of modern information and communication technologies. Objective We present the education portal AKUTNE.CZ as an important part of the MEFANET’s content. Our focus is primarily on simulation-based tools for teaching and learning acute medicine issues. Methods Three fundamental elements of the MEFANET e-publishing system are described: (1) medical disciplines linker, (2) authentication/authorization framework, and (3) multidimensional quality assessment. A new set of tools for technology-enhanced learning have been introduced recently: Sandbox (works in progress), WikiLectures (collaborative content authoring), Moodle-MEFANET (central learning management system), and Serious Games (virtual casuistics and interactive algorithms). The latest development in MEFANET is designed for indexing metadata about simulation-based learning objects, also known as electronic virtual patients or virtual clinical cases. The simulations assume the form of interactive algorithms for teaching and learning acute medicine. An anonymous questionnaire of 10 items was used to explore students’ attitudes and interests in using the interactive algorithms as part of their medical or health care studies. Data collection was conducted over 10 days in February 2013. Results In total, 25 interactive algorithms in the Czech and English languages have been developed and published on the AKUTNE.CZ education portal to allow the users to test and improve their knowledge and skills in the field of acute medicine. In the feedback survey, 62 participants completed the online questionnaire (13.5%) from the total 460 addressed. Positive attitudes toward the interactive algorithms outnumbered negative trends. Conclusions The peer-reviewed algorithms were used for conducting problem-based learning sessions in general medicine (first aid, anesthesiology and pain management, emergency medicine) and in nursing (emergency medicine for midwives, obstetric analgesia, and anesthesia for midwifes). The feedback from the survey suggests that the students found the interactive algorithms as effective learning tools, facilitating enhanced knowledge in the field of acute medicine. The interactive algorithms, as a software platform, are open to academic use worldwide. The existing algorithms, in the form of simulation-based learning objects, can be incorporated into any educational website (subject to the approval of the authors). PMID:23835586

Assessing Instructional Strategies and Resulting Student Attitudes Regarding Two-Way Television Instruction.

ERIC Educational Resources Information Center

Denton, Jon J.; And Others

Designed to compare instructional strategies and effectiveness of medical school faculty using both in-person and two-way television delivery systems, this paper presents classroom observation data obtained from presentations by seven faculty members of the College of Medicine at Texas A&M University over a 9-month period. It includes a…

Managing a Test Item Bank on a Microcomputer: Can It Help You and Your Students?

ERIC Educational Resources Information Center

Peterson, Julian A.; Meister, Lynn L.

1983-01-01

Describes a test item bank developed by the Association for Medical School Departments of Biochemistry (Texas). Programs (written in Pascal) allow self-evaluation by interactive student access to questions randomly selected from a chosen category. Potential users of the system (having student, manager, and instructor modes) are invited to contact…

Language-in-Healthcare Policy, Interaction Patterns, and Unequal Care on the U.S.-Mexico Border

ERIC Educational Resources Information Center

Martinez, Glenn

2008-01-01

This paper examines the implementation of language-in-healthcare policy in a highly bilingual, medically stressed border region of south Texas. In its current form, federal language-in-healthcare policy unevenly impacts different geographic regions. Healthcare markets along the U.S.-Mexico border are particularly taxed by the recent language…

The mitochondrial genome of a Texas outbreak strain of the cattle tick, Rhipicephalus (Boophilus) microplus, derived from whole genome sequencing Pacific Biosciences and Illumina reads

USDA-ARS?s Scientific Manuscript database

The cattle fever tick, Rhipicephalus (Boophilus) microplus is one of the most significant medical veterinary pests in the world, vectoring several serious livestock diseases negatively impacting agricultural economies of tropical and subtropical countries around the world. We assembled the complete ...

Color transfer algorithm in medical images

NASA Astrophysics Data System (ADS)

Wang, Weihong; Xu, Yangfa

2007-12-01

In digital virtual human project, image data acquires from the freezing slice of human body specimen. The color and brightness between a group of images of a certain organ could be quite different. The quality of these images could bring great difficulty in edge extraction, segmentation, as well as 3D reconstruction process. Thus it is necessary to unify the color of the images. The color transfer algorithm is a good algorithm to deal with this kind of problem. This paper introduces the principle of this algorithm and uses it in the medical image processing.

The University of Texas M.D. Anderson Cancer Center Proton Therapy Facility

NASA Astrophysics Data System (ADS)

Smith, Alfred; Newhauser, Wayne; Latinkic, Mitchell; Hay, Amy; McMaken, Bruce; Styles, John; Cox, James

2003-08-01

The University of Texas M.D. Anderson Cancer Center (MDACC), in partnership with Sanders Morris Harris Inc., a Texas-based investment banking firm, and The Styles Company, a developer and manager of hospitals and healthcare facilities, is building a proton therapy facility near the MDACC main complex at the Texas Medical Center in Houston, Texas USA. The MDACC Proton Therapy Center will be a freestanding, investor-owned radiation oncology center offering state-of-the-art proton beam therapy. The facility will have four treatment rooms: three rooms will have rotating, isocentric gantries and the fourth treatment room will have capabilities for both large and small field (e.g. ocular melanoma) treatments using horizontal beam lines. There will be an additional horizontal beam room dedicated to physics research and development, radiation biology research, and outside users who wish to conduct experiments using proton beams. The first two gantries will each be initially equipped with a passive scattering nozzle while the third gantry will have a magnetically swept pencil beam scanning nozzle. The latter will include enhancements to the treatment control system that will allow for the delivery of proton intensity modulation treatments. The proton accelerator will be a 250 MeV zero-gradient synchrotron with a slow extraction system. The facility is expected to open for patient treatments in the autumn of 2005. It is anticipated that 675 patients will be treated during the first full year of operation, while full capacity, reached in the fifth year of operation, will be approximately 3,400 patients per year. Treatments will be given up to 2-shifts per day and 6 days per week.

Evaluation of Active Mortality Surveillance System Data for Monitoring Hurricane-Related Deaths—Texas, 2008

PubMed Central

Choudhary, Ekta; Zane, David F.; Beasley, Crystal; Jones, Russell; Rey, Araceli; Noe, Rebecca S.; Martin, Colleen; Wolkin, Amy F.; Bayleyegn, Tesfaye M.

2015-01-01

Introduction The Texas Department of State Health Services (DSHS) implemented an active mortality surveillance system to enumerate and characterize hurricane-related deaths during Hurricane Ike in 2008. This surveillance system used established guidelines and case definitions to categorize deaths as directly, indirectly, and possibly related to Hurricane Ike. Objective The objective of this study was to evaluate Texas DSHS’ active mortality surveillance system using US Centers for Disease Control and Prevention’s (CDC) surveillance system evaluation guidelines. Methods Using CDC’s Updated Guidelines for Surveillance System Evaluation, the active mortality surveillance system of the Texas DSHS was evaluated. Data from the active mortality surveillance system were compared with Texas vital statistics data for the same time period to estimate the completeness of reported disaster-related deaths. Results From September 8 through October 13, 2008, medical examiners (MEs) and Justices of the Peace (JPs) in 44 affected counties reported deaths daily by using a one-page, standardized mortality form. The active mortality surveillance system identified 74 hurricane-related deaths, whereas a review of vital statistics data revealed only four deaths that were hurricane-related. The average time of reporting a death by active mortality surveillance and vital statistics was 14 days and 16 days, respectively. Conclusions Texas’s active mortality surveillance system successfully identified hurricane-related deaths. Evaluation of the active mortality surveillance system suggested that it is necessary to collect detailed and representative mortality data during a hurricane because vital statistics do not capture sufficient information to identify whether deaths are hurricane-related. The results from this evaluation will help improve active mortality surveillance during hurricanes which, in turn, will enhance preparedness and response plans and identify public health interventions to reduce future hurricane-related mortality rates. PMID:22800916

Serological detection of Tick-Borne Relapsing Fever in Texan domestic dogs

PubMed Central

Snell, Chloe B.; Adetunji, Shakirat A.; Piccione, Julie

2017-01-01

Tick-Borne Relapsing Fever (TBRF) is caused by spirochetes in the genus Borrelia. Very limited information exists on the incidence of this disease in humans and domestic dogs in the United States. The main objective of this study is to evaluate exposure of dogs to Borrelia turicatae, a causative agent of TBRF, in Texas. To this end, 878 canine serum samples were submitted to Texas A&M Veterinary Medical Diagnostic Laboratory from October 2011 to September 2012 for suspected tick-borne illnesses. The recombinant Borrelial antigen glycerophosphodiester phosphodiesterase (GlpQ) was expressed, purified, and used as a diagnostic antigen in both ELISA assays and Immunoblot analysis. Unfortunately, due to significant background reaction, the use of GlpQ as a diagnostic marker in the ELISA assay was not effective in discriminating dogs exposed to B. turicatae. Nevertheless, immunoblot assays showed that 17 out of 853 samples tested were considered to be seropositive, which constitutes 1.99% of all Texas samples tested in this study. The majority of positive samples were from central and southern Texas. Exposure to TBRF spirochetes may be seasonal, with 70.59% (12 out of 17) of the cases detected between June and December. In addition, 2 out of the 17 sero-reactive cases (11.76%) showed reactivity to both B. burgdorferi (causative agent of Lyme disease) and B. turicatae (a causative agent of TBRF). This is the first report of TBRF sero-prevalence in companion animals in an endemic area. Our findings further indicate that B. turicatae is maintained in domestic canids in Texas in regions where human disease also occurs, suggesting that domestic dogs could serve as sentinels for this disease. PMID:29232415

Teamwork: an essential for leading and launching innovation.

PubMed

Davis, Patricia D; Marshall, David R

2014-01-01

Teamwork and innovation require a merging of special skills sets to produce the best outcomes. Collaboration and innovation have become core competencies for effectiveness in every industry. The capacity to collaborate and innovate has never been more important, especially in health care, with the regulatory and quality mandates to evaluate every aspect of service to ensure that we add value for patients and families. The examination of teamwork and innovation, which are inextricably linked, are described and discussed. The art of building teams, steps for leading change, and an approach to innovation in health care are described. The University of Texas Medical Branch in Galveston, Texas, shares one approach and experience called Innovation Forerunners-nurses from all levels and areas-to embed the tools and concepts of teamwork and innovation across patient care areas.

How concerns for bisphosphonate-induced osteonecrosis of the jaw affect clinical practice among dentists: a study from the South Texas Oral Health Network

PubMed Central

Gonzales, Cara B.; Young, Veronica; Ketchum, Norma S.; Bone, Jamie; Oates, Thomas W.; Mungia, Rahma

2015-01-01

Bisphosphonate-induced osteonecrosis of the jaw (BONJ) represents a growing concern for dentists and patients, in that it may alter clinical care. This study assesses the knowledge and perceptions of practicing dentists in relation to the risk of BONJ and how their knowledge and perceptions influence their decisions when developing treatment plans. For this study, a sample of dentists (n = 93) in South Texas completed a 38-item survey about BONJ knowledge and perception and their current clinical practices for patients undergoing bisphosphonate therapy. Knowledge score groupings reflected differences between low-knowledge and high-knowledge dentists in terms of their behavior concerning medical history, alternative treatments offered, and routine blood testing for patients on bisphosphonate therapy. PMID:25734289

Identifying Psoriasis and Psoriatic Arthritis Patients in Retrospective Databases When Diagnosis Codes Are Not Available: A Validation Study Comparing Medication/Prescriber Visit-Based Algorithms with Diagnosis Codes.

PubMed

Dobson-Belaire, Wendy; Goodfield, Jason; Borrelli, Richard; Liu, Fei Fei; Khan, Zeba M

2018-01-01

Using diagnosis code-based algorithms is the primary method of identifying patient cohorts for retrospective studies; nevertheless, many databases lack reliable diagnosis code information. To develop precise algorithms based on medication claims/prescriber visits (MCs/PVs) to identify psoriasis (PsO) patients and psoriatic patients with arthritic conditions (PsO-AC), a proxy for psoriatic arthritis, in Canadian databases lacking diagnosis codes. Algorithms were developed using medications with narrow indication profiles in combination with prescriber specialty to define PsO and PsO-AC. For a 3-year study period from July 1, 2009, algorithms were validated using the PharMetrics Plus database, which contains both adjudicated medication claims and diagnosis codes. Positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity of the developed algorithms were assessed using diagnosis code as the reference standard. Chosen algorithms were then applied to Canadian drug databases to profile the algorithm-identified PsO and PsO-AC cohorts. In the selected database, 183,328 patients were identified for validation. The highest PPVs for PsO (85%) and PsO-AC (65%) occurred when a predictive algorithm of two or more MCs/PVs was compared with the reference standard of one or more diagnosis codes. NPV and specificity were high (99%-100%), whereas sensitivity was low (≤30%). Reducing the number of MCs/PVs or increasing diagnosis claims decreased the algorithms' PPVs. We have developed an MC/PV-based algorithm to identify PsO patients with a high degree of accuracy, but accuracy for PsO-AC requires further investigation. Such methods allow researchers to conduct retrospective studies in databases in which diagnosis codes are absent. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Volumetric three-dimensional display system with rasterization hardware

NASA Astrophysics Data System (ADS)

Favalora, Gregg E.; Dorval, Rick K.; Hall, Deirdre M.; Giovinco, Michael; Napoli, Joshua

2001-06-01

An 8-color multiplanar volumetric display is being developed by Actuality Systems, Inc. It will be capable of utilizing an image volume greater than 90 million voxels, which we believe is the greatest utilizable voxel set of any volumetric display constructed to date. The display is designed to be used for molecular visualization, mechanical CAD, e-commerce, entertainment, and medical imaging. As such, it contains a new graphics processing architecture, novel high-performance line- drawing algorithms, and an API similar to a current standard. Three-dimensional imagery is created by projecting a series of 2-D bitmaps ('image slices') onto a diffuse screen that rotates at 600 rpm. Persistence of vision fuses the slices into a volume-filling 3-D image. A modified three-panel Texas Instruments projector provides slices at approximately 4 kHz, resulting in 8-color 3-D imagery comprised of roughly 200 radially-disposed slices which are updated at 20 Hz. Each slice has a resolution of 768 by 768 pixels, subtending 10 inches. An unusual off-axis projection scheme incorporating tilted rotating optics is used to maintain good focus across the projection screen. The display electronics includes a custom rasterization architecture which converts the user's 3- D geometry data into image slices, as well as 6 Gbits of DDR SDRAM graphics memory.

Malpractice risk and cost are significantly reduced after tort reform.

PubMed

Stewart, Ronald M; Geoghegan, Kathy; Myers, John G; Sirinek, Kenneth R; Corneille, Michael G; Mueller, Deborah; Dent, Daniel L; Wolf, Steven E; Pruitt, Basil A

2011-04-01

Rising medical malpractice premiums have reached a crisis point in many areas of the United States. In 2003 the Texas legislature passed a comprehensive package of tort reform laws that included a cap at $250,000 on noneconomic damages in most medical malpractice cases. We hypothesized that tort reform laws significantly reduce the risk of malpractice lawsuit in an academic medical center. We compared malpractice prevalence, incidence, and liability costs before and after comprehensive state tort reform measures were implemented. Two prospectively maintained institutional databases were used to calculate and characterize malpractice risk: a surgical operation database and a risk management and malpractice database. Risk groups were divided into pretort reform (1992 to 2004) and post-tort reform groups (2004 to the present). Operative procedures were included for elective, urgent, and emergency general surgery procedures. During the study period, 98,513 general surgical procedures were performed. A total of 28 lawsuits (25 pre-reform, 3 postreform) were filed, naming general surgery faculty or residents. The prevalence of lawsuits filed/100,000 procedures performed is as follows: before reform, 40 lawsuits/100,000 procedures, and after reform, 8 lawsuits/100,000 procedures (p < 0.01, relative risk 0.21 [95% CI 0.063 to 0.62]). Virtually all of the liability and defense cost was in the pretort reform period: $595,000/year versus $515/year in the postreform group (p < 0.01). Implementation of comprehensive tort reform in Texas was associated with a significant decrease in the prevalence and cost of surgical malpractice lawsuits at one academic medical center. Copyright © 2011. Published by Elsevier Inc.

An efficient dictionary learning algorithm and its application to 3-D medical image denoising.

PubMed

Li, Shutao; Fang, Leyuan; Yin, Haitao

2012-02-01

In this paper, we propose an efficient dictionary learning algorithm for sparse representation of given data and suggest a way to apply this algorithm to 3-D medical image denoising. Our learning approach is composed of two main parts: sparse coding and dictionary updating. On the sparse coding stage, an efficient algorithm named multiple clusters pursuit (MCP) is proposed. The MCP first applies a dictionary structuring strategy to cluster the atoms with high coherence together, and then employs a multiple-selection strategy to select several competitive atoms at each iteration. These two strategies can greatly reduce the computation complexity of the MCP and assist it to obtain better sparse solution. On the dictionary updating stage, the alternating optimization that efficiently approximates the singular value decomposition is introduced. Furthermore, in the 3-D medical image denoising application, a joint 3-D operation is proposed for taking the learning capabilities of the presented algorithm to simultaneously capture the correlations within each slice and correlations across the nearby slices, thereby obtaining better denoising results. The experiments on both synthetically generated data and real 3-D medical images demonstrate that the proposed approach has superior performance compared to some well-known methods. © 2011 IEEE

Programmable architecture for pixel level processing tasks in lightweight strapdown IR seekers

NASA Astrophysics Data System (ADS)

Coates, James L.

1993-06-01

Typical processing tasks associated with missile IR seeker applications are described, and a straw man suite of algorithms is presented. A fully programmable multiprocessor architecture is realized on a multimedia video processor (MVP) developed by Texas Instruments. The MVP combines the elements of RISC, floating point, advanced DSPs, graphics processors, display and acquisition control, RAM, and external memory. Front end pixel level tasks typical of missile interceptor applications, operating on 256 x 256 sensor imagery, can be processed at frame rates exceeding 100 Hz in a single MVP chip.

A hybrid flower pollination algorithm based modified randomized location for multi-threshold medical image segmentation.

PubMed

Wang, Rui; Zhou, Yongquan; Zhao, Chengyan; Wu, Haizhou

2015-01-01

Multi-threshold image segmentation is a powerful image processing technique that is used for the preprocessing of pattern recognition and computer vision. However, traditional multilevel thresholding methods are computationally expensive because they involve exhaustively searching the optimal thresholds to optimize the objective functions. To overcome this drawback, this paper proposes a flower pollination algorithm with a randomized location modification. The proposed algorithm is used to find optimal threshold values for maximizing Otsu's objective functions with regard to eight medical grayscale images. When benchmarked against other state-of-the-art evolutionary algorithms, the new algorithm proves itself to be robust and effective through numerical experimental results including Otsu's objective values and standard deviations.

From patient care to research: a validation study examining the factors contributing to data quality in a primary care electronic medical record database.

PubMed

Coleman, Nathan; Halas, Gayle; Peeler, William; Casaclang, Natalie; Williamson, Tyler; Katz, Alan

2015-02-05

Electronic Medical Records (EMRs) are increasingly used in the provision of primary care and have been compiled into databases which can be utilized for surveillance, research and informing practice. The primary purpose of these records is for the provision of individual patient care; validation and examination of underlying limitations is crucial for use for research and data quality improvement. This study examines and describes the validity of chronic disease case definition algorithms and factors affecting data quality in a primary care EMR database. A retrospective chart audit of an age stratified random sample was used to validate and examine diagnostic algorithms applied to EMR data from the Manitoba Primary Care Research Network (MaPCReN), part of the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). The presence of diabetes, hypertension, depression, osteoarthritis and chronic obstructive pulmonary disease (COPD) was determined by review of the medical record and compared to algorithm identified cases to identify discrepancies and describe the underlying contributing factors. The algorithm for diabetes had high sensitivity, specificity and positive predictive value (PPV) with all scores being over 90%. Specificities of the algorithms were greater than 90% for all conditions except for hypertension at 79.2%. The largest deficits in algorithm performance included poor PPV for COPD at 36.7% and limited sensitivity for COPD, depression and osteoarthritis at 72.0%, 73.3% and 63.2% respectively. Main sources of discrepancy included missing coding, alternative coding, inappropriate diagnosis detection based on medications used for alternate indications, inappropriate exclusion due to comorbidity and loss of data. Comparison to medical chart review shows that at MaPCReN the CPCSSN case finding algorithms are valid with a few limitations. This study provides the basis for the validated data to be utilized for research and informs users of its limitations. Analysis of underlying discrepancies provides the ability to improve algorithm performance and facilitate improved data quality.

A fuzzy optimal threshold technique for medical images

NASA Astrophysics Data System (ADS)

Thirupathi Kannan, Balaji; Krishnasamy, Krishnaveni; Pradeep Kumar Kenny, S.

2012-01-01

A new fuzzy based thresholding method for medical images especially cervical cytology images having blob and mosaic structures is proposed in this paper. Many existing thresholding algorithms may segment either blob or mosaic images but there aren't any single algorithm that can do both. In this paper, an input cervical cytology image is binarized, preprocessed and the pixel value with minimum Fuzzy Gaussian Index is identified as an optimal threshold value and used for segmentation. The proposed technique is tested on various cervical cytology images having blob or mosaic structures, compared with various existing algorithms and proved better than the existing algorithms.

Novel medical image enhancement algorithms

NASA Astrophysics Data System (ADS)

Agaian, Sos; McClendon, Stephen A.

2010-01-01

In this paper, we present two novel medical image enhancement algorithms. The first, a global image enhancement algorithm, utilizes an alpha-trimmed mean filter as its backbone to sharpen images. The second algorithm uses a cascaded unsharp masking technique to separate the high frequency components of an image in order for them to be enhanced using a modified adaptive contrast enhancement algorithm. Experimental results from enhancing electron microscopy, radiological, CT scan and MRI scan images, using the MATLAB environment, are then compared to the original images as well as other enhancement methods, such as histogram equalization and two forms of adaptive contrast enhancement. An image processing scheme for electron microscopy images of Purkinje cells will also be implemented and utilized as a comparison tool to evaluate the performance of our algorithm.

Assessing Resilience: How Plans, Strategies, and After Action Reports Can Improve Our Understanding of Organizational Preparedness

DTIC Science & Technology

2016-09-01

BOMBING AFTER ACTION REPORT ...................................................................................................55 C. MAY 2014 SAN...Continuity of Operations DHS Department of Homeland Security DPS Texas Department of Public Safety EMS Emergency Medical Services ESL English as a Second...2013 Boston Marathon bombings , and the 2014 wildfires in San Diego County. This chapter also provides overall findings regarding the adaptive

Cosmonaut Dezhurov during medical operations training

NASA Image and Video Library

1994-06-11

Cosmonaut Vladimir N. Dezhurov (center), Mir 18 mission commander, gets his blood pressure taken by Dr. Michael J. Barrett, flight surgeon. Cosmonaut Anatoliy Y. Solovyev (right), Mir 19 mission commander, looks on. Solovyev, Dezhurov, along with their respective flight engineers and a number of other cosmonauts and astronauts participating in the joint program, were in Houston, Texas, to prepare for their upcoming missions.

Emergency Management of Chronic Wounds

DTIC Science & Technology

2007-01-01

ABEMe aDepartment of Emergency Medicine , Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239-7500, USA...bVeterans Administration Medical Center, Portland, OR, USA cEmergency Medicine , The University of Texas Health Science Center at San Antonio, San Antonio...result in a sustained restoration of anatomic and * Corresponding author. Department of Emergency Medicine , Oregon Health & Science University, 3181

University of Texas Southwestern Medical Center (UTSW): Lung Cancer Oncogenotype-Selective Drug Target Discovery (Natural Products Focus) | Office of Cancer Genomics

Cancer.gov

The goal of this project is to use small molecules and RNAi to functionally define subtypes of non-small cell lung cancer (NSCLC) using a panel of cell lines prepared and molecularly annotated by Drs. John Minna and Adi Gazdar. Experimental Approaches Lung Cancer Natural Products Screening/Chemical Library Screening

University of Texas Southwestern Medical Center: Lung Cancer Oncogenotype-Selective Drug Target Discovery (Natural Products Focus) | Office of Cancer Genomics

Cancer.gov

The goal of this project is to use small molecules and RNAi to functionally define subtypes of non-small cell lung cancer (NSCLC) using a panel of cell lines prepared and molecularly annotated by Drs. John Minna and Adi Gazdar. Experimental Approaches Lung Cancer Natural Products Screening/Chemical Library Screening

A Traumatic Death Support Group Program: Applying an Integrated Conceptual Framework

ERIC Educational Resources Information Center

Walijarvi, Corrine M.; Weiss, Ann H.; Weinman, Maxine L.

2012-01-01

This article describes an 8-week, curriculum-based traumatic death support group program that is offered at Bo's Place, a grief and bereavement center in Houston, Texas. The program was implemented in 2006 in an effort to help family members who had experienced a death in the family by suicide, murder, accident, or sudden medical problem. The…

Lossless medical image compression using geometry-adaptive partitioning and least square-based prediction.

PubMed

Song, Xiaoying; Huang, Qijun; Chang, Sheng; He, Jin; Wang, Hao

2018-06-01

To improve the compression rates for lossless compression of medical images, an efficient algorithm, based on irregular segmentation and region-based prediction, is proposed in this paper. Considering that the first step of a region-based compression algorithm is segmentation, this paper proposes a hybrid method by combining geometry-adaptive partitioning and quadtree partitioning to achieve adaptive irregular segmentation for medical images. Then, least square (LS)-based predictors are adaptively designed for each region (regular subblock or irregular subregion). The proposed adaptive algorithm not only exploits spatial correlation between pixels but it utilizes local structure similarity, resulting in efficient compression performance. Experimental results show that the average compression performance of the proposed algorithm is 10.48, 4.86, 3.58, and 0.10% better than that of JPEG 2000, CALIC, EDP, and JPEG-LS, respectively. Graphical abstract ᅟ.

Stochastic resource allocation in emergency departments with a multi-objective simulation optimization algorithm.

PubMed

Feng, Yen-Yi; Wu, I-Chin; Chen, Tzu-Li

2017-03-01

The number of emergency cases or emergency room visits rapidly increases annually, thus leading to an imbalance in supply and demand and to the long-term overcrowding of hospital emergency departments (EDs). However, current solutions to increase medical resources and improve the handling of patient needs are either impractical or infeasible in the Taiwanese environment. Therefore, EDs must optimize resource allocation given limited medical resources to minimize the average length of stay of patients and medical resource waste costs. This study constructs a multi-objective mathematical model for medical resource allocation in EDs in accordance with emergency flow or procedure. The proposed mathematical model is complex and difficult to solve because its performance value is stochastic; furthermore, the model considers both objectives simultaneously. Thus, this study develops a multi-objective simulation optimization algorithm by integrating a non-dominated sorting genetic algorithm II (NSGA II) with multi-objective computing budget allocation (MOCBA) to address the challenges of multi-objective medical resource allocation. NSGA II is used to investigate plausible solutions for medical resource allocation, and MOCBA identifies effective sets of feasible Pareto (non-dominated) medical resource allocation solutions in addition to effectively allocating simulation or computation budgets. The discrete event simulation model of ED flow is inspired by a Taiwan hospital case and is constructed to estimate the expected performance values of each medical allocation solution as obtained through NSGA II. Finally, computational experiments are performed to verify the effectiveness and performance of the integrated NSGA II and MOCBA method, as well as to derive non-dominated medical resource allocation solutions from the algorithms.

Intelligent Medical Systems for Aerospace Emergency Medical Services

NASA Technical Reports Server (NTRS)

Epler, John; Zimmer, Gary

2004-01-01

The purpose of this project is to develop a portable, hands free device for emergency medical decision support to be used in remote or confined settings by non-physician providers. Phase I of the project will entail the development of a voice-activated device that will utilize an intelligent algorithm to provide guidance in establishing an airway in an emergency situation. The interactive, hands free software will process requests for assistance based on verbal prompts and algorithmic decision-making. The device will allow the CMO to attend to the patient while receiving verbal instruction. The software will also feature graphic representations where it is felt helpful in aiding in procedures. We will also develop a training program to orient users to the algorithmic approach, the use of the hardware and specific procedural considerations. We will validate the efficacy of this mode of technology application by testing in the Johns Hopkins Department of Emergency Medicine. Phase I of the project will focus on the validation of the proposed algorithm, testing and validation of the decision making tool and modifications of medical equipment. In Phase 11, we will produce the first generation software for hands-free, interactive medical decision making for use in acute care environments.

Automatic Classification Using Supervised Learning in a Medical Document Filtering Application.

ERIC Educational Resources Information Center

Mostafa, J.; Lam, W.

2000-01-01

Presents a multilevel model of the information filtering process that permits document classification. Evaluates a document classification approach based on a supervised learning algorithm, measures the accuracy of the algorithm in a neural network that was trained to classify medical documents on cell biology, and discusses filtering…

Border Injuries: An Analysis of Prehospital Demographics, Mechanisms, and Patterns of Injuries Encountered by USBP EMS Agents in the El Paso (Texas USA) Sector.

PubMed

Baker, Russell A

2017-08-01

Study Objective The aim of this study was to evaluate Emergency Medical Services (EMS), use, injury mechanisms, prehospital assessments, and injuries among those receiving aid from the United States Border Patrol (USBP) in the El Paso (Texas USA) Sector. This is a time-series, retrospective analysis of all prehospital data for injuries among patients receiving care from USBP EMS on the US Mexico border in the El Paso sector from February 6, 2014 to February 6, 2016. A total of 473 documented EMS encounters occurred in this two-year period and demonstrated a male gender predominance (male 63%; female 37%) with the most prominent ages between 22-40 years old. The most prevalent EMS call types were medical (55%) and trauma (42%). The most common chief complaints were an injured or painful extremity (35%) and rash (13%). The most common USBP EMS provider primary impression was traumatic injury (34%), followed by fever/infection (17%) and extremity injury (7%); however, the most common secondary impression was also extremity injury (20%). The most common mechanism of injury was fall (26%) and motor vehicle accident (MVA; 22%). The USBP EMS was the first provider on scene in 96% of the MVAs. The author reports on injury patterns, mechanisms, chief complaints, EMS impressions, as well as demographics of patients reporting to USBP EMS. A knowledge of these injury patterns will be useful to EMS administrators and physicians along the US Mexico border. Baker RA . Border injuries: an analysis of prehospital demographics, mechanisms, and patterns of injuries encountered by USBP EMS agents in the El Paso (Texas USA) Sector. Prehosp Disaster Med. 2017;32(4):431-436.

Distribution and characterization of Heterobilharzia americana in dogs in Texas.

PubMed

Rodriguez, J Y; Lewis, B C; Snowden, K F

2014-06-16

Heterobilharzia americana is a trematode parasite (family Schistosomatidae) that infects a wide range of wild mammalian hosts. Canine cases have been reported in the Gulf coast and south Atlantic states, Kansas, and Oklahoma. A total of 238 canine H. americana cases in Texas were retrospectively collected for a period of approximately 22 years from case records at the Texas Veterinary Medical Diagnostic Laboratory and the Veterinary Medical Teaching Hospital pathology service, diagnostic parasitology service, and Gastrointestinal Laboratory at Texas A&M University College of Veterinary Medicine. Of these cases, 26 patients had 1-2 repeat positive tests for a total of 268 positive tests (26 biopsies, 39 necropsies, 160 fecal examinations, and 43 PCR). Multiple dogs were infected in 12 households. Cases were distributed primarily in the eastern region of Texas in 42 of 254 counties. Cases were seen as far west as Kerr county and in counties bordering Oklahoma, Louisiana, Mexico, and the Gulf of Mexico. The median dog age was 5.6 years (2.7 months to 17.2 years) and the median weight was 20.5 kg (1-61.6 kg). All American Kennel Club (AKC) breed groups were represented (n=186): crossbred (20%), herding (17.8%), sporting (16.1%), toy (10.8%), hounds (10.8%), working (10.1%), terrier (8.5%), non-sporting (4.9%), and miscellaneous (1%). No seasonal pattern of diagnosis was apparent. Clinical signs reported (n=90) were diarrhea (67%), weight loss (38%), anorexia/hyporexia (27%), vomiting (22%), hematochezia (20%), lethargy (17%), polyuria/polydipsia (6%), and collapse (3%). In 39 necropsy cases, trematode eggs were identified by histopathology in the small intestine (84%), liver (84%), large intestine (39%), pancreas (35%), lung (9%), lymph node (8%), spleen (4%), and stomach (3%). Adult parasites were identified histologically in four cases. Granulomatous inflammation associated with the eggs was the most commonly reported histopathologic change. Other changes reported were fibrosis, pigment in macrophages, and organ mineralization. Glomerulonephritis was identified in four cases. Of 20 necropsy cases where death was attributable to H. americana infection, only one case was diagnosed ante mortem. Eleven of these dogs were examined by a veterinarian but H. americana was included as a differential diagnosis in only two cases. Reported differential diagnoses included ethylene glycol toxicity, cholecalciferol toxicity, lymphoma, and pancreatitis. These data indicate that this parasite is more widely distributed and more common than is generally recognized. Increased awareness may aid in more diagnoses and timely therapy. Copyright © 2014 Elsevier B.V. All rights reserved.

Payment system reform: one state's journey.

PubMed

Millwee, Billy; Goldfield, Norbert; Averill, Richard; Hughes, John

2013-01-01

In June 2011, Texas enacted Senate Bill 7, which mandates a Medicaid quality-based outcomes payment program on the basis of a common set of outcomes that apply to all types of provider systems including hospitals, managed care plans, medical homes, managed long-term care plans, and Accountable Care Organizations. The quality-based outcome measures focus on potentially preventable events (services) such as preventable admissions and readmissions that result in unnecessary expense, patient inconvenience, and risk of complications. The payment adjustments relate to a provider system's effectiveness in reducing the rate at which potentially preventable events occur. The program envisioned by Texas Medicaid is one that is administratively simple, establishes the right financial incentives to drive delivery system improvement, and does not intrude on the provider practice or the patient. Rather than imposing a series of processes that must be followed or require rigid adherence to standardized protocols, the payment adjustments are based on risk-adjusted comparisons of the rate of potentially preventable events for an individual provider systems to an empirically derived performance standard such as the state average. This article proposes a payment system design that can meet the ambitious objectives of the Texas legislation.

An algorithm to improve diagnostic accuracy in diabetes in computerised problem orientated medical records (POMR) compared with an established algorithm developed in episode orientated records (EOMR).

PubMed

de Lusignan, Simon; Liaw, Siaw-Teng; Dedman, Daniel; Khunti, Kamlesh; Sadek, Khaled; Jones, Simon

2015-06-05

An algorithm that detects errors in diagnosis, classification or coding of diabetes in primary care computerised medial record (CMR) systems is currently available. However, this was developed on CMR systems that are episode orientated medical records (EOMR); and do not force the user to always code a problem or link data to an existing one. More strictly problem orientated medical record (POMR) systems mandate recording a problem and linking consultation data to them. To compare the rates of detection of diagnostic accuracy using an algorithm developed in EOMR with a new POMR specific algorithm. We used data from The Health Improvement Network (THIN) database (N = 2,466,364) to identify a population of 100,513 (4.08%) patients considered likely to have diabetes. We recalibrated algorithms designed to classify cases of diabetes to take account of that POMR enforced coding consistency in the computerised medical record systems [In Practice Systems (InPS) Vision] that contribute data to THIN. We explored the different proportions of people classified as having type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) and with diabetes unclassifiable as either T1DM or T2DM. We compared proportions using chi-square tests and used Tukey's test to compare the characteristics of the people in each group. The prevalence of T1DM using the original EOMR algorithm was 0.38% (9,264/2,466,364), and for T2DM 3.22% (79,417/2,466,364). The prevalence using the new POMR algorithm was 0.31% (7,750/2,466,364) T1DM and 3.65% (89,990/2,466,364) T2DM. The EOMR algorithms also left more people unclassified 11,439 (12%), as to their type of diabetes compared with 2,380 (2.4%), for the new algorithm. Those people who were only classified by the EOMR system differed in terms of older age, and apparently better glycaemic control, despite not being prescribed medication for their diabetes (p < 0.005). Increasing the degree of problem orientation of the medical record system can improve the accuracy of recording of diagnoses and, therefore, the accuracy of using routinely collected data from CMRs to determine the prevalence of diabetes mellitus; data processing strategies should reflect the degree of problem orientation.

Meeting medical terminology needs--the Ontology-Enhanced Medical Concept Mapper.

PubMed

Leroy, G; Chen, H

2001-12-01

This paper describes the development and testing of the Medical Concept Mapper, a tool designed to facilitate access to online medical information sources by providing users with appropriate medical search terms for their personal queries. Our system is valuable for patients whose knowledge of medical vocabularies is inadequate to find the desired information, and for medical experts who search for information outside their field of expertise. The Medical Concept Mapper maps synonyms and semantically related concepts to a user's query. The system is unique because it integrates our natural language processing tool, i.e., the Arizona (AZ) Noun Phraser, with human-created ontologies, the Unified Medical Language System (UMLS) and WordNet, and our computer generated Concept Space, into one system. Our unique contribution results from combining the UMLS Semantic Net with Concept Space in our deep semantic parsing (DSP) algorithm. This algorithm establishes a medical query context based on the UMLS Semantic Net, which allows Concept Space terms to be filtered so as to isolate related terms relevant to the query. We performed two user studies in which Medical Concept Mapper terms were compared against human experts' terms. We conclude that the AZ Noun Phraser is well suited to extract medical phrases from user queries, that WordNet is not well suited to provide strictly medical synonyms, that the UMLS Metathesaurus is well suited to provide medical synonyms, and that Concept Space is well suited to provide related medical terms, especially when these terms are limited by our DSP algorithm.

Astronaut McDivitt - Blood Pressure Check - Preflight Examination - Merritt Island, FL

NASA Image and Video Library

1965-06-01

S65-19524 (1 June 1965) --- Dr. Charles A. Berry, chief of Center Medical Programs, MSC, Houston, Texas, prepares to check the blood pressure of astronaut James A. McDivitt, command pilot for the Gemini-Titan 4 spaceflight. McDivitt is on the tilt table at the Aero Medical Area, MSC, Merritt Island, where he and astronaut Edward H. White II (out of frame), GT-4 pilot, underwent preflight physicals in preparation for the four-day, 62-revolution spaceflight. The two astronauts were declared in top physical condition. In the background is Dr. Gordon Benson, NASA physician at Cape Kennedy.

Space Technology - Game Changing Development NASA Facts: Autonomous Medical Operations

NASA Technical Reports Server (NTRS)

Thompson, David E.

2018-01-01

The AMO (Autonomous Medical Operations) Project is working extensively to train medical models on the reliability and confidence of computer-aided interpretation of ultrasound images in various clinical settings, and of various anatomical structures. AI (Artificial Intelligence) algorithms recognize and classify features in the ultrasound images, and these are compared to those features that clinicians use to diagnose diseases. The acquisition of clinically validated image assessment and the use of the AI algorithms constitutes fundamental baseline for a Medical Decision Support System that will advise crew on long-duration, remote missions.

[Development of a video image system for wireless capsule endoscopes based on DSP].

PubMed

Yang, Li; Peng, Chenglin; Wu, Huafeng; Zhao, Dechun; Zhang, Jinhua

2008-02-01

A video image recorder to record video picture for wireless capsule endoscopes was designed. TMS320C6211 DSP of Texas Instruments Inc. is the core processor of this system. Images are periodically acquired from Composite Video Broadcast Signal (CVBS) source and scaled by video decoder (SAA7114H). Video data is transported from high speed buffer First-in First-out (FIFO) to Digital Signal Processor (DSP) under the control of Complex Programmable Logic Device (CPLD). This paper adopts JPEG algorithm for image coding, and the compressed data in DSP was stored to Compact Flash (CF) card. TMS320C6211 DSP is mainly used for image compression and data transporting. Fast Discrete Cosine Transform (DCT) algorithm and fast coefficient quantization algorithm are used to accelerate operation speed of DSP and decrease the executing code. At the same time, proper address is assigned for each memory, which has different speed;the memory structure is also optimized. In addition, this system uses plenty of Extended Direct Memory Access (EDMA) to transport and process image data, which results in stable and high performance.

The Texas Advanced Directive Law: Unfinished Business.

PubMed

Kapottos, Michael; Youngner, Stuart

2015-01-01

The Texas Advance Directive Act allows physicians and hospitals to overrule patient or family requests for futile care. Purposefully not defining futility, the law leaves its determination in specific cases to an institutional process. While the law has received several criticisms, it does seem to work constructively in the cases that come to the review process. We introduce a new criticism: While the law has been justified by an appeal to professional values such as avoiding harm to patients, avoiding the provision of unseemly care, and good stewardship of medical resources, it is applied incompletely. It allows physicians and institutional committees to refuse "futile" treatments desired by patients and families while at the same time providing no way of regulating physicians who recommend or even push "futile" treatments in similar cases. In this sense, the TADA is incomplete on its own terms.

Meaningless comparisons lead to false optimism in medical machine learning

PubMed Central

Kording, Konrad; Recht, Benjamin

2017-01-01

A new trend in medicine is the use of algorithms to analyze big datasets, e.g. using everything your phone measures about you for diagnostics or monitoring. However, these algorithms are commonly compared against weak baselines, which may contribute to excessive optimism. To assess how well an algorithm works, scientists typically ask how well its output correlates with medically assigned scores. Here we perform a meta-analysis to quantify how the literature evaluates their algorithms for monitoring mental wellbeing. We find that the bulk of the literature (∼77%) uses meaningless comparisons that ignore patient baseline state. For example, having an algorithm that uses phone data to diagnose mood disorders would be useful. However, it is possible to explain over 80% of the variance of some mood measures in the population by simply guessing that each patient has their own average mood—the patient-specific baseline. Thus, an algorithm that just predicts that our mood is like it usually is can explain the majority of variance, but is, obviously, entirely useless. Comparing to the wrong (population) baseline has a massive effect on the perceived quality of algorithms and produces baseless optimism in the field. To solve this problem we propose “user lift” that reduces these systematic errors in the evaluation of personalized medical monitoring. PMID:28949964

Automated identification of drug and food allergies entered using non-standard terminology.

PubMed

Epstein, Richard H; St Jacques, Paul; Stockin, Michael; Rothman, Brian; Ehrenfeld, Jesse M; Denny, Joshua C

2013-01-01

An accurate computable representation of food and drug allergy is essential for safe healthcare. Our goal was to develop a high-performance, easily maintained algorithm to identify medication and food allergies and sensitivities from unstructured allergy entries in electronic health record (EHR) systems. An algorithm was developed in Transact-SQL to identify ingredients to which patients had allergies in a perioperative information management system. The algorithm used RxNorm and natural language processing techniques developed on a training set of 24 599 entries from 9445 records. Accuracy, specificity, precision, recall, and F-measure were determined for the training dataset and repeated for the testing dataset (24 857 entries from 9430 records). Accuracy, precision, recall, and F-measure for medication allergy matches were all above 98% in the training dataset and above 97% in the testing dataset for all allergy entries. Corresponding values for food allergy matches were above 97% and above 93%, respectively. Specificities of the algorithm were 90.3% and 85.0% for drug matches and 100% and 88.9% for food matches in the training and testing datasets, respectively. The algorithm had high performance for identification of medication and food allergies. Maintenance is practical, as updates are managed through upload of new RxNorm versions and additions to companion database tables. However, direct entry of codified allergy information by providers (through autocompleters or drop lists) is still preferred to post-hoc encoding of the data. Data tables used in the algorithm are available for download. A high performing, easily maintained algorithm can successfully identify medication and food allergies from free text entries in EHR systems.

Medical chart validation of an algorithm for identifying multiple sclerosis relapse in healthcare claims.

PubMed

Chastek, Benjamin J; Oleen-Burkey, Merrikay; Lopez-Bresnahan, Maria V

2010-01-01

Relapse is a common measure of disease activity in relapsing-remitting multiple sclerosis (MS). The objective of this study was to test the content validity of an operational algorithm for detecting relapse in claims data. A claims-based relapse detection algorithm was tested by comparing its detection rate over a 1-year period with relapses identified based on medical chart review. According to the algorithm, MS patients in a US healthcare claims database who had either (1) a primary claim for MS during hospitalization or (2) a corticosteroid claim following a MS-related outpatient visit were designated as having a relapse. Patient charts were examined for explicit indication of relapse or care suggestive of relapse. Positive and negative predictive values were calculated. Medical charts were reviewed for 300 MS patients, half of whom had a relapse according to the algorithm. The claims-based criteria correctly classified 67.3% of patients with relapses (positive predictive value) and 70.0% of patients without relapses (negative predictive value; kappa 0.373: p < 0.001). Alternative algorithms did not improve on the predictive value of the operational algorithm. Limitations of the algorithm include lack of differentiation between relapsing-remitting MS and other types, and that it does not incorporate measures of function and disability. The claims-based algorithm appeared to successfully detect moderate-to-severe MS relapse. This validated definition can be applied to future claims-based MS studies.

Using geometrical, textural, and contextual information of land parcels for classification of detailed urban land use

USGS Publications Warehouse

Wu, S.-S.; Qiu, X.; Usery, E.L.; Wang, L.

2009-01-01

Detailed urban land use data are important to government officials, researchers, and businesspeople for a variety of purposes. This article presents an approach to classifying detailed urban land use based on geometrical, textural, and contextual information of land parcels. An area of 6 by 14 km in Austin, Texas, with land parcel boundaries delineated by the Travis Central Appraisal District of Travis County, Texas, is tested for the approach. We derive fifty parcel attributes from relevant geographic information system (GIS) and remote sensing data and use them to discriminate among nine urban land uses: single family, multifamily, commercial, office, industrial, civic, open space, transportation, and undeveloped. Half of the 33,025 parcels in the study area are used as training data for land use classification and the other half are used as testing data for accuracy assessment. The best result with a decision tree classification algorithm has an overall accuracy of 96 percent and a kappa coefficient of 0.78, and two naive, baseline models based on the majority rule and the spatial autocorrelation rule have overall accuracy of 89 percent and 79 percent, respectively. The algorithm is relatively good at classifying single-family, multifamily, commercial, open space, and undeveloped land uses and relatively poor at classifying office, industrial, civic, and transportation land uses. The most important attributes for land use classification are the geometrical attributes, particularly those related to building areas. Next are the contextual attributes, particularly those relevant to the spatial relationship between buildings, then the textural attributes, particularly the semivariance texture statistic from 0.61-m resolution images.

DRAFT LANDSAT DATA MOSAIC: MONTGOMERY COUNTY, TEXAS; HARRIS COUNTY, TEXAS; FORT BEND COUNTY, TEXAS; BRAZORIA COUNTY, TEXAS; GALVESTON COUNTY, TEXAS

EPA Science Inventory

This is a draft Landsat Data Mosaic, which contains remote sensing information for Montgomery County, Texas Harris County, Texas Fort Bend County, Texas Brazoria County, Texas Galveston County, and Texas Imagery dates on the following dates: October 6, 1999 and September 29, 200...

[Knowledge of BLS and AED resuscitation algorithm amongst medical students--preliminary results].

PubMed

Chojnacki, Piotr; Ilieva, Rada; Kołodziej, Anna; Królikowska, Agata; Lipka, Jarosław; Ruta, Jaromir

2011-01-01

Early recognition of cardiac arrest (CA) and immediate commencement of resuscitation, may increase the survival rate among CA victims. We therefore conducted a survey among medical students to assess their knowledge of BLS and AED. The audit was performed among students, most of whom had completed at least one first aid course and those who had not done a first-aid course at all. The ERC-recommended questionnaire 2005 was used for the survey. One hundred and sixty five students completed the survey. Most of them recognized the usefulness of basic resuscitation algorithms and the use of AEDs. 88% of students recognized the importance offirst aid courses, and 91.6% would undertake them again. Despite obvious enthusiasm and self-declared adequate knowledge, 45.7% of the audited students were not familiar with the guidelines and answered wrongly to more than 6 of 12 questions in the questionnaire. The vast majority of the first year medical students were not familiar with the algorithms. We conclude that general knowledge of resuscitation algorithms among medical students is inadequate, and regular refresher courses are essential.

JPEG2000 still image coding quality.

PubMed

Chen, Tzong-Jer; Lin, Sheng-Chieh; Lin, You-Chen; Cheng, Ren-Gui; Lin, Li-Hui; Wu, Wei

2013-10-01

This work demonstrates the image qualities between two popular JPEG2000 programs. Two medical image compression algorithms are both coded using JPEG2000, but they are different regarding the interface, convenience, speed of computation, and their characteristic options influenced by the encoder, quantization, tiling, etc. The differences in image quality and compression ratio are also affected by the modality and compression algorithm implementation. Do they provide the same quality? The qualities of compressed medical images from two image compression programs named Apollo and JJ2000 were evaluated extensively using objective metrics. These algorithms were applied to three medical image modalities at various compression ratios ranging from 10:1 to 100:1. Following that, the quality of the reconstructed images was evaluated using five objective metrics. The Spearman rank correlation coefficients were measured under every metric in the two programs. We found that JJ2000 and Apollo exhibited indistinguishable image quality for all images evaluated using the above five metrics (r > 0.98, p < 0.001). It can be concluded that the image quality of the JJ2000 and Apollo algorithms is statistically equivalent for medical image compression.

Obesity-related costs and the economic impact of laparoscopic adjustable gastric banding procedures: benefits in the Texas Employees Retirement System.

PubMed

Perryman, M Ray; Gleghorn, Virginia

2010-01-01

To assess the return on investment (ROI) and economic impact of providing insurance coverage for the laparoscopic adjustable gastric banding (LAGB) procedure in classes II and III obese members of the Texas Employees Retirement System (ERS) and their dependents from payer, employer, and societal perspectives. Classes II and III obese employee members and their adult dependents were identified in a Texas ERS database using self-reported health risk assessment (HRA) data. Direct health costs and related absenteeism and mortality losses were estimated using data from previous research. A dynamic input-output model was then used to calculate overall economic effects by incorporating direct, indirect, and induced impacts. Direct health costs were inflation-adjusted to 2008 US dollars using the Consumer Price Index for Medical Care and other spending categories were similarly adjusted using relevant consumer and industrial indices. The future cost savings and other monetary benefits were discounted to present value using a real rate of 4.00%. From the payer perspective (ERS), the payback period for direct health costs associated with the LAGB procedure was 23-24 months and the annual return (over 5 years) was 28.8%. From the employer perspective (State of Texas), the costs associated with the LAGB procedure were recouped within 17-19 months (in terms of direct, indirect, and induced gains as they translated into State revenue) and the annual return (over 5 years) was 45.5%. From a societal perspective, the impact on total business activity for Texas (over 5 years) included gains of $195.3 million in total expenditures, $93.8 million in gross product, and 1354 person-years of employment. The analysis was limited by the following: reliance on other studies for methodology and use of a control sample; restriction of cost savings to 2.5 years which required out-of-sample forecasting; conservative assumptions related to the cost of the procedure; exclusion of presenteeism; and no sensitivity analyses performed. This analysis indicates that providing benefits for the LAGB procedure to eligible members of the Texas ERS and their dependents is worthy of support from payer, employer, and societal perspectives.

DSP Implementation of the Retinex Image Enhancement Algorithm

NASA Technical Reports Server (NTRS)

Hines, Glenn; Rahman, Zia-Ur; Jobson, Daniel; Woodell, Glenn

2004-01-01

The Retinex is a general-purpose image enhancement algorithm that is used to produce good visual representations of scenes. It performs a non-linear spatial/spectral transform that synthesizes strong local contrast enhancement and color constancy. A real-time, video frame rate implementation of the Retinex is required to meet the needs of various potential users. Retinex processing contains a relatively large number of complex computations, thus to achieve real-time performance using current technologies requires specialized hardware and software. In this paper we discuss the design and development of a digital signal processor (DSP) implementation of the Retinex. The target processor is a Texas Instruments TMS320C6711 floating point DSP. NTSC video is captured using a dedicated frame-grabber card, Retinex processed, and displayed on a standard monitor. We discuss the optimizations used to achieve real-time performance of the Retinex and also describe our future plans on using alternative architectures.

A survey of the state-of-the-art and focused research in range systems, task 1

NASA Technical Reports Server (NTRS)

Omura, J. K.

1986-01-01

This final report presents the latest research activity in voice compression. We have designed a non-real time simulation system that is implemented around the IBM-PC where the IBM-PC is used as a speech work station for data acquisition and analysis of voice samples. A real-time implementation is also proposed. This real-time Voice Compression Board (VCB) is built around the Texas Instruments TMS-3220. The voice compression algorithm investigated here was described in an earlier report titled, Low Cost Voice Compression for Mobile Digital Radios, by the author. We will assume the reader is familiar with the voice compression algorithm discussed in this report. The VCB compresses speech waveforms at data rates ranging from 4.8 K bps to 16 K bps. This board interfaces to the IBM-PC 8-bit bus, and plugs into a single expansion slot on the mother board.

The scope and direction of health informatics.

PubMed

McGinnis, Patrick J

2002-05-01

Health Informatics (HI) is a dynamic discipline based on the medical sciences, information sciences, and cognitive sciences. Its domain can broadly be defined as medical information management. The purpose of this paper is to provide an overview of this domain, discuss the current "state of the art," and indicate the likely growth areas for health informatics. The sources of information used in this paper are selected publications from the literature of Health Informatics, HI 5300: Introduction to Health Informatics, which is a course from the Department of Health Informatics at the University of Texas Houston Health Sciences Center, and the author's personal experience in practicing telemedicine and implementing an electronic medical record at the NASA-Johnson Space Center. The conclusion is that the direction of Health Informatics is in the direction of data management, transfer, and representation via electronic medical records and the Internet.

The scope and direction of health informatics

NASA Technical Reports Server (NTRS)

McGinnis, Patrick J.

2002-01-01

Health Informatics (HI) is a dynamic discipline based on the medical sciences, information sciences, and cognitive sciences. Its domain can broadly be defined as medical information management. The purpose of this paper is to provide an overview of this domain, discuss the current "state of the art," and indicate the likely growth areas for health informatics. The sources of information used in this paper are selected publications from the literature of Health Informatics, HI 5300: Introduction to Health Informatics, which is a course from the Department of Health Informatics at the University of Texas Houston Health Sciences Center, and the author's personal experience in practicing telemedicine and implementing an electronic medical record at the NASA-Johnson Space Center. The conclusion is that the direction of Health Informatics is in the direction of data management, transfer, and representation via electronic medical records and the Internet.

An algorithm for calculating exam quality as a basis for performance-based allocation of funds at medical schools.

PubMed

Kirschstein, Timo; Wolters, Alexander; Lenz, Jan-Hendrik; Fröhlich, Susanne; Hakenberg, Oliver; Kundt, Günther; Darmüntzel, Martin; Hecker, Michael; Altiner, Attila; Müller-Hilke, Brigitte

2016-01-01

The amendment of the Medical Licensing Act (ÄAppO) in Germany in 2002 led to the introduction of graded assessments in the clinical part of medical studies. This, in turn, lent new weight to the importance of written tests, even though the minimum requirements for exam quality are sometimes difficult to reach. Introducing exam quality as a criterion for the award of performance-based allocation of funds is expected to steer the attention of faculty members towards more quality and perpetuate higher standards. However, at present there is a lack of suitable algorithms for calculating exam quality. In the spring of 2014, the students' dean commissioned the "core group" for curricular improvement at the University Medical Center in Rostock to revise the criteria for the allocation of performance-based funds for teaching. In a first approach, we developed an algorithm that was based on the results of the most common type of exam in medical education, multiple choice tests. It included item difficulty and discrimination, reliability as well as the distribution of grades achieved. This algorithm quantitatively describes exam quality of multiple choice exams. However, it can also be applied to exams involving short assay questions and the OSCE. It thus allows for the quantitation of exam quality in the various subjects and - in analogy to impact factors and third party grants - a ranking among faculty. Our algorithm can be applied to all test formats in which item difficulty, the discriminatory power of the individual items, reliability of the exam and the distribution of grades are measured. Even though the content validity of an exam is not considered here, we believe that our algorithm is suitable as a general basis for performance-based allocation of funds.

ContextD: an algorithm to identify contextual properties of medical terms in a Dutch clinical corpus.

PubMed

Afzal, Zubair; Pons, Ewoud; Kang, Ning; Sturkenboom, Miriam C J M; Schuemie, Martijn J; Kors, Jan A

2014-11-29

In order to extract meaningful information from electronic medical records, such as signs and symptoms, diagnoses, and treatments, it is important to take into account the contextual properties of the identified information: negation, temporality, and experiencer. Most work on automatic identification of these contextual properties has been done on English clinical text. This study presents ContextD, an adaptation of the English ConText algorithm to the Dutch language, and a Dutch clinical corpus. We created a Dutch clinical corpus containing four types of anonymized clinical documents: entries from general practitioners, specialists' letters, radiology reports, and discharge letters. Using a Dutch list of medical terms extracted from the Unified Medical Language System, we identified medical terms in the corpus with exact matching. The identified terms were annotated for negation, temporality, and experiencer properties. To adapt the ConText algorithm, we translated English trigger terms to Dutch and added several general and document specific enhancements, such as negation rules for general practitioners' entries and a regular expression based temporality module. The ContextD algorithm utilized 41 unique triggers to identify the contextual properties in the clinical corpus. For the negation property, the algorithm obtained an F-score from 87% to 93% for the different document types. For the experiencer property, the F-score was 99% to 100%. For the historical and hypothetical values of the temporality property, F-scores ranged from 26% to 54% and from 13% to 44%, respectively. The ContextD showed good performance in identifying negation and experiencer property values across all Dutch clinical document types. Accurate identification of the temporality property proved to be difficult and requires further work. The anonymized and annotated Dutch clinical corpus can serve as a useful resource for further algorithm development.

Water Quality Management Survey Columbus AFB, Mississippi.

DTIC Science & Technology

1984-05-01

Occupational and Environmettal Health Laboratory Aerospace Medical Division (AFSC) Brooks Air Force BaseTexas 78235 -84 07 11 058 NOTICES When Government ...drawings, specifications, or other data are used for any purpose other than a definitely related Government procurement operation, the Goverment thereby...incurs no responsibility nor any obligation whatsoever. The fact that the Government may have formulated, or in any way supplied the said drawings

Mum's the Word: Feds Are Serious About Protecting Patients' Privacy.

PubMed

Conde, Crystal

2010-08-01

The Health Information Technology for Economic and Clinical Health (HITECH) Act significantly changes HIPAA privacy and security policies that affect physicians. Chief among the changes are the new breach notification regulations, developed by the U.S. Department of Health and Human Services Office for Civil Rights. The Texas Medical Association has developed resources to help physicians comply with the new HIPAA regulations.

Students Learn Systems-Based Care and Facilitate System Change as Stakeholders in a Free Clinic Experience

ERIC Educational Resources Information Center

Colbert, Colleen Y.; Ogden, Paul E.; Lowe, Darla; Moffitt, Michael J.

2010-01-01

Systems-based practice (SBP) is rarely taught or evaluated during medical school, yet is one of the required competencies once students enter residency. We believe Texas A&M College of Medicine students learn about systems issues informally, as they care for patients at a free clinic in Temple, TX. The mandatory free clinic rotation is part of…

Perforated Solitary Diverticulitis of the Ascending Colon

DTIC Science & Technology

2005-06-01

postoperative day 6. DISCUSSION Diverticuli of the right colon exist in approximately 1% to 5% of patients with diverticular disease .1-3 They are...ORIGINAL REPORTS Perforated Solitary Diverticulitis of the Ascending Colon CPT David S. Kauvar, MC, USA, MAJ, Jayson Aydelotte, MC, USA, and MAJ...Michael Harnisch, MC, USA Department of Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas KEY WORDS: solitary colon diverticulum

Heart Rate Monitor

NASA Technical Reports Server (NTRS)

1984-01-01

In the mid 70's, NASA saw a need for a long term electrocardiographic electrode suitable for use on astronauts. Heart Rate Inc.'s insulated capacitive electrode is constructed of thin dielectric film applied to stainless steel surface, originally developed under a grant by Texas Technical University. HRI, Inc. was awarded NASA license and continued development of heart rate monitor for use on exercise machines for physical fitness and medical markets.

Enhancement of Radiation Therapy in Prostate Cancer by DNA-PKcs Inhibitor

DTIC Science & Technology

2014-09-01

of DAB2IP in chemo- resistance of prostate cancer cells. Clin Cancer Res 2013;19:4740- 4749. POLYMERIC NANOPARTICLES FOR TARGETED... cancer , NU7441, Targeting John Wiley & Sons, Inc. Journal of Biomedical Materials Research: Part A 1 POLYMERIC NANOPARTICLES FOR TARGETED...The University of Texas Southwestern Medical Center, Dallas, TX, 75390 Running Title: Nanoparticles for radiosensitization of prostate cancer cells

University of Texas Southwestern Medical Center (UTSW): SW04428 is a Novel Topoisomerase 1 Inhibitor | Office of Cancer Genomics

Cancer.gov

This study shows the changes in gene expression in response to SW044248, a compound that displays selective toxicity for some NSCLC cell lines. This data led to the discovery that SW044248 is an inhibitor of topoisomerase 1 (Top1) different from other Top1 inhibitors such as camptothecin1. Read the abstract

Psychological and Organizational Climate: Dimensions and Relationships

DTIC Science & Technology

1977-03-07

SPSYCHOLOGICAL AND ON IZATIONAL CUMATE: DIESINSAND RELATINSI’ K0 A. P. INES L . R. JAMES REPWIINO 77-12 N(AVAL HEALTH RESEARCH CENTER SAN DIEGO...CALIFORNIA 92152 a NAVAL MEDICAL RESEARCH AND DEVELOPMENT COMMAND BhEThESDA1 MARYLAND Psychological and Organizational Climate: Dimensions and...Relationships Allan P. Jones Naval Health Research Center San Diego, California 92152 and Lawrence R. James Institute of Behavioral Research Texas Christian

Job Satisfaction of Dietitians in the Army Medical Specialists Corps

DTIC Science & Technology

1981-01-01

in the clinical branches while only 3.&% were assigned as staff administrative dietitians in the production and service branches. Distribution of the...Leavenworth, Kansas and the U.S. Amy-Baylor University Program in Health Care Administration , Fort Sam Houston, Texas. Test of analysis of variance of mean...Chief, Food Service Division; Chief, Production and Service Branch; Chief, Clinical Dietetic Branch; Staff Administrative Dietitian; Staff Clinical

A Novel Field-Deployable Point-of-Care Diagnostic Test for Cutaneous Leishmaniasis

DTIC Science & Technology

2016-10-01

and should not be construed as an official Department of the Army position, policy or decision unless so designated by other documentation. REPORT...PERFORMING ORGANIZATION REPORT NUMBER Venezuela Av. Block 36 Bellavista, Callao-Peru University of Texas Medical Branch,301 University Blvd, Marvin...practices, decision making, policies (including regulatory policies ), or social actions; or improving social, economic, civic, or environmental

Air toxics and asthma: impacts and end points.

PubMed Central

Eschenbacher, W L; Holian, A; Campion, R J

1995-01-01

The National Urban Air Toxics Research Center (NUATRC) hosted a medical/scientific workshop focused on possible asthma/air toxics relationships, with the results of the NUATRC's first research contract with the University of Cincinnati as the point of discussion. The workshop was held at the Texas Medical Center on 4 February 1994 and featured presentations by distinguished academic, government, and industry scientists. This one-day session explored the impact of various environmental factors, including air toxics, on asthma incidence and exacerbation; an emphasis was placed on future research directions to be pursued in the asthma/air toxics area. A key research presentation on the association of air toxics and asthma, based on the study sponsored by NUATRC, was given by Dr. George Leikauf of the University of Cincinnati Medical Center. Additional presentations were made by H. A. Boushey, Jr., Cardiovascular Research Institute/University of California at San Francisco, who spoke on of the Basic Mechanisms of Asthma; K. Sexton, U.S. Environmental Protection Agency, who spoke on hazardous air pollutants: science/policy interface; and D. V. Bates, Department of Health Care and Epidemiology at the University of British Columbia, who spoke on asthma epidemiology. H. Koren, U.S. Environmental Protection Agency, and M. Yeung, of the Respiratory Division/University of British Columbia, Vancouver General Hospital, discussed occupational health impacts on asthma. Doyle Pendleton, Texas Natural Resource Conservation Commission, reviewed air quality measurements in Texas. The information presented at the workshop suggested a possible association of asthma exacerbations with ozone and particulate matter (PM10); however, direct relationships between worsening asthma and air toxic ambient levels were not established. Possible respiratory health effects associated with air toxics will require considerably more investigation, especially in the area of human exposure assessment. Two major recommendations for future research resulted from this workshop and an accompanying NUATRC Scientific Advisory Panel meeting: a need for more complete individual personal exposure assessments so that accurate determinations of actual personal exposures to various pollutants can be made; and a need for field experiments utilizing biomarkers of exposure and effect to more accurately assess the extent and variability of the biological effects, if any, of individual air toxics. PMID:8549475

Automatable algorithms to identify nonmedical opioid use using electronic data: a systematic review.

PubMed

Canan, Chelsea; Polinski, Jennifer M; Alexander, G Caleb; Kowal, Mary K; Brennan, Troyen A; Shrank, William H

2017-11-01

Improved methods to identify nonmedical opioid use can help direct health care resources to individuals who need them. Automated algorithms that use large databases of electronic health care claims or records for surveillance are a potential means to achieve this goal. In this systematic review, we reviewed the utility, attempts at validation, and application of such algorithms to detect nonmedical opioid use. We searched PubMed and Embase for articles describing automatable algorithms that used electronic health care claims or records to identify patients or prescribers with likely nonmedical opioid use. We assessed algorithm development, validation, and performance characteristics and the settings where they were applied. Study variability precluded a meta-analysis. Of 15 included algorithms, 10 targeted patients, 2 targeted providers, 2 targeted both, and 1 identified medications with high abuse potential. Most patient-focused algorithms (67%) used prescription drug claims and/or medical claims, with diagnosis codes of substance abuse and/or dependence as the reference standard. Eleven algorithms were developed via regression modeling. Four used natural language processing, data mining, audit analysis, or factor analysis. Automated algorithms can facilitate population-level surveillance. However, there is no true gold standard for determining nonmedical opioid use. Users must recognize the implications of identifying false positives and, conversely, false negatives. Few algorithms have been applied in real-world settings. Automated algorithms may facilitate identification of patients and/or providers most likely to need more intensive screening and/or intervention for nonmedical opioid use. Additional implementation research in real-world settings would clarify their utility. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Incorporating resident research into the dermatology residency program.

PubMed

Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C

2013-01-01

Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education.

Dose versus diagnosis: iatrogenic radiation exposure by multidetector computerised tomography in an academic emergency department with measurement of clinically actionable results and emergently treatable findings.

PubMed

Baskerville, J R; Chang, J H; Viator, M; Rutledge, W; Miryala, R; Duval, K E; Nishino, T K

2009-01-01

To determine the iatrogenic absorbed dosage of radiation of the patient in milligray (mGy) computerised tomography dose index volume (CTDIvol) when tested with multidetector computerised tomography (MDCT) in the emergency department (ED) setting and calculate the absorbed dosage of radiation per clinically actionable result and emergently treatable finding (ETF). The University of Texas Medical Branch (UTMB) ED located in Galveston, Texas, USA, is a level 1 trauma and tertiary referral centre treating 70,000 patients per annum. A retrospective cross-sectional data analysis of 770 emergency patients investigated by MDCT in July 2007. The presence of actionable results and ETF were determined by chart review. A total of 5320 emergency patients was treated in the UTMB ED in July 2007. This included 4508 medical and 812 trauma patients. A total of 1094 MDCT studies was performed, of which complete data were available on 1046. A total of 770 patients was investigated by MDCT, representing 14.47% of all emergency patients. This included 33.99% of trauma patients and 10.96% of medical patients. Actionable results were found in 341 studies and ETF in 105 studies. The mean radiation was 163.27 and 530.23 mGy CTDIvol for actionable results and ETF, respectively, for all studies. The mean radiation was 53.27 and 106.36 mGy CTDIvol for medical and trauma patients, respectively. The absorbed dosage of radiation of patients investigated by MDCT is clinically significant. The actionable results and ETF in our study demonstrate considerable opportunity for improvement in the utilisation of this technology by physicians.

Incorporating resident research into the dermatology residency program

PubMed Central

Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C

2013-01-01

Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education. PMID:23901305

Medical image processing on the GPU - past, present and future.

PubMed

Eklund, Anders; Dufort, Paul; Forsberg, Daniel; LaConte, Stephen M

2013-12-01

Graphics processing units (GPUs) are used today in a wide range of applications, mainly because they can dramatically accelerate parallel computing, are affordable and energy efficient. In the field of medical imaging, GPUs are in some cases crucial for enabling practical use of computationally demanding algorithms. This review presents the past and present work on GPU accelerated medical image processing, and is meant to serve as an overview and introduction to existing GPU implementations. The review covers GPU acceleration of basic image processing operations (filtering, interpolation, histogram estimation and distance transforms), the most commonly used algorithms in medical imaging (image registration, image segmentation and image denoising) and algorithms that are specific to individual modalities (CT, PET, SPECT, MRI, fMRI, DTI, ultrasound, optical imaging and microscopy). The review ends by highlighting some future possibilities and challenges. Copyright © 2013 Elsevier B.V. All rights reserved.

Novel Near-Lossless Compression Algorithm for Medical Sequence Images with Adaptive Block-Based Spatial Prediction.

PubMed

Song, Xiaoying; Huang, Qijun; Chang, Sheng; He, Jin; Wang, Hao

2016-12-01

To address the low compression efficiency of lossless compression and the low image quality of general near-lossless compression, a novel near-lossless compression algorithm based on adaptive spatial prediction is proposed for medical sequence images for possible diagnostic use in this paper. The proposed method employs adaptive block size-based spatial prediction to predict blocks directly in the spatial domain and Lossless Hadamard Transform before quantization to improve the quality of reconstructed images. The block-based prediction breaks the pixel neighborhood constraint and takes full advantage of the local spatial correlations found in medical images. The adaptive block size guarantees a more rational division of images and the improved use of the local structure. The results indicate that the proposed algorithm can efficiently compress medical images and produces a better peak signal-to-noise ratio (PSNR) under the same pre-defined distortion than other near-lossless methods.

Knowledge requirements for automated inference of medical textbook markup.

PubMed Central

Berrios, D. C.; Kehler, A.; Fagan, L. M.

1999-01-01

Indexing medical text in journals or textbooks requires a tremendous amount of resources. We tested two algorithms for automatically indexing nouns, noun-modifiers, and noun phrases, and inferring selected binary relations between UMLS concepts in a textbook of infectious disease. Sixty-six percent of nouns and noun-modifiers and 81% of noun phrases were correctly matched to UMLS concepts. Semantic relations were identified with 100% specificity and 94% sensitivity. For some medical sub-domains, these algorithms could permit expeditious generation of more complex indexing. PMID:10566445

An Efficient Optimization Method for Solving Unsupervised Data Classification Problems.

PubMed

Shabanzadeh, Parvaneh; Yusof, Rubiyah

2015-01-01

Unsupervised data classification (or clustering) analysis is one of the most useful tools and a descriptive task in data mining that seeks to classify homogeneous groups of objects based on similarity and is used in many medical disciplines and various applications. In general, there is no single algorithm that is suitable for all types of data, conditions, and applications. Each algorithm has its own advantages, limitations, and deficiencies. Hence, research for novel and effective approaches for unsupervised data classification is still active. In this paper a heuristic algorithm, Biogeography-Based Optimization (BBO) algorithm, was adapted for data clustering problems by modifying the main operators of BBO algorithm, which is inspired from the natural biogeography distribution of different species. Similar to other population-based algorithms, BBO algorithm starts with an initial population of candidate solutions to an optimization problem and an objective function that is calculated for them. To evaluate the performance of the proposed algorithm assessment was carried on six medical and real life datasets and was compared with eight well known and recent unsupervised data classification algorithms. Numerical results demonstrate that the proposed evolutionary optimization algorithm is efficient for unsupervised data classification.

Classification of Medical Datasets Using SVMs with Hybrid Evolutionary Algorithms Based on Endocrine-Based Particle Swarm Optimization and Artificial Bee Colony Algorithms.

PubMed

Lin, Kuan-Cheng; Hsieh, Yi-Hsiu

2015-10-01

The classification and analysis of data is an important issue in today's research. Selecting a suitable set of features makes it possible to classify an enormous quantity of data quickly and efficiently. Feature selection is generally viewed as a problem of feature subset selection, such as combination optimization problems. Evolutionary algorithms using random search methods have proven highly effective in obtaining solutions to problems of optimization in a diversity of applications. In this study, we developed a hybrid evolutionary algorithm based on endocrine-based particle swarm optimization (EPSO) and artificial bee colony (ABC) algorithms in conjunction with a support vector machine (SVM) for the selection of optimal feature subsets for the classification of datasets. The results of experiments using specific UCI medical datasets demonstrate that the accuracy of the proposed hybrid evolutionary algorithm is superior to that of basic PSO, EPSO and ABC algorithms, with regard to classification accuracy using subsets with a reduced number of features.

Validation of an automated electronic algorithm and "dashboard" to identify and characterize decompensated heart failure admissions across a medical center.

PubMed

Cox, Zachary L; Lewis, Connie M; Lai, Pikki; Lenihan, Daniel J

2017-01-01

We aim to validate the diagnostic performance of the first fully automatic, electronic heart failure (HF) identification algorithm and evaluate the implementation of an HF Dashboard system with 2 components: real-time identification of decompensated HF admissions and accurate characterization of disease characteristics and medical therapy. We constructed an HF identification algorithm requiring 3 of 4 identifiers: B-type natriuretic peptide >400 pg/mL; admitting HF diagnosis; history of HF International Classification of Disease, Ninth Revision, diagnosis codes; and intravenous diuretic administration. We validated the diagnostic accuracy of the components individually (n = 366) and combined in the HF algorithm (n = 150) compared with a blinded provider panel in 2 separate cohorts. We built an HF Dashboard within the electronic medical record characterizing the disease and medical therapies of HF admissions identified by the HF algorithm. We evaluated the HF Dashboard's performance over 26 months of clinical use. Individually, the algorithm components displayed variable sensitivity and specificity, respectively: B-type natriuretic peptide >400 pg/mL (89% and 87%); diuretic (80% and 92%); and International Classification of Disease, Ninth Revision, code (56% and 95%). The HF algorithm achieved a high specificity (95%), positive predictive value (82%), and negative predictive value (85%) but achieved limited sensitivity (56%) secondary to missing provider-generated identification data. The HF Dashboard identified and characterized 3147 HF admissions over 26 months. Automated identification and characterization systems can be developed and used with a substantial degree of specificity for the diagnosis of decompensated HF, although sensitivity is limited by clinical data input. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessing bioterrorism preparedness and response of rural veterinarians: experiences and training needs.

PubMed

Hsu, Chiehwen Ed; Jacobson, Holly; Feldman, Katherine; Miller, Jerry A; Rodriguez, Lori; Soto Mas, Francisco

2008-01-01

Veterinarians play a unique role in emergency preparedness and response, and federal agencies and academic institutions therefore allocate considerable resources to provide training to enhance their readiness. However, the level of preparedness of veterinarians in many rural regions is yet to be improved. This article reports an assessment of the bioterrorism preparedness, specifically the experience and training needs, of rural veterinarians in North Texas. The study employed a cross-sectional design with a study population that included all veterinarians (N = 352) in the 37 counties within Texas Department of State Health Services Regions 2 and 3. Data on veterinarians practicing or residing in the target region were obtained from the Texas State Board of Veterinary Medical Examiners. The response rate was 35% (n = 121). Results indicate that chemical exposure was the condition most frequently seen and treated, followed by botulism and anthrax. The majority (80%) of respondents indicated that they had not previously participated in training related to bioterrorism preparedness, and many (41%) also indicated a willingness to participate in a state health department-initiated bioterrorism response plan. However, only 18% were confident in their ability to diagnose and treat bioterrorism cases. These results suggest that many North Texas veterinarians practicing in rural regions could benefit from additional training in bioterrorism preparedness and response. An area in particular need of further training is the diagnosis and treatment of Category A agents. Federal, state, and local health agencies are urged to increase training opportunities and to make additional efforts to involve veterinarians in bioterrorism preparedness and response.

Proceedings of the Third International Workshop on Neural Networks and Fuzzy Logic, volume 2

NASA Technical Reports Server (NTRS)

Culbert, Christopher J. (Editor)

1993-01-01

Papers presented at the Neural Networks and Fuzzy Logic Workshop sponsored by the National Aeronautics and Space Administration and cosponsored by the University of Houston, Clear Lake, held 1-3 Jun. 1992 at the Lyndon B. Johnson Space Center in Houston, Texas are included. During the three days approximately 50 papers were presented. Technical topics addressed included adaptive systems; learning algorithms; network architectures; vision; robotics; neurobiological connections; speech recognition and synthesis; fuzzy set theory and application, control and dynamics processing; space applications; fuzzy logic and neural network computers; approximate reasoning; and multiobject decision making.

Climate Modeling with a Million CPUs

NASA Astrophysics Data System (ADS)

Tobis, M.; Jackson, C. S.

2010-12-01

Michael Tobis, Ph.D. Research Scientist Associate University of Texas Institute for Geophysics Charles S. Jackson Research Scientist University of Texas Institute for Geophysics Meteorological, oceanographic, and climatological applications have been at the forefront of scientific computing since its inception. The trend toward ever larger and more capable computing installations is unabated. However, much of the increase in capacity is accompanied by an increase in parallelism and a concomitant increase in complexity. An increase of at least four additional orders of magnitude in the computational power of scientific platforms is anticipated. It is unclear how individual climate simulations can continue to make effective use of the largest platforms. Conversion of existing community codes to higher resolution, or to more complex phenomenology, or both, presents daunting design and validation challenges. Our alternative approach is to use the expected resources to run very large ensembles of simulations of modest size, rather than to await the emergence of very large simulations. We are already doing this in exploring the parameter space of existing models using the Multiple Very Fast Simulated Annealing algorithm, which was developed for seismic imaging. Our experiments have the dual intentions of tuning the model and identifying ranges of parameter uncertainty. Our approach is less strongly constrained by the dimensionality of the parameter space than are competing methods. Nevertheless, scaling up remains costly. Much could be achieved by increasing the dimensionality of the search and adding complexity to the search algorithms. Such ensemble approaches scale naturally to very large platforms. Extensions of the approach are anticipated. For example, structurally different models can be tuned to comparable effectiveness. This can provide an objective test for which there is no realistic precedent with smaller computations. We find ourselves inventing new code to manage our ensembles. Component computations involve tens to hundreds of CPUs and tens to hundreds of hours. The results of these moderately large parallel jobs influence the scheduling of subsequent jobs, and complex algorithms may be easily contemplated for this. The operating system concept of a "thread" re-emerges at a very coarse level, where each thread manages atomic computations of thousands of CPU-hours. That is, rather than multiple threads operating on a processor, at this level, multiple processors operate within a single thread. In collaboration with the Texas Advanced Computing Center, we are developing a software library at the system level, which should facilitate the development of computations involving complex strategies which invoke large numbers of moderately large multi-processor jobs. While this may have applications in other sciences, our key intent is to better characterize the coupled behavior of a very large set of climate model configurations.

Correlation Between Interphase Chromatin Structure and - and High-Let Radiation-Induced - and Intra-Chromosome Exchange Hotspots

NASA Astrophysics Data System (ADS)

Zhang, Ye; Wu, Honglu; Mangala, Lingegowda; Asaithamby, Aroumougame; Chen, David

2012-07-01

CORRELATION BETWEEN INTERPHASE CHROMATIN STRUCTURE AND LOW- AND HIGH-LET RADIATION-INDUCED INTER- AND INTRA-CHROMOSOME EXCHANGE HOTSPOTS Ye Zhang1,2, Lingegowda S. Mangala1,3, Aroumougame Asaithamby4, David J. Chen4, and Honglu Wu1 1 NASA Johnson Space Center, Houston, Texas, USA 2 Wyle Integrated Science and Engineering Group, Houston, Texas, USA 3 University of Houston Clear Lake, Houston, Texas, USA 4 University of Texas, Southwestern Medical Center, Dallas, Texas, USA To investigate the relationship between chromosome aberrations induced by low- and high-LET radiation and chromatin folding, we reconstructed the three dimensional structure of chromosome 3 and measured the physical distances between different regions of this chromosome. Previously, we investigated the location of breaks involved in inter- and intrachromosomal type exchange events in chromosome 3 of human epithelial cells, using the multicolor banding in situ hybridization (mBAND) technique. After exposure to both low- and high-LET radiations in vitro, intra-chromosome exchanges occurred preferentially between a break in the 3p21 and one in the 3q11 regions, and the breaks involved in inter-chromosome exchanges occurred in two regions near the telomeres of the chromosome. In this study, human epithelial cells were fixed in G1 phase and interphase chromosomes hybridized with an mBAND probe for chromosome 3 were captured with a laser scanning confocal microscope. The 3-dimensional structure of interphase chromosome 3 with different colored regions was reconstructed, and the distance between different regions was measured. We show that, in most of the G1 cells, the regions containing 3p21 and 3q11 are colocalized in the center of the chromosome domain, whereas, the regions towards the telomeres of the chromosome are located in the peripherals of the chromosome domain. Our results demonstrate that the distribution of breaks involved in radiation-induced inter and intra-chromosome aberrations depends upon both the location of fragile sites and the folding of chromatins.

Development of a new metal artifact reduction algorithm by using an edge preserving method for CBCT imaging

NASA Astrophysics Data System (ADS)

Kim, Juhye; Nam, Haewon; Lee, Rena

2015-07-01

CT (computed tomography) images, metal materials such as tooth supplements or surgical clips can cause metal artifact and degrade image quality. In severe cases, this may lead to misdiagnosis. In this research, we developed a new MAR (metal artifact reduction) algorithm by using an edge preserving filter and the MATLAB program (Mathworks, version R2012a). The proposed algorithm consists of 6 steps: image reconstruction from projection data, metal segmentation, forward projection, interpolation, applied edge preserving smoothing filter, and new image reconstruction. For an evaluation of the proposed algorithm, we obtained both numerical simulation data and data for a Rando phantom. In the numerical simulation data, four metal regions were added into the Shepp Logan phantom for metal artifacts. The projection data of the metal-inserted Rando phantom were obtained by using a prototype CBCT scanner manufactured by medical engineering and medical physics (MEMP) laboratory research group in medical science at Ewha Womans University. After these had been adopted the proposed algorithm was performed, and the result were compared with the original image (with metal artifact without correction) and with a corrected image based on linear interpolation. Both visual and quantitative evaluations were done. Compared with the original image with metal artifacts and with the image corrected by using linear interpolation, both the numerical and the experimental phantom data demonstrated that the proposed algorithm reduced the metal artifact. In conclusion, the evaluation in this research showed that the proposed algorithm outperformed the interpolation based MAR algorithm. If an optimization and a stability evaluation of the proposed algorithm can be performed, the developed algorithm is expected to be an effective tool for eliminating metal artifacts even in commercial CT systems.

Designing an algorithm to preserve privacy for medical record linkage with error-prone data.

PubMed

Pal, Doyel; Chen, Tingting; Zhong, Sheng; Khethavath, Praveen

2014-01-20

Linking medical records across different medical service providers is important to the enhancement of health care quality and public health surveillance. In records linkage, protecting the patients' privacy is a primary requirement. In real-world health care databases, records may well contain errors due to various reasons such as typos. Linking the error-prone data and preserving data privacy at the same time are very difficult. Existing privacy preserving solutions for this problem are only restricted to textual data. To enable different medical service providers to link their error-prone data in a private way, our aim was to provide a holistic solution by designing and developing a medical record linkage system for medical service providers. To initiate a record linkage, one provider selects one of its collaborators in the Connection Management Module, chooses some attributes of the database to be matched, and establishes the connection with the collaborator after the negotiation. In the Data Matching Module, for error-free data, our solution offered two different choices for cryptographic schemes. For error-prone numerical data, we proposed a newly designed privacy preserving linking algorithm named the Error-Tolerant Linking Algorithm, that allows the error-prone data to be correctly matched if the distance between the two records is below a threshold. We designed and developed a comprehensive and user-friendly software system that provides privacy preserving record linkage functions for medical service providers, which meets the regulation of Health Insurance Portability and Accountability Act. It does not require a third party and it is secure in that neither entity can learn the records in the other's database. Moreover, our novel Error-Tolerant Linking Algorithm implemented in this software can work well with error-prone numerical data. We theoretically proved the correctness and security of our Error-Tolerant Linking Algorithm. We have also fully implemented the software. The experimental results showed that it is reliable and efficient. The design of our software is open so that the existing textual matching methods can be easily integrated into the system. Designing algorithms to enable medical records linkage for error-prone numerical data and protect data privacy at the same time is difficult. Our proposed solution does not need a trusted third party and is secure in that in the linking process, neither entity can learn the records in the other's database.

Achieving Internet-based efficiencies in a rural IDS: a case study.

PubMed

Bacus, R; Zunke, R

2001-09-01

After suffering payment cuts resulting from the Balanced Budget Act of 1997, Colorado-Fayette Medical Center (CFMC), a not-for-profit, rural integrated delivery system in Texas, wanted to reduce costs by gaining systemwide Internet access for its internal information system at a reasonable price. An application service provider affiliated with the Texas Hospital Association, helped CFMC achieve its goals for the project by performing a needs assessment, installing a wide-area network (WAN) with Internet access, and training staff. The new WAN enabled CFMC to improve its Web presence, allow radiologic image viewing at all sites, negotiate more favorable prices from vendors, implement electronic communication for staff members, and take advantage of on-line education opportunities. CFMC has found that the monthly fee paid to THN is offset by savings on long-distance calls, Internet service provider fees, and marketing and advertising costs.

Medical Response, Search and Recovery during the Space Shuttle Columbia Accident Investigation

NASA Technical Reports Server (NTRS)

Stepaniak, Philip C.

2010-01-01

On February 1, 2003, the Space Shuttle Columbia broke apart during atmospheric re-entry on mission STS-107. After an event such as this, with high visibility and international interest, the operational challenge of recovering the crewmembers could not be underestimated. The Space Shuttle Program is organized to respond to a vehicle mishap using the resources of the Mishap Investigation Team (MIT). On the afternoon of Feb. 1, 2003, the MIT deployed to Barksdale Air Force Base (AFB), Louisiana. This location became the investigative center and interim storage location for crewmembers received from the Lufkin, Texas Disaster Field Office (DFO). The Lufkin DFO served as the primary area for all operations, including staging assets and deploying field teams for search, recovery and security of crewmember remains. More than 2,000 people from numerous organizations were involved with the recovery of the crew. All seven crewmembers of STS-107 were recovered and ceremonial last rights were administered. Astronaut and military personnel escorted the crew with honor to the MIT at Barksdale AFB, Louisiana. At Barksdale AFB a temporary morgue was established in an aircraft hangar and operated for approximately two weeks during which time coordination with the DFO field recovery teams, Armed Forces Institute of Pathology (AFIP) medical personnel, and the crew surgeons was on going. Families of crewmembers and NASA management were notified daily of the current findings. Working under the leadership of the MIT Lead, the medical team developed and executed a short-term plan to identify and relocate the crew with a military honor guard and protocol to the medical examiner at the Armed Forces Port Mortuary, Dover AFB, Delaware. After operations at Barksdale AFB were concluded the medical team transitioned back to Houston and a long-term plan was developed and implemented which involved the Air Force Mortuary Affairs at Randolph AFB, Texas. This plan was coordinated with search teams in the field, Barksdale AFB Mortuary Affairs, KSC security, AFIP, and the crew surgeons at JSC.

Campaign supports new name for TX hospital. Effort expands children's hospital's image and increases awareness.

PubMed

2007-01-01

For years, the North Texas Hospital for Children at Medical City in Dallas struggled with its brand awareness. It's long-winded name was largely unknown among the city's 1.2 million residents. The hospital needed a new name and it needed one fast. The year 2005 proved to be both a burden and an opportunity for the 311-bed pediatric hospital. It survived a legal battle with a local competitor for the right to use the word "children's" in its name, created a new identity, and launched a three-year branding initiative to introduce its new name: Medical City Children's Hospital.

A joint FED watermarking system using spatial fusion for verifying the security issues of teleradiology.

PubMed

Viswanathan, P; Krishna, P Venkata

2014-05-01

Teleradiology allows transmission of medical images for clinical data interpretation to provide improved e-health care access, delivery, and standards. The remote transmission raises various ethical and legal issues like image retention, fraud, privacy, malpractice liability, etc. A joint FED watermarking system means a joint fingerprint/encryption/dual watermarking system is proposed for addressing these issues. The system combines a region based substitution dual watermarking algorithm using spatial fusion, stream cipher algorithm using symmetric key, and fingerprint verification algorithm using invariants. This paper aims to give access to the outcomes of medical images with confidentiality, availability, integrity, and its origin. The watermarking, encryption, and fingerprint enrollment are conducted jointly in protection stage such that the extraction, decryption, and verification can be applied independently. The dual watermarking system, introducing two different embedding schemes, one used for patient data and other for fingerprint features, reduces the difficulty in maintenance of multiple documents like authentication data, personnel and diagnosis data, and medical images. The spatial fusion algorithm, which determines the region of embedding using threshold from the image to embed the encrypted patient data, follows the exact rules of fusion resulting in better quality than other fusion techniques. The four step stream cipher algorithm using symmetric key for encrypting the patient data with fingerprint verification system using algebraic invariants improves the robustness of the medical information. The experiment result of proposed scheme is evaluated for security and quality analysis in DICOM medical images resulted well in terms of attacks, quality index, and imperceptibility.

Function of Brg1 Chromatin Remodeling Factor in Sonic Hedgehog-Dependent Medulloblastoma Initiation and Maintenance

DTIC Science & Technology

2015-12-01

tumor suppressors and REST-targeted neuronal genes. Brg1 deletion led to the inhibition of Shh-type medulloblastoma growth by deregulation of the...China University of Rostock & Research Institute for the Biology of Farm Animals, Germany University of Texas Southwestern Medical Center at...of Rostock & Research Institute for the Biology of Farm Animals, Germany . Mentor: Prof. Dr. Hans-Martin Seyfert 2010- 2014 Postdoctoral

Navy and Marine Corps Medical News. January 22, 2010

DTIC Science & Technology

2010-01-22

Naval Postgraduate Dental School Orofacial Pain Center Has Unique DOD Mission 6 6 Navy Barracks in Texas to Open as Early as February 7 A Sailor...conditions, such as post-traumatic stress disorders, traumatic brain injuries or fibromyalgia that can contribute to their orofacial pain ...present in orofacial pain patients. A key research interest of the OPC is the role of stress in chronic pain . “We

U.S. Army Public Health Command (Provisional ) - Organization Overview and Environmental Health Engineering Services

DTIC Science & Technology

2010-06-15

Veterinary Medical care for Government-Owned Animals Zoonotic disease surveillance and control Food safety and food defense quality assurance...surveillance and epidemiology • Laboratory services • Health risk assessment • Zoonotic disease surveillance and control • Food safety and food...Command vs Technical – Lack of flexibility in resource cross leveling • 1994: VETCOM activated with HQ at Ft. Sam Houston Texas VETCOM Mission Food

Molecular innovations towards theranostics of aggressive prostate cancer

DTIC Science & Technology

2016-09-01

Xiankai Sun, PhD CONTRACTING ORGANIZATION: University of Texas Southwestern Medical Center Dallas, TX 75390-8542 REPORT DATE : September 2016 TYPE OF...number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) September 2016 2. REPORT TYPE Annual 3. DATES COVERED (From...Partner PI’s lab for the treatment of aggressive prostate cancer. To date , we have designed and synthesized the proposed bifunctional chelator

Doctor 911.

PubMed

Conde, Crystal

2011-05-01

The Texas Medical Association has helped many physicians realize a happy ending to their legal nightmares. When the association believes a physician member has been unfairly scrutinized or mistreated by public and private organizations, it can devote resources, assistance, and expertise to advocate on the physician's behalf. TMA also has resources available to physicians who suspect their billing and coding practices may need some revision or who simply want to make sure they're on track.

Ebola virus disease cluster in the United States--Dallas County, Texas, 2014.

PubMed

Chevalier, Michelle S; Chung, Wendy; Smith, Jessica; Weil, Lauren M; Hughes, Sonya M; Joyner, Sibeso N; Hall, Emily; Srinath, Divya; Ritch, Julia; Thathiah, Prea; Threadgill, Heidi; Cervantes, Diana; Lakey, David L

2014-11-21

Since March 10, 2014, Guinea, Liberia, and Sierra Leone have experienced the largest known Ebola virus disease (Ebola) epidemic with approximately 13,000 persons infected as of October 28, 2014. Before September 25, 2014, only four patients with Ebola had been treated in the United States; all of these patients had been diagnosed in West Africa and medically evacuated to the United States for care.

The utility of rural and underserved designations in geospatial assessments of distance traveled to healthcare services: implications for public health research and practice.

PubMed

Smith, Matthew Lee; Dickerson, Justin B; Wendel, Monica L; Ahn, Sangnam; Pulczinski, Jairus C; Drake, Kelly N; Ory, Marcia G

2013-01-01

Health disparities research in rural populations is based on several common taxonomies identified by geography and population density. However, little is known about the implications of different rurality definitions on public health outcomes. To help illuminate the meaning of different rural designations often used in research, service delivery, or policy reports, this study will (1) review the different definitions of rurality and their purposes; (2) identify the overlap of various rural designations in an eight-county Brazos Valley region in Central Texas; (3) describe participant characteristic profiles based on distances traveled to obtain healthcare services; and (4) examine common profile characteristics associated with each designation. Data were analyzed from a random sample from 1,958 Texas adults participating in a community assessment. K-means cluster analysis was used to identify natural groupings of individuals based on distance traveled to obtain three healthcare services: medical care, dental care, and prescription medication pick-up. Significant variation in cluster representation and resident characteristics was observed by rural designation. Given widely used taxonomies for designating areas as rural (or provider shortage) in health-related research, this study highlights differences that could influence research results and subsequent program and policy development based on rural designation.

Style-independent document labeling: design and performance evaluation

NASA Astrophysics Data System (ADS)

Mao, Song; Kim, Jong Woo; Thoma, George R.

2003-12-01

The Medical Article Records System or MARS has been developed at the U.S. National Library of Medicine (NLM) for automated data entry of bibliographical information from medical journals into MEDLINE, the premier bibliographic citation database at NLM. Currently, a rule-based algorithm (called ZoneCzar) is used for labeling important bibliographical fields (title, author, affiliation, and abstract) on medical journal article page images. While rules have been created for medical journals with regular layout types, new rules have to be manually created for any input journals with arbitrary or new layout types. Therefore, it is of interest to label any journal articles independent of their layout styles. In this paper, we first describe a system (called ZoneMatch) for automated generation of crucial geometric and non-geometric features of important bibliographical fields based on string-matching and clustering techniques. The rule based algorithm is then modified to use these features to perform style-independent labeling. We then describe a performance evaluation method for quantitatively evaluating our algorithm and characterizing its error distributions. Experimental results show that the labeling performance of the rule-based algorithm is significantly improved when the generated features are used.

A new kernel-based fuzzy level set method for automated segmentation of medical images in the presence of intensity inhomogeneity.

PubMed

Rastgarpour, Maryam; Shanbehzadeh, Jamshid

2014-01-01

Researchers recently apply an integrative approach to automate medical image segmentation for benefiting available methods and eliminating their disadvantages. Intensity inhomogeneity is a challenging and open problem in this area, which has received less attention by this approach. It has considerable effects on segmentation accuracy. This paper proposes a new kernel-based fuzzy level set algorithm by an integrative approach to deal with this problem. It can directly evolve from the initial level set obtained by Gaussian Kernel-Based Fuzzy C-Means (GKFCM). The controlling parameters of level set evolution are also estimated from the results of GKFCM. Moreover the proposed algorithm is enhanced with locally regularized evolution based on an image model that describes the composition of real-world images, in which intensity inhomogeneity is assumed as a component of an image. Such improvements make level set manipulation easier and lead to more robust segmentation in intensity inhomogeneity. The proposed algorithm has valuable benefits including automation, invariant of intensity inhomogeneity, and high accuracy. Performance evaluation of the proposed algorithm was carried on medical images from different modalities. The results confirm its effectiveness for medical image segmentation.

The Scope and Direction of Health Informatics

NASA Technical Reports Server (NTRS)

McGinnis, Patrick J.

2001-01-01

Health Informatics (HI) is a dynamic discipline based upon the medical sciences, information sciences, and cognitive sciences. Its domain is can broadly be defined as medical information management. The purpose of this paper is to provide an overview of this domain, discuss the current "state of the art" , and indicate the likely growth areas for health informatics. The sources of information utilized in this paper are selected publications from the literature of Health Informatics, HI 5300: Introduction to Health Informatics, which is a course from the Department of Health Informatics at the University of Texas Houston Health Sciences Center, and the author's personal experience in practicing telemedicine and implementing an electronic medical record at the NASA Johnson Space Center. The conclusion is that the direction of Health Informatics is in the direction of data management, transfer, and representation via electronic medical records and the Internet.

Proceedings of the Space Station Freedom Clinical Experts Seminar

NASA Technical Reports Server (NTRS)

Billica, Roger P. (Editor); Lloyd, Charles W. (Editor); Doarn, Charles R. (Editor)

1991-01-01

These are the proceedings of the Space Station Freedom Health Maintenance Facility 1990 Clinical Experts Seminar held August 27-29, 1990, at the Nassau Bay Hilton, Houston, Texas. Contained within are the agenda, list of medical consultants, executive summary, individual presentations, and the comments generated from the working groups. Issues include the adequacy of current Health Maintenance Facility for Space Station Freedom; impact of having, or not having, an ACRV or physician on board Space Station Freedom; new and developing technologies, techniques, and medications and their impact on the evolving Space Station Freedom, considerations surrounding x-ray, ultrasound, lab, decontamination, blood transfusion, nutrition, safe-haven, computer/telemedicine; suggestions as to how to train the Crew Medical Officer; and, how the consultant network will interface over the next several years.

Commentary: Binding Early Offers versus Caps for Medical Malpractice Claims?

PubMed Central

O'Connell, Jeffrey

2007-01-01

Like damages caps, early offer reform promises reduction in the costs of medical liability cases. In contrast to damages caps, early offer reform offers advantages to both claimant and defendant. Under early offer, the defendant would have the option to offer an injured patient periodic payments for the patient's net economic losses as they accrue, but not payments for noneconomic losses (pain and suffering). If an early offer were made and accepted, that would settle the claim. This commentary1 explains how an early offer reform might work and summarizes data from a recent closed claim study of medical malpractice cases in Texas and Florida. The data show widespread opportunities for successful early offers and provide evidence that substantial per case savings would result. PMID:17517116

Camp for all connection: a community health information outreach project.

PubMed

Huber, Jeffrey T; Walsh, Teresa J; Varman, Beatriz

2005-07-01

The purpose of the Camp For All Connection project is to facilitate access to electronic health information resources at the Camp For All facility. Camp For All is a barrier-free camp working in partnership with organizations to enrich the lives of children and adults with chronic illnesses and disabilities and their families by providing camping and retreat experiences. The camp facility is located on 206 acres in Burton, Texas. The project partners are Texas Woman's University, Houston Academy of Medicine-Texas Medical Center Library, and Camp For All. The Camp For All Connection project placed Internet-connected workstations at the camp's health center in the main lodge and provided training in the use of electronic health information resources. A train-the-trainer approach was used to provide training to Camp For All staff. Project workstations are being used by health care providers and camp staff for communication purposes and to make better informed health care decisions for Camp For All campers. A post-training evaluation was administered at the end of the train-the-trainer session. In addition, a series of site visits and interviews was conducted with camp staff members involved in the project. The site visits and interviews allowed for ongoing dialog between project staff and project participants.

Community Perceptions of Biobanking Participation: A Qualitative Study among Mexican-Americans in Three Texas Cities.

PubMed

Heredia, Natalia I; Krasny, Sarah; Strong, Larkin L; Von Hatten, Laura; Nguyen, Lynne; Reininger, Belinda M; McNeill, Lorna H; Fernández, María E

2017-01-01

Most biospecimens in the US are collected from non-Hispanic Whites, limiting the generalizability of findings. There is a need to increase participation in biobanking among ethnic and racial minorities. The purpose of this study was to use qualitative methods to identify factors that may influence Mexican-American individuals' willingness to participate in biobanking. We conducted 15 focus groups in three Texas cities with Mexican-American individuals, in both Spanish and English. Lack of knowledge about medical research and biobanks, lack of information about the specifics of biobanking participation, lack of communication of the results, fear of pain or harm, and distrust of the healthcare system or health research were identified as barriers to biobanking participation. Facilitators to participation were altruism, safety, understanding biobanking procedures and purposes, perceived benefits to participation, and culturally appropriate recruitment strategies. Although Mexican-Americans living in Texas are willing to donate biospecimens for altruistic reasons, such as helping society or advancing science, they want more information about what biobanking entails. They want to be assured that participation will not cause them harm and that the research is conducted with good intentions. Results from this study can inform educational materials or interventions to increase Hispanic participation in biobanking. © 2016 S. Karger AG, Basel.

Community perceptions of biobanking participation: A qualitative study among Mexican-Americans in three Texas cities

PubMed Central

Heredia, Natalia I.; Krasny, Sarah; Strong, Larkin L.; Von Hatten, Laura; Nguyen, Lynne; Reininger, Belinda M.; McNeill, Lorna H.; Fernández, María E.

2016-01-01

Background Most biospecimens in the U.S. are collected from Non-Hispanic Whites, limiting the generalizability of findings. There is a need to increase participation in biobanking among ethnic and racial minorities. The purpose of this study was to use qualitative methods to identify factors that may influence Mexican-American individuals’ willingness to participate in biobanking. Methods We conducted 15 focus groups in three Texas cities with Mexican-American individuals, in both Spanish and English. Results Lack of knowledge about medical research and biobanks, lack of information about the specifics of biobanking participation, lack of communication of the results, fear of pain or harm, and distrust of the healthcare system or health research were identified as barriers to biobanking participation. Facilitators to participation were altruism, safety, understanding biobanking procedures and purposes, perceived benefits to participation, and culturally-appropriate recruitment strategies. Although Mexican-Americans living in Texas are willing to donate biospecimens for altruistic reasons, such as helping society or advancing science, they want more information about what biobanking entails. They want to be assured that participation will not cause them harm, and that the research is conducted with good intentions. Conclusion Results from this study can inform educational materials or interventions to increase Hispanic participation in biobanking. PMID:27926908

RayPlus: a Web-Based Platform for Medical Image Processing.

PubMed

Yuan, Rong; Luo, Ming; Sun, Zhi; Shi, Shuyue; Xiao, Peng; Xie, Qingguo

2017-04-01

Medical image can provide valuable information for preclinical research, clinical diagnosis, and treatment. As the widespread use of digital medical imaging, many researchers are currently developing medical image processing algorithms and systems in order to accommodate a better result to clinical community, including accurate clinical parameters or processed images from the original images. In this paper, we propose a web-based platform to present and process medical images. By using Internet and novel database technologies, authorized users can easily access to medical images and facilitate their workflows of processing with server-side powerful computing performance without any installation. We implement a series of algorithms of image processing and visualization in the initial version of Rayplus. Integration of our system allows much flexibility and convenience for both research and clinical communities.

Identifying patients with ischemic heart disease in an electronic medical record.

PubMed

Ivers, Noah; Pylypenko, Bogdan; Tu, Karen

2011-01-01

Increasing utilization of electronic medical records (EMRs) presents an opportunity to efficiently measure quality indicators in primary care. Achieving this goal requires the development of accurate patient-disease registries. This study aimed to develop and validate an algorithm for identifying patients with ischemic heart disease (IHD) within the EMR. An algorithm was developed to search the unstructured text within the medical history fields in the EMR for IHD-related terminology. This algorithm was applied to a 5% random sample of adult patient charts (n = 969) drawn from a convenience sample of 17 Ontario family physicians. The accuracy of the algorithm for identifying patients with IHD was compared to the results of 3 trained chart abstractors. The manual chart abstraction identified 87 patients with IHD in the random sample (prevalence = 8.98%). The accuracy of the algorithm for identifying patients with IHD was as follows: sensitivity = 72.4% (95% confidence interval [CI]: 61.8-81.5); specificity = 99.3% (95% CI: 98.5-99.8); positive predictive value = 91.3% (95% CI: 82.0-96.7); negative predictive value = 97.3 (95% CI: 96.1-98.3); and kappa = 0.79 (95% CI: 0.72-0.86). Patients with IHD can be accurately identified by applying a search algorithm for the medical history fields in the EMR of primary care providers who were not using standardized approaches to code diagnoses. The accuracy compares favorably to other methods for identifying patients with IHD. The results of this study may aid policy makers, researchers, and clinicians to develop registries and to examine quality indicators for IHD in primary care.

An Algorithm Approach to Determining Smoking Cessation Treatment for Persons Living with HIV/AIDS: Results of a Pilot Trial

PubMed Central

Cropsey, Karen L.; Jardin, Bianca; Burkholder, Greer; Clark, C. Brendan; Raper, James L.; Saag, Michael

2015-01-01

Background Smoking now represents one of the biggest modifiable risk factors for disease and mortality in PLHIV. To produce significant changes in smoking rates among this population, treatments will need to be both acceptable to the larger segment of PLHIV smokers as well as feasible to implement in busy HIV clinics. The purpose of this study was to evaluate the feasibility and effects of a novel proactive algorithm-based intervention in an HIV/AIDS clinic. Methods PLHIV smokers (N =100) were proactively identified via their electronic medical records and were subsequently randomized at baseline to receive a 12-week pharmacotherapy-based algorithm treatment or treatment as usual. Participants were tracked in-person for 12-weeks. Participants provided information on smoking behaviors and associated constructs of cessation at each follow-up session. Results The findings revealed that many smokers reported utilizing prescribed medications when provided with a supply of cessation medication as determined by an algorithm. Compared to smokers receiving treatment as usual, PLHIV smokers prescribed these medications reported more quit attempts and greater reduction in smoking. Proxy measures of cessation readiness (e.g., motivation, self-efficacy) also favored participants receiving algorithm treatment. Conclusions This algorithm-derived treatment produced positive changes across a number of important clinical markers associated with smoking cessation. Given these promising findings coupled with the brief nature of this treatment, the overall pattern of results suggests strong potential for dissemination into clinical settings as well as significant promise for further advancing clinical health outcomes in this population. PMID:26181705

Pediatric medical complexity algorithm: a new method to stratify children by medical complexity.

PubMed

Simon, Tamara D; Cawthon, Mary Lawrence; Stanford, Susan; Popalisky, Jean; Lyons, Dorothy; Woodcox, Peter; Hood, Margaret; Chen, Alex Y; Mangione-Smith, Rita

2014-06-01

The goal of this study was to develop an algorithm based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), codes for classifying children with chronic disease (CD) according to level of medical complexity and to assess the algorithm's sensitivity and specificity. A retrospective observational study was conducted among 700 children insured by Washington State Medicaid with ≥1 Seattle Children's Hospital emergency department and/or inpatient encounter in 2010. The gold standard population included 350 children with complex chronic disease (C-CD), 100 with noncomplex chronic disease (NC-CD), and 250 without CD. An existing ICD-9-CM-based algorithm called the Chronic Disability Payment System was modified to develop a new algorithm called the Pediatric Medical Complexity Algorithm (PMCA). The sensitivity and specificity of PMCA were assessed. Using hospital discharge data, PMCA's sensitivity for correctly classifying children was 84% for C-CD, 41% for NC-CD, and 96% for those without CD. Using Medicaid claims data, PMCA's sensitivity was 89% for C-CD, 45% for NC-CD, and 80% for those without CD. Specificity was 90% to 92% in hospital discharge data and 85% to 91% in Medicaid claims data for all 3 groups. PMCA identified children with C-CD (who have accessed tertiary hospital care) with good sensitivity and good to excellent specificity when applied to hospital discharge or Medicaid claims data. PMCA may be useful for targeting resources such as care coordination to children with C-CD. Copyright © 2014 by the American Academy of Pediatrics.

Opto-numerical procedures supporting dynamic lower limbs monitoring and their medical diagnosis

NASA Astrophysics Data System (ADS)

Witkowski, Marcin; Kujawińska, Malgorzata; Rapp, Walter; Sitnik, Robert

2006-01-01

New optical full-field shape measurement systems allow transient shape capture at rates between 15 and 30 Hz. These frequency rates are enough to monitor controlled movements used e.g. for medical examination purposes. In this paper we present a set of algorithms which may be applied for processing of data gathered by fringe projection method implemented for lower limbs shape measurement. The purpose of presented algorithms is to locate anatomical structures based on the limb shape and its deformation in time. The algorithms are based on local surface curvature calculation and analysis of curvature maps changes during the measurement sequence. One of anatomical structure of high medical interest that is possible to scan and analyze, is patella. Tracking of patella position and orientation under dynamic conditions may lead to detect pathological patella movements and help in knee joint disease diagnosis. Therefore the usefulness of the algorithms developed was proven at examples of patella localization and monitoring.

Classification and management of gynecomastia: defining the role of ultrasound-assisted liposuction.

PubMed

Rohrich, Rod J; Ha, Richard Y; Kenkel, Jeffrey M; Adams, William P

2003-02-01

Gynecomastia, or excessive male breast development, has an incidence of 32 to 65 percent in the male population. This condition has important physical and psychological impacts. Advances in elucidating the pathophysiology of gynecomastia have been made, though understanding remains limited. Recommendations for evaluation and workup have varied and are often arbitrary. A diagnostic algorithm is suggested, with emphasis on a comprehensive history, physical examination, and minimizing unnecessary diagnostic testing. Medical management has had limited success; surgical therapy, primarily through excisional techniques, has been the accepted standard. Although effective, excisional techniques subject patients to large, visible scars. Ultrasound-assisted liposuction has recently emerged as a safe and effective method for the treatment of gynecomastia. It is particularly efficient in the removal of the dense, fibrous male breast tissue while offering advantages in minimal external scarring. A new system of classification and graduated treatment is proposed, based on glandular versus fibrous hypertrophy and degree of breast ptosis (skin excess). The authors' series of 61 patients with gynecomastia from 1987 to 2000 at the University of Texas Southwestern Department of Plastic Surgery demonstrated an overall success rate of 86.9 percent using suction-assisted lipectomy (1987 to 1997) and ultrasound-assisted liposuction (1997 to 2000). The authors have found ultrasound-assisted liposuction to be effective in treating most grades of gynecomastia. Excisional techniques are reserved for severe gynecomastia with significant skin excess after attempted ultrasound-assisted liposuction.

A psychometric evaluation of the clinician-rated Quick Inventory of Depressive Symptomatology (QIDS-C16) in patients with bipolar disorder.

PubMed

Bernstein, Ira H; Rush, A John; Suppes, Trisha; Trivedi, Madhukar H; Woo, Ada; Kyutoku, Yasushi; Crismon, M Lynn; Dennehy, Ellen; Carmody, Thomas J

2009-06-01

The clinician-rated, 16-item Quick Inventory of Depressive Symptomatology (QIDS-C16) has been extensively evaluated in patients with major depressive disorder (MDD). This report assesses the psychometric properties of the QIDS-C16 in outpatients with bipolar disorder (BD, N = 405) and MDD (N = 547) and in bipolar patients in the depressed phase only (BD-D) (N = 99) enrolled in the Texas Medication Algorithm Project (TMAP) using classical test theory (CTT) and the Samejima graded item response theory (IRT) model. Values of coefficient alpha were very similar in BD, MDD, and BD-D groups at baseline (alpha = 0.80-0.81) and at exit (alpha = 0.82-0.85). The QIDS-C16 was unidimensional for all three groups. MDD and BD-D patients (n = 99) had comparable symptom levels. The BD-D patients (n = 99) had the most, and bipolar patients in the manic phase had the least depressive symptoms at baseline. IRT analyses indicated that the QIDS-C16 was most sensitive to the measurement of depression for both MDD patients and for BD-D patients in the average range. The QIDS-C16 is suitable for use with patients with BD and can be used as an outcome measure in trials enrolling both BD and MDD patients. John Wiley & Sons, Ltd

An analysis of 20 years of radiation-related health care complaints in Texas for the purposes of quality improvement.

PubMed

Thommen, P J; Emery, R J

2006-05-01

In an effort to reveal the possible underlying causes of radiation-related health care complaints in the State of Texas, complaint data were evaluated using historical Texas Department of Health-Bureau of Radiation Control (TDH-BRC) reports. A major aim of the study was to generate a summary of the most commonly reported complaints that might be generalized to health care providers using sources of radiation across Texas. A generalizable list of common complaints would be a valuable tool for education and prevention programs, serving to possibly reduce the overall incidence of radiation-related medical complaints. Descriptive text summary reports of complaints were obtained from the TDH-BRC for the 20-y period inclusive of 1981 to 2001. The information was systematically coded into a computerized database. During the 20-y period of study, 481 health care-related complaints were identified, with approximately 74% consisting of claims of an "uncredentialed technician" (39%), "overexposure" (21%), or "regulatory violation" (14%). The most common categories of complaints imply some patient understanding or knowledge of the credentialing requirements of workers, the applicable dose limits, or the regulatory requirements associated with medical procedures. Since it is unlikely that an average patient would be aware of such issues, the findings suggest the complaints are not actually indications of the inappropriate uses of radiation, but are rather based on the patient's broader perception of services rendered. Most of the complaints levied during the period of study were done so anonymously (58%) and were levied against a generic facility (61%) rather than a specific technician (5%), doctor (4%), or student (1%). Approximately 61% of the complaints resulted in the issuance of a notice of violation upon investigation by the TDH-BRC, but the available data did not permit definitive linkage between the initial complaint and the violation issued. Taken in aggregate, the analysis suggests that improved communications between health care providers and the patients they serve could possibly serve to prevent future complaints. Although the analysis was limited to the data from a single state, the results may be of use to quality assurance programs on a broader scale because of the objective identification of likely common issues. Possible options for improving the means of systematically collecting initial compliant data in the future are also discussed.

Large-Scale Optimization for Bayesian Inference in Complex Systems

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

Willcox, Karen; Marzouk, Youssef

2013-11-12

The SAGUARO (Scalable Algorithms for Groundwater Uncertainty Analysis and Robust Optimization) Project focused on the development of scalable numerical algorithms for large-scale Bayesian inversion in complex systems that capitalize on advances in large-scale simulation-based optimization and inversion methods. The project was a collaborative effort among MIT, the University of Texas at Austin, Georgia Institute of Technology, and Sandia National Laboratories. The research was directed in three complementary areas: efficient approximations of the Hessian operator, reductions in complexity of forward simulations via stochastic spectral approximations and model reduction, and employing large-scale optimization concepts to accelerate sampling. The MIT--Sandia component of themore » SAGUARO Project addressed the intractability of conventional sampling methods for large-scale statistical inverse problems by devising reduced-order models that are faithful to the full-order model over a wide range of parameter values; sampling then employs the reduced model rather than the full model, resulting in very large computational savings. Results indicate little effect on the computed posterior distribution. On the other hand, in the Texas--Georgia Tech component of the project, we retain the full-order model, but exploit inverse problem structure (adjoint-based gradients and partial Hessian information of the parameter-to-observation map) to implicitly extract lower dimensional information on the posterior distribution; this greatly speeds up sampling methods, so that fewer sampling points are needed. We can think of these two approaches as ``reduce then sample'' and ``sample then reduce.'' In fact, these two approaches are complementary, and can be used in conjunction with each other. Moreover, they both exploit deterministic inverse problem structure, in the form of adjoint-based gradient and Hessian information of the underlying parameter-to-observation map, to achieve their speedups.« less

A joint watermarking/encryption algorithm for verifying medical image integrity and authenticity in both encrypted and spatial domains.

PubMed

Bouslimi, D; Coatrieux, G; Roux, Ch

2011-01-01

In this paper, we propose a new joint watermarking/encryption algorithm for the purpose of verifying the reliability of medical images in both encrypted and spatial domains. It combines a substitutive watermarking algorithm, the quantization index modulation (QIM), with a block cipher algorithm, the Advanced Encryption Standard (AES), in CBC mode of operation. The proposed solution gives access to the outcomes of the image integrity and of its origins even though the image is stored encrypted. Experimental results achieved on 8 bits encoded Ultrasound images illustrate the overall performances of the proposed scheme. By making use of the AES block cipher in CBC mode, the proposed solution is compliant with or transparent to the DICOM standard.

Desiderata for computable representations of electronic health records-driven phenotype algorithms.

PubMed

Mo, Huan; Thompson, William K; Rasmussen, Luke V; Pacheco, Jennifer A; Jiang, Guoqian; Kiefer, Richard; Zhu, Qian; Xu, Jie; Montague, Enid; Carrell, David S; Lingren, Todd; Mentch, Frank D; Ni, Yizhao; Wehbe, Firas H; Peissig, Peggy L; Tromp, Gerard; Larson, Eric B; Chute, Christopher G; Pathak, Jyotishman; Denny, Joshua C; Speltz, Peter; Kho, Abel N; Jarvik, Gail P; Bejan, Cosmin A; Williams, Marc S; Borthwick, Kenneth; Kitchner, Terrie E; Roden, Dan M; Harris, Paul A

2015-11-01

Electronic health records (EHRs) are increasingly used for clinical and translational research through the creation of phenotype algorithms. Currently, phenotype algorithms are most commonly represented as noncomputable descriptive documents and knowledge artifacts that detail the protocols for querying diagnoses, symptoms, procedures, medications, and/or text-driven medical concepts, and are primarily meant for human comprehension. We present desiderata for developing a computable phenotype representation model (PheRM). A team of clinicians and informaticians reviewed common features for multisite phenotype algorithms published in PheKB.org and existing phenotype representation platforms. We also evaluated well-known diagnostic criteria and clinical decision-making guidelines to encompass a broader category of algorithms. We propose 10 desired characteristics for a flexible, computable PheRM: (1) structure clinical data into queryable forms; (2) recommend use of a common data model, but also support customization for the variability and availability of EHR data among sites; (3) support both human-readable and computable representations of phenotype algorithms; (4) implement set operations and relational algebra for modeling phenotype algorithms; (5) represent phenotype criteria with structured rules; (6) support defining temporal relations between events; (7) use standardized terminologies and ontologies, and facilitate reuse of value sets; (8) define representations for text searching and natural language processing; (9) provide interfaces for external software algorithms; and (10) maintain backward compatibility. A computable PheRM is needed for true phenotype portability and reliability across different EHR products and healthcare systems. These desiderata are a guide to inform the establishment and evolution of EHR phenotype algorithm authoring platforms and languages. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Implementation of MPEG-2 encoder to multiprocessor system using multiple MVPs (TMS320C80)

NASA Astrophysics Data System (ADS)

Kim, HyungSun; Boo, Kenny; Chung, SeokWoo; Choi, Geon Y.; Lee, YongJin; Jeon, JaeHo; Park, Hyun Wook

1997-05-01

This paper presents the efficient algorithm mapping for the real-time MPEG-2 encoding on the KAIST image computing system (KICS), which has a parallel architecture using five multimedia video processors (MVPs). The MVP is a general purpose digital signal processor (DSP) of Texas Instrument. It combines one floating-point processor and four fixed- point DSPs on a single chip. The KICS uses the MVP as a primary processing element (PE). Two PEs form a cluster, and there are two processing clusters in the KICS. Real-time MPEG-2 encoder is implemented through the spatial and the functional partitioning strategies. Encoding process of spatially partitioned half of the video input frame is assigned to ne processing cluster. Two PEs perform the functionally partitioned MPEG-2 encoding tasks in the pipelined operation mode. One PE of a cluster carries out the transform coding part and the other performs the predictive coding part of the MPEG-2 encoding algorithm. One MVP among five MVPs is used for system control and interface with host computer. This paper introduces an implementation of the MPEG-2 algorithm with a parallel processing architecture.

A serum protein-based algorithm for the detection of Alzheimer disease.

PubMed

O'Bryant, Sid E; Xiao, Guanghua; Barber, Robert; Reisch, Joan; Doody, Rachelle; Fairchild, Thomas; Adams, Perrie; Waring, Steven; Diaz-Arrastia, Ramon

2010-09-01

To develop an algorithm that separates patients with Alzheimer disease (AD) from controls. Longitudinal case-control study. The Texas Alzheimer's Research Consortium project. Patients  We analyzed serum protein-based multiplex biomarker data from 197 patients diagnosed with AD and 203 controls. Main Outcome Measure  The total sample was randomized equally into training and test sets and random forest methods were applied to the training set to create a biomarker risk score. The biomarker risk score had a sensitivity and specificity of 0.80 and 0.91, respectively, and an area under the curve of 0.91 in detecting AD. When age, sex, education, and APOE status were added to the algorithm, the sensitivity, specificity, and area under the curve were 0.94, 0.84, and 0.95, respectively. These initial data suggest that serum protein-based biomarkers can be combined with clinical information to accurately classify AD. A disproportionate number of inflammatory and vascular markers were weighted most heavily in the analyses. Additionally, these markers consistently distinguished cases from controls in significant analysis of microarray, logistic regression, and Wilcoxon analyses, suggesting the existence of an inflammatory-related endophenotype of AD that may provide targeted therapeutic opportunities for this subset of patients.

Hurricanes Harvey and Irma - High-Resolution Flood Mapping and Monitoring from Sentinel SAR with the Depolarization Reduction Algorithm for Global Observations of InundatioN (DRAGON)

NASA Astrophysics Data System (ADS)

Nghiem, S. V.; Brakenridge, G. R.; Nguyen, D. T.

2017-12-01

Hurricane Harvey inflicted historical catastrophic flooding across extensive regions around Houston and southeast Texas after making landfall on 25 August 2017. The Federal Emergency Management Agency (FEMA) requested urgent supports for flood mapping and monitoring in an emergency response to the extreme flood situation. An innovative satellite remote sensing method, called the Depolarization Reduction Algorithm for Global Observations of inundatioN (DRAGON), has been developed and implemented for use with Sentinel synthetic aperture radar (SAR) satellite data at a resolution of 10 meters to identify, map, and monitor inundation including pre-existing water bodies and newly flooded areas. Results from this new method are hydrologically consistent and have been verified with known surface waters (e.g., coastal ocean, rivers, lakes, reservoirs, etc.), with clear-sky high-resolution WorldView images (where waves can be seen on surface water in inundated areas within a small spatial coverage), and with other flood maps from the consortium of Global Flood Partnership derived from multiple satellite datasets (including clear-sky Landsat and MODIS at lower resolutions). Figure 1 is a high-resolution (4K UHD) image of a composite inundation map for the region around Rosharon (in Brazoria County, south of Houston, Texas). This composite inundation map reveals extensive flooding on 29 August 2017 (four days after Hurricane Harvey made landfall), and the inundation was still persistent in most of the west and south of Rosharon one week later (5 September 2017) while flooding was reduced in the east of Rosharon. Hurricane Irma brought flooding to a number of areas in Florida. As of 10 September 2017, Sentinel SAR flood maps reveal inundation in the Florida Panhandle and over lowland surfaces on several islands in the Florida Keys. However, Sentinel SAR results indicate that flooding along the Florida coast was not extreme despite Irma was a Category-5 hurricane that might have inflicted a potentially strong storm surge. DRAGON flood mapping products over various regions in Texas and in Florida were provided to FEMA. Figure 1. Composite inundation map derived from Sentinel SAR data for the region around Rosharon on 9/5/2017 (orange), inundation on 8/29/2017 (yellow), and pre-existing surface waters on 8/5/2017 (blue).

Texas Affordable Baccalaureate Program: A Collaboration between the Texas Higher Education Coordinating Board, South Texas College, and Texas A&M University-Commerce. CBE Case Study

ERIC Educational Resources Information Center

Klein-Collins, Rebecca; Glancey, Kathleen

2015-01-01

This case study is part of a series on newer competency-based degree programs that have been emerging in recent years. In January 2014, the Texas Higher Education Coordinating Board (THECB), South Texas College (STC), and Texas A&M University-Commerce (A&M Commerce) launched the Texas Affordable Baccalaureate Program, the state's first…

Medical therapy cost considerations for glaucoma.

PubMed

Fiscella, Richard G; Green, Amy; Patuszynski, Daniel H; Wilensky, Jacob

2003-07-01

To determine the calculated daily patient cost (cost minimization) of medical glaucoma therapy and review cost trends. Experimental, controlled, prospective study. The actual volume of various glaucoma medications or glaucoma medications with redesigned bottles was determined for most commercially available sizes of the tested products. The drops per milliliter based on the actual volume and the daily costs of the dosage schedules recommended by the manufacturers were compared. The cost of each bottle of medication was determined from the average wholesale price (AWP) in the United States. A comparison to 1999 prices where applicable will be analyzed to review costing trends. The generic timolol products (range, US dollars 0.38-US dollars 0.46 per day) were similar on a cost per day basis vs Betimol (Santen, Napa Valley, California, USA), Optipranolol (Bausch and Lomb Pharmaceuticals, Tampa, Florida, USA) and Timoptic (Merck, West Point, Pennsylvania, USA). Their percentage cost increase ranged from 5% to 22% since 1999, except for generic timolol XE gel-forming solution (48%). Betagan (Allergan, Irvine, California, USA), Betoptic S (Alcon Laboratories, Fort Worth, Texas, USA), and Ocupress (Novartis, Duluth, Georgia, USA) ranged from US dollars 0.88 to US dollars 1.11 per day, and their percentage cost increase ranged from 33% to 53%. Some brand-only products have raised their AWPs a greater percentage, including Betoptic S (37%), Iopidine (Alcon, Fort Worth, Texas, USA) (50%), Ocupress (Novartis Ophthalmics, Duluth, Georgia, USA) (53%), and Pilopine gel (Alcon, Fort Worth, Texas, USA) (32%). The mean cost per day for the topical carbonic anhydrase inhibitors Azopt (Alcon Laboratories; US dollars 1.33 per day) and Trusopt (Merck; US dollars 1.05 per day) differed from 1999 when prices were almost identical. Cosopt (Merck; timolol 0.5% plus dorzolamide 2%, US dollars 1.04 per day) was less than the cost of separate bottles of a topical carbonic anhydrase inhibitor and a beta-blocker. The selective alpha-2 agonist brimonidine 0.15% with Purite (Alphagan-P, Allergan, 5 ml) twice daily was US dollars 1.29 per day. The prostaglandin analogs were comparably priced with Lumigan (Allergan) US dollars 0.95 per day, Xalatan (Pharmacia and Upjohn, Kalamazoo, Michigan, USA) US dollars 1.25 per day, Travatan (Alcon Laboratories) US dollars 1.01 per day, and Rescula (Novartis) US dollars 0.90 per day. All generic timolol, Betimol, Optipranolol, Timoptic, and Timoptic XE (Merck) ranged from US dollars 0.38 to US dollars 0.50 per day. Other beta-blocker products were about twice as costly, ranging from US dollars 0.88 to US dollars 1.11 per day. Cosopt (US dollars 1.05 per day) was less costly than separate bottles of a topical beta-blocker and a topical carbonic anhydrase inhibitor dosed three times daily or twice daily. The prostaglandin analogs ranged from US dollars 0.90 per day (Rescula) to US dollars 1.25 per day (Xalatan). Newer glaucoma medications exhibit similar costs per day in many cases, compared with more traditional medications, especially with greater price increases in older brand-only products.

A hybrid approach to select features and classify diseases based on medical data

NASA Astrophysics Data System (ADS)

AbdelLatif, Hisham; Luo, Jiawei

2018-03-01

Feature selection is popular problem in the classification of diseases in clinical medicine. Here, we developing a hybrid methodology to classify diseases, based on three medical datasets, Arrhythmia, Breast cancer, and Hepatitis datasets. This methodology called k-means ANOVA Support Vector Machine (K-ANOVA-SVM) uses K-means cluster with ANOVA statistical to preprocessing data and selection the significant features, and Support Vector Machines in the classification process. To compare and evaluate the performance, we choice three classification algorithms, decision tree Naïve Bayes, Support Vector Machines and applied the medical datasets direct to these algorithms. Our methodology was a much better classification accuracy is given of 98% in Arrhythmia datasets, 92% in Breast cancer datasets and 88% in Hepatitis datasets, Compare to use the medical data directly with decision tree Naïve Bayes, and Support Vector Machines. Also, the ROC curve and precision with (K-ANOVA-SVM) Achieved best results than other algorithms

5 CFR Appendix III to Part 1201 - Approved Hearing Locations By Regional Office

Code of Federal Regulations, 2011 CFR

2011-01-01

..., Missouri Cleveland, Ohio Cincinnati, Ohio Columbus, Ohio Dayton, Ohio Milwaukee, Wisconsin Dallas Regional..., Oklahoma Corpus Christi, Texas Dallas, Texas El Paso, Texas Houston, Texas San Antonio, Texas Temple, Texas...

Identification of Dyslipidemic Patients Attending Primary Care Clinics Using Electronic Medical Record (EMR) Data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) Database.

PubMed

Aref-Eshghi, Erfan; Oake, Justin; Godwin, Marshall; Aubrey-Bassler, Kris; Duke, Pauline; Mahdavian, Masoud; Asghari, Shabnam

2017-03-01

The objective of this study was to define the optimal algorithm to identify patients with dyslipidemia using electronic medical records (EMRs). EMRs of patients attending primary care clinics in St. John's, Newfoundland and Labrador (NL), Canada during 2009-2010, were studied to determine the best algorithm for identification of dyslipidemia. Six algorithms containing three components, dyslipidemia ICD coding, lipid lowering medication use, and abnormal laboratory lipid levels, were tested against a gold standard, defined as the existence of any of the three criteria. Linear discriminate analysis, and bootstrapping were performed following sensitivity/specificity testing and receiver's operating curve analysis. Two validating datasets, NL records of 2011-2014, and Canada-wide records of 2010-2012, were used to replicate the results. Relative to the gold standard, combining laboratory data together with lipid lowering medication consumption yielded the highest sensitivity (99.6%), NPV (98.1%), Kappa agreement (0.98), and area under the curve (AUC, 0.998). The linear discriminant analysis for this combination resulted in an error rate of 0.15 and an Eigenvalue of 1.99, and the bootstrapping led to AUC: 0.998, 95% confidence interval: 0.997-0.999, Kappa: 0.99. This algorithm in the first validating dataset yielded a sensitivity of 97%, Negative Predictive Value (NPV) = 83%, Kappa = 0.88, and AUC = 0.98. These figures for the second validating data set were 98%, 93%, 0.95, and 0.99, respectively. Combining laboratory data with lipid lowering medication consumption within the EMR is the best algorithm for detecting dyslipidemia. These results can generate standardized information systems for dyslipidemia and other chronic disease investigations using EMRs.

Medical Surveillance Monthly Report (MSMR). Volume 2, Number 7, September 1996

DTIC Science & Technology

1996-09-01

in the use of permethrin-impregnated uniforms. Three soldiers had a febrile illness associated with a petechial rash resembling Rocky Mountain...Spotted Fever (RMSF) and the remaining 25 soldiers had a rash described as a localized, expanding circular rash, similar to erythema migrans (EM). The...Carolina, and Texas and has been implicated as the possible infectious agent.¹ Ticks were also screened for the spotted fever group and one D

Disaster Relief and Emergency Medical Services (DREAMS): Texas A&M Digital EMS and the Detection and Remediation of Chemical Threat Agents

DTIC Science & Technology

2004-10-01

the bacterial exopolysaccharide has been initiated. The enterobacterium Erwinia amylovora , the fire blight pathogen of rosaceous plants and pome...A&M University Erwinia amylovora bacteriophage ERA 103 plaques surrounded by halos. Task 15: Development of Integrated Microfluidic-based Sensors for...fruit, produces copious amounts of extra cellular polysaccharide (amylovoran), which acts as a host specific toxin during pathogenesis. The E. amylovora

Business Case Analysis: Costs of Laundry Services

DTIC Science & Technology

2006-05-01

CONTRACT NUMBER Business Case Analysis: Costs of Laundry Services 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) 5d. PROJECT NUMBER Butler...Jonathan, B, Major, MSC 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION William Beaumont...Army Medical Center REPORT NUMBER 5005 N. Piedras Street El Paso, Texas 79920 9. SPONSORING/MONITORING AGENCY NAME( S ) AND ADDRESS(ES) 10. SPONSOR

Environmental Assessment for the Construction of a Photovoltaic Solar Array at Laughlin Air Force Base, Texas

DTIC Science & Technology

2011-10-01

Alabama, 1996 Years of Experience: 24 Brian Howard. Ph.D, Quality Assurance Post Doctoral Research Associate, Burnham Institute for Medical... Research , La Jolla, CA, 1991 Post -Doctoral Research Fellow, F. Hoffmann-La Roche & Co., Basel, Switzerland, 1990 Ph.D. Toxicology, Utah State University... research any eligibility determinations, additional archeological testing or avoidance that may be warranted. Thank you for your cooperation in this state

Molecular Innovations Toward Theranostics of Aggressive Prostate Cancer

DTIC Science & Technology

2015-09-01

Xiankai Sun, PhD CONTRACTING ORGANIZATION: University of Texas Southwestern Medical Center, Dallas, TX 75390 REPORT DATE : September 2015 TYPE OF REPORT...number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) September 2015 2. REPORT TYPE Annual 3. DATES COVERED (From...toxicity. To date , we have developed the radiochemistry procedure to label the T-SMDC with 68Ga efficiently. We have started evaluating its therapeutic

Balloon Dilation of Sinus Ostia in the Department of Defense: Diagnoses, Actual Indications, and Outcomes

DTIC Science & Technology

2016-05-18

acute rhinosinusitis. However, this technology is often advertised and utilized for off-label indications, which lack evidence - based support...DEPARTMENT OF THE AIR FORCE 59TH MEDICAL WING (AETC) JOINT BASE SAN ANTONIO - LACKLAND TEXAS MEMORANDUM FOR 959 MDOS ATTN: MAJ ADRIENNE LAURY...McMains, MD1 1 Department of Otolaryngology-Head and Neck Surgery , San Antonio Uniformed Services Health Education Consortium (SAUSHEC), Ft. Sam

Multidrug-Resistant Gram-Negative Bacteria Colonization of Healthy US Military Personnel in the US and Afghanistan

DTIC Science & Technology

2013-02-05

daily antimalarial chemoprophylaxis, which might alter an individual’s colonizing pathogens. Given the reports of increasing MDR pathogens isolated...deployed healthy active duty service members in San Antonio, Texas and 100 healthy active duty service members deployed to a single province in...Afghanistan. Participants were recruited after they presented to their respective outpatient medical clinic for acute, non-urgent/emergent care with no active

A Project to Develop a Marketing Plan in Support of William Beaumont Army Medical Center, Fort Bliss, Texas

DTIC Science & Technology

1989-12-01

need for a consumer- oriented outlook ( Kotler 1987). Each of these authors are discussing the need for health care organizations to pursue effective...to the customer. Between these definitional extremes is the point of 17 view presented by Kotler and Clarke (1987). Their joint exhaustive definition...Types of Health Care Organizations, Adapted from Kotler Strategic Marketing for Nonprofit Orqanizations (Englewood Cliffs: Prentice- Hall, 1987). GENERAL

Final Environmental Impact Statement: Disposal and Reuse of Carswell Air Force Base, Texas

DTIC Science & Technology

1994-07-01

maintenance shops, airfield infrastructure, medical clinic, and child care center. New construction would include a reserve training center, guard...includes a private cemetery and a child care center. The cemetery would be left undisturbed and the child care center would be converted for a city hall... child care center, and a floodplain associated with Farmers Branch Creek. The golf course area could be reused soon after disposal of the property

Selection and Classification of United States Military Officers: A fifty-Year Bibliography (1937-1986)

DTIC Science & Technology

1989-03-01

orientation in Naval aviation cadets. Journal of Educational Psychology , 45, 91-109. 908 Creelman , J.A. (1954). An analysis of the physical fitness index...International Index to Periodicals. (e) Military Testing Association Proceedings, and (f) Psychological Abstracts. The research organizations of the armed...Texas, can trace its beginning to a number of Psychological Research Units of the Medical Division of the United States Army Air Corps. Some of the

Exploring the Readability of Consent Forms in Human Research in the United States Army

DTIC Science & Technology

2005-03-01

subjects: autonomy (respect for persons), beneficence, and justice. Readability of consent forms 12 The report also defined how these principles apply to...Regional Medical Command, Fort Sam Houston, Texas CPT Heidi P. Mon) U.S. Army-Baylor University Graduate Program in Health Care Administration March...United States v. Karl Brandt, 1947). The opinion in that case included 10 basic principles for human research, called the Nuremberg Code

Fast Lossless Compression of Multispectral-Image Data

NASA Technical Reports Server (NTRS)

Klimesh, Matthew

2006-01-01

An algorithm that effects fast lossless compression of multispectral-image data is based on low-complexity, proven adaptive-filtering algorithms. This algorithm is intended for use in compressing multispectral-image data aboard spacecraft for transmission to Earth stations. Variants of this algorithm could be useful for lossless compression of three-dimensional medical imagery and, perhaps, for compressing image data in general.

Read Across Texas! 2002 Texas Reading Club Manual.

ERIC Educational Resources Information Center

Edgmon, Missy; Ferate-Soto, Paolo; Foley, Lelana; Hager, Tina; Heard, Adriana; Ingham, Donna; Lopez, Nohemi; McMahon, Dorothy; Meyer, Sally; Parrish, Leila; Rodriguez-Gibbs, Josefina; Moreyra-Torres, Maricela; Travis, Gayle; Welch, Willy

The goal of the Texas Reading Club is to encourage the children of Texas to become library users and lifelong readers. This manual was created for the 2002 Texas Reading Club, a program of the Texas State Library and Archives Commission. The theme, "Read Across Texas!" invites children to explore the history, geography, and culture of…

Combining Public Health Education and Disease Ecology Research: Using Citizen Science to Assess Chagas Disease Entomological Risk in Texas

PubMed Central

Curtis-Robles, Rachel; Wozniak, Edward J.; Auckland, Lisa D.; Hamer, Gabriel L.; Hamer, Sarah A.

2015-01-01

Background Chagas disease is a zoonotic parasitic disease well-documented throughout the Americas and transmitted primarily by triatomine ‘kissing bug’ vectors. In acknowledgment of the successful history of vector control programs based on community participation across Latin America, we used a citizen science approach to gain novel insight into the geographic distribution, seasonal activity, and Trypanosoma cruzi infection prevalence of kissing bugs in Texas while empowering the public with information about Chagas disease. Methodology/Principal Findings We accepted submissions of kissing bugs encountered by the public in Texas and other states from 2013–2014 while providing educational literature about Chagas disease. In the laboratory, kissing bugs were identified to species, dissected, and tested for T. cruzi infection. A total of 1,980 triatomines were submitted to the program comprised of at least seven species, of which T. gerstaeckeri and T. sanguisuga were the most abundant (85.7% of submissions). Triatomines were most commonly collected from dog kennels and outdoor patios; Overall, 10.5% of triatomines were collected from inside the home. Triatomines were submitted from across Texas, including many counties which were not previously known to harbor kissing bugs. Kissing bugs were captured primarily throughout April-October, and peak activity occurred in June-July. Emails to our dedicated account regarding kissing bugs were more frequent in the summer months (June-August) than the rest of the year. We detected T. cruzi in 63.3% of tested bugs. Conclusions/Significance Citizen science is an efficient approach for generating data on the distribution, phenology, and infection prevalence of kissing bugs—vectors of the Chagas disease parasite—while educating the public and medical community. PMID:26658425

Combining Public Health Education and Disease Ecology Research: Using Citizen Science to Assess Chagas Disease Entomological Risk in Texas.

PubMed

Curtis-Robles, Rachel; Wozniak, Edward J; Auckland, Lisa D; Hamer, Gabriel L; Hamer, Sarah A

2015-12-01

Chagas disease is a zoonotic parasitic disease well-documented throughout the Americas and transmitted primarily by triatomine 'kissing bug' vectors. In acknowledgment of the successful history of vector control programs based on community participation across Latin America, we used a citizen science approach to gain novel insight into the geographic distribution, seasonal activity, and Trypanosoma cruzi infection prevalence of kissing bugs in Texas while empowering the public with information about Chagas disease. We accepted submissions of kissing bugs encountered by the public in Texas and other states from 2013-2014 while providing educational literature about Chagas disease. In the laboratory, kissing bugs were identified to species, dissected, and tested for T. cruzi infection. A total of 1,980 triatomines were submitted to the program comprised of at least seven species, of which T. gerstaeckeri and T. sanguisuga were the most abundant (85.7% of submissions). Triatomines were most commonly collected from dog kennels and outdoor patios; Overall, 10.5% of triatomines were collected from inside the home. Triatomines were submitted from across Texas, including many counties which were not previously known to harbor kissing bugs. Kissing bugs were captured primarily throughout April-October, and peak activity occurred in June-July. Emails to our dedicated account regarding kissing bugs were more frequent in the summer months (June-August) than the rest of the year. We detected T. cruzi in 63.3% of tested bugs. Citizen science is an efficient approach for generating data on the distribution, phenology, and infection prevalence of kissing bugs-vectors of the Chagas disease parasite-while educating the public and medical community.

Cloud-Based Evaluation of Anatomical Structure Segmentation and Landmark Detection Algorithms: VISCERAL Anatomy Benchmarks.

PubMed

Jimenez-Del-Toro, Oscar; Muller, Henning; Krenn, Markus; Gruenberg, Katharina; Taha, Abdel Aziz; Winterstein, Marianne; Eggel, Ivan; Foncubierta-Rodriguez, Antonio; Goksel, Orcun; Jakab, Andras; Kontokotsios, Georgios; Langs, Georg; Menze, Bjoern H; Salas Fernandez, Tomas; Schaer, Roger; Walleyo, Anna; Weber, Marc-Andre; Dicente Cid, Yashin; Gass, Tobias; Heinrich, Mattias; Jia, Fucang; Kahl, Fredrik; Kechichian, Razmig; Mai, Dominic; Spanier, Assaf B; Vincent, Graham; Wang, Chunliang; Wyeth, Daniel; Hanbury, Allan

2016-11-01

Variations in the shape and appearance of anatomical structures in medical images are often relevant radiological signs of disease. Automatic tools can help automate parts of this manual process. A cloud-based evaluation framework is presented in this paper including results of benchmarking current state-of-the-art medical imaging algorithms for anatomical structure segmentation and landmark detection: the VISCERAL Anatomy benchmarks. The algorithms are implemented in virtual machines in the cloud where participants can only access the training data and can be run privately by the benchmark administrators to objectively compare their performance in an unseen common test set. Overall, 120 computed tomography and magnetic resonance patient volumes were manually annotated to create a standard Gold Corpus containing a total of 1295 structures and 1760 landmarks. Ten participants contributed with automatic algorithms for the organ segmentation task, and three for the landmark localization task. Different algorithms obtained the best scores in the four available imaging modalities and for subsets of anatomical structures. The annotation framework, resulting data set, evaluation setup, results and performance analysis from the three VISCERAL Anatomy benchmarks are presented in this article. Both the VISCERAL data set and Silver Corpus generated with the fusion of the participant algorithms on a larger set of non-manually-annotated medical images are available to the research community.

How Effective Is Algorithm-Guided Treatment for Depressed Inpatients? Results from the Randomized Controlled Multicenter German Algorithm Project 3 Trial

PubMed Central

Wiethoff, Katja; Baghai, Thomas C; Fisher, Robert; Seemüller, Florian; Laakmann, Gregor; Brieger, Peter; Cordes, Joachim; Malevani, Jaroslav; Laux, Gerd; Hauth, Iris; Möller, Hans-Jürgen; Kronmüller, Klaus-Thomas; Smolka, Michael N; Schlattmann, Peter; Berger, Maximilian; Ricken, Roland; Stamm, Thomas J; Heinz, Andreas; Bauer, Michael

2017-01-01

Abstract Background Treatment algorithms are considered as key to improve outcomes by enhancing the quality of care. This is the first randomized controlled study to evaluate the clinical effect of algorithm-guided treatment in inpatients with major depressive disorder. Methods Inpatients, aged 18 to 70 years with major depressive disorder from 10 German psychiatric departments were randomized to 5 different treatment arms (from 2000 to 2005), 3 of which were standardized stepwise drug treatment algorithms (ALGO). The fourth arm proposed medications and provided less specific recommendations based on a computerized documentation and expert system (CDES), the fifth arm received treatment as usual (TAU). ALGO included 3 different second-step strategies: lithium augmentation (ALGO LA), antidepressant dose-escalation (ALGO DE), and switch to a different antidepressant (ALGO SW). Time to remission (21-item Hamilton Depression Rating Scale ≤9) was the primary outcome. Results Time to remission was significantly shorter for ALGO DE (n=91) compared with both TAU (n=84) (HR=1.67; P=.014) and CDES (n=79) (HR=1.59; P=.031) and ALGO SW (n=89) compared with both TAU (HR=1.64; P=.018) and CDES (HR=1.56; P=.038). For both ALGO LA (n=86) and ALGO DE, fewer antidepressant medications were needed to achieve remission than for CDES or TAU (P<.001). Remission rates at discharge differed across groups; ALGO DE had the highest (89.2%) and TAU the lowest rates (66.2%). Conclusions A highly structured algorithm-guided treatment is associated with shorter times and fewer medication changes to achieve remission with depressed inpatients than treatment as usual or computerized medication choice guidance. PMID:28645191

How Effective Is Algorithm-Guided Treatment for Depressed Inpatients? Results from the Randomized Controlled Multicenter German Algorithm Project 3 Trial.

PubMed

Adli, Mazda; Wiethoff, Katja; Baghai, Thomas C; Fisher, Robert; Seemüller, Florian; Laakmann, Gregor; Brieger, Peter; Cordes, Joachim; Malevani, Jaroslav; Laux, Gerd; Hauth, Iris; Möller, Hans-Jürgen; Kronmüller, Klaus-Thomas; Smolka, Michael N; Schlattmann, Peter; Berger, Maximilian; Ricken, Roland; Stamm, Thomas J; Heinz, Andreas; Bauer, Michael

2017-09-01

Treatment algorithms are considered as key to improve outcomes by enhancing the quality of care. This is the first randomized controlled study to evaluate the clinical effect of algorithm-guided treatment in inpatients with major depressive disorder. Inpatients, aged 18 to 70 years with major depressive disorder from 10 German psychiatric departments were randomized to 5 different treatment arms (from 2000 to 2005), 3 of which were standardized stepwise drug treatment algorithms (ALGO). The fourth arm proposed medications and provided less specific recommendations based on a computerized documentation and expert system (CDES), the fifth arm received treatment as usual (TAU). ALGO included 3 different second-step strategies: lithium augmentation (ALGO LA), antidepressant dose-escalation (ALGO DE), and switch to a different antidepressant (ALGO SW). Time to remission (21-item Hamilton Depression Rating Scale ≤9) was the primary outcome. Time to remission was significantly shorter for ALGO DE (n=91) compared with both TAU (n=84) (HR=1.67; P=.014) and CDES (n=79) (HR=1.59; P=.031) and ALGO SW (n=89) compared with both TAU (HR=1.64; P=.018) and CDES (HR=1.56; P=.038). For both ALGO LA (n=86) and ALGO DE, fewer antidepressant medications were needed to achieve remission than for CDES or TAU (P<.001). Remission rates at discharge differed across groups; ALGO DE had the highest (89.2%) and TAU the lowest rates (66.2%). A highly structured algorithm-guided treatment is associated with shorter times and fewer medication changes to achieve remission with depressed inpatients than treatment as usual or computerized medication choice guidance. © The Author 2017. Published by Oxford University Press on behalf of CINP.

Designing an Algorithm to Preserve Privacy for Medical Record Linkage With Error-Prone Data

PubMed Central

Pal, Doyel; Chen, Tingting; Khethavath, Praveen

2014-01-01

Background Linking medical records across different medical service providers is important to the enhancement of health care quality and public health surveillance. In records linkage, protecting the patients’ privacy is a primary requirement. In real-world health care databases, records may well contain errors due to various reasons such as typos. Linking the error-prone data and preserving data privacy at the same time are very difficult. Existing privacy preserving solutions for this problem are only restricted to textual data. Objective To enable different medical service providers to link their error-prone data in a private way, our aim was to provide a holistic solution by designing and developing a medical record linkage system for medical service providers. Methods To initiate a record linkage, one provider selects one of its collaborators in the Connection Management Module, chooses some attributes of the database to be matched, and establishes the connection with the collaborator after the negotiation. In the Data Matching Module, for error-free data, our solution offered two different choices for cryptographic schemes. For error-prone numerical data, we proposed a newly designed privacy preserving linking algorithm named the Error-Tolerant Linking Algorithm, that allows the error-prone data to be correctly matched if the distance between the two records is below a threshold. Results We designed and developed a comprehensive and user-friendly software system that provides privacy preserving record linkage functions for medical service providers, which meets the regulation of Health Insurance Portability and Accountability Act. It does not require a third party and it is secure in that neither entity can learn the records in the other’s database. Moreover, our novel Error-Tolerant Linking Algorithm implemented in this software can work well with error-prone numerical data. We theoretically proved the correctness and security of our Error-Tolerant Linking Algorithm. We have also fully implemented the software. The experimental results showed that it is reliable and efficient. The design of our software is open so that the existing textual matching methods can be easily integrated into the system. Conclusions Designing algorithms to enable medical records linkage for error-prone numerical data and protect data privacy at the same time is difficult. Our proposed solution does not need a trusted third party and is secure in that in the linking process, neither entity can learn the records in the other’s database. PMID:25600786

The Diabetes Management Education Program in South Texas: An Economic and Clinical Impact Analysis.

PubMed

Kash, Bita A; Lin, Szu-Hsuan; Baek, Juha; Ohsfeldt, Robert L

2017-01-01

Diabetes is a major chronic disease that can lead to serious health problems and high healthcare costs without appropriate disease management and treatment. In the United States, the number of people diagnosed with diabetes and the cost for diabetes treatment has dramatically increased over time. To improve patients' self-management skills and clinical outcomes, diabetes management education (DME) programs have been developed and operated in various regions. This community case study explores and calculates the economic and clinical impacts of expanding a model DME program into 26 counties located in South Texas. The study sample includes 355 patients with type 2 diabetes and a follow-up hemoglobin A1c level measurement among 1,275 individuals who participated in the DME program between September 2012 and August 2013. We used the Gilmer's cost differentials model and the United Kingdom Prospective Diabetes Study (UKPDS) Risk Engine methodology to predict 3-year healthcare cost savings and 10-year clinical benefits of implementing a DME program in the selected 26 Texas counties. Changes in estimated 3-year cost and the estimated treatment effect were based on baseline hemoglobin A1c level. An average 3-year reduction in medical treatment costs per program participant was $2,033 (in 2016 dollars). The total healthcare cost savings for the 26 targeted counties increases as the program participation rate increases. The total projected cost saving ranges from $12 million with 5% participation rate to $185 million with 75% participation rate. A 10-year outlook on additional clinical benefits associated with the implementation and expansion of the DME program at 60% participation is estimated to result in approximately 4,838 avoided coronary heart disease cases and another 392 cases of avoided strokes. The implementation of this model DME program in the selected 26 counties would contribute to substantial healthcare cost savings and clinical benefits. Organizations that provide DME services may benefit from reduction in medical treatment costs and improvement in clinical outcomes for populations with diabetes.

Dual-Credit/Dual-Enrollment Coursework and Long-Term College Success in Texas. Issue Brief

ERIC Educational Resources Information Center

Radunzel, Justine; Noble, Julie; Wheeler, Sue

2014-01-01

This study was a cooperative effort of the Texas-ACT College Success Research Consortium, a research partnership between ACT and the following Texas four-year postsecondary institutions: (1) The University of Texas at Austin; (2) Texas A&M University at College Station; (3) Texas A&M University at Commerce; and (4) University of Texas--Pan…

33 CFR 165.804 - Snake Island, Texas City, Texas; mooring and fleeting of vessels-safety zone.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Snake Island, Texas City, Texas... Guard District § 165.804 Snake Island, Texas City, Texas; mooring and fleeting of vessels—safety zone... Turning Basin west of Snake Island; (3) The area of Texas City Channel from the north end of the Turning...

33 CFR 165.804 - Snake Island, Texas City, Texas; mooring and fleeting of vessels-safety zone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Snake Island, Texas City, Texas... Guard District § 165.804 Snake Island, Texas City, Texas; mooring and fleeting of vessels—safety zone... Turning Basin west of Snake Island; (3) The area of Texas City Channel from the north end of the Turning...

A Survey of U.S. Navy Medical Communications and Evacuations at Sea

DTIC Science & Technology

1984-07-05

specialized 0 sector of the health care system . The majority of these medical departments are headed by an independent duty corpsman who, unlike many...the U.S. Navy has focused increasing attention on the development and implementation of clinical algorithms and telemedicine systems to enhance...a computer assisted clinical algorithm system for use aboard submarines. 5- 7 Although initial work focused upon acute abdominal pain, future

An optimized compression algorithm for real-time ECG data transmission in wireless network of medical information systems.

PubMed

Cho, Gyoun-Yon; Lee, Seo-Joon; Lee, Tae-Ro

2015-01-01

Recent medical information systems are striving towards real-time monitoring models to care patients anytime and anywhere through ECG signals. However, there are several limitations such as data distortion and limited bandwidth in wireless communications. In order to overcome such limitations, this research focuses on compression. Few researches have been made to develop a specialized compression algorithm for ECG data transmission in real-time monitoring wireless network. Not only that, recent researches' algorithm is not appropriate for ECG signals. Therefore this paper presents a more developed algorithm EDLZW for efficient ECG data transmission. Results actually showed that the EDLZW compression ratio was 8.66, which was a performance that was 4 times better than any other recent compression method widely used today.

Government regulations and other influences on the medical use of computers.

PubMed

Mishelevich, D J; Grams, R R; Mize, S G; Smith, J P

1979-01-01

This paper presents points brought out in a panel discussion held at the 12th Hawaiian International Conference on System Sciences, January 1979. The session was attended by approximately two dozen interested parties from various segments of the academic, government, and health care communities. The broad categories covered include the specific problems of government regulations and their impact on specific clinical information systems installed at The University of Texas Health Science Center at Dallas, opportunities in a regulated environment, problems in a regulated environment, vendor-related issues in the marketing and manufacture of computer-based information systems, rational approaches to government control, and specific issues related to medical computer science.

Proceedings of the Third International Workshop on Neural Networks and Fuzzy Logic, volume 1

NASA Technical Reports Server (NTRS)

Culbert, Christopher J. (Editor)

1993-01-01

Documented here are papers presented at the Neural Networks and Fuzzy Logic Workshop sponsored by the National Aeronautics and Space Administration and cosponsored by the University of Houston, Clear Lake. The workshop was held June 1-3, 1992 at the Lyndon B. Johnson Space Center in Houston, Texas. During the three days approximately 50 papers were presented. Technical topics addressed included adaptive systems; learning algorithms; network architectures; vision; robotics; neurobiological connections; speech recognition and synthesis; fuzzy set theory and application, control, and dynamics processing; space applications; fuzzy logic and neural network computers; approximate reasoning; and multiobject decision making.

Applications of the JARS method to study levee sites in southern Texas and southern New Mexico

USGS Publications Warehouse

Ivanov, J.; Miller, R.D.; Xia, J.; Dunbar, J.B.

2007-01-01

We apply the joint analysis of refractions with surface waves (JARS) method to several sites and compare its results to traditional refraction-tomography methods in efforts of finding a more realistic solution to the inverse refraction-traveltime problem. The JARS method uses a reference model, derived from surface-wave shear-wave velocity estimates, as a constraint. In all of the cases JARS estimates appear more realistic than those from the conventional refraction-tomography methods. As a result, we consider, the JARS algorithm as the preferred method for finding solutions to the inverse refraction-tomography problems. ?? 2007 Society of Exploration Geophysicists.

Performance evaluation of image denoising developed using convolutional denoising autoencoders in chest radiography

NASA Astrophysics Data System (ADS)

Lee, Donghoon; Choi, Sunghoon; Kim, Hee-Joung

2018-03-01

When processing medical images, image denoising is an important pre-processing step. Various image denoising algorithms have been developed in the past few decades. Recently, image denoising using the deep learning method has shown excellent performance compared to conventional image denoising algorithms. In this study, we introduce an image denoising technique based on a convolutional denoising autoencoder (CDAE) and evaluate clinical applications by comparing existing image denoising algorithms. We train the proposed CDAE model using 3000 chest radiograms training data. To evaluate the performance of the developed CDAE model, we compare it with conventional denoising algorithms including median filter, total variation (TV) minimization, and non-local mean (NLM) algorithms. Furthermore, to verify the clinical effectiveness of the developed denoising model with CDAE, we investigate the performance of the developed denoising algorithm on chest radiograms acquired from real patients. The results demonstrate that the proposed denoising algorithm developed using CDAE achieves a superior noise-reduction effect in chest radiograms compared to TV minimization and NLM algorithms, which are state-of-the-art algorithms for image noise reduction. For example, the peak signal-to-noise ratio and structure similarity index measure of CDAE were at least 10% higher compared to conventional denoising algorithms. In conclusion, the image denoising algorithm developed using CDAE effectively eliminated noise without loss of information on anatomical structures in chest radiograms. It is expected that the proposed denoising algorithm developed using CDAE will be effective for medical images with microscopic anatomical structures, such as terminal bronchioles.

Bat-Inspired Algorithm Based Query Expansion for Medical Web Information Retrieval.

PubMed

Khennak, Ilyes; Drias, Habiba

2017-02-01

With the increasing amount of medical data available on the Web, looking for health information has become one of the most widely searched topics on the Internet. Patients and people of several backgrounds are now using Web search engines to acquire medical information, including information about a specific disease, medical treatment or professional advice. Nonetheless, due to a lack of medical knowledge, many laypeople have difficulties in forming appropriate queries to articulate their inquiries, which deem their search queries to be imprecise due the use of unclear keywords. The use of these ambiguous and vague queries to describe the patients' needs has resulted in a failure of Web search engines to retrieve accurate and relevant information. One of the most natural and promising method to overcome this drawback is Query Expansion. In this paper, an original approach based on Bat Algorithm is proposed to improve the retrieval effectiveness of query expansion in medical field. In contrast to the existing literature, the proposed approach uses Bat Algorithm to find the best expanded query among a set of expanded query candidates, while maintaining low computational complexity. Moreover, this new approach allows the determination of the length of the expanded query empirically. Numerical results on MEDLINE, the on-line medical information database, show that the proposed approach is more effective and efficient compared to the baseline.

The psychopharmacology algorithm project at the Harvard South Shore Program: an algorithm for acute mania.

PubMed

Mohammad, Othman; Osser, David N

2014-01-01

This new algorithm for the pharmacotherapy of acute mania was developed by the Psychopharmacology Algorithm Project at the Harvard South Shore Program. The authors conducted a literature search in PubMed and reviewed key studies, other algorithms and guidelines, and their references. Treatments were prioritized considering three main considerations: (1) effectiveness in treating the current episode, (2) preventing potential relapses to depression, and (3) minimizing side effects over the short and long term. The algorithm presupposes that clinicians have made an accurate diagnosis, decided how to manage contributing medical causes (including substance misuse), discontinued antidepressants, and considered the patient's childbearing potential. We propose different algorithms for mixed and nonmixed mania. Patients with mixed mania may be treated first with a second-generation antipsychotic, of which the first choice is quetiapine because of its greater efficacy for depressive symptoms and episodes in bipolar disorder. Valproate and then either lithium or carbamazepine may be added. For nonmixed mania, lithium is the first-line recommendation. A second-generation antipsychotic can be added. Again, quetiapine is favored, but if quetiapine is unacceptable, risperidone is the next choice. Olanzapine is not considered a first-line treatment due to its long-term side effects, but it could be second-line. If the patient, whether mixed or nonmixed, is still refractory to the above medications, then depending on what has already been tried, consider carbamazepine, haloperidol, olanzapine, risperidone, and valproate first tier; aripiprazole, asenapine, and ziprasidone second tier; and clozapine third tier (because of its weaker evidence base and greater side effects). Electroconvulsive therapy may be considered at any point in the algorithm if the patient has a history of positive response or is intolerant of medications.

Algorithm for Screening Phasor Measurement Unit Data for Power System Events and Categories and Common Characteristics for Events Seen in Phasor Measurement Unit Relative Phase-Angle Differences and Frequency Signals

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

Allen, A.; Santoso, S.; Muljadi, E.

2013-08-01

A network of multiple phasor measurement units (PMU) was created, set up, and maintained at the University of Texas at Austin to obtain actual power system measurements for power system analysis. Power system analysis in this report covers a variety of time ranges, such as short- term analysis for power system disturbances and their effects on power system behavior and long- term power system behavior using modal analysis. The first objective of this report is to screen the PMU data for events. The second objective of the report is to identify and describe common characteristics extracted from power system eventsmore » as measured by PMUs. The numerical characteristics for each category and how these characteristics are used to create selection rules for the algorithm are also described. Trends in PMU data related to different levels and fluctuations in wind power output are also examined.« less

76 FR 7833 - Texas Eastern Transmission, LP; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-11

...] Texas Eastern Transmission, LP; Notice of Application Take notice that on January 25, 2011, Texas Eastern Transmission, LP (Texas Eastern), 5400 Westheimer Court, Houston, Texas 77056, filed in the above... TEAM 2012 Project. Specifically, Texas Eastern requests: (i) Authorization under NGA sections 7(b) and...

Evaluating ACLS Algorithms for the International Space Station (ISS) - A Paradigm Revisited

NASA Technical Reports Server (NTRS)

Alexander, Dave; Brandt, Keith; Locke, James; Hurst, Victor, IV; Mack, Michael D.; Pettys, Marianne; Smart, Kieran

2007-01-01

The ISS may have communication gaps of up to 45 minutes during each orbit and therefore it is imperative to have medical protocols, including an effective ACLS algorithm, that can be reliably autonomously executed during flight. The aim of this project was to compare the effectiveness of the current ACLS algorithm with an improved algorithm having a new navigation format.

Endangered Species Management Plan for Fort Hood, Texas: FY06-10

DTIC Science & Technology

2007-05-01

Texas red oak, post oak, Texas ash (Fraxinus texensis), shin oak, blackjack oak (Quercus marilandica), slippery elm (Ulmus rubra), cedar elm ...by Ashe juniper and Texas oak. Other important tree species included live oak, cedar elm (Ulmus crassifolia), Lacey oak (Quercus laceyi), Arizona...0.83 m (Cimprich 2005). Nest substrates include shin oak, Texas red oak, Texas redbud, Ashe juniper, Texas ash, Plateau live oak, cedar elm , rusty

Novel Algorithm for Classification of Medical Images

NASA Astrophysics Data System (ADS)

Bhushan, Bharat; Juneja, Monika

2010-11-01

Content-based image retrieval (CBIR) methods in medical image databases have been designed to support specific tasks, such as retrieval of medical images. These methods cannot be transferred to other medical applications since different imaging modalities require different types of processing. To enable content-based queries in diverse collections of medical images, the retrieval system must be familiar with the current Image class prior to the query processing. Further, almost all of them deal with the DICOM imaging format. In this paper a novel algorithm based on energy information obtained from wavelet transform for the classification of medical images according to their modalities is described. For this two types of wavelets have been used and have been shown that energy obtained in either case is quite distinct for each of the body part. This technique can be successfully applied to different image formats. The results are shown for JPEG imaging format.

Basic management of medical emergencies: recognizing a patient's distress.

PubMed

Reed, Kenneth L

2010-05-01

Medical emergencies can happen in the dental office, possibly threatening a patient's life and hindering the delivery of dental care. Early recognition of medical emergencies begins at the first sign of symptoms. The basic algorithm for management of all medical emergencies is this: position (P), airway (A), breathing (B), circulation (C) and definitive treatment, differential diagnosis, drugs, defibrillation (D). The dentist places an unconscious patient in a supine position and comfortably positions a conscious patient. The dentist then assesses airway, breathing and circulation and, when necessary, supports the patient's vital functions. Drug therapy always is secondary to basic life support (that is, PABCD). Prompt recognition and efficient management of medical emergencies by a well-prepared dental team can increase the likelihood of a satisfactory outcome. The basic algorithm for managing medical emergencies is designed to ensure that the patient's brain receives a constant supply of blood containing oxygen.

Medical subdomain classification of clinical notes using a machine learning-based natural language processing approach.

PubMed

Weng, Wei-Hung; Wagholikar, Kavishwar B; McCray, Alexa T; Szolovits, Peter; Chueh, Henry C

2017-12-01

The medical subdomain of a clinical note, such as cardiology or neurology, is useful content-derived metadata for developing machine learning downstream applications. To classify the medical subdomain of a note accurately, we have constructed a machine learning-based natural language processing (NLP) pipeline and developed medical subdomain classifiers based on the content of the note. We constructed the pipeline using the clinical NLP system, clinical Text Analysis and Knowledge Extraction System (cTAKES), the Unified Medical Language System (UMLS) Metathesaurus, Semantic Network, and learning algorithms to extract features from two datasets - clinical notes from Integrating Data for Analysis, Anonymization, and Sharing (iDASH) data repository (n = 431) and Massachusetts General Hospital (MGH) (n = 91,237), and built medical subdomain classifiers with different combinations of data representation methods and supervised learning algorithms. We evaluated the performance of classifiers and their portability across the two datasets. The convolutional recurrent neural network with neural word embeddings trained-medical subdomain classifier yielded the best performance measurement on iDASH and MGH datasets with area under receiver operating characteristic curve (AUC) of 0.975 and 0.991, and F1 scores of 0.845 and 0.870, respectively. Considering better clinical interpretability, linear support vector machine-trained medical subdomain classifier using hybrid bag-of-words and clinically relevant UMLS concepts as the feature representation, with term frequency-inverse document frequency (tf-idf)-weighting, outperformed other shallow learning classifiers on iDASH and MGH datasets with AUC of 0.957 and 0.964, and F1 scores of 0.932 and 0.934 respectively. We trained classifiers on one dataset, applied to the other dataset and yielded the threshold of F1 score of 0.7 in classifiers for half of the medical subdomains we studied. Our study shows that a supervised learning-based NLP approach is useful to develop medical subdomain classifiers. The deep learning algorithm with distributed word representation yields better performance yet shallow learning algorithms with the word and concept representation achieves comparable performance with better clinical interpretability. Portable classifiers may also be used across datasets from different institutions.

Performance characterization of image and video analysis systems at Siemens Corporate Research

NASA Astrophysics Data System (ADS)

Ramesh, Visvanathan; Jolly, Marie-Pierre; Greiffenhagen, Michael

2000-06-01

There has been a significant increase in commercial products using imaging analysis techniques to solve real-world problems in diverse fields such as manufacturing, medical imaging, document analysis, transportation and public security, etc. This has been accelerated by various factors: more advanced algorithms, the availability of cheaper sensors, and faster processors. While algorithms continue to improve in performance, a major stumbling block in translating improvements in algorithms to faster deployment of image analysis systems is the lack of characterization of limits of algorithms and how they affect total system performance. The research community has realized the need for performance analysis and there have been significant efforts in the last few years to remedy the situation. Our efforts at SCR have been on statistical modeling and characterization of modules and systems. The emphasis is on both white-box and black box methodologies to evaluate and optimize vision systems. In the first part of this paper we review the literature on performance characterization and then provide an overview of the status of research in performance characterization of image and video understanding systems. The second part of the paper is on performance evaluation of medical image segmentation algorithms. Finally, we highlight some research issues in performance analysis in medical imaging systems.

Aggregated Indexing of Biomedical Time Series Data

PubMed Central

Woodbridge, Jonathan; Mortazavi, Bobak; Sarrafzadeh, Majid; Bui, Alex A.T.

2016-01-01

Remote and wearable medical sensing has the potential to create very large and high dimensional datasets. Medical time series databases must be able to efficiently store, index, and mine these datasets to enable medical professionals to effectively analyze data collected from their patients. Conventional high dimensional indexing methods are a two stage process. First, a superset of the true matches is efficiently extracted from the database. Second, supersets are pruned by comparing each of their objects to the query object and rejecting any objects falling outside a predetermined radius. This pruning stage heavily dominates the computational complexity of most conventional search algorithms. Therefore, indexing algorithms can be significantly improved by reducing the amount of pruning. This paper presents an online algorithm to aggregate biomedical times series data to significantly reduce the search space (index size) without compromising the quality of search results. This algorithm is built on the observation that biomedical time series signals are composed of cyclical and often similar patterns. This algorithm takes in a stream of segments and groups them to highly concentrated collections. Locality Sensitive Hashing (LSH) is used to reduce the overall complexity of the algorithm, allowing it to run online. The output of this aggregation is used to populate an index. The proposed algorithm yields logarithmic growth of the index (with respect to the total number of objects) while keeping sensitivity and specificity simultaneously above 98%. Both memory and runtime complexities of time series search are improved when using aggregated indexes. In addition, data mining tasks, such as clustering, exhibit runtimes that are orders of magnitudes faster when run on aggregated indexes. PMID:27617298

[Medical computer-aided detection method based on deep learning].

PubMed

Tao, Pan; Fu, Zhongliang; Zhu, Kai; Wang, Lili

2018-03-01

This paper performs a comprehensive study on the computer-aided detection for the medical diagnosis with deep learning. Based on the region convolution neural network and the prior knowledge of target, this algorithm uses the region proposal network, the region of interest pooling strategy, introduces the multi-task loss function: classification loss, bounding box localization loss and object rotation loss, and optimizes it by end-to-end. For medical image it locates the target automatically, and provides the localization result for the next stage task of segmentation. For the detection of left ventricular in echocardiography, proposed additional landmarks such as mitral annulus, endocardial pad and apical position, were used to estimate the left ventricular posture effectively. In order to verify the robustness and effectiveness of the algorithm, the experimental data of ultrasonic and nuclear magnetic resonance images are selected. Experimental results show that the algorithm is fast, accurate and effective.

Cyber crimes.

PubMed

Nuzback, Kara

2014-07-01

Since it began offering cyber liability coverage in December 2011, the Texas Medical Liability Trust has received more than 150 cyber liability claims, most of which involved breaches of electronic protected health information. TMLT's cyber liability insurance will protect practices financially should a breach occur. The insurance covers a breach notification to customers and business partners, expenses for legal counsel, information security and forensic data services, public relations support, call center and website support, credit monitoring, and identity theft restoration services.

A Guide to the Estimation of the Hazard Presented by Chemicals in Human Milk.

DTIC Science & Technology

1985-11-01

Occupational and Environmental Health Laboratory Aerospace Medical Division (AFSC) Brooks Air Force Base , Texas 78235-5501 i "-_,-..,,," ,_. .,..,;.: 1...AD-RISS 651 A GUIDE TO THE ESTIMATION OF THE HZRR PRESENTED BY CHEMICALS IN HUMAN M.. (U) AIR FORCE OCCUPATIONAL ANo ENYIRONMENTAL HEALTH LAD BROOKS...illustration purposes and does not constitute endorsement or recommendation for use by the United States Air Force . Do not return this copy. Retain or

Operational Testing of Software-Intensive Systems: Observations and Comments

DTIC Science & Technology

2011-03-01

Hood and Camp Bowie , Texas, October 16–December 8, 2006. This phase included an engineering company, an attack helicopter troop, and a battalion (-) of... Arnold . 2007a. Test data report for the Black Hawk Utility Helicopter (UH-60M) Initial Operational Test Phase IIa, Medical Evacuation Helicopter (HH...60M) Ex- cursion. U.S. Army Operational Test Command, Febru- ary 2007. Manning, W., J. B. Bush, C. Scott, and C. Arnold . 2007b. Test data report for

A Case of Chagas Cardiomyopathy Following Infection in South Central Texas

DTIC Science & Technology

2017-05-24

author(s), title, etc.) has been entered into our computer file. Please advise us (by phone or mail) that your presentation was given. At that time , we...and time . Your contributions are vital to the medical mission. We look forward to assisting you in your future publication/presentation efforts...letter of approval or disapproval. 9. Once your manuscript, poster or presentation has been approved for a one- time public release, you may proceed with

Quantitative Analysis of the Contributing Factors Affecting Specialty Care No-Show Rates at Brooke Army Medical Center

DTIC Science & Technology

2007-03-30

2002). In the Vein Treatment Surgery Center in Texas, failure to properly cancel cosmetic appointments will result in forfeiture of the patients’ $100...appointments. This problem affects more than just the United States. Missed appointments cost the National Healthcare System ( NHS ) in England a...significant amount of money last year. Official figures from the NHS showed 5.7 million appointments were missed in 2004-2005 (Carvel, 2006). When patients

Microenvironment -Programmed Metastatic Prostate Cancer Stem Cells (mPCSCs)

DTIC Science & Technology

2016-10-01

accomplished all goals in Aims 1 and 2. Our lab recently relocated from the MD Anderson Cancer Center to Roswell Park Cancer Institute in Buffalo. We ...G. Tang, M.D., Ph.D. CONTRACTING ORGANIZATION: University of Texas MD Anderson Cancer Center Houston, TX 77030 REPORT DATE: October 2016 TYPE OF... Anderson Cancer Center Houston, TX 77030 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) U.S. Army Medical

A Case of Acquired Pulmonary Alveolar Proteinosis Successfully Treated with Whole Lung Lavage

DTIC Science & Technology

2016-05-18

DEPARTMENT OF THE AIR FORCE 59TH MEDICAL WING (AETC) JOINT BASE SAN ANTONIO - LACKLAND TEXAS MEMORANDUMFORSGVT ATTN: MAJ CHARLES BORDERS FROM...forward your request for funds to the designated wing POC. 4. Congratulations, and thank you for your efforts and time. Your contributions are vital...INTELLECTUAL PROPERTY RIGHTS AGREEMENT ETC.? D YES [gj NO NOTE: If the answer is YES then attach a copy of the Agreement to the Publications

Epidemoligic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides: Baseline Questionnaires

DTIC Science & Technology

1982-11-01

19M I Prepared for: The Surgeon General ~, United States Air Force Washington, D.C. 20314 USAF SCHOOL OF AEROSPACE MEDICINE Brooks Air Force Base...School of Aerospace Medicine , Aerospace Medical Division, AFSC, Brooks Air Force Base, Texas, under job order 2767-00-01. la When Government drawings...Wolfe. Ljeujenant; Colonel, USAF. M C S F. IlFONMING ORGANIZATION NAMS AND AODRESS 10. PROGRAM ELEMENT. PROJECT, TASKUSAF School of Aerospace Medicine

Physical Performance Assessment in Military Service Members

DTIC Science & Technology

2012-08-01

funded by a grant from the Military Amputee Research Program. The views expressed in this article are those of the authors and do not reflect the official...Fort Sam Houston, Texas . Partici- pants ranged in age from 18 to 43 years and had no current or recent history (within 6 months) of medical or...in older adults (age >65 years).17 How- ever, limited research exists regarding normal TSA in younger adults. We define TSA as the ability to ascend

CCL3L1-CCR5 Genotype Improves the Assessment of AIDS Risk in HIV-1-Infected Individuals

DTIC Science & Technology

2008-09-08

J. Dolan3,4,5,6*, Sunil K. Ahuja1,2,9* 1 Veterans Administration Research Center for AIDS and HIV-1 Infection, South Texas Veterans Health Care...States of America, 3 Infectious Disease Clinical Research Program, Uniformed Services University, Bethesda, Maryland, United States of America, 4...in Translational Research . Support for the Wilford Hall Medical Center cohort was provided by the Infectious Disease Clinical Research Program (IDCRP

Injuries after Hurricane Katrina among Gulf Coast Evacuees sheltered in Houston, Texas.

PubMed

Faul, Mark; Weller, Nancy F; Jones, Julie A

2011-09-01

After Hurricane Katrina and a decline in the living conditions at a major temporary shelter in New Orleans, Louisiana, residents were offered transport to a Mega-Shelter in Houston, Texas. Approximately 200,000 Gulf Coast residents were transported to Houston's Astrodome/Reliant Center Complex for appropriate triage and transfer to other shelter facilities. The Katrina Clinic was quickly organized to treat evacuees with acute injuries and illnesses as well as chronic medical conditions. Clinic physicians documented 1130 hurricane-related injuries during Katrina Clinic's operational interval, September 1-22, 2005. This article documents the nature, extent, and location of injuries treated at that clinic. We compare the frequency of injury among Katrina evacuees who visited the clinic to that of injuries among clinic outpatient records recorded in a nationally representative database. Using the Barell Matrix system and codes from the International Classification of Diseases, Ninth Revision, we classify Katrina injuries by body region and nature of injury; we also document the large number of hurricane-related immunizations distributed at the temporary outpatient clinic. The results show a 42% higher injury proportion among Katrina evacuees and that approximately half of all of the evacuees required immunizations. Lower leg extremity injuries were among the most frequent injuries. Future planning for hurricanes should take into account nonfatal injuries requiring medical treatment and other supportive care. Copyright © 2011 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

Curricular Innovation in the Surgery Clerkship: Can Assessment Methods Influence Development of Critical Thinking and Clinical Skills?

PubMed

McClintic, James A; Snyder, Clifford L; Brown, Kimberly M

2018-03-12

Although key clinical skills have been defined in the Core Entrustable Professional Activities, there is a need to improve medical school curricula with standardized training opportunities and assessments of these skills. Thus, we aimed to develop an innovative curriculum that emphasized critical thinking and clinical skills. We hypothesized that we would be able to observe measurable improvement on assessments of students' critical thinking and clinical skills after the implementation of the new curriculum. Prospective, Quasi-Experimental study with the use of historical controls. This study took place through the third-year surgical clerkship at the University of Texas Medical Branch at the Galveston, Houston, and Austin, Texas, locations. A total of 214 students taking the third-year surgical clerkship for the first time during the periods of interest were included. Although the students with traditional curriculum improved 9.5% on a short answer exam from preclerkship to postclerkship completion, the students with new curriculum improved by 40%. Students under the new curriculum performed significantly better on the Objective Structured Clinical Exam; however, their shelf scores were lower. Under this new curriculum and grading system, we demonstrated that students can be incentivized to improve critical thinking and clinical skills, but this needs to be balanced with knowledge-based incentives. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

DNA contents in Texas bluegrass (Poa arachnifera) selected in Texas and Oklahoma determined by flow cytometry

USDA-ARS?s Scientific Manuscript database

Texas bluegrass (Poa arachnifera Torr.) is a dioecious, perennial, cool-season grass native to southern Kansas, Oklahoma, western Arkansas and most of Texas. Its major use has been for forage on rangelands in Texas and Oklahoma. More recently, interspecific hybrids between Texas bluegrass and Kentuc...

Analysis of behavioral risk factor surveillance system data to assess the health of Hispanic Americans with diabetes in El Paso County, Texas.

PubMed

Martinez, Nelda C; Bader, Julia

2007-01-01

The purpose of this study is to determine and describe the health of Hispanic Americans who live in El Paso County, Texas, along the US-Mexico border, particularly the multidimensional self-management practices of those with diabetes. This study also assesses Hispanic Americans with diabetes consistent with Healthy People 2010 diabetes goals and objectives. Data from the 2002 Paso del Norte Behavioral Risk Factor Surveillance System are used for analysis of behavioral health risk factors associated with diabetes among Hispanic Americans in El Paso County, Texas. One- and two-way frequency tables with logistic regression and tests for comparison of means are used for data analysis. The greatest numbers of Hispanic American residents are younger, with those diagnosed with diabetes aged 45 years and older and with lower level of education, lowest income level, and unable to work. The odds of having diabetes are 4 times greater with increasing age and 6 times greater with lower income level. The type of medical treatment is consistent with the frequency of various diabetes self-management behaviors to optimize health. Hispanic Americans are within the goal for several Healthy People 2010 targets for diabetes. Hispanic Americans along the US-Mexico border remain at risk for development of diabetes, although several self-management behavioral activities are recognized as important for prevention of diabetes to optimize quality of life.

Illness Symptoms Experienced by Children Exposed to Benzene After a Flaring Incident at the BP Refinery Facility in Texas City.

PubMed

D'Andrea, Mark A; Reddy, G Kesava

2016-10-01

Objective To evaluate the illness symptoms experienced by children who were exposed to benzene following a flaring incident at the BP refinery in Texas City, Texas. Methods A total of 641 children, aged <17 years, exposed to benzene were included. Using medical charts, data on the children's illness symptoms as well as the serum levels of β-2-microglobulin and the amount of urinary excretion of phenol were reviewed and analyzed. Results A total of 1790 illness symptoms were reported in 641 children exposed to benzene. Upper respiratory symptoms were the most (67%) frequently reported, followed by neurological symptoms (57%), diarrhea (25%), and cough (24%). Logistic regression analysis indicated that neurological symptoms (R(2) = 0.75), chest pain (R(2) = 0.64), joint pain (R(2) = 0.57), and vision difficulty (R(2) = 0.54) were positively associated with increasing age. β-2-Microglobulin levels were significantly higher in children <5 years compared with those >5 year (P = .04). Conversely, urinary phenol levels were significantly lower in children <5 years compared with those >5 years (P = .00). Conclusion Together, these findings reveal that children exposed to benzene experience a range of illness symptoms and an altered profile of urinary phenol indicating their vulnerability to potentially increased health complications. © The Author(s) 2016.

Texas Pulse Oximetry Project: A Multicenter Educational and Quality Improvement Project for Implementation of Critical Congenital Heart Disease Screening Using Pulse Oximetry.

PubMed

Guillory, Charleta; Gong, Alice; Livingston, Judith; Creel, Liza; Ocampo, Elena; McKee-Garrett, Tiffany

2017-07-01

Objective  Critical congenital heart disease (CCHD) is a leading cause of death in infants. Newborn screening (NBS) by pulse oximetry allows early identification of CCHD in asymptomatic newborns. To improve readiness of hospital neonatal birthing facilities for mandatory screening in Texas, an educational and quality improvement (QI) project was piloted to identify an implementation strategy for CCHD NBS in a range of birthing hospitals. Study Design  Thirteen Texas hospitals implemented standardized CCHD screening by pulse oximetry. An educational program was devised and a tool kit was created to facilitate education and implementation. Newborn nursery nurses' knowledge was assessed using a pre- and posttest instrument. Results  The nurses' knowledge assessment improved from 71 to 92.5% ( p  < 0.0001). Of 11,322 asymptomatic newborns screened after 24 hours of age, 11 had a positive screen, with 1 confirmed case of CCHD. Pulse oximetry CCHD NBS had sensitivity of 100%, specificity of 99.91%, false-positive rate of 0.088%, positive predictive value of 9.09%, and negative predictive value of 100%. Conclusion  Our educational program, including a tool kit, QI processes, and standardized pulse oximetry CCHD NBS, is applicable for a range of hospital birthing facilities and may facilitate wide-scale implementation, thereby improving newborn health. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Medical image segmentation based on SLIC superpixels model

NASA Astrophysics Data System (ADS)

Chen, Xiang-ting; Zhang, Fan; Zhang, Ruo-ya

2017-01-01

Medical imaging has been widely used in clinical practice. It is an important basis for medical experts to diagnose the disease. However, medical images have many unstable factors such as complex imaging mechanism, the target displacement will cause constructed defect and the partial volume effect will lead to error and equipment wear, which increases the complexity of subsequent image processing greatly. The segmentation algorithm which based on SLIC (Simple Linear Iterative Clustering, SLIC) superpixels is used to eliminate the influence of constructed defect and noise by means of the feature similarity in the preprocessing stage. At the same time, excellent clustering effect can reduce the complexity of the algorithm extremely, which provides an effective basis for the rapid diagnosis of experts.

A Comparison of different learning models used in Data Mining for Medical Data

NASA Astrophysics Data System (ADS)

Srimani, P. K.; Koti, Manjula Sanjay

2011-12-01

The present study aims at investigating the different Data mining learning models for different medical data sets and to give practical guidelines to select the most appropriate algorithm for a specific medical data set. In practical situations, it is absolutely necessary to take decisions with regard to the appropriate models and parameters for diagnosis and prediction problems. Learning models and algorithms are widely implemented for rule extraction and the prediction of system behavior. In this paper, some of the well-known Machine Learning(ML) systems are investigated for different methods and are tested on five medical data sets. The practical criteria for evaluating different learning models are presented and the potential benefits of the proposed methodology for diagnosis and learning are suggested.

Effects of Simulated Microgravity on the Expression Profile of Microrna in Human Lymphoblastoid Cells

NASA Astrophysics Data System (ADS)

Zhang, Ye; Wu, Honglu; Ramesh, Govindarajan; Rohde, Larry; Story, Michael; Mangala, Lingegowda

2012-07-01

EFFECTS OF SIMULATED MICROGRAVITY ON THE EXPRESSION PROFILE OF MICRORNA IN HUMAN LYMPHOBLASTOID CELLS Lingegowda S. Mangala1,2, Ye Zhang1,3, Zhenhua He2, Kamal Emami1, Govindarajan T. Ramesh4, Michael Story 5, Larry H. Rohde2, and Honglu Wu1 1 NASA Johnson Space Center, Houston, Texas, USA 2 University of Houston Clear Lake, Houston, Texas, USA 3 Wyle Integrated Science and Engineering Group, Houston, Texas, USA 4 Norfolk State University, Norfolk, VA, USA 5 University of Texas, Southwestern Medical Center, Dallas, Texas, USA This study explores the changes in expression of microRNA (miRNA) and related genes under simulated microgravity conditions. In comparison to static 1g, microgravity has been shown to alter global gene expression patterns and protein levels in cultured cells or animals. miRNA has recently emerged as an important regulator of gene expression, possibly regulating as many as one-third of all human genes. However, very little is known about the effect of altered gravity on miRNA expression. To test the hypothesis that the miRNA expression profile would be altered in zero gravity resulting in altered regulation of gene expression leading to metabolic or functional changes in cells, we cultured TK6 human lymphoblastoid cells in a High Aspect Ratio Vessel (HARV; bioreactor) for 72 h either in the rotating condition to model microgravity in space or in the static condition as a control. Expression of several miRNA was changed significantly in the simulated microgravity condition including miR-150, miR-34a, miR-423-5p, miR-22 and miR-141, miR-618 and miR-222. To confirm whether this altered miRNA expression correlates with gene expression and functional changes of the cells, we performed DNA microarray and validated the related genes using q-RT PCR. Network and pathway analysis of gene and miRNA expression profiles indicates that the regulation of cell communication and catalytic activities, as well as pathways involved in immune response_IL-15 signaling and NGF mediated NF-kB activation were significantly altered under the simulated microgravity condition.

Characterization of Pollution Transport into Texas Using OMI and TES Satellite and In Situ data, and HYSPLIT Back Trajectory Analyses: implications for TCEQ State Implementation Plans and High School/Undergraduate STEM Education

NASA Astrophysics Data System (ADS)

Boxe, C.; Bella, D.; Khaimova, J.; Culpepper, J.; Ahmed, N.; Belkalai, A.; Ealy, J.; Arroyo, I.; Lahoumh, M.; Jenkins, O.; Emmanuel, S.; Andrews, J.; Fu, D.; Wu, L.; Choi, Y.; Morris, G.; Osterman, G. B.; Johnson, L. P.; Austin, S. A.

2014-12-01

Using an online trajectory analysis tool NASA, ArcGIS, Satellite and EPA in situ data, we assess whether high pollution events in Texas are primarily sourced locally or remotely. We focus satellite data that exemplify high O3 and NO2 over Texas's lower troposphere. Four day back trajectory analyses of all dates show that upper-, mid-, and lower-tropospheric air over Texas, containing high O3, is transported from the Gulf of Mexico, Southeast USA, Midwest USA, Northeast USA, the Atlantic Ocean, Pacific Ocean, Mexico, etc. Only day showed air at 1 km is sourced within Texas. Satellite data show O3 enhancements in the boundary layer and O3 and NO2 enhancements via tropospheric column profiles. These enhancements complement four-day trajectory analysis. This study provides a viable basis for more quantifiable and accurate information for developing effective air quality State Implementation Plans. STEM Impact: (i) D. Bella was an NSF-LSAMP undergraduate research mentee with me at Medgar Evers College-CUNY; she received a B.S. in Environmental Science (and a Chemistry Minor) and is now a Ph.D. graduate student at University at Albany's School of Public Health. (ii) J. Khaimova is an undergraduate Geology and Planetary Science B.S. major at Brooklyn College-CUNY. I have supported Jessica's summer internship in summer 2013 as a CUNY Summer Research Fellow, where she is currently an NSF-REU research mentee at Pennsylvania State University's Meteorology Department. (iii) J. Culpepper received his B.S. in Environmental Science from MEC-CUNY and will be a Ph.D. student, Fall 2014 at University of Iowa's Civil and Environmental Engineering Department. (iv) S. Gentle was a high school researcher with me within ACS's Project SEED Program for high school students. S. Gentle will start her undergraduate career Fall 2014 at Pennsylvania State University and seeks to attain a B.S. in Chemistry. (v). All parties, including high school and undergraduate researchers seek to attend medical/graduate school to pursue an M.D/Ph.D. in a STEM-discipline.

A Parallel Point Matching Algorithm for Landmark Based Image Registration Using Multicore Platform

PubMed Central

Yang, Lin; Gong, Leiguang; Zhang, Hong; Nosher, John L.; Foran, David J.

2013-01-01

Point matching is crucial for many computer vision applications. Establishing the correspondence between a large number of data points is a computationally intensive process. Some point matching related applications, such as medical image registration, require real time or near real time performance if applied to critical clinical applications like image assisted surgery. In this paper, we report a new multicore platform based parallel algorithm for fast point matching in the context of landmark based medical image registration. We introduced a non-regular data partition algorithm which utilizes the K-means clustering algorithm to group the landmarks based on the number of available processing cores, which optimize the memory usage and data transfer. We have tested our method using the IBM Cell Broadband Engine (Cell/B.E.) platform. The results demonstrated a significant speed up over its sequential implementation. The proposed data partition and parallelization algorithm, though tested only on one multicore platform, is generic by its design. Therefore the parallel algorithm can be extended to other computing platforms, as well as other point matching related applications. PMID:24308014

Quantum associative memory with linear and non-linear algorithms for the diagnosis of some tropical diseases.

PubMed

Tchapet Njafa, J-P; Nana Engo, S G

2018-01-01

This paper presents the QAMDiagnos, a model of Quantum Associative Memory (QAM) that can be a helpful tool for medical staff without experience or laboratory facilities, for the diagnosis of four tropical diseases (malaria, typhoid fever, yellow fever and dengue) which have several similar signs and symptoms. The memory can distinguish a single infection from a polyinfection. Our model is a combination of the improved versions of the original linear quantum retrieving algorithm proposed by Ventura and the non-linear quantum search algorithm of Abrams and Lloyd. From the given simulation results, it appears that the efficiency of recognition is good when particular signs and symptoms of a disease are inserted given that the linear algorithm is the main algorithm. The non-linear algorithm helps confirm or correct the diagnosis or give some advice to the medical staff for the treatment. So, our QAMDiagnos that has a friendly graphical user interface for desktop and smart-phone is a sensitive and a low-cost diagnostic tool that enables rapid and accurate diagnosis of four tropical diseases. Copyright © 2017 Elsevier Ltd. All rights reserved.

Volumetric visualization algorithm development for an FPGA-based custom computing machine

NASA Astrophysics Data System (ADS)

Sallinen, Sami J.; Alakuijala, Jyrki; Helminen, Hannu; Laitinen, Joakim

1998-05-01

Rendering volumetric medical images is a burdensome computational task for contemporary computers due to the large size of the data sets. Custom designed reconfigurable hardware could considerably speed up volume visualization if an algorithm suitable for the platform is used. We present an algorithm and speedup techniques for visualizing volumetric medical CT and MR images with a custom-computing machine based on a Field Programmable Gate Array (FPGA). We also present simulated performance results of the proposed algorithm calculated with a software implementation running on a desktop PC. Our algorithm is capable of generating perspective projection renderings of single and multiple isosurfaces with transparency, simulated X-ray images, and Maximum Intensity Projections (MIP). Although more speedup techniques exist for parallel projection than for perspective projection, we have constrained ourselves to perspective viewing, because of its importance in the field of radiotherapy. The algorithm we have developed is based on ray casting, and the rendering is sped up by three different methods: shading speedup by gradient precalculation, a new generalized version of Ray-Acceleration by Distance Coding (RADC), and background ray elimination by speculative ray selection.

Characterization and error analysis of an operational retrieval algorithm for estimating column ozone and aerosol properties from ground-based ultra-violet irradiance measurements

NASA Astrophysics Data System (ADS)

Taylor, Thomas E.; L'Ecuyer, Tristan; Slusser, James; Stephens, Graeme; Krotkov, Nick; Davis, John; Goering, Christian

2005-08-01

Extensive sensitivity and error characteristics of a recently developed optimal estimation retrieval algorithm which simultaneously determines aerosol optical depth (AOD), aerosol single scatter albedo (SSA) and total ozone column (TOC) from ultra-violet irradiances are described. The algorithm inverts measured diffuse and direct irradiances at 7 channels in the UV spectral range obtained from the United States Department of Agriculture's (USDA) UV-B Monitoring and Research Program's (UVMRP) network of 33 ground-based UV-MFRSR instruments to produce aerosol optical properties and TOC at all seven wavelengths. Sensitivity studies of the Tropospheric Ultra-violet/Visible (TUV) radiative transfer model performed for various operating modes (Delta-Eddington versus n-stream Discrete Ordinate) over domains of AOD, SSA, TOC, asymmetry parameter and surface albedo show that the solutions are well constrained. Realistic input error budgets and diagnostic and error outputs from the retrieval are analyzed to demonstrate the atmospheric conditions under which the retrieval provides useful and significant results. After optimizing the algorithm for the USDA site in Panther Junction, Texas the retrieval algorithm was run on a cloud screened set of irradiance measurements for the month of May 2003. Comparisons to independently derived AOD's are favorable with root mean square (RMS) differences of about 3% to 7% at 300nm and less than 1% at 368nm, on May 12 and 22, 2003. This retrieval method will be used to build an aerosol climatology and provide ground-truthing of satellite measurements by running it operationally on the USDA UV network database.

Pediatric Medical Complexity Algorithm: A New Method to Stratify Children by Medical Complexity

PubMed Central

Cawthon, Mary Lawrence; Stanford, Susan; Popalisky, Jean; Lyons, Dorothy; Woodcox, Peter; Hood, Margaret; Chen, Alex Y.; Mangione-Smith, Rita

2014-01-01

OBJECTIVES: The goal of this study was to develop an algorithm based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), codes for classifying children with chronic disease (CD) according to level of medical complexity and to assess the algorithm’s sensitivity and specificity. METHODS: A retrospective observational study was conducted among 700 children insured by Washington State Medicaid with ≥1 Seattle Children’s Hospital emergency department and/or inpatient encounter in 2010. The gold standard population included 350 children with complex chronic disease (C-CD), 100 with noncomplex chronic disease (NC-CD), and 250 without CD. An existing ICD-9-CM–based algorithm called the Chronic Disability Payment System was modified to develop a new algorithm called the Pediatric Medical Complexity Algorithm (PMCA). The sensitivity and specificity of PMCA were assessed. RESULTS: Using hospital discharge data, PMCA’s sensitivity for correctly classifying children was 84% for C-CD, 41% for NC-CD, and 96% for those without CD. Using Medicaid claims data, PMCA’s sensitivity was 89% for C-CD, 45% for NC-CD, and 80% for those without CD. Specificity was 90% to 92% in hospital discharge data and 85% to 91% in Medicaid claims data for all 3 groups. CONCLUSIONS: PMCA identified children with C-CD (who have accessed tertiary hospital care) with good sensitivity and good to excellent specificity when applied to hospital discharge or Medicaid claims data. PMCA may be useful for targeting resources such as care coordination to children with C-CD. PMID:24819580

76 FR 23322 - Change in Bank Control Notices; Acquisitions of Shares of a Bank or Bank Holding Company

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-26

... Street, Dallas, Texas 75201-2272: 1. Jonathan Ross Kasling of Hughes Springs, Texas, Individually; Mayo Givens Kasling III of Hughes Springs, Texas, Individually; Jonathan Ross Kasling of Hughes Springs, Texas; Mayo Givens Kasling III of Hughes Springs, Texas; Mayo Givens Kasling, Jr. of Hughes Springs, Texas and...

78 FR 19268 - Change in Bank Control Notices; Acquisitions of Shares of a Bank or Bank Holding Company

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-29

... Street, Dallas, Texas 75201-2272: 1. Larry Alton Jobe, Dallas, Texas; Leland A. Jobe, Dallas, Texas; Jennifer M. Jobe, Dallas, Texas; Lezlie MacElroy, Pilot Point, Texas; and Lorrie J. Fry, Austin, Texas... FEDERAL RESERVE SYSTEM Change in Bank Control Notices; Acquisitions of Shares of a Bank or Bank...

Local-search based prediction of medical image registration error

NASA Astrophysics Data System (ADS)

Saygili, Görkem

2018-03-01

Medical image registration is a crucial task in many different medical imaging applications. Hence, considerable amount of work has been published recently that aim to predict the error in a registration without any human effort. If provided, these error predictions can be used as a feedback to the registration algorithm to further improve its performance. Recent methods generally start with extracting image-based and deformation-based features, then apply feature pooling and finally train a Random Forest (RF) regressor to predict the real registration error. Image-based features can be calculated after applying a single registration but provide limited accuracy whereas deformation-based features such as variation of deformation vector field may require up to 20 registrations which is a considerably high time-consuming task. This paper proposes to use extracted features from a local search algorithm as image-based features to estimate the error of a registration. The proposed method comprises a local search algorithm to find corresponding voxels between registered image pairs and based on the amount of shifts and stereo confidence measures, it predicts the amount of registration error in millimetres densely using a RF regressor. Compared to other algorithms in the literature, the proposed algorithm does not require multiple registrations, can be efficiently implemented on a Graphical Processing Unit (GPU) and can still provide highly accurate error predictions in existence of large registration error. Experimental results with real registrations on a public dataset indicate a substantially high accuracy achieved by using features from the local search algorithm.

Medical-Grade Channel Access and Admission Control in 802.11e EDCA for Healthcare Applications

PubMed Central

Son, Sunghwa; Park, Kyung-Joon; Park, Eun-Chan

2016-01-01

In this paper, we deal with the problem of assuring medical-grade quality of service (QoS) for real-time medical applications in wireless healthcare systems based on IEEE 802.11e. Firstly, we show that the differentiated channel access of IEEE 802.11e cannot effectively assure medical-grade QoS because of priority inversion. To resolve this problem, we propose an efficient channel access algorithm. The proposed algorithm adjusts arbitrary inter-frame space (AIFS) in the IEEE 802.11e protocol depending on the QoS measurement of medical traffic, to provide differentiated near-absolute priority for medical traffic. In addition, based on rigorous capacity analysis, we propose an admission control scheme that can avoid performance degradation due to network overload. Via extensive simulations, we show that the proposed mechanism strictly assures the medical-grade QoS and improves the throughput of low-priority traffic by more than several times compared to the conventional IEEE 802.11e. PMID:27490666

Constructing Benchmark Databases and Protocols for Medical Image Analysis: Diabetic Retinopathy

PubMed Central

Kauppi, Tomi; Kämäräinen, Joni-Kristian; Kalesnykiene, Valentina; Sorri, Iiris; Uusitalo, Hannu; Kälviäinen, Heikki

2013-01-01

We address the performance evaluation practices for developing medical image analysis methods, in particular, how to establish and share databases of medical images with verified ground truth and solid evaluation protocols. Such databases support the development of better algorithms, execution of profound method comparisons, and, consequently, technology transfer from research laboratories to clinical practice. For this purpose, we propose a framework consisting of reusable methods and tools for the laborious task of constructing a benchmark database. We provide a software tool for medical image annotation helping to collect class label, spatial span, and expert's confidence on lesions and a method to appropriately combine the manual segmentations from multiple experts. The tool and all necessary functionality for method evaluation are provided as public software packages. As a case study, we utilized the framework and tools to establish the DiaRetDB1 V2.1 database for benchmarking diabetic retinopathy detection algorithms. The database contains a set of retinal images, ground truth based on information from multiple experts, and a baseline algorithm for the detection of retinopathy lesions. PMID:23956787

Ethics questions raised by the neuropsychiatric, neuropsychological, educational, developmental, and family characteristics of 18 juveniles awaiting execution in Texas.

PubMed

Lewis, Dorothy Otnow; Yeager, Catherine A; Blake, Pamela; Bard, Barbara; Strenziok, Maren

2004-01-01

Eighteen males condemned to death in Texas for homicides committed prior to the defendants' 18th birthdays received systematic psychiatric, neurologic, neuropsychological, and educational assessments, and all available medical, psychological, educational, social, and family data were reviewed. Six subjects began life with potentially compromised central nervous system (CNS) function (e.g., prematurity, respiratory distress syndrome). All but one experienced serious head traumas in childhood and adolescence. All subjects evaluated neurologically and neuropsychologically had signs of prefrontal cortical dysfunction. Neuropsychological testing was more sensitive to executive dysfunction than neurologic examination. Fifteen (83%) had signs, symptoms, and histories consistent with bipolar spectrum, schizoaffective spectrum, or hypomanic disorders. Two subjects were intellectually limited, and one suffered from parasomnias and dissociation. All but one came from extremely violent and/or abusive families in which mental illness was prevalent in multiple generations. Implications regarding the ethics involved in matters of culpability and mitigation are considered.

Making lemonade from lemons: a case study on loss of space at the Dolph Briscoe, Jr. Library, University of Texas Health Science Center at San Antonio.

PubMed

Tobia, Rajia C; Feldman, Jonquil D

2010-01-01

The setting for this case study is the Dolph Briscoe, Jr. Library, University of Texas Health Science Center at San Antonio, a health sciences campus with medical, dental, nursing, health professions, and graduate schools. During 2008-2009, major renovations to the library building were completed including office space for a faculty development department, multipurpose classrooms, a 24/7 study area, study rooms, library staff office space, and an information commons. The impetus for changes to the library building was the decreasing need to house collections in an increasingly electronic environment, the need for office space for other departments, and growth of the student body. About 40% of the library building was remodeled or repurposed, with a loss of approximately 25% of the library's original space. Campus administration proposed changes to the library building, and librarians worked with administration, architects, and construction managers to seek renovation solutions that meshed with the library's educational mission.

Making lemonade from lemons: a case study on loss of space at the Dolph Briscoe, Jr. Library, University of Texas Health Science Center at San Antonio

PubMed Central

Tobia, Rajia C.; Feldman, Jonquil D.

2010-01-01

The setting for this case study is the Dolph Briscoe, Jr. Library, University of Texas Health Science Center at San Antonio, a health sciences campus with medical, dental, nursing, health professions, and graduate schools. During 2008–2009, major renovations to the library building were completed including office space for a faculty development department, multipurpose classrooms, a 24/7 study area, study rooms, library staff office space, and an information commons. The impetus for changes to the library building was the decreasing need to house collections in an increasingly electronic environment, the need for office space for other departments, and growth of the student body. About 40% of the library building was remodeled or repurposed, with a loss of approximately 25% of the library's original space. Campus administration proposed changes to the library building, and librarians worked with administration, architects, and construction managers to seek renovation solutions that meshed with the library's educational mission. PMID:20098652

Health hazard evaluation/toxicity determination report 74-16-272, Marathon Battery Company, Waco, Texas. [Hazards to personnel from nickel and cadmium exposure

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

Thoburn, T.W.; Larsen, L.R.

1976-03-01

A health hazard evaluation investigation was conducted by NIOSH at the Marathon Battery Company in Waco, Texas, acting on a request from an authorized employee representative regarding exposure to dust and fumes in maintenance and production areas in the nickel-cadmium battery assembly factory. The prevailing symptoms among the approximately 60 affected predominantly female employees, was nausea. Environmental evaluation revealed that a potential hazard exists to employees from exposure to nickel and cadmium dusts. Workers in 4 departments showed levels of cadmium and nickel in hair and urine above those found in the control group; workers in 2 of the 4more » departments also showed excessive symptomatology and physical findings indicating upper respiratory irritation. Air samples also showed some excessive levels of cadmium and nickel particularly in these same 2 departments. However, medical evaluation of employees failed to demonstrate any apparent serious occupationally induced illness.« less

Roadmap to developing a recombinant coronavirus S protein receptor-binding domain vaccine for severe acute respiratory syndrome

PubMed Central

Jiang, Shibo; Bottazzi, Maria Elena; Du, Lanying; Lustigman, Sara; Tseng, Chien-Te Kent; Curti, Elena; Jones, Kathryn; Zhan, Bin; Hotez, Peter J

2013-01-01

A subunit vaccine, RBD-S, is under development to prevent severe acute respiratory syndrome (SARS) caused by SARS coronavirus (SARS-CoV), which is classified by the US NIH as a category C pathogen. This vaccine is comprised of a recombinant receptor-binding domain (RBD) of the SARS-CoV spike (S) protein and formulated on alum, together with a synthetic glucopyranosyl lipid A. The vaccine would induce neutralizing antibodies without causing Th2-type immunopathology. Vaccine development is being led by the nonprofit product development partnership; Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development in collaboration with two academic partners (the New York Blood Center and University of Texas Medical Branch); an industrial partner (Immune Design Corporation); and Walter Reed Army Institute of Research. A roadmap for the product development of the RBD-S SARS vaccine is outlined with a goal to manufacture the vaccine for clinical testing within the next 5 years. PMID:23252385

When promotoras and technology meet: A qualitative analysis of promotoras’ use of small media to increase cancer screening among South Texas Latinos

PubMed Central

Fernandez, Maria E.; LaRue, Denise M.; Bartholomew, L. Kay

2012-01-01

Computer-based multimedia technologies can be used to tailor health messages, but promotoras (Spanish-speaking community health workers) rarely use these tools. Promotoras delivered health messages about colorectal cancer screening to medically underserved Latinos in South Texas using two small media formats: a “low-tech” format (flipchart and video); and a “high-tech” format consisting of a tailored, interactive computer program delivered on a tablet computer. Using qualitative methods, we observed promotora training and intervention delivery, and conducted interviews with five promotoras to compare and contrast program implementation of both formats. We discuss the ways each format aided or challenged promotoras’ intervention delivery. Findings reveal that some aspects of both formats enhanced intervention delivery by tapping into Latino health communication preferences and facilitating interpersonal communication, while other aspects hindered intervention delivery. This study contributes to our understanding of how community health workers use low- and high-tech small media formats when delivering health messages to Latinos. PMID:21986243

Max-margin weight learning for medical knowledge network.

PubMed

Jiang, Jingchi; Xie, Jing; Zhao, Chao; Su, Jia; Guan, Yi; Yu, Qiubin

2018-03-01

The application of medical knowledge strongly affects the performance of intelligent diagnosis, and method of learning the weights of medical knowledge plays a substantial role in probabilistic graphical models (PGMs). The purpose of this study is to investigate a discriminative weight-learning method based on a medical knowledge network (MKN). We propose a training model called the maximum margin medical knowledge network (M 3 KN), which is strictly derived for calculating the weight of medical knowledge. Using the definition of a reasonable margin, the weight learning can be transformed into a margin optimization problem. To solve the optimization problem, we adopt a sequential minimal optimization (SMO) algorithm and the clique property of a Markov network. Ultimately, M 3 KN not only incorporates the inference ability of PGMs but also deals with high-dimensional logic knowledge. The experimental results indicate that M 3 KN obtains a higher F-measure score than the maximum likelihood learning algorithm of MKN for both Chinese Electronic Medical Records (CEMRs) and Blood Examination Records (BERs). Furthermore, the proposed approach is obviously superior to some classical machine learning algorithms for medical diagnosis. To adequately manifest the importance of domain knowledge, we numerically verify that the diagnostic accuracy of M 3 KN is gradually improved as the number of learned CEMRs increase, which contain important medical knowledge. Our experimental results show that the proposed method performs reliably for learning the weights of medical knowledge. M 3 KN outperforms other existing methods by achieving an F-measure of 0.731 for CEMRs and 0.4538 for BERs. This further illustrates that M 3 KN can facilitate the investigations of intelligent healthcare. Copyright © 2018 Elsevier B.V. All rights reserved.

Texas motorcycle crash countermeasure workshop.

DOT National Transportation Integrated Search

2013-06-01

The Texas Department of Transportation (TxDOT) contracted with the Texas A&M : Transportation Institute (TTI) to develop a 5-year strategic plan for improving motorcycle safety : in the State of Texas. The Texas Strategic Action Plan for Motorcycl...

A new approach to evaluate regional methane emission from irrigated rice paddies: Combining process study, modeling and remote sensing into GIS

NASA Astrophysics Data System (ADS)

Ding, Aiju

2000-10-01

A large seasonal variation in methane emission from Texas rice fields was observed in most of the growing seasons from 1989 through 1997. In general, the pattern showed small fluxes in the early season of cultivation and reached maximum at post-heading time, then declined and stopped after fields were drained. The amount of methane emission positively relates to the aboveground biomass, the number of effective stems and tillers, and nitrogen addition. The day-to-day pattern of methane emissions was similar among all cultivars. The seasonal total methane emission shows a significant positive correlation with post-heading plant height. The total methane emission from Texas rice fields was estimated as 33.25 × 109 g in 1993, ranging from 25.85 × 109 g/yr to 40.65 × 109 g/yr. A mitigation technique was developed to obtain both high yield and less methane emission from Texas rice fields. A new approach was also developed to evaluate regional to large-scale methane emission from irrigated rice paddies. By combining modeling, ground truth information and remote sensing into a Geographic Information System (GIS)-a computer based system, the seasonal methane emission from a large area can be calculated efficiently and more accurately. The methodology was tested at the Richmond Irrigation District (RID) site in Texas. The average daily methane emission varied from field to field and even within a single field. The calculated seasonal total methane emission from RID rice fields was as low as 3.34 × 108 g CH4 in 1996 and as high as 7.80 × 108 g CH4 in 1998. To support the application of the estimation method in a worldwide study, an algorithm describing the mapping of irrigated rice paddies from Landsat TM data was demonstrated. The accuracy in 1998- supervised classification approached 95% when cloud cover was taken into account. Model uncertainty and data availability are the two major potential problems in worldwide application of the new approach. A potential alternative model is proposed which allows estimation of regional methane emission from rice plant height.

Validating the LASSO algorithm by unmixing spectral signatures in multicolor phantoms

NASA Astrophysics Data System (ADS)

Samarov, Daniel V.; Clarke, Matthew; Lee, Ji Yoon; Allen, David; Litorja, Maritoni; Hwang, Jeeseong

2012-03-01

As hyperspectral imaging (HSI) sees increased implementation into the biological and medical elds it becomes increasingly important that the algorithms being used to analyze the corresponding output be validated. While certainly important under any circumstance, as this technology begins to see a transition from benchtop to bedside ensuring that the measurements being given to medical professionals are accurate and reproducible is critical. In order to address these issues work has been done in generating a collection of datasets which could act as a test bed for algorithms validation. Using a microarray spot printer a collection of three food color dyes, acid red 1 (AR), brilliant blue R (BBR) and erioglaucine (EG) are mixed together at dierent concentrations in varying proportions at dierent locations on a microarray chip. With the concentration and mixture proportions known at each location, using HSI an algorithm should in principle, based on estimates of abundances, be able to determine the concentrations and proportions of each dye at each location on the chip. These types of data are particularly important in the context of medical measurements as the resulting estimated abundances will be used to make critical decisions which can have a serious impact on an individual's health. In this paper we present a novel algorithm for processing and analyzing HSI data based on the LASSO algorithm (similar to "basis pursuit"). The LASSO is a statistical method for simultaneously performing model estimation and variable selection. In the context of estimating abundances in an HSI scene these so called "sparse" representations provided by the LASSO are appropriate as not every pixel will be expected to contain every endmember. The algorithm we present takes the general framework of the LASSO algorithm a step further and incorporates the rich spatial information which is available in HSI to further improve the estimates of abundance. We show our algorithm's improvement over the standard LASSO using the dye mixture data as the test bed.

A Mobile Phone HIV Medication Adherence Intervention: Acceptability and Feasibility Study.

PubMed

Martin, C Andrew; Upvall, Michele J

We present the findings of a qualitative pilot study designed to describe the experience of HIV medication adherence using a mobile phone application. Nine semi-structured focus group discussions were conducted over a 3-month period at an AIDS Services Organization in Central Texas. The data were analyzed following the principles of thematic analysis. During analysis, four themes were identified, and relations between these themes were delineated to reflect the experiences of the 23 participants. The mobile phone application, Care4Today™ Mobile Health Manager, was the intervention tool. Collection of focus group discussion outcomes over a 3-month period with baseline versus end-of-study data determined the feasibility and acceptability of this medication adherence intervention. The findings suggest that when individuals are offered the necessary resources, such as a mobile phone medication reminder application, they may have greater success in performing the behavior. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Chauncey Leake and the development of bioethics in America.

PubMed

Brody, Howard

2014-03-01

Chauncey D. Leake (1896-1978) occupies a unique place in the history of American bioethics. A pharmacologist, he was largely an autodidact in both history and philosophy, and believed that ethics should ideally be taught to medical students by those with philosophical training. After pioneering work on medical ethics during the 1920s, he helped to lay the groundwork for important centers for bioethics and medical humanities at two institutions where he worked, the University of California-San Francisco and the University of Texas Medical Branch-Galveston. Understanding Leake's role in American bioethics requires navigating a number of paradoxes--why he was described respectfully in his time but largely forgotten today; how in the 1920s he could write forward-looking pieces that anticipated many of the themes taken up by bioethics a half-century later, yet played largely a reactionary role when the new bioethics actually arrived; and why he advocated turning to philosophy and philosophers for a proper understanding of ethics, yet appeared often to misunderstand philosophical ethics.

Noninvasive evaluation of mental stress using by a refined rough set technique based on biomedical signals.

PubMed

Liu, Tung-Kuan; Chen, Yeh-Peng; Hou, Zone-Yuan; Wang, Chao-Chih; Chou, Jyh-Horng

2014-06-01

Evaluating and treating of stress can substantially benefits to people with health problems. Currently, mental stress evaluated using medical questionnaires. However, the accuracy of this evaluation method is questionable because of variations caused by factors such as cultural differences and individual subjectivity. Measuring of biomedical signals is an effective method for estimating mental stress that enables this problem to be overcome. However, the relationship between the levels of mental stress and biomedical signals remain poorly understood. A refined rough set algorithm is proposed to determine the relationship between mental stress and biomedical signals, this algorithm combines rough set theory with a hybrid Taguchi-genetic algorithm, called RS-HTGA. Two parameters were used for evaluating the performance of the proposed RS-HTGA method. A dataset obtained from a practice clinic comprising 362 cases (196 male, 166 female) was adopted to evaluate the performance of the proposed approach. The empirical results indicate that the proposed method can achieve acceptable accuracy in medical practice. Furthermore, the proposed method was successfully used to identify the relationship between mental stress levels and bio-medical signals. In addition, the comparison between the RS-HTGA and a support vector machine (SVM) method indicated that both methods yield good results. The total averages for sensitivity, specificity, and precision were greater than 96%, the results indicated that both algorithms produced highly accurate results, but a substantial difference in discrimination existed among people with Phase 0 stress. The SVM algorithm shows 89% and the RS-HTGA shows 96%. Therefore, the RS-HTGA is superior to the SVM algorithm. The kappa test results for both algorithms were greater than 0.936, indicating high accuracy and consistency. The area under receiver operating characteristic curve for both the RS-HTGA and a SVM method were greater than 0.77, indicating a good discrimination capability. In this study, crucial attributes in stress evaluation were successfully recognized using biomedical signals, thereby enabling the conservation of medical resources and elucidating the mapping relationship between levels of mental stress and candidate attributes. In addition, we developed a prototype system for mental stress evaluation that can be used to provide benefits in medical practice. Copyright © 2014. Published by Elsevier B.V.

Texas pavement preservation center four-year summary report.

DOT National Transportation Integrated Search

2009-07-04

The Texas Pavement Preservation Center (TPPC), in joint collaboration with the Center for Transportation Research (CTR) of the University of Texas at Austin and the Texas Transportation Institute (TTI) of Texas A&M University, promotes the use of pav...

Quantitative assessment of the impact of biomedical image acquisition on the results obtained from image analysis and processing.

PubMed

Koprowski, Robert

2014-07-04

Dedicated, automatic algorithms for image analysis and processing are becoming more and more common in medical diagnosis. When creating dedicated algorithms, many factors must be taken into consideration. They are associated with selecting the appropriate algorithm parameters and taking into account the impact of data acquisition on the results obtained. An important feature of algorithms is the possibility of their use in other medical units by other operators. This problem, namely operator's (acquisition) impact on the results obtained from image analysis and processing, has been shown on a few examples. The analysed images were obtained from a variety of medical devices such as thermal imaging, tomography devices and those working in visible light. The objects of imaging were cellular elements, the anterior segment and fundus of the eye, postural defects and others. In total, almost 200'000 images coming from 8 different medical units were analysed. All image analysis algorithms were implemented in C and Matlab. For various algorithms and methods of medical imaging, the impact of image acquisition on the results obtained is different. There are different levels of algorithm sensitivity to changes in the parameters, for example: (1) for microscope settings and the brightness assessment of cellular elements there is a difference of 8%; (2) for the thyroid ultrasound images there is a difference in marking the thyroid lobe area which results in a brightness assessment difference of 2%. The method of image acquisition in image analysis and processing also affects: (3) the accuracy of determining the temperature in the characteristic areas on the patient's back for the thermal method - error of 31%; (4) the accuracy of finding characteristic points in photogrammetric images when evaluating postural defects - error of 11%; (5) the accuracy of performing ablative and non-ablative treatments in cosmetology - error of 18% for the nose, 10% for the cheeks, and 7% for the forehead. Similarly, when: (7) measuring the anterior eye chamber - there is an error of 20%; (8) measuring the tooth enamel thickness - error of 15%; (9) evaluating the mechanical properties of the cornea during pressure measurement - error of 47%. The paper presents vital, selected issues occurring when assessing the accuracy of designed automatic algorithms for image analysis and processing in bioengineering. The impact of acquisition of images on the problems arising in their analysis has been shown on selected examples. It has also been indicated to which elements of image analysis and processing special attention should be paid in their design.

Improved particle swarm optimization algorithm for android medical care IOT using modified parameters.

PubMed

Sung, Wen-Tsai; Chiang, Yen-Chun

2012-12-01

This study examines wireless sensor network with real-time remote identification using the Android study of things (HCIOT) platform in community healthcare. An improved particle swarm optimization (PSO) method is proposed to efficiently enhance physiological multi-sensors data fusion measurement precision in the Internet of Things (IOT) system. Improved PSO (IPSO) includes: inertia weight factor design, shrinkage factor adjustment to allow improved PSO algorithm data fusion performance. The Android platform is employed to build multi-physiological signal processing and timely medical care of things analysis. Wireless sensor network signal transmission and Internet links allow community or family members to have timely medical care network services.

Providing Housing, Food and Medical Support for 25,000 Katrina Evacuees with 12 Hours Notice: The Harris County Medical Support of the Superdome Evacuees

NASA Technical Reports Server (NTRS)

Hamilton, Douglas; Smart, Kieran; Gavagan, Tom

2006-01-01

Hurricane Katrina was responsible for trapping 25,000 people in the New Orleans Superdome and isolating many others throughout Louisiana and Mississippi. The transport of these evacuees to the Reliant Park (Houston, Texas) used 500 buses each containing about 55 people. Processing the arriving evacuees included addressing their health status and medical needs as follows: an initial triage at disembarkation, a secondary triage in the Reliant Astrodome and Center, and definitive clinical care in the Reliant Arena "Katrina" Clinic. Baylor College of Medicine (BCM) physicians boarded buses and identified the sickest for emergency transport to Harris County Hospital District (HCHD) hospitals. BCM departments represented included pediatrics, family and community medicine, internal medicine, radiology, obstetrics and gynecology, orthopedics, surgery, and psychiatry. Astrodome and Center triage was managed by BCM physicians and staffed by HCHD Nurses and volunteers from Texas and beyond. The Reliant Astrodome, Center and Arena reached peak headcounts of 15,000,4500, and 2500, respectively Most evacuees visiting the triage sites in the Astrodome and Center were treated using "over-the-counter" medications with the remaining being transported to the "Katrina" clinic. The clinic was equipped with a lab, pharmacy, digital X-ray, and ultrasound machines in addition to electronic patient records created using 80 computer terminals. The Katrina clinic saw more than 15,000 patients during 15 days of operations (2,000 on the first full day), administered 10,000 tetanus shots, and filled thousands of prescriptions. At the peak of operations, the clinic saw 150 patients/hour with 25 physicians scheduled for each 12-hour shift. Approximately 900 people were transported to hospital emergency rooms. Within 3 weeks of arriving at the Reliant Park facilities, more than 90% of the families found permanent housing, enrolled children in schools, and found work. Using data obtained from manual and electronic medical records, this presentation will document the major milestones and lessons learned from this extraordinary project to help the Katrina evacuees.

Establishing a Research and Evaluation Capability for the Joint Medical Education and Training Campus.

PubMed

Kirby, Sheila Nataraj; Marsh, Julie A; Thie, Harry J

2011-01-01

In calling for the transformation of military medical education and training, the 2005 Base Realignment and Closure Commission recommended relocating basic and specialty enlisted medical training to a single site to take advantage of economies of scale and the opportunity for joint training. As a result, a joint medical education and training campus (METC) has been established at Fort Sam Houston, Texas. Two of METC's primary long-term goals are to become a high-performing learning organization and to seek accreditation as a community college. Such goals require a clear model of organizational improvement with well-defined metrics for measuring its performance and using research and evaluation to assess and improve that performance. Lessons learned from a review of practices at institutions with similar missions-such as community colleges, corporate universities, the UK's Defence Medical Education and Training Agency, and other federal agencies, such as the Veterans Health Administration-establish a clear need for an office of institutional research to help METC attain its organizational goals. They also provide useful recommendations regarding the METC office's structure, scope, and governance.

Establishing a Research and Evaluation Capability for the Joint Medical Education and Training Campus

PubMed Central

Kirby, Sheila Nataraj; Marsh, Julie A.; Thie, Harry J.

2011-01-01

Abstract In calling for the transformation of military medical education and training, the 2005 Base Realignment and Closure Commission recommended relocating basic and specialty enlisted medical training to a single site to take advantage of economies of scale and the opportunity for joint training. As a result, a joint medical education and training campus (METC) has been established at Fort Sam Houston, Texas. Two of METC's primary long-term goals are to become a high-performing learning organization and to seek accreditation as a community college. Such goals require a clear model of organizational improvement with well-defined metrics for measuring its performance and using research and evaluation to assess and improve that performance. Lessons learned from a review of practices at institutions with similar missions—such as community colleges, corporate universities, the UK's Defence Medical Education and Training Agency, and other federal agencies, such as the Veterans Health Administration—establish a clear need for an office of institutional research to help METC attain its organizational goals. They also provide useful recommendations regarding the METC office's structure, scope, and governance. PMID:28083182

Severe sepsis and septic shock in pre-hospital emergency medicine: survey results of medical directors of emergency medical services concerning antibiotics, blood cultures and algorithms.

PubMed

Casu, Sebastian; Häske, David

2016-06-01

Delayed antibiotic treatment for patients in severe sepsis and septic shock decreases the probability of survival. In this survey, medical directors of different emergency medical services (EMS) in Germany were asked if they are prepared for pre-hospital sepsis therapy with antibiotics or special algorithms to evaluate the individual preparations of the different rescue areas for the treatment of patients with this infectious disease. The objective of the survey was to obtain a general picture of the current status of the EMS with respect to rapid antibiotic treatment for sepsis. A total of 166 medical directors were invited to complete a short survey on behalf of the different rescue service districts in Germany via an electronic cover letter. Of the rescue districts, 25.6 % (n = 20) stated that they keep antibiotics on EMS vehicles. In addition, 2.6 % carry blood cultures on the vehicles. The most common antibiotic is ceftriaxone (third generation cephalosporin). In total, 8 (10.3 %) rescue districts use an algorithm for patients with sepsis, severe sepsis or septic shock. Although the German EMS is an emergency physician-based rescue system, special opportunities in the form of antibiotics on emergency physician vehicles are missing. Simultaneously, only 10.3 % of the rescue districts use a special algorithm for sepsis therapy. Sepsis, severe sepsis and septic shock do not appear to be prioritized as highly as these deadly diseases should be in the pre-hospital setting.

Identification of chronic rhinosinusitis phenotypes using cluster analysis.

PubMed

Soler, Zachary M; Hyer, J Madison; Ramakrishnan, Viswanathan; Smith, Timothy L; Mace, Jess; Rudmik, Luke; Schlosser, Rodney J

2015-05-01

Current clinical classifications of chronic rhinosinusitis (CRS) have been largely defined based upon preconceived notions of factors thought to be important, such as polyp or eosinophil status. Unfortunately, these classification systems have little correlation with symptom severity or treatment outcomes. Unsupervised clustering can be used to identify phenotypic subgroups of CRS patients, describe clinical differences in these clusters and define simple algorithms for classification. A multi-institutional, prospective study of 382 patients with CRS who had failed initial medical therapy completed the Sino-Nasal Outcome Test (SNOT-22), Rhinosinusitis Disability Index (RSDI), Medical Outcomes Study Short Form-12 (SF-12), Pittsburgh Sleep Quality Index (PSQI), and Patient Health Questionnaire (PHQ-2). Objective measures of CRS severity included Brief Smell Identification Test (B-SIT), CT, and endoscopy scoring. All variables were reduced and unsupervised hierarchical clustering was performed. After clusters were defined, variations in medication usage were analyzed. Discriminant analysis was performed to develop a simplified, clinically useful algorithm for clustering. Clustering was largely determined by age, severity of patient reported outcome measures, depression, and fibromyalgia. CT and endoscopy varied somewhat among clusters. Traditional clinical measures, including polyp/atopic status, prior surgery, B-SIT and asthma, did not vary among clusters. A simplified algorithm based upon productivity loss, SNOT-22 score, and age predicted clustering with 89% accuracy. Medication usage among clusters did vary significantly. A simplified algorithm based upon hierarchical clustering is able to classify CRS patients and predict medication usage. Further studies are warranted to determine if such clustering predicts treatment outcomes. © 2015 ARS-AAOA, LLC.

Improving the Collection of Race, Ethnicity, and Language Data to Reduce Healthcare Disparities: A Case Study from an Academic Medical Center

PubMed Central

Lee, Wei-Chen; Veeranki, Sreenivas P.; Serag, Hani; Eschbach, Karl; Smith, Kenneth D.

2016-01-01

Well-designed electronic health records (EHRs) must integrate a variety of accurate information to support efforts to improve quality of care, particularly equity-in-care initiatives. This case study provides insight into the challenges those initiatives may face in collecting accurate race, ethnicity, and language (REAL) information in the EHR. We present the experience of an academic medical center strengthening its EHR for better collection of REAL data with funding from the EHR Incentive Programs for meaningful use of health information technology and the Texas Medicaid 1115 Waiver program. We also present a plan to address some of the challenges that arose during the course of the project. Our experience at an academic medical center can provide guidance about the likely challenges similar institutions may expect when they implement new initiatives to collect REAL data, particularly challenges regarding scope, personnel, and other resource needs. PMID:27843424

Pulse!!: a model for research and development of virtual-reality learning in military medical education and training.

PubMed

Dunne, James R; McDonald, Claudia L

2010-07-01

Pulse!! The Virtual Clinical Learning Lab at Texas A&M University-Corpus Christi, in collaboration with the United States Navy, has developed a model for research and technological development that they believe is an essential element in the future of military and civilian medical education. The Pulse!! project models a strategy for providing cross-disciplinary expertise and resources to educational, governmental, and business entities challenged with meeting looming health care crises. It includes a three-dimensional virtual learning platform that provides unlimited, repeatable, immersive clinical experiences without risk to patients, and is available anywhere there is a computer. Pulse!! utilizes expertise in the fields of medicine, medical education, computer science, software engineering, physics, computer animation, art, and architecture. Lab scientists collaborate with the commercial virtual-reality simulation industry to produce research-based learning platforms based on cutting-edge computer technology.

BIRAM: a content-based image retrieval framework for medical images

NASA Astrophysics Data System (ADS)

Moreno, Ramon A.; Furuie, Sergio S.

2006-03-01

In the medical field, digital images are becoming more and more important for diagnostics and therapy of the patients. At the same time, the development of new technologies has increased the amount of image data produced in a hospital. This creates a demand for access methods that offer more than text-based queries for retrieval of the information. In this paper is proposed a framework for the retrieval of medical images that allows the use of different algorithms for the search of medical images by similarity. The framework also enables the search for textual information from an associated medical report and DICOM header information. The proposed system can be used for support of clinical decision making and is intended to be integrated with an open source picture, archiving and communication systems (PACS). The BIRAM has the following advantages: (i) Can receive several types of algorithms for image similarity search; (ii) Allows the codification of the report according to a medical dictionary, improving the indexing of the information and retrieval; (iii) The algorithms can be selectively applied to images with the appropriated characteristics, for instance, only in magnetic resonance images. The framework was implemented in Java language using a MS Access 97 database. The proposed framework can still be improved, by the use of regions of interest (ROI), indexing with slim-trees and integration with a PACS Server.

Validation of psoriatic arthritis diagnoses in electronic medical records using natural language processing

PubMed Central

Cai, Tianxi; Karlson, Elizabeth W.

2013-01-01

Objectives To test whether data extracted from full text patient visit notes from an electronic medical record (EMR) would improve the classification of PsA compared to an algorithm based on codified data. Methods From the > 1,350,000 adults in a large academic EMR, all 2318 patients with a billing code for PsA were extracted and 550 were randomly selected for chart review and algorithm training. Using codified data and phrases extracted from narrative data using natural language processing, 31 predictors were extracted and three random forest algorithms trained using coded, narrative, and combined predictors. The receiver operator curve (ROC) was used to identify the optimal algorithm and a cut point was chosen to achieve the maximum sensitivity possible at a 90% positive predictive value (PPV). The algorithm was then used to classify the remaining 1768 charts and finally validated in a random sample of 300 cases predicted to have PsA. Results The PPV of a single PsA code was 57% (95%CI 55%–58%). Using a combination of coded data and NLP the random forest algorithm reached a PPV of 90% (95%CI 86%–93%) at sensitivity of 87% (95% CI 83% – 91%) in the training data. The PPV was 93% (95%CI 89%–96%) in the validation set. Adding NLP predictors to codified data increased the area under the ROC (p < 0.001). Conclusions Using NLP with text notes from electronic medical records improved the performance of the prediction algorithm significantly. Random forests were a useful tool to accurately classify psoriatic arthritis cases to enable epidemiological research. PMID:20701955

Decreased rates of hypoglycemia following implementation of a comprehensive computerized insulin order set and titration algorithm in the inpatient setting.

PubMed

Sinha Gregory, Naina; Seley, Jane Jeffrie; Gerber, Linda M; Tang, Chin; Brillon, David

2016-12-01

More than one-third of hospitalized patients have hyperglycemia. Despite evidence that improving glycemic control leads to better outcomes, achieving recognized targets remains a challenge. The objective of this study was to evaluate the implementation of a computerized insulin order set and titration algorithm on rates of hypoglycemia and overall inpatient glycemic control. A prospective observational study evaluating the impact of a glycemic order set and titration algorithm in an academic medical center in non-critical care medical and surgical inpatients. The initial intervention was hospital-wide implementation of a comprehensive insulin order set. The secondary intervention was initiation of an insulin titration algorithm in two pilot medicine inpatient units. Point of care testing blood glucose reports were analyzed. These reports included rates of hypoglycemia (BG < 70 mg/dL) and hyperglycemia (BG >200 mg/dL in phase 1, BG > 180 mg/dL in phase 2). In the first phase of the study, implementation of the insulin order set was associated with decreased rates of hypoglycemia (1.92% vs 1.61%; p < 0.001) and increased rates of hyperglycemia (24.02% vs 27.27%; p < 0.001) from 2010 to 2011. In the second phase, addition of a titration algorithm was associated with decreased rates of hypoglycemia (2.57% vs 1.82%; p = 0.039) and increased rates of hyperglycemia (31.76% vs 41.33%; p < 0.001) from 2012 to 2013. A comprehensive computerized insulin order set and titration algorithm significantly decreased rates of hypoglycemia. This significant reduction in hypoglycemia was associated with increased rates of hyperglycemia. Hardwiring the algorithm into the electronic medical record may foster adoption.

Development of an algorithm to identify fall-related injuries and costs in Medicare data.

PubMed

Kim, Sung-Bou; Zingmond, David S; Keeler, Emmett B; Jennings, Lee A; Wenger, Neil S; Reuben, David B; Ganz, David A

2016-12-01

Identifying fall-related injuries and costs using healthcare claims data is cost-effective and easier to implement than using medical records or patient self-report to track falls. We developed a comprehensive four-step algorithm for identifying episodes of care for fall-related injuries and associated costs, using fee-for-service Medicare and Medicare Advantage health plan claims data for 2,011 patients from 5 medical groups between 2005 and 2009. First, as a preparatory step, we identified care received in acute inpatient and skilled nursing facility settings, in addition to emergency department visits. Second, based on diagnosis and procedure codes, we identified all fall-related claim records. Third, with these records, we identified six types of encounters for fall-related injuries, with different levels of injury and care. In the final step, we used these encounters to identify episodes of care for fall-related injuries. To illustrate the algorithm, we present a representative example of a fall episode and examine descriptive statistics of injuries and costs for such episodes. Altogether, we found that the results support the use of our algorithm for identifying episodes of care for fall-related injuries. When we decomposed an episode, we found that the details present a realistic and coherent story of fall-related injuries and healthcare services. Variation of episode characteristics across medical groups supported the use of a complex algorithm approach, and descriptive statistics on the proportion, duration, and cost of episodes by healthcare services and injuries verified that our results are consistent with other studies. This algorithm can be used to identify and analyze various types of fall-related outcomes including episodes of care, injuries, and associated costs. Furthermore, the algorithm can be applied and adopted in other fall-related studies with relative ease.

76 FR 18210 - Texas Eastern Transmission, LP; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-01

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP11-138-000] Texas Eastern Transmission, LP; Notice of Application On March 15, 2011, Texas Eastern Transmission Corporation (Texas Eastern), 5400 Westheimer Court, Houston, Texas 77056-5310, filed with the Federal Energy Regulatory...

Status Report on Medical Materiel Items Tested and Evaluated for Use in the USAF Aeromedical Evacuation System

DTIC Science & Technology

1990-12-01

Volumetric Infusion Pump is conditionally acceptable for use. The Air -In- Line detector does not sense air bubbles 0.95 cm (3/8 inch) or smaller...been fitted with an improved brushless air circulation motor, Brailsford model T- 2NFR. Using the new motor, the 185 passed EMI and is acceptable for...USAF School of Aerospace Medicine, Human Systems Division, Air Force Systems Command, Brooks Air Force Base, Texas, under job order 7930-16- 12. This

Quality Circles at Wilford Hall U.S.A.F. Medical Center, Lackland Air Force Base, Texas: Some Preliminary Findings

DTIC Science & Technology

1982-08-01

relationships which can be identified from one sample population and generalized to cause and effect in different persons, settings, and times...affect the cause-and-effect relationship which one can draw with a civilian group? Will it be pos- sible to generalize about other groups within... relationship about quality circles obtained in a military health care facility be generalized to a civil- ian one? Can a causal relationship about quality

Proceedings: Army Medical Department Service Psychology Symposium Held at El Paso, Texas on 13-17 November 1978

DTIC Science & Technology

1978-11-01

Assessing the Psychological Component in Low Back Pain with the MMPI P003 754 Hypnosis in Army Aviation: A Case Study P003 755 Psychiatric Symptoms...in Low Back Pain with the MMPI - Frank H. Rath, Jr. and Thomas Scully . o ...... ° . 77 Hypnosis in Amy Aviation: A Case Study - William R. Gentry...and New Directions Dr. Ray Gentry Weight Control Program (Thursday) Hypnosis in Army Aviation (Friday) Dr. Gary Greenfiel• Desertion in the Volunteer

Next Generation 9-1-1: Policy Implications of Incident Related Imagery on the Public Safety Answering Point

DTIC Science & Technology

2017-03-01

Enhanced 9-1-1 EMD eye movement desensitization and reprocessing EMS emergency medical service ESInet Emergency Service IP Network ETNS...Trident), football at Peter B’s, Texas Hold ‘ Em mid-IR, countless cups of Starbucks coffee, and of course, Manny’s Cuban brew. Each of you made this...something to consider. The military has done a good job of recognizing the effects of this [PTSD] trauma. Sadly, the Fire Service, EMS and Law