Barbara S. Ducatman MD
Full Text Available The most common benchmarks for faculty productivity are derived from Medical Group Management Association (MGMA or Vizient-AAMC Faculty Practice Solutions Center ® (FPSC databases. The Association of Pathology Chairs has also collected similar survey data for several years. We examined the Association of Pathology Chairs annual faculty productivity data and compared it with MGMA and FPSC data to understand the value, inherent flaws, and limitations of benchmarking data. We hypothesized that the variability in calculated faculty productivity is due to the type of practice model and clinical effort allocation. Data from the Association of Pathology Chairs survey on 629 surgical pathologists and/or anatomic pathologists from 51 programs were analyzed. From review of service assignments, we were able to assign each pathologist to a specific practice model: general anatomic pathologists/surgical pathologists, 1 or more subspecialties, or a hybrid of the 2 models. There were statistically significant differences among academic ranks and practice types. When we analyzed our data using each organization’s methods, the median results for the anatomic pathologists/surgical pathologists general practice model compared to MGMA and FPSC results for anatomic and/or surgical pathology were quite close. Both MGMA and FPSC data exclude a significant proportion of academic pathologists with clinical duties. We used the more inclusive FPSC definition of clinical “full-time faculty” (0.60 clinical full-time equivalent and above. The correlation between clinical full-time equivalent effort allocation, annual days on service, and annual work relative value unit productivity was poor. This study demonstrates that effort allocations are variable across academic departments of pathology and do not correlate well with either work relative value unit effort or reported days on service. Although the Association of Pathology Chairs–reported median work relative
Gabril, Manal Y; Yousef, George M
Informatics can be defined as using highly advanced technologies to improve patient diagnosis or management. Pathology informatics had evolved as a response to the overwhelming amount of information that was available, in an attempt to better use and maintain them. The most commonly used tools of informatics can be classified into digital imaging, telepathology, as well as Internet and electronic data mining. Digital imaging is the storage of anatomical pathology information, either gross pictures or microscopic slides, in an electronic format. These images can be used for education, archival, diagnosis, and consultation. Virtual microscopy is the more advanced form of digital imaging with enhanced efficiency and accessibility. Telepathology is now increasingly becoming a useful tool in anatomical pathology practice. Different types of telepathology communications are available for both diagnostic and consultation services. The spectrum of applications of informatics in the field of anatomical pathology is broad and encompasses medical education, clinical services, and pathology research. Informatics is now settling on solid ground as an important tool for pathology teaching, with digital teaching becoming the standard tool in many institutions. After a slow start, we now witness the transition of informatics from the research bench to bedside. As we are moving into a new era of extensive pathology informatics utilization, several challenges have to be addressed, including the cost of the new technology, legal issues, and resistance of pathologists. It is clear from the current evidence that pathology informatics will continue to grow and have a major role in the future of our specialty. However, it is also clear that it is not going to fully replace the human factor or the regular microscope.
Ducatman, Barbara S; Parslow, Tristram
The most common benchmarks for faculty productivity are derived from Medical Group Management Association (MGMA) or Vizient-AAMC Faculty Practice Solutions Center ® (FPSC) databases. The Association of Pathology Chairs has also collected similar survey data for several years. We examined the Association of Pathology Chairs annual faculty productivity data and compared it with MGMA and FPSC data to understand the value, inherent flaws, and limitations of benchmarking data. We hypothesized that the variability in calculated faculty productivity is due to the type of practice model and clinical effort allocation. Data from the Association of Pathology Chairs survey on 629 surgical pathologists and/or anatomic pathologists from 51 programs were analyzed. From review of service assignments, we were able to assign each pathologist to a specific practice model: general anatomic pathologists/surgical pathologists, 1 or more subspecialties, or a hybrid of the 2 models. There were statistically significant differences among academic ranks and practice types. When we analyzed our data using each organization's methods, the median results for the anatomic pathologists/surgical pathologists general practice model compared to MGMA and FPSC results for anatomic and/or surgical pathology were quite close. Both MGMA and FPSC data exclude a significant proportion of academic pathologists with clinical duties. We used the more inclusive FPSC definition of clinical "full-time faculty" (0.60 clinical full-time equivalent and above). The correlation between clinical full-time equivalent effort allocation, annual days on service, and annual work relative value unit productivity was poor. This study demonstrates that effort allocations are variable across academic departments of pathology and do not correlate well with either work relative value unit effort or reported days on service. Although the Association of Pathology Chairs-reported median work relative value unit productivity
Full Text Available This study qualitatively explored the role of gender and related factors that influence medical doctors’ decisions in selecting a specialisation within medical laboratory medicine. This study is novel in that it disaggregates doctors by specialisation. It further focuses on non-clinical medical specialists who have been ignored in the global human resources for health literature. Hakim’s preference theory as well as socialisation theory is adapted to explain some of the reasons female doctors make certain career choices regarding specialisation within the medical field. The study focused on laboratory doctors in the public and private sector in KwaZulu- Natal. A qualitative approach was adopted given the small population size and the need for an interpretive approach to the data. The research design was an exploratory case study and thematic analysis was used to discover the relevant themes. The non-probability purposeful sample comprised a total of 20 participants, of which 11 were anatomical pathologists and 9 were haematologists, all based in KwaZulu-Natal, South Africa. Data collection was performed via in-depth interviews. Trustworthiness of the data was ensured through methods of credibility and triangulation. The key finding is that although gender is a significant factor in career choice (for specific disciplines, it is one of many factors that determine self-selection into a specific medical laboratory specialisation. The conclusions, although not generalisable, have implications for human resources for health policies targeted at achieving higher levels of recruitment in laboratory medicine as a profession.
Zarbo, Richard J; Nakhleh, Raouf E; Walsh, Molly
Measurement of physicians' and patients' satisfaction with laboratory services has recently become a requirement of health care accreditation agencies in the United States. To our knowledge, this is the first customer satisfaction survey of anatomic pathology services to provide a standardized tool and benchmarks for subsequent measures of satisfaction. This Q-Probes study assessed physician satisfaction with anatomic pathology laboratory services and sought to determine characteristics that correlate with a high level of physician satisfaction. In January 2001, each laboratory used standardized survey forms to assess physician customer satisfaction with 10 specific elements of service in anatomic pathology and an overall satisfaction rating based on a scale of rankings from a 5 for excellent to a 1 for poor. Data from up to 50 surveys returned per laboratory were compiled and analyzed by the College of American Pathologists. A general questionnaire collected information about types of services offered and each laboratory's quality assurance initiatives to determine characteristics that correlate with a high level of physician satisfaction. Hospital-based laboratories in the United States (95.8%), as well as others from Canada and Australia. Ninety-four voluntary subscriber laboratories in the College of American Pathologists Q-Probes quality improvement program participated in this survey. Roughly 70% of respondents were from hospitals with occupied bedsizes of 300 or less, 65% were private nonprofit institutions, just over half were located in cities, one third were teaching hospitals, and 19% had pathology residency training programs. Overall physician satisfaction with anatomic pathology and 10 selected aspects of the laboratory service (professional interaction, diagnostic accuracy, pathologist responsiveness to problems, pathologist accessibility for frozen section, tumor board presentations, courtesy of secretarial and technical staff, communication of
Full Text Available The use of telepathology for clinical applications in Canada has steadily become more attractive over the last 10 years, driven largely by its potential to provide rapid pathology consulting services throughout the country regardless of the location of a particular institution. Based on this trend, the president of the Canadian Association of Pathologists asked a working group consisting of pathologists, technologists, and healthcare administrators from across Canada to oversee the development of guidelines to provide Canadian pathologists with basic information on how to implement and use this technology. The guidelines were systematically developed, based on available medical literature and the clinical experience of early adopters of telepathology in Canada. While there are many different modalities and applications of telepathology, this document focuses specifically on whole-slide imaging as applied to intraoperative pathology consultation (frozen section, primary diagnosis, expert or second opinions and quality assurance activities. Applications such as hematopathology, microbiology, tumour boards, education, research and technical and/or standard-related issues are not covered.
The 2015 Institute of Medicine report on diagnostic error has placed a national spotlight on the importance of improving communication among clinicians and between clinicians and patients . The report emphasizes the critical role that communication plays in patient safety and outlines ways that pathologists can support this process. Despite recognition of communication as an essential element in patient care, pathologists currently undergo limited (if any) formal training in communication skills. To address this gap, we at the University of Washington Medical Center developed communication training with the goal of establishing best practice procedures for effective pathology communication. The course includes lectures, role playing, and simulated clinician-pathologist interactions for training and evaluation of pathology communication performance. Providing communication training can help create reliable communication pathways that anticipate and address potential barriers and errors before they happen. © 2016 American Medical Association. All Rights Reserved.
Wincewicz, A; Szepietowska, A; Sulkowski, S
This paper presents a complete overview of the scientific, professional and social activity of a great Polish pathologist, Witold Nowicki (1878-1941), from mainly Polish-written, original sources with a major impact on mostly his own publications. The biographical commemoration of this eminent professor is not only due to the fact that he provided a profound microscopic characterization of pneumatosis cystoides in 1909 and 1924. Nowicki greatly influenced the development of anatomical pathology in Poland, having authored over 82 publications, with special reference to tuberculosis, lung cancer, sarcomatous carcinomas, scleroma and others. However, the first of all his merits for the readership of Polish pathologists was his textbook titled Anatomical Pathology, which was a basic pathology manual in pre-war Poland. Witold Nowicki - as the head of the academic pathological anatomy department and former dean of the medical faculty - was shot with other professors by Nazi Germans in the Wuleckie hills in Lvov during World War Two. Professor Nowicki was described as being "small in size but great in spirit" by one of his associates, and remains an outstanding example of a meticulous pathologist, a patient tutor and a great social activist to follow.
Wesley Y. Naritoku MD, PhD
Full Text Available A shortage of physicians in the United States has been long projected. Because of predictions of retirement among the aging pathology workforce, there is an anticipated shortage of pathologist as well. To address the pathology workforce shortage among pathologists, the Association of Pathology Chairs assembled a subcommittee of the Association of Pathology Chairs Advocacy Committee to explore ways to identify the strengths, weaknesses, opportunities, and threats to the pathology workforce. One opportunity to encourage strong candidates to pursue pathology as a career is to explore possibility to revisit advanced credit for the post-sophomore fellowship. A survey that was designed to understand the post-sophomore fellowship training better was distributed on the listserv of the Program Directors Section of the Association of Pathology Chairs. A review of the literature on post-sophomore fellowship programs is presented in light of the findings from this survey. Many post-sophomore fellowship programs are run similar to a first-year resident experience, although programs show great diversity in curriculum, including some programs that focus on research. Post-sophomore fellowships attract medical students to the area of pathology and tend to end up in academic and research positions. A second survey of program directors served as an opinion poll of challenging issues that affect residency training. From the second opinion poll, most program directors feel that residents can use additional training to improve the outcome of our future pathologists.
The joint annual congress of the South African Society of Pathologists, International Academy of Pathology, South African Association of Clinical Biochemists and the Southern African Microbiology Society, was held from 13 to 15 July 1981 in Bloemfontein. This congress covered facets of clinical biochemistry, anatomical pathology, virology, microbiology, immunology and molecular biology
This publication only contains the abstracts of papers delivered on the 22nd annual congress of the South African Society of Pathologists on 5-7 July 1987. The topics covered, include anatomical pathology, haematology, biochemistry microbiology, and immunology
Detecting and preventing the occurrence of errors in the practices of laboratory medicine and anatomic pathology: 15 years' experience with the College of American Pathologists' Q-PROBES and Q-TRACKS programs.
Novis, David A
This review extracts those studies from the CAP Q-PROBES and Q-TRACKS programs that have benchmarked and monitored the occurrence of errors in the practices of laboratory medicine and anatomic pathology. The outcomes of these studies represent in aggregate the analysis of millions of data points collected in thousands of hospitals throughout the United States. Also presented in this review are hospital and laboratory practices associated with improved performance (ie, fewer errors). Only those associations that were shown to be statistically significant are presented. They represent only a small fraction of the practices examined in these studies. The reader is encouraged to peruse the Q-PROBES studies cited in the reference list to learn about the wide range of practices investigated. The institution of some of these practices for which the associated error reductions were not statistically significant might nonetheless improve performance in some environments. There is no way of knowing whether some better-performing institutions compensated for not employing presumably beneficial practices by applying other practices about which the studies' authors neglected to inquire. Nor is there any way of knowing whether institutions in which performance was poor employed presumably beneficial practices, but possessed operational flaws about which the studies' authors neglected to inquire. Certainly, hospitals operating in the bottom 10% of benchmarked performances would do well to investigate the possibility that some of these practices might reduce the incidence of errors in their institutions. From the results of these studies, there emerge two complementary strategies that appear to be associated with reduction of errors. Obviously, the first strategy involves doing what is necessary to prevent the occurrence of errors in the first place. Several tactics may accomplish this goal. Healthcare workers responsible for specific tasks must be properly educated and motivated
Kato, Hirohisa; Oizumi, Hiroyuki; Suzuki, Jun; Hamada, Akira; Watarai, Hikaru; Sadahiro, Mitsuaki
Although wedge resection can be curative for small lung tumours, tumour marking is sometimes required for resection of non-palpable or visually undetectable lung nodules as a method for identification of tumours. Tumour marking sometimes fails and occasionally causes serious complications. We have performed many thoracoscopic segmentectomies using 3D computed tomography simulation for undetectable small lung tumours without any tumour markings. The aim of this study was to investigate whether thoracoscopic segmentectomy planned with 3D computed tomography simulation could precisely remove non-palpable and visually undetectable tumours. Between January 2012 and March 2016, 58 patients underwent thoracoscopic segmentectomy using 3D computed tomography simulation for non-palpable, visually undetectable tumours. Surgical outcomes were evaluated. A total of 35, 14 and 9 patients underwent segmentectomy, subsegmentectomy and segmentectomy combined with adjacent subsegmentectomy, respectively. All tumours were correctly resected without tumour marking. The median tumour size and distance from the visceral pleura was 14 ± 5.2 mm (range 5-27 mm) and 11.6 mm (range 1-38.8 mm), respectively. Median values related to the procedures were operative time, 176 min (range 83-370 min); blood loss, 43 ml (range 0-419 ml); duration of chest tube placement, 1 day (range 1-8 days); and postoperative hospital stay, 5 days (range 3-12 days). Two cases were converted to open thoracotomy due to bleeding. Three cases required pleurodesis for pleural fistula. No recurrences occurred during the mean follow-up period of 44.4 months (range 5-53 months). Thoracoscopic segmentectomy using 3D computed tomography simulation was feasible and could be performed to resect undetectable tumours with no tumour markings. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Zarbo, Richard J
Measurement of physicians' and patients' satisfaction with laboratory services has become a standard practice in the United States, prompted by national accreditation requirements. Unlike other surveys of hospital-, outpatient care-, or physician-related activities, no ongoing, comprehensive customer satisfaction survey of anatomic pathology services is available for subscription that would allow continual benchmarking against peer laboratories. Pathologists, therefore, must often design their own local assessment tools to determine physician satisfaction in anatomic pathology. To describe satisfaction survey design that would elicit specific information from physician customers about key elements of anatomic pathology services. The author shares his experience in biannually assessing customer satisfaction in anatomic pathology with survey tools designed at the Henry Ford Hospital, Detroit, Mich. Benchmarks for physician satisfaction, opportunities for improvement, and characteristics that correlated with a high level of physician satisfaction were identified nationally from a standardized survey tool used by 94 laboratories in the 2001 College of American Pathologists Q-Probes quality improvement program. In general, physicians are most satisfied with professional diagnostic services and least satisfied with pathology services related to poor communication. A well-designed and conducted customer satisfaction survey is an opportunity for pathologists to periodically educate physician customers about services offered, manage unrealistic expectations, and understand the evolving needs of the physician customer. Armed with current information from physician customers, the pathologist is better able to strategically plan for resources that facilitate performance improvements in anatomic pathology laboratory services that align with evolving clinical needs in health care delivery.
Ragazzi, Moira; Piana, Simonetta; Longo, Caterina; Castagnetti, Fabio; Foroni, Monica; Ferrari, Guglielmo; Gardini, Giorgio; Pellacani, Giovanni
surgical specimens other than the skin and to evaluate the diagnostic capability of this technology from pathologists' viewpoint.
Allen, Timothy Craig
Pathologists' advocacy plays a central role in the establishment of continuously improving patient care quality and patient safety, and in the maintenance and progress of pathology as a profession. Pathology advocacy's primary goal is the betterment of patient safety and quality medical care; however, payment is a necessary and appropriate component to both, and has a central role in advocacy. Now is the time to become involved in pathology advocacy; the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act of 2015 (MACRA) and the Protecting Access to Medicare Act of 2014 (PAMA) are 2 of the most consequential pieces of legislation impacting the pathology and laboratory industry in the last 20 years. Another current issue of far-reaching impact for pathologists is balance billing, and yet many pathologists have little or no understanding of balance billing. Pathologists at all stages of their careers, and in every professional setting, need to participate. Academic pathologists have a special obligation to, if not become directly involved in advocacy, at least have a broad and current understanding of those issues, as well as the need and responsibility of pathologists to actively engage in advocacy efforts to address them, in order to teach residents the place of advocacy, and its value, as an inseparable and indispensable component of their professional responsibilities.
The proceedings of the twenty third annual congress of the South African Society of Pathologists are presented. Papers on the following topics were presented: anatomical pathology, virology, microbiology, chemical biochemistry, and haematology. Separate abstracts were prepared for thirteen of the papers presented. The remaining papers were considered out of scope for INIS
Pathology and pathologists are rarely the subjects of works of fiction. In the existing sources, the kind of representation naturally depends on the occupations and attitudes of the respective authors. The surgeon and gynecologist Carl Ludwig Schleich recollected Rudolf Virchow's free and easy handling of an autopsy assistant and his simultaneous understanding for a mourning husband. The dermatologist Gottfried Benn processed his disturbing impressions of pathology as an expressionistic dialogue between professor and students, with a violent ending. The writer and dramatic adviser Günther Weisenborn recalled unpleasant details about the autopsy course in his earlier medical studies, which he linked with individual views about the life of a deceased young woman. Praise, so to speak, to the dissecting pathologist have been sensitively written by the lawyer Maxence van der Meersch and by the surgeon Peter Bamm. Finally, the bestselling novelist Arthur Hailey gives an excellent fictional portrayal of the microscopic pathologist in The Final Diagnosis.
Leong, Anthony S Y; Leong, F Joel W M
The imposition of laboratory cost containment, often from external forces, dictates the necessity to develop strategies to meet laboratory cost savings. In addition, the national and worldwide shortage of anatomical pathologists makes it imperative to examine our current practice and laboratory set-ups. Some of the strategies employed in other areas of pathology and laboratory medicine include improvements in staff productivity and the adoption of technological developments that reduce manual intervention. However, such opportunities in anatomical pathology are few and far between. Centralisation has been an effective approach in bringing economies of scale, the adoption of 'best practices' and the consolidation of pathologists, but this has not been possible in anatomical pathology because conventional histoprocessing takes a minimum of 14 hours and clinical turnaround time requirements necessitate that the laboratory and pathologist be in proximity and on site. While centralisation of laboratories for clinical chemistry, haematology and even microbiology has been successful in Australia and other countries, the essential requirements for anatomical pathology laboratories are different. In addition to efficient synchronised courier networks, a method of ultra-rapid tissue processing and some expedient system of returning the prepared tissue sections to the remote laboratory are essential to maintain the turnaround times mandatory for optimal clinical management. The advent of microwave-stimulated tissue processing that can be completed in 30-60 minutes and the immediate availability of compressed digital images of entire tissue sections via telepathology completes the final components of the equation necessary for making centralised anatomical pathology laboratories a reality.
Robboy, Stanley J; Gupta, Saurabh; Crawford, James M; Cohen, Michael B; Karcher, Donald S; Leonard, Debra G B; Magnani, Barbarajean; Novis, David A; Prystowsky, Michael B; Powell, Suzanne Z; Gross, David J; Black-Schaffer, W Stephen
Pathologists are physicians who make diagnoses based on interpretation of tissue and cellular specimens (surgical/cytopathology, molecular/genomic pathology, autopsy), provide medical leadership and consultation for laboratory medicine, and are integral members of their institutions' interdisciplinary patient care teams. To develop a dynamic modeling tool to examine how individual factors and practice variables can forecast demand for pathologist services. Build and test a computer-based software model populated with data from surveys and best estimates about current and new pathologist efforts. Most pathologists' efforts focus on anatomic (52%), laboratory (14%), and other direct services (8%) for individual patients. Population-focused services (12%) (eg, laboratory medical direction) and other professional responsibilities (14%) (eg, teaching, research, and hospital committees) consume the rest of their time. Modeling scenarios were used to assess the need to increase or decrease efforts related globally to the Affordable Care Act, and specifically, to genomic medicine, laboratory consolidation, laboratory medical direction, and new areas where pathologists' expertise can add value. Our modeling tool allows pathologists, educators, and policy experts to assess how various factors may affect demand for pathologists' services. These factors include an aging population, advances in biomedical technology, and changing roles in capitated, value-based, and team-based medical care systems. In the future, pathologists will likely have to assume new roles, develop new expertise, and become more efficient in practicing medicine to accommodate new value-based delivery models.
Weitzman, James B
Electronic medical devices (EMDs) with downloadable memories, such as implantable cardiac pacemakers, defibrillators, drug pumps, insulin pumps, and glucose monitors, are now an integral part of routine medical practice in the United States, and functional organ replacements, such as the artificial heart, pancreas, and retina, will most likely become commonplace in the near future. Often, EMDs end up in the hands of the pathologist as a surgical specimen or at autopsy. No established guidelines for systematic examination and reporting or comprehensive reviews of EMDs currently exist for the pathologist. To provide pathologists with a general overview of EMDs, including a brief history; epidemiology; essential technical aspects, indications, contraindications, and complications of selected devices; potential applications in pathology; relevant government regulations; and suggested examination and reporting guidelines. Articles indexed on PubMed of the National Library of Medicine, various medical and history of medicine textbooks, US Food and Drug Administration publications and product information, and specifications provided by device manufacturers. Studies were selected on the basis of relevance to the study objectives. Descriptive data were selected by the author. Suggested examination and reporting guidelines for EMDs received as surgical specimens and retrieved at autopsy. Electronic medical devices received as surgical specimens and retrieved at autopsy are increasing in number and level of sophistication. They should be systematically examined and reported, should have electronic memories downloaded when indicated, will help pathologists answer more questions with greater certainty, and should become an integral part of the formal knowledge base, research focus, training, and practice of pathology.
Austin Blackburn Wiles MD
Full Text Available Academic pathologists perform clinical duties, as well as valuable nonclinical activities. Nonclinical activities may consist of research, teaching, and administrative management among many other important tasks. While clinical duties have many clear metrics to measure productivity, like the relative value units of Medicare reimbursement, nonclinical performance is often difficult to measure. Despite the difficulty of evaluating nonclinical activities, nonclinical productivity is used to determine promotion, funding, and inform professional evaluations of performance. In order to better evaluate the important nonclinical performance of academic pathologists, we present an evaluation system for leadership use. This system uses a Microsoft Excel workbook to provide academic pathologist respondents and reviewing leadership a transparent, easy-to-complete system that is both flexible and scalable. This system provides real-time feedback to academic pathologist respondents and a clear executive summary that allows for focused guidance of the respondent. This system may be adapted to fit practices of varying size, measure performance differently based on years of experience, and can work with many different institutional values.
Raab, Stephen Spencer
An anatomic pathology diagnostic error may be secondary to a number of active and latent technical and/or cognitive components, which may occur anywhere along the total testing process in clinical and/or laboratory domains. For the pathologist interpretive steps of diagnosis, we examine Kahneman's framework of slow and fast thinking to explain different causes of error in precision (agreement) and in accuracy (truth). The pathologist cognitive diagnostic process involves image pattern recognition and a slow thinking error may be caused by the application of different rationally-constructed mental maps of image criteria/patterns by different pathologists. This type of error is partly related to a system failure in standardizing the application of these maps. A fast thinking error involves the flawed leap from image pattern to incorrect diagnosis. In the ideal state, anatomic pathology systems would target these cognitive error causes as well as the technical latent factors that lead to error.
Strickland-Marmol, Leah B; Muro-Cacho, Carlos A; Washington, Kay; Foulis, Philip R
- Cancer registrars should work closely with pathologists to ensure compliance with reporting standards. Many registrars, however, have little contact with pathologists, resulting in a lack of "real-time" interaction that is essential for their professional activities and development. - To facilitate registrars' case management, as cancer biology becomes more complex, we developed the ATP (Ask the Pathologist) forum as a place to ask pathology-related questions about neoplasms, such as terminology, biology, histologic classification, extent of disease, molecular markers, and prognostic factors. - Questions posted are reviewed by the ATP multidisciplinary oversight committee, which consists of 3 pathologists, 4 cancer registrars, 1 internal medicine physician, the pathology resident member of the College of American Pathologists Cancer Committee, and 2 medical technologists. The oversight committee may answer the question. Alternatively, the committee may forward the question to a content expert pathologist, determine that the question is better suited for another reference Web site, or both. - Since September 2013, when the ATP forum became available, users have posted 284 questions, of which 48 (17%) related to gastrointestinal tumors, 43 (15%) to breast tumors, and 37 (13%) to general pathology. The average turnaround time, from question posted to response, is 11.1 days. - The ATP forum has had a positive impact in the daily activities of cancer registrars. Of 440 registrars surveyed, more than 90% considered that questions were answered satisfactorily, and one-third reported that ATP answers affected how they managed a given case.
Essig, Harald; Gellrich, Nils-Claudius; Rana, Majeed; Meyer, Andreas; Eckardt, André M; Kokemueller, Horst; See, Constantin von; Lindhorst, Daniel; Tavassol, Frank; Ruecker, Martin
The quality of the interdisciplinary interface in oncological treatment between surgery, pathology and radiotherapy is mainly dependent on reliable anatomical three-dimensional (3D) allocation of specimen and their context sensitive interpretation which defines further treatment protocols. Computer-assisted preoperative planning (CAPP) allows for outlining macroscopical tumor size and margins. A new technique facilitates the 3D virtual marking and mapping of frozen sections and resection margins or important surgical intraoperative information. These data could be stored in DICOM format (Digital Imaging and Communication in Medicine) in terms of augmented reality and transferred to communicate patient's specific tumor information (invasion to vessels and nerves, non-resectable tumor) to oncologists, radiotherapists and pathologists
Full Text Available Abstract The quality of the interdisciplinary interface in oncological treatment between surgery, pathology and radiotherapy is mainly dependent on reliable anatomical three-dimensional (3D allocation of specimen and their context sensitive interpretation which defines further treatment protocols. Computer-assisted preoperative planning (CAPP allows for outlining macroscopical tumor size and margins. A new technique facilitates the 3D virtual marking and mapping of frozen sections and resection margins or important surgical intraoperative information. These data could be stored in DICOM format (Digital Imaging and Communication in Medicine in terms of augmented reality and transferred to communicate patient's specific tumor information (invasion to vessels and nerves, non-resectable tumor to oncologists, radiotherapists and pathologists.
Ramaiah, Lila; Hinrichs, Mary Jane; Skuba, Elizabeth V; Iverson, William O; Ennulat, Daniela
The continuing education course on integrating clinical and anatomical pathology data was designed to communicate the importance of using a weight of evidence approach to interpret safety findings in toxicology studies. This approach is necessary, as neither clinical nor anatomic pathology data can be relied upon in isolation to fully understand the relationship between study findings and the test article. Basic principles for correlating anatomic pathology and clinical pathology findings and for integrating these with other study end points were reviewed. To highlight these relationships, a series of case examples, presented jointly by a clinical pathologist and an anatomic pathologist, were used to illustrate the collaborative effort required between clinical and anatomical pathologists. In addition, the diagnostic utility of traditional liver biomarkers was discussed using results from a meta-analysis of rat hepatobiliary marker and histopathology data. This discussion also included examples of traditional and novel liver and renal biomarker data implementation in nonclinical toxicology studies to illustrate the relationship between discrete changes in biochemistry and tissue morphology.
Brown, Danielle L
Qualitative histopathology is the gold standard for routine examination of morphological tissue changes in the regulatory or academic environment. The human eye is exceptional for pattern recognition but often cannot detect small changes in quantity. In cases where detection of subtle quantitative changes is critical, more sensitive methods are required. Two-dimensional histomorphometry can provide additional quantitative information and is quite useful in many cases. However, the provided data may not be referent to the entire tissue and, as such, it makes several assumptions, which are sources of bias. In contrast, stereology is design based rather than assumption based and uses stringent sampling methods to obtain accurate and precise 3-dimensional information using geometrical and statistical principles. Recent advances in technology have made stereology more approachable and practical for the pathologist in both regulatory and academic environments. This review introduces pathologists to the basic principles of stereology and walks the reader through some real-world examples for the application of these principles in the workplace.
... completely without the help of a dermatologist or plastic surgeon. These doctors may use one of many types of treatments — from actual surgery to techniques like microdermabrasion and laser treatment — to reduce the appearance of stretch marks. These techniques are ...
Ritzman, Mitzi J.; Sanger, Dixie; Coufal, Kathy L.
This study explored how a school-based speech-language pathologist implemented a classroom-based service delivery model that focused on collaborative practices in classroom settings. The study used ethnographic observations and interviews with 1 speech-language pathologist to provide insights into how she implemented collaborative consultation and…
Tad T Brunyé
Full Text Available A pilot study examined the extent to which eye movements occurring during interpretation of digitized breast biopsy whole slide images (WSI can distinguish novice interpreters from experts, informing assessments of competency progression during training and across the physician-learning continuum. A pathologist with fellowship training in breast pathology interpreted digital WSI of breast tissue and marked the region of highest diagnostic relevance (dROI. These same images were then evaluated using computer vision techniques to identify visually salient regions of interest (vROI without diagnostic relevance. A non-invasive eye tracking system recorded pathologists' (N = 7 visual behavior during image interpretation, and we measured differential viewing of vROIs versus dROIs according to their level of expertise. Pathologists with relatively low expertise in interpreting breast pathology were more likely to fixate on, and subsequently return to, diagnostically irrelevant vROIs relative to experts. Repeatedly fixating on the distracting vROI showed limited value in predicting diagnostic failure. These preliminary results suggest that eye movements occurring during digital slide interpretation can characterize expertise development by demonstrating differential attraction to diagnostically relevant versus visually distracting image regions. These results carry both theoretical implications and potential for monitoring and evaluating student progress and providing automated feedback and scanning guidance in educational settings.
Daniel, Christel; García Rojo, Marcial; Bourquard, Karima; Henin, Dominique; Schrader, Thomas; Della Mea, Vincenzo; Gilbertson, John; Beckwith, Bruce A
Integrating anatomic pathology information- text and images-into electronic health care records is a key challenge for enhancing clinical information exchange between anatomic pathologists and clinicians. The aim of the Integrating the Healthcare Enterprise (IHE) international initiative is precisely to ensure interoperability of clinical information systems by using existing widespread industry standards such as Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7). To define standard-based informatics transactions to integrate anatomic pathology information to the Healthcare Enterprise. We used the methodology of the IHE initiative. Working groups from IHE, HL7, and DICOM, with special interest in anatomic pathology, defined consensual technical solutions to provide end-users with improved access to consistent information across multiple information systems. The IHE anatomic pathology technical framework describes a first integration profile, "Anatomic Pathology Workflow," dedicated to the diagnostic process including basic image acquisition and reporting solutions. This integration profile relies on 10 transactions based on HL7 or DICOM standards. A common specimen model was defined to consistently identify and describe specimens in both HL7 and DICOM transactions. The IHE anatomic pathology working group has defined standard-based informatics transactions to support the basic diagnostic workflow in anatomic pathology laboratories. In further stages, the technical framework will be completed to manage whole-slide images and semantically rich structured reports in the diagnostic workflow and to integrate systems used for patient care and those used for research activities (such as tissue bank databases or tissue microarrayers).
Abanmi, Abdullah A; Al Zouman, Abdulrahman Y; Al Hussaini, Husa; Al-Asmari, Abdulrahman
Prayer marks (PMs) are asymptomatic, chronic skin changes that consist mainly of thickening, lichenification, and hyperpigmentation, and develop over a long period of time as a consequence of repeated, extended pressure on bony prominences during prayer. Three hundred and forty-nine Muslims and 24 non-Muslims were examined for the appearance of PMs at different body sites. The prospective study of 349 Muslims (both males and females) with regular praying habits showed the occurrence of PMs on specific locations, such as the forehead, knees, ankles, and dorsa of the feet, leading to dermatologic changes consisting of lichenification and hyperpigmentation. The incidence of PMs was significantly higher in males than in females. Older subjects (over 50 years of age) demonstrated a significantly higher frequency of lichenification and hyperpigmentation, suggesting that repeated pressure and friction for prolonged periods are the causative factors for the development of PMs. Histologic examination of skin biopsies from the affected sites showed compact orthokeratosis, hypergranulosis, dermal papillary fibrosis, and dermal vascularization. PMs were not associated with any risk of secondary complications, such as erythema, bullous formation, and infections. PMs are commonly occurring dermatologic changes in Muslims who pray for prolonged periods.
Epstein, J I
This review article covers the full range of issues concerning malpractice as it relates to pathologists. Following a brief summary as to the incidence and general statistics on the outcome of lawsuits as well as common pathology misdiagnoses resulting in lawsuits, the definition of malpractice is discussed. These include duty, breech of standard of care, proximal cause, and damage. Details are provided as to what a pathologist should do from the initial threat of a lawsuit, to the initial lawsuit, and through the initial physician/lawyer meeting. An in-depth analysis as to how pathologists should handle themselves through the discovery process and, in particular, deposition is provided. Plaintiff attorneys' goals at deposition are covered in depth. These goals include: 1) education about the pathologist's case and strategies; 2) impeachment of the pathologist's credibility; and 3) judgment as to how effective a witness the pathologist will be at trial. Various types of plaintiff's attorney at deposition are summarized. Also discussed is the post-deposition meeting with the legal representative, whether to settle, and specific issues relating to trial. Finally, general tips on how to avoid a lawsuit in pathology are reviewed.
Full Text Available Despite the prognostic importance of mitotic count as one of the components of the Bloom – Richardson grade , several studies ([2, 9, 10] have found that pathologists’ agreement on the mitotic grade is fairly modest. Collecting a set of more than 4,200 candidate mitotic figures, we evaluate pathologists' agreement on individual figures, and train a computerized system for mitosis detection, comparing its performance to the classifications of three pathologists. The system’s and the pathologists’ classifications are based on evaluation of digital micrographs of hematoxylin and eosin stained breast tissue. On figures where the majority of pathologists agree on a classification, we compare the performance of the trained system to that of the individual pathologists. We find that the level of agreement of the pathologists ranges from slight to moderate, with strong biases, and that the system performs competitively in rating the ground truth set. This study is a step towards automatic mitosis count to accelerate a pathologist's work and improve reproducibility.
Hsu, Chih-Yi; Jung, Shih-Ming; Chuang, Shih-Sung
Anatomical pathology was not popular in Taiwan a few decades ago, with a severe shortage of pathologists. However, there has been a steady increase in recent years, and now there is a threat of oversupply We evaluated supply and demand over the past three decades and compared the findings with other countries. We collected the enrollment data of pathologists and physicians from the Taiwan Society of Pathology, the Department of Health, Executive Yuan, and Taiwan Medical Association, and analyzed equivalent data from other countries. We sent questionnaires to pathology chiefs to inquire about future job vacancies. The number of pathologists has increased at an annual rate of 4.93% between 2004 and 2008, in contrast to 3.7% for all physicians. There has been a net annual increase of 12 pathologists in the past 13 years. The estimated average number of consultant posts per year was nine, which was only one-third of the average number of first-year residents (R1s). The number of pathologists/million population in Taiwan was 14.83, which was comparable to that in Japan and South Korea but much smaller than that in Canada and the United States. The ratio of pathologists to physicians in Taiwan was 0.97%, which was higher than that in Japan (0.68%) and South Korea (0.64%), but lower than in Canada (1.32%) and the United States (1.46%). On average, 1.79% of medical graduates chose pathology for their R1 training in Taiwan, which was higher than that in the United States (1.50%) and Canada (1.10-1.20%). Anatomical pathology is no longer a specialty that is facing a physician shortage in Taiwan, and there is now a relatively high pathologist/physician ratio among Asian countries. We suggest that a decrease in the number of R1s in pathology is needed to maintain a balance between supply and demand. Copyright © 2011 Formosan Medical Association & Elsevier. Published by Elsevier B.V. All rights reserved.
Haffajee, Zenobia Ayesha Mohamed; Kumar, Beena; Francis, Glenn; Peck, Martyn; Badrick, Tony
The Royal College of Pathologists of Australasia Quality Assurance Program (RCPAQAP) Anatomical Pathology provides a comprehensive External Quality Assurance (EQA) exercise to review the reporting of immunohistochemistry (IHC) and in-situ hybridization (ISH) breast markers through an audit of clinical results. The aim of this exercise was to provide information regarding the quality of breast marker testing within clinical laboratories from 2005 to 2015. This comprehensive audit included estrogen, progesterone, and HER2 marker reporting. This was an important quality assurance activity established in response to ongoing difficulties experienced in laboratories in this area of testing.
Stempsey, W E
The profession of pathology is a practice in the technical sense used by many philosophers. Such practices have internal goods, which, it is hoped, lead to the attainment of a certain end. The ultimate end of the practice of pathology must be the good of the patient in terms of restoring health. Key internal goods in pathology are technical competence, the proper pathologist-patient relationship, and the proper pathologist-clinician relationship. Virtues are predispositions to act so as to attain the end of the practice and further the internal goods. Technical growth in the practice of pathology must be accompanied by continued attempts to articulate the goals and internal goods of the practice. Only if pathologists are predisposed to act in accordance with proper goals will an ethical practice be assured.
Speech-language pathologists play important roles in supporting people to be competent communicators in the languages of their communities. However, with over 7000 languages spoken throughout the world and the majority of the global population being multilingual, there is often a mismatch between the languages spoken by children and families and their speech-language pathologists. This paper provides insights into service provision for multilingual children within an English-dominant country by viewing Australia's multilingual population as a microcosm of ethnolinguistic minorities. Recent population studies of Australian pre-school children show that their most common languages other than English are: Arabic, Cantonese, Vietnamese, Italian, Mandarin, Spanish, and Greek. Although 20.2% of services by Speech Pathology Australia members are offered in languages other than English, there is a mismatch between the language of the services and the languages of children within similar geographical communities. Australian speech-language pathologists typically use informal or English-based assessments and intervention tools with multilingual children. Thus, there is a need for accessible culturally and linguistically appropriate resources for working with multilingual children. Recent international collaborations have resulted in practical strategies to support speech-language pathologists during assessment, intervention, and collaboration with families, communities, and other professionals. The International Expert Panel on Multilingual Children's Speech was assembled to prepare a position paper to address issues faced by speech-language pathologists when working with multilingual populations. The Multilingual Children's Speech website ( http://www.csu.edu.au/research/multilingual-speech ) addresses one of the aims of the position paper by providing free resources and information for speech-language pathologists about more than 45 languages. These international
Christopher, Mary M; Hotz, Christine S
Clinical pathologists use descriptive terms or modifiers to express the probability or likelihood of a cytologic diagnosis. Words are imprecise in meaning, however, and may be used and interpreted differently by pathologists and clinicians. The goals of this study were to 1) assess the frequency of use of 18 modifiers, 2) determine the probability of a positive diagnosis implied by the modifiers, 3) identify preferred modifiers for different levels of probability, 4) ascertain the importance of factors that affect expression of diagnostic certainty, and 5) evaluate differences based on gender, employment, and experience. We surveyed 202 clinical pathologists who were board-certified by the American College of Veterinary Pathologists (Clinical Pathology). Surveys were distributed in October 2001 and returned by e-mail, fax, or surface mail over a 2-month period. Results were analyzed by parametric and nonparametric tests. Survey response rate was 47.5% (n = 96) and primarily included clinical pathologists at veterinary schools (n = 58) and diagnostic laboratories (n = 31). Eleven of 18 terms were used "often" or "sometimes" by >/= 50% of respondents. Broad variability was found in the probability assigned to each term, especially those with median values of 75 to 90%. Preferred modifiers for 7 numerical probabilities ranging from 0 to 100% included 68 unique terms; however, a set of 10 terms was used by >/= 50% of respondents. Cellularity and quality of the sample, experience of the pathologist, and implications of the diagnosis were the most important factors affecting the expression of probability. Because of wide discrepancy in the implied likelihood of a diagnosis using words, defined terminology and controlled vocabulary may be useful in improving communication and the quality of data in cytology reporting.
Full Text Available The role of adhesion molecules is very important both in the activation of carcinogenesis and in the differentiation of subtypes of breast carcinoma, aiding in diagnosis, prognosis and therapeutic choice in these tumors. Therefore, understanding the functions and interrelationships among these molecules is crucial to the pathologist, who often uses these factors as a resource to differentiate tumors and further classify them according to a molecular point of view. Our goal is to describe the applicability and the difficulties encountered by the pathologist in the diagnosis of breast carcinoma, discussing the most commonly used markers of adhesion in routine analyses.
Ye, Jay J
Pathologists' daily tasks consist of both the professional interpretation of slides and the secretarial tasks of translating these interpretations into final pathology reports, the latter of which is a time-consuming endeavor for most pathologists. To describe an artificial intelligence that performs secretarial tasks, designated as Secretary-Mimicking Artificial Intelligence (SMILE). The underling implementation of SMILE is a collection of computer programs that work in concert to "listen to" the voice commands and to "watch for" the changes of windows caused by slide bar code scanning; SMILE responds to these inputs by acting upon PowerPath Client windows (Sunquest Information Systems, Tucson, Arizona) and its Microsoft Word (Microsoft, Redmond, Washington) Add-In window, eventuating in the reports being typed and finalized. Secretary-Mimicking Artificial Intelligence also communicates relevant information to the pathologist via the computer speakers and message box on the screen. Secretary-Mimicking Artificial Intelligence performs many secretarial tasks intelligently and semiautonomously, with rapidity and consistency, thus enabling pathologists to focus on slide interpretation, which results in a marked increase in productivity, decrease in errors, and reduction of stress in daily practice. Secretary-Mimicking Artificial Intelligence undergoes encounter-based learning continually, resulting in a continuous improvement in its knowledge-based intelligence. Artificial intelligence for pathologists is both feasible and powerful. The future widespread use of artificial intelligence in our profession is certainly going to transform how we practice pathology.
McCloskey, Cindy B; Domen, Ronald E; Conran, Richard M; Hoffman, Robert D; Post, Miriam D; Brissette, Mark D; Gratzinger, Dita A; Raciti, Patricia M; Cohen, David A; Roberts, Cory A; Rojiani, Amyn M; Kong, Christina S; Peterson, Jo Elle G; Johnson, Kristen; Plath, Sue; Powell, Suzanne Zein-Eldin
Competency-based medical education has evolved over the past decades to include the Accreditation Council for Graduate Medical Education Accreditation System of resident evaluation based on the Milestones project. Entrustable professional activities represent another means to determine learner proficiency and evaluate educational outcomes in the workplace and training environment. The objective of this project was to develop entrustable professional activities for pathology graduate medical education encompassing primary anatomic and clinical pathology residency training. The Graduate Medical Education Committee of the College of American Pathologists met over the course of 2 years to identify and define entrustable professional activities for pathology graduate medical education. Nineteen entrustable professional activities were developed, including 7 for anatomic pathology, 4 for clinical pathology, and 8 that apply to both disciplines with 5 of these concerning laboratory management. The content defined for each entrustable professional activity includes the entrustable professional activity title, a description of the knowledge and skills required for competent performance, mapping to relevant Accreditation Council for Graduate Medical Education Milestone subcompetencies, and general assessment methods. Many critical activities that define the practice of pathology fit well within the entrustable professional activity model. The entrustable professional activities outlined by the Graduate Medical Education Committee are meant to provide an initial framework for the development of entrustable professional activity-related assessment and curricular tools for pathology residency training.
Meijer, G.A.; Oudejans, J.J.; Koevoets, J.J.M.; Meijer, C.J.L.M.
Adequate budget control in pathology practice requires accurate allocation of resources. Any changes in types and numbers of specimens handled or protocols used will directly affect the pathologists' workload and consequently the allocation of resources. The aim of the present study was to develop a
Meijer, G A; Oudejans, J J; Koevoets, J J M; Meijer, C J L M
Adequate budget control in pathology practice requires accurate allocation of resources. Any changes in types and numbers of specimens handled or protocols used will directly affect the pathologists' workload and consequently the allocation of resources. The aim of the present study was to develop a model for measuring the pathologists' workload that can take into account the changes mentioned above. The diagnostic process was analyzed and broken up into separate activities. The time needed to perform these activities was measured. Based on linear regression analysis, for each activity, the time needed was calculated as a function of the number of slides or blocks involved. The total pathologists' time required for a range of specimens was calculated based on standard protocols and validated by comparing to actually measured workload. Cutting up, microscopic procedures and dictating turned out to be highly correlated to number of blocks and/or slides per specimen. Calculated workload per type of specimen was significantly correlated to the actually measured workload. Modeling pathologists' workload based on formulas that calculate workload per type of specimen as a function of the number of blocks and slides provides a basis for a comprehensive, yet flexible, activity-based costing system for pathology.
Full Text Available Biomarker testing has become standard of care for patients diagnosed with non-small cell lung cancer. Although it can be successfully performed in circulating tu-mor cells, at present, the vast majority of investigations are carried out using di-rect tumor sampling, either through aspiration methods, which render most often isolated cells, or tissue sampling, that could range from minute biopsies to large resections. Consequently, pathologists play a central role in this process. Recent evidence suggests that refining NSCLC diagnosis might be clinically signifi-cant, particularly in cases of lung adenocarcinomas (ADC, which in turn, has prompted a new proposal for the histologic classification of such pulmonary neo-plasms. These changes, in conjunction with the mandatory incorporation of biomarker testing in routine NSCLC tissue processing, have directly affected the pathologist’s role in lung cancer work-up. This new role pathologists must play is complex and demanding, and requires a close interaction with surgeons, oncologists, radiologists and molecular pathologists. Pathologists often find themselves as the central figure in the coordination of a process, that involves assuring that the tumor samples are properly fixed, but without disruption of the DNA structure, obtaining the proper diagnosis with a minimum of tissue waste, providing pre-analytical evaluation of tumor samples selected for biomarker testing, which includes assessment of the proportion of tumor to normal tissues, as well as cell viability, and assuring that this entire pro-cess happens in a timely fashion. Therefore, it is part of the pathologist’s respon-sibilities to assure that the samples received in their laboratories, be processed in a manner that allows for optimal biomarker testing. This article goal is to discuss the essential role pathologists must play NSCLC bi-omarker testing, as well as to provide a summarized review of the main NSCLC bi-omarkers of
Giles, Melanie; Barker, Mary; Hayes, Amanda
Speech language pathologists play an important role in the care of patients with speech, language, or swallowing difficulties that can result from a variety of medical conditions. This article describes how speech language pathologists assess and treat these conditions and the red flags that suggest a referral to a speech language pathologist is indicated.
France, N; Lawrence, S; Smith, J F
This paper examines the progressive exertion of external managerial control over New Zealand pathologists as the country's New Public Management health reforms were implemented during the 1990s. Perspectives on professionalism, and its role in the effective use of resources, are discussed as part of the examination of this shift in decision-making power from pathologists to external management. Our analysis, based on a range of archived and interview data collected over the period 1997-2000, suggests that publicly unacceptable compromises in pathology service quality were risked by the pursuit of tight bureaucratic and free market controls over pathology practice. The paper concludes with suggestions for a health professional control model facilitative of maximal health gain.
Vineeth G Nair
Full Text Available Born in 1866, Aldred Scott Warthin was a pathologist and teacher of great repute. Even though many know him from his eponyms, the true value of his achievements, and how far he was ahead of his peers, is known to but a few modern day medical students. It was in fact, based on his work, that Henry Lynch came up with his theories on the genetic nature of cancer. He died in 1931 leaving a lot of work unfinished.
Post-termination relationships are complex because the client may need additional services and it may be difficult to determine when the speech-language pathologist-client relationship is truly terminated. In my contribution to this scientific forum, discharge experiences from speech-language pathologists working in Cyprus and Greece will be explored in search of commonalities and differences in the way in which pathologists end therapy from different cultural perspectives. Within this context the personal impact on speech-language pathologists of the discharge process will be highlighted. Inherent in this process is how speech-language pathologists learn to hold their feelings, anxieties and reactions when communicating discharge to clients. Overall speech-language pathologists working in Cyprus and Greece experience similar emotional responses to positive and negative therapy endings as speech-language pathologists working in Australia. The major difference is that Cypriot and Greek therapists face serious limitations in moving their clients on after therapy has ended.
Fritzsche Florian Rudolf
Full Text Available Abstract Background Pathologists are highly trained medical professionals who play an essential part in the diagnosis and therapy planning of malignancies and inflammatory diseases. Their work is associated with potential health hazards including injuries involving infectious human tissue, chemicals which are assumed to be carcinogenic or long periods of microscope and computer work. This study aimed to provide the first comprehensive assessment of the health situation of pathologists in Switzerland. Methods Pathologists in Switzerland were contacted via the Swiss Society of Pathologists and asked to answer an ethically approved, online anonymous questionnaire comprising 48 questions on occupational health problems, workplace characteristics and health behaviour. Results 163 pathologists participated in the study. Forty percent of pathologists reported musculoskeletal problems in the previous month. The overall prevalence was 76%. Almost 90% of pathologists had visual refraction errors, mainly myopia. 83% of pathologists had experienced occupational injuries, mostly cutting injuries, in their professional career; more than one fifth of participants reported cutting injuries in the last year. However, long lasting injuries and infectious diseases were rare. Depression and burnout affected every eighth pathologist. The prevalence of smoking was substantially below that of the general Swiss population. Conclusions The results of this study suggest that more care should be taken in technical and personal protective measures, ergonomic workplace optimisation and reduction of work overload and work inefficiencies. Despite the described health risks, Swiss pathologists were optimistic about their future and their working situation. The high rate of ametropia and psychological problems warrants further study.
Love, Jennifer C; Derrick, Sharon M; Wiersema, Jason M; Peters, Charles
Microscopic saw mark analysis is a well published and generally accepted qualitative analytical method. However, little research has focused on identifying and mitigating potential sources of error associated with the method. The presented study proposes the use of classification trees and random forest classifiers as an optimal, statistically sound approach to mitigate the potential for error of variability and outcome error in microscopic saw mark analysis. The statistical model was applied to 58 experimental saw marks created with four types of saws. The saw marks were made in fresh human femurs obtained through anatomical gift and were analyzed using a Keyence digital microscope. The statistical approach weighed the variables based on discriminatory value and produced decision trees with an associated outcome error rate of 8.62-17.82%. © 2014 American Academy of Forensic Sciences.
Bowman, Adrian W.; Katina, Stanislav; Smith, Joanna; Brown, Denise
Methods for capturing images in three dimensions are now widely available, with stereo-photogrammetry and laser scanning being two common approaches. In anatomical studies, a number of landmarks are usually identified manually from each of these images and these form the basis of subsequent statistical analysis. However, landmarks express only a very small proportion of the information available from the images. Anatomically defined curves have the advantage of providing a much richer expression of shape. This is explored in the context of identifying the boundary of breasts from an image of the female torso and the boundary of the lips from a facial image. The curves of interest are characterised by ridges or valleys. Key issues in estimation are the ability to navigate across the anatomical surface in three-dimensions, the ability to recognise the relevant boundary and the need to assess the evidence for the presence of the surface feature of interest. The first issue is addressed by the use of principal curves, as an extension of principal components, the second by suitable assessment of curvature and the third by change-point detection. P-spline smoothing is used as an integral part of the methods but adaptations are made to the specific anatomical features of interest. After estimation of the boundary curves, the intermediate surfaces of the anatomical feature of interest can be characterised by surface interpolation. This allows shape variation to be explored using standard methods such as principal components. These tools are applied to a collection of images of women where one breast has been reconstructed after mastectomy and where interest lies in shape differences between the reconstructed and unreconstructed breasts. They are also applied to a collection of lip images where possible differences in shape between males and females are of interest. PMID:26041943
Elsmore, Matthew James
-border setting, with a particular focus on small business and consumers. The article's overall message is to call for a rethink of received wisdom suggesting that trade marks are effective trade-enabling devices. The case is made for reassessing how we think about European trade mark law.......First, this article argues that trade mark law should be approached in a supplementary way, called reconfiguration. Second, the article investigates such a reconfiguration of trade mark law by exploring the interplay of trade marks and service transactions in the Single Market, in the cross...
Donnelly, Jennifer C
Over the past decade, prenatal screening and diagnosis has moved from the second into the first trimester, with aneuploidy screening becoming both feasible and effective. With vast improvements in ultrasound technology, sonologists can now image the fetus in greater detail at all gestational ages. In the hands of experienced sonographers, anatomic surveys between 11 and 14 weeks can be carried out with good visualisation rates of many structures. It is important to be familiar with the normal development of the embryo and fetus, and to be aware of the major anatomical landmarks whose absence or presence may be deemed normal or abnormal depending on the gestational age. Some structural abnormalities will nearly always be detected, some will never be and some are potentially detectable depending on a number of factors.
Mark Tompkins Canaccord
Mark Tompkins Canaccord is a senior technologist for ecosystem and water resources management in SEC SAID Oakland, California office. In his career which lasts over fifteen years Mark has worked on project involving lake restorations, clean water engineering, ecological engineering and management, hydrology, hydraulics, sediment transport and other projects for environmental planning all over the country. Mark Tompkins Canaccord tries to blend his skills of planning and engineering with s...
Full Text Available Dysphagia and communication impairment are common consequences of stroke. Stroke survivors with either or both of these impairments are likely to have poorer long-term outcomes than those who do not have them. Speech-language pathologists (SLP play a significant role in the screening, formal assessment, management, and rehabilitation of stroke survivors who present with dysphagia and/or communication impairment. Early diagnosis and referral is critical, as is intensive intervention as soon as the patient is able to participate. The SLP is also responsible for educating carers and staff in strategies that can support the patient and for making appropriate environmental modifications (e.g. altering diet consistencies or providing information in an aphasia-friendly format to optimize the stroke survivor′s participation, initially, in the rehabilitation program and, subsequently, within the community.
Johnson, Cheryl DeConde
Emphasis on classroom listening has gained importance for all children and especially for those with hearing loss and special listening needs. The rationale can be supported from trends in educational placements, the Response to Intervention initiative, student performance and accountability, the role of audition in reading, and improvement in hearing technologies. Speech-language pathologists have an instrumental role advocating for the accommodations that are necessary for effective listening for these children in school. To identify individual listening needs and make relevant recommendations for accommodations, a classroom listening assessment is suggested. Components of the classroom listening assessment include observation, behavioral assessment, self-assessment, and classroom acoustics measurements. Together, with a strong rationale, the results can be used to implement a plan that results in effective classroom listening for these children. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Remick, Amera K.; Catlin, Natasha R.; Quist, Erin M.; Steinbach, Thomas J.; Dixon, Darlene
The Society of Toxicologic Pathology (STP) Education Committee and the STP Reproductive Special Interest Group held a North Carolina regional meeting entitled, “Juvenile Toxicology: Relevance and Challenges for Toxicologists and Pathologists” on March 13, 2015, at the National Institute of Environmental Health Sciences/National Toxicology Program in Research Triangle Park, North Carolina. The purpose of this regional meeting was to familiarize attendees with the topic of juvenile toxicity testing and discuss its relevance to clinical pediatric medicine, regulatory perspectives, challenges of appropriate study design confronted by toxicologists, and challenges of histopathologic examination and interpretation of juvenile tissues faced by pathologists. The 1-day meeting was a success with over 60 attendees representing industry, government, research organizations, and academia. PMID:26220944
Barksdale, Sarah Kay
Merkel cell carcinoma (MCC) is a rarely made but potentially devastating diagnosis. While local disease might be cured by surgery and radiotherapy, advanced disease is usually rapidly progressive and fatal. Until very recently, the only approach to metastatic MCC was cytotoxic chemotherapy with results so disappointing that current treatment guidelines discourage its use and recommend clinical trial as a more viable treatment option. Fortunately, recent advances in the understanding of the molecular pathogenesis of this tumour have produced a wide variety of experimental treatments for MCC, some of which are quite promising. The most current information regarding the diagnosis, staging, management of this tumour is briefly presented as well as new insights into the molecular basis of MCC and therapeutic approaches to MCC. Copyright © 2017 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.
Svistunov, V V; Makarov, S V; Makarova, A E
The paper considers the development and current state of the regulation of work quota setting and remuneration in pathologists. Reasoning from the current staff standards for morbid anatomy departments (units), the authors present a method to calculate the load of pathologists. The essence of the proposed method is demonstrated using a specific example.
Al-Marzooq, Yusef M.; Chopra, Rajan; Al-Bahrani, Ahmed T.; Younis, Mohammad; Al-Mulhim, Abdulrahman S.; Al-Mommatten, Mohammed I.
Fine-needle aspiration biopsy (FNAB) may yield different results depending on its operator. We compared the proportions of unsatisfactory aspirates obtained by pathologists vs. surgeons. In a retrospective review, all FNAB reports and slides performed between March 2002 and February 2003 were grouped by organ/site and according to whether they were done by pathologist or a surgeon. The proportions of unsatisfactory aspirates for pathologists and surgeons were compared. Of 692 FNAB's, 390 were performed by pathologists at the FNAC clinic and the remainder by surgeons. Overall, 15.5% of aspirates obtained were unsatisfactory (n=107). Of aspirates obtained by surgeons, 29.5% were unsatisfactory, compared to 4.6% of those obtained by pathologists (P<0.001). Pathologists had significantly lower proportions of unsatisfactory aspirates in all sites. A 33% reduction in the number of lymph node excisional biopsies has been reported subsequent to establishment of the FNAC clinic. The advantages of a pathologist performing FNAB are that a rapid evaluation can be rendered regarding specimen adequacy and the need for repeating the procedure. In addition, pathologists can direct the distribution of aspirated material for other tests such as culture study, flow cytometry and electron microscopy, as indicated by preliminary evaluation of the smears. These factors significantly lower the proportions of unsatisfactory specimens and improve the diagnstic accuracy of FNAB technique. (author)
Hartman, Douglas J
Optimizing pathologist workflow can be difficult because it is affected by many variables. Surgical pathologists must complete many tasks that culminate in a final pathology report. Several software systems can be used to enhance/improve pathologist workflow. These include voice recognition software, pre-sign-out quality assurance, image utilization, and computerized provider order entry. Recent changes in the diagnostic coding and the more prominent role of centralized electronic health records represent potential areas for increased ways to enhance/improve the workflow for surgical pathologists. Additional unforeseen changes to the pathologist workflow may accompany the introduction of whole-slide imaging technology to the routine diagnostic work. Copyright © 2015 Elsevier Inc. All rights reserved.
Evans, Philip M
The goal of radiation therapy is to achieve maximal therapeutic benefit expressed in terms of a high probability of local control of disease with minimal side effects. Physically this often equates to the delivery of a high dose of radiation to the tumour or target region whilst maintaining an acceptably low dose to other tissues, particularly those adjacent to the target. Techniques such as intensity modulated radiotherapy (IMRT), stereotactic radiosurgery and computer planned brachytherapy provide the means to calculate the radiation dose delivery to achieve the desired dose distribution. Imaging is an essential tool in all state of the art planning and delivery techniques: (i) to enable planning of the desired treatment, (ii) to verify the treatment is delivered as planned and (iii) to follow-up treatment outcome to monitor that the treatment has had the desired effect. Clinical imaging techniques can be loosely classified into anatomic methods which measure the basic physical characteristics of tissue such as their density and biological imaging techniques which measure functional characteristics such as metabolism. In this review we consider anatomical imaging techniques. Biological imaging is considered in another article. Anatomical imaging is generally used for goals (i) and (ii) above. Computed tomography (CT) has been the mainstay of anatomical treatment planning for many years, enabling some delineation of soft tissue as well as radiation attenuation estimation for dose prediction. Magnetic resonance imaging is fast becoming widespread alongside CT, enabling superior soft-tissue visualization. Traditionally scanning for treatment planning has relied on the use of a single snapshot scan. Recent years have seen the development of techniques such as 4D CT and adaptive radiotherapy (ART). In 4D CT raw data are encoded with phase information and reconstructed to yield a set of scans detailing motion through the breathing, or cardiac, cycle. In ART a set of
Mocko, Michael Jeffrey [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Zavorka, Lukas [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Koehler, Paul E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
This is a review of Mark-IV target neutronics design. It involved the major redesign of the upper tier, offering harder neutron spectra for upper-tier FPs; a redesign of the high-resolution (HR) moderator; and a preservation of the rest of Mark-III features.
Stock Mark Stock Scientific Visualization Specialist Mark.Stock@nrel.gov | 303-275-4174 Dr. Stock , virtual reality, parallel computing, and manipulation of large spatial data sets. As an artist, he creates . Stock built the SUNLIGHT artwork that is installed on the Webb Building in downtown Denver. In addition
Schmidt, Rodney A; Simmons, Kim; Grimm, Erin E; Middlebrooks, Michael; Changchien, Rosy
Electronic document management systems (EDMSs) have the potential to improve the efficiency of anatomic pathology laboratories. We implemented a novel but simple EDMS for scanned documents as part of our laboratory information system (AP-LIS) and collected cost-benefit data with the intention of discerning the value of such a system in general and whether integration with the AP-LIS is advantageous. We found that the direct financial benefits are modest but the indirect and intangible benefits are large. Benefits of time savings and access to data particularly accrued to pathologists and residents (3.8 h/d saved for 26 pathologists and residents). Integrating the scanned document management system (SDMS) into the AP-LIS has major advantages in terms of workflow and overall simplicity. This simple, integrated SDMS is an excellent value in a practice like ours, and many of the benefits likely apply in other practice settings.
Post, Miriam D; Johnson, Kristen; Brissette, Mark D; Conran, Richard Michael; Domen, Ronald E; Hoffman, Robert D; McCloskey, Cindy B; Raciti, Patricia M; Roberts, Cory Anthony; Rojiani, Amyn M; Tucker, J Allan; Powell, Suzanne Z
-Multiple sources have identified challenges that training programs face in preparing graduates for the "real world" practice of pathology, and many training programs have sought to decrease the gap between skills acquired during training and those required in practice. However, there exists the possibility that some of the difficulty experienced by newly trained pathologists and employers might arise from differences between employer expectations of new hires and what applicants expect from their first job. -To define the constellation of skills and attributes employers prioritize when hiring newly trained pathologists. -A survey of fellows of the College of American Pathologists in practice for 5 or more years in the United States was administered and the results were analyzed. -A total of 630 pathologists who were responsible for hiring a new-in-practice pathologist completed the survey. Regardless of practice setting, certain skills and attributes were rated critically important in new hires, including ethics/integrity, work ethic, and professionalism. Seventy-one percent reported having some difficulty hiring entry-level pathologists and cited inadequate training/experience during residency, and applicants having unrealistic expectations regarding work load/hours as the most common reasons. -Prospective employers not only expect well-developed diagnostic skills in their job applicants, but also require evidence of a strong work ethic and outstanding professionalism. Successful applicants must display willingness to assume responsibilities and flexibility regarding existing and new responsibilities. A secondary but important finding of this survey was that most jobs are garnered through word-of-mouth recommendations; therefore, it is crucial for pathologists-in-training to hone their networking skills.
Federal Laboratory Consortium — The Mark I Test Facility is a state-of-the-art space environment simulation test chamber for full-scale space systems testing. A $1.5M dollar upgrade in fiscal year...
Kieli Linnagaleriis avatud 2. Ars Baltica fototriennaalil 'Can You Hear Me?' esindab Eestit Mark Raidpere seeriaga 'Portreed 1998'. Näituse Eesti-poolne kuraator Anu Liivak, kataloogiteksti kirjutas Anders Härm. Tuntumaid osalejaid triennaalil Wolfgang Tillmans
Planchebaseret udendørs udstilling på musikfestivalen Copenhell 18-20/6 2015. En mindre udgave af udstillingen Marks of Metal - Logodesign og visualitet i heavy metal. Udarbejdet i samarbejde med Mediemuseet.......Planchebaseret udendørs udstilling på musikfestivalen Copenhell 18-20/6 2015. En mindre udgave af udstillingen Marks of Metal - Logodesign og visualitet i heavy metal. Udarbejdet i samarbejde med Mediemuseet....
Groupe de protection des biens
As part of the campaign to protect CERN property and for insurance reasons, all computer hardware belonging to the Organization must be marked with the words 'PROPRIETE CERN'.IT Division has recently introduced a new marking system that is both economical and easy to use. From now on all desktop hardware (PCs, Macintoshes, printers) issued by IT Division with a value equal to or exceeding 500 CHF will be marked using this new system.For equipment that is already installed but not yet marked, including UNIX workstations and X terminals, IT Division's Desktop Support Service offers the following services free of charge:Equipment-marking wherever the Service is called out to perform other work (please submit all work requests to the IT Helpdesk on 78888 or email@example.com; for unavoidable operational reasons, the Desktop Support Service will only respond to marking requests when these coincide with requests for other work such as repairs, system upgrades, etc.);Training of personnel designated by Division Leade...
Cesmebasi, Alper; Muhleman, Mitchel A; Hulsberg, Paul; Gielecki, Jerzy; Matusz, Petru; Tubbs, R Shane; Loukas, Marios
Occipital neuralgia is a debilitating disorder first described in 1821 as recurrent headaches localized in the occipital region. Other symptoms that have been associated with this condition include paroxysmal burning and aching pain in the distribution of the greater, lesser, or third occipital nerves. Several etiologies have been identified in the cause of occipital neuralgia and include, but are not limited to, trauma, fibrositis, myositis, fracture of the atlas, and compression of the C-2 nerve root, C1-2 arthrosis syndrome, atlantoaxial lateral mass osteoarthritis, hypertrophic cervical pachymeningitis, cervical cord tumor, Chiari malformation, and neurosyphilis. The management of occipital neuralgia can include conservative approaches and/or surgical interventions. Occipital neuralgia is a multifactorial problem where multiple anatomic areas/structures may be involved with this pathology. A review of these etiologies may provide guidance in better understanding occipital neuralgia. © 2014 Wiley Periodicals, Inc.
DeBonis, David A; Moncrieff, Deborah
Unanswered questions regarding the nature of auditory processing disorders (APDs), how best to identify at-risk students, how best to diagnose and differentiate APDs from other disorders, and concerns about the lack of valid treatments have resulted in ongoing confusion and skepticism about the diagnostic validity of this label. This poses challenges for speech-language pathologists (SLPs) who are working with school-age children and whose scope of practice includes APD screening and intervention. The purpose of this article is to address some of the questions commonly asked by SLPs regarding APDs in school-age children. This article is also intended to serve as a resource for SLPs to be used in deciding what role they will or will not play with respect to APDs in school-age children. The methodology used in this article included a computerized database review of the latest published information on APD, with an emphasis on the work of established researchers and expert panels, including articles from the American Speech-Language-Hearing Association and the American Academy of Audiology. The article concludes with the authors' recommendations for continued research and their views on the appropriate role of the SLP in performing careful screening, making referrals, and supporting intervention.
Royall, Julia; Isyagi, Micongwe Moses; Iliyasu, Yawale; Lukande, Robert; Vuhahula, Edda
The shared practice of pathology via the Internet holds great potential for pathologists in sub-Saharan Africa (SSA) and their global partners. Application of the Internet is constrained by issues of bandwidth, cost, and power. The penetration of mobile telephony and the arrival of smartphones have changed the use of Internet and social media in Africa and therefore the work of the 4 African pathologists featured in this article. As pathology in SSA struggles for visibility and usefulness, the Internet and its electronic applications provide a critical infrastructure as well as a podium for pathologists across the continent. Copyright © 2017 Elsevier Inc. All rights reserved.
Anatomical relationship between traditional acupuncture point ST 36 and Omura's ST 36 (True ST 36) with their therapeutic effects: 1) inhibition of cancer cell division by markedly lowering cancer cell telomere while increasing normal cell telomere, 2) improving circulatory disturbances, with reduction of abnormal increase in high triglyceride, L-homocystein, CRP, or cardiac troponin I & T in blood by the stimulation of Omura's ST 36--Part 1.
Omura, Yoshiaki; Chen, Yemeng; Lu, Dominic P; Shimotsura, Yasuhiro; Ohki, Motomu; Duvvi, Harsha
Using Bi-Digital O-Ring Test Resonance Phenomena between 2 identical substances, Omura, Y. succeeded in making the image of the outline of internal organs without use of standard imaging devices since 1982. When he imaged the outline of the stomach on the abdominal wall, a number of the lines came out from upper and lower parts of stomach wall. When the lines were followed, they were very close to the well-known stomach meridians. Subsequently, he found a method of localizing meridians and their corresponding acupuncture points as well as shapes and diameters accurately. At the anatomical location of ST 36 described in traditional textbooks, Omura, Y. found there is no acupuncture point. However, in the close vicinity, there is an acupuncture point which he named as true ST 36 in the mid 1980s, but it is generally known as Omura's ST 36. When the effects of the acupuncture on these 2 locations were compared, Omura's ST 36 (true ST 36) produced very significant well-known acupuncture beneficial effects including improved circulation and blood chemistry, while in the traditional ST 36, the effects were small. In this article, the anatomical relationship between these two acupuncture points, with a short distance of 0.6 approximately 1.5 cm between the centers of these locations, was described. In early 2000, Omura, Y. found Press Needle Stimulation of Omura's ST 36, using "Press-Release" procedure repeated 200 times, 4 times a day to cancer patients reduced high cancer cell telomere of 600-1500ng and high Oncogen C-fos Ab2 and Integrin alpha5beta1 of 100-700ng BDORT units to close to lyg (= 10(-24) g) BDORT units. In addition there was a significant reduction of Asbestos and Hg from cancer cells, while markedly reduced normal cell telomere of lyg was increased to optimally high amounts of 500-530ng BDORTunits. Thus, cancer cells can no longer divide and cancer activity is inhibited. The authors have successfully applied this method for a variety of cancers as well as
Cheung, King Sing
Petri nets are a formal and theoretically rich model for the modelling and analysis of systems. A subclass of Petri nets, augmented marked graphs possess a structure that is especially desirable for the modelling and analysis of systems with concurrent processes and shared resources.This monograph consists of three parts: Part I provides the conceptual background for readers who have no prior knowledge on Petri nets; Part II elaborates the theory of augmented marked graphs; finally, Part III discusses the application to system integration. The book is suitable as a first self-contained volume
van Rhijn, Bas W G; van Leenders, Geert J L H; Ooms, Bert C M; Kirkels, Wim J; Zlotta, Alexandre R; Boevé, Egbert R; Jöbsis, Adriaan C; van der Kwast, Theo H
A new grading system for bladder cancer (BCa) was adopted in 2004 to reduce observer variability and provide better prognostic information. We compared the World Health Organization (WHO) 1973 and 2004 systems for observer variability and prognosis. Slides of 173 primary non-muscle-invasive BCa were reviewed two times by four pathologists. Intra- and interobserver variability were assessed using κ statistics. We determined the mean grade (eg, G1/low malignant potential is 1 grade point, G2/low grade is 2 grade points) of the pathologists per grading cycle. Kaplan-Meier analyses were applied for prediction of recurrence and progression. For WHO 2004 and 1973 grading, the agreement between the pathologists was 39-74% (κ: 0.14-0.58) and 39-64% (κ: 0.15-0.41), respectively. The intraobserver agreement varied from 71% to 88% (κ: 0.55-0.81). The mean grade of a pathologist was constant (difference below 0.1 grade point) irrespective of the grading system. Conversely, mean-grade differences among the pathologists were high, up to 0.7 grade point. The mean grades for the WHO 2004 system were 0.3-0.5 grade point higher than those of WHO 1973. Mean grade distinguished low and high graders among the pathologists and was strongly linked with risk of progression in each grade category. The variation in mean grade among individual pathologists exceeded the grade shift caused by WHO 2004 grading. Knowledge of the pathologist's mean grade allows a better assessment of the prognostic value of grading. Mean grade has the potential to become a tool for quality assurance in pathology. Copyright © 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved.
Geller, Berta M; Nelson, Heidi D; Weaver, Donald L; Frederick, Paul D; Allison, Kimberly H; Onega, Tracy; Carney, Patricia A; Tosteson, Anna N A; Elmore, Joann G
Second opinions in pathology improve patient safety by reducing diagnostic errors, leading to more appropriate clinical treatment decisions. Little objective data are available regarding the factors triggering a request for second opinion despite second opinion consultations being part of the diagnostic system of pathology. Therefore we sought to assess breast biopsy cases and interpreting pathologists characteristics associated with second opinion requests. Collected pathologist surveys and their interpretations of 60 test set cases were used to explore the relationships between case characteristics, pathologist characteristics and case perceptions, and requests for second opinions. Data were evaluated by logistic regression and generalised estimating equations. 115 pathologists provided 6900 assessments; pathologists requested second opinions on 70% (4827/6900) of their assessments 36% (1731/4827) of these would not have been required by policy. All associations between case characteristics and requesting second opinions were statistically significant, including diagnostic category, breast density, biopsy type, and number of diagnoses noted per case. Exclusive of institutional policies, pathologists wanted second opinions most frequently for atypia (66%) and least frequently for invasive cancer (20%). Second opinion rates were higher when the pathologist had lower assessment confidence, in cases with higher perceived difficulty, and cases with borderline diagnoses. Pathologists request second opinions for challenging cases, particularly those with atypia, high breast density, core needle biopsies, or many co-existing diagnoses. Further studies should evaluate whether the case characteristics identified in this study could be used as clinical criteria to prompt system-level strategies for mandating second opinions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Page, Stephen J; Wallace, Sarah E
Constraint-induced language therapy (CILT) has received recent attention as a possible intervention to improve expressive language in people with nonfluent aphasia. Difficulties have been reported with the practical implementation of constraint-induced movement therapy due to its intensive treatment parameters. It remains unknown whether similar challenges may exist with CILT. To determine the opinions of speech-language pathologists (SLPs) about CILT for people with nonfluent aphasia. One hundred sixty-seven SLPs completed an electronic survey assessing their opinions of various aspects of CILT. Over 60% of participants felt that people with aphasia would be very unlikely or somewhat unlikely to adhere to CILT. The majority felt that people with aphasia would hold high or moderate concerns with the number of hours spent in therapy (high, 41.8%; moderate, 31.4%), the number of days spent in therapy (high, 44.4%; moderate, 24.8%), likelihood for managed care reimbursement (high, 74.8%; moderate, 15.2%), and other logistical issues (high, 39.2%; moderate, 30.7%). With respect to providing CILT, participants cited the number of hours of therapy (high, 37.3%; moderate, 21.6%) and the number of consecutive days of therapy (high, 29.4%; moderate, 20.3%) as concerns. There were 70.6% who indicated that their facilities lacked resources to provide CILT, and 90.9% felt that most facilitates do not have the resources to provide CILT. Some SLPs hold significant concerns with the administration of CILT, particularly related to its dosing and reimbursement parameters. Additional work is needed to investigate the issues that were identified in this survey using qualitative methods with SLPs and people with aphasia and to examine modified CILT protocols.
Aeffner, Famke; Wilson, Kristin; Bolon, Brad; Kanaly, Suzanne; Mahrt, Charles R; Rudmann, Dan; Charles, Elaine; Young, G David
Historically, pathologists perform manual evaluation of H&E- or immunohistochemically-stained slides, which can be subjective, inconsistent, and, at best, semiquantitative. As the complexity of staining and demand for increased precision of manual evaluation increase, the pathologist's assessment will include automated analyses (i.e., "digital pathology") to increase the accuracy, efficiency, and speed of diagnosis and hypothesis testing and as an important biomedical research and diagnostic tool. This commentary introduces the many roles for pathologists in designing and conducting high-throughput digital image analysis. Pathology review is central to the entire course of a digital pathology study, including experimental design, sample quality verification, specimen annotation, analytical algorithm development, and report preparation. The pathologist performs these roles by reviewing work undertaken by technicians and scientists with training and expertise in image analysis instruments and software. These roles require regular, face-to-face interactions between team members and the lead pathologist. Traditional pathology training is suitable preparation for entry-level participation on image analysis teams. The future of pathology is very exciting, with the expanding utilization of digital image analysis set to expand pathology roles in research and drug development with increasing and new career opportunities for pathologists. © 2016 by The Author(s) 2016.
Dewar, Rajan; Parkash, Vinita; Forrow, Lachlan; Truog, Robert D
How pathologists communicate an error is complicated by the absence of a direct physician-patient relationship. Using 2 examples, we elaborate on how other physician colleagues routinely play an intermediary role in our day-to-day transactions and in the communication of a pathologist error to the patient. The concept of a "dual-hybrid" mind-set in the intermediary physician and its role in representing the pathologists' viewpoint adequately is considered. In a dual-hybrid mind-set, the intermediary physician can align with the patients' philosophy and like the patient, consider the smallest deviation from norm to be an error. Alternatively, they might embrace the traditional physician philosophy and communicate only those errors that resulted in a clinically inappropriate outcome. Neither may effectively reflect the pathologists' interests. We propose that pathologists develop strategies to communicate errors that include considerations of meeting with the patients directly. Such interactions promote healing for the patient and are relieving to the well-intentioned pathologist.
Dreschhoff, G.A.M.; Zeller, E.J.
A method is described of providing permanent identification markings to gemstones such as diamond crystals by irradiating the cooled gemstone with protons in the desired pattern. The proton bombardment results in a reaction limited to a defined plane and converting the bombarded area of the plane into a different crystal lattice from that of the preirradiated stone. (author)
Full Text Available Mark Watson is a British comedian and novelist. His five novels to date – 'Bullet Points' (2004, 'A Light-Hearted Look At Murder' (2007, 'Eleven' (2010, 'The Knot' (2012 and 'Hotel Alpha' (2014 – explore human relationships and communities in contemporary society. His latest novel Hotel Alpha tells the story of an extraordinary hotel in London and two mysterious disappearances that raise questions no one seems willing to answer. External to the novel, readers can also discover more about the hotel and its inhabitants in one hundred extra stories that expand the world of the novel and can be found at http://www.hotelalphastories.com. In conversation here with Dr Katy Shaw, Mark offers some reflections on his writing process, the field of contemporary literature, and the vitality of the novel form in the twenty-first century.
Geserick, Gunther; Vendura, Klaus; Wirth, Ingo
Since Werkgartner described and correctly interpreted the muzzle imprint mark around the gunshot entrance wound in 1922, this finding has been generally accepted as a sign of a contact shot. In further studies, it could finally be clarified that the muzzle imprint mark is caused by the expansive power of the powder gases with pressure on and abrasion of the skin at the muzzle (weapon imprint). Its shape depends on the firearm, the ammunition and the anatomical conditions, but does not require a bullet. Examinations under a magnifying glass microscope and histological investigations can complete the macroscopic findings. Occasionally, the muzzle imprint mark requires a certain "drying period" in order to become clearly visible. In rare cases, muzzle imprint marks also form on textiles perforated by the projectile. Characteristically shaped muzzled imprint marks can provide clues to the type of the firearm and its position at the time of discharge.
Full Text Available From 1990 to present, 14 liver pathologists and 2 clinical hepatologists from 9 countries have met annually to hold thematic 2.5-day meetings centered on case-based discussion. The goal of these meetings has been to identify gaps in knowledge in our field and fuel scholarly effort to address these gaps. The founding principles were worldwide representation, good representation of women, compatibility of participants, commitment to stable membership and regular attendance, mutual education and friendship, and free exchange of ideas. A summary report of the 2.5-day meeting constituted an enduring document that captured the free flow of ideas discussed. These ideas were open to all participants for the pursuit of scholarship back at their home institutions. However, any idea borne out of an Elves meeting merits open invitation for other Elves to participate in, using established standards for meaningful coauthorship. Over 26 consecutive meetings (1990-2015, themes covered the breadth of liver pathology. With retirement of 2 individuals, resignation of 3, and death of 1, six new members were nominated and voted into membership. Over these same 26 years, active members published 2025 articles indexed in PubMEd Central under the topic “liver;” 3% of these articles represented collaborations between members. This international group represents a successful model in a subspecialty of anatomic pathology for open exchange of ideas, mutual education, and generation of topics worthy of scholarly investigation. We conclude that a self-selected group of subspecialty pathologists can meet successfully over 26 years, maintain a high state of engagement through each annual meeting, self-renew as a result of retirement or resignation, and provide a creative stimulus for highly productive academic careers.
The use of radioactive isotopes as tracers in biology has been developed thanks to the economic generation of the required isotopes in accelerators and nuclear reactors, and to the multiple applications of tracers in the life domain; the most usual isotopes employed in biology are carbon, hydrogen, phosphorus and sulfur isotopes, because these elements are present in most of organic molecules. Most of the life science knowledge appears to be dependent to the extensive use of nuclear tools and radioactive tracers; the example of the utilization of radioactive phosphorus marked ATP to study the multiple reactions with proteins, nucleic acids, etc., is given
Sunday 13th November at 10:00amat Geneva's St. Peter's Cathedral To mark Einstein Year and the importance of the intercultural dialogue of which it forms a part, a religious service will take place on Sunday 13 November at 10 a.m. in St. Peter's Cathedral, to which CERN members and colleagues are warmly welcomed. Pastor Henry Babel, senior minister at the Cathedral, will speak on the theme: 'God in Einstein's Universe'. Diether Blechschmidt will convey a message on behalf of the scientific community.
The minimal-marking project conducted in Ryerson's School of Journalism throughout 2012 and early 2013 resulted in significantly higher grammar scores in two first-year classes of minimally marked university students when compared to two traditionally marked classes. The "minimal-marking" concept (Haswell, 1983), which requires…
Steel, Joanne; Ferguson, Alison; Spencer, Elizabeth; Togher, Leanne
To investigate speech pathologists' current practice with adults who are in post-traumatic amnesia (PTA). Speech pathologists with experience of adults in PTA were invited to take part in an online survey through Australian professional email/internet-based interest groups. Forty-five speech pathologists responded to the online survey. The majority of respondents (78%) reported using informal, observational assessment methods commencing at initial contact with people in PTA or when patients' level of alertness allowed and initiating formal assessment on emergence from PTA. Seven respondents (19%) reported undertaking no assessment during PTA. Clinicians described using a range of techniques to monitor cognitive-communication during PTA, including static, dynamic, functional and impairment-based methods. The study confirmed that speech pathologists have a key role in the multidisciplinary team caring for the person in PTA, especially with family education and facilitating interactions with the rehabilitation team and family. Decision-making around timing and means of assessment of cognitive-communication during PTA appeared primarily reliant on speech pathologists' professional experience and the culture of their workplace. The findings support the need for further research into the nature of cognitive-communication disorder and resolution over this period.
Robboy, Stanley J; Weintraub, Sally; Horvath, Andrew E; Jensen, Bradden W; Alexander, C Bruce; Fody, Edward P; Crawford, James M; Clark, Jimmy R; Cantor-Weinberg, Julie; Joshi, Megha G; Cohen, Michael B; Prystowsky, Michael B; Bean, Sarah M; Gupta, Saurabh; Powell, Suzanne Z; Speights, V O; Gross, David J; Black-Schaffer, W Stephen
Results of prior pathology workforce surveys have varied between a state of equilibrium and predictions of shortage. To assess the current and future supply of pathologists, and apply a dynamic modeling tool for assessing the effects of changing market forces and emerging technologies on the supply of pathologists' services through 2030. Data came from various sources, including the literature, College of American Pathologists' internal data, and primary research through custom-developed surveys for the membership and for pathology practice managers Through 2010, there were approximately 18 000 actively practicing pathologists in the United States (5.7 per 100 000 population), approximately 93% of whom were board certified. Our model projects that the absolute and per capita numbers of practicing pathologists will decrease to approximately 14 000 full-time equivalent (FTE) pathologists or 3.7 per 100 000 in the coming 2 decades. This projection reflects that beginning in 2015, the numbers of pathologists retiring will increase precipitously, and is anticipated to peak by 2021. Including all types of separation, the net pathologist strength will begin falling by year 2015. Unless workforce entry or exit rates change, this trend will continue at least through 2030. These changes reflect the closure of many training programs 2 to 4 decades ago and the substantially decreased number of graduating residents. This comprehensive analysis predicts that pathologist numbers will decline steadily beginning in 2015. Anticipated population growth in general and increases in disease incidence owing to the aging population, to be presented in a companion article on demand, will lead to a net deficit in excess of more than 5700 FTE pathologists. To reach the projected need in pathologist numbers of nearly 20 000 FTE by 2030 will require an increase from today of approximately 8.1% more residency positions. We believe a pathologist shortage will negatively impact both
Binmadi, Nada O; Almazrooa, Soulafa A
To investigate the awareness and usage of oral and maxillofacial pathology (OMFP) subspecialty services among pathologists in Saudi Arabia. Methods: In this cross-sectional study, we conducted an electronic questionnaire survey of pathologists in all regions of Saudi Arabia. The study was conducted between July 2015 and August 2016. The questionnaire comprised 19 questions to evaluate the knowledge of pathologists regarding microscopic OMFP and their perceptions towards this subspecialty. Results: Most of the pathologists surveyed (94.6%) were aware of the OMFP subspecialty and its scope of practice. Although most of the pathologists recognized the importance and need of this subspecialty, 70% of them never referred or consulted an oral pathologist as they either diagnosed the cases themselves or did not know any oral pathologist (57.7%). The pathologists had the greatest difficulty in identifying and diagnosing odontogenic tumors, salivary gland tumors, and odontogenic cysts. Conclusion: Pathologists are aware of the OMFP subspecialty, but their utilization of the services offered by OMFP specialists in Saudi Arabia is quite low despite the strong demand for OMFP services.
Khramtsov, A I; Isianov, N N; Khorzhevskiĭ, V A
The recently developed Web-ring of pathology-related Web-sites has transformed computer-mediated communications for Russian-speaking pathologists. Though the pathologists may be geographically dispersed, the network provides a complex of asynchronous and synchronous conferences for the purposes of diagnosis, consultations, education, communication, and collaboration in the field of pathology. This paper describes approaches to be used by participants of the pathology-related Web-ring. The approaches are analogous to the tools employed in telepathology and digital microscopy. One of the novel methodologies is the use of Web-based conferencing systems, in which the whole slide digital images of tissue microarrays were jointly reviewed online by pathologists at distant locations. By using ImageScope (Aperio Technologies) and WebEx connect desktop management technology, they shared presentations and images and communicated in realtime. In this manner, the Web-based forums and conferences will be a powerful addition to a telepathology.
Rumbach, Anna F; Rose, Tanya A; Cheah, Mynn
To explore Australian speech-language pathologists' use of non-speech oral motor exercises, and rationales for using/not using non-speech oral motor exercises in clinical practice. A total of 124 speech-language pathologists practising in Australia, working with paediatric and/or adult clients with speech sound difficulties, completed an online survey. The majority of speech-language pathologists reported that they did not use non-speech oral motor exercises when working with paediatric or adult clients with speech sound difficulties. However, more than half of the speech-language pathologists working with adult clients who have dysarthria reported using non-speech oral motor exercises with this population. The most frequently reported rationale for using non-speech oral motor exercises in speech sound difficulty management was to improve awareness/placement of articulators. The majority of speech-language pathologists agreed there is no clear clinical or research evidence base to support non-speech oral motor exercise use with clients who have speech sound difficulties. This study provides an overview of Australian speech-language pathologists' reported use and perceptions of non-speech oral motor exercises' applicability and efficacy in treating paediatric and adult clients who have speech sound difficulties. The research findings provide speech-language pathologists with insight into how and why non-speech oral motor exercises are currently used, and adds to the knowledge base regarding Australian speech-language pathology practice of non-speech oral motor exercises in the treatment of speech sound difficulties. Implications for Rehabilitation Non-speech oral motor exercises refer to oral motor activities which do not involve speech, but involve the manipulation or stimulation of oral structures including the lips, tongue, jaw, and soft palate. Non-speech oral motor exercises are intended to improve the function (e.g., movement, strength) of oral structures. The
Ferguson, Alison; Duffield, Gemma; Worrall, Linda
The assessment and management of a person with aphasia for whom decision-making capacity is queried represents a highly complex clinical issue. In addition, there are few published guidelines and even fewer published accounts of empirical research to assist. The research presented in this paper aimed to identify the main issues for speech pathologists when decision-making capacity for legal and related matters arose for their clients with aphasia, and to describe qualitatively the nature of these issues and the practices of the speech pathologists in these situations. The methodology was informed by the qualitative research paradigm and made use of the semi-structured interview methods developed for the Critical Incident Technique. Nine speech pathologists, with a range of clinical experience between three and 27 years, were interviewed by telephone, with verbatim notes being taken on-line by the interviewer. The speech pathologists described a total of 21 clients (15 male, six female) with acquired neurological communication disorders (including cerebral vascular accident, traumatic brain injury, and tumour) whose care had raised critical incidents for the speech pathologist in relation to legal and related matters. These verbatim notes were qualitatively analysed using NVivo qualitative analysis software. The main incidents related to legal decisions (for example, power of attorney, will-making), as well as decisions involving consent for medical treatment, discharge, accommodation, and business/financial decisions. In all but one of the incidents recounted, the issues centred on a situation of conflict between the person with aphasia and their family, friends or with the multidisciplinary team. The roles taken by the speech pathologists ranged from those expected within a speech pathology scope of practice, such as that of assessor and consultant, to those which arguably present dilemmas and conflict of interest, for example, interpreter, advocate. The
González-Rivas, Diego; Lirio, Francisco; Sesma, Julio
Nowadays, sublobar anatomic resections are gaining momentum as a valid alternative for early stage lung cancer. Despite being technically demanding, anatomic segmentectomies can be performed by uniportal video-assisted thoracic surgery (VATS) approach to combine the benefits of minimally invasiveness with the maximum lung sparing. This procedure can be even more complex if a combined resection of multiple segments from different lobes has to be done. Here we report five cases of combined and unusual segmentectomies done by the same experienced surgeon in high volume institutions to show uniportal VATS is a feasible approach for these complex resections and to share an excellent educational resource.
The SLAR (Spacer Location and Repositioning) program has developed the technology and tooling necessary to locate and reposition the fuel channel spacers that separate the pressure tube from the calandria tube in a CANDU reactor. The in-channel SLAR tool contains all the inspection probes, and is capable of moving spacers under remote control. The SLAR inspection computer system translates all eddy currents and ultrasonic signals from the in-channel tool into various graphic displays. The in-channel SLAR tool can be delivered and manipulated in a fuel channel by either a SLAR delivery machine or a SLARette delivery machine. The SLAR delivery machine consists of a modified fuelling machine, and is capable of operating under totally remote control in automatic or semi-automatic mode. The SLARette delivery machine is a smaller less automated version, which was designed to be quickly installed, operated, and removed from a limited number of fuel channels during regular annual maintenance outages. This paper describes the design and operation of the SLARette Mark 2 system. 5 figs
Kenny, Belinda J.; Lincoln, Michelle; Blyth, Katrina; Balandin, Susan
Background: Speech pathologists are confronted by ethical issues when they need to make decisions about client care, address team conflict, and fulfil the range of duties and responsibilities required of health professionals. However, there has been little research into the specific nature of ethical dilemmas experienced by speech pathologists and…
Knoeff, Rina; Zwijnenberg, Robert
Almost every medical faculty possesses anatomical and/or pathological collections: human and animal preparations, wax- and other models, as well as drawings, photographs, documents and archives relating to them. In many institutions these collections are well-preserved, but in others they are poorly
Hutchins, Tiffany L.; Gerety, Katherine W.; Mulligan, Moira
Purpose: This study (a) gathered information about the kinds of dysphagia management services school-based speech-language pathologists (SLPs) provide, (b) examined the attitudes of SLPs related to dysphagia management, (c) compared the responses of SLPs on the basis of their experience working in a medical setting, and (d) investigated the…
Crowley, Rebecca S.; Legowski, Elizabeth; Medvedeva, Olga; Reitmeyer, Kayse; Tseytlin, Eugene; Castine, Melissa; Jukic, Drazen; Mello-Thoms, Claudia
The purpose of this study is threefold: (1) to develop an automated, computer-based method to detect heuristics and biases as pathologists examine virtual slide cases, (2) to measure the frequency and distribution of heuristics and errors across three levels of training, and (3) to examine relationships of heuristics to biases, and biases to…
Background: Negative attitudes toward stuttering and people who stutter (PWS) are found in various groups of people in many regions. However the results of previous studies examining the influence of fluency coursework and clinical certification on the attitudes of speech-language pathologists (SLPs) toward PWS are equivocal. Furthermore, there…
Kenny, Belinda; Lincoln, Michelle; Balandin, Susan
Purpose: To investigate the approaches of experienced speech-language pathologists (SLPs) to ethical reasoning and the processes they use to resolve ethical dilemmas. Method: Ten experienced SLPs participated in in-depth interviews. A narrative approach was used to guide participants' descriptions of how they resolved ethical dilemmas. Individual…
Guiberson, Mark; Atkins, Jenny
This study describes the backgrounds, diversity training, and professional perspectives reported by 154 Colorado speech-language pathologists in serving children from culturally and linguistically diverse (CLD) backgrounds. The authors compare the results of the current survey to those of a similar survey collected in 1996. Respondents reported…
Beck, Ann R.; Dennis, Marcia
Speech-language pathologists (N=21) and teachers (N=54) were surveyed regarding their perceptions of classroom-based interventions. The two groups agreed about the primary advantages and disadvantages of most interventions, the primary areas of difference being classroom management and ease of data collection. Other findings indicated few…
van Rijssen, Lennart B.; Rombouts, Steffi J. E.; Walma, Marieke S.; Vogel, Jantien A.; Tol, Johanna A.; Molenaar, Isaac Q.; van Eijck, Casper H. J.; Verheij, Joanne; van de Vijver, Marc J.; Busch, Olivier R. C.; Besselink, Marc G. H.
Recent advances in pancreatic surgery have the potential to improve outcomes for patients with pancreatic cancer. We address 3 new, trending topics in pancreatic surgery that are of relevance to the pathologist. First, increasing awareness of the prognostic impact of intraoperatively detected
Wiles, Austin Blackburn; Idowu, Michael O; Clevenger, Charles V; Powers, Celeste N
Academic pathologists perform clinical duties, as well as valuable nonclinical activities. Nonclinical activities may consist of research, teaching, and administrative management among many other important tasks. While clinical duties have many clear metrics to measure productivity, like the relative value units of Medicare reimbursement, nonclinical performance is often difficult to measure. Despite the difficulty of evaluating nonclinical activities, nonclinical productivity is used to determine promotion, funding, and inform professional evaluations of performance. In order to better evaluate the important nonclinical performance of academic pathologists, we present an evaluation system for leadership use. This system uses a Microsoft Excel workbook to provide academic pathologist respondents and reviewing leadership a transparent, easy-to-complete system that is both flexible and scalable. This system provides real-time feedback to academic pathologist respondents and a clear executive summary that allows for focused guidance of the respondent. This system may be adapted to fit practices of varying size, measure performance differently based on years of experience, and can work with many different institutional values.
Maul, Christine A.
The purpose of this research was to identify specific clinical skills in speech-language pathologists (SLPs) that may constitute cultural competency, a term which currently lacks operational definition. Through qualitative interview methods, the following research questions were addressed: (1) What dominant themes, if any, can be found in SLPs'…
Male infertility is receiving increasing attention in Africa as up to 50% of cases of infertility are ascribed to it. In the management of this condition, the clinical laboratory plays a crucial role especially in the proper identification of causes of infertility. The role of the pathologists in this respect stems from the choice of laboratory ...
Girolametto, Luigi; Weitzman, Elaine; Greenberg, Janice
Purpose: This study examined the efficacy of a professional development program for early childhood educators that facilitated emergent literacy skills in preschoolers. The program, led by a speech-language pathologist, focused on teaching alphabet knowledge, print concepts, sound awareness, and decontextualized oral language within naturally…
Nelson, Ann Marie; Manabe, Yukari C; Lucas, Sebastian B
Antiretroviral therapy has significantly improved the quality and length of life for those patients able to access effective and sustained treatment. The resulting restoration of the immune response is associated with a change in the clinical presentation of opportunistic infections, and the histologic reaction to pathogens. A complex combination of alterations in host response across the stages of HIV infection has been documented over the past 3 decades. The defects are seen in both acute and chronic phases of inflammation and involve innate and adaptive immunity. In advanced stages of HIV infection, the marked disruption of lymphoid tissue and loss of follicular dendritic cells limits the host's ability to process antigen and mount specific responses to pathogens. There are qualitative and quantitative defects in CD4 T cells due to HIV infection. The resulting indirect effects include loss of cytokine production, dysregulation of B-cell function, loss of cellular mediated immunity and "holes" in the immunologic repertoire that may not be restored with the use of antiretroviral therapy. Immune reconstitution allows the host to respond to and control infection, but a significant number of patients will have atypical inflammatory syndromes during the recovery period. We briefly discuss the impact of HIV infection on the immune system and give an overview of the spectrum of conditions attributed to the Immune Reconstitution Inflammatory syndrome (IRIS). Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available Background: Although pathology informatics (PI is essential to modern pathology practice, the field is often poorly understood. Pathologists who have received little to no exposure to informatics, either in training or in practice, may not recognize the roles that informatics serves in pathology. The purpose of this study was to characterize perceptions of PI by noninformatics-oriented pathologists and to do so at two large centers with differing informatics environments. Methods: Pathology trainees and staff at Cleveland Clinic (CC and Massachusetts General Hospital (MGH were surveyed. At MGH, pathology department leadership has promoted a pervasive informatics presence through practice, training, and research. At CC, PI efforts focus on production systems that serve a multi-site integrated health system and a reference laboratory, and on the development of applications oriented to department operations. The survey assessed perceived definition of PI, interest in PI, and perceived utility of PI. Results: The survey was completed by 107 noninformatics-oriented pathologists and trainees. A majority viewed informatics positively. Except among MGH trainees, confusion of PI with information technology (IT and help desk services was prominent, even in those who indicated they understood informatics. Attendings and trainees indicated desire to learn more about PI. While most acknowledged that having some level of PI knowledge would be professionally useful and advantageous, only a minority plan to utilize it. Conclusions: Informatics is viewed positively by the majority of noninformatics pathologists at two large centers with differing informatics orientations. Differences in departmental informatics culture can be attributed to the varying perceptions of PI by different individuals. Incorrect perceptions exist, such as conflating PI with IT and help desk services, even among those who claim to understand PI. Further efforts by the PI community could
Lorin De La Grandmaison, Geoffroy; Durigon, Michel; Moutel, Grégoire; Hervé, Christian
War crimes in the former Yugoslavia since 1991 have been subjected to several international medico-legal investigations of mass graves within the framework of inquiries led by the ICTY. Forensic pathologists involved in the ICTY missions could be subjected to ethical tensions due to the difficulties of the missions, the emergent conflicts between forensic scientists of the teams and the original nature of the ICTY proceedings. In order to study the nature of such ethical tensions, we sent a questionnaire to 65 forensic pathologists who have been involved in the ICTY missions. The rate of answer was 38%. The majority of the forensic pathologists questioned (n=18) did not know how the medico-legal data were exploited by the ICTY. Three of them have been subjected to pressures. Three of them were aware of mass grave sites wittingly not investigated by the ICTY. Fifteen considered that the ICTY respected the elementary rules of the law and four of them questioned the impartiality of the justice led by the ICTY. Two conflicting types of ethics can be drawn from these results: a conviction ethics which is shared by most of the forensic pathologists questioned and a responsibility ethics. In the first, the forensic pathologist completely agrees with the need for an international war crime tribunal even if such justice can be challenged regarding the respect of human rights and impartiality. In the second, he or she needs to conduct himself in ways that do not infringe impartiality. As medical deontology duty requires an impartiality ethics, discursive ethics are needed to ease ethical tensions and to suggest ethical guidelines. Alternatives to international justice through a truth and reconciliation commission and by the way of humanitarian mission of victims’ identification combined with forensic investigations for historical purposes could be considered. PMID:16909642
Narabayashi, I [Kinki Univ., Higashi-Osaka, Osaka (Japan); Ito, K; Yoshida, S; Yamaguchi, H; Kahata, S
In routine clinical studies, we have noted that in some cases anatomical marks have been transferred to scintigrams through the scintillation camera. It was thought that radioactive point sources could be used as anatomical marks. However, this method resulted in an ill-defined area of brightness. The marking equipment for the scintillation camera used in this study consisted of a linear potentiometer and a sine-cosine potentiometer. We designed a marking method for a data processing system using the marking equipment for a scintillation camera. The data processing system of a scintillation camera is composed of EDR-4000 (8K core memories), MT recorder, CRT display, and graphic display unit and it is connected by on-line to the scintillation camera. A marking program was made in order to record marking addresses on a processed image. Using this soft program and graphpen of the graphic display unit, we transferred marks to processed image by points and lines. Subtraction scintigraphy using /sup 198/Au-colloid and /sup 75/Se-selenomethionine was performed on cases of pancreas carcinoma. After marking addresses were recorded on a processed image by this marking method, the signals from the scintillation camera were fed into the input controller. Then these signals with marking points were transferred from the computer to the MT recorder. Subtraction scintigraphy by this system made it possible to examine each picture with /sup 198/Au-colloid of /sup 75/Se-selenomethionine at different times.
Kostabi, Kalev Mark, 1960-
Kalev Mark Kostabi oma sisekujunduslikest eelistustest, ameeriklaste ja itaallaste kodude sisekujunduse erinevustest, kunstist kui ruumikujunduse ühest osast, oma New Yorgi ja Rooma korterite kujundusest
Voegels, Richard Louis
Full Text Available The advent of endoscopy and computed tomography at the beginning of the 1980s brought to rhinology a revival of anatomy and physiology study. In 1994, the International Conference of Sinus Disease was conceived because the official “Terminologia Anatomica” had little information on the detailed sinonasal anatomy. In addition, there was a lack of uniformity of terminology and definitions. After 20 years, a new conference has been held. The need to use the same terminology led to the publication by the European Society of Rhinology of the “European Position Paper on the Anatomical Terminology of the Internal Nose and Paranasal Sinuses,” that can be accessed freely at www.rhinologyjournal.com. Professor Valerie Lund et al wrote this document reviewing the anatomical terms, comparing to the “Terminology Anatomica” official order to define the structures without eponyms, while respecting the embryological development and especially universalizing and simplifying the terms. A must-read! The text's purpose lies beyond the review of anatomical terminology to universalize the language used to refer to structures of the nasal and paranasal cavities. Information about the anatomy, based on extensive review of the current literature, is arranged in just over 50 pages, which are direct and to the point. The publication may be pleasant reading for learners and teachers of rhinology. This text can be a starting point and enables searching the universal terminology used in Brazil, seeking to converge with this new European proposal for a nomenclature to help us communicate with our peers in Brazil and the rest of the world. The original text of the European Society of Rhinology provides English terms that avoided the use of Latin, and thus fall beyond several national personal translations. It would be admirable if we created our own cross-cultural adaptation of this new suggested anatomical terminology.
Marquart-Elbaz, C; Varnaison, E; Sick, H; Grosshans, E; Cribier, B
We showed in a companion paper that the definition of the French "subcutaneous cellular tissue" considerably varied from the 18th to the end of the 20th centuries and has not yet reached a consensus. To address the anatomic reality of this "subcutaneous cellular tissue", we investigated the anatomic structures underlying the fat tissue in normal human skin. Sixty specimens were excised from the surface to the deep structures (bone, muscle, cartilage) on different body sites of 3 cadavers from the Institut d'Anatomie Normale de Strasbourg. Samples were paraffin-embedded, stained and analysed with a binocular microscope taking x 1 photographs. Specimens were also excised and fixed after subcutaneous injection of Indian ink, after mechanic tissue splitting and after performing artificial skin folds. The aspects of the deep parts of the skin greatly varied according to their anatomic localisation. Below the adipose tissue, we often found a lamellar fibrous layer which extended from the interlobular septa and contained horizontally distributed fat cells. No specific tissue below the hypodermis was observed. Artificial skin folds concerned either exclusively the dermis, when they were superficial or included the hypodermis, but no specific structure was apparent in the center of the fold. India ink diffused to the adipose tissue, mainly along the septa, but did not localise in a specific subcutaneous compartment. This study shows that the histologic aspects of the deep part of the skin depend mainly on the anatomic localisation. Skin is composed of epidermis, dermis and hypodermis and thus the hypodermis can not be considered as being "subcutaneous". A difficult to individualise, fibrous lamellar structure in continuity with the interlobular septa is often found under the fat lobules. This structure is a cleavage line, as is always the case with loose connective tissues, but belongs to the hypodermis (i.e. fat tissue). No specific tissue nor any virtual space was
Di Domenico, Stefano; Simonassi, Claudio; Chessa, Leonardo
Flexible fiberoptic bronchoscopy is an indispensable tool for optimal management of intensive care unit patients. However, the acquisition of sufficient training in bronchoscopy is not straightforward during residency, because of technical and ethical problems. Moreover, the use of commercial simulators is limited by their high cost. In order to overcome these limitations, we realized a low-cost anatomical simulator to acquire and maintain the basic skill to perform bronchoscopy in ventilated patients. We used 1.5 mm diameter iron wire to construct the bronchial tree scaffold; glazier-putty was applied to create the anatomical model. The model was covered by several layers of newspaper strips previously immersed in water and vinilic glue. When the model completely dried up, it was detached from the scaffold by cutting it into six pieces, it was reassembled, painted and fitted with an endotracheal tube. We used very cheap material and the final cost was euro16. The trainer resulted in real-scale and anatomically accurate, with appropriate correspondence on endoscopic view between model and patients. All bronchial segments can be explored and easily identified by endoscopic and external vision. This cheap simulator is a valuable tool for practicing, particularly in a hospital with limited resources for medical training.
Moreau, Vincent G.
Up until now, the only variable alphanumeric data which could be added to banknotes was the number, applied by means of impact typographical numbering boxes. As an additional process or an alternative to this mechanical method, a non-contact laser marking process can be used offering high quality and greater levels of flexibility. For this purpose KBA-GIORI propose an exclusive laser marking solution called NotaMark. The laser marking process NotaMark is the ideal solution for applying variable data and personalizing banknotes (or any other security documents) with a very high resolution, for extremely large production volumes. A completely integrated solution has been developed comprised of laser light sources, marking head units, and covers and extraction systems. NotaMark allows the marking of variable data by removing locally and selectively, specific printed materials leaving the substrate itself untouched. A wide range of materials has already been tested extensively. NotaMark is a new security feature which is easy to identify and difficult to counterfeit, and which complies with the standard mechanical and chemical resistance tests in the security printing industry as well as with other major soiling tests. The laser marking process opens up a whole new range of design possibilities and can be used to create a primary security feature such as numbering, or to enhance the value of existing features.
Hadely, Kathleen A; Power, Emma; O'Halloran, Robyn
Communication and swallowing disorders are a common consequence of stroke. Clinical practice guidelines (CPGs) have been created to assist health professionals to put research evidence into clinical practice and can improve stroke care outcomes. However, CPGs are often not successfully implemented in clinical practice and research is needed to explore the factors that influence speech pathologists' implementation of stroke CPGs. This study aimed to describe speech pathologists' experiences and current use of guidelines, and to identify what factors influence speech pathologists' implementation of stroke CPGs. Speech pathologists working in stroke rehabilitation who had used a stroke CPG were invited to complete a 39-item online survey. Content analysis and descriptive and inferential statistics were used to analyse the data. 320 participants from all states and territories of Australia were surveyed. Almost all speech pathologists had used a stroke CPG and had found the guideline "somewhat useful" or "very useful". Factors that speech pathologists perceived influenced CPG implementation included the: (a) guideline itself, (b) work environment, (c) aspects related to the speech pathologist themselves, (d) patient characteristics, and (e) types of implementation strategies provided. There are many different factors that can influence speech pathologists' implementation of CPGs. The factors that influenced the implementation of CPGs can be understood in terms of knowledge creation and implementation frameworks. Speech pathologists should continue to adapt the stroke CPG to their local work environment and evaluate their use. To enhance guideline implementation, they may benefit from a combination of educational meetings and resources, outreach visits, support from senior colleagues, and audit and feedback strategies.
Haller, Jasmine; David, Marjorie Parker; Lee, Nathan E; Shalin, Sara C; Gardner, Jerad M
- Patients with rare tumors have difficulty finding reliable information about their disease. Facebook patient support groups allow patients to educate one another. - To investigate how these patients perceive the value of pathologists, both in Facebook groups and real-world patient care. - Survey links were posted in 12 Facebook patient groups: 6 with an active pathologist member (angiosarcoma, epithelioid hemangioendothelioma, epithelioid sarcoma, dermatofibrosarcoma protuberans [×2], and desmoid fibromatosis), and 6 without "active" pathologist involvement (aggressive angiomyxoma, chondrosarcoma, Ewing sarcoma, leiomyosarcoma, liposarcoma, and osteosarcoma). - A total of 542 people responded (403 were patients): 264 from groups with a pathologist, and 278 from groups without active pathologist involvement. Of groups with an active pathologist, respondents agreed the pathologist's posts helped them better understand their disease (107 of 119; 90%) and relieved some of their disease-related anxiety (92 of 119; 77%). And for these groups 98% (117 of 119) of respondents agreed that having a pathologist in their group was a good thing; 83% (192 of 232) wanted more pathologists involved. More respondents from groups with an active pathologist (219 of 236; 93%) than without one (215 of 252; 85%) agreed: "pathologists are an important part of the patient care team for patients with cancer and other rare tumors" ( P = .008). - This study is the first to evaluate the impact of pathologist interaction with Facebook patient support groups and to assess perceptions about the specialty of pathology from a large group of patients with rare tumors. Pathologist involvement in Facebook patient groups appears to positively influence patient perception of the importance of pathologists. We hope these data will encourage more pathologists to participate in Facebook patient support groups.
Mirjalili, S Ali; McFadden, Sarah L; Buckenham, Tim; Wilson, Ben; Stringer, Mark D
Anatomical planes used in clinical practice and teaching anatomy are largely derived from cadaver studies. Numerous inconsistencies in clinically important surface markings exist between and within anatomical reference texts. The aim of this study was to reassess the accuracy of common anatomical planes in vivo using computed tomographic (CT) imaging. CT scans of the trunk in supine adults at end tidal inspiration were analyzed by dual consensus reporting to determine the anatomy of five anatomical planes: sternal angle, transpyloric, subcostal, supracristal, and the plane of the pubic crest. Patients with kyphosis, scoliosis, or abnormal lordosis, distorting space-occupying lesions, or visceromegaly were excluded. Among 153 thoracic CT scans (mean age 63 years, 53% female), the sternal angle was most common at T4 (females) or T4/5 (males) vertebral level, and the tracheal bifurcation, aortic arch, and pulmonary trunk were most often below this plane. In 108 abdominal CT scans (mean age 60 years, 59% female), the subcostal and supracristal planes were most often at L2 (58%) and L4 (69%), respectively. In 52 thoracoabdominal CT scans (mean age 61 years, 56% female), the transpyloric plane was between lower L1 and upper L2 (75%); in this plane were the superior mesenteric artery (56%), formation of the portal vein (53%), tip of the ninth rib (60%), and the left renal hilum (54%), but the right renal hilum and gallbladder fundus were more often below. The surface anatomy of anatomical planes needs revising in the light of results from living subjects using modern imaging techniques. Copyright © 2012 Wiley Periodicals, Inc.
Full Text Available Introduction: Smartphone applications (apps have become increasingly prevalent in medicine. Due to most pathologists, pathology trainees, technicians, and medical students use smartphones; apps can be a different way for general pathology education. “General pathologist-helper (GP-HELPER” is a novel app developed as a reference tool in general pathology and especially for general pathologists, developed for Android and iOS platforms. Materials and Methods: “GP-HELPER,” was created using Mobincube website platform. This tool also integrates “FORUM GP-HELPER,” an external website created using Miarroba website (http://forum-gp-helper.mboards.com and “COMMUNITY GP-HELPER” a multichannel chat created using Chatango website platform. Results: The application was released in July 2015, and it is been periodically updated since then. The app has permanent information (offline data about different pathology protocols (TNM latest edition, protocols regarding management of tumors of unknown primary origin, and flowcharts for some of the most difficult tumors to diagnose and a database with more than 5000 immunohistochemistry results from different tumors. Online data have links to more than 1100 reference pathology video lectures, 250 antibodies information, more than 70 pathology association websites, 46 pathology providers, and 78 outstanding pathology journal websites. Besides this information, the app has two interactive places such as “FORUM GP-HELPER” and “COMMUNITY GP-HELPER” that let users to stay in touch everywhere and every time. Expert consult section is also available. Conclusions: “GP-HELPER” pretends to integrate offline and online data about pathology with two interactive external places in order to represent a reference tool for general pathologists and associate members.
Smartphone applications (apps) have become increasingly prevalent in medicine. Due to most pathologists, pathology trainees, technicians, and medical students use smartphones; apps can be a different way for general pathology education. "General pathologist-helper (GP-HELPER)" is a novel app developed as a reference tool in general pathology and especially for general pathologists, developed for Android and iOS platforms. "GP-HELPER," was created using Mobincube website platform. This tool also integrates "FORUM GP-HELPER," an external website created using Miarroba website (http://forum-gp-helper.mboards.com) and "COMMUNITY GP-HELPER" a multichannel chat created using Chatango website platform. The application was released in July 2015, and it is been periodically updated since then. The app has permanent information (offline data) about different pathology protocols (TNM latest edition, protocols regarding management of tumors of unknown primary origin, and flowcharts for some of the most difficult tumors to diagnose) and a database with more than 5000 immunohistochemistry results from different tumors. Online data have links to more than 1100 reference pathology video lectures, 250 antibodies information, more than 70 pathology association websites, 46 pathology providers, and 78 outstanding pathology journal websites. Besides this information, the app has two interactive places such as "FORUM GP-HELPER" and "COMMUNITY GP-HELPER" that let users to stay in touch everywhere and every time. Expert consult section is also available. "GP-HELPER" pretends to integrate offline and online data about pathology with two interactive external places in order to represent a reference tool for general pathologists and associate members.
Full Text Available Molecular pathological analysis has an expanding role in patient diagnosis and management. The performance of these techniques relies on excellent laboratory procedures. However, the crucial step is obtaining the best samples for molecular analysis. Archiving and selection of these are the responsibilities of all pathologists even if they are not working at a center with molecular pathological facilities. This review focuses on the features of different types of materials for molecular pathological analysis. Many steps that might affect the results, including communication between the pathologist and the oncology team, features of different types of materials (cytological, tissue blocks, biopsy, circulating tumor cells (CTCs and cell-free circulating nucleic acids, effects of tissue processing, methods for selecting the best material, and tissue saving and tumor enrichment methods are discussed. The procedures for referral to a center for molecular pathological analysis are also mentioned. Awareness of the importance of the cytopathological and histopathological material of the patients for future molecular pathological analysis by pathologists is of the utmost importance.
Raddatz, Barbara B; Spitzbarth, Ingo; Matheis, Katja A; Kalkuhl, Arno; Deschl, Ulrich; Baumgärtner, Wolfgang; Ulrich, Reiner
High-throughput, genome-wide transcriptome analysis is now commonly used in all fields of life science research and is on the cusp of medical and veterinary diagnostic application. Transcriptomic methods such as microarrays and next-generation sequencing generate enormous amounts of data. The pathogenetic expertise acquired from understanding of general pathology provides veterinary pathologists with a profound background, which is essential in translating transcriptomic data into meaningful biological knowledge, thereby leading to a better understanding of underlying disease mechanisms. The scientific literature concerning high-throughput data-mining techniques usually addresses mathematicians or computer scientists as the target audience. In contrast, the present review provides the reader with a clear and systematic basis from a veterinary pathologist's perspective. Therefore, the aims are (1) to introduce the reader to the necessary methodological background; (2) to introduce the sequential steps commonly performed in a microarray analysis including quality control, annotation, normalization, selection of differentially expressed genes, clustering, gene ontology and pathway analysis, analysis of manually selected genes, and biomarker discovery; and (3) to provide references to publically available and user-friendly software suites. In summary, the data analysis methods presented within this review will enable veterinary pathologists to analyze high-throughput transcriptome data obtained from their own experiments, supplemental data that accompany scientific publications, or public repositories in order to obtain a more in-depth insight into underlying disease mechanisms.
Volmar, Keith E; Idowu, Michael O; Hunt, Jennifer L; Souers, Rhona J; Meier, Frederick A; Nakhleh, Raouf E
The rate of surgical pathology report defects is an indicator of quality and it affects clinician satisfaction. To establish benchmarks for defect rates and defect fractions through a large, multi-institutional prospective application of standard taxonomy. Participants in a 2011 Q-Probes study of the College of American Pathologists prospectively reviewed all surgical pathology reports that underwent changes to correct defects and reported details regarding the defects. Seventy-three institutions reported 1688 report defects discovered in 360,218 accessioned cases, for an aggregate defect rate of 4.7 per 1000 cases. Median institutional defect rate was 5.7 per 1000 (10th to 90th percentile range, 13.5-0.9). Defect rates were higher in institutions with a pathology training program (8.5 versus 5.0 per 1000, P = .01) and when a set percentage of cases were reviewed after sign-out (median, 6.7 versus 3.8 per 1000, P = .10). Defect types were as follows: 14.6% misinterpretations, 13.3% misidentifications, 13.7% specimen defects, and 58.4% other report defects. Overall, defects were most often detected by pathologists (47.4%), followed by clinicians (22.0%). Misinterpretations and specimen defects were most often detected by pathologists (73.5% and 82.7% respectively, P benchmarking data on report defects and defect fractions using standardized taxonomy.
Lewandrowski, Kent; Black-Schaffer, Steven
There is relatively little published literature concerning utilization management in anatomic pathology. Nonetheless there are many utilization management opportunities that currently exist and are well recognized. Some of these impact only the cost structure within the pathology department itself whereas others reduce charges for third party payers. Utilization management may result in medical legal liabilities for breaching the standard of care. For this reason it will be important for pathology professional societies to develop national utilization guidelines to assist individual practices in implementing a medically sound approach to utilization management. © 2013.
Tormey, William P; Borovickova, Ingrid; Moore, Tara M
The attitudes and experiences of pathologists and coroners to the provision of biochemical forensic toxicology in the Republic of Ireland were determined using separate questionnaires to each group anonymously. Replies were received from 36/88 (41%) of pathologists and 19/71 (27%) of coroners. 37% of coroners considered that histopathologists give an adequate opinion in forensic toxicology yet 58% of pathologists reported that they did not have adequate access to expert medical interpretative toxicological opinion. For drug-drug interactions and metabolic diseases, 69% of pathologists were unhappy with the processes and 68% of coroner replies did not know if vitreous samples were used appropriately. There is a clear requirement for retraining of coroners and for the appointment of medical toxicology expertise to improve the quality of service for coroners.
Nakhleh, Raouf E
In this article the core components of a comprehensive quality assurance and improvement plan are outlined. Quality anatomic pathology work comes with focus on accurate, timely, and complete reports. A commitment to continuous quality improvement and a systems approach with a persistent effort helps to achieve this end. Departments should have a quality assurance and improvement plan that includes a risk assessment of real and potential problems facing the laboratory. The plan should also list the individuals responsible for carrying out the program with adequate resources, a defined timetable, and annual assessment for progress and future directions. Quality assurance monitors should address regulatory requirements and be organized by laboratory division (surgical pathology, cytology, etc) as well as 5 segments (preanalytic, analytic, postanalytic phases of the test cycle, turn-around-time, and customer satisfaction). Quality assurance data can also be used to evaluate individual pathologists using multiple parameters with peer group comparison.
Ye, Yingjiang; Shen, Zhanlong; Wang, Shan
Abominoperineal resection (APR) is the main approach of lower rectal cancer treatment. Recently, it was found that conventional APR had higher incidence rate of positive circumferential resection margin(CRM) and intraoperative perforation (IOP), which was the crucial reason of local recurrence and worse prognosis. Extralevator abdominoperineal excision(ELAPE) procedure was proposed by European panels including surgeons, radiologist and pathologists, and considered to lower the positive rates of CRM and IOP. Definitive surgical planes and anatomic landmarks are the cores of this procedure, which are the prerequisite for the guarantee of safety and smoothness of surgery. To realize the anatomy of muscles, fascias, blood vessels and nervous of perineal region is the base of carrying out ELAPE procedure. In this paper, we introduce the key anatomy related to ELAPE procedure and summarize the principle of ELAPE procedure as "two planes and four landmarks", which will be beneficial to the popularization and application.
Mahoney, Peter; Carr, Debra; Arm, Richard; Gibb, Iain; Hunt, Nicholas; Delaney, Russ J
The aim of this work was to further develop a synthetic model of ballistic head injury by the addition of skin and soft tissue layers to an anatomically correct polyurethane skull filled with gelatine 10% by mass. Six head models were impacted with 7.62 x 39 mm full metal jacket mild steel core (FMJ MSC) bullets with a mean velocity of 652 m/s. The impact events were filmed with high-speed cameras. The models were imaged pre- and post-impact using computed tomography. The models were assessed post impact by two experienced Home Office pathologists and the images assessed by an experienced military radiologist. The findings were scored against real injuries. The entry wounds, exit wounds and fracture patterns were scored positively, but the synthetic skin and soft tissue layer was felt to be too extendable. Further work is ongoing to address this.
Magid, Margret S; Shah, Darshana T; Cambor, Carolyn L; Conran, Richard M; Lin, Amy Y; Peerschke, Ellinor I B; Pessin, Melissa S; Harris, Ilene B
The practice of pathology is not generally addressed in the undergraduate medical school curriculum. It is desirable to develop practical pathology competencies in the fields of anatomic pathology and laboratory medicine for every graduating medical student to facilitate (1) instruction in effective utilization of these services for optimal patient care, (2) recognition of the role of pathologists and laboratory scientists as consultants, and (3) exposure to the field of pathology as a possible career choice. A national committee was formed, including experts in anatomic pathology and/or laboratory medicine and in medical education. Suggested practical pathology competencies were developed in 9 subspecialty domains based on literature review and committee deliberations. The competencies were distributed in the form of a survey in late 2012 through the first half of 2013 to the medical education community for feedback, which was subjected to quantitative and qualitative analysis. An approval rate of ≥80% constituted consensus for adoption of a competency, with additional inclusions/modifications considered following committee review of comments. The survey included 79 proposed competencies. There were 265 respondents, the majority being pathologists. Seventy-two percent (57 of 79) of the competencies were approved by ≥80% of respondents. Numerous comments (N = 503) provided a robust resource for qualitative analysis. Following committee review, 71 competencies (including 27 modified and 3 new competencies) were considered to be essential for undifferentiated graduating medical students. Guidelines for practical pathology competencies have been developed, with the hope that they will be implemented in undergraduate medical school curricula.
Full Text Available Intuitively, higher intelligence might be assumed to correspond to more efficient information transfer in the brain, but no direct evidence has been reported from the perspective of brain networks. In this study, we performed extensive analyses to test the hypothesis that individual differences in intelligence are associated with brain structural organization, and in particular that higher scores on intelligence tests are related to greater global efficiency of the brain anatomical network. We constructed binary and weighted brain anatomical networks in each of 79 healthy young adults utilizing diffusion tensor tractography and calculated topological properties of the networks using a graph theoretical method. Based on their IQ test scores, all subjects were divided into general and high intelligence groups and significantly higher global efficiencies were found in the networks of the latter group. Moreover, we showed significant correlations between IQ scores and network properties across all subjects while controlling for age and gender. Specifically, higher intelligence scores corresponded to a shorter characteristic path length and a higher global efficiency of the networks, indicating a more efficient parallel information transfer in the brain. The results were consistently observed not only in the binary but also in the weighted networks, which together provide convergent evidence for our hypothesis. Our findings suggest that the efficiency of brain structural organization may be an important biological basis for intelligence.
Azhar, Raed A; Metcalfe, Charles; Gill, Inderbir S
Partial nephrectomy provides equivalent long-term oncologic and superior functional outcomes as radical nephrectomy for T1a renal masses. Herein, we review the various vascular clamping techniques employed during minimally invasive partial nephrectomy, describe the evolution of our partial nephrectomy technique and provide an update on contemporary thinking about the impact of ischemia on renal function. Recently, partial nephrectomy surgical technique has shifted away from main artery clamping and towards minimizing/eliminating global renal ischemia during partial nephrectomy. Supported by high-fidelity three-dimensional imaging, novel anatomic-based partial nephrectomy techniques have recently been developed, wherein partial nephrectomy can now be performed with segmental, minimal or zero global ischemia to the renal remnant. Sequential innovations have included early unclamping, segmental clamping, super-selective clamping and now culminating in anatomic zero-ischemia surgery. By eliminating 'under-the-gun' time pressure of ischemia for the surgeon, these techniques allow an unhurried, tightly contoured tumour excision with point-specific sutured haemostasis. Recent data indicate that zero-ischemia partial nephrectomy may provide better functional outcomes by minimizing/eliminating global ischemia and preserving greater vascularized kidney volume. Contemporary partial nephrectomy includes a spectrum of surgical techniques ranging from conventional-clamped to novel zero-ischemia approaches. Technique selection should be tailored to each individual case on the basis of tumour characteristics, surgical feasibility, surgeon experience, patient demographics and baseline renal function.
Engelberg, Jesse A; Retallack, Hanna; Balassanian, Ronald; Dowsett, Mitchell; Zabaglo, Lila; Ram, Arishneel A; Apple, Sophia K; Bishop, John W; Borowsky, Alexander D; Carpenter, Philip M; Chen, Yunn-Yi; Datnow, Brian; Elson, Sarah; Hasteh, Farnaz; Lin, Fritz; Moatamed, Neda A; Zhang, Yanhong; Cardiff, Robert D
Hormone receptor status is an integral component of decision-making in breast cancer management. IHC4 score is an algorithm that combines hormone receptor, HER2, and Ki-67 status to provide a semiquantitative prognostic score for breast cancer. High accuracy and low interobserver variance are important to ensure the score is accurately calculated; however, few previous efforts have been made to measure or decrease interobserver variance. We developed a Web-based training tool, called "Score the Core" (STC) using tissue microarrays to train pathologists to visually score estrogen receptor (using the 300-point H score), progesterone receptor (percent positive), and Ki-67 (percent positive). STC used a reference score calculated from a reproducible manual counting method. Pathologists in the Athena Breast Health Network and pathology residents at associated institutions completed the exercise. By using STC, pathologists improved their estrogen receptor H score and progesterone receptor and Ki-67 proportion assessment and demonstrated a good correlation between pathologist and reference scores. In addition, we collected information about pathologist performance that allowed us to compare individual pathologists and measures of agreement. Pathologists' assessment of the proportion of positive cells was closer to the reference than their assessment of the relative intensity of positive cells. Careful training and assessment should be used to ensure the accuracy of breast biomarkers. This is particularly important as breast cancer diagnostics become increasingly quantitative and reproducible. Our training tool is a novel approach for pathologist training that can serve as an important component of ongoing quality assessment and can improve the accuracy of breast cancer prognostic biomarkers. Copyright © 2015 Elsevier Inc. All rights reserved.
Lund, Anker Brink; Meyer, Gitte
Bogstaveligt talt: Hvad er civilsamfundet? Anker Brink Lund og Gitte Meyer fra CBS Center for Civil Society Studies gennemgår civilsamfundet bogstav for bogstav. Vi er nået til M for Marked.......Bogstaveligt talt: Hvad er civilsamfundet? Anker Brink Lund og Gitte Meyer fra CBS Center for Civil Society Studies gennemgår civilsamfundet bogstav for bogstav. Vi er nået til M for Marked....
This document offers some marks on the petroleum fiscality in France: the taxes as the 'accises' and the 'TVA', the part of the taxes in the sale price at the service station, the comparison with other countries of Europe, the tax revenues and the Government budget. It provides also marks on the fuels prices formation (margins), the world petroleum markets (supply and demand) and the part of the petroleum companies on the petroleum market. (A.L.B.)
Lai, W.; McCauley, E.W.
Computer simulations representative of the wetwell of Mark I BWR's have predicted pressures and related phenomena. However, calculational predictions for purposes of engineering decision will be possible only if the code can be verified, i.e., shown to compute in accord with measured values. Described in the report is a set of single downcomer spherical flask bench mark experiments designed to produce quantitative data to validate various air-water dynamic computations; the experiments were performed since relevant bench mark data were not available from outside sources. Secondary purposes of the study were to provide a test bed for the instrumentation and post-experiment data processing techniques to be used in the Laboratory's reactor safety research program and to provide additional masurements for the air-water scaling study
Stolzenburg, Jens-Uwe; Schwalenberg, Thilo; Horn, Lars-Christian; Neuhaus, Jochen; Constantinides, Costantinos; Liatsikos, Evangelos N
In the present study, we review current literature and based on our experience, we present the anatomical landmarks of open and laparoscopic/endoscopic radical prostatectomy. A thorough literature search was performed with the Medline database on the anatomy and the nomenclature of the structures surrounding the prostate gland. The correct handling of puboprostatic ligaments, external urethral sphincter, prostatic fascias and neurovascular bundle is necessary for avoiding malfunction of the urogenital system after radical prostatectomy. When evaluating new prostatectomy techniques, we should always take into account both clinical and final oncological outcomes. The present review adds further knowledge to the existing "postprostatectomy anatomical hazard" debate. It emphasizes upon the role of the puboprostatic ligaments and the course of the external urethral sphincter for urinary continence. When performing an intrafascial nerve sparing prostatectomy most urologists tend to approach as close to the prostatic capsula as possible, even though there is no concurrence regarding the nomenclature of the surrounding fascias and the course of the actual neurovascular bundles. After completion of an intrafascial technique the specimen does not contain any periprostatic tissue and thus the detection of pT3a disease is not feasible. This especially becomes problematic if the tumour reaches the resection margin. Nerve sparing open and laparoscopic radical prostatectomy should aim in maintaining sexual function, recuperating early continence after surgery, without hindering the final oncological outcome to the procedure. Despite the different approaches for radical prostatectomy the key for better results is the understanding of the anatomy of the bladder neck and the urethra.
Gkantsinikoudis, N; Chaniotakis, C; Gkasdaris, G; Georgiou, N; Kapetanakis, S
The sternal foramen (SF) constitutes a specific anatomic defect in sternum, indicating an impaired fusion of ossificated segments, which occurs either in an anatomical part of the sternum or in sternal joints. The aim of this article is to provide baseline statistical data about the variations of the SF, to present a short review of the relevant literature and to compare results with other studies and populations. We review relevant literature, and we present data obtai-ned from skeletal samples of known population and sex. A total of 35 well-preserved dried sterna from the prefecture of Eastern Macedonia and Thrace, Greece, were selected: 20 men and 15 women with a mean age of 55 ± 6 years old. Measurements were made with a sliding calliper and photographic documentation. The incidence of the SF in the 35 dried specimens was 14.2%, 4 men (20% of male sample) and 1 woman (6.6% of female sample) and 80% of sternal foramina were observed in male individuals. The SF was found in the sternum body (2 cases, 40% of foramina), in xiphoid process (2 cases, 40% of foramina) and in sternoxiphoidal junction (1 case, 20% of foramina). All of the sterna presented 1 single visible SF. Two anatomically unique cases were identified throughout these 5 sterna, both belonging in male subjects. The SF constitutes a relatively common variation with great radiological, clinical, and forensic significance. Presence of a SF with irregular bony margins complicates considerably radiological differential diagnosis. Awareness of this important anatomic variation is fundamental for clinicians and autopsy pathologists, in order to avoid severe fatal complications and elucidate the exact cause of death, respectively.
Ameerika kunstnikust Mark Napierist (sünd. 1961) ja tema loomingust, 2001. a. tehtud meiliintervjuu kunstnikuga. Võrguteosest "The Digital Landfill" (1998), koos Andy Deckiga loodud tööst "GrafficJam" (1999), töödest "Shredder" (1998), "Feed", "Riot", "P-Soup" (2000), võrgukunstist ja muust
Full Text Available The minimal-marking project conducted in Ryerson’s School of Journalism throughout 2012 and early 2013 resulted in significantly higher grammar scores in two first-year classes of minimally marked university students when compared to two traditionally marked classes. The “minimal-marking” concept (Haswell, 1983, which requires dramatically more student engagement, resulted in more successful learning outcomes for surface-level knowledge acquisition than the more traditional approach of “teacher-corrects-all.” Results suggest it would be effective, not just for grammar, punctuation, and word usage, the objective here, but for any material that requires rote-memory learning, such as the Associated Press or Canadian Press style rules used by news publications across North America.
Panopoulos, Nickolas J
This article recounts the experiences that shaped my career as a molecular plant pathologist. It focuses primarily on technical and conceptual developments in molecular phytobacteriology, shares some personal highlights and untold stories that impacted my professional development, and describes the early years of agricultural biotechnology. Writing this article required reflection on events occurring over several decades that were punctuated by a mid-career relocation across the Atlantic. I hope it will still be useful, informative, and enjoyable to read. An extended version of the abstract is provided in the Supplemental Materials , available online.
Hoeltge, Gerald A
The Laboratory Accreditation Program of the College of American Pathologists (CAP) began in 2015 to allow accredited laboratories to devise their own strategies for quality control of laboratory testing. Participants now have the option to implement individualized quality control plans (IQCPs). Only nonwaived testing that features an internal control (built-in, electronic, or procedural) is eligible for IQCP accreditation. The accreditation checklists that detail the requirements have been peer-reviewed by content experts on CAP's scientific resource committees and by a panel of accreditation participants. Training and communication have been key to the successful introduction of the new IQCP requirements. Copyright © 2016 Elsevier Inc. All rights reserved.
Picard, Cécile; Fontaine, Juliette; Chouvet, Brigitte; Balme, Brigitte; Traverse-Glehen, Alexandra
Syphilis is a resurging sexually transmitted infection linked to Treponema Pallidum. Syphilitic lymphadenitis can be present during the 3 stages of the disease. Its histological diagnosis remains challenging for the pathologist given its possible misleading aspect and its ability to mimic as well as reactional as tumoral conditions. We report the case of an HIV-infected young patient referred for suspicion of an aggressive lymphoma. Histological and immunohistochemical analysis of cervical lymphadenopathy revealed secondary syphilis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Fernando, R; Vanezis, P
A Thai Airbus, carrying 99 passengers and 14 crew members, traveling from Bangkok to Kathmandu, hit a mountain and crashed several minutes before landing. There were no survivors. Recovered human remains, none of which was easily identifiable, varied in size from a small piece of muscle to mutilated bodies. Of the 97 fragments, only 15 were sufficiently intact (albeit, only partially) to be designated as "bodies." Of the fragments and "bodies," only 11 were positively identified. Causes of death, although all traumatic, could not be stated accurately due to the degree of disintegration. Identification of human remains in these circumstances is a major problem for the pathologist.
Campobasso, C P; Introna, F
An adequate death investigation requires the combined efforts and cooperation of experts in different disciplines: crime scene technicians, death investigators, forensic pathologists, anthropologists, entomologists, other medical and non-medical professionals. These front-line experts play a crucial role in every death investigation process. The forensic pathologist normally has the legal authority to take charge of the dead body at a death scene and his primary functions are the exterior and interior examination of the cadaver by analyzing the extent of antemortem injuries and the postmortem changes and the recovery of physical evidence. He is responsible for determining how, when and why of any death which is the result of violence, suspicious or unexplained circumstances or a death which is sudden or unattended, defending and explaining the reasons for making these diagnoses in a courtroom. The forensic entomologist can provide invaluable aid in death cases where human remains are colonized by insects and in the overall investigation. His principal role is to identify the arthropods associated with such cases and to analyze entomological data for interpreting insect evidence. He is responsible for determining the period of insect activity according to all the variables affecting insect invasion of remains and their development. The major goal of medico-criminal entomology is to contribute to the determination of the time, cause, manner and place of the investigated death (especially on badly decomposed corpses or skeletonized human remains) with the support of all the elements which can be inferred from the study of insects found on the cadaver or nearby. The application of techniques devised recently in forensic entomology can allow experts in the field to collect strong entomological evidence and provide useful information not only in a death investigation including movement or storage of the remains following death, time of dismemberment, postmortem artifacts
West, Nicholas P; Quirke, Philip; Hagemann-Madsen, Rikke Hjarnø
Colorectal cancer is common in the Western world and is a leading cause of cancer related mortality. The introduction of multidisciplinary teams and focus on quality control has led to improved outcomes in which pathologists play a central role through feedback to surgeons, radiologists, and oncologists. This review focuses on the importance of pathological examination of the resection specimen and subsequent feedback to the surgical team regarding quality. Specific markers of oncological quality including grading the plane of surgery, tissue morphometry and lymph node yields are discussed.
The 1980 annual congress of the South African Society of Pathologists was held in cooperation with the Southern African Society for Haematology, International Academy of Pathology, South African Association of Clinical Biochemistry and the Southern African Microbiology Society on the 7-9th July at the South African Institute for Medical Research. The subjects covered in this abstracts include virology, microbiology, histopathology, immunology, and chemical pathology. It seems that the use of isotopes as tracers is very popular in pathology and relative fields
Thomas von Ungern-Sternberg
A common assumption in the literature on the double marginalization problem is that the retailer can set his mark-up only in the second stage of the game after the producer has moved. To the extent that the sequence of moves is designed to reflect the relative bargaining power of the two parties it is just as plausible to let the retailer move first. Furthermore, retailers frequently calculate their selling prices by adding a percentage mark-up to their wholesale prices. This allows a retaile...
In this study, anatomical and palynological features of the roots, stems, petiole and leaves of Salvia willeana (Holmboe) Hedge and Salvia veneris Hedge, Salvia species endemic to Cyprus, were investigated. In the anatomical characteristics of stem structures, it was found that the chlorenchyma composed of 6 or 7 rows of ...
Liu, Zenghui; Chen, A.; Van de Velde, Hans
This study investigates prosodic marking of focus in Bai, a Sino-Tibetan language spoken in the Southwest of China, by adopting a semi-spontaneous experimental approach. Our data show that Bai speakers increase the duration of the focused constituent and reduce the duration of the post-focus
Kenneth R. Eversole
Careful selection of trees to be pruned can make the difference between profit and loss on the pruning investment, especially in stands where no thinning is contemplated. Expert marking is required to make sure that the pruned trees will grow rapidly. The most important variable influencing the cost of clear wood produced by pruning is growth rate. For example, at 3...
Okazaki, Yuki; Aoki, Nobutada; Mukai, Narihiko; Sano, Yuji; Yamamoto, Seiji.
An object is disposed in laser beam permeating liquid or gaseous medium. Laser beams such as CW laser or pulse laser oscillated from a laser device are emitted to the object to apply laser markings with less degradation of identification and excellent corrosion resistance on the surface of the object simply and easily. Upon applying the laser markings, a liquid or gas as a laser beam permeating medium is blown onto the surface of the object, or the liquid or gas in the vicinity of the object is sucked, the laser beam-irradiated portion on the surface can be cooled positively. Accordingly, the laser marking can be formed on the surface of the object with less heat affection to the object. In addition, if the content of a nitrogen gas in the laser beam permeating liquid medium is reduced by degassing to lower than a predetermined value, or the laser beam permeating gaseous medium is formed by an inert gas, a laser marking having high corrosion resistance and reliability can be formed on the surface of the objective member. (N.H.)
Swapna A. Mahale
Full Text Available Aim: The aim of this study is to evaluate the anatomic variables affecting the interdental papilla. Materials and Methods: Thirty adult patients were evaluated. Papilla score (PS, tooth form/shape, gingival thickness, crest bone height and keratinized gingiva/attached gingiva were recorded for 150 inter proximal sites. Data were analyzed using SPSS software package (version 7.0 and the significance level was set at 95% confidence interval. Pearson′s correlation was applied to correlate the relationship between the factors and the appearance of the papilla. Results: Competent papillae (complete fill interdentally were associated with: (1 Crown width (CW: length ≥0.87; (2 bone crest-contact point ≤5 mm; and (3 inter proximal gingival tissue thickness ≥1.5 mm. Gingival thickness correlated negatively with PS (r = −0.37 to −0.54 and positively with tissue height (r = 0.23-0.43. Tooth form (i.e., CW to length ratio correlated negatively with PS (r = −0.37 to −0.61. Conclusion: Gingival papilla appearance was associated significantly with tooth form/shape, crestal bone height and interproximal gingival thickness.
Sanketh, D Sharathkumar; Srinivasan, Samuel Raj; Patil, Shankargouda; Ranganathan, Kannan
In the present study, we simulated clinical scenarios by explicitly describing the history and clinical and histological features of hypothetical patients presenting with oral lichen planus (OLP), oral lichenoid lesion, and epithelial dysplasia in a self-designed questionnaire. By doing so, we aimed to elicit a diagnosis from oral pathologists and trainees, analyze their responses, appraise issues, and propose solutions regarding the diagnosis of OLP. The questionnaire was distributed to 100 oral pathologists and trainees in South India. Six questions were designed to assess awareness of the diagnostic aspects of OLP. Ten questions were hypothetical clinical scenarios (HCS) devised to evaluate respondents' knowledge of diagnostic guidelines and the criteria used by the respondents to render a diagnosis. There were 60 of 100 responses to the questionnaire. More than half the respondents were aware of the World Health Organization and modified guidelines of OLP. We observed considerable variations in diagnoses for the HCS. Our study illustrates the ambiguity in rendering an accurate diagnosis, despite adequate guidelines. Based on the responses for the HCS, we hypothesized that changes in the distribution (unilateral or bilateral) and clinical characteristic of OLP, and habits of patients, have a significant bearing on the clinical and final diagnoses of the lesion. © 2016 John Wiley & Sons Australia, Ltd.
- Comprehensive molecular investigations of mainstream carcinogenic processes have led to the use of effective molecular targeted agents in most cases of solid tumors in clinical settings. - To update readers regarding the evolving role of the pathologist in the therapeutic decision-making process and the introduction of next-generation technologies into pathology practice. - Current literature on the topic, primarily sourced from the PubMed (National Center for Biotechnology Information, Bethesda, Maryland) database, were reviewed. - Adequate evaluation of cytologic-based and tissue-based predictive diagnostic biomarkers largely depends on both proper pathologic characterization and customized processing of biospecimens. Moreover, increased requests for molecular testing have paralleled the recent, sharp decrease in tumor material to be analyzed-material that currently comprises cytology specimens or, at minimum, small biopsies in most cases of metastatic/advanced disease. Traditional diagnostic pathology has been completely revolutionized by the introduction of next-generation technologies, which provide multigene, targeted mutational profiling, even in the most complex of clinical cases. Combining traditional and molecular knowledge, pathologists integrate the morphological, clinical, and molecular dimensions of a disease, leading to a proper diagnosis and, therefore, the most-appropriate tailored therapy.
Snowdon, C; Elbourne, D R; Garcia, J
To describe the attitudes of neonatologists to trial related perinatal postmortem examinations (PMs), in the light of declining perinatal PM rates and poor levels of participation in pathology studies. A qualitative study was carried out, using semistructured interviews. Twenty six neonatologists from five UK neonatal units were interviewed; five UK perinatal pathologists also contributed to the study. The professionals involved were all linked to one or both of two neonatal trials. Pathologists expressed concern over the difficulties experienced in UK perinatal pathology and the impact on research of inadequate levels of samples. The interviews with neonatologists reveal discomfort over approaching bereaved parents for PMs, and a widespread concern that parents should not be further distressed or feel under pressure to consent. Although there was support for neonatal trials, the study highlights a view that PMs may be unnecessary if the cause of death seems apparent or when a baby was born prematurely, and a devaluation of PMs among some younger staff. Poor rates of participation in pathology studies may be accounted for by a notable sense of disconnection between trial interventions and pathology studies. Neonatologists were concerned to protect vulnerable parents and varied in whether they saw this as compatible with inclusion in trial related pathology studies. Dedicated research is needed to document and gain an understanding of the consent process and should examine the usefulness and impact of consent forms. It should assess whether professionals might benefit from training, to help parents to come to their decisions.
Baker, B; Ross, E; Girson, J
The present study aimed to examine the attitudes of a group of South African speech-language pathologists towards stuttering and stuttering therapy. Further aims were to investigate whether a stereotype of stutterers was found among these speech-language pathologists, and to determine whether there was any relationship between the attitudes held about stutterers, and the therapists' training and experience. A random probability sample of respondents was selected from the population of speech therapists registered with the Interim Medical and Dental Council of South Africa (I.M.D.C.S.A.). A self-administered mailed questionnaire was employed to realise the aims of the study. The main result of this investigation indicated that almost 50% of the sample of qualified clinicians surveyed, viewed stutterers as a group characterised by specific personality traits and psychological problems. This belief held true irrespective of the number of years of experience working in the field, the time of graduation, the frequency of treating stutterers, or the training emphasis. Implications of these results are considered with respect to student training, continuing education of qualified practitioners and future research.
Lawton, Thomas J.; Acs, Geza; Argani, Pedram; Farshid, Gelareh; Gilcrease, Michael; Goldstein, Neal; Koerner, Frederick; Rowe, J. Jordi; Sanders, Melinda; Shah, Sejal S.; Reynolds, Carol
Fibroepithelial lesions with cellular stroma are frequently termed cellular fibroadenomas although criteria for distinguishing them from a phyllodes tumor are vague and subjective. However, the clinical implications and surgical management for these 2 lesions may be different. We randomly selected 21 cases of fibroepithelial lesions sent in consultation to the senior author that were challenging to classify as cellular fibroadenoma or phyllodes tumor. One to 2 representative slides of each case along with patient age were sent to 10 pathologists who specialize in breast pathology. The World Health Organization criteria for phyllodes tumors and a diagnosis form were included with the study set. For the purposes of data reporting, fibroadenoma and cellular fibroadenoma are considered together. In only 2 cases was there uniform agreement as to whether the tumor represented a fibroadenoma or phyllodes tumor. Of the remaining 19 cases, if the diagnoses of fibroadenoma and benign phyllodes tumor were combined and separated from borderline and malignant phyllodes tumors, there was 100% agreement in 53% of cases and 90% agreement in 79% of cases. This study highlights the difficulty that exists in distinguishing some cellular fibroadenomas from phyllodes tumors even for pathologists who specialize in breast pathology. However, there appears to be considerable agreement when cellular fibroadenomas and benign phyllodes tumors are distinguished from borderline and malignant phyllodes tumors. Further studies are needed to determine if there is a clinically significant difference between cellular fibroadenomas and benign phyllodes tumors and how to better distinguish them from borderline and malignant phyllodes tumors. PMID:25161205
Bertram, Christof A; Klopfleisch, Robert
Using light microscopy to describe the microarchitecture of normal and diseased tissues has changed very little since the middle of the 19th century. While the premise of histologic analysis remains intact, our relationship with the microscope is changing dramatically. Digital pathology offers new forms of visualization, and delivery of images is facilitated in unprecedented ways. This new technology can untether us entirely from our light microscopes, with many pathologists already performing their jobs using virtual microscopy. Several veterinary colleges have integrated virtual microscopy in their curriculum, and some diagnostic histopathology labs are switching to virtual microscopy as their main tool for the assessment of histologic specimens. Considering recent technical advancements of slide scanner and viewing software, digital pathology should now be considered a serious alternative to traditional light microscopy. This review therefore intends to give an overview of the current digital pathology technologies and their potential in all fields of veterinary pathology (ie, research, diagnostic service, and education). A future integration of digital pathology in the veterinary pathologist's workflow seems to be inevitable, and therefore it is proposed that trainees should be taught in digital pathology to keep up with the unavoidable digitization of the profession.
Lockyer, Jocelyn M; Violato, Claudio; Fidler, Herta; Alakija, Pauline
There is increasing interest in ensuring that physicians demonstrate the full range of Accreditation Council for Graduate Medical Education competencies. To determine whether it is possible to develop a feasible and reliable multisource feedback instrument for pathologists and laboratory medicine physicians. Surveys with 39, 30, and 22 items were developed to assess individual physicians by 8 peers, 8 referring physicians, and 8 coworkers (eg, technologists, secretaries), respectively, using 5-point scales and an unable-to-assess category. Physicians completed a self-assessment survey. Items addressed key competencies related to clinical competence, collaboration, professionalism, and communication. Data from 101 pathologists and laboratory medicine physicians were analyzed. The mean number of respondents per physician was 7.6, 7.4, and 7.6 for peers, referring physicians, and coworkers, respectively. The reliability of the internal consistency, measured by Cronbach alpha, was > or = .95 for the full scale of all instruments. Analysis indicated that the medical peer, referring physician, and coworker instruments achieved a generalizability coefficient of .78, .81, and .81, respectively. Factor analysis showed 4 factors on the peer questionnaire accounted for 68.8% of the total variance: reports and clinical competency, collaboration, educational leadership, and professional behavior. For the referring physician survey, 3 factors accounted for 66.9% of the variance: professionalism, reports, and clinical competency. Two factors on the coworker questionnaire accounted for 59.9% of the total variance: communication and professionalism. It is feasible to assess this group of physicians using multisource feedback with instruments that are reliable.
Renshaw, Andrew A; Gould, Edwin W
To assess the overall impact of access to the electronic medical record (EMR) on anatomic pathology performance. We reviewed the results of all use of the EMR by 1 pathologist over an 18-month period. Of the 10,107 cases (913 cytology and 9,194 surgical pathology) reviewed, the EMR (excluding anatomic pathology records) was accessed in 222 (2.2% of all cases, 6.5% of all cytology cases, and 1.8% of all surgical pathology cases). The EMR was used to evaluate a critical value in 20 (9.0%) cases and make a more specific diagnosis in 77 (34.7%) cases, a less specific diagnosis in 4 (1.8%) cases, and a systemic rather than localized diagnosis in 4 (1.8%) cases. The percentage of cases in which the physician was contacted decreased from 7.3% for the prior 18 months to 6.7%, but this change was not significant (P = .13). Twelve cases were subsequently sent for interinstitutional consultation, and no disagreements were identified. The EMR was accessed in 2.2% of all surgical pathology and cytology cases and affected the diagnosis in 48% of these cases.
Spies, Florian; Kühne, Michael; Reichlin, Tobias; Osswald, Stefan; Sticherling, Christian; Knecht, Sven
Anatomically guided pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation. However, the position where to confirm electrical isolation is ill-defined. The aim of the current study was to quantify the relationship between the anatomical and electrical definition of the pulmonary vein ostium. We analyzed 20 patients with paroxysmal AF undergoing PVI using radiofrequency energy and an electroanatomical mapping system. The anatomical ostium was defined based on the geometry obtained from preprocedural magnetic resonance imaging and computed tomography. The electrical ostium was defined at the position with a far-field atrial signal preceding a sharp pulmonary vein (PV) signal without any isoelectric interval in between. The electrically defined ostia were 8.4 ± 4.7 mm more distal in the PV compared to the anatomically defined ostia. The distances varied considerably between the four PVs and were 10.5 ± 6.5 mm, 7.4 ± 4.3 mm, 5.3 ± 4.0 mm, and 8.3 ± 3.4 mm for the left superior, left inferior, right superior, and right inferior PVs, respectively (P = 0.009). The position of the electrical and anatomical ostium differs markedly. The site of the electrical ostium is variable within the PV but always more distal in the PV compared to the site of the anatomical ostium. © 2017 Wiley Periodicals, Inc.
Isa Carla Osterkamp
Full Text Available ABSTRACT Charcoal is widely accepted as evidence of the occurrence of palaeo-wildfire. Although fossil charcoal remains have been used in many studies, investigation into the anatomical changes occurring during charring are few. The present study analyses changes in selected anatomical characters during artificial charring of modern wood of three species of the genus Araucaria (i.e. Araucaria angustifolia, Araucaria bidwillii and Araucaria columnaris. Wood samples of the studied species was charred under controlled conditions at varying temperatures. Measurements of anatomical features of uncharred wood and artificial charcoal were statistically analysed. The anatomical changes were statistically correlated with charring temperatures and most of the parameters showed marked decreases with increasing charring temperature. Compared to the intrinsic variability in anatomical features, both within and between growth rings of an individual plant, the changes induced by temperature account only for a comparatively small percentage of the observed variability. Regarding Araucaria charcoal, it seems possible that at least general taxonomic and palaeoenvironmental implications can be drawn from such material. However, it is not clear so far whether these results and interpretations based on only three taxa, can be generalized for the entire family and anatomically similar fossil taxa or not.
Ziyatdinov, R. R.; Shigabiev, R. R.; Talipov, D. N.
Development of the automated road marking recognition systems in existing and future vehicles control systems is an urgent task. One way to implement such systems is the use of neural networks. To test the possibility of using neural network software has been developed with the use of a single-layer perceptron. The resulting system based on neural network has successfully coped with the task both when driving in the daytime and at night.
Heloisa Helou Doca
Full Text Available A leitura cuidadosa do texto do “Tratado de Paris”, em 1900, leva Mark Twain a concluir que a intenção política norte-americana era, claramente, a de subjugação. Declara-se, abertamente, antiimperialista, nesse momento, apesar das inúmeras críticasrecebidas por antagonistas políticos que defendiam o establishment dos Estados Unidos. Após viajar para a Europa e Oriente, em 1867, como correspondente do jornal Daily Alta Califórnia, Mark Twain publica, em 1869, seu relato de viagem, The Innocents Abroad or TheNew Pilgrim’s Progress. Nosso estudo demonstra que o autor, apesar das diversas máscaras usadas em seus relatos, narra histórias, culturas e tradições, tanto da Europa quanto do Oriente, já com os olhos bem abertos pelo viés antiimperialista. Faz uso da paródia, sátira, ironia e humor para dessacralizar impérios, monarcas e a Igreja que subjugavam os mais fracos, iluminando, desde então, os estudos sobre culturas. Nosso estudo, outrossim, faz uma reflexão sobre cultura, tradição e o olhar do viajante, justificando o “olhar inocente” do narrador em seu relato.After carefully reading the Treaty of Paris in 1900, Mark Twain concluded that the goal of U.S. policy was clearly one ofsubjugation. He openly declared himself an anti-imperialist at that time, in spite of the numerous criticisms he received from political opponents who supported the United States status quo. After traveling to Europe and the East in 1867 as a correspondent for The DailyAlta California newspaper, Mark Twain published his travel report, The Innocents Abroad or The New Pilgrim’s Progress in 1869. Our study demonstrates that the author, in spite of using different guises in his reports, narrated histories, cultures and traditions – from both Europe and the East – with a viewpoint already imbued by his anti-imperialistic ideals. Twain made use of parody, satire, irony and humor within his texts in order to desecrate empires,monarchs and
Full Text Available The establishment of radiofrequency catheter ablation techniques as the mainstay in the treatment of tachycardia has renewed new interest in cardiac anatomy. The interventional arrhythmologist has drawn attention not only to the gross anatomic details of the heart but also to architectural and histological characteristics of various cardiac regions that are relevant to the development or recurrence of tachyarrhythmias and procedural related complications of catheter ablation. In this review, therefore, we discuss some anatomic landmarks commonly used in catheter ablations including the terminal crest, sinus node region, Koch’s triangle, cavotricuspid isthmus, Eustachian ridge and valve, pulmonary venous orifices, venoatrial junctions, and ventricular outflow tracts. We also discuss the anatomical features of important structures in the vicinity of the atria and pulmonary veins, such as the esophagus and phrenic nerves. This paper provides basic anatomic information to improve understanding of the mapping and ablative procedures for cardiac interventional electrophysiologists.
Zipoli, Richard P; Kennedy, Marianne
A total of 240 speech-language pathologists responded to a questionnaire examining attitudes toward and use of research and evidence-based practice (EBP). Perceived barriers to EBP were also explored. Positive attitudes toward research and EBP were reported. Attitudes were predicted by exposure to research and EBP practice during graduate training and the clinical fellowship year (CFY). Clinical experience and opinions of colleagues were used to guide decision making more frequently than research studies or clinical practice guidelines. Only exposure to research and EBP during the CFY predicted use of evidence-based resources. Respondents reported a decline in exposure to research and EBP as they moved from graduate training into the CFY. A lack of time was perceived as a barrier to EBP.
Stiegler, Lillian N
Echolalia is a common element in the communication of individuals with autism spectrum disorders. Recent contributions to the literature reflect significant disagreement regarding how echolalia should be defined, understood, and managed. The purpose of this review article is to give speech-language pathologists and others a comprehensive view of the available perspectives on echolalia. Published literature from the disciplines of behavioral intervention, linguistics, and speech-language intervention is discussed. Special areas of focus include operational definitions, rationales associated with various approaches, specific procedures used to treat or study echolalic behavior, and reported conclusions. Dissimilarities in the definition and understanding of echolalia have led to vastly different approaches to management. Evidence-based practice protocols are available to guide speech-language interventionists in their work with individuals with autism spectrum disorders.
Tucker, Janice K
Telepractice in speech-language pathology shows the potential to mitigate the current shortage of speech-language pathologists (SLPs) available to serve a growing number of persons with communication disorders. Since a majority of American Speech-Language-Hearing Association (ASHA) certified SLPs work in schools and the population of communicatively impaired clients in schools continues to grow, research into the use of telepractice in the educational setting is warranted. This article reports upon the perspectives of SLPs regarding the use of telepractice in school settings. In-depth qualitative interviews were conducted with five SLPs experienced in the delivery of telepractice. Four major themes emerged: barriers, benefits, reasons for acceptance and use of telepractice, and suggestions to resolve telepractice professional issues.
Janice K. Tucker
Full Text Available This research surveyed 170 school-based speech-language pathologists (SLPs in one northeastern state, with only 1.8% reporting telepractice use in school-settings. These results were consistent with two ASHA surveys (2002; 2011 that reported limited use of telepractice for school-based speech-language pathology. In the present study, willingness to use telepractice was inversely related to age, perhaps because younger members of the profession are more accustomed to using technology. Overall, respondents were concerned about the validity of assessments administered via telepractice; whether clinicians can adequately establish rapport with clients via telepractice; and if therapy conducted via telepractice can be as effective as in-person speech-language therapy. Most respondents indicated the need to establish procedures and guidelines for school-based telepractice programs.
Watanabe, Atsushi; Kusuoka, Osamu; Sato, Norihiro; Nakazono, Osamu; Wasko, Michael; Potenta, Daniel; Nakae, Dai; Hatakeyama, Hirofumi; Iwata, Hijiri; Naota, Misaki; Anzai, Takayuki
The Standard for Exchange of Nonclinical Data (SEND), introduced by the US Food and Drug Administration (FDA), is a scheme for the computerization, electronic application, and screening of preclinical data. Since its establishment, related organizations have been working together to implement SEND. However, it is difficult for individual pharmaceutical companies that often outsource to achieve complete compliance with SEND; hence, the cooperation of contract research organizations (CROs) and SEND Registered Solution Providers (RSPs) is indispensable. In SEND, most data, including those on pathology findings, are converted into controlled terminology (CT), but it is not a simple process to convert findings or levels of severity in the field of pathology, which is a descriptive science. The authors have successfully completed an FDA trial submission for a toxicology test conducted at a CRO and in doing so acquired important knowledge. This article presents a clear picture of such important knowledge from a pathologist's viewpoint.
This paper presents recent results from the Mark III detector at SPEAR, in the open charm sector. The first topic discussed is the reanalysis of the direct measurement of the D hadronic branching fractions, where a detailed study has been made of the Cabibbo suppressed and multi-π 0 's D decays backgrounds in the double tag sample. Next, the Dalitz plot analysis of the D decays to Kππ is presented, leading to the relative fractions of three-body versus pseudoscalarvector decays. 7 refs., 5 figs
Adler, J.; Bolton, T.; Bunnell, K.
The design and construction of the new Mark III vertex chamber is described. Initial tests with cosmic rays prove the ability of track reconstruction and yield triplet resolutions below 50 μm at 3 atm using argon/ethane (50:50). Also performed are studies using a prototype of a pressurized wire vertex chamber with 8 mm diameter straw geometry. Spatial resolution of 35mm was obtained using dimethyl ether (DME) at 1 atm and 30 μm using argon/ethane (50/50 mixture) at 4 atm. Preliminary studies indicate the DME to adversely affect such materials as aluminized Mylar and Delrin
The history of anatomical terminology in Japan began with the publication of Waran Naikei Ihan-teimŏ in 1805 and Chŏtei Kaitai Shinsho in 1826. Although the establishment of Japanese anatomical terminology became necessary during the Meiji era when many western anatomy books imported into Janan were translated, such terminology was not unified during this period and varied among translators. In 1871, Tsukumo Ono's Kaibŏgaku Gosen was published by the Ministry of Education. Although this book is considered to be the first anatomical glossary terms in Japan, its contents were incomplete. Overseas, the German Anatomical Society established a unified anatomical terminology in 1895 called the Basle Nomina Anatomica (B.N.A.). Based on this development, Kaibŏgaku Meishŭ which follows the BNA, by Buntarŏ Suzuki was published in 1905. With the subsequent establishment in 1935 of Jena Nomina Anatomica (J.N.A.), the unification of anatomical terminology was also accelerated in Japan, leading to the further development of terminology.
Barcelo Héctor A
Full Text Available Abstract Education shows that active participation allows the best development of skills to acquire, and the results are better when the information is well documented. Now, with digital images and the Internet, in the case of the Static Telepathology (ST, it is easy to share macroscopic and microscopic photographs. The progress of the technologies enabled a form of Dynamic Telepathology (DT named "virtual slides", with navigation tools, and can be moved around changing powers as desired, making any personal computer into a digital microscope. The use of these tools in continuous education leads to optimal development of knowledge. We reported the experience of a Latin-American Pathologist from La Rioja, a small Province of Argentina, and we also mentioned the electronic publications in Virtual Hispano-American Congresses of Pathology (VHACP since 1997(18 reports in the case of ST and in two Virtual Slide Congress (VSC. In the 1st (2005 and 2nd (2007 Internet VSCs two of our cases were digitized in Spain (case 1 and 3 respectively. In these Virtual Slides, the microscopic images can be moved remotely from any computer connected to the Internet, we should recognize that it will become a valuable continuing Medical Education tool in microscopy, probably related to the phrase "a picture is worth more than a thousand words", then we might add; "what about thousands of images?" Similarly, the autoevaluation test is very important. ST and DT, in support of Virtual Congresses allows learning, teaching and sharing of diseases in scientific presentations and the exchange of views in the forums, these are the optimum material for distance education. In addition we received CDs or DVDs and certificates as authors, recognized by European Institutions. The active participation and the autoevaluation test are the best tools for continuous medical education in telepathology, not only for pathologists in developing countries but for the entire world.
Douglas J Hartman
Full Text Available Introduction: Telepathology allows the digital transmission of images for rapid access to pathology experts. Recent technologic advances in smartphones have allowed them to be used to acquire and transmit digital images of the glass slide, representing cost savings and efficiency gains over traditional forms of telepathology. We report our experience with developing an iPhone application (App - Pocket Pathologist to facilitate rapid diagnostic pathology teleconsultation utilizing a smartphone. Materials and Methods: A secure, web-based portal (http://pathconsult.upmc.com/ was created to facilitate remote transmission of digital images for teleconsultation. The App augments functionality of the web-based portal and allows the user to quickly and easily upload digital images for teleconsultation. Image quality of smartphone cameras was evaluated by capturing images using different adapters that directly attach phones to a microscope ocular lens. Results: The App was launched in August 2013. The App facilitated easy submission of cases for teleconsultation by limiting the number of data entry fields for users and enabling uploading of images from their smartphone′s gallery wirelessly. Smartphone cameras properly attached to a microscope create static digital images of similar quality to a commercial digital microscope camera. Conclusion: Smartphones have great potential to support telepathology because they are portable, provide ubiquitous internet connectivity, contain excellent digital cameras, and can be easily attached to a microscope. The Pocket Pathologist App represents a significant reduction in the cost of creating digital images and submitting them for teleconsultation. The iPhone App provides an easy solution for global users to submit digital pathology images to pathology experts for consultation.
Capalbo, Emanuela, E-mail: firstname.lastname@example.org [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Sajadidehkordi, Farideh, E-mail: email@example.com [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Colombi, Claudio; Ticha, Vladimira; Moretti, Angela, E-mail: firstname.lastname@example.org [Dipartimento di Scienze Diagnostiche, UOC di Radiologia Diagnostica ed Interventistica, A.O San Carlo Borromeo. Via Pio II, 3, 20153 Milano (Italy); Peli, Michela, E-mail: email@example.com [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Cosentino, Maria, E-mail: firstname.lastname@example.org [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Lovisatti, Maria, E-mail: email@example.com [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Berti, Elisabetta, E-mail: firstname.lastname@example.org [Dipartimento di Scienze Diagnostiche, UOC di Anatomia Patologica, A.O San Carlo Borromeo. Via Pio II, 3, Milano 20153 (Italy); Cariati, Maurizio, E-mail: email@example.com [Dipartimento di Scienze Diagnostiche, UOC di Radiologia Diagnostica ed Interventistica, A.O San Carlo Borromeo. Via Pio II, 3, 20153 Milano (Italy)
Objective: Evaluating correlation estimation between diagnostic ultrasound (U.S.) of breast lesions and fine needle aspiration cytology (FNAC), and the correlation between cytology and histology (I) of these lesions undergo surgery. Materials and methods: In 2010 we performed 1589 ultrasound breast. We identified 210 suspicious lesions to be subjected to FNAC, which was performed with pathologist on site, and extemporaneous analysis of the sample to assess their appropriateness. We classified the lesions in 5 ultrasound (U) classes according to the criteria defined by Echographic BIRADS Lexicon. The results of cytology were classified in 5 classes (C) according to the guidelines of F.O.N.Ca.M. Then we evaluated the diagnostic correlation between U.S. and FNAC, and between FNAC and Histology. Results: The distribution of lesions in U classes was: 57U2, 55U3, 36U4 and 62U5. The diagnostic concordance between U and FNAC was 96.7%, with a sensitivity of 98%, specificity 93%, negative and positive predictive value respectively of 94.9% and 97.3%, and diagnostic accuracy of 96.6%. The 98 patients with C4-C5 lesions were subjected to surgery and the histology confirmed high-grade malignancy of lesions with a concordance of 99.7%. Conclusions: Having achieved high diagnostic concordance between U and FNAC, and then between FNAC and histology, we may say that the FNAC, less invasive and traumatic for the patient than needle biopsy (CB), may be still a valid method when performed with pathologist on-site to assess the adequacy of the sample taken.
Hersh, Deborah; Armstrong, Elizabeth; Bourke, Noni
To explore in detail the narrative of a speech pathologist (SP) working with Indigenous Australian clients with acquired communication disorders following stroke or brain injury. There is some evidence that Indigenous clients do not find speech pathology rehabilitation to be culturally appropriate but, currently, there is very little published on the nature of this service or the experiences of SPs who provide this rehabilitation. This research uses both thematic and structural narrative analysis of data from a semi-structured, in-depth interview with a SP to examine the adaptations that she made to address the needs of her adult neurological caseload of (mainly) Indigenous Australians from both urban and remote regions. The thematic analysis resulted in a core theme of flexibility and four other sub-themes: awareness of cultural context, client focus/person-centredness, being practical and working ethically. The structural narrative analysis allowed insight into the nature of clinical reasoning in a context lacking predictability and where previous clinical certainties required adaptation. Individual, detailed narratives are useful in exposing the challenges and clinical reasoning behind culturally sensitive practice. Implications for Rehabilitation Speech pathologists (SPs) can learn from hearing the clinical stories of colleagues with experience of providing rehabilitation in culturally diverse contexts, as well as from ongoing training in culturally competent and safe practices. Such stories help bridge understanding from the general to the particular. SPs working with Indigenous Australians with acquired communication disorders post-stroke and brain injury may find it helpful to consider how the themes, drawn from an interview with the clinician in this study - flexibility, awareness of cultural context, person-centredness, being practical and working ethically - might apply to their practice. Narratives may be helpful in staff training and form an important
Ross, Jeffrey S
Mutation status of the KRAS gene identifies a distinct disease subtype of metastatic colorectal carcinoma that does not respond to antibody therapeutics targeting the epidermal growth factor receptor. This is currently the only validated marker in metastatic colorectal carcinoma with a clear implication in treatment selection. KRAS testing is widely accepted in clinical practice to guide metastatic colorectal carcinoma therapeutic decisions, and there are many commercially available platforms to perform the test. To evaluate the critical role of pathologists in the full implementation of KRAS testing by optimizing tumor tissue collection and fixation procedures and by choosing testing technologies and reliable Clinical Laboratory Improvement Amendments of 1988-certified laboratories to perform the tests. Prospective clinical trials, retrospective studies, and quality assessment and survey reports were identified in the following databases: PubMed, American Society of Clinical Oncology Proceedings (American Society of Clinical Oncology Annual Meeting and Gastrointestinal Cancer Symposium) and European Society for Medical Oncology Proceedings (Annals of Oncology European Society for Medical Oncology Congress and Annals of Oncology World Congress on Gastrointestinal Cancers). More bona fide standards are needed to address the variety of available test methods, which have different performance characteristics including speed, sensitivity to detect rare mutations, and technical requirements. Refined standards addressing timing of KRAS testing, laboratory performance and accuracy, quality assurance and control, proper tissue collection, and appropriate result reporting would also be greatly beneficial. Pathologists should be aware that the amount of information they need to manage will increase, because future trends and technological advances will enhance the predictive power of diagnostic tests or the scope of the biomarker panels tested routinely across tumor types.
... 46 Shipping 7 2010-10-01 2010-10-01 false Hull markings. 185.602 Section 185.602 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) OPERATIONS Markings Required § 185.602 Hull markings. (a) Each vessel must be marked as required by part 67...
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Export marks. 28.193... Drawback Filing of Notice and Removal § 28.193 Export marks. In addition to the marks and brands required... chapter, the exporter shall mark the word “Export” on the Government side of each case or Government head...
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Export marks. 28.103... Manufacturing Bonded Warehouse § 28.103 Export marks. (a) General. In addition to the marks and brands required... provisions of part 19 of this chapter, the proprietor shall mark the word “Export” on the Government side of...
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Export marks. 28.144... § 28.144 Export marks. (a) General Requirement. In addition to the marks and brands required to be... brewer shall mark the word “Export” on each container or case of beer, or the words “Beer concentrate for...
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Export marks. 28.154..., for Exportation or Transfer to a Foreign-Trade Zone § 28.154 Export marks. In addition to the marks... provisions of part 19 of this chapter, the proprietor shall mark the word “Export” on the Government side of...
XIA Yin; LI Xi-ping; HAN De-min; ZHENG Jun; LONG Hai-shan; SHI Jin-feng
Background Minimally invasive surgery in skull base relying on searching for possible anatomic basis for endoscopic technology is controversial. The objective of this study was to observe the spatial relationships between main blood vessels and nerves in the cerebellopontine angle area and provide anatomic basis for lateral and posterior skull base minimally invasive surgery via endoscopic retrosigmoid keyhole approach.Methods This study was conducted on thirty dried adult skulls to measure the spatial relationships among the surface bony marks of posterior cranial fossa, and to locate the most appropriate drilling area for retrosigmoid keyhole approach.In addition, we used 10 formaldehyde-fixed adult cadaver specimens for simulating endoscopic retrosigmoid approach to determine the visible scope.Results The midpoint between the mastoid tip and the asterion was the best drilling point for retrosigmoid approach. A hole centered on this point with the 2.0 cm in diameter was suitable for exposing the related structures in the cerebellopontine angle. Retrosigmoid keyhole approach can decrease the pressure on the cerebellum and expose the related structures effectively which include facial nerve, vestibulocochlear nerve, trigeminal nerve, glossopharyngeal nerve, vagus nerve, accessory nerve, hypoglossal nerve, anterior inferior cerebellar artery, posterior inferior cerebellar artery and labyrinthine artery, etc.Conclusions Exact location on endoscope retrosigmoid approach can avoid dragging cerebellum during the minimally invasive surgery. The application of retrosigmoid keyhole approach will extend the application of endoscopic technology.
Mark Wilcox speaks to Georgia Patey, Commissioning Editor: Professor Mark Wilcox is a Consultant Microbiologist and Head of Microbiology at the Leeds Teaching Hospitals (Leeds, UK), the Professor of Medical Microbiology at the University of Leeds (Leeds, UK), and is the Lead on Clostridium difficile and the Head of the UK C. difficile Reference Laboratory for Public Health England (PHE). He was the Director of Infection Prevention (4 years), Infection Control Doctor (8 years) and Clinical Director of Pathology (6 years) at the Leeds Teaching Hospitals. He is Chair of PHE's Rapid Review Panel (reviews utility of infection prevention and control products for National Health Service), Deputy Chair of the UK Department of Health's Antimicrobial Resistance and Healthcare Associated Infection Committee and a member of PHE's HCAI/AR Programme Board. He is a member of UK/European/US working groups on C. difficile infection. He has provided clinical advice as part of the FDA/EMA submissions for the approval of multiple novel antimicrobial agents. He heads a healthcare-associated infection research team at University of Leeds, comprising approximately 30 doctors, scientists and nurses; projects include multiple aspects of C. difficile infection, diagnostics, antimicrobial resistance and the clinical development of new antimicrobial agents. He has authored more than 400 publications, and is the coeditor of Antimicrobial Chemotherapy (5th/6th/7th Editions, 15 December 2007).
Okuda, Itsuko; Udagawa, Harushi; Hirata, Kazuaki; Nakajima, Yasuo
The aim of this study was to compare thoracic duct (TD) configuration depicted by magnetic resonance imaging (MRI) with TD configuration described in the anatomical literature. MRI Scans were acquired with a three-dimensional T2-weighted turbo spin echo (TSE) MRI with a two-dimensional prospective acquisition correction (PACE) technique in 63 patients. We found with MRI that TD displacement occurred more on the left side than that reported in the anatomical literature, and this tendency was more marked in elderly patients. In patients with marked leftward TD displacement, the TD configuration on MRI was compared to the descending aortic configuration on chest radiography. The degree of correspondence between the MRI findings and the anatomical literature was assessed by a χ 2 goodness-of-fit test, and P<0.05 indicated a significant difference. The degree of similarity was determined between TD configuration and aortic configuration by Kendall's coefficient of concordance (W). On MRI scans the TD was often located to the left of the mid-vertebral line compared to the location reported in the anatomical literature (P<0.001). Nine patients had marked leftward TD displacement, a configuration similar to that of the descending aorta (W=1); however, no association with age was established. The TD configuration depicted by MRI differed from that described in the anatomical literature. (author)
Ritzman, Mitzi J.; Sanger, Dixie
Purpose: The purpose of this study was to survey the opinions of principals concerning the role of speech-language pathologists (SLPs) serving students with communication disorders who have been involved in violence. Method: A mixed methods design involving 678 questionnaires was mailed to elementary, middle, and high school principals in a…
Tramontana, G. Michael; Blood, Ingrid M.; Blood, Gordon W.
The purpose of this study was to determine (a) the general knowledge bases demonstrated by school-based speech-language pathologists (SLPs) in the area of genetics, (b) the confidence levels of SLPs in providing services to children and their families with genetic disorders/syndromes, (c) the attitudes of SLPs regarding genetics and communication…
Landsbergen, K.M.; Prins, J.B.; Brunner, H.G.; Duijvendijk, P. van; Nagengast, F.M.; Krieken, J.H.J.M. van; Ligtenberg, M.J.; Hoogerbrugge-van der Linden, N.
According to the Dutch Guideline on Hereditary Colorectal Cancer published in 2008, patients with recently diagnosed colorectal cancer (CRC) should undergo microsatellite instability (MSI) testing by a pathologist immediately after tumour resection if they are younger than 50 years, or if a second
Ellis Cowling; KaDonna Randolph
The purpose of this article is to encourage development of an enduring mutually beneficial collaboration between data and information analysts in the US Forest Serviceâs "Enhanced Forest Inventory and Analysis (FIA) Program" and forest pathologists and geneticists in the information exchange group (IEG) titled "Genetics and Breeding of Southern Forest...
Squires, Katie E.; Gillam, Sandra L.; Reutzel, D. Ray
Speech language pathologists (SLPs) have developed specialized knowledge about oral language and its relationship to early literacy development that can be particularly useful to early childhood educators. The purpose of this article is to highlight ways in which an SLP can support early childhood teachers in a Response to Intervention role by…
Brown, Paula M.; Quenin, Cathy
The specialty preparation program within the speech-language pathology master's degree program at Nazareth College in Rochester, New York, was designed to train speech-language pathologists to work with children who are deaf and hard of hearing, ages 0 to 21. The program is offered in collaboration with the Rochester Institute of Technology,…
Faught, Gayle G.; Conners, Frances A.; Barber, Angela B.; Price, Hannah R.
Background: Phonological memory (PM) plays a significant role in language development but is impaired in individuals with Down syndrome (DS). Without formal recommendations on how to address PM limitations in clients with DS, it is possible speech-language pathologists (SLPs) find ways to do so in their practices. Aims: This study asked if and how…
Adler, Jacob J.; Judd, Mariah V.; Bringman, Lauren R.; Wells, Clark D.; Marrs, Kathleen A.
We developed an interactive laboratory that allows students to identify and grade tissue samples from human breast biopsies, using techniques similar to those used by actual pathologists. This unique lab develops a practical and intellectual understanding of basic tissue structures that make up living systems, utilizing technology to bring…
Myotte, Theodore; Hutchins, Tiffany L.; Cannizzaro, Michael S.; Belin, Gayle
Masters-level speech-language pathologists in communication sciences and disorders (n = 122) completed a survey soliciting their reasons for not pursuing doctoral study. Factor analysis revealed a four-factor solution including one reflecting a lack of interest in doctoral study (Factor 2) and one reflecting practical financial concerns (Factor…
Rosati, L A
This brief historical review of pathology stresses the impact of microbial discovery on the development of pathology as a medical specialty. If, as it has been said, the microscope invented the pathologist, it was the microbe, especially the pathogenic bacterium, that gave him his name and made him clinically relevant.
Aldous, Kerryn; Tolmie, Rhiannon; Worrall, Linda; Ferguson, Alison
Speech-language pathologists' scope of practice is currently unclear in relation to their contribution to the multi-disciplinary assessment of decision-making capacity for clients with aphasia and related neurogenic communication disorders. The primary aim of the current research study was to investigate the common practices of speech-language pathologists involved in assessments of decision-making capacity. The study was completed through the use of an online survey. There were 51 of 59 respondents who indicated involvement in evaluations of decision-making. Involvement in this kind of assessment was most commonly reported by speech-language pathologists working in inpatient acute and rehabilitation settings. Respondents reported using a variety of formal and informal assessment methods in their contributions to capacity assessment. Discussion with multidisciplinary team members was reported to have the greatest influence on their recommendations. Speech-language pathologists reported that they were dissatisfied with current protocols for capacity assessments in their workplace and indicated they would benefit from further education and training in this area. The findings of this study are discussed in light of their implications for speech-language pathology practice.
Jones, Corinne A.; Hoffman, Matthew R.; Geng, Zhixian; Abdelhalim, Suzan M.; Jiang, Jack J.; McCulloch, Timothy M.
Purpose: The purpose of this study was to investigate inter- and intrarater reliability among expert users, novice users, and speech-language pathologists with a semiautomated high-resolution manometry analysis program. We hypothesized that all users would have high intrarater reliability and high interrater reliability. Method: Three expert…
Hackworth, Rhonda S.
The current study, a preliminary examination of whether music teachers are more susceptible to vocal problems than teachers of other subjects, asked for expert evaluation of audio recordings from licensed speech-language pathologists. Participants (N = 41) taught music (n = 23) or another subject (n = 18) in either elementary (n = 21), middle (n =…
Foster, Abby; Worrall, Linda; Rose, Miranda; O'Halloran, Robyn
An evidence-practice gap has been identified in current acute aphasia management practice, with the provision of services to people with aphasia in the acute hospital widely considered in the literature to be inconsistent with best-practice recommendations. The reasons for this evidence-practice gap are unclear; however, speech pathologists practising in this setting have articulated a sense of dissonance regarding their limited service provision to this population. A clearer understanding of why this evidence-practice gap exists is essential in order to support and promote evidence-based approaches to the care of people with aphasia in acute care settings. To provide an understanding of speech pathologists' conceptualization of evidence-based practice for acute post-stroke aphasia, and its implementation. This study adopted a phenomenological approach, underpinned by a social constructivist paradigm. In-depth interviews were conducted with 14 Australian speech pathologists, recruited using a purposive sampling technique. An inductive thematic analysis of the data was undertaken. A single, overarching theme emerged from the data. Speech pathologists demonstrated a sense of disempowerment as a result of their relationship with evidence-based practice for acute aphasia management. Three subthemes contributed to this theme. The first described a restricted conceptualization of evidence-based practice. The second revealed speech pathologists' strained relationships with the research literature. The third elucidated a sense of professional unease over their perceived inability to enact evidence-based clinical recommendations, despite their desire to do so. Speech pathologists identified a current knowledge-practice gap in their management of aphasia in acute hospital settings. Speech pathologists place significant emphasis on the research evidence; however, their engagement with the research is limited, in part because it is perceived to lack clinical utility. A sense
Full Text Available Goedel's functional "Dialectica" interpretation can be used to extract functional programs from non-constructive proofs in arithmetic by employing two sorts of higher-order witnessing terms: positive realisers and negative counterexamples. In the original interpretation decidability of atoms is required to compute the correct counterexample from a set of candidates. When combined with recursion, this choice needs to be made for every step in the extracted program, however, in some special cases the decision on negative witnesses can be calculated only once. We present a variant of the interpretation in which the time complexity of extracted programs can be improved by marking the chosen witness and thus avoiding recomputation. The achieved effect is similar to using an abortive control operator to interpret computational content of non-constructive principles.
Kobata, Hitoshi; Miyake, Hiroji; Kitamura, Junji; Kajikawa, Hiroshi; Ohta, Tomio
The authors report here a case of hemangioma of the left parietal bone which presented headache and papilledema. This patient is a 37-year-old female who had, prior to admission, complained of increasing headache for one year and blurred vision for three months. She had no history of head injury. Local physical examinations revealed a slight bulging in her left parietal region which was insensitive to palpation and not adherent to the overlying scalp. Neurological examinations revealed bilateral papilledema and an incongruous bitemporal upper quadrant defect in the visual field. All the other neurological and laboratory data were normal. A plain skull roentogenogram showed a 9 x 9 cm osteolytic and characteristic honeycomb lesion in the parietal region. Systemic bone survey revealed a similar lesion in the right tibia which was not histologically examined. A marked accumulation of isotopes was detected on the bone scintigrams at both lesions. Selective external carotid angiograms demonstrated a tumor stain fed by the superficial temporal, occipital, and middle meningial arteries. CT scans of the brain and skull clearly showed a local thickening of and structural changes in the skull bone and also a mass effect on the brain and lateral ventricle. The lesioned bone was removed en bloc and replaced by an artificial bone. It was highly vascular, but not adherent to the overlying dura. The post-operative course was uneventful, and the headache and papilledema disappeared. Hemangioma of the skull presenting marked hyperostosis, as reported above, seems to be rare. In addition, in this case, skeletal angioma without any clinical manifestation was detected. Clinical and radiological pictures of the hemangioma of the skull and other bones were briefly discussed. (author)
Burdan, F; Dworzański, W; Cendrowska-Pinkosz, M; Burdan, M; Dworzańska, A
Uniform international terminology is a fundamental issue of medicine. Names of various organs or structures have developed since early human history. The first proper anatomical books were written by Hippocrates, Aristotle and Galen. For this reason the modern terms originated from Latin or Greek. In a modern time the terminology was improved in particular by Vasalius, Fabricius and Harvey. Presently each known structure has internationally approved term that is explained in anatomical or histological terminology. However, some elements received eponyms, terms that incorporate the surname of the people that usually describe them for the first time or studied them (e.g., circle of Willis, follicle of Graff, fossa of Sylvious, foramen of Monro, Adamkiewicz artery). Literature and historical hero also influenced medical vocabulary (e.g. Achilles tendon and Atlas). According to various scientists, all the eponyms bring colour to medicine, embed medical traditions and culture to our history but lack accuracy, lead of confusion, and hamper scientific discussion. The current article presents a wide list of the anatomical eponyms with their proper anatomical term or description according to international anatomical terminology. However, since different eponyms are used in various countries, the list could be expanded.
Maeseneer, M. de; Shahabpour, M.; Vanderdood, K.; Ridder, F. de; Osteaux, M. [Dept. of Radiology, Free Univ. Brussels (Belgium); Roy, F. van [Dept. of Experimental Anatomy, Free Univ. Brussels (Belgium)
In this article we study the ligaments and tendons of the posterolateral corner of the knee by anatomic dissection, MR-anatomic correlation, and MR imaging. The posterolateral aspect of two fresh cadaveric knee specimens was dissected. The MR-anatomic correlation was performed in three other specimens. The MR images of 122 patients were reviewed and assessed for the visualization of different posterolateral structures. Anatomic dissection and MR-anatomic correlation demonstrated the lateral collateral, fabellofibular, and arcuate ligaments, as well as the biceps and popliteus tendons. On MR images of patients the lateral collateral ligament was depicted in all cases. The fabellofibular, arcuate, and popliteofibular ligaments were visualized in 33, 25, and 38% of patients, respectively. Magnetic resonance imaging allows a detailed appreciation of the posterolateral corner of the knee. (orig.)
Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.
The ability to accurately measure subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) from images is important for improved assessment and management of patients with various conditions such as obesity, diabetes mellitus, obstructive sleep apnea, cardiovascular disease, kidney disease, and degenerative disease. Although imaging and analysis methods to measure the volume of these tissue components have been developed [1, 2], in clinical practice, an estimate of the amount of fat is obtained from just one transverse abdominal CT slice typically acquired at the level of the L4-L5 vertebrae for various reasons including decreased radiation exposure and cost [3-5]. It is generally assumed that such an estimate reliably depicts the burden of fat in the body. This paper sets out to answer two questions related to this issue which have not been addressed in the literature. How does one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? At what anatomic location do the volumes of SAT and VAT correlate maximally with the corresponding single-slice area measures? To answer these questions, we propose two approaches for slice localization: linear mapping and non-linear mapping which is a novel learning based strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. We then study the volume-to-area correlations and determine where they become maximal. We demonstrate on 50 abdominal CT data sets that this mapping achieves significantly improved consistency of anatomic localization compared to current practice. Our results also indicate that maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized.
Full Text Available Neonatal acute kidney injury (AKI, that becomes acute renal failure (when renal replacement is needed, represents a common clinical problem in critically ill infants admitted to neonatal intensive care unit (NICU centers. This article is aimed at reviewing the most important histological renal changes generally considered typical of AKI, useful to confirm, at morphological level, the structural and cell lesions responsible for the clinical picture. In the first part a simple schematic approach to the elementary lesions of the developing kidney will be proposed, aimed to decipher the renal lesions. In the second part, the typical lesions of AKI in the neonate will be presented and discussed. In the final part, we’ll prospect the necessity for a more accurate microscopic analysis of the kidney in every neonate undergoing asphyxia or sepsis, in order to reveal subtle renal changes that might allow a pathological diagnosis of AKI even in newborns in which the clinical and laboratory pictures were not representative of a severe kidney damage. Finally, the role of the clinical-pathological discussion between the pathologist and the neonatologist will be underlined, in order to reach a final diagnosis, based on the clinical history, the laboratory findings, and the histological lesions. In this article, the role of the pathologist in the evaluation of a neonatal kidney in a newborn with the clinical diagnosis of AKI is described, with particular attention to the differences existing between the preterm and the at term kidney, focusing on the differentiation between developmental changes occurring in the kidney in the perinatal period and the histological lesions induced by pathological events occurring around birth. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological
Mahmut Sinan Abit
Full Text Available Most of the patients in our daily practice have one or more ocular surface disorders including conjucntivitis, keratitis, dry eye disease, meibomian gland dysfunction, contact lens related symptoms, refractive errors,computer vision syndrome. Lacrimal gland has an important role in all above mentioned pathologies due to its major secretory product. An anatomical and physiological knowledge about lacrimal gland is a must in understanding basic and common ophthalmological cases. İn this paper it is aimed to explain the lacrimal gland diseases from an anatomical perspective.
National Oceanic and Atmospheric Administration, Department of Commerce — The Shark Mark Recapture Database is a Cooperative Research Program database system used to keep multispecies mark-recapture information in a common format for...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — A mile by mile breakdown of the on-street bicycle pavement markings installed within the City of Pittsburgh. These include bike lanes, shared lane markings...
This research addressed an array of issues related to measuring pavement markings retroreflectivity, factors : related to pavement marking performance, subjective evaluation process, best practices for using mobile : retroreflectometers, sampling pav...
A 68-year-old man was admitted because of symptoms of lumbar pain. He was known to have chronic anemia with ring sideroblasts and diabetes melitus and to be in heart failure. Three months before he had been given 7 units of red cell concentrate. On admission the outstanding features were brown discoloration of the skin, absent body hair, tachycardia, hepatomegaly and small testicles. He had a normocytic anemia, hyperglycemia and raised transaminases, hypogonadism and vitamin D3 deficiency. The serum levels of iron, transferrin saturation and feritin were markedly elevated. Liver iron content/g dried liver was 4.2 g (by biomagnetometer). Radiology of the lumbar vertebrae showed osteoporosis and sonography confirmed hepatomegaly. The known myelodysplastic syndrome (MDS) had fed to secondary hemosiderosis with heart failure, liver involvement, diabetes mellitus, hypogonadism and osteoporosis. Symptomatic treatment was unsuccessfully complemented by desferoxamine (up to 4 g/12 h) to release iron. But very good iron excretion was then achieved with deferiprone (3 x 1 g/d). The patient later died of the sequelae of hemosiderosis. Even when they have not required transfusions, patients with long-standing MDS should be examined regularly for the possible development of secondary hemosiderosis so that iron-chelating agents can be administered as needed.
When Christophe Seith from the company Cegelec sat down to work on 14 May 2009 at 10:09 a.m. to create the EDMS document entitled "Rapport tournée PH semaine 20", little did he know that he would be the proud creator of the millionth EDMS document and the happy prize winner of a celebratory bottle of champagne to mark the occasion. In the run up to the creation of the millionth EDMS document the EDMS team had been closely monitoring the steady rise in the EDMS number generator, so as to ensure the switch from the six figured i.d. to seven figures would run smoothly and of course, to be able to congratulate the creator of the millionth EDMS document. From left to right: Stephan Petit (GS-ASE- EDS Section Leader), Christophe Delamare (GS- ASE Group Leader), Christophe Seith, creator of the millionth EDMS document, David Widegren, (GS-ASE- EPS Section Leader). The millionth EDMS document. For t...
... 46 Shipping 4 2010-10-01 2010-10-01 false Hull markings. 122.602 Section 122.602 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE THAN 150....602 Hull markings. (a) Each vessel must be marked as required by part 67, subpart I, of this chapter...
... 7 Agriculture 3 2010-01-01 2010-01-01 false Marking containers. 160.32 Section 160.32 Agriculture... STANDARDS FOR NAVAL STORES Analysis, Inspection, and Grading on Request § 160.32 Marking containers. The interested person shall provide any labor necessary for marking the containers, after the contents have been...
... of the vessel. (2) The type of vessel. (3) Specific purpose or limitation approved by the Coast Guard...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Inflatable Lifejackets § 160.176-23 Marking. (a) General. Each inflatable lifejacket must be marked with the information required by this section. Each marking must be...
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Export marks. 28.123..., or Transportation to a Manufacturing Bonded Warehouse § 28.123 Export marks. (a) General. In addition... filled under the provisions of part 24 of this chapter, the proprietor shall mark the word “Export” on...
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Export marks. 28.223... Export marks. In addition to the marks and brands required to be placed on kegs, barrels, cases, crates... “Export” on each container or case before removal for export, for use on vessels or aircraft, or for...
Laboratory compliance with the American Society of Clinical Oncology/college of American Pathologists guidelines for human epidermal growth factor receptor 2 testing: a College of American Pathologists survey of 757 laboratories.
Nakhleh, Raouf E; Grimm, Erin E; Idowu, Michael O; Souers, Rhona J; Fitzgibbons, Patrick L
To ensure quality human epidermal growth receptor 2 (HER2) testing in breast cancer, the American Society of Clinical Oncology/College of American Pathologists guidelines were introduced with expected compliance by 2008. To assess the effect these guidelines have had on pathology laboratories and their ability to address key components. In late 2008, a survey was distributed with the HER2 immunohistochemistry (IHC) proficiency testing program. It included questions regarding pathology practice characteristics and assay validation using fluorescence in situ hybridization or another IHC laboratory assay and assessed pathologist HER2 scoring competency. Of the 907 surveys sent, 757 (83.5%) were returned. The median laboratory accessioned 15 000 cases and performed 190 HER2 tests annually. Quantitative computer image analysis was used by 33% of laboratories. In-house fluorescence in situ hybridization was performed in 23% of laboratories, and 60% of laboratories addressed the 6- to 48-hour tissue fixation requirement by embedding tissue on the weekend. HER2 testing was performed on the initial biopsy in 40%, on the resection specimen in 6%, and on either in 56% of laboratories. Testing was validated with only fluorescence in situ hybridization in 47% of laboratories, whereas 10% of laboratories used another IHC assay only; 13% used both assays, and 12% and 15% of laboratories had not validated their assays or chose "not applicable" on the survey question, respectively. The 90% concordance rate with fluorescence in situ hybridization results was achieved by 88% of laboratories for IHC-negative findings and by 81% of laboratories for IHC-positive cases. The 90% concordance rate for laboratories using another IHC assay was achieved by 80% for negative findings and 75% for positive cases. About 91% of laboratories had a pathologist competency assessment program. This survey demonstrates the extent and characteristics of HER2 testing. Although some American Society of
Hancock, Adrienne; Haskin, Gregory
The cultures and service needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) minority groups are relevant to speech-language pathologists (SLPs). In particular, transgender individuals seeking communication services from SLPs in order to improve quality of life require culturally and clinically competent clinicians. Knowledge and attitudes regarding a population are foundational stages toward cultural competency (Turner, Wilson, & Shirah, 2006). The purpose of this research is to assess LGBTQ knowledge and attitudes among aspiring and practicing SLPs. An online survey was completed by 279 SLPs from 4 countries. Mean accuracy scores on LGBTQ culture questions were near 50%. Self-ratings indicated more comfort than knowledge, with generally positive feelings toward LGBTQ subgroups. Transgender communication is within SLPs' scope of practice, yet 47% indicated such services were not addressed in their master's curriculum, and 51% did not know how to describe transgender communication therapy. When respondents were asked to indicate priority of 10 LGBTQ topics for a continuing education seminar, communication masculinization/feminization best practice and case examples had the highest mean priority scores. There is a need to promote LGBTQ cultural competence within speech-language pathology. This study provides direction for improving LGBTQ cultural competence among SLPs.
Min Hye Jang
Full Text Available Background: Since 2003, the Korean Society of Pathologists (KSP has been officially providing medical advisory services (MAS. We reviewed the cases submitted to the KSP between 2003 and 2014. Methods: In total, 1,950 cases were submitted, most by private health insurance companies. The main purposes of the consultations were to clarify the initial diagnoses and to assign a proper disease classification code. We comprehensively reviewed 1,803 consultation cases with detailed information. Results: In spite of some fluctuations, the number of submitted cases has been significantly increasing over the 12 study years. The colon and rectum (40.3%, urinary bladder (14.2%, and stomach (6.9% were the three most common tissues of origin. The most common diagnoses for each of the three tissues of origin were neuroendocrine tumor (50.7%, non-invasive papillary urothelial carcinoma (70.7%, and adenocarcinoma (36.2%. Regardless of the tissue of origin, neuroendocrine tumor of the digestive system was the most common diagnosis (419 of 1,803. Conclusions: In the current study, we found that pathologic consultations associated with private health insurance accounted for a large proportion of the MAS. Coding of the biologic behavior of diseases was the main issue of the consultations. In spite of the effort of the KSP to set proper guidelines for coding and classification of tumors, this review revealed that problems still exist and will continue to be an important issue.
Negative attitudes toward stuttering and people who stutter (PWS) are found in various groups of people in many regions. However the results of previous studies examining the influence of fluency coursework and clinical certification on the attitudes of speech-language pathologists (SLPs) toward PWS are equivocal. Furthermore, there have been few empirical studies on the attitudes of Korean SLPs toward stuttering. To determine whether the attitudes of Korean SLPs and speech-language pathology students toward stuttering would be different according to the status of clinical certification, stuttering coursework completion and clinical practicum in stuttering. Survey data from 37 certified Korean SLPs and 70 undergraduate students majoring in speech-language pathology were analysed. All the participants completed the modified Clinician Attitudes Toward Stuttering (CATS) Inventory. Results showed that the diagnosogenic view was still accepted by many participants. Significant differences were found in seven out of 46 CATS Inventory items according to the certification status. In addition significant differences were also found in three items and one item according to stuttering coursework completion and clinical practicum experience in stuttering, respectively. Clinical and educational experience appears to have mixed influences on SLPs' and students' attitudes toward stuttering. While SLPs and students may demonstrate more appropriate understanding and knowledge in certain areas of stuttering, they may feel difficulty in their clinical experience, possibly resulting in low self-efficacy. © 2014 Royal College of Speech and Language Therapists.
Crowley, Rebecca S; Legowski, Elizabeth; Medvedeva, Olga; Reitmeyer, Kayse; Tseytlin, Eugene; Castine, Melissa; Jukic, Drazen; Mello-Thoms, Claudia
The purpose of this study is threefold: (1) to develop an automated, computer-based method to detect heuristics and biases as pathologists examine virtual slide cases, (2) to measure the frequency and distribution of heuristics and errors across three levels of training, and (3) to examine relationships of heuristics to biases, and biases to diagnostic errors. The authors conducted the study using a computer-based system to view and diagnose virtual slide cases. The software recorded participant responses throughout the diagnostic process, and automatically classified participant actions based on definitions of eight common heuristics and/or biases. The authors measured frequency of heuristic use and bias across three levels of training. Biases studied were detected at varying frequencies, with availability and search satisficing observed most frequently. There were few significant differences by level of training. For representativeness and anchoring, the heuristic was used appropriately as often or more often than it was used in biased judgment. Approximately half of the diagnostic errors were associated with one or more biases. We conclude that heuristic use and biases were observed among physicians at all levels of training using the virtual slide system, although their frequencies varied. The system can be employed to detect heuristic use and to test methods for decreasing diagnostic errors resulting from cognitive biases.
Gold, Rinat; Gold, Azgad
The purpose of this study was to examine the attitudes, feelings, and practice characteristics of speech-language pathologists (SLPs) in Israel regarding the subject of delivering bad news. One hundred and seventy-three Israeli SLPs answered an online survey. Respondents represented SLPs in Israel in all stages of vocational experience, with varying academic degrees, from a variety of employment settings. The survey addressed emotions involved in the process of delivering bad news, training on this subject, and background information of the respondents. Frequency distributions of the responses of the participants were determined, and Pearson correlations were computed to determine the relation between years of occupational experience and the following variables: frequency of delivering bad news, opinions regarding training, and emotions experienced during the process of bad news delivery. Our survey showed that bad news delivery is a task that most participants are confronted with from the very beginning of their careers. Participants regarded training in the subject of delivering bad news as important but, at the same time, reported receiving relatively little training on this subject. In addition, our survey showed that negative emotions are involved in the process of delivering bad news. Training SLPs on specific techniques is required for successfully delivering bad news. The emotional burden associated with breaking bad news in the field of speech-language pathology should be noticed and addressed.
Kenny, Belinda; Lincoln, Michelle; Balandin, Susan
To investigate the approaches of experienced speech-language pathologists (SLPs) to ethical reasoning and the processes they use to resolve ethical dilemmas. Ten experienced SLPs participated in in-depth interviews. A narrative approach was used to guide participants' descriptions of how they resolved ethical dilemmas. Individual narrative transcriptions were analyzed by using the participant's words to develop an ethical story that described and interpreted their responses to dilemmas. Key concepts from individual stories were then coded into group themes to reflect participants' reasoning processes. Five major themes reflected participants' approaches to ethical reasoning: (a) focusing on the well-being of the client, (b) fulfilling professional roles and responsibilities, (c) attending to professional relationships, (d) managing resources, and (e) integrating personal and professional values. SLPs demonstrated a range of ethical reasoning processes: applying bioethical principles, casuistry, and narrative reasoning when managing ethical dilemmas in the workplace. The results indicate that experienced SLPs adopted an integrated approach to ethical reasoning. They supported clients' rights to make health care choices. Bioethical principles, casuistry, and narrative reasoning provided useful frameworks for facilitating health professionals' application of codes of ethics to complex professional practice issues.
Signorelli, Monique E; Madill, Catherine J; McCabe, Patricia
The purpose of this study was to determine the management options and voice therapy techniques currently being used by practicing speech-language pathologists (SLPs) to treat vocal fold nodules (VFNs) in children. The sources used by SLPs to inform and guide their clinical decisions when managing VFNs in children were also explored. Sixty-two SLPs completed a 23-item web-based survey. Data was analysed using frequency counts, content analyses, and supplementary analyses. SLPs reported using a range of management options and voice therapy techniques to treat VFNs in children. Voice therapy was reportedly the most frequently used management option across all respondents, with the majority of SLPs using a combination of indirect and direct voice therapy techniques. When selecting voice therapy techniques, the majority of SLPs reported that they did not use the limited external evidence available to guide their clinical decisions. Additionally, the majority of SLPs reported that they frequently relied on lower levels of evidence or non-evidence-based sources to guide clinical practice both in the presence and absence of higher quality evidence. Further research needs to investigate strategies to remove the barriers that impede SLPs use of external evidence when managing VFNs in children.
Langner, Cord; Aust, Daniela; Ensari, Arzu; Villanacci, Vincenzo; Becheanu, Gabriel; Miehlke, Stephan; Geboes, Karel; Münch, Andreas
Microscopic colitis has emerged as a major cause of chronic watery non-bloody diarrhoea, particularly in elderly females. The term is used as an umbrella term to categorize a subgroup of colitides with distinct clinicopathological phenotypes and no significant endoscopic abnormalities. Lymphocytic colitis is defined by an increased number of surface intraepithelial lymphocytes, and collagenous colitis by a thickened collagen band underneath the surface epithelium. There is increased inflammation in the lamina propria, but only little or no crypt architectural distortion. Incomplete and variant forms showing less characteristic features have been reported under different names. The differential diagnosis mainly includes resolving infectious colitis and changes related to the intake of drugs such as non-steroidal anti-inflammatory drugs. Substantial clinical and histological overlap between lymphocytic and collagenous colitis has been described, raising the suspicion that the conditions are two histological manifestations of the same entity, possibly representing different manifestations during the disease course or different stages of disease development. In this review, we provide a practical approach for pathologists, with a focus on diagnostic criteria and differential diagnosis, and discuss recent insights into the pathogenesis of disease and the relationship with classic chronic inflammatory bowel disease, i.e. Crohn's disease and ulcerative colitis. © 2014 John Wiley & Sons Ltd.
Powell, Rachel K
This lead article of the Clinical Forum focuses on the research that supports why speech-language pathologists (SLPs) are an integral part of the overarching curriculum for all students in schools. Focus on education has shifted to student performance in our global world, specifically in college and career readiness standards. This article reviews recommendations on best practice from the American Speech-Language-Hearing Association on SLPs' roles in schools, as well as data on school-based services. Implementation of these practices as it is applicable to school initiatives will be explored. Methods of interventions available in schools, from general education to special education, will be discussed based on national guidelines for a Response to Intervention and Multi-Tiered System of Support. Research regarding teacher knowledge of the linguistic principles of reading instruction will be explored, as well as correlation between teacher knowledge and student performance. The implications for how SLPs as the linguistic experts offer unique roles in curriculum and the evidence available to support this role will be explored. Implications for future research needs will be discussed. The demands of a highly rigorous curriculum allow SLPs a unique opportunity to apply their knowledge in linguistic principles to increase student performance and achievement. With the increased focus on student achievement, growth outcome measures, and value-added incentives, it is critical that SLPs become contributors to the curriculum for all students and that data to support this role are gathered through focused research initiatives.
Kalkhoff, Nicole L; Collins, Dana R
The goal of this study was to determine if job satisfaction differs between speech-language pathologists (SLPs) working in school settings and SLPs working in medical settings. The Job Satisfaction Survey (JSS) by Spector (1997) was sent via electronic mail to 250 SLPs in each of the 2 settings. Job satisfaction scores were computed from subscale category ratings and were compared between the 2 settings. Subscale category ratings for pay, promotion, supervision, benefits, contingent rewards, operating conditions, coworkers, nature of work, and communication were analyzed for differences between and within settings. Age, caseload size, and years-at-position were analyzed by linear regression to determine whether these factors might predict SLPs' job satisfaction. The survey had a response rate of 19.6% (N = 98 participants). Although SLPs in both settings were generally satisfied with their jobs, SLPs in medical settings had significantly higher total job satisfaction scores. Respondents from both settings had similar satisfaction ratings for subscale categories, with nature of work receiving the highest rating and operating conditions and promotion the lowest. Results of the linear regression analysis for age, caseload size, and years-at-position were not significant. Further research should evaluate important aspects of job satisfaction in both settings, especially nature of work operating conditions, and promotion.
Campbell, Walter S; Foster, Kirk W; Hinrichs, Steven H
The ability to transfer image markup and annotation data from one scanned image of a slide to a newly acquired image of the same slide within a single vendor platform was investigated. The goal was to study the ability to use image markup and annotation data files as a mechanism to capture and retain pathologist knowledge without retaining the entire whole slide image (WSI) file. Accepted mathematical principles were investigated as a method to overcome variations in scans of the same glass slide and to accurately associate image markup and annotation data across different WSI of the same glass slide. Trilateration was used to link fixed points within the image and slide to the placement of markups and annotations of the image in a metadata file. Variation in markup and annotation placement between WSI of the same glass slide was reduced from over 80 μ to less than 4 μ in the x-axis and from 17 μ to 6 μ in the y-axis (P < 0.025). This methodology allows for the creation of a highly reproducible image library of histopathology images and interpretations for educational and research use.
Pascoe, Michelle; Klop, Daleen; Mdlalo, Thandeka; Ndhambi, Mikateko
Developed with a strong awareness of past injustices, South Africa's progressive constitution emphasises a full spectrum of human rights. While the constitution celebrates many languages and cultures, speech-language pathologists (SLPs) face challenges in translating these values into practice with a diverse clientele. Similarly, Article 19 of the Universal Declaration of Human Rights focuses on freedom of expression in one's language of choice, but is often perceived as a "Cinderella" right (i.e. one that is frequently neglected). This paper presents a literature review undertaken in association with the Health Professions Council of South Africa to produce guidelines to support SLPs in their practice with diverse linguistic and cultural groups. The aim was to identify key points for inclusion in a set of human rights-driven guidelines. Specific objectives were to critique: (1) current guidelines for SLPs working with diverse cultural and linguistic groups; and (2) equivalent guidelines for related professions. Content analysis of the datasets revealed key themes which formed the basis of an initial skeleton, to be further developed through a consultative process and discussion, ultimately aiming to provide supportive, practical guidelines to better equip South African SLPs to serve all the people of the country.
Murphy, Declan; Lyons, Rena; Carroll, Clare; Caulfield, Mari; De Paor, Gráinne
According to Article 19 of the Universal Declaration on Human Rights "Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers." The purpose of this paper is to elucidate communication as a human right in the life of a young man called Declan who has Down syndrome. This commentary paper is co-written by Declan, his sister who is a speech-language pathologist (SLP) with an advocacy role, his SLP, and academics. Declan discusses, in his own words, what makes communication hard, what helps communication, his experiences of speech-language pathology, and what he knows about human rights. He also discusses his passion for politics, his right to be an active citizen and participate in the political process. This paper also focuses on the role of speech-language pathology in supporting and partnering with people with communication disabilities to have their voices heard and exercise their human rights.
Trejo, Mariano; Meli, Francisco; Lambre, Hector; Blessing, Ricardo; Gigy Traynor, Ignacio; Miguez, Victor
We studied through RM angiography (3D TOF) with high magnetic field equipment (1.5 T) different infrequent intracerebral vascular anatomic variants. For their detection we emphasise the value of post-processed images obtained after conventional angiographic sequences. These post-processed images should be included in routine protocols for evaluation of the intracerebral vascular structures. (author)
De Brucker, Y; Ilsen, B; Muylaert, C
We report the CT findings in a case of partial anomalous pulmonary venous return (PAPVR) from the left upper lobe in an adult. PAPVR is an anatomic variant in which one to three pulmonary veins drain into the right atrium or its tributaries, rather than into the left atrium. This results in a left...
A new study from NCI researchers finds that the HPV vaccine protects young women from infection with high-risk HPV types at the three primary anatomic sites where persistent HPV infections can cause cancer. The multi-site protection also was observed at l
M. V. Demesсhenko
Full Text Available Purpose: to identify anatomical landmarks on tibial articular surface to serve as reference in preparing tibial canal with respect to the center of ACL footprint during single bundle arthroscopic repair.Materials and methods. Twelve frozen knee joint specimens and 68 unpaired macerated human tibia were studied using anatomical, morphometric, statistical methods as well as graphic simulation.Results. Center of the tibial ACL footprint was located 13,1±1,7 mm anteriorly from posterior border of intercondylar eminence, at 1/3 of the distance along the line connecting apexes of internal and external tubercles and 6,1±0,5 mm anteriorly along the perpendicular raised to this point.Conclusion. Internal and external tubercles, as well as posterior border of intercondylar eminence can be considered as anatomical references to determine the center of the tibial ACL footprint and to prepare bone canals for anatomic ligament repair.
Bergman, E.M.; Verheijen, I.W.; Scherpbier, A.J.J.A.; Vleuten, C.P.M. van der; Bruin, A.B. De
Eight factors are claimed to have a negative influence on anatomical knowledge of medical students: (1) teaching by nonmedically qualified teachers, (2) the absence of a core anatomy curriculum, (3) decreased use of dissection as a teaching tool, (4) lack of teaching anatomy in context, (5)
Macchi, Veronica; Porzionato, Andrea; Stecco, Carla; Caro, Raffaele
The anatomical theatre played a pivotal role in the evolution of medical education, allowing students to directly observe and participate in the process of dissection. Due to the increase of training programs in clinical anatomy, the Institute of Human Anatomy at the University of Padova has renovated its dissecting room. The main guidelines in…
Background and Aim: Magnetic resonance urography (MRU) is considered to be the next step in uroradiology. This technique combines superb anatomical images and functional information in a single test. In this article, we aim to present the topic of MRU in children and how it has been implemented in Northern Greece so ...
Paulsen, Rasmus R.; Larsen, Rasmus
With the increasing clinical use of 3D surface scanners, there is a need for accurate and reliable algorithms that can produce anatomically plausible surfaces. In this paper, a combined method for surface alignment and reconstruction is proposed. It is based on an implicit surface representation...
Eckerman, Keith F
Covering the history of human model development, this title presents the major anatomical and physical models that have been developed for human body radiation protection, diagnostic imaging, and nuclear medicine therapy. It explores how these models have evolved and the role that modern technologies have played in this development.
Elaine T. Howard; Floyd G. Manwiller
To obtain a definitive description of the wood and anatomy of all 10 species of southern pine, juvenile, intermediate, and mature wood was sampled at three heights in one tree of each species and examined under a light microscope. Photographs and three-dimensional drawings were made to illustrate the morphology. No significant anatomical differences were found...
Galant, Christine; Bouvier, Corinne; Larousserie, Frédérique; Aubert, Sébastien; Audard, Virginie; Brouchet, Anne; Marie, Béatrice; Guinebretière, Jean-Marc; de Pinieux du Bouexic, Gonzague
The management of patients having a bone lesion requires in many cases the realization of a histological sample in order to obtain a diagnosis. However, with the technological evolution, CT-guided biopsies are performed more frequently, often in outpatient clinics. Interpretation of these biopsies constitutes new challenges for the pathologists within the wide spectrum of bone entities. The purpose of the document is to propose guidelines based on the experience of the French committee of bone pathologists of the reference network on bone tumors (RESOS) regarding the indications and limitations of the diagnosis on restricted material. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.
When veterinary pathologists testify as expert witnesses in animal cruelty trials, they may find themselves in an intimidating and unfamiliar environment. The legal rules are clouded in mystery, the lawyers dwell on mundane details, and the witness's words are extracted with precision by a verbal scalpel. An unprepared expert witness can feel ungrounded and stripped of confidence. The goal of this article is to lift the veil of mystery and give the veterinary pathologist the tools to be a knowledgeable and confident expert witness before and during testimony. This article discusses the types of expert witnesses, disclosure requirements and the importance of a good report, the legal basics of expert testimony, and how to be an effective expert witness. The article references Minnesota law; however, the laws are similar in most jurisdictions and based on the same constitutional requirements, and the concepts presented are applicable in nearly every courtroom.(1). © The Author(s) 2016.
V. N. Bubenchikova
Full Text Available The article present results of the study for a anatomic structure of Campanula rotundifolia grass from Campanulaceae family. Despite its dispersion and application in folk medicine, there are no data about its anatomic structure, therefore to estimate the indices of authenticity and quality of raw materials it is necessary to develop microdiagnostical features in the first place, which could help introducing of thisplant in a medical practice. The purpose of this work is to study anatomical structureof Campanula rotundifolia grass to determine its diagnostic features. Methods. Thestudy for anatomic structure was carried out in accordance with the requirements of State Pharmacopoeia, edition XIII. Micromed laboratory microscope with digital adjutage was used to create microphotoes, Photoshop CC was used for their processing. Result. We have established that stalk epidermis is prosenchymal, slightly winding with straight of splayed end cells. After study for the epidermis cells we established that upper epidermis cells had straight walls and are slightly winding. The cells of lower epidermishave more winding walls with prolong wrinkled cuticule. Presence of simple one-cell, thin wall, rough papillose hair on leaf and stalk epidermis. Cells of epidermis in fauces of corolla are prosenchymal, with winding walls, straight or winding walls in a cup. Papillary excrescences can be found along the cup edges. Stomatal apparatus is anomocytic. Conclusion. As the result of the study we have carried out the research for Campanula rotundifolia grass anatomic structure, and determined microdiagnostic features for determination of raw materials authenticity, which included presence of simple, one-cell, thin-walled, rough papillose hair on both epidermises of a leaf, along the veins, leaf edge, and stalk epidermis, as well as the presence of epidermis cells with papillary excrescences along the edges of leaves and cups. Intercellular canals are situatedalong the
Tworek, Joseph A; Henry, Michael R; Blond, Barbara; Jones, Bruce Allen
Gynecologic cytopathology is a heavily regulated field, with Clinical Laboratory Improvement Amendments of 1988 mandating the collection of many quality metrics. There is a lack of consensus regarding methods to collect, monitor, and benchmark these data and how these data should be used in a quality assurance program. Furthermore, the introduction of human papilloma virus testing and proficiency testing has provided more data to monitor. To determine good laboratory practices in quality assurance of gynecologic cytopathology. Data were collected through a written survey consisting of 98 questions submitted to 1245 Clinical Laboratory Improvement Amendments-licensed or Department of Defense laboratories. There were 541 usable responses. Additional input was sought through a Web posting of results and questions on the College of American Pathologists Web site. Four senior authors who authored the survey and 28 cytopathologists and cytotechnologists were assigned to 5 working groups to analyze data and present statements on good laboratory practices in gynecologic cytopathology at the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference. Ninety-eight attendees at the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference discussed and voted on good laboratory practice statements to obtain consensus. This paper describes the rationale, background, process, and strengths and limitations of a series of papers that summarize good laboratory practice statements in quality assurance in gynecologic cytopathology.
Heritage, Brody; Quail, Michelle; Cocks, Naomi
This study explored the predictors of the outcomes of turnover and occupation attrition intentions for speech-language pathologists. The researchers examined the mediating effects of job satisfaction and strain on the relationship between stress and the latter outcomes. Additionally, the researchers examined the importance of embeddedness in predicting turnover intentions after accounting for stress, strain and job satisfaction. An online questionnaire was used to explore turnover and attrition intentions in 293 Australian speech-language pathologists. Job satisfaction contributed to a significant indirect effect on the stress and turnover intention relationship, however strain did not. There was a significant direct effect between stress and turnover intention after accounting for covariates. Embeddedness and the perceived availability of alternative jobs were also found to be significant predictors of turnover intentions. The mediating model used to predict turnover intentions also predicted occupation attrition intentions. The effect of stress on occupation attrition intentions was indirect in nature, the direct effect negated by mediating variables. Qualitative data provided complementary evidence to the quantitative model. The findings indicate that the proposed parsimonious model adequately captures predictors of speech-language pathologists' turnover and occupation attrition intentions. Workplaces and the profession may wish to consider these retention factors.
Penide, J.; Quintero, F.; Riveiro, A.; Fernández, A.; Val, J. del; Comesaña, R.; Lusquiños, F.; Pou, J.
Highlights: • Laser marking of alumina using near infrared (NIR) lasers was experimentally analyzed. • Color change produced by NIR lasers is due to thermally induced oxygen vacancies. • Laser marking results obtained using NIR lasers and green laser are compared. • High contrast marks on alumina were achieved. - Abstract: Alumina serves as raw material for a broad range of advanced ceramic products. These elements should usually be identified by some characters or symbols printed directly on them. In this sense, laser marking is an efficient, reliable and widely implemented process in industry. However, laser marking of alumina still leads to poor results since the process is not able to produce a dark mark, yielding bad contrast. In this paper, we present an experimental study on the process of marking alumina by three different lasers working in two wavelengths: 1064 nm (Near-infrared) and 532 nm (visible, green radiation). A colorimetric analysis has been carried out in order to compare the resulting marks and its contrast. The most suitable laser operating conditions were also defined and are reported here. Moreover, the physical process of marking by NIR lasers is discussed in detail. Field Emission Scanning Electron Microscopy, High Resolution Transmission Electron Microscopy and X-ray Photoelectron Spectroscopy were also employed to analyze the results. Finally, we propose an explanation for the differences of the coloration induced under different atmospheres and laser parameters. We concluded that the atmosphere is the key parameter, being the inert one the best choice to produce the darkest marks
Blood, Gordon W; Blood, Ingrid M; Coniglio, Amy D; Finke, Erinn H; Boyle, Michael P
Children with autism spectrum disorders (ASD) are primary targets for bullies and victimization. Research shows school personnel may be uneducated about bullying and ways to intervene. Speech-language pathologists (SLPs) in schools often work with children with ASD and may have victims of bullying on their caseloads. These victims may feel most comfortable turning to SLPs for help during one-to-one treatment sessions to discuss these types of experiences. A nationwide survey mailed to 1000 school-based SLPs, using a vignette design technique, determined perceptions about intervention for bullying and use of specific strategies. Results revealed a majority of the SLPs (89%) responses were in "likely" or "very likely" to intervene categories for all types of bullying (physical, verbal, relational and cyber), regardless of whether the episode was observed or not. A factor analysis was conducted on a 14 item strategy scale for dealing with bullying for children with ASD. Three factors emerged, labeled "Report/Consult", "Educate the Victim", and Reassure the Victim". SLPs providing no services to children with ASD on their caseloads demonstrated significantly lower mean scores for the likelihood of intervention and using select strategies. SLPs may play an important role in reducing and/or eliminating bullying episodes in children with ASD. Readers will be able to (a) explain four different types of bullying, (b) describe the important role of school personnel in reducing and eliminating bullying, (c) describe the perceptions and strategies selected by SLPs to deal with bullying episodes for students with ASD, and (d) outline the potential role of SLPs in assisting students with ASD who are victimized. Copyright © 2013 Elsevier Inc. All rights reserved.
Howell, Lydia Pleotis; Lyons, Mary Lipscomb; Thor, Ann; Dandar, Valerie
There is attrition of women across professorial ranks in academic pathology. Women are underrepresented as leaders; 15.4% of academic pathology departments are chaired by women, according to the Association of American Medical Colleges (AAMC). To identify areas for targeted interventions that can advance academic and leadership development of women faculty by examining (1) sex differences in career satisfaction in US medical school pathology departments participating in the AAMC's Faculty Forward Engagement Survey, and (2) findings from a survey of the Association of Pathology Chairs (APC). The AAMC Faculty Forward Engagement Survey data are from 14 US medical schools participating in the 2011-2012 survey. Pathologists' response rate was 66% (461 of 697). To investigate sex differences, t tests and χ(2) analyses were used. The APC survey, administered to academic department chairs, had a 55% response rate (104 of 189). According to the Faculty Forward Engagement Survey, women report more time in patient care and less time in research. Women consider formal mentorship, feedback, and career advancement more important than men do and are less satisfied with communication and governance. The APC survey shows that 20% to 40% of nonchair department leaders are women. More than half of chairs report satisfaction with the sex diversity of their departmental leaders. Opportunities exist for department chairs and professional organizations to create targeted interventions to support career satisfaction, recruitment, retention, and career and leadership development for women in academic pathology. Although chairs report satisfaction with diversity within department leadership, responses of women faculty indicate there is work to be done to grow more women leaders.
Walter H Henricks
Full Text Available Electronic health records (EHRs have emerged as a major topic in health care and are central to the federal government′s strategy for transforming healthcare delivery in the United States. Recent federal actions that aim to promote the use of EHRs promise to have significant implications for laboratories and for pathology practices. Under the HITECH (Health Information Technology Economic and Clinical Health Act, an EHR incentive program has been established through which individual physicians and hospitals can qualify to receive incentive payments if they achieve "meaningful use" of "certified" EHR technology. The rule also establishes payment penalties in future years for eligible providers who have not met the requirements for meaningful use of EHRs. Meaningful use must be achieved using EHR technology that has been certified in accordance with functional and technical criteria that are set forth a regulation that parallels the meaningful use criteria in the incentive program. These actions and regulations are important to laboratories and pathologists for a number of reasons. Several of the criteria and requirements in the meaningful use rules and EHR certification criteria relate directly or indirectly to laboratory testing and laboratory information management, and future stage requirements are expected to impact the laboratory as well. Furthermore, as EHR uptake expands, there will be greater expectations for electronic interchange of laboratory information and laboratory information system (LIS-EHR interfaces. Laboratories will need to be aware of the technical, operational, and business challenges that they may face as expectations for LIS-EHR increase. This paper reviews the important recent federal efforts aimed at accelerating EHR use, including the incentive program for EHR meaningful use, provider eligibility, and EHR certification criteria, from a perspective of their relevance for laboratories and pathology practices.
Karamchandani, Dipti M; Chetty, Runjan
Immune checkpoint inhibitors (CPIs) are a relatively new class of 'miracle' dugs that have revolutionised the treatment and prognosis of some advanced-stage malignancies, and have increased the survival rates significantly. This class of drugs includes cytotoxic T lymphocyte antigen-4 inhibitors such as ipilimumab; programmed cell death protein-1 inhibitors such as nivolumab, pembrolizumab and avelumab; and programmed cell death protein ligand-1 inhibitors such as atezolizumab. These drugs stimulate the immune system by blocking the coinhibitory receptors on the T cells and lead to antitumoural response. However, a flip side of these novel drugs is immune-related adverse events (irAEs), secondary to immune-mediated process due to disrupted self-tolerance. The irAEs in the gastrointestinal (GI) tract/liver may result in diarrhoea, colitis or hepatitis. An accurate diagnosis of CPI-induced colitis and/or hepatitis is essential for optimal patient management. As we anticipate greater use of these drugs in the future given the significant clinical response, pathologists need to be aware of the spectrum of histological findings that may be encountered in GI and/or liver biopsies received from these patients, as well as differentiate them from its histopathological mimics. This present review discusses the clinical features, detailed histopathological features, management and the differential diagnosis of the luminal GI and hepatic irAEs that may be encountered secondary to CPI therapy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Williams, Corinne J; McLeod, Sharynne
Within predominantly English-speaking countries such as the US, UK, Canada, New Zealand, and Australia, there are a significant number of people who speak languages other than English. This study aimed to examine Australian speech-language pathologists' (SLPs) perspectives and experiences of multilingualism, including their assessment and intervention practices, and service delivery methods when working with children who speak languages other than English. A questionnaire was completed by 128 SLPs who attended an SLP seminar about cultural and linguistic diversity. Approximately one half of the SLPs (48.4%) reported that they had at least minimal competence in a language(s) other than English; but only 12 (9.4%) reported that they were proficient in another language. The SLPs spoke a total of 28 languages other than English, the most common being French, Italian, German, Spanish, Mandarin, and Auslan (Australian sign language). Participants reported that they had, in the past 12 months, worked with a mean of 59.2 (range 1-100) children from multilingual backgrounds. These children were reported to speak between two and five languages each; the most common being: Vietnamese, Arabic, Cantonese, Mandarin, Australian Indigenous languages, Tagalog, Greek, and other Chinese languages. There was limited overlap between the languages spoken by the SLPs and the children on the SLPs' caseloads. Many of the SLPs assessed children's speech (50.5%) and/or language (34.2%) without assistance from others (including interpreters). English was the primary language used during assessments and intervention. The majority of SLPs always used informal speech (76.7%) and language (78.2%) assessments and, if standardized tests were used, typically they were in English. The SLPs sought additional information about the children's languages and cultural backgrounds, but indicated that they had limited resources to discriminate between speech and language difference vs disorder.
Kuang, Jiayi; Li, Yuxuan; He, Yufeng; Gan, Lin; Wang, Aiming; Chen, Yanhua; Li, Xiaoting; Guo, Lin; Tang, Rongjun
To compare the effects of oblique insertion at anatomical points and conventional acupuncture for sacroiliac joint injury. Eighty patients were randomly divided into an observation group and a control group, 40 cases in each one. In the observation group, oblique insertion therapy at anatomical points was used, and the 9 points of equal division (anatomical points) marked by palpating the anatomical symbol were treated as the insertion acupoints. In the control group, conventional acupuncture was applied, and perpendicular insertion was adopted at Huantiao (GB 30), Zhibian (BL 54) and Weizhong (BL 40), etc. In the two groups, the! treatment was given once a day and 5 times per week. Ten treatments were made into one course and two courses were required. The clinical effects, the changes of visual analogue scale (VAS) and Oswestry dysfunctional index. (ODI) before and after treatment were observed in the two groups. The total effective rate of the observation group was 90.0% (36/40), which was better than 72.5% (29/40) of the control group (P sacroiliac joint injury is superior to that of conventional acupuncture, which can effectively relieve pain and improve the disfunction.
The Mark II Detector, presently in the design stage, is a SLAC/LBL detector project to replace the Mark I now in operation at SPEAR. While similar in concept to the Mark I it will have improved momentum resolution, shower detection, solid angle coverage for both triggering and tracking and a magnet design providing easier access to those particles transmitted through the aluminum coil
Ivanitskij, A.V.; Sarkisova, T.N.
The paper is concerned with the description of rare congenital heart disease: anatomically corrected malposition of major vessels in a 9-mos 24 day old girl. The diagnosis of this disease was shown on the results of angiocardiography, concomitant congenital heart diseases were descibed. This abnormality is characterized by common atrioventricular and ventriculovascular joints and inversion position of the major vessels, it is always attended by congenital heart diseases. Surgical intervention is aimed at the elimination of concomitant heart dieseases
Vollmers, Stacy M; Miller, Darryl W; Kilic, Ozcan
This study analyzed brand mark clusters (i.e., various types of brand marks displayed in combination) used by hospitals in the United States. The brand marks were assessed against several normative criteria for creating brand marks that are memorable and that elicit positive affect. Overall, results show a reasonably high level of adherence to many of these normative criteria. Many of the clusters exhibited pictorial elements that reflected benefits and that were conceptually consistent with the verbal content of the cluster. Also, many clusters featured icons that were balanced and moderately complex. However, only a few contained interactive imagery or taglines communicating benefits.
Full Text Available The intrinsic relationship between the architecture of the brain and the range of sensory and behavioral phenomena it produces is a relevant question in neuroscience. Here, we review recent knowledge gained on the architecture of the anatomical connectivity by means of complex network analysis. It has been found that corticocortical networks display a few prominent characteristics: (i modular organization, (ii abundant alternative processing paths and (iii the presence of highly connected hubs. Additionally, we present a novel classification of cortical areas of the cat according to the role they play in multisensory connectivity. All these properties represent an ideal anatomical substrate supporting rich dynamical behaviors, as-well-as facilitating the capacity of the brain to process sensory information of different modalities segregated and to integrate them towards a comprehensive perception of the real world. The result here exposed are mainly based in anatomical data of cats’ brain, but we show how further observations suggest that, from worms to humans, the nervous system of all animals might share fundamental principles of organization.
Full Text Available Having broad knowledge of anatomy is essential for practicing dentistry. Certain anatomical structures call for detailed studies due to their anatomical and functional importance. Nevertheless, some structures are difficult to visualize and identify due to their small volume and complicated access. Such is the case of the parasympathetic ganglia located in the cranial part of the autonomic nervous system, which include: the ciliary ganglion (located deeply in the orbit, laterally to the optic nerve, the pterygopalatine ganglion (located in the pterygopalatine fossa, the submandibular ganglion (located laterally to the hyoglossus muscle, below the lingual nerve, and the otic ganglion (located medially to the mandibular nerve, right beneath the oval foramen. The aim of this study was to present these structures in dissected anatomic specimens and perform a comparative analysis regarding location and morphology. The proximity of the ganglia and associated nerves were also analyzed, as well as the number and volume of fibers connected to them. Human heads were dissected by planes, partially removing the adjacent structures to the point we could reach the parasympathetic ganglia. With this study, we concluded that there was no significant variation regarding the location of the studied ganglia. Morphologically, our observations concur with previous classical descriptions of the parasympathetic ganglia, but we observed variations regarding the proximity of the otic ganglion to the mandibular nerve. We also observed that there were variations regarding the number and volume of fiber bundles connected to the submandibular, otic, and pterygopalatine ganglia.
Welsh, L.W.; Welsh, J.J.; Rizzo, T.A. Jr.
This investigation evaluates the anatomic concepts of individual spaces or compartments within the larynx by isotope and dye diffusion. The authors identified continuity of spaces particularly within the submucosal planes and a relative isolation within the fixed structures resulting from the longitudinal pattern of fibroelastic tissues, muscle bands, and perichondrium. The historical data of anatomic resistance are refuted by the radioisotope patterns of dispersion and the histologic evidence of tissue permeability to the carbon particles. There is little clinical application of the compartment concept to the perimeter of growth and the configuration of extensive endolaryngeal cancers. The internal and extralaryngeal lymphatic network is presented and the regional associations are identified. The normal ipsilateral relationship is distorted by dispersion within the endolarynx supervening the anatomic midline. The effects of lymphatic obstruction caused by regional lymphadenectomy, tumor fixation, and irradiation-infection sequelae are illustrated; these result in widespread bilateral lymphatic nodal terminals. Finally, the evidence suggests that the internal network is modified by external interruption to accommodate an outflow system in continuity with the residual patent lymphatic channels
Cricetomys gambianus, Mystromys albicaudatus, Thallomys paedulcus and Saccostomus campestris). The stomachs of all species are markedly sac- culated with a highly modified corpus containing either numerous papillae or several diverticula ...
Goodglass, H; Wingfield, A
Changing trends in the approach to neurolinguistics are reviewed. We suggest that these trends are marked by a distinct convergence between linguistic/cognitive and anatomic/physiological approaches to the study of aphasia. With respect to the former, we cite the refinement of analysis of language symptoms and the introduction of experimental methods that reveal real-time aspects of language processing. With respect to the latter, we cite the technical advances in static and dynamic brain imaging that have allowed the in vivo analysis of lesion sites in aphasic patients, and the identification of foci of metabolic activity during linguistic/cognitive tasks in normal brains. We cite recent imaging studies of category-specific lexical dissociations as examples of the productive convergence of anatomic and technological advances to illuminate a particularly challenging problem.
Intention of the present study was to refer the silhouettes of the irradiation field to anatomically definite osseous structures. For this examination the caudal, cranial and the lateral borders were marked by different methods and their position with respect to the corresponding osseous structures was detected. For documenting the soft-tissue structures the following techniques could be applied: lymphography, hysterosalpingography, vaginal contrasting and computerized tomography. The evaluation of the obtained results showed that the dorsal silhouette ranges between the 4th and 5th lumbar vertebrae, that the lateral silhouette reaches the middle of the head of the femur and that the caudal one includes the obturator. The detection and definition of the target area for curative radiotherapy of corporal and cervical carcinomas can therefore renounce on the contrast representation of soft-tissue organs. On the contrary it is even possible to adjust the irradiation field with the therapy simulator under consideration of anatomically fixed osseous structures. (orig./MG) [de
... SECURITY INFORMATION § 1520.13 Marking SSI. (a) Marking of paper records. In the case of paper records... back cover, including a binder cover or folder, if the document has a front and back cover; (2) Any.... 552 and 49 CFR parts 15 and 1520. (d) Other types of records. In the case of non-paper records that...
In 2012, UDOT implemented a performance-based warranty on a portion of an I-15 pavement marking : project. The awarded contract requested a contractor warranty on the implemented markings for a total : duration of six years. This is the first time th...
... pounds. (7) Maximum design density of lading (Max. Lading density), in pounds per gallon. (8) Material... cryogenic liquid, in hours, and the name of that cryogenic liquid (MRHT __ hrs, name of cryogenic liquid). Marked rated holding marking for additional cryogenic liquids may be displayed on or adjacent to the...
... 25 Indians 1 2010-04-01 2010-04-01 false Price marking. 141.16 Section 141.16 Indians BUREAU OF... AND ZUNI RESERVATIONS General Business Practices § 141.16 Price marking. The price of each article... visible to the customer and that affords the customer a reasonable opportunity to learn the price of the...
Iris Andriessen; Eline Nievers; Laila Faulk; Jaco Dagevos
Original title: Liever Mark dan Mohammed? Does Mohammed have less chance of succeeding on the Dutch labour market than Mark, even though they both have the same qualifications and work experience? And are employers less friendly towards Sonaya than Paula? This study investigates the
... 7 Agriculture 8 2010-01-01 2010-01-01 false Container markings. 956.162 Section 956.162... WALLA VALLEY OF SOUTHEAST WASHINGTON AND NORTHEAST OREGON Rules and Regulations § 956.162 Container markings. Effective April 15, 1997, no handler shall ship any container of Walla Walla Sweet Onions except...
Full Text Available One of the most severe events occurring in critically ill patients admitted to a neonatal intensive care unit (NICU center is represented by the multiple organ failure (MOF, a systemic inflammatory response leading to a progressive organ dysfunction and mortality in newborns. MOF may occur in newborns primarily affected by multiple single organ diseases, including respiratory distress syndrome neonatal sepsis with acute kidney injury, post-asphyxial hypoxic-ischemic encephalopathy and pandemic influenza A (H1N1 infection. In a previous article from our group, based on the histological examination of all organs at autopsy of newborns affected by MOF, all organs studied did not escape to be damaged, including thymus and pancreas normally not mentioned in the literature of MOF. The aim of this article is to review the most important pathological changes pathologists should look for in every case of MOF occurring in the perinatal period, with particular attention to systemic endothelial changes occurring in blood vessels in all organs and sytems. On the basis of our experience, matching data during the last phases of the clinicopathological diagnosis represents a useful method, much more productive as compared to the method based on giving pathological answers to the clinical questions prospected before autopsy. As for the pathological features observed in neonatal MOF, one of them deserves a particular attention: the vascular lesions, and in particular the multiple changes occurring during MOF development in endothelial cells, ending with the loss of the endothelial barrier, probably the most relevant histological lesion followed by the insurgence of interstitial edema and disseminated intravascular coagulation. Small vessels should be observed at high power, with particular attention to the size and shape of endothelial nuclei, in order to evidence endothelial swelling, probably the initial modification of the endothelial cells leading to their
Korbl, Jasmin Dvorah; Wood, Benjamin Andrew; Harvey, Nathan Tobias
Certain diagnoses in dermatopathology have significant implications for patient management and on occasion appropriate clinical care may be facilitated by a phone call from the reporting dermatopathologist to the referring doctor. Whether this is appropriate depends on a number of factors. The concept of 'critical diagnoses' is now well established in surgical pathology, having evolved from critical value policies in clinical pathology and haematology. However, only limited attempts have been made to assess perceptions among different clinical groups. We designed a survey to assess the attitudes of pathologists, dermatologists, surgeons and general practitioners as to what circumstances warrant telephone contact in addition to a standard written report, as well as their approaches to routine histology follow-up. The survey was distributed Australia-wide via a combination of specialist colleges, medical forums and collegiate contacts. A total of 262 responses were received, encompassing representations from all of the targeted specialties. Approximately 20% of respondents were aware of adverse outcomes or 'near misses' which they felt had been due in some part to inadequate communication of histopathology results. While most practitioners have formal systems in place to review histopathology reports, this practice is not universal. There were a number clinical situations where there was a discrepancy between the expectations of clinicians and those of pathologists, in particular with regard to a diagnosis of cutaneous melanoma as well as cutaneous lesions which might be associated with inherited cancer syndromes. It is our hope that the results of this study will facilitate discussion between pathologists and referring clinicians at a local level to minimise the potential for miscommunication. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.
Kim, Jin Su; Lee, Dong Soo; Lee, Byung Il; Lee, Jae Sung; Shin, Hee Won; Chung, June Key; Lee, Myung Chul
The use of statistical parametric mapping (SPM) program has increased for the analysis of brain PET and SPECT images. Montreal neurological institute (MNI) coordinate is used in SPM program as a standard anatomical framework. While the most researchers look up Talairach atlas to report the localization of the activations detected in SPM program, there is significant disparity between MNI templates and Talairach atlas. That disparity between Talairach and MNI coordinates makes the interpretation of SPM result time consuming, subjective and inaccurate. The purpose of this study was to develop a program to provide objective anatomical information of each x-y-z position in ICBM coordinate. Program was designed to provide the anatomical information for the given x-y-z position in MNI coordinate based on the statistical probabilistic anatomical map (SPAM) images of ICBM. When x-y-z position was given to the program, names of the anatomical structures with non-zero probability and the probabilities that the given position belongs to the structures were tabulated. The program was coded using IDL and JAVA language for the easy transplantation to any operating system or platform. Utility of this program was shown by comparing the results of this program to those of SPM program. Preliminary validation study was performed by applying this program to the analysis of PET brain activation study of human memory in which the anatomical information on the activated areas are previously known. Real time retrieval of probabilistic information with 1 mm spatial resolution was archived using the programs. Validation study showed the relevance of this program: probability that the activated area for memory belonged to hippocampal formation was more than 80%. These programs will be useful for the result interpretation of the image analysis performed on MNI coordinate, as done in SPM program
Mackey, Jason; Brown, Robert D; Moomaw, Charles J; Hornung, Richard; Sauerbeck, Laura; Woo, Daniel; Foroud, Tatiana; Gandhi, Dheeraj; Kleindorfer, Dawn; Flaherty, Matthew L; Meissner, Irene; Anderson, Craig; Rouleau, Guy; Connolly, E Sander; Deka, Ranjan; Koller, Daniel L; Abruzzo, Todd; Huston, John; Broderick, Joseph P
Previous studies have suggested that family members with intracranial aneurysms (IAs) often harbor IAs in similar anatomic locations. IA location is important because of its association with rupture. We tested the hypothesis that anatomic susceptibility to IA location exists using a family-based IA study. We identified all affected probands and first-degree relatives (FDRs) with a definite or probable phenotype in each family. We stratified each IA of the probands by major arterial territory and calculated each family's proband-FDR territory concordance and overall contribution to the concordance analysis. We then matched each family unit to an unrelated family unit selected randomly with replacement and performed 1001 simulations. The median concordance proportions, odds ratios (ORs), and P values from the 1001 logistic regression analyses were used to represent the final results of the analysis. There were 323 family units available for analysis, including 323 probands and 448 FDRs, with a total of 1176 IAs. IA territorial concordance was higher in the internal carotid artery (55.4% versus 45.6%; OR, 1.54 [1.04-2.27]; P=0.032), middle cerebral artery (45.8% versus 30.5%; OR, 1.99 [1.22-3.22]; P=0.006), and vertebrobasilar system (26.6% versus 11.3%; OR, 2.90 [1.05-8.24], P=0.04) distributions in the true family compared with the comparison family. Concordance was also higher when any location was considered (53.0% versus 40.7%; OR, 1.82 [1.34-2.46]; PIA development, we found that IA territorial concordance was higher when probands were compared with their own affected FDRs than with comparison FDRs, which suggests that anatomic vulnerability to IA formation exists. Future studies of IA genetics should consider stratifying cases by IA location.
Arroyo-Hernández, M; Mellado-Romero, M; Páramo-Díaz, P; García-Lamas, L; Vilà-Rico, J
Ankle sprains are one of the most common injuries. Despite appropriate conservative treatment, approximately 20-40% of patients continue to have chronic ankle instability and pain. In 75-80% of cases there is an isolated rupture of the anterior talofibular ligament. A retrospective observational study was conducted on 21 patients surgically treated for chronic ankle instability by means of an arthroscopic anatomical repair, between May 2012 and January 2013. There were 15 men and 6 women, with a mean age of 30.43 years (range 18-48). The mean follow-up was 29 months (range 25-33). All patients were treated by arthroscopic anatomical repair of anterior talofibular ligament. Four (19%) patients were found to have varus hindfoot deformity. Associated injuries were present in 13 (62%) patients. There were 6 cases of osteochondral lesions, 3 cases of posterior ankle impingement syndrome, and 6 cases of peroneal pathology. All these injuries were surgically treated in the same surgical time. A clinical-functional study was performed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. The mean score before surgery was 66.12 (range 60-71), and after surgery it increased up to a mean of 96.95 (range 90-100). All patients were able to return to their previous sport activity within a mean of 21.5 weeks (range 17-28). Complications were found in 3 (14%) patients. Arthroscopic anatomical ligament repair technique has excellent clinical-functional results with a low percentage of complications, and enables patients to return to their previous sport activity within a short period of time. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.
McLeod, Sharynne; Verdon, Sarah; Bowen, Caroline
A major challenge for the speech-language pathology profession in many cultures is to address the mismatch between the "linguistic homogeneity of the speech-language pathology profession and the linguistic diversity of its clientele" (Caesar & Kohler, 2007, p. 198). This paper outlines the development of the Multilingual Children with Speech Sound Disorders: Position Paper created to guide speech-language pathologists' (SLPs') facilitation of multilingual children's speech. An international expert panel was assembled comprising 57 researchers (SLPs, linguists, phoneticians, and speech scientists) with knowledge about multilingual children's speech, or children with speech sound disorders. Combined, they had worked in 33 countries and used 26 languages in professional practice. Fourteen panel members met for a one-day workshop to identify key points for inclusion in the position paper. Subsequently, 42 additional panel members participated online to contribute to drafts of the position paper. A thematic analysis was undertaken of the major areas of discussion using two data sources: (a) face-to-face workshop transcript (133 pages) and (b) online discussion artifacts (104 pages). Finally, a moderator with international expertise in working with children with speech sound disorders facilitated the incorporation of the panel's recommendations. The following themes were identified: definitions, scope, framework, evidence, challenges, practices, and consideration of a multilingual audience. The resulting position paper contains guidelines for providing services to multilingual children with speech sound disorders (http://www.csu.edu.au/research/multilingual-speech/position-paper). The paper is structured using the International Classification of Functioning, Disability and Health: Children and Youth Version (World Health Organization, 2007) and incorporates recommendations for (a) children and families, (b) SLPs' assessment and intervention, (c) SLPs' professional
Musser, James M
In a series of four articles published between 1916 and 1919 in The Journal of Medical Research, precursor to The American Journal of Pathology, the investigative pathologist S. Burt Wolbach unambiguously showed that Rocky Mountain spotted fever has a tick-borne mode of transmission, the causative agent replicates intracellularly, and the disease is fundamentally a vasculitis. Although underappreciated, Wolbach's tour-de-force work epitomized investigative pathology. These four articles should be mandatory reading for young investigators and are recommended also to seasoned investigators who seek reinvigoration in the beauty in their craft. Copyright © 2013 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.
Richard, Gail J
A summary of issues regarding auditory processing disorder (APD) is presented, including some of the remaining questions and challenges raised by the articles included in the clinical forum. Evolution of APD as a diagnostic entity within audiology and speech-language pathology is reviewed. A summary of treatment efficacy results and issues is provided, as well as the continuing dilemma for speech-language pathologists (SLPs) charged with providing treatment for referred APD clients. The role of the SLP in diagnosing and treating APD remains under discussion, despite lack of efficacy data supporting auditory intervention and questions regarding the clinical relevance and validity of APD.
Educational reform is sweeping the country. The adoption and the implementation of the Common Core State Standards in almost every state are meant to transform education. It is intended to update the way schools educate, the way students learn, and to ultimately prepare the nation's next generation for the global workplace. This article will describe the Common Core State Standard initiative and the underlying concerns about the quality of education in the United States as well as the opportunities this reform initiative affords speech-language pathologists. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Penide, J.; Quintero, F.; Riveiro, A.; Fernández, A.; del Val, J.; Comesaña, R.; Lusquiños, F.; Pou, J.
Alumina serves as raw material for a broad range of advanced ceramic products. These elements should usually be identified by some characters or symbols printed directly on them. In this sense, laser marking is an efficient, reliable and widely implemented process in industry. However, laser marking of alumina still leads to poor results since the process is not able to produce a dark mark, yielding bad contrast. In this paper, we present an experimental study on the process of marking alumina by three different lasers working in two wavelengths: 1064 nm (Near-infrared) and 532 nm (visible, green radiation). A colorimetric analysis has been carried out in order to compare the resulting marks and its contrast. The most suitable laser operating conditions were also defined and are reported here. Moreover, the physical process of marking by NIR lasers is discussed in detail. Field Emission Scanning Electron Microscopy, High Resolution Transmission Electron Microscopy and X-ray Photoelectron Spectroscopy were also employed to analyze the results. Finally, we propose an explanation for the differences of the coloration induced under different atmospheres and laser parameters. We concluded that the atmosphere is the key parameter, being the inert one the best choice to produce the darkest marks.
Drinnan, A J; Melton, M J
The uniqueness of an individual's bite mark is generally accepted. The use of bite mark analysis to identify or exclude those suspected of crimes is now a well established activity in forensic dentistry. Although the techniques for evaluating bite mark evidence are extremely sophisticated, it is important that the courtroom presentation of such evidence should be as simple as possible and be directed towards those who must judge it. Dentists likely to be involved in the courtroom presentation of bite mark evidence should: be certain that their local law enforcement personnel are frequently updated on the techniques to be used for producing the optimum evidence needed to evaluate bite marks; become acquainted with the current techniques of evaluating bite mark evidence and understand their difficulties and pitfalls; meet with the lawyers (prosecution or defence) before a courtroom appearance, briefing them on the significance of the particular findings; prepare clear and easily understandable visual aids to present to the court the techniques used in the analysis and the bases for the conclusion reached; and offer conclusions derived from the bite mark investigation.
Gorse, M.J.; Purinton, P.T.; Penwick, R.C.; Aron, D.N.; Roberts, R.E.
Talocalcaneal luxation in dogs was studied by anatomic dissection of the talocalcaneal joint in cadavers and review of five clinical cases. The integrity of the talocalcaneal joint was maintained by two strong ligaments traversing the tarsal sinus between the two bones. The joint was found to be a low motion joint. Luxation in clinical cases was not always apparent on standard radiographic views. Three dogs were treated surgically with a screw inserted in lag fashion from talus to calcaneus. One luxation was treated surgically with figure-of-eight orthopedic wires and one was treated with external coaptation. Four dogs returned to their previous levels of function without clinically detectable lameness
Skandalakis, J E; Colborn, G L; Androulakis, J A; Skandalakis, L J; Pemberton, L B
The embryology and surgical anatomy of the inguinal area is presented with emphasis on embryologic and anatomic entities related to surgery. We have presented the factors, such as patent processus vaginalis and defective posterior wall of the inguinal canal, that may be responsible for the genesis of congenital inguinofemoral herniation. These, together with impaired collagen synthesis and trauma, are responsible for the formation of the acquired inguinofemoral hernia. Still, we do not have all the answers for an ideal repair. Despite the latest successes in repair, we, to paraphrase Ritsos, are awaiting the triumphant return of Theseus.
With liberalisation and globalisation of the Indian economy, it has become possible for anyone to get into production and services in most of the sectors. This has led to rampant misuse and appropriation of trade marks. In an insulated economy, with monopoly markets, law protecting trade marks had a limited role. In the changed context, however, trade mark law will be a field of much interest for academics and practitioners. Towards this, the paper explores the formation of trade mark law in ...
Jane Leslie Hayes
Use of elemental markers to study movement of arthropod pests of field crops is reviewed. Trace elements, rubidium (Rb) and cesium (Cs), have provided a nondisruptive method of marking natural adult populations via developmental stage consumption of treated host plants. Multigenerational marking occurs with the transfer of elemental markers from marked adults to...
Vaucher, R; Dast, S; Assaf, N; Sinna, R
The surgical approach of gynecomastia, sexual reassignment surgery in female-to-male transsexuals and the increase of number of obese wishing to turn to plastic surgery led us to deepen the anatomical knowledge of the nipple areola complex (NAC) in men, poorly retailed in the literature. By inspiring us of the methodology of a Japanese study, we studied 50 healthy volunteers male, from 18 to 55 years old, from July till August 2015. We measured various distances relative to the NAC to define its vertical and horizontal position, as well as the internipple distance according to the size, to the weight and to the body mass index (BMI). At the end of the analysis, we were able to underline a lower vertical thoracic position of the NAC in the tall category of person, a more side horizontal position to the subject presenting a high BMI and a linear relation between the BMI and the internipple (Em) defined by (Em)=8.96×BMI. The surgeon's judgment and the desires of the patient are essentials basis of therapeutics decisions that could be lean on this anatomical study, which allowed to establish an idea of the cartography of the NAC in man. It will be interesting and necessary to confront it with other studies with larger scale. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
The paper presents data on meson decays obtained using the MARK III detector operating at SPEAR. Results on hadronic decays; decays of the etasub(e); and results on radiative decays; are all described. (U.K.)
Pavement markings play a critical role in maintaining a safe and efficient driving environment for road users, especially during nighttime conditions. The Texas Department of Transportation (TxDOT) spends millions of dollars each year for installatio...
Crick, Robert Alan
Describes how Mark Twain's essay "Fenimore Cooper's Literary Offenses" helped students to get interested in writing and inspired them to write a similar essay critiquing the movie "Batman." Provides excerpts from students' essays. (PRA)
... “To Close, Press Together Full Length”. The marking may be applied to the container by the silk screen process, using a suitable ink or paint, or may be applied by other means shown to be acceptable. (b...
... eddy current examination combined with a visual inspection, the marking is as illustrated in paragraph..., securely affixed in a manner prescribed by the cylinder manufacturer, near the original manufacturer's...
Wong, Alec; Allen, Craig R.; Hart, Noelle M.; Haak, Danielle M.; Pope, Kevin L.; Smeenk, Nicholas A.; Stephen, Bruce J.; Uden, Daniel R.
The exoskeleton of gastropods provides a convenient surface for carrying marks, and i the interest of improving future marking methods our laboratory assessed the performance of an enamel paint. The endurance of the paint was also compared to other marking methods assessed in the past. We marked the shells of 30 adult Chinese mystery snails Bellamya chinensis and held them in an aquarium for 181 days. We observed no complete degradation of any enamel-paint mark during the 181 days. The enamel-paint mark was superior to a nai;-polish mark, which lasted a median of 100 days. Enamel-paint marks also have a lower rate of loss (0.00 month-1 181 days) than plastic bee tags (0.01 month-1, 57 days), gouache paint (0.07 month-1, 18.5 days), or car body paint from studies found in scientific literature. Legibility of enamel-paint marks had a median lifetime of 102 days. The use of enamel paint on the shells of gastropods is a viable option for studies lasting up to 6 months. Furthermore, visits to capture-mark-recapture site 1 year after application of enamel-paint marks on B. chinesnis shells produced several individuals on which the enamel paint was still visible, although further testing is required to clarify durability over longer periods.
A. L. Goncharov
Full Text Available The identification of small colon lesions is one of the major problems in laparoscopic colonic resection.Research objective: to develop a technique of visualization of small tumors of a colon by preoperative endoscopic marking of a tumor.Materials and methods. In one day prior to operation to the patient after bowel preparation the colonoscopy is carried out. In the planned point near tumor on antimesentery edge the submucous infiltration of marking solution (Micky Sharpz blue tattoo pigment, UK is made. The volume of entered solution of 1–3 ml. In only 5 months of use of a technique preoperative marking to 14 patients with small (the size of 1–3 cm malignant tumors of the left colon is performed.Results. The tattoo mark was well visualized by during operation at 13 of 14 patients. In all cases we recorded no complications. Time of operation with preoperative marking averaged 108 min, that is significantly less in comparison with average time of operation with an intra-operative colonoscopy – 155 min (р < 0.001.Conclusions. The first experience of preoperative endoscopic marking of non palpable small tumors of a colon is encouraging. Performance of a technique wasn't accompanied by complications and allowed to reduce significantly time of operation and to simplify conditions of performance of operation.
Judson, Christopher H; Voss, Andreas; Obopilwe, Elifho; Dyrna, Felix; Arciero, Robert A; Shea, Kevin P
Suture anchor repair for anterior shoulder instability can be performed using a number of different repair techniques, but none has been proven superior in terms of anatomic and biomechanical properties. Purpose/Hypothesis: The purpose was to compare the anatomic footprint coverage and biomechanical characteristics of 4 different Bankart repair techniques: (1) single row with simple sutures, (2) single row with horizontal mattress sutures, (3) double row with sutures, and (4) double row with labral tape. The hypotheses were as follows: (1) double-row techniques would improve the footprint coverage and biomechanical properties compared with single-row techniques, (2) horizontal mattress sutures would increase the footprint coverage compared with simple sutures, and (3) repair techniques with labral tape and sutures would not show different biomechanical properties. Controlled laboratory study. Twenty-four fresh-frozen cadaveric specimens were dissected. The native labrum was removed and the footprint marked and measured. Repair for each of the 4 groups was performed, and the uncovered footprint was measured using a 3-dimensional digitizer. The strength of the repair sites was assessed using a servohydraulic testing machine and a digital video system to record load to failure, cyclic displacement, and stiffness. The double-row repair techniques with sutures and labral tape covered 73.4% and 77.0% of the footprint, respectively. These percentages were significantly higher than the footprint coverage achieved by single-row repair techniques using simple sutures (38.1%) and horizontal mattress sutures (32.8%) ( P row and double-row groups or between the simple suture and horizontal mattress suture techniques. Likewise, there was no difference in the biomechanical properties of the double-row repair techniques with sutures versus labral tape. Double-row repair techniques provided better coverage of the native footprint of the labrum but did not provide superior
Korpman, R A
The demands for information retrieval, processing, and synthesis placed on all providers of health care have increased dramatically in the last several decades. Although systems have been developed to capture charge-related data in support of cost reimbursement, there has been a conspicuous lack of attention paid to information tools to directly enhance the delivery of patient care. The termination of cost reimbursement, together with an increasing recognition of the problems inherent in current manual record-keeping systems, is creating a significant new focus on medical information. This change in focus requires a shift in systems orientation away from financial and departmentally centered systems and toward patient-centered approaches. There is thus increasing recognition of the need for a physician-level medical information specialist to serve as an institution's chief information officer, assuming responsibility for the collection, manipulation, and availability of all patient care-related data. By virtue of training, typical experience, hospital presence, and a noncompetitive position with the hospital's medical staff, the pathologist is uniquely suited for this position. To effectively perform this role, a variety of new specialized data management tools are becoming available. Integrated information systems, patient care management by exception, decision support tools, and, in the future, "artificial intelligence" assists can all be expected to become staples of pathology practice, especially impacting those pathologists who choose to be responsive to the new practice milieu of medical information science.
Cochrane, Frances Clare; Brown, Louise; Siyambalapitiya, Samantha; Plant, Christopher
This study explored speech-language pathologists' (SLPs) perspectives about factors that influence clinical management of Aboriginal and Torres Strait Islander adults with acquired communication disorders (e.g. aphasia, motor speech disorders). Using a qualitative phenomenological approach, seven SLPs working in North Queensland, Australia with experience working with this population participated in semi-structured in-depth interviews. Qualitative content analysis was used to identify categories and overarching themes within the data. Four categories, in relation to barriers and facilitators, were identified from participants' responses: (1) The Practice Context; (2) Working Together; (3) Client Factors; and (4) Speech-Language Pathologist Factors. Three overarching themes were also found to influence effective speech pathology services: (1) Aboriginal and Torres Strait Islander Cultural Practices; (2) Information and Communication; and (3) Time. This study identified many complex and inter-related factors which influenced SLPs' effective clinical management of this caseload. The findings suggest that SLPs should employ a flexible, holistic and collaborative approach in order to facilitate effective clinical management with Aboriginal and Torres Strait Islander people with acquired communication disorders.
Jain, Deepali; Ghosh, Subha; Teixeira, Lucileia; Mukhopadhyay, Sanjay
Most pathologists are familiar with the microscopic features of tuberculosis and the need to examine special stains for acid-fast bacteria (AFB) in cases of granulomatous lung disease. However, misconceptions do exist, including the concept that finding AFB in "caseating granulomas" confirms the diagnosis of tuberculosis. This dogma is attributable to the high prevalence of tuberculosis in many countries, as well as unfamiliarity with the microscopic spectrum of non-tuberculous mycobacterial lung disease. This review aims to provide surgical pathologists with practical tips to identify AFB, illustrate the histologic overlap between pulmonary tuberculosis and non-tuberculous mycobacterial lung disease, and highlight the importance of cultures in this setting. M. tuberculosis and non-tuberculous mycobacteria cannot be reliably differentiated either on the basis of the tissue reaction or by bacterial morphology on acid-fast stains. Although a presumptive clinical diagnosis of tuberculosis can be made without culture-confirmation, the only definitive means to determine the true identity of AFB is by cultures or molecular methods. Making this distinction is most critical when AFB are found in incidentally detected lung nodules in geographic locations where the incidence of tuberculosis is low, because in such settings AFB in necrotizing granulomas of the lung are more likely to be non-tuberculous mycobacteria than M. tuberculosis. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available Tomoyuki Konno,1 Yoichi Aota,2 Tomoyuki Saito,1 Ning Qu,3 Shogo Hayashi,3 Shinichi Kawata,3 Masahiro Itoh3 1Department of Orthopaedic Surgery, Yokohama City University, 2Department of Spine and Spinal Cord, Yokohama Brain and Spine Center, Yokohama City, 3Department of Anatomy, Tokyo Medical University, Tokyo, Japan Object: Entrapment of the middle cluneal nerve (MCN under the long posterior sacroiliac ligament (LPSL is a possible, and underdiagnosed, cause of low-back and/or leg symptoms. To date, detailed anatomical studies of MCN entrapment are few. The purpose of this study was to ascertain, using cadavers, the relationship between the MCN and LPSL and to investigate MCN entrapment. Methods: A total of 30 hemipelves from 20 cadaveric donors (15 female, 5 male designated for education or research, were studied by gross anatomical dissection. The age range of the donors at death was 71–101 years with a mean of 88 years. Branches of the MCN were identified under or over the gluteus maximus fascia caudal to the posterior superior iliac spine (PSIS and traced laterally as far as their finest ramification. Special attention was paid to the relationship between the MCN and LPSL. The distance from the branch of the MCN to the PSIS and to the midline and the diameter of the MCN were measured. Results: A total of 64 MCN branches were identified in the 30 hemipelves. Of 64 branches, 10 (16% penetrated the LPSL. The average cephalocaudal distance from the PSIS to where the MCN penetrated the LPSL was 28.5±11.2 mm (9.1–53.7 mm. The distance from the midline was 36.0±6.4 mm (23.5–45.2 mm. The diameter of the MCN branch traversing the LPSL averaged 1.6±0.5 mm (0.5–3.1 mm. Four of the 10 branches penetrating the LPSL had obvious constriction under the ligament. Conclusion: This is the first anatomical study illustrating MCN entrapment. It is likely that MCN entrapment is not a rare clinical entity. Keywords: middle cluneal nerve, sacroiliac joint
Kachlik, David; Bozdechova, Ivana; Cech, Pavel; Musil, Vladimir; Baca, Vaclav
Anatomical terminology serves as a basic communication tool in all the medical fields. Therefore Latin anatomical nomenclature has been repetitively issued and revised from 1895 (Basiliensia Nomina Anatomica) until 1998, when the last version was approved and published as the Terminologia Anatomica (International Anatomical Terminology) by the Federative Committee on Anatomical Terminology. A brief history of the terminology and nomenclature development is mentioned, along with the concept and contributions of the Terminologia Anatomica including the employed abbreviations. Examples of obsolete anatomical terms and their current synonyms are listed. Clinicians entered the process of the nomenclature revision and this aspect is demonstrated with several examples of terms used in clinical fields only, some already incorporated in the Terminologia Anatomica and a few obsolete terms still alive in non-theoretical communication. Frequent mistakes in grammar and orthography are stated as well. Authors of the article strongly recommend the use of the recent revision of the Latin anatomical nomenclature both in theoretical and clinical medicine.
Hunsche, S; Sauner, D; Maarouf, M; Hoevels, M; Luyken, K; Schulte, O; Lackner, K; Sturm, V; Treuer, H
For application in magnetic resonance (MR) guided stereotactic neurosurgery, two methods for transformation of MR-image coordinates in stereotactic, frame-based coordinates exist: the direct stereotactic fiducial-based transformation method and the indirect anatomical landmark method. In contrast to direct stereotactic MR transformation, indirect transformation is based on anatomical landmark coregistration of stereotactic computerized tomography and non-stereotactic MR images. In a patient study, both transformation methods have been investigated with visual inspection and mutual information analysis. Comparison was done for our standard imaging protocol, including t2-weighted spin-echo as well as contrast enhanced t1-weighted gradient-echo imaging. For t2-weighted spin-echo imaging, both methods showed almost similar and satisfying performance with a small, but significant advantage for fiducial-based transformation. In contrast, for t1-weighted gradient-echo imaging with more geometric distortions due to field inhomogenities and gradient nonlinearity than t2-weighted spin-echo imaging, mainly caused by a reduced bandwidth per pixel, anatomical landmark transformation delivered markedly better results. Here, fiducial-based transformation yielded results which are intolerable for stereotactic neurosurgery. Mean Euclidian distances between both transformation methods were 0.96 mm for t2-weighted spin-echo and 1.67 mm for t1-weighted gradient-echo imaging. Maximum deviations were 1.72 mm and 3.06 mm, respectively
Freund, Wolfgang; Aschoff, Andrik J.; Stuber, Gregor; Schmitz, Bernd; Brinkmann, Alexander; Wagner, Florian; Dinse, Alexander
Extracranial MR neurography has so far mainly been used with 2D datasets. We investigated the use of 3D datasets for peripheral neurography of the sciatic nerve. A total of 40 thighs (20 healthy volunteers) were examined with a coronally oriented magnetization-prepared rapid acquisition gradient echo sequence with isotropic voxels of 1 x 1 x 1 mm and a field of view of 500 mm. Anatomical landmarks were palpated and marked with MRI markers. After MR scanning, the sciatic nerve was identified by two readers independently in the resulting 3D dataset. In every volunteer, the sciatic nerve could be identified bilaterally over the whole length of the thigh, even in areas of close contact to isointense muscles. The landmark of the greater trochanter was falsely palpated by 2.2 cm, and the knee joint by 1 cm. The mean distance between the bifurcation of the sciatic nerve and the knee-joint gap was 6 cm (±1.8 cm). The mean results of the two readers differed by 1-6%. With the described method of MR neurography, the sciatic nerve was depicted reliably and objectively in great anatomical detail over the whole length of the thigh. Important anatomical information can be obtained. The clinical applications of MR neurography for the brachial plexus and lumbosacral plexus/sciatic nerve are discussed. (orig.)
Weiss, Avery H; Phillips, James O; Kelly, John P
To examine the anatomic features and function of the macula in achiasma and to compare visual acuity, eye movements, foveation, and eye velocity before and after tenotomy and reattachment (T&R) surgery. Case series. Two children with isolated achiasma. Ophthalmologic examinations, brain magnetic resonance imaging, full-field and multifocal electroretinography (ERG), visual evoked potentials (VEPs), spectral-domain optical coherence tomography (OCT), eye-movement recordings, and unilateral T&R in 1 patient. Visual acuity before and after surgery, macular anatomic features and function, and eye velocity before and after T&R surgery in 1 patient. Magnetic resonance imaging and VEP confirmed absence of decussation of retinofugal fibers in both patients. Visual acuity was 20/100 and 20/200. The anatomic features and function of the fovea and macula were normal by OCT and multifocal ERG. After T&R, there was a marked reduction in horizontal eye velocity and monocular visual acuity improved to 20/80. The finding that the macula is normal in achiasma suggests that reduced acuity is the result of retinal image motion from nystagmus. Two-muscle T&R reduces horizontal retinal image motion and can improve visual acuity in achiasma or patients with infantile nystagmus. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Hunsche, S [Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne (Germany); Sauner, D [Institute for Diagnostic and Interventional Radiology, Friedrich-Schiller-University of Jena, Jena (Germany); Maarouf, M [Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne (Germany); Hoevels, M [Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne (Germany); Luyken, K [Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne (Germany); Schulte, O [Department of Radiology, University of Cologne, Cologne (Germany); Lackner, K [Department of Radiology, University of Cologne, Cologne (Germany); Sturm, V [Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne (Germany); Treuer, H [Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne (Germany)
For application in magnetic resonance (MR) guided stereotactic neurosurgery, two methods for transformation of MR-image coordinates in stereotactic, frame-based coordinates exist: the direct stereotactic fiducial-based transformation method and the indirect anatomical landmark method. In contrast to direct stereotactic MR transformation, indirect transformation is based on anatomical landmark coregistration of stereotactic computerized tomography and non-stereotactic MR images. In a patient study, both transformation methods have been investigated with visual inspection and mutual information analysis. Comparison was done for our standard imaging protocol, including t2-weighted spin-echo as well as contrast enhanced t1-weighted gradient-echo imaging. For t2-weighted spin-echo imaging, both methods showed almost similar and satisfying performance with a small, but significant advantage for fiducial-based transformation. In contrast, for t1-weighted gradient-echo imaging with more geometric distortions due to field inhomogenities and gradient nonlinearity than t2-weighted spin-echo imaging, mainly caused by a reduced bandwidth per pixel, anatomical landmark transformation delivered markedly better results. Here, fiducial-based transformation yielded results which are intolerable for stereotactic neurosurgery. Mean Euclidian distances between both transformation methods were 0.96 mm for t2-weighted spin-echo and 1.67 mm for t1-weighted gradient-echo imaging. Maximum deviations were 1.72 mm and 3.06 mm, respectively.
The diagnosis of bone tumors is particularly difficult and requires specific knowledge and experience. This is done not only of clinical workers and X-ray specialists but also of pathologists, who are mostly unable to gather enough experience because those diseases are relatively rare. The specialities of the diagnosis of bone tumors are pointed out and the indispensable co-operation between the fields of work of clinical specialists, radiologists and pathologists is emphasized. Bone growths are classified according to the proposals of the World Health Organization, forming the basis for the subsequent therapy. An absolute pre-requisite for an exact diagnosis in the synopsis of the X-ray structures and the histologic findings. In various cases the dignity of a bone tumor cannot be determined; in such instances radical removal is recommended to preclude recidivation and possible malignity. In difficult cases a reference centre for bone tumors should be consulted. (orig.) [de
Anderson, Kleber M.; Costa, Suelen F.; Sampaio, Francisco J.B.; Favorito, Luciano A.
ABSTRACT Objectives: To assess the incidence of anatomical anomalies in patients with retractile testis. Materials and Methods: We studied prospectively 20 patients (28 testes) with truly retractile testis and compared them with 25 human fetuses (50 testes) with testis in scrotal position. We analyzed the relations among the testis, epididymis and patency of the processus vaginalis (PV). To analyze the relations between the testis and epididymis, we used a previous classification according to epididymis attachment to the testis and the presence of epididymis atresia. To analyze the structure of the PV, we considered two situations: obliteration of the PV and patency of the PV. We used the Chi-square test for contingency analysis of the populations under study (p patent processus vaginalis and epididymal anomalies. PMID:27564294
Puchalski, Ralph B; Shah, Nameeta; Miller, Jeremy; Dalley, Rachel; Nomura, Steve R; Yoon, Jae-Guen; Smith, Kimberly A; Lankerovich, Michael; Bertagnolli, Darren; Bickley, Kris; Boe, Andrew F; Brouner, Krissy; Butler, Stephanie; Caldejon, Shiella; Chapin, Mike; Datta, Suvro; Dee, Nick; Desta, Tsega; Dolbeare, Tim; Dotson, Nadezhda; Ebbert, Amanda; Feng, David; Feng, Xu; Fisher, Michael; Gee, Garrett; Goldy, Jeff; Gourley, Lindsey; Gregor, Benjamin W; Gu, Guangyu; Hejazinia, Nika; Hohmann, John; Hothi, Parvinder; Howard, Robert; Joines, Kevin; Kriedberg, Ali; Kuan, Leonard; Lau, Chris; Lee, Felix; Lee, Hwahyung; Lemon, Tracy; Long, Fuhui; Mastan, Naveed; Mott, Erika; Murthy, Chantal; Ngo, Kiet; Olson, Eric; Reding, Melissa; Riley, Zack; Rosen, David; Sandman, David; Shapovalova, Nadiya; Slaughterbeck, Clifford R; Sodt, Andrew; Stockdale, Graham; Szafer, Aaron; Wakeman, Wayne; Wohnoutka, Paul E; White, Steven J; Marsh, Don; Rostomily, Robert C; Ng, Lydia; Dang, Chinh; Jones, Allan; Keogh, Bart; Gittleman, Haley R; Barnholtz-Sloan, Jill S; Cimino, Patrick J; Uppin, Megha S; Keene, C Dirk; Farrokhi, Farrokh R; Lathia, Justin D; Berens, Michael E; Iavarone, Antonio; Bernard, Amy; Lein, Ed; Phillips, John W; Rostad, Steven W; Cobbs, Charles; Hawrylycz, Michael J; Foltz, Greg D
Glioblastoma is an aggressive brain tumor that carries a poor prognosis. The tumor's molecular and cellular landscapes are complex, and their relationships to histologic features routinely used for diagnosis are unclear. We present the Ivy Glioblastoma Atlas, an anatomically based transcriptional atlas of human glioblastoma that aligns individual histologic features with genomic alterations and gene expression patterns, thus assigning molecular information to the most important morphologic hallmarks of the tumor. The atlas and its clinical and genomic database are freely accessible online data resources that will serve as a valuable platform for future investigations of glioblastoma pathogenesis, diagnosis, and treatment. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.
Karemore, Gopal; Brandt, S.; Karssemeijer, N.
was represented by geodesic distance (s) from nipple and parametric angle (¿) as shown in figure 1. The scoring technique called MTR (mammographic texture resemblance marker) used this breast coordinate system to extract Gaussian derivative features. The features extracted using the (x,y) and the curve......Purpose Many researchers have investigated measures also other than density in the mammogram such as measures based on texture to improve breast cancer risk assessment. However, parenchymal texture characteristics are highly dependent on the orientation of vasculature structure and fibrous tissue...... methodologies as seen from table 2 in given temporal study. Conclusion The curve-linear anatomical breast coordinate system facilitated computerized analysis of mammograms. The proposed coordinate system slightly improved the risk segregation by Mammographic Texture Resemblance and minimized the geometrical...
Zaunbauer, W.; Daepp, S.; Haertel, M.
Radiodiagnostically relevant normal values and variations for measurements of the cervical region, the arithmetical average and the standard deviation were determined from adequate computer tomograms on 60 healthy women and men, aged 20 to 83 years. The sagittal diameter of the prevertebral soft tissue and the lumina of the upper respiratory tract were evaluated at exactly defined levels between the hyoid bone and the incisura jugularis sterni. - The thickness of the aryepiglottic folds, the maximal sagittal and transverse diameters of the thyroid gland and the calibre of the great cervical vessels were defined. - To assess information about laryngeal function in computerized tomography, measurements of distances between the cervical spine and anatomical fixed points of the larynx and hypopharynx were made as well as of the degree of vocal cord movement during normal respiration and phonation. (orig.) [de
Atlas, S.W.; Grossman, R.I.; Savino, P.J.
Internuclear ophthalmoplegia is a gaze disorder characterized by impaired adduction of the side of a lesion in the medial longitudinal fasciculus (MLF) with dissociated nystagmus of the abducting eye. Eleven patients with internuclear ophthalmoplegia (nine with multiple sclerosis, two with infarction) were examined with spin-echo MR imaging performed at 1.5 T. Nine of the 11 patients also underwent CT. MR imaging was highly sensitive (10 of 11 cases) and CT was of no value (0 of 9 cases) in detecting clinically suspected MLF lesions. These lesions must be distinguished from ''pseudo-MLF hyperintensity,'' which appears as a thin, strictly midline, linear hyperintensity just interior to the fourth ventricle and aqueduct in healthy subjects. True MLF lesions are nodular, more prominent, and slightly off the midline, corresponding to the paramedian anatomic site of the MLF
Aim: The goal in anterior cruciate ligament reconstruction (ACLR) is to restore the normal anatomic structure and function of the knee. In the significant proportion of patients after the traditional single-bundle ACLR, complaints of instability still continue. Anatomic double bundle ACLR may provide normal kinematics in knees, much closer to the natural anatomy. The aim of this study is to clinically assess the early outcomes of our anatomical double bundle ACLR. Material and Method: In our ...
Gambino, Carol; McLaughlin, Patrick; Kuo, Loretta; Kammerman, Frani; Shenkin, Peter; Diaczuk, Peter; Petraco, Nicholas; Hamby, James; Petraco, Nicholas D K
Over the last several decades, forensic examiners of impression evidence have come under scrutiny in the courtroom due to analysis methods that rely heavily on subjective morphological comparisons. Currently, there is no universally accepted system that generates numerical data to independently corroborate visual comparisons. Our research attempts to develop such a system for tool mark evidence, proposing a methodology that objectively evaluates the association of striated tool marks with the tools that generated them. In our study, 58 primer shear marks on 9 mm cartridge cases, fired from four Glock model 19 pistols, were collected using high-resolution white light confocal microscopy. The resulting three-dimensional surface topographies were filtered to extract all "waviness surfaces"-the essential "line" information that firearm and tool mark examiners view under a microscope. Extracted waviness profiles were processed with principal component analysis (PCA) for dimension reduction. Support vector machines (SVM) were used to make the profile-gun associations, and conformal prediction theory (CPT) for establishing confidence levels. At the 95% confidence level, CPT coupled with PCA-SVM yielded an empirical error rate of 3.5%. Complementary, bootstrap-based computations for estimated error rates were 0%, indicating that the error rate for the algorithmic procedure is likely to remain low on larger data sets. Finally, suggestions are made for practical courtroom application of CPT for assigning levels of confidence to SVM identifications of tool marks recorded with confocal microscopy. Copyright © 2011 Wiley Periodicals, Inc.
Stephenson, S. N.
A participant evaluation of a Deep Space Network (DSN) is described. The Mark IVA project is an implementation to upgrade the tracking and data acquisition systems of the dSN. Approximately six hundred DSN operations and engineering maintenance personnel were surveyed. The survey obtained a convenience sample including trained people within the population in order to learn what training had taken place and to what effect. The survey questionnaire used modifications of standard rating scales to evaluate over one hundred items in four training dimensions. The scope of the evaluation included Mark IVA vendor training, a systems familiarization training seminar, engineering training classes, a on-the-job training. Measures of central tendency were made from participant rating responses. Chi square tests of statistical significance were performed on the data. The evaluation results indicated that the effects of different Mark INA training methods could be measured according to certain ratings of technical training effectiveness, and that the Mark IVA technical training has exhibited positive effects on the abilities of DSN personnel to operate and maintain new Mark IVA equipment systems.
Stephenson, S. N.
A participant evaluation of a Deep Space Network (DSN) is described. The Mark IVA project is an implementation to upgrade the tracking and data acquisition systems of the dSN. Approximately six hundred DSN operations and engineering maintenance personnel were surveyed. The survey obtained a convenience sample including trained people within the population in order to learn what training had taken place and to what effect. The survey questionnaire used modifications of standard rating scales to evaluate over one hundred items in four training dimensions. The scope of the evaluation included Mark IVA vendor training, a systems familiarization training seminar, engineering training classes, a on-the-job training. Measures of central tendency were made from participant rating responses. Chi square tests of statistical significance were performed on the data. The evaluation results indicated that the effects of different Mark INA training methods could be measured according to certain ratings of technical training effectiveness, and that the Mark IVA technical training has exhibited positive effects on the abilities of DSN personnel to operate and maintain new Mark IVA equipment systems.
John Larry Blau
Full Text Available Background: Beaker is a relatively new laboratory information system (LIS offered by Epic Systems Corporation as part of its suite of health-care software and bundled with its electronic medical record, EpicCare. It is divided into two modules, Beaker anatomic pathology (Beaker AP and Beaker Clinical Pathology. In this report, we describe our experience implementing Beaker AP version 2014 at an academic medical center with a go-live date of October 2015. Methods: This report covers preimplementation preparations and challenges beginning in September 2014, issues discovered soon after go-live in October 2015, and some post go-live optimizations using data from meetings, debriefings, and the project closure document. Results: We share specific issues that we encountered during implementation, including difficulties with the proposed frozen section workflow, developing a shared specimen source dictionary, and implementation of the standard Beaker workflow in large institution with trainees. We share specific strategies that we used to overcome these issues for a successful Beaker AP implementation. Several areas of the laboratory-required adaptation of the default Beaker build parameters to meet the needs of the workflow in a busy academic medical center. In a few areas, our laboratory was unable to use the Beaker functionality to support our workflow, and we have continued to use paper or have altered our workflow. In spite of several difficulties that required creative solutions before go-live, the implementation has been successful based on satisfaction surveys completed by pathologists and others who use the software. However, optimization of Beaker workflows has continued to be an ongoing process after go-live to the present time. Conclusions: The Beaker AP LIS can be successfully implemented at an academic medical center but requires significant forethought, creative adaptation, and continued shared management of the ongoing product by
Cobb, Ernest D.; Biesecker, J.E.
The United States is undergoing a dramatic growth of population and demands on its natural resources. The effects are widespread and often produce significant alterations of the environment. The hydrologic bench-mark network was established to provide data on stream basins which are little affected by these changes. The network is made up of selected stream basins which are not expected to be significantly altered by man. Data obtained from these basins can be used to document natural changes in hydrologic characteristics with time, to provide a better understanding of the hydrologic structure of natural basins, and to provide a comparative base for studying the effects of man on the hydrologic environment. There are 57 bench-mark basins in 37 States. These basins are in areas having a wide variety of climate and topography. The bench-mark basins and the types of data collected in the basins are described.
Alexander, J.P.; Baggs, R.; Fujino, D.
We have completed constructing and begun operating the Mark II Drift Chamber Vertex Detector. The chamber, based on a modified jet cell design, achieves 30 μm spatial resolution and 2 gas mixtures. Special emphasis has been placed on controlling systematic errors including the use of novel construction techniques which permit accurate wire placement. Chamber performance has been studied with cosmic ray tracks collected with the chamber located both inside and outside the Mark II. Results on spatial resolution, average pulse shape, and some properties of CO 2 mixtures are presented. 10 refs., 12 figs., 1 tab
of a large-scale business simulation model as a vehicle for doing research in management controls. The major results of the program were the...development of the Mark I business simulation model and the Simulation Package (SIMPAC). SIMPAC is a method and set of programs facilitating the construction...of large simulation models. The object of this document is to describe the Mark I Corporation model, state why parts of the business were modeled as they were, and indicate the research applications of the model. (Author)
Trung-Hau Le Thua
Full Text Available Aim: The anatomical study and clinical application for the vascularized corticoperiosteal flap from the medial femoral condyle have been performed and described previously. Although prior studies have described the composite osteomyocutaneous flap from the medial femoral condyle, a detailed analysis of the vascularity of this region has not yet been fully evaluated. Methods: This anatomical study described the variability of the arteries from the medial femoral condyle in 40 cadaveric specimens. Results: The descending genicular artery (DGA was found in 33 of 40 cases (82.5%. The superomedial genicular artery (SGA was present in 10 cases (25%. All 33 cases (100% of the DGA had articular branches to the periosteum of the medial femoral condyle. Muscular branches and saphenous branches of the DGA were present in 25 cases (62.5% and 26 cases (70.3%, respectively. Conclusion: The current study demonstrates that the size and length of the vessels to the medial femoral condyle are sufficient for a vascularized bone flap. A careful preoperative vascular assessment is essential prior to use of the vascularized composite osteomyocutaneous flap from the medial femoral condyle, because of the considerable anatomical variations in different branches of the DGA.
Stubblefield, Phoebe R
The current focus in forensic anthropology on increasing scientific certainty in ancestry determination reinforces the need to examine the ancestry of skeletal remains used for osteology instruction. Human skeletal remains were discovered on the University of North Dakota campus in 2007. After recovery, the osteological examination resulted in a profile for a 33- to 46-year-old woman of African descent with stature ranging from 56.3 to 61.0 in. The pattern of postmortem damage indicated that the remains had been prepared for use as an anatomical teaching specimen. Review of the American history of anatomical teaching revealed a preference for Black subjects, which apparently extended to states like North Dakota despite extremely low resident populations of people of African descent. This study emphasizes the need to examine the ancestry of older teaching specimens that lack provenience, rather than assuming they are derived from typical (i.e., Indian) sources of anatomical material. © 2011 American Academy of Forensic Sciences.
Context Collaborative Digital Anatomic Pathology refers to the use of information technology that supports the creation and sharing or exchange of information, including data and images, during the complex workflow performed in an Anatomic Pathology department from specimen reception to report transmission and exploitation. Collaborative Digital Anatomic Pathology can only be fully achieved using medical informatics standards. The goal of the international integrating the Healthcare Enterprise (IHE) initiative is precisely specifying how medical informatics standards should be implemented to meet specific health care needs and making systems integration more efficient and less expensive. Objective To define the best use of medical informatics standards in order to share and exchange machine-readable structured reports and their evidences (including whole slide images) within hospitals and across healthcare facilities. Methods Specific working groups dedicated to Anatomy Pathology within multiple standards organizations defined standard-based data structures for Anatomic Pathology reports and images as well as informatic transactions in order to integrate Anatomic Pathology information into the electronic healthcare enterprise. Results The DICOM supplements 122 and 145 provide flexible object information definitions dedicated respectively to specimen description and Whole Slide Image acquisition, storage and display. The content profile “Anatomic Pathology Structured Report” (APSR) provides standard templates for structured reports in which textual observations may be bound to digital images or regions of interest. Anatomic Pathology observations are encoded using an international controlled vocabulary defined by the IHE Anatomic Pathology domain that is currently being mapped to SNOMED CT concepts. Conclusion Recent advances in standards for Collaborative Digital Anatomic Pathology are a unique opportunity to share or exchange Anatomic Pathology structured
Cho, Kathleen R; Cooper, Kumarasen; Croce, Sabrina; Djordevic, Bojana; Herrington, Simon; Howitt, Brooke; Hui, Pei; Ip, Philip; Koebel, Martin; Lax, Sigurd; Quade, Bradley J; Shaw, Patricia; Vidal, August; Yemelyanova, Anna; Clarke, Blaise; Hedrick Ellenson, Lora; Longacre, Teri A; Shih, Ie-Ming; McCluggage, W Glenn; Malpica, Anais; Oliva, Esther; Parkash, Vinita; Matias-Guiu, Xavier
The aim of this article is to propose guidelines and recommendations in problematic areas in pathologic reporting of endometrial carcinoma (EC) regarding special techniques and ancillary studies. An organizing committee designed a comprehensive survey with different questions related to pathologic features, diagnosis, and prognosis of EC that was sent to all members of the International Society of Gynecological Pathologists. The special techniques/ancillary studies group received 4 different questions to be addressed. Five members of the group reviewed the literature and came up with recommendations and an accompanying text which were discussed and agreed upon by all members of the group. Twelve different recommendations are made. They address the value of immunohistochemistry, ploidy, and molecular analysis for assessing prognosis in EC, the value of steroid hormone receptor analysis to predict response to hormone therapy, and parameters regarding applying immunohistochemistry and molecular tests for assessing mismatch deficiency in EC.
Giangreco, Michael F
When speech-language pathologists provide educationally related services for students with lowincidence disabilities who are placed in inclusive classrooms, they are asked to work with a variety of other adults. The ways in which these adults make decisions about individualizing a student's educational program, determine related services, and coordinate their activities have an impact on educational outcomes for students as well as on interprofessional interactions. This article summarizes a team process for making related services decisions called VISTA (Vermont Interdependent Services Team Approach) and a series of nine research studies pertaining to the use and impact of VISTA. It also addresses related topics, such as team size, consumer perspectives, and paraprofessional supports. Five major implications from these studies are offered concerning (a) developing a disposition of being an ongoing learner, (b) developing a shared framework among team members, (c) having a research-based process to build consensus, (d) clarifying roles, and (e) increasing involvement of families and general education teachers.
This report provides a transcript of an interview with Dr. Clarance Lushbaugh by representatives of the DOE Office of Human Radiation Experiments. Dr. Lushbaugh was chosen for this interview because of his research involving experimental use of irradiation with human beings at Los Alamos and at the Oak Ridge Institute of Nuclear Science (ORINS). After a brief biographical sketch Dr. Lushbaugh and his assistant Mrs. Ann Swipe defend their use of total body irradiation using the LETBI (Low Exposure Total Body Irradiation) and the LETBI (Medium Energy Total Body Irradiator). Dr. Lushbaugh also discusses his earlier experiments involving use of nitrogen mustards in chemotherapy application, his early interest in the LD50 for man, his early impressions of low-level spray radiation as introduced by Heubline, anedotal information for his duties a pathologist for Los Alamos, and his developing interest in establishing safer radiation limits for human exposure
Fischer, Andrew H; Schwartz, Mary R; Moriarty, Ann T; Wilbur, David C; Souers, Rhona; Fatheree, Lisa; Booth, Christine N; Clayton, Amy C; Kurtyz, Daniel F I; Padmanabhan, Vijayalakshmi; Crothers, Barbara A
Immunohistochemistry (IHC) is important for cytology but poses special challenges because preanalytic conditions may differ from the conditions of IHC-positive controls. To broadly survey cytology laboratories to quantify preanalytic platforms for cytology IHC and identify problems with particular platforms or antigens. To discover how validation guidelines for HER2 testing have affected cytology. A voluntary survey of cytology IHC practices was sent to 1899 cytology laboratories participating in the College of American Pathologists Nongynecologic Cytopathology Education Program in the fall of 2009. A total of 818 laboratories (43%) responded to the survey by April 2010. Three hundred fourty-five of 791 respondents (44%) performed IHC on cytology specimens. Seventeen different fixation and processing platforms prior to antibody reaction were reported. A total of 59.2% of laboratories reported differences between the platforms for cytology specimens and positive controls, but most (155 of 184; 84%) did not alter antibody dilutions or antigen retrieval for cytology IHC. When asked to name 2 antibodies for which staining conditions differed between cytology and surgical samples, there were 18 responses listing 14 antibodies. A total of 30.6% of laboratories performing IHC offered HER2 testing before publication of the 2007 College of American Pathologists/American Society of Clinical Oncologists guidelines, compared with 33.6% afterward, with increased performance of testing by reference laboratories. Three laboratories validated a nonformalin HER2 platform. The platforms for cytology IHC and positive controls differ for most laboratories, yet conditions are uncommonly adjusted for cytology specimens. Except for the unsuitability of air-dried smears for HER2 testing, the survey did not reveal evidence of systematic problems with any antibody or platform.
Kiser, Patti K; Löhr, Christiane V; Meritet, Danielle; Spagnoli, Sean T; Milovancev, Milan; Russell, Duncan S
Although quantitative assessment of margins is recommended for describing excision of cutaneous malignancies, there is poor understanding of limitations associated with this technique. We described and quantified histologic artifacts in inked margins and determined the association between artifacts and variance in histologic tumor-free margin (HTFM) measurements based on a novel grading scheme applied to 50 sections of normal canine skin and 56 radial margins taken from 15 different canine mast cell tumors (MCTs). Three broad categories of artifact were 1) tissue deformation at inked edges, 2) ink-associated artifacts, and 3) sectioning-associated artifacts. The most common artifacts in MCT margins were ink-associated artifacts, specifically ink absent from an edge (mean prevalence: 50%) and inappropriate ink coloring (mean: 45%). The prevalence of other artifacts in MCT skin was 4-50%. In MCT margins, frequency-adjusted kappa statistics found fair or better inter-rater reliability for 9 of 10 artifacts; intra-rater reliability was moderate or better in 9 of 10 artifacts. Digital HTFM measurements by 5 blinded pathologists had a median standard deviation (SD) of 1.9 mm (interquartile range: 0.8-3.6 mm; range: 0-6.2 mm). Intraclass correlation coefficients demonstrated good inter-pathologist reliability in HTFM measurement (κ = 0.81). Spearman rank correlation coefficients found negligible correlation between artifacts and HTFM SDs ( r ≤ 0.3). These data confirm that although histologic artifacts commonly occur in inked margin specimens, artifacts are not meaningfully associated with variation in HTFM measurements. Investigators can use the grading scheme presented herein to identify artifacts associated with tissue processing.
Kagu-Eesti Regionaalarengu Programmi raames Eesti Kunstiakadeemia arhitektuurikateedri IV kursuse eriala valikaines 1998/99 tehtud tööst "HyperMobiilne Reaalsus & Kagu Eesti" (juhendajad Ralf Tamm, Ülar Mark). Ühises töös osalesid Tartu Ülikooli geograafiatudengid (juhendaja Rein Ahas). 4 illustratsiooni
Turunduskommunikatsioonifirma Ogilvy & Mather suunajuht Mark Earls leiab, et kuna turg on üle ujutatud võrdselt heade toodetega ja tarbija teab, et tegelikult pole oluline, millise toote ta valib, muutub turundusrevolutsiooni keskne idee - tarbijavajaduste kindlakstegemine ja rahuldamine - tähtsusetuks.
... SSI. (a) Marking of paper records. In the case of paper records containing SSI, a covered person must... limitation statement on the bottom, of— (1) The outside of any front and back cover, including a binder cover... types of records. In the case of non-paper records that contain SSI, including motion picture films...
Ten Raa, T.
Monopoly prices are too high. It is a price level problem, in the sense that the relative mark-ups have Ramsey optimal proportions, at least for independent constant elasticity demands. I show that this feature of monopoly prices breaks down the moment one demand is replaced by the textbook linear
Soosaar, Mark, 1946-
Riigikogu keskkonnakomisjoni liikme Mark Soosaare sõnul peaks Eesti Taani eeskujul jõudma parlamentaarse otsuseni loobuda tuumajaamaehitusest, vähendada tuleks märgatavalt Eesti metsade raiumist. Vene-Saksa gaasitarneleppe vastu töötamise asemel tuleks otsida ühisosa nii Venemaa kui teiste Läänemeremaadega
Jul 16, 2015 ... question, eliciting answers that range from Mark as in direct and open ... or armed response, especially in a context where such actions were unrealistic. (whether ..... identity; social memory; to name a few) of power. It implies ... an elite-driven enterprise in the simplistic sense of the word, although the elite's ...
Abrams, G.S.; Alam, M.S.; Blocker, C.A.
First results from the SLAC-LBL Mark II magnetic detector at SPEAR are presented. The performance of the detector is discussed and preliminary results are given on inclusive baryon production R/sub p + anti p/, R/sub Λ + anti Λ/, on decay modes of the D mesons and on two-photon production of eta' mesons
... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Approved markings. 1150.3 Section 1150.3 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued... permanently affixed to the exterior surface of the barrel, covering the circumference of the barrel from the...
... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Miscellaneous § 226.91 Marking. (a) USAID policy is that all programs, projects, activities... support of the American people through the United States Agency for International Development (USAID). The...
Forbes, Peter G. M.; Lauritzen, Steffen; Møller, Jesper
We present a framework for fingerprint matching based on marked point process models. An efficient Monte Carlo algorithm is developed to calculate the marginal likelihood ratio for the hypothesis that two observed prints originate from the same finger against the hypothesis that they originate from...... different fingers. Our model achieves good performance on an NIST-FBI fingerprint database of 258 matched fingerprint pairs....
Robert L. Phillips
A Simple, inexpensive collar made of Armor-tite (a vinyl-coated nylon fabric) was designed for marking white-tailed deer (Odocoileus virginianus) and moose (Alces alces). Field tests showed that the material is easily seen and extrememly durable. It may be suitable for use on other large mammals. The collar can be quickly fitted to individual animals under field...
What, to borrow a theological phrase, are the marks of a truly holistic kinesiology department? "In Kinesis and the Nature of the Human Person" (2010), I examined the theoretical impact of Aristotle's definition of "kinesis" and Polanyi's theory of "tacit knowledge" on kinesiology. The intention here, however, is practical rather than theoretical.…
Rank, Sirje, 1966-
Ilmunud ka: Delovõje Vedomosti 13. apr. lk. 6. Briti rõivakett Marks & Spencer kaebas, et Briti maksuseadused, mis ei lubanud emafirma Suurbritannias maksustavast tulust maha kanda Saksamaal, Prantsusmaal ja Belgias asunud tütarfirmade suuri kahjumeid üheksakümnendate aastate lõpus, on vastuolus EL-i ühisturu seadustega
Zijlmans, Maeike; Otte, Willem M; Van't Klooster, Maryse A; van Diessen, Eric; Leijten, Frans Ss; Sander, Josemir W
OBJECTIVE: To quantify the use of question marks in titles of published studies. DESIGN AND SETTING: Literature review. PARTICIPANTS: All Pubmed publications between 1 January 2013 and 31 December 2013 with an available abstract. Papers were classified as being clinical when the search terms clin*,
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Export marks. 28.216 Section 28.216 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS EXPORTATION OF ALCOHOL Exportation of Wine With Benefit of Drawback § 28.216...
Back in May 2011, an article in "Primary Science" described how the idea for a quality mark for primary science was developed from an initial conversation at an Association for Science Education annual conference (Turner, Marshall and Elsmore, 2011). Its intention then, as now, was to support and champion good practice and raise the…
... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Anatomical Planes 1 Figure 1 to Part 1203 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR BICYCLE HELMETS Pt. 1203, Fig. 1 Figure 1 to Part 1203—Anatomical Planes ER10MR98.001 ...
Hvidtfeldt, Mogens; Pedersen, Steen
To assess facilities and applications of a programme for a PC based CT measurements in 3D of anatomical angelse in the skeleton.......To assess facilities and applications of a programme for a PC based CT measurements in 3D of anatomical angelse in the skeleton....
The anatomical and physical properties of Khaya anthotheca (Welw.) C. DC wood from the transition forest of middle altitude (zone 1) and the humid dense forest of low altitude (zone 2) in the East of the Democratic Republic of Congo were evaluated to ascertain the effect of growth area on the anatomical and physical ...
The aim of this study was to investigate the anatomical structure of the trunk wood and the roots of A. nitida and R. racemosa, two mangrove trees from Gabon. The anatomical differences between the trunks and the roots were used to understand their bio-remediating differences through heavy metals. It was found that the ...
Domínguez-Rodrigo, Manuel; Baquedano, Enrique
All models of evolution of human behaviour depend on the correct identification and interpretation of bone surface modifications (BSM) on archaeofaunal assemblages. Crucial evolutionary features, such as the origin of stone tool use, meat-eating, food-sharing, cooperation and sociality can only be addressed through confident identification and interpretation of BSM, and more specifically, cut marks. Recently, it has been argued that linear marks with the same properties as cut marks can be created by crocodiles, thereby questioning whether secure cut mark identifications can be made in the Early Pleistocene fossil record. Powerful classification methods based on multivariate statistics and machine learning (ML) algorithms have previously successfully discriminated cut marks from most other potentially confounding BSM. However, crocodile-made marks were marginal to or played no role in these comparative analyses. Here, for the first time, we apply state-of-the-art ML methods on crocodile linear BSM and experimental butchery cut marks, showing that the combination of multivariate taphonomy and ML methods provides accurate identification of BSM, including cut and crocodile bite marks. This enables empirically-supported hominin behavioural modelling, provided that these methods are applied to fossil assemblages.
... 19 Customs Duties 1 2010-04-01 2010-04-01 false Special marking on certain articles. 11.9 Section... OF THE TREASURY PACKING AND STAMPING; MARKING Marking § 11.9 Special marking on certain articles. (a... of additional U.S. Note 4, Chapter 91. If any article so required to be marked is found not to be...
... 19 Customs Duties 1 2010-04-01 2010-04-01 false Methods of marking specific articles. 134.43...; DEPARTMENT OF THE TREASURY COUNTRY OF ORIGIN MARKING Method and Location of Marking Imported Articles § 134.43 Methods of marking specific articles. (a) Marking previously required by certain provisions of the...
Yao, Jianhua; Summers, Ronald M.
The spinal column constitutes the central axis of human torso and is often used by radiologists to reference the location of organs in the chest and abdomen. However, visually identifying and labeling vertebrae is not trivial and can be timeconsuming. This paper presents an approach to automatically label vertebrae based on two pieces of anatomical knowledge: one vertebra has at most two attached ribs, and ribs are attached only to thoracic vertebrae. The spinal column is first extracted by a hybrid method using the watershed algorithm, directed acyclic graph search and a four-part vertebra model. Then curved reformations in sagittal and coronal directions are computed and aggregated intensity profiles along the spinal cord are analyzed to partition the spinal column into vertebrae. After that, candidates for rib bones are detected using features such as location, orientation, shape, size and density. Then a correspondence matrix is established to match ribs and vertebrae. The last vertebra (from thoracic to lumbar) with attached ribs is identified and labeled as T12. The rest of vertebrae are labeled accordingly. The method was tested on 50 CT scans and successfully labeled 48 of them. The two failed cases were mainly due to rudimentary ribs.
Avetisov, S E; Narbut, M N
Being just a relatively small part of the fibrous tunic of the eyeball, the cornea is, nevertheless, unique in terms of the variety of its functions. Because the cornea differs significantly from other protective frames in its structure, it provides the possibility of light transmission and strong refraction that largely contributes to the total refraction of the eye. The development of ophthalmology is impossible without improving methods of adequate anatomical and functional assessment of the eye not only as a whole, but also as a collection of interacting structures.In this regard, examination methods of the cornea have undergone significant advances in recent years. So far, the level of corneal transparency has been judged by biomicroscopy findings or indirect characteristics (thickness, structure, etc.). Confocal microscopy of the cornea and wave-based examinations involving one of the available laser interferometers (OCT or HRT) are also used. However, the data obtained with these methods resembles that of layer-specific reflectometry, i.e. the magnitude of directed reflection of the light beam from corneal corpuscles, which does not completely agree with the classical idea of transparency.
Trotovsek, Blaz; Belghiti, Jacques; Gadzijev, Eldar M; Ravnik, Dean; Hribernik, Marija
The anterior approach to right hepatectomy using the liver hanging maneuver without liver mobilization claims to be anatomically evaluated. During this procedure a 4 to 6-cm blind dissection between the inferior vena cava and the liver is performed. Short subhepatic veins, entering the inferior vena cava could be torn and a hemorrhage, difficult to control, could occur. On 100 corrosive casts of livers the anterior surface of the inferior vena cava was studied to evaluate the position, diameter and draining area of short subhepatic veins and inferior right hepatic vein. The width of the narrowest point on the planned route of blind dissection was determined. The average value of the narrowest point on the planned route of blind dissection was 8.7+/-2.3mm (range 2-15mm). The ideal angle of dissection being 0 degrees was found in 93% of cases. In 7% we found the angle of 5 degrees toward the right border of inferior vena cava to be the better choice. Our results show that liver hanging maneuver is a safe procedure. With the dissection in the proposed route the risk of disrupting short subhepatic veins is low (7%).
Galvez, Carlos; Navarro-Martinez, Jose; Bolufer, Sergio; Lirio, Francisco; Sesma, Julio; Corcoles, Juan Manuel
Nonintubated procedures have widely developed during the last years, thus nowadays major anatomical resections are performed in spontaneously breathing patients in some centers. In an attempt for combining less invasive surgical approaches with less aggressive anesthesia, nonintubated uniportal video-assisted thoracic surgery (VATS) lobectomies and segmentectomies have been proved feasible and safe, but there are no comparative trials and the evidence is still poor. A program in nonintubated uniportal major surgery should be started in highly experienced units, overcoming first a learning period performing minor procedures and a training program for the management of potential crisis situations when operating on these patients. A multidisciplinary approach including all the professionals in the operating room (OR), emergency protocols and a comprehensive knowledge of the special physiology of nonintubated surgery are mandatory. Some concerns about regional analgesia, vagal block for cough reflex control and oxygenation techniques, combined with some specific surgical tips can make safer these procedures. Specialists must remember an essential global concept: all the efforts are aimed at decreasing the invasiveness of the whole procedure in order to benefit patients' intraoperative status and postoperative recovery.
Sakka, L; Chazal, J
The meninges correspond to an anatomical concept. For the morphologist, the microscopic organization, the hypothetical presence of a subdural space, the nature of the interface between the deep meningeal layer and the nervous parenchyma in the perivascular spaces are the central issues. For the clinician, dynamic aspects of cerebrospinal fluid flow, secretion, and resorption are essential factors with practical consequences in terms of disease and patient management. Comparative anatomy, embryology, and organogenesis provide an interesting perspective for the descriptive and functional anatomy of the meninges. Usually considered as protective membranes, the meninges play a prominent role in the development and maintenance of the central nervous system. The meninges are in constant evolution, from their formation to senescence. The meninges present three layers in children and adults: the dura mater, the arachnoid and the pia mater. The cerebrospinal fluid is secreted by the choroid plexuses, flows through the ventricles and the subarachnoid space, and is absorbed by arachnoid granulations. Other sites of secretion and resorption are suggested by comparative anatomy and human embryology and organogenesis.
Thistle, Jennifer J.; McNaughton, David
Purpose: This study examined the effect of instruction in an active listening strategy on the communication skills of pre-service speech-language pathologists (SLPs). Method: Twenty-three pre-service SLPs in their 2nd year of graduate study received a brief strategy instruction in active listening skills. Participants were videotaped during a…
Wolff, Antonio C.; Hammond, M. Elizabeth H.; Schwartz, Jared N.; Hagerty, Karen L.; Allred, D. Craig; Cote, Richard J.; Dowsett, Mitchell; Fitzgibbons, Patrick L.; Hanna, Wedad M.; Langer, Amy; McShane, Lisa M.; Paik, Soonmyung; Pegram, Mark D.; Perez, Edith A.; Press, Michael F.; Rhodes, Anthony; Sturgeon, Catharine; Taube, Sheila E.; Tubbs, Raymond; Vance, Gail H.; van de Vijver, Marc; Wheeler, Thomas M.; Hayes, Daniel F.
PURPOSE: To develop a guideline to improve the accuracy of human epidermal growth factor receptor 2 (HER2) testing in invasive breast cancer and its utility as a predictive marker. METHODS: The American Society of Clinical Oncology and the College of American Pathologists convened an expert panel,
Bedwinek, Anne P.; Kummer, Ann W.; Rice, Gale B.; Grames, Lynn Marty
Purpose: The purpose of this study was to obtain information regarding the education and experience of preschool and school-based speech-language pathologists (SLPs) regarding the assessment and treatment of children born with cleft lip and/or palate and to determine their continuing education needs in this area. Method: A 16-item mixed-methods…
Al-Dawaideh, Ahmad Mousa
Speech-language pathologists (SLPs) frequently work with people with severe communication disorders who require assistive technology (AT) for communication. The purpose of this study was to investigate the SLPs perceptions of the importance of and ability level required for using AT, and the relationship of AT with gender, level of education,…
Centers for Disease Control and Prevention, 2007
This accordion style pamphlet, dual sided with English and Spanish text, suggests questions for parents to ask their Speech-Language Pathologist and speech and language therapy services for their children. Sample questions include: How will I participate in my child's therapy sessions? How do you decide how much time my child will spend on speech…
Southwestern Region Deaf-Blind Center, Sacramento, CA.
The booklet offers five presentations from a 1975 special conference on the role of the psychologist, audiologist, and speech pathologist in working with the deaf-blind child. The first paper, "Meeting the Needs of the Severely Handicapped" by L. Hall, addresses the needs of special education, the role of administration in special education, and…
Pavement marking is important for safety. Maximizing pavement marking performance in terms of increased retroreflectivity, within limited budget constraints, allows agencies to make better decisions toward providing more effective pavement marking pe...
Full Text Available This study was aimed at determining intra and inter-observer concordance rates in the Gleason scoring of prostatic adenocarcinoma, before and after a web-based educational course. In this self-controlled study, 150 tissue samples of prostatic adenocarcinoma are re-examined to be scored according to the Gleason scoring system. Then all pathologists attend a free web-based course. Afterwards, the same 150 samples [with different codes compared to the previous ones] are distributed differently among the pathologists to be assigned Gleason scores. After gathering the data, the concordance rate in the first and second reports of pathologists is determined. In the pre web-education, the mean kappa value of Interobserver agreement was 0.25 [fair agreement]. Post web-education significantly improved with the mean kappa value of 0.52 [moderate agreement]. Using weighted kappa values, significant improvement was observed in inter-observer agreement in higher scores of Gleason grade; Score 10 was achieved for the mean kappa value in post web-education was 0.68 [substantial agreement] compared to 0.25 (fair agreement in pre web-education. Web-based training courses are attractive to pathologists as they do not need to spend much time and money. Therefore, such training courses are strongly recommended for significant pathological issues including the grading of the prostate adenocarcinoma. Through web-based education, pathologists can exchange views and contribute to the rise in the level of reproducibility. Such programs need to be included in post-graduation programs.
Sihn, Kyu Hwan
This paper aimed to examine the anatomical revolution from Yilingaicuo (Correcting the Errors of Medicine) and Quantixinlun(Outline of Anatomy and Physiology) in late imperial China. As the cephalocentrism which the brain superintend human operation of the mind was diffused in China since 16th century, the cephalocentrism and the cardiocentrism had competed for the hegemony of anatomical conception. Because of the advent of Yilingaicuo and Quantixinlun, the cephalocentrism became the main stream in the anatomical conception. The supporters of the Wang Yangming's Xinxue(the Learning of Heart and Mind) argued that the heart was the central organ of perception, sensitivity, and morality of the human body in medicine since 16th century. Even reformist and revolutionary intellectuals like Tan sitong and Mao zedong who had supported the Wang Yangming's Xinxue embraced the cephalocentrism in the late 19th century and the early 20th century. May Fourth intellectuals had not obsessed metaphysical interpretation of human body any more in the New Culture Movement in 1910s. They regarded human body as the object of research and writing. The anatomy was transformed into the instrumental knowledge for mutilation of the body. Yilingaicuo challenged the traditional conception of body, and Chinese intellectuals drew interest in the anatomy knowledge based on real mutilation. Quantixinlun based on Western medicine fueled a controversy about anatomy. Though new knowledge of anatomy was criticized by traditional Chinese medical doctors from the usefulness and morality of anatomy, nobody disavowed new knowledge of anatomy from the institutionalization of Western medicine in medical school. The internal development of cephalocentrism and positivism had influence on anatomy in China since 16th century. The advent of Yilingaicuo and Quantixinlun provided the milestone of new anatomy, though both sides represented traditional Chinese medicine and Western medicine respectively. They
Brass, Patrick; Hellmich, Martin; Kolodziej, Laurentius; Schick, Guido; Smith, Andrew F
Central venous catheters (CVCs) can help with diagnosis and treatment of the critically ill. The catheter may be placed in a large vein in the neck (internal jugular vein), upper chest (subclavian vein) or groin (femoral vein). Whilst this is beneficial overall, inserting the catheter risks arterial puncture and other complications and should be performed with as few attempts as possible. Traditionally, anatomical 'landmarks' on the body surface were used to find the correct place in which to insert catheters, but ultrasound imaging is now available. A Doppler mode is sometimes used to supplement plain 'two-dimensional' ultrasound. The primary objective of this review was to evaluate the effectiveness and safety of two-dimensional (imaging ultrasound (US) or ultrasound Doppler (USD)) guided puncture techniques for insertion of central venous catheters via the internal jugular vein in adults and children. We assessed whether there was a difference in complication rates between traditional landmark-guided and any ultrasound-guided central vein puncture.Our secondary objectives were to assess whether the effect differs between US and USD; whether the effect differs between ultrasound used throughout the puncture ('direct') and ultrasound used only to identify and mark the vein before the start of the puncture procedure (indirect'); and whether the effect differs between different groups of patients or between different levels of experience among those inserting the catheters. We searched the Central Register of Controlled Trials (CENTRAL) (2013, Issue 1), MEDLINE (1966 to 15 January 2013), EMBASE (1966 to 15 January 2013), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to 15 January 2013 ), reference lists of articles, 'grey literature' and dissertations. An additional handsearch focused on intensive care and anaesthesia journals and abstracts and proceedings of scientific meetings. We attempted to identify unpublished or ongoing studies
Coolant temperature coefficients for the Mark 22 charge published previously are non-conservative because of the neglect of a significant mechanism which has a positive contribution to reactivity. Even after correcting for this effect, dynamic tests made on a Mark VIB charge in the early 60's suggest the results are still non-conservative. This memorandum takes both of these sources of information into account in making a best estimate of the prompt (coolant plus metal) temperature coefficient. Although no safety issues arise from this work (the overall temperature coefficient still strongly contributes to reactor stability), it is obviously desirable to use best estimates for prompt coefficients in limits and other calculations
Guo, Chenjuan; Yang, Bin; Andersen, Ove
Eco-routing is a simple yet effective approach to substantially reducing the environmental impact, e.g., fuel consumption and greenhouse gas (GHG) emissions, of vehicular transportation. Eco-routing relies on the ability to reliably quantify the environmental impact of vehicles as they travel...... in a spatial network. The procedure of quantifying such vehicular impact for road segments of a spatial network is called eco-weight assignment. EcoMark 2.0 proposes a general framework for eco-weight assignment to enable eco-routing. It studies the abilities of six instantaneous and five aggregated models......, and experiments for assessing the utility of the impact models in assigning eco-weights. The application of EcoMark 2.0 indicates that the instantaneous model EMIT and the aggregated model SIDRA-Running are suitable for assigning eco-weights under varying circumstances. In contrast, other instantaneous models...
Malde, Harold E.
A photograph made with a level camera, if taken at a known height above a permanent mark on the ground, can be later repeated with exactness for measurement of changes in terrain. Such a photograph is one of several means for establishing a geologic bench mark and is especially useful for monitoring the subtle qualities of a landscape that are otherwise hard to map and describe, including the effects of man's use. Moreover, the geometry of such a photograph provides the same angular measurements between objects as can be made with a transit. A measurement of distance on a single photograph, however, requires control points. These can be surveyed at any convenient time, not necessarily when the initial photograph is made. Distances can also be determined by simple stereophotography from a base line of suitable length.
Hackel, Lloyd A.; Dane, C. Brent; Harris, Fritz
The invention is a method and apparatus for marking components by inducing a shock wave on the surface that results in an indented (strained) layer and a residual compressive stress in the surface layer. One embodiment of the laser peenmarking system rapidly imprints, with single laser pulses, a complete identification code or three-dimensional pattern and leaves the surface in a state of deep residual compressive stress. A state of compressive stress in parts made of metal or other materials is highly desirable to make them resistant to fatigue failure and stress corrosion cracking. This process employs a laser peening system and beam spatial modulation hardware or imaging technology that can be setup to impress full three dimensional patterns into metal surfaces at the pulse rate of the laser, a rate that is at least an order of magnitude faster than competing marking technologies.
Ten Raa, T.
Monopoly prices are too high. It is a price level problem, in the sense that the relative mark-ups have Ramsey optimal proportions, at least for independent constant elasticity demands. I show that this feature of monopoly prices breaks down the moment one demand is replaced by the textbook linear demand or, even within the constant elasticity framework, dependence is introduced. The analysis provides a single Generalized Inverse Elasticity Rule for the problems of monopoly, Pareto and Ramsey.
Snoj, L.; Smodis, B.
TRIGA Mark II research reactor at the Jozef Stefan Institute [JSI] is extensively used for various applications, such as: irradiation of various samples, training and education, verification and validation of nuclear data and computer codes, testing and development of experimental equipment used for core physics tests at a nuclear power plant. The paper briefly describes the aforementioned activities and shows that even such small reactors are still indispensable in nuclear science and technology. (author)
Bastue, Jens; Olsen, Flemmming Ove
with a thoroughly tested ray-tracing model is presented and compared with experimental results. Special emphasis is put on two different applications namely marking in metal with TEA-CO2 laser and marking in glass with excimer laser. The results are evaluated on the basis of the achievable energy enhancement......Today, mask based laser materials processing and especially marking is widely used. However, the energy efficiency in such processes is very low .This paper gives a review of the results, that may be obtained using the energy enhancing technique . Results of simulations performed...
Gunnal, Sandhya Arvind; Farooqui, Mujibuddin S; Wabale, Rajendra N
Although posterior communicating artery (PCoA) is a smaller branch of the internal carotid artery, it gives the main contribution in the formation of circle of Willis (CW) by communicating with the internal carotid arterial system and the vertebro-basilar arterial system. The size of PCoA varies frequently. The present work aims to study the PCoA regarding its morphology, morphometry, and symmetry. This study was conducted on 170 human cadaveric brains. Brains were dissected carefully and delicately to expose all components of CW, especially PCoA. Morphological variations of PCoA were noted along with its morphometry and symmetry. Morphological variations of PCoA were aplasia (3.52%), hypoplasia (25.29%), fenestration (0.58%), and persistent fetal pattern (16.47%). In the present study, we found the five different types of terminations of PCoA. Type I termination was the most common type, seen in 92.94% of cases, Type II termination was seen in 1.17%, Type III and Type IV terminations both were seen in 0.58%, and Type V was seen in 1.17%. The mean length of PCoA was 15.9 mm and 15.3 mm on the right and left sides, respectively. The mean diameter of PCoA was 2.1 mm and 1.9 mm on the right and left sides, respectively. Symmetry of PCoA was seen in 65.29% and asymmetric PCoA was seen in 34.70% of cases. The present study provides the complete description of PCoA regarding its morphology, symmetry, and morphometry. Awareness of these anatomical variations is important in neurovascular procedures.
Kutra, Dominik; Bergtholdt, Martin; Sabczynski, Jörg; Dössel, Olaf; Buelow, Thomas
Breast cancer is the most common cancer in women in the western world. In the breast cancer care-cycle, MRIis e.g. employed in lesion characterization and therapy assessment. Reading of a single three dimensional image or comparing a multitude of such images in a time series is a time consuming task. Radiological reporting is done manually by translating the spatial position of a finding in an image to a generic representation in the form of a breast diagram, outlining quadrants or clock positions. Currently, registration algorithms are employed to aid with the reading and interpretation of longitudinal studies by providing positional correspondence. To aid with the reporting of findings, knowledge about the breast anatomy has to be introduced to translate from patient specific positions to a generic representation. In our approach we fit a geometric primitive, the semi-super-ellipsoid to patient data. Anatomical knowledge is incorporated by fixing the tip of the super-ellipsoid to the mammilla position and constraining its center-point to a reference plane defined by landmarks on the sternum. A coordinate system is then constructed by linearly scaling the fitted super-ellipsoid, defining a unique set of parameters to each point in the image volume. By fitting such a coordinate system to a different image of the same patient, positional correspondence can be generated. We have validated our method on eight pairs of baseline and follow-up scans (16 breasts) that were acquired for the assessment of neo-adjuvant chemotherapy. On average, the location predicted and the actual location of manually set landmarks are within a distance of 5.6 mm. Our proposed method allows for automatic reporting simply by uniformly dividing the super-ellipsoid around its main axis.
Dave, Tarjani Vivek; Mohammed, Faraz Ali; Ali, Mohammad Javed; Naik, Milind N
Background The aim of this study was to assess the etiological factors contributing to the failure of a dacryocystorhinostomy (DCR). Patients and methods Retrospective review was performed in 100 consecutive patients who were diagnosed with anatomically failed DCR at presentation to a tertiary care hospital over a 5-year period from 2010 to 2015. Patient records were reviewed for demographic data, type of past surgery, preoperative endoscopic findings, previous use of adjuvants such as intubation and mitomycin C, and intraoperative notes during the re-revision. The potential etiological factors for failure were noted. Results Of the 100 patients with failed DCRs, the primary surgery was an external DCR in 73 and endoscopic DCR in 27 patients. Six patients in each group had multiple revisions. The mean ages at presentation in the external and endoscopic groups were 39.41 years and 37.19 years, respectively. All patients presented with epiphora. The most common causes of failure were inadequate osteotomy (69.8% in the external group and 85.1% in the endoscopic group, P=0.19) followed by inadequate or inappropriate sac marsupialization (60.2% in the external group and 77.7% in the endoscopic group, P=0.16) and cicatricial closure of the ostium (50.6% in the external group and 55.5% in the endoscopic group, P=0.83). The least common causes such as ostium granulomas and paradoxical middle turbinate (1.37%, n=1) were noted in the external group only. Conclusion Inadequate osteotomy, incomplete sac marsupialization, and cicatricial closure of the ostium were the most common causes of failure and did not significantly differ in the external and endoscopic groups. Meticulous evaluation to identify causative factors for failure and addressing them are crucial for subsequent successful outcomes. PMID:27555748
Gao, Yaozong; Shen, Dinggang
Anatomical landmark detection plays an important role in medical image analysis, e.g. for registration, segmentation and quantitative analysis. Among the various existing methods for landmark detection, regression-based methods have recently attracted much attention due to their robustness and efficiency. In these methods, landmarks are localised through voting from all image voxels, which is completely different from the classification-based methods that use voxel-wise classification to detect landmarks. Despite their robustness, the accuracy of regression-based landmark detection methods is often limited due to (1) the inclusion of uninformative image voxels in the voting procedure, and (2) the lack of effective ways to incorporate inter-landmark spatial dependency into the detection step. In this paper, we propose a collaborative landmark detection framework to address these limitations. The concept of collaboration is reflected in two aspects. (1) Multi-resolution collaboration. A multi-resolution strategy is proposed to hierarchically localise landmarks by gradually excluding uninformative votes from faraway voxels. Moreover, for informative voxels near the landmark, a spherical sampling strategy is also designed at the training stage to improve their prediction accuracy. (2) Inter-landmark collaboration. A confidence-based landmark detection strategy is proposed to improve the detection accuracy of ‘difficult-to-detect’ landmarks by using spatial guidance from ‘easy-to-detect’ landmarks. To evaluate our method, we conducted experiments extensively on three datasets for detecting prostate landmarks and head and neck landmarks in computed tomography images, and also dental landmarks in cone beam computed tomography images. The results show the effectiveness of our collaborative landmark detection framework in improving landmark detection accuracy, compared to other state-of-the-art methods. (paper)
Surikov, E V; Ivanets, I V
A fracture of nasal bones is becoming a very common injury due to the increasingly greater number of car accidents and aggravated criminal situation. A total of 500 cases of nasal fracture associated with external deformities were included in the present study. The following kinds of deformities were identified: unilateral retraction, lateral displacement of the entire dorsum of the nose, and depressed comminuted fracture. Rhinoscopy revealed in addition such abnormalities associated with septal fracture as submucous hemorrhage, pathological mobility of the pyramid, deflection of the nasal septum at an acute angle. All in all, four types of nasal septum fractures were distinguished depending on the shape and localization of the fracture line. Two of them resulted in marked impairment of nasal breathing while two others required surgical intervention in the acute period after the injury.
Mark Raidpere videod "Vekovka", "Dedication / Pühendus", "Majestoso Mystico" näitusel Pariisis Michel Reini galeriis. Osaleb koos saksa fotograafi Sven Johnega näitusel Napolis. Kreekas Thessalonikis valminud filmist "1:1:1"
Until the 1830s, most Americans were unfamiliar with the images of anatomy. Then a small vanguard of reformers and missionaries began to preach, at home and around the world, that an identification with the images and concepts of anatomy was a crucial part of the civilizing process. In his essay, Sappol charts the changes in the perception of self that resulted from this anatomical evangelism. Today, as anatomical images abound in the arts and the media, we still believe that anatomical images show us our inner reality.
Fujieda, Kaori; Okubo, Kosaku
The ongoing development of world wide web technologies has facilitated a change in health communication, which has now become bi-directional and encompasses people with diverse backgrounds. To enable an even greater role for medical illustrations, a data set, BodyParts3D, has been generated and its data set can be used by anyone to create and exchange customised three-dimensional (3D) anatomical images. BP3D comprises more than 3000 3D object files created by segmenting a digital mannequin in accordance with anatomical naming conventions. This paper describes the methodologies and features used to generate an anatomically correct male mannequin.
Girsowicz, Elie; Georg, Yannick; Lefebvre, François; Lejay, Anne; Thaveau, Fabien; Roy, Catherine; Ohana, Mickael; Chakfe, Nabil
With the steady increase of endovascular procedures involving the aortic arch (AA), an actual depiction of its anatomy has become mandatory. It has also become necessary to evaluate the natural evolution of the AA morphology as part of the evaluation of endovascular devices durability. The objective of this study was to perform a morphological and anatomical study of the AA and of the supra aortic trunks (SAT) in healthy patients, with an evaluation of their evolution with time, with a specific orientation applied to endovascular therapies of the AA. Sixty-one patients (31 men, mean age 50.8 [18-82]) with a normal anatomy were included in the study. Measurements included the diameters of the AA and SAT in 17 locations, their distance and angulation based on computed tomography angiography data. Statistical analysis focused on descriptive statistics, differences between genders, as well as correlations with age. Aortic diameters (mean ± SD) were 29.5 ± 3.9 mm at the ascending aorta, 28.6 ± 3.9 mm at the innominate artery (IA), 27.1 ± 3.2 mm at the left common carotid artery (LCCA), 25.3 ± 3.0 mm at the left subclavian artery (LSCA), 23.9 ± 3.3 mm at the descending aorta. Mean angulation of the AA was 82° (95% confidence interval [CI]: 78.95-85.19°), mean angulation between LSCA/LCCA was -5.7° (95% CI: -0.9 to 18.7°) and -1.8° (95% CI: 5.4-26.4°) between LCCA/IA. Mean distance between the LSCA and the LCCA was 14.3 mm (95% CI: 13-15.6 mm) and 21.8 mm (95% CI: 20.3-23.4 mm) between LCCA and IA. All diameters of the AA increased with age (P Men had diameters statistically (P women except at the LCCA ostium level. A statistically significant increase of the distances between the LSCA and the LCCA, between the LSCA and the IA and between the IA and the LCCA was found with age, P = 0.027, better understanding of the three-dimensional aspects of the AA, confirmed the variability and heterogeneity of the SAT disposition, and discussed the principles of vascular
Barker, T.M.; Young, J.
Full text: The Internet, and in particular, the World-Wide Web, has provided tremendous opportunities for enabling access and transfer of information. Traditionally, Internet services have relied on textual methods for delivery of information. The World-Wide Web (WWW) in its current (and ever-changing form) is primarily a method of communication which includes both graphical and textual information. The easy-to-use graphical interface, developed as part of the WWW, is based on the Hypertext Mark-up Language (HTML). More advanced interfaces can be developed by incorporating interactive documents, which can be updated depending upon the wishes of the user. The Common Gateway Interface (CGI) can be utilised to transfer information b y utilising various programming and scripting languages (eg. C, Perl). This paper describes the development of a WWW interface for the viewing of anatomical and radiographic information in the form of two-dimensional cross-sectional images and three-dimensional reconstruction images. HTML documents were prepared using a commercial software program (HotDog, Sausage Software Co., Australia). Forms were used to control user-selection parameters such as imaging modality and cross-sectional slice number. All documents were developed and tested using Netscape 2.0. Visual and radiographic images were processed using ANALYZE TM Version 7.5 (Biomedical Imaging Resource, Mayo Foundation, Rochester, USA). Perl scripting was used to process all requests passed to the WWW server. ANSI 'C' programming was used to implement image processing operations which are performed in response to user-selected options. The interface which has been developed is easy to use, is independent of browsing software, is accessible by multiple users, and provides an example of how easily medical imaging data can be distributed amongst interested parties. Various imaging datasets, including the Visible Human Project TM (National Library of Medicine, USA.) have been prepared
Suseno, H.; Daryoko, M.; Goeritno, A.
The TRIGA Mark II Reactor in the Centre for Research and Development Nuclear Technique Bandung has been partially decommissioned as part of an upgrading project. The upgrading project was carried out from 1995 to 2000 and is being commissioned in 2001. The decommissioning portion of the project included disassembly of some components of the reactor core, producing contaminated material. This contaminated material (grid plate, reflector, thermal column, heat exchanger and pipe) will be sent to the Decontamination Facility at the Radioactive Waste Management Development Centre. (author)
Abrams, G.; Baden, A.R.; Boyer, J.; Butler, F.; Drell, P.S.; Fay, J.; Gidal, G.; Goldhaber, G.; Haggerty, J.; Harr, R.; Hearty, C.; Herrup, D.; Holmgren, S.O.; Jaffre, M.; Juricic, I.; Kadyk, J.A.; Kral, J.F.; Levi, M.E.; Lynch, G.R.; Richman, J.D.; Rouse, F.R.; Schaad, M.W.; Schmidke, W.B.; Schumm, B.A.; Trilling, G.H.; Wood, D.R.; Akerlof, C.; Bonvicini, G.; Chapman, J.; Chmeissani, M.; Frey, R.; Gero, E.; Hong, S.J.; Koska, W.; Nitz, D.; Petradza, M.; Thun, R.; Tschirhart, R.; Veltman, H.; Alexander, J.P.; Ballam, J.; Barklow, T.; Bartelt, J.; De Boer, W.; Boyarski, A.; Braune, K.; Bulos, F.; Burke, D.L.; Cords, D.; Coupal, D.P.; Destaebler, H.C.; Dorfan, J.M.; Feldman, G.J.; Fernandes, D.; Field, R.C.; Fordham, C.; Fujino, D.; Gan, K.K.; Glanzman, T.; Grosse-Wiesmann, P.; Hanson, G.; Hayes, K.; Himel, T.; Hutchinson, D.; Innes, W.R.; Jacobsen, R.G.; Jaros, J.A.; Jung, C.K.; Karlen, D.; Klein, S.R.; Koetke, D.; Komamiya, M.; Kowalski, L.A.; Kozanecki, W.; Lankford, A.J.; Larsen, R.R.; Lueth, V.; Mattison, T.; Moffeit, K.C.; Mueller, L.; Munger, C.T.; Nash, J.; Ong, R.A.; O'Shaughnessy, K.F.; Perl, J.; Perl, M.L.; Perrier, F.; Petersen, A.; Pitthan, R.; Riles, K.; Swartz, M.; Taylor, R.E.; Van Kooten, R.; Voruganti, P.; Weigend, A.; Woods, M.; Wormser, G.; Wright, R.; Alvarez, M.; Calvino, F.; Fernandez, E.; Ford, W.T.; Hinshaw, D.A.; Rankin, P.; Smith, J.G.; Wagner, S.R.; Weber, P.; White, S.L.; Averill, D.; Blockus, D.; Brabson, B.; Brom, J.M.; Murray, W.N.; Ogren, H.; Rust, D.R.; Snyder, A.; Yurko, M.; Barish, B.C.; Hawkes, C.M.; Hoenk, M.; Kuhlen, M.; Li, Z.; McKenna, J.A.; Milliken, B.D.; Nelson, M.E.; Peck, C.; Porter, F.C.; Soderstrom, E.; Stroynowski, R.; Weinstein, A.J.; Weir, A.J.; Wicklund, E.; Wolf, R.C.; Wu, D.Y.; Barnett, B.A.; Boswell, C.; Dauncey, P.; Drewer, D.C.; Harral, B.; Hylen, J.; Matthews, J.A.J.; Stoker, D.P.; Vejcik, S.; Breakstone, A.; Cence, R.J.; Gong, X.; Harris, F.A.; Koide, A.; Parker, S.I.; Green, A.; Lawrence Berkeley Lab., CA; California Univ., Berkeley
The Mark II detector has been upgraded in preparation for its role as the first detector to take data at the Stanford Linear Collider. The new detector components include the central drift chamber, the time-of-flight system, the coil, the endcap electromagnetic calorimeters and the beam energy and luminosity measuring devices. There have also been improvements in detector hermeticity. All of the major components were installed for a test run at the PEP storage ring (√s=29 GeV) in 1985. This paper describes the upgraded detector, including its trigger and data acquisition systems, and gives performance figures for its components. Future improvements are also discussed. (orig.)
Lin, Ansheng, E-mail: firstname.lastname@example.org; Chen, Yen-Shu; Yuann, Yng-Ruey
Highlights: • The Kuosheng Mark III containment model is established using GOTHIC. • Containment pressure and temperature responses due to LOCA are presented. • The calculated results are all below the design values and compared with the FSAR results. • The calculated results can be served as an analysis reference for an SPU project in the future. -- Abstract: Kuosheng nuclear power plant in Taiwan is a twin-unit BWR/6 plant, and both units utilize the Mark III containment. Currently, the plant is performing a stretch power uprate (SPU) project to increase the core thermal power to 103.7% OLTP (original licensed thermal power). However, the containment response in the Kuosheng Final Safety Analysis Report (FSAR) was completed more than twenty-five years ago. The purpose of this study is to establish a Kuosheng Mark III containment model using the containment program GOTHIC. The containment pressure and temperature responses under the design-basis accidents, which are the main steam line break (MSLB) and the recirculation line break (RCLB) accidents, are investigated. Short-term and long-term analyses are presented in this study. The short-term analysis is to calculate the drywell peak pressure and temperature which happen in the early stage of the LOCAs. The long-term analysis is to calculate the peak pressure and temperature of the reactor building space. In the short-term analysis, the calculated peak drywell to wetwell differential pressure is 140.6 kPa for the MSLB, which is below than the design value of 189.6 kPa. The calculated peak drywell temperature is 158 °C, which is still below the design value of 165.6 °C. In addition, in the long-term analysis, the calculated peak containment pressure is 47 kPa G, which is below the design value of 103.4 kPa G. The calculated peak values of containment temperatures are 74.7 °C, which is lower than the design value of 93.3 °C. Therefore, the Kuosheng Mark III containment can maintain the integrity after
Jared, R.C.; Haggerty, J.S.; Herrup, D.A.; Kirsten, F.A.; Lee, K.L.; Olson, S.R.; Wood, D.R.
An end cap calorimeter system has been added to the MARK II detector in preparation for its use at the SLAC Linear Collider. The calorimeter uses 8744 rectangular proportional counter tubes. This paper describes the design features of the data acquisition electronics that has been installed on the calorimeter. The design and use of computer-based test stands for the amplification and signal-shaping components is also covered. A portion of the complete system has been tested in a beam at SLAC. In these initial tests, using only the calibration provided by the test stands, a resolution of 18%/√E was achieved
A Review of the Published Anatomical Research on the African Giant Rat ... of their anatomy and morphophysiology however, the scientific bases for these ... conference proceedings and unpublished research dissertations and thesis. All data ...
Hou, Weibin; Yan, Weigang; Ji, Zhigang
Nephrometry score systems, including RENAL nephrometry, preoperative aspects and dimensions used for an anatomical classification system, C-index, diameter-axial-polar nephrometry, contact surface area score, calculating resected and ischemized volume, renal tumor invasion index, surgical approach renal ranking score, zonal NePhRO score, and renal pelvic score, have been reviewed. Moreover, salient anatomic features like the perinephric fat and vascular variants also have been discussed. We then extract 7 anatomic characteristics, namely tumor size, spatial location, adjacency, exophytic/endophytic extension, vascular variants, pelvic anatomy, and perinephric fat as important features for partial nephrectomy. For novice surgeons, comprehensive and adequate anatomic consideration may help them in their early clinical practice. Copyright © 2015 Elsevier Inc. All rights reserved.
anatomical structure of each human female body. Hassen ... pregnancy ovaries become really slightly displaced they would keep the proposed three- ... ovarian ligament, which anchors the ovary to the uterus; and the suspensory ligament,.
Kachlik, David; Baca, Vaclav; Bozdechova, Ivana; Cech, Pavel; Musil, Vladimir
The anatomical terminology is a base for medical communication. It is elaborated into a nomenclature in Latin. Its history goes back to 1895, when the first Latin anatomical nomenclature was published as Basiliensia Nomina Anatomica. It was followed by seven revisions (Jenaiensia Nomina Anatomica 1935, Parisiensia Nomina Anatomica 1955, Nomina Anatomica 2nd to 6th edition 1960-1989). The last revision, Terminologia Anatomica, (TA) created by the Federative Committee on Anatomical Terminology and approved by the International Federation of Associations of Anatomists, was published in 1998. Apart from the official Latin anatomical terminology, it includes a list of recommended English equivalents. In this article, major changes and pitfalls of the nomenclature are discussed, as well as the clinical anatomy terms. The last revision (TA) is highly recommended to the attention of not only teachers, students and researchers, but also to clinicians, doctors, translators, editors and publishers to be followed in their activities.
Hutchcroft, Will; Wang, Guobao; Chen, Kevin T; Catana, Ciprian; Qi, Jinyi
This paper extends the kernel method that was proposed previously for dynamic PET reconstruction, to incorporate anatomical side information into the PET reconstruction model. In contrast to existing methods that incorporate anatomical information using a penalized likelihood framework, the proposed method incorporates this information in the simpler maximum likelihood (ML) formulation and is amenable to ordered subsets. The new method also does not require any segmentation of the anatomical image to obtain edge information. We compare the kernel method with the Bowsher method for anatomically-aided PET image reconstruction through a simulated data set. Computer simulations demonstrate that the kernel method offers advantages over the Bowsher method in region of interest quantification. Additionally the kernel method is applied to a 3D patient data set. The kernel method results in reduced noise at a matched contrast level compared with the conventional ML expectation maximization algorithm.
Young, Bruce A
Many reptiles, and other vertebrates, have internally coupled ears in which a patent anatomical connection allows pressure waves generated by the displacement of one tympanic membrane to propagate (internally) through the head and, ultimately, influence the displacement of the contralateral tympanic membrane. The pattern of tympanic displacement caused by this internal coupling can give rise to novel sensory cues. The auditory mechanics of reptiles exhibit more anatomical variation than in any other vertebrate group. This variation includes structural features such as diverticula and septa, as well as coverings of the tympanic membrane. Many of these anatomical features would likely influence the functional significance of the internal coupling between the tympanic membranes. Several of the anatomical components of the reptilian internally coupled ear are under active motor control, suggesting that in some reptiles the auditory system may be more dynamic than previously recognized.
Sezan, M.I.; Minerbo, G.N.; Schaetzing, R.
The authors develop a technique for automatic anatomically selective enhancement of digital chest radiographs. Anatomically selective enhancement is motivated by the desire to simultaneously meet the different enhancement requirements of the lung field and the mediastinum. A recent peak detection algorithm and a set of rules are applied to the image histogram to determine automatically a gray-level threshold between the lung field and mediastinum. The gray-level threshold facilitates anatomically selective gray-scale modification and/or unsharp masking. Further, in an attempt to suppress possible white-band or black-band artifacts due to unsharp masking at sharp edges, local-contrast adaptivity is incorporated into anatomically selective unsharp masking by designing an anatomy-sensitive emphasis parameter which varies asymmetrically with positive and negative values of the local image contrast
... 46 Shipping 3 2010-10-01 2010-10-01 false Hull markings. 78.50-5 Section 78.50-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS OPERATIONS Markings on Vessels § 78.50-5 Hull markings. Vessels shall be marked as required by parts 67 and 69 of this chapter. [CGD 72...
... 46 Shipping 7 2010-10-01 2010-10-01 false Hull markings. 196.40-5 Section 196.40-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS OPERATIONS Markings on Vessels § 196.40-5 Hull markings. Vessels shall be marked as required by parts 67 and 69 of this chapter...
... 46 Shipping 4 2010-10-01 2010-10-01 false Hull markings. 97.40-5 Section 97.40-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS OPERATIONS Markings on Vessels § 97.40-5 Hull markings. Vessels shall be marked as required by parts 67 and 69 of this...
Bie, Jing; Lo, Hong K.; Wong, S.C.
This paper compares two types of circulatory markings at a double-lane traffic roundabout: the concentric marking scheme and the Alberta marking scheme. The effects of these two marking schemes on drivers' lane choice behavior, delay, and safety, are compared based on data collected from before and
Rutten, Matthieu J.C.M. [Department of Radiology, Jeroen Bosch Hospital, Nieuwstraat 34, 5211 NL ' s-Hertogenbosch (Netherlands)]. E-mail: M.Rutten@JBZ.nl; Maresch, Bas J. [Department of Radiology, Hospital Gelderse Vallei, Willy Brandtlaan 10, 6710 HN Ede (Netherlands)]. E-mail: MareschB@zgv.nl; Jager, Gerrit J. [Department of Radiology, Jeroen Bosch Hospital, Nieuwstraat 34, 5211 NL ' s-Hertogenbosch (Netherlands)]. E-mail: G.Jager@JBZ.nl; Blickman, Johan G. [Department of Radiology, University Medical Center Nijmegen, Geert Grooteplein Zuid 18, 6500 HB Nijmegen (Netherlands)]. E-mail: J.Blickman@rad.umcn.nl; Holsbeeck, Marnix T. van [Department of Radiology, Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI 48202 (United States)]. E-mail: email@example.com
Magnetic resonance imaging and high-resolution ultrasound (US) are frequently used for the detection of rotator cuff tears. The diagnostic yield of US is influenced by several factors as technique, knowledge of the imaging characteristics of anatomic and pathologic findings and of pitfalls. The purpose of this article is to illustrates that the standardized high-resolution US examination of the shoulder covers the entire rotator cuff and correlates with MR imaging and anatomic sections.
Rubini, Giuseppe; Antonica, Filippo; Renna, Maria Antonia; Ferrari, Cristina; Iuele, Francesca; Stabile Ianora, Antonio Amato; Losco, Matteo; Niccoli Asabella, Artor
Nuclear medicine images are difficult to interpret because they do not include anatomical details. The aim of this study was to obtain lymphoscintigrams with anatomical landmarks that could be easily interpreted by General Physicians. Traditional lymphoscintigrams were processed with Adobe© Photoshop® CS6 and converted into vector images created by Illustrator®. The combination with a silhouette vector improved image interpretation, without resulting in longer radiation exposure or acquisition times.
Guillermo Adrián Rivera-Cardona
Full Text Available The obturator artery is one of the parietal branches arising from the internal iliac artery, the anatomical variation from which this artery originates is called “The corona mortis”, generally from the external iliac artery or the inferior epigastric artery. This finding was observed bilaterally in a male cadaver during a pelvis dissection. Clinical consideration of the anatomical variation in the obturator artery, during surgical procedures, is of great importance due to the risk of pelvic hemorrhage.
Koehler, Paul E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
This presentation includes General Design Considerations; Current (Mark-III) Lower Tier; Mark-III Upper Tier; Performance Metrics; General Improvements for Material Science; General Improvements for Nuclear Science; Improving FOM for Nuclear Science; General Design Considerations Summary; Design Optimization Studies; Expected Mark-IV Performance: Material Science; Expected Mark-IV Performance: Nuclear Science (Disk); Mark IV Enables Much Wider Range of Nuclear-Science FOM Gains than Mark III; Mark-IV Performance Summary; Rod or Disk? Center or Real FOV?; and Project Cost and Schedule.
He Xiangming; Yan Yushun; Zhang Quanrong
Nuclear particle track-etched anti-bogus mark is a new type of forgery-proof product after engraving gravure printing, thermocolour, fluorescence, laser hologram and metal concealed anti-bogus mark. The mark is manufactured by intricate high technology and the state strictly controlled sensitive nuclear facilities to ensure the mark not to be copied. The pattern of the mark is specially characterized by permeability of liquid to be discriminated from forgery. The genuine mark can be distinguished from sham one by transparent liquid (e.g. water), colorful pen and chemical reagent. The mark has passed the official examination of health safety. It is no danger of nuclear irradiation. (author)
Turmezei, Tom D
Previous research focusing on Classical Latin and Greek roots has shown that understanding the etymology of English anatomical terms may be beneficial for students of human anatomy. However, not all anatomical terms are derived from Classical origins. This study aims to explore the linguistic roots of the Modern English terminology used in human gross anatomy. By reference to the Oxford English Dictionary, etymologies were determined for a lexicon of 798 Modern English gross anatomical terms from the 40(th) edition of Gray's Anatomy. Earliest traceable language of origin was determined for all 798 terms; language of acquisition was determined for 747 terms. Earliest traceable languages of origin were: Classical Latin (62%), Classical Greek (24%), Old English (7%), Post-Classical Latin (3%), and other (4%). Languages of acquisition were: Classical Latin (42%), Post-Classical Latin (29%), Old English (8%), Modern French (6%), Classical Greek (5%), Middle English (3%), and other (7%). While the roots of Modern English anatomical terminology mostly lie in Classical languages (accounting for the origin of 86% of terms), the anatomical lexicon of Modern English is actually much more diverse. Interesting and perhaps less familiar examples from these languages and the methods by which such terms have been created and absorbed are discussed. The author suggests that awareness of anatomical etymologies may enhance the enjoyment and understanding of human anatomy for students and teachers alike. Copyright © 2012 Wiley Periodicals, Inc.
Hegdé, Jay; Felleman, Daniel J
The primate visual system has been shown to be organized into an anatomical hierarchy by the application of a few principled criteria. It has been widely assumed that cortical visual processing is also hierarchical, with the anatomical hierarchy providing a defined substrate for clear levels of hierarchical function. A large body of empirical evidence seemed to support this assumption, including the general observations that functional properties of visual neurons grow progressively more complex at progressively higher levels of the anatomical hierarchy. However, a growing body of evidence, including recent direct experimental comparisons of functional properties at two or more levels of the anatomical hierarchy, indicates that visual processing neither is hierarchical nor parallels the anatomical hierarchy. Recent results also indicate that some of the pathways of visual information flow are not hierarchical, so that the anatomical hierarchy cannot be taken as a strict flowchart of visual information either. Thus, while the sustaining strength of the notion of hierarchical processing may be that it is rather simple, its fatal flaw is that it is overly simplistic.
Morabito, E; Zendri, E; Piazza, R; Ganzerla, R; Montalbani, S; Marcoleoni, E; Bonetto, F; Scandella, A; Barbante, C; Gambaro, A
Atmospheric pollutants may cause damage to monuments and historical buildings. Besides air contaminants, soluble salts are also responsible for stone deterioration and decay in outdoor and indoor monuments. The problem of how to conserve works of arts thus requires a deep knowledge of contaminants' concentration and distribution inside buildings. In this work, water-soluble ions inside St. Mark's Basilica in Venice were studied, with the aim of understanding their principal source and distribution inside the building. With the aid of Fourier transform infrared spectroscopy and scanning electron microscopy analysis, the interaction between ions and surface's material was also investigated. Ion chromatographic analysis of depositions highlighted a large amount of "deteriorating agents" such as sulphates and chlorides. A possible source in the innermost area of the basilica has been found for formates and nitrates. On the contrary, a decrease of chloride, from the entrance to the innermost area, has been found, which indicates that the source is outside the building. It is emphasized that different contaminants behave differently on different material, and the effect of pollution inside churches and monuments is not easy to predict. Wood and brick seem to react differently than stone and mortar to the damaging action of salts and pollutants. The present work should be considered a useful tool for the future preservation of St. Mark's Basilica in Venice.
Pernu, Tuomas K.
The mental realm seems different to the physical realm; the mental is thought to be dependent on, yet distinct from the physical. But how, exactly, are the two realms supposed to be different, and what, exactly, creates the seemingly insurmountable juxtaposition between the mental and the physical? This review identifies and discusses five marks of the mental, features that set characteristically mental phenomena apart from the characteristically physical phenomena. These five marks (intentionality, consciousness, free will, teleology, and normativity) are not presented as a set of features that define mentality. Rather, each of them is something we seem to associate with phenomena we consider mental, and each of them seems to be in tension with the physical view of reality in its own particular way. It is thus suggested how there is no single mind-body problem, but a set of distinct but interconnected problems. Each of these separate problems is analyzed, and their differences, similarities and connections are identified. This provides a useful basis for future theoretical work on psychology and philosophy of mind, that until now has too often suffered from unclarities, inadequacies, and conflations. PMID:28736537
Geller, Elaine; Foley, Gilbert M
To outline an expanded framework for clinical practice in speech-language pathology. This framework broadens the focus on discipline-specific knowledge and infuses mental health constructs within the study of communication sciences and disorders, with the objective of expanding the potential "ports or points of entry" (D. Stern, 1995) for clinical intervention with young children who are language impaired. Specific mental health constructs are highlighted in this article. These include relationship-based learning, attachment theory, working dyadically (the client is the child and parent), reflective practice, transference-countertransference, and the use of self. Each construct is explored as to the way it has been applied in traditional and contemporary models of clinical practice. The underlying premise in this framework is that working from a relationally based and reflective perspective augments change and growth in both client and parent(s). The challenge is for speech-language pathologists to embed mental health constructs within their discipline-specific expertise. This leads to paying attention to both observable aspects of clients' behaviors as well as their internal affective states.
Friderike Schmidt von Wûhlisch
Full Text Available Limited research has been carried out in the field of speech-language pathology with regard to ways of maximising health literacy and client recall. However, speech-language pathologists (SLPs frequently provide vast amounts of information that clients need to understand, apply and review in order to manage their (or their child’s health. This exploratory study aimed to contribute information about ways in which SLPs can overcome low health literacy and poor client recall so that treatment effectiveness is improved. A case-study design was used with specific focus on four clients receiving treatment for dysphagia, voice disorders (including laryngectomies and cleft lip and/or palate management in Cape Town. Strategies which may be able to maximise health literacy and client recall of clinical information were trialled and evaluated by clients and their SLPs, using semi-structured interviews. The researchers proposed a combination of high-tech strategies which assisted in all the cases. No single solution or universal tool was found that would be appropriate for all. There is a need to evaluate the long-term effectiveness of the combined strategies across a wider population, at different stages of rehabilitation and in diverse contexts. Implications and suggestions for future related research are presented.
Preuss, Johanna; Madea, Burkhard
Twenty years after the Second World War the public were made aware of War Crimes committed by the German forensic pathologist, Gerhart Panning (1900-1944). From 1942 till 1944, Panning was professor at the Institute of Forensic Medicine at the University of Bonn. Panning died of tuberculosis on 22 March 1944. After the Second World War, Panning's widow tried to obtain denazification for her husband. There were no particularly serious doubts. In 1965, Konrad Graf von Moltke, the son of Helmuth James Graf von Moltke (1907-1944), presented to the court a private letter from his father to his mother. In this letter, written in 1941, Panning's experiments on Soviet prisoners are described. In the so-called Callsen trial in the court of Darmstadt from 1960 to 1968, the experiments were confirmed by witnesses. In 1941, Panning performed experiments in cooperation with the Sicherheitsstaffel (Nazi special police) in the Ukraine to prove that captured ammunition of the soviet infantry violated international law. For this purpose, different parts of the bodies of living Soviets were used as firing targets. He published the results of these experiments in a scientific journal without any evidence of the origin of these observations. In this article, Panning's life and crimes have been described.
Siegel, Ellin B; Maddox, Laura L; Ogletree, Billy T; Westling, David L
Speech-language pathologists in school settings were surveyed with an instrument created from the National Joint Committee for the Communication Needs of Persons with Severe Disabilities' quality indicators self-assessment tool. Participants valued practice indicators of quality communication assessment and intervention to a higher degree than their actual practice. These findings appear to suggest that SLPs may not provide best practice services to individuals with severe disabilities. Suggestions for enhancing inservice training and intervention practices of SLPs and team members who work with individuals with severe disabilities are provided. The reader will be able to; (1) understand the value of using the NJC quality indicators to guide SLP practices with individuals with severe disabilities in schools; (2) recognize that research indicates that SLPs working with individuals with severe disabilities in schools may not provide best practice services to the extent that they value these practices; (3) discuss possible strategies to increase the quality of services provided to individuals with severe disabilities in schools.
van Kleeck, Anne
The need for speech-language pathologists (SLPs) to consider an academic talk (AT) register in addition to an everyday casual talk (CT) register of oral language with children beginning in the preschool years is presented, the AT and CT registers are distinguished in a comprehensive manner, ideas regarding AT language assessment are proposed, and suggestions for fostering children's skills with the AT register are offered. Extant research and scholarship from a wide variety of disciplines are integrated and organized. The author discusses the role of the SLP in supporting AT skills beginning in the preschool years and the added risk of difficulties with the AT register for children with language impairment who are from diverse backgrounds. Two broad categories-social-interactive and cognitive-that give rise to linguistic features that differentiate between the CT and AT registers are deduced from extant scholarship. SLPs should consider children's competence with the AT register as they work to prepare preschoolers and older children for the language demands of school.
The prevalence of autism spectrum disorder (ASD) has increased significantly in the last decade as have treatment choices. Nonetheless, the vastly diverse autism topic includes issues related to naming, description, iden-tification, assessment, and differentiation from other neu-rodevelopmental conditions. ASD issues directly impact speech-language pathologists (SLPs) who often see these children as the second contact, after pediatric medical practitioners. Because of shared symptomology, differentiation among neurodevelopmental disorders is crucial as it impacts treatment, educational choices, and the performance trajectory of affected children. To highlight issues in: identification and differentiation of ASD from other communication and language challenges, the prevalence differences between ASD gender phenotypes, and the insufficient consideration of cultural factors in evaluating ASD in children. A second objective was to propose a tool to assist SLPs in the management of autism in children. A universal resource toolkit development project for SLP communities at large is proposed. The resource is comprised of research-based observation and screening tools for caregivers and educators, as well as parent questionnaires for portraying the children's function in the family, cultural com-munity, and educational setting. © 2017 S. Karger AG, Basel.
Waag, Sonja; Stoffel, Michael H; Spadavecchia, Claudia; Eichenberger, Urs; Rohrbach, Helene
The sheep is a popular animal model for human biomechanical research involving invasive surgery on the hind limb. These painful procedures can only be ethically justified with the application of adequate analgesia protocols. Regional anaesthesia as an adjunct to general anaesthesia may markedly improve well-being of these experimental animals during the postoperative period due to a higher analgesic efficacy when compared with systemic drugs, and may therefore reduce stress and consequently the severity of such studies. As a first step 14 sheep cadavers were used to establish a new technique for the peripheral blockade of the sciatic and the femoral nerves under sonographic guidance and to evaluate the success rate by determination of the colorization of both nerves after an injection of 0.5 mL of a 0.1% methylene blue solution. First, both nerves were visualized sonographically. Then, methylene blue solution was injected and subsequently the length of colorization was measured by gross anatomical dissection of the target nerves. Twenty-four sciatic nerves were identified sonographically in 12 out of 13 cadavers. In one animal, the nerve could not be ascertained unequivocally and, consequently, nerve colorization failed. Twenty femoral nerves were located by ultrasound in 10 out of 13 cadavers. In three cadavers, signs of autolysis impeded the scan. This study provides a detailed anatomical description of the localization of the sciatic and the femoral nerves and presents an effective and safe yet simple and rapid technique for performing peripheral nerve blocks with a high success rate.
Hoogeveen, R C; van der Stelt, P F; Berkhout, W E R
Lateral cephalograms in orthodontic practice display an area cranial of the base of the skull that is not required for diagnostic evaluation. Attempts have been made to reduce the radiation dose to the patient using collimators combining the shielding of the areas above the base of the skull and below the mandible. These so-called "wedge-shaped" collimators have not become standard equipment in orthodontic offices, possibly because these collimators were not designed for today's combination panoramic-cephalometric imaging systems. It also may be that the anatomical variability of the area below the mandible makes this area unsuitable for standardized collimation. In addition, a wedge-shaped collimator shields the cervical vertebrae; therefore, assessment of skeletal maturation, which is based on the stage of development of the cervical vertebrae, cannot be performed. In this report, we describe our investigations into constructing a collimator to be attached to the cephalostat and shield the cranial area of the skull, while allowing the visualization of diagnostically relevant structures and markedly reducing the size of the irradiated area. The shape of the area shielded by this "anatomically shaped cranial collimator" (ACC) was based on mean measurements of cephalometric landmarks of 100 orthodontic patients. It appeared that this collimator reduced the area of irradiation by almost one-third without interfering with the imaging system or affecting the quality of the image. Further research is needed to validate the clinical efficacy of the collimator.
The K Basin Spent Nuclear Fuel (SNF) Project Multi-Canister Overpack (MCO) subprojection eludes the design and fabrication of a canister that will be used to confine, contain, and maintain fuel in a critically safe array to enable its removal from the K Basins, vacuum drying, transport, staging, hot conditioning, and interim storage (Goldinann 1997). Each MCO consists of a shell, shield plug, fuel baskets (Mark IA or Mark IV), and other incidental equipment. The Mark IA intact and scrap fuel baskets are a safety class item for criticality control and components necessary for criticality control will be constructed from 304L stainless steel. It is proposed that a copper divider subassembly be used in both Mark IA and Mark IV scrap baskets to increase the safety basis margin during cold vacuum drying. The use of copper would increase the heat conducted away from hot areas in the baskets out to the wall of the MCO by both radiative and conductive heat transfer means. Thus copper subassembly will likely be a safety significant component of the scrap fuel baskets. This report examines the structural, cost and corrosion consequences associated with using a copper subassembly in the stainless steel MCO scrap fuel baskets
Full Text Available Background: MAP/microtubule affinity-regulating kinase 4 (MARK4 is a serine-threonine kinase expressed in two spliced isoforms, MARK4L and MARK4S, of which MARK4L is a candidate for a role in neoplastic transformation. Methods: We performed mutation analysis to identify sequence alterations possibly affecting MARK4 expression. We then investigated the MARK4L and MARK4S expression profile in 21 glioma cell lines and 36 tissues of different malignancy grades, glioblastoma-derived cancer stem cells (GBM CSCs and mouse neural stem cells (NSCs by real-time PCR, immunoblotting and immunohistochemistry. We also analyzed the sub-cellular localisation of MARK4 isoforms in glioma and normal cell lines by immunofluorescence. Results: Mutation analysis rules out sequence variations as the cause of the altered MARK4 expression in glioma. Expression profiling confirms that MARK4L is the predominant isoform, whereas MARK4S levels are significantly decreased in comparison and show an inverse correlation with tumour grade. A high MARK4L/MARK4S ratio also characterizes undifferentiated cells, such as GBM CSCs and NSCs. Accordingly, only MARK4L is expressed in brain neurogenic regions. Moreover, while both MARK4 isoforms are localised to the centrosome and midbody in glioma and normal cells, the L isoform exhibits an additional nucleolar localisation in tumour cells. Conclusions: The observed switch towards MARK4L suggests that the balance between the MARK4 isoforms is carefully guarded during neural differentiation but may be subverted in gliomagenesis. Moreover, the MARK4L nucleolar localisation in tumour cells features this MARK4 isoform as a nucleolus-associated tumour marker.
Hwang, Dooseong; Jeong, Gyeonghwan; Moon, Jeikwon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)
The first research reactor in Korea, KRR 1, is a TRIGA Mark II type with open pool and fixed core. Its power was 100 kWth at its construction and it was upgraded to 250 kWth. Its construction was started in 1957. The first criticality was reached in 1962 and it had been operated for 36,000 hours. The second reactor, KRR 2, is a TRIGA Mark III type with open pool and movable core. These reactors were shut down in 1995, and the decision was made to decommission both reactors. The aim of the decommissioning activities is to decommission the KRR 2 reactor and decontaminate the residual building structures and site, and to release them as unrestricted areas. The KRR 1 reactor was decided to be preserve as a historical monument. A project was launched for the decommissioning of these reactors in 1997, and approved by the regulatory body in 2000. A total budget for the project was 20.0 million US dollars. It was anticipated that this project would be completed and the site turned over to KEPCO by 2010. However, it was discovered that the pool water of the KRR 1 reactor was leaked into the environment in 2009. As a result, preservation of the KRR 1 reactor as a monument had to be reviewed, and it was decided to fully decommission the KRR 1 reactor. Dismantling of the KRR 1 reactor takes place from 2011 to 2014 with a budget of 3.25 million US dollars. The scope of the work includes licensing of the decommissioning plan change, removal of pool internals including the reactor core, removal of the thermal and thermalizing columns, removal of beam port tubes and the aluminum liner in the reactor tank, removal of the radioactive concrete (the entire concrete structure will not be demolished), sorting the radioactive waste (concrete and soil) and conditioning the radioactive waste for final disposal, and final statuses of the survey and free release of the site and building, and turning over the site to KEPCO. In this paper, the current status of the TRIGA Mark-II type reactor
Kumasaka, K; Yanai, M; Hosokawa, N; Iwasaki, Y; Hoshino, T; Arashima, Y; Hayashi, K; Murakami, J; Tsuchiya, T; Kawano, K
To identify our role and the customers' satisfaction, the on-call consultation service records of the Department of Clinical Pathology, Nihon University School of Medicine, Itabashi Hospital (NUIH), were analyzed. Between 1995 and 1998, 1,789 consultation services were recorded, and approximately 40% were from physicians, and 50% were from medical technologists. During office hours, many physicians made contact with us at the office of clinical pathology, the clinical laboratory and other places in the hospital by various means. They asked us to interpret multidisciplinary laboratory data, and to provide the specific information that might affect clinical management. Medical technologists asked for clinical information of patients with extreme measured values and requested that we contact with physicians. In contrast, on weekends/holidays or after routine working hours, physicians sometimes requested non-automated laboratory tests such as peripheral blood smears/bone marrow smears or Gram stains. The major contents of our responses to medical technologists were concerned with blood banking and handling of instruments not to be operated in routine work. These results reconfirm that we are still required to have clinical competence for common laboratory procedures and to have the capability of interpretation of multidisciplinary laboratory data in the university hospital. Traditionally, most Japanese clinical pathologists have been focused their attention on bench work in research laboratories. However, the present study shows that the clinical pathologists need to bridge the real gap between laboratory technology and patient care. Our on-call service system can enhance the education of clinical pathologists, and improve not only laboratory quality assurance but also patient care. In addition, in response to a need for customer access to this service with a shortage of clinical pathologists, a more effective method would be to set up a proactive systemic approach in
The task was to compute the maximum aluminum-oxide and oxide-coolant temperatures of assemblies cladded in 99+ percent aluminum. The assemblies considered were the Mark VB, VE, V5, 15 and 25. These assemblies consist of nested slug columns with individual uranium slugs cladded in aluminum cans. The CREDIT code was modified to calculate the oxide film thickness and the aluminum-oxide temperature at each axial increment. This information in this report will be used to evaluate the potential for cladding corrosion of the Mark 25 assembly
Louro, S.R.W.; Ribeiro, P.C.; Bemski, G.
Electron spin resonance spectra of organic phosphate free human hemoglobin marked with nitric oxide at the sixth coordination position of one of the four hemes allow to observe the transition from the tense (T) to the relaxed (R) conformation, as a function of parcial oxygen pressure. The spectra are composites of contributions from α sub(T), α sub(R) and β chains spectra, showing the presence of only two conformations: T and R. In the absence of organic phosphates NO binds to α and β chains with the same probability, but in the presence of phosphates NO combines preferentially with α chains. The dissociation of NO proceeds at least an order of magnitude faster in T than in R configuration. (author) [pt
A survey is presented of Mark III results on the iota(1440), a possible glueball state observed in radiative J/psi decays. The measurements include a spin-parity determination using both the iota → Ksub(s) 0 K +- π +- and iota → K + K - π 0 decay modes; an upper limit on the K*anti-K content of the Kanti-Kπ Dalitz plot; branching fractions and isospin; stringent upper limits for several hadronic channels, including iota → zetaπ→etaππ; and results from a search for iota radiative decays into vector mesons. These measurements are discussed in the context of theoretical ideas about the iota and results on the E(1420), a state observed in hadronic interactions. 11 refs., 7 figs
Park, S. K.; Jung, W. S.; Jung, K. H.; Baek, S. T.; Jung, K. J.
TRIGA Mark-III (KRR-2) is the second research reactor in Korea. Construction of KRR-2 was started in 1969 and first criticality was achieved in 1972. After 24 years operation, KRR-2 has stopped its operation at the end of 1995 due to normal operation of HANARO. KRR-2 was then decided to decommission in 1996 by government. Decontamination and decommissioning (D and D) will be conducted in accordance with domestic laws and international regulations. Selected method of D and D will be devoted to protect workers and environment and to minimize radioactive wastes produced. The major D and D work will be conducted safely by using conventional industrial equipment because of relatively low radioactivity and contamination in the facility. When removing activated concrete from reactor pool, it will be installed a temporary containment and ventilation system. In this paper, structure of KRR-2 and method of D and D in each step are presented and discussed
Schroeder, T; Sillesen, H
of dihydralazine was of the same order of magnitude as the effect of 5% CO2 inhalation. These results in normal subjects should be extrapolated to diseased persons only with extreme caution. Still, the very marked and long lasting vasodilation observed suggests that dihydralazine, from a theoretical point of view.......v. xenon-133 technique in seven young, normotensive volunteers before and 15, 60 and 180 min after 6.25 mg i.v. dihydralazine, corresponding approximately to 0.1 mg kg-1 body weight. For comparison the CBF reactivity to inhalation of 5% CO2 in air was investigated. Dihydralazine increased CBF throughout...... the period of study, in median 16, 27 and 23% at the three periods of measurements, respectively. The arterial blood pressure remained unchanged, whereas heart rate increased significantly. During CO2 inhalation, CBF increased on average 29%. Thus, the cerebral vasodilation exerted by a small i.v. dose...
Tallinnas Pärnu mnt. 102C asuvas büroohoones paikneva MarkIT büroo sisekujundusest. Sisearhitektid Kard Männil (SAB Miu Miu Miu) ja Loreida Hein (Studio La), nende tähtsamate tööde loetelu. Valge büroomööbel on sisearhitektide projekteeritud. Graafika on sisearhitektid ise joonistanud
O' Malley, Martin E. [University of Toronto, Princess Margaret Hospital, 3-920, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Alharbi, Fawaz [University of Toronto, Toronto General Hospital, NCSB 1C572, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Qassim University, Department of Medical Imaging, Buraydah, Qassim (Saudi Arabia); Chawla, Tanya P. [University of Toronto, Mount Sinai Hospital, Room 567, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Moshonov, Hadas [University of Toronto, Joint Department of Medical Imaging, Toronto, Ontario (Canada)
To determine superior-inferior anatomic borders for CT following inconclusive/nondiagnostic US for possible appendicitis. Ninety-nine patients with possible appendicitis and inconclusive/nondiagnostic US followed by CT were included in this retrospective study. Two radiologists reviewed CT images and determined superior-inferior anatomic borders required to diagnose or exclude appendicitis and diagnose alternative causes. This ''targeted'' coverage was used to estimate potential reduction in anatomic coverage compared to standard abdominal/pelvic CT. The study group included 83 women and 16 men; mean age 32 (median, 29; range 18-73) years. Final diagnoses were: nonspecific abdominal pain 50/99 (51 %), appendicitis 26/99 (26 %), gynaecological 12/99 (12 %), gastrointestinal 9/99 (10 %), and musculoskeletal 2/99 (2 %). Median dose-length product for standard CT was 890.0 (range, 306.3 - 2493.9) mGy.cm. To confidently diagnose/exclude appendicitis or identify alternative diagnoses, maximum superior-inferior anatomic CT coverage was the superior border of L2-superior border of pubic symphysis, for both reviewers. Targeted CT would reduce anatomic coverage by 30-55 % (mean 39 %, median 40 %) compared to standard CT. When CT is performed for appendicitis following inconclusive/nondiagnostic US, targeted CT from the superior border of L2-superior border of pubic symphysis can be used resulting in significant reduction in exposure to ionizing radiation compared to standard CT. (orig.)
Mukhtar, A.; Ishaq, M.; Islam, Q.U.
To evaluate the efficacy of primary and redo retinectomy in eyes with complex retinal detachment. Study Design: Quasi-experimental study. Place and Duration of Study: Armed Forces Institute of Ophthalmology Rawalpindi from Jan 2012 to June 2013. Patients and Methods: Fifty eight eyes (patients) underwent relaxing retinectomies for complex retinal detachment with proliferative vitreoretinopathy or intrinsic retinal shortening. Operative technique included pars plana vitrectomy, proliferative vitreoretinopathy management, use of intraoperative perfluorocarbon liquid, retinectomy, endolaser and intraocular temponade. The main outcome was anatomic success, defined as complete retinal reattachment at four months follow up. Eighteen eyes out of the same primary group underwent second retinectomy because of anatomical failure. Results: Mean age of study population was 53.78 ± 15.11 years, 56.9% of patients were male(s). Anatomic success rate after 1st retinectomy was achieved in 68.96% (40 eyes out of 58). In eighteen eyes that underwent 2nd retinectomy, anatomic success rate was 72.22% (13 eyes out of 18). Overall success rate was 91.3% (53 eyes out of 58) in our study. Conclusions: Relaxing retinectomies for retinal shortening can improve the anatomical success rate in patients with complex RD. (author)
O'Malley, Martin E.; Alharbi, Fawaz; Chawla, Tanya P.; Moshonov, Hadas
To determine superior-inferior anatomic borders for CT following inconclusive/nondiagnostic US for possible appendicitis. Ninety-nine patients with possible appendicitis and inconclusive/nondiagnostic US followed by CT were included in this retrospective study. Two radiologists reviewed CT images and determined superior-inferior anatomic borders required to diagnose or exclude appendicitis and diagnose alternative causes. This ''targeted'' coverage was used to estimate potential reduction in anatomic coverage compared to standard abdominal/pelvic CT. The study group included 83 women and 16 men; mean age 32 (median, 29; range 18-73) years. Final diagnoses were: nonspecific abdominal pain 50/99 (51 %), appendicitis 26/99 (26 %), gynaecological 12/99 (12 %), gastrointestinal 9/99 (10 %), and musculoskeletal 2/99 (2 %). Median dose-length product for standard CT was 890.0 (range, 306.3 - 2493.9) mGy.cm. To confidently diagnose/exclude appendicitis or identify alternative diagnoses, maximum superior-inferior anatomic CT coverage was the superior border of L2-superior border of pubic symphysis, for both reviewers. Targeted CT would reduce anatomic coverage by 30-55 % (mean 39 %, median 40 %) compared to standard CT. When CT is performed for appendicitis following inconclusive/nondiagnostic US, targeted CT from the superior border of L2-superior border of pubic symphysis can be used resulting in significant reduction in exposure to ionizing radiation compared to standard CT. (orig.)
Diagnostic reproducibility of hydatidiform moles: ancillary techniques (p57 immunohistochemistry and molecular genotyping) improve morphologic diagnosis for both recently trained and experienced gynecologic pathologists.
Gupta, Mamta; Vang, Russell; Yemelyanova, Anna V; Kurman, Robert J; Li, Fanghong Rose; Maambo, Emily C; Murphy, Kathleen M; DeScipio, Cheryl; Thompson, Carol B; Ronnett, Brigitte M
Distinction of hydatidiform moles from nonmolar specimens (NMs) and subclassification of hydatidiform moles as complete hydatidiform mole (CHM) and partial hydatidiform mole (PHM) are important for clinical practice and investigational studies; however, diagnosis based solely on morphology is affected by interobserver variability. Molecular genotyping can distinguish these entities by discerning androgenetic diploidy, diandric triploidy, and biparental diploidy to diagnose CHMs, PHMs, and NMs, respectively. Eighty genotyped cases (27 CHMs, 27 PHMs, 26 NMs) were selected from a series of 200 potentially molar specimens previously diagnosed using p57 immunohistochemistry and genotyping. Cases were classified by 6 pathologists (3 faculty level gynecologic pathologists and 3 fellows) on the basis of morphology, masked to p57 immunostaining and genotyping results, into 1 of 3 categories (CHM, PHM, or NM) during 2 diagnostic rounds; a third round incorporating p57 immunostaining results was also conducted. Consensus diagnoses (those rendered by 2 of 3 pathologists in each group) were also determined. Performance of experienced gynecologic pathologists versus fellow pathologists was compared, using genotyping results as the gold standard. Correct classification of CHMs ranged from 59% to 100%; there were no statistically significant differences in performance of faculty versus fellows in any round (P-values of 0.13, 0.67, and 0.54 for rounds 1 to 3, respectively). Correct classification of PHMs ranged from 26% to 93%, with statistically significantly better performance of faculty versus fellows in each round (P-values of 0.04, <0.01, and <0.01 for rounds 1 to 3, respectively). Correct classification of NMs ranged from 31% to 92%, with statistically significantly better performance of faculty only in round 2 (P-values of 1.0, <0.01, and 0.61 for rounds 1 to 3, respectively). Correct classification of all cases combined ranged from 51% to 75% by morphology and 70% to 80
Tramontana, G Michael; Blood, Ingrid M; Blood, Gordon W
The purpose of this study was to determine (a) the general knowledge bases demonstrated by school-based speech-language pathologists (SLPs) in the area of genetics, (b) the confidence levels of SLPs in providing services to children and their families with genetic disorders/syndromes, (c) the attitudes of SLPs regarding genetics and communication disorders, (d) the primary sources used by SLPs to learn about genetic disorders/syndromes, and (e) the association between general knowledge, confidence, attitudes, the number of years of experience working as an SLP, and the number of children currently provided services with genetic disorders/syndromes on SLPs' caseloads. Survey data from a nationwide sample of 533 SLPs was analyzed. Results showed SLPs earned a median knowledge score about genetics of 66% correct responses. Their mean confidence and attitude ratings were in the "unsure" categories while they reported they learned about genetics from three main sources, (a) self-study via web and internet-based searches, (b) on-the-job training and (c) popular press magazines and newspapers. Analyses revealed that Confidence summary scores, Attitude Summary scores, the number of children with genetic disorders/syndromes on SLPs' caseloads are positively associated with the ratings of participants with the highest Knowledge scores. Readers will be able to (a) explain the important links between developmental and communication disabilities and genetics, (b) describe the associations between knowledge about genetics and confidence, attitudes, and the number of children with genetic disorders/syndromes on their caseloads, and (c) outline the clinical and theoretical implications of the results from this study. Copyright © 2012 Elsevier Inc. All rights reserved.
Landsbergen, K M; Prins, J B; Brunner, H G; van Duijvendijk, P; Nagengast, F M; van Krieken, J H; Ligtenberg, M; Hoogerbrugge, N
According to the Dutch Guideline on Hereditary Colorectal Cancer published in 2008, patients with recently diagnosed colorectal cancer (CRC) should undergo microsatellite instability (MSI) testing by a pathologist immediately after tumour resection if they are younger than 50 years, or if a second CRC has been diagnosed before the age of 70 years, owing to the high risk of Lynch syndrome (MIPA). The aim of the present MIPAPS study was to investigate general distress and cancer-specific distress following MSI testing. From March 2007 to September 2009, 400 patients who had been tested for MSI after newly diagnosed CRC were recruited from 30 Dutch hospitals. Levels of general distress (SCL-90) and cancer-specific distress (IES) were assessed immediately after MSI result disclosure (T1) and 6 months later (T2). Response rates were 23/77 (30%) in the MSI-positive patients and 58/323 (18%) in the MSI-negative patients. Levels of general distress and cancer-specific distress were moderate. In the MSI-positive group, 27% of the patients had high general distress at T1 versus 18% at T2 (p = 0.5), whereas in the MSI-negative group, these percentage were 14 and 18% (p = 0.6), respectively. At T1 and T2, cancer-specific distress rates in the MSI-positive group and MSI-negative group were 39 versus 27% (p = 0.3) and 38 versus 36% (p = 1.0), respectively. High levels of general distress were correlated with female gender, low social support and high perceived cancer risk. Moderate levels of distress were observed after MSI testing, similar to those found in other patients diagnosed with CRC. Immediately after result disclosure, high cancer-specific distress was observed in 40% of the MSI-positive patients.
Mcleod, Sharynne; Baker, Elise
A survey of 231 Australian speech-language pathologists (SLPs) was undertaken to describe practices regarding assessment, analysis, target selection, intervention, and service delivery for children with speech sound disorders (SSD). The participants typically worked in private practice, education, or community health settings and 67.6% had a waiting list for services. For each child, most of the SLPs spent 10-40 min in pre-assessment activities, 30-60 min undertaking face-to-face assessments, and 30-60 min completing paperwork after assessments. During an assessment SLPs typically conducted a parent interview, single-word speech sampling, collected a connected speech sample, and used informal tests. They also determined children's stimulability and estimated intelligibility. With multilingual children, informal assessment procedures and English-only tests were commonly used and SLPs relied on family members or interpreters to assist. Common analysis techniques included determination of phonological processes, substitutions-omissions-distortions-additions (SODA), and phonetic inventory. Participants placed high priority on selecting target sounds that were stimulable, early developing, and in error across all word positions and 60.3% felt very confident or confident selecting an appropriate intervention approach. Eight intervention approaches were frequently used: auditory discrimination, minimal pairs, cued articulation, phonological awareness, traditional articulation therapy, auditory bombardment, Nuffield Centre Dyspraxia Programme, and core vocabulary. Children typically received individual therapy with an SLP in a clinic setting. Parents often observed and participated in sessions and SLPs typically included siblings and grandparents in intervention sessions. Parent training and home programs were more frequently used than the group therapy. Two-thirds kept up-to-date by reading journal articles monthly or every 6 months. There were many similarities with
Goffi-Fynn, Jeanne C; Carroll, Linda M
This study was designed as a qualitative case study to demonstrate the process of diagnosis and treatment between a voice team to manage a singer diagnosed with muscular tension dysphonia (MTD). Traditionally, literature suggests that MTD is challenging to treat and little in the literature directly addresses singers with MTD. Data collected included initial medical screening with laryngologist, referral to speech-language pathologist (SLP) specializing in voice disorders among singers, and adjunctive voice training with voice teacher trained in vocology (singing voice specialist or SVS). Initial target goals with SLP included reducing extrinsic laryngeal tension, using a relaxed laryngeal posture, and effective abdominal-diaphragmatic support for all phonation events. Balance of respiratory forces, laryngeal coordination, and use of optimum filtering of the source signal through resonance and articulatory awareness was emphasized. Further work with SVS included three main goals including a lowered breathing pattern to aid in decreasing subglottic air pressure, vertical laryngeal position to lower to allow for a relaxed laryngeal position, and a top-down singing approach to encourage an easier, more balanced registration, and better resonance. Initial results also emphasize the retraining of subject toward a sensory rather than auditory mode of monitoring. Other areas of consideration include singers' training and vocal use, the psychological effects of MTD, the personalities potentially associated with it, and its relationship with stress. Finally, the results emphasize that a positive rapport with the subject and collaboration between all professionals involved in a singer's care are essential for recovery. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.
Eckfeldt, John H; Karger, Amy B; Miller, W Greg; Rynders, Gregory P; Inker, Lesley A
Cystatin C is becoming an increasingly popular biomarker for estimating glomerular filtration rate, and accurate measurements of cystatin C concentrations are necessary for accurate estimates of glomerular filtration rate. To assess the accuracy of cystatin C concentration measurements in laboratories participating in the College of American Pathologists CYS Survey. Two fresh frozen serum pools, the first from apparently healthy donors and the second from patients with chronic kidney disease, were prepared and distributed to laboratories participating in the CYS Survey along with the 2 usual processed human plasma samples. Target values were established for each pool by using 2 immunoassays and ERM DA471/IFCC international reference material. For the normal fresh frozen pool (ERM-DA471/IFCC-traceable target of 0.960 mg/L), the all-method mean (SD, % coefficient of variation [CV]) reported by all of the 123 reporting laboratories was 0.894 mg/L (0.128 mg/L, 14.3%). For the chronic kidney disease pool (ERM-DA471/IFCC-traceable target of 2.37 mg/L), the all-method mean (SD, %CV) was 2.258 mg/L (0.288 mg/L, 12.8%). There were substantial method-specific biases (mean milligram per liter reported for the normal pool was 0.780 for Siemens, 0.870 for Gentian, 0.967 for Roche, 1.061 for Diazyme, and 0.970 for other/not specified reagents; and mean milligram per liter reported for the chronic kidney disease pool was 2.052 for Siemens, 2.312 for Gentian, 2.247 for Roche, 2.909 for Diazyme, and 2.413 for other/not specified reagents). Manufacturers need to improve the accuracy of cystatin C measurement procedures if cystatin C is to achieve its full potential as a biomarker for estimating glomerular filtration rate.
Valenstein, Paul N; Wang, Edward; O'Donohue, Tom
The Veterans Health Administration (VA) operates the largest integrated laboratory network in the United States. To assess whether the unique characteristics of VA laboratories impact efficiency of operations, we compared the productivity of VA and non-VA facilities. Financial and activity data were prospectively collected from 124 VA and 131 non-VA laboratories enrolled in the College of American Pathologists Laboratory Management Index Program (LMIP) during 2002. In addition, secular trends in 5 productivity ratios were calculated for VA and non-VA laboratories enrolled in LMIP from 1997 through 2002. Veterans Health Administration and non-VA facilities did not differ significantly in size. Inpatients accounted for a lower percentage of testing at VA facilities than non-VA facilities (21.7% vs 37.3%; P benefits; P depreciation, and maintenance than their non-VA counterparts (all P <.001), resulting in lower overall cost per on-site test result (2.64 dollars vs 3.40 dollars; P <.001). Cost per referred (sent-out) test did not differ significantly between the 2 groups. Analysis of 6-year trends showed significant increases in both VA (P <.001) and non-VA (P =.02) labor productivity (on-site tests/total FTE). Expenses at VA laboratories for labor per test, consumables per test, overall expense per test, and overall laboratory expense per discharge decreased significantly during the 6-year period (P <.001), while in non-VA facilities the corresponding ratios showed no significant change. Overall productivity of VA laboratories is superior to that of non-VA facilities enrolled in LMIP. The principal advantages enjoyed by the VA are higher-than-average labor productivity (tests/FTE) and lower-than-average consumable expenses.
HRANAFINA--Croatian Anatomical and Physiological Terminology is a project of the University of Zagreb School of Dental Medicine funded by the Croatian Science Foundation. It is performed in cooperation with other Croatian universities with medical schools. This project has a two-pronged aim: firstly, building of Croatian anatomical and physiological terminology and secondly, Croatian anatomical and physiological terminology usage popularization between health professionals, medical students, scientists and translators. Internationally recognized experts from Croatian universities with medical faculties and linguistics experts are involved in the project. All project activities are coordinated in agreement with the National Coordinator for Development of Croatian Professional Terminology. The project enhances Croatian professional terminology and Croatian language in general, increases competitiveness of Croatian scientists on international level and facilitates the involvement of Croatian scientists, health care providers and medical students in European projects.
Wan, Yong; Lewis, A Kelsey; Colasanto, Mary; van Langeveld, Mark; Kardon, Gabrielle; Hansen, Charles
The anatomical atlas has been at the intersection of science and art for centuries. These atlases are essential to biological research, but high-quality atlases are often scarce. Recent advances in imaging technology have made high-quality 3D atlases possible. However, until now there has been a lack of practical workflows using standard tools to generate atlases from images of biological samples. With certain adaptations, CG artists' workflow and tools, traditionally used in the film industry, are practical for building high-quality biological atlases. Researchers have developed a workflow for generating a 3D anatomical atlas using accessible artists' tools. They used this workflow to build a mouse limb atlas for studying the musculoskeletal system's development. This research aims to raise the awareness of using artists' tools in scientific research and promote interdisciplinary collaborations between artists and scientists. This video (http://youtu.be/g61C-nia9ms) demonstrates a workflow for creating an anatomical atlas.
İlham Eröz Poyraz
Full Text Available Momordica charantia L. (Cucurbitaceae used for some medicinal purposes like antidiabetic, anticancer, antiviral and treat to gastritis was investigated. Morphological studies were supported by morphometric measurements and drawings of male and female flowers, fruit and seeds of the species. In anatomical studies, cross sections of stem and leaf, upper and lower surface sections of leaves were evaluated. It was detected that the stem with typical anatomical properties of a climbing dicotyl plant. The leaves were amphistotamic and with lots of cyctoliths on the lower surface of leaves. Stomata are anomocytic and situated much more at the lower surface of leaves. Morpho-anatomical investigations on Momordica charantia L. (Cucurbitaceae*
Hasan, S T; Shanahan, D A; Pridie, A K; Neal, D E
A method is described for percutaneous localization of the sacral foramina, for neuromodulation of bladder function. We carried out an anatomical study of 5 male and 5 female human cadaver pelves. Using the described surface markings, needles were placed percutaneously into all sacral foramina from nine different angles. Paths of needle entry were studied by subsequent dissection. We observed that although it was possible to enter any sacral foramen at a wide range of insertion angles, the incidence of nerve root/vascular penetration increased with increasing angle of needle entry. Also, the incidence of nerve root penetration was higher with the medial approach compared with lateral entry. The insertion of a needle into the S1 foramen was associated with a higher incidence of nerve root penetration and presents a potential for arterial haemorrhage. On the other hand the smaller S3 and S4 nerve roots were surrounded by venous plexuses, presenting a potential source of venous haemorrhage during procedures. Our study suggests a new method for identifying the surface markings of sacral foramina and it describes the paths of inserted needles into the respective foramina. In addition, it has highlighted some potential risk factors secondary to needle insertion.
Theofanous, T.G.; Yan, H.; Ratnam, U.; Amarasooriya, W.H.
The authors are proposing a probabilistic methodology, the risk-oriented accident analysis methodology (ROAAM) as an overall systematic, disciplined approach for addressing the Mark-1 liner attack issue. The probabilistic framework encompasses the key features of the phenomenology, yet it is flexible enough to allow independent quantification of individual components as it may arise from independent research efforts. As a first step in this direction, the authors assembled, discussed, and took into consideration in the quantification proposed all relevant prior work. Furthermore, as an essential aspect of the overall methodology, most of those whose work has been referenced and/or used in this report have been asked to comment. The details of this work, the comments received, and the authors' responses are included in NUREG/CR-5423. As an even more important characteristic of the methodology, it is hoped that other quantifications (or information relevant to such) of independent components will become available in the future so that one can aim for convergence and closure
Tests performed in 105-K in 1987 and 1988 demonstrated that the stack plume can successfully be made visible (i.e., marked) by introducing smoke into the stack breech. The ultimate objective of these tests is to provide a means during an emergency evacuation so that an evacuee can readily identify the stack plume and evacuate in the opposite direction, thus minimizing the potential of severe radiation exposure. The EPA has also requested DOE to arrange for more tests to settle a technical question involving the correct calculation of stack downwash. New test canisters were received in 1988 designed to produce more smoke per unit time; however, these canisters have not been evaluated, because normal ventilation conditions have not been reestablished in K Area. Meanwhile, both the authorization and procedure to conduct the tests have expired. The tests can be performed during normal reactor operation. It is recommended that appropriate authorization and procedure approval be obtained to resume testing after K Area restart
Ryan, J. W.; Ma, C.; Schupler, B. R.
A data base handler which would act to tie Mark 3 system programs together is discussed. The data base handler is written in FORTRAN and is implemented on the Hewlett-Packard 21MX and the IBM 360/91. The system design objectives were to (1) provide for an easily specified method of data interchange among programs, (2) provide for a high level of data integrity, (3) accommodate changing requirments, (4) promote program accountability, (5) provide a single source of program constants, and (6) provide a central point for data archiving. The system consists of two distinct parts: a set of files existing on disk packs and tapes; and a set of utility subroutines which allow users to access the information in these files. Users never directly read or write the files and need not know the details of how the data are formatted in the files. To the users, the storage medium is format free. A user does need to know something about the sequencing of his data in the files but nothing about data in which he has no interest.
Kim, Jae Hun; Jeong, Ho Gul; Hwang, Jae Joon; Lee, Jung Hee; Han, Sang Sun [Dept. of Oral and Maxillofacial Radiology, Yonsei University, College of Dentistry, Seoul (Korea, Republic of)
The aim of this study was to compare the coordinates of anatomical landmarks on cone-beam computed tomographic (CBCT) images in varied head positions before and after reorientation using image analysis software. CBCT images were taken in a normal position and four varied head positions using a dry skull marked with 3 points where gutta percha was fixed. In each of the five radiographic images, reference points were set, 20 anatomical landmarks were identified, and each set of coordinates was calculated. Coordinates in the images from the normally positioned head were compared with those in the images obtained from varied head positions using statistical methods. Post-reorientation coordinates calculated using a three-dimensional image analysis program were also compared to the reference coordinates. In the original images, statistically significant differences were found between coordinates in the normal-position and varied-position images. However, post-reorientation, no statistically significant differences were found between coordinates in the normal-position and varied-position images. The changes in head position impacted the coordinates of the anatomical landmarks in three-dimensional images. However, reorientation using image analysis software allowed accurate superimposition onto the reference positions.
von Graevenitz, Georg; Greenhalgh, Christine; Helmers, Christian; Schautschick, Philipp
This report explores the problem of “cluttering” of trade mark registers. The report consists of two parts: the first presents a conceptual discussion of “cluttering” of trade mark registers. The second part provides an exploratory empirical analysis of trade mark applications at the UK Intellectual Property Office (UKIPO) and the European trade mark office (OHIM). This part contains results of a descriptive and an econometric analysis. According to our definition, cluttering arises where fir...
Bottlang, Michael; Helzel, Inga; Long, William B; Madey, Steven
: Intraoperative contouring of long bridging plates for stabilization of flail chest injuries is difficult and time consuming. This study implemented for the first time biometric parameters to derive anatomically contoured rib plates. These plates were tested on a range of cadaveric ribs to quantify plate fit and to extract a best-fit plating configuration. : Three left and three right rib plates were designed, which accounted for anatomic parameters required when conforming a plate to the rib surface. The length lP over which each plate could trace the rib surface was evaluated on 109 cadaveric ribs. For each rib level 3-9, the plate design with the highest lP value was extracted to determine a best-fit plating configuration. Furthermore, the characteristic twist of rib surfaces was measured on 49 ribs to determine the surface congruency of anatomic plates with a constant twist. : The tracing length lP of the best-fit plating configuration ranged from 12.5 cm to 14.7 cm for ribs 3-9. The corresponding range for standard plates was 7.1-13.7 cm. The average twist of ribs over 8-cm, 12-cm, and 16-cm segments was 8.3 degrees, 20.6 degrees, and 32.7 degrees, respectively. The constant twist of anatomic rib plates was not significantly different from the average rib twist. : A small set of anatomic rib plates can minimize the need for intraoperative plate contouring for fixation of ribs 3-9. Anatomic rib plates can therefore reduce the time and complexity of flail chest stabilization and facilitate spanning of flail segments with long plates.
Ramakrishnan, Tyagi; Schlafly, Millicent; Reed, Kyle B
This case study compares a transfemoral amputee's gait while using the existing Ossur Total Knee 2000 and our novel 3D printed anatomically scalable transfemoral prosthetic knee. The anatomically scalable transfemoral prosthetic knee is 3D printed out of a carbon-fiber and nylon composite that has a gear-mesh coupling with a hard-stop weight-actuated locking mechanism aided by a cross-linked four-bar spring mechanism. This design can be scaled using anatomical dimensions of a human femur and tibia to have a unique fit for each user. The transfemoral amputee who was tested is high functioning and walked on the Computer Assisted Rehabilitation Environment (CAREN) at a self-selected pace. The motion capture and force data that was collected showed that there were distinct differences in the gait dynamics. The data was used to perform the Combined Gait Asymmetry Metric (CGAM), where the scores revealed that the overall asymmetry of the gait on the Ossur Total Knee was more asymmetric than the anatomically scalable transfemoral prosthetic knee. The anatomically scalable transfemoral prosthetic knee had higher peak knee flexion that caused a large step time asymmetry. This made walking on the anatomically scalable transfemoral prosthetic knee more strenuous due to the compensatory movements in adapting to the different dynamics. This can be overcome by tuning the cross-linked spring mechanism to emulate the dynamics of the subject better. The subject stated that the knee would be good for daily use and has the potential to be adapted as a running knee.
Tang, Qisheng; Lian, Yuxi; Yu, Jinhua; Wang, Yuanyuan; Shi, Zhifeng; Chen, Liang
Tumor location served as an important prognostic factor in glioma patients was considered to postulate molecular features according to cell origin theory. However, anatomic distribution of unique molecular subtypes was not widely investigated. The relationship between molecular phenotype and histological subgroup were also vague based on tumor location. Our group focuses on the study of glioma anatomic location of distinctive molecular subgroups and histology subtypes, and explores the possibility of their consistency based on clinical background. We retrospectively reviewed 143 cases with both molecular information (IDH1/TERT/1p19q) and MRI images diagnosed as cerebral diffuse gliomas. The anatomic distribution was analyzed between distinctive molecular subgroups and its relationship with histological subtypes. The influence of tumor location, molecular stratification and histology diagnosis on survival outcome was investigated as well. Anatomic locations of cerebral diffuse glioma indicate varied clinical outcome. Based on that, it can be stratified into five principal molecular subgroups according to IDH1/TERT/1p19q status. Triple-positive (IDH1 and TERT mutation with 1p19q codeletion) glioma tended to be oligodendroglioma present with much better clinical outcome compared to TERT mutation only group who is glioblastoma inclined (median overall survival 39 months VS 18 months). Five molecular subgroups were demonstrated with distinctive locational distribution. This kind of anatomic feature is consistent with its corresponding histological subtypes. Each molecular subgroup in glioma has unique anatomic location which indicates distinctive clinical outcome. Molecular diagnosis can be served as perfect complementary tool for the precise diagnosis. Integration of histomolecular diagnosis will be much more helpful in routine clinical practice in the future.
... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Supervision of marking and packaging...) Identifying and Marking Product § 590.418 Supervision of marking and packaging. (a) Evidence of label approval... has on file evidence that such official identification or packaging material bearing such official...
... INFORMATION SECURITY PROGRAM Derivative Classification § 1203.501 Applying derivative classification markings. Persons who apply derivative classification markings shall: (a) Observe and respect original... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Applying derivative classification markings...
... ARRANGEMENTS LIFESAVING SYSTEMS FOR CERTAIN INSPECTED VESSELS Requirements for All Vessels § 199.176 Markings on lifesaving appliances. (a) Lifeboats and rescue boats. Each lifeboat and rescue boat must be plainly marked as follows: (1) Each side of each lifeboat and rescue boat bow must be marked in block...
... T Tax Determined TD Wine Spirits Addition WSA (Sec. 201, Pub. L. 85-859, 72 Stat. 1360, as amended... TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS DISTILLED SPIRITS PLANTS Containers and Marks... to identify certain marks: Mark Abbreviation Completely Denatured Alcohol CDA Distilled Spirits...
... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Marking of outside containers. 316.13... INSPECTION AND CERTIFICATION MARKING PRODUCTS AND THEIR CONTAINERS § 316.13 Marking of outside containers. (a... domestic commerce is moved from an official establishment, the outside container shall bear an official...
C.C. Foster; E.D. Forsman; E.C. Meslow; G.S. Miller; J.A. Reid; F.F. Wagner; A.B. Carey; J.B. Lint
We compared survival, reproduction, and body mass of radio-marked and non radio-marked spotted owls (Strix occidentalis) to determine if backpack radios influenced reproduction or survival. In most study areas and years, there were no differences (P > 0.05) in survival of males and females or in survival of radio-marked versus banded owls. There...
This paper presents evidence that marking student texts with well considered checklists is more effective than marking by hand. An experiment conducted on first-year students illustrated that the checklists developed to mark introductions, conclusions and paragraphs yielded better revision results than handwritten ...
Jacobsen, Aase Roland
Tooth-marked dinosaur bones provide insight into feeding behaviours and biting strategies of theropod dinosaurs. The majority of theropod tooth marks reported to date have been found on herbivorous dinosaur bones, although some tyrannosaurid bones with tooth marks have also been reported. In 1988...
... 46 Shipping 4 2010-10-01 2010-10-01 false Markings on lifesaving appliances. 108.645 Section 108.645 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Equipment Markings and Instructions § 108.645 Markings on lifesaving appliances. (a...
Joshi, Shreyas S; Uzzo, Robert G
Anatomic tumor complexity can be objectively measured and reported using nephrometry. Various scoring systems have been developed in an attempt to correlate tumor complexity with intraoperative and postoperative outcomes. Nephrometry may also predict tumor biology in a noninvasive, reproducible manner. Other scoring systems can help predict surgical complexity and the likelihood of complications, independent of tumor characteristics. The accumulated data in this new field provide provocative evidence that objectifying anatomic complexity can consolidate reporting mechanisms and improve metrics of comparisons. Further prospective validation is needed to understand the full descriptive and predictive ability of the various nephrometry scores. Copyright © 2017 Elsevier Inc. All rights reserved.
Feragen, Aasa; Petersen, Jens; Owen, Megan
We present a fast and robust supervised algorithm for label- ing anatomical airway trees, based on geodesic distances in a geometric tree-space. Possible branch label configurations for a given unlabeled air- way tree are evaluated based on the distances to a training set of labeled airway trees....... In tree-space, the airway tree topology and geometry change continuously, giving a natural way to automatically handle anatomical differences and noise. The algorithm is made efficient using a hierarchical approach, in which labels are assigned from the top down. We only use features of the airway...
Mandl, Peter; Bong, David; Balint, Peter V
Our study provides a detailed anatomic and sonographic description of the subtalar joint, a single joint that, anatomically, is divided into the anterior subtalar joint (ASTJ) and the posterior subtalar joint (PSTJ). Cadaver specimens of the ankle and foot were examined in detail by ultrasound (US......), and the subtalar joints of all the specimens were injected with colored latex of a contrasting color under US guidance. Compatible with other studies, examination of the sections revealed lack of communication between the ASTJ and the PSTJ and communication between the PSTJ and the posterior recess...... of agreement between images acquired in cadaver specimens and images acquired in four centers using healthy patients....
Domen, Ronald E
The role of the humanities (eg, philosophy, bioethics, literature, music, theater, religion, anthropology) in medical education has been argued long and hard for decades. It is argued that the study of subjects included in the humanities can enhance critical thinking skills, foster a deeper level of learning and understanding, and help to enhance one's level of compassion, empathy, and moral/ethical reasoning. It is the author's contention that writing and reading poetry (as an example of a personal pursuit in the humanities) can help achieve these goals not only in our contact with patients but also in our contact with other humans and cultures in the world at large.
Coati, Irene; Fassan, Matteo; Farinati, Fabio; Graham, David Y; Genta, Robert M; Rugge, Massimo
Western countries are seeing a constant decline in the incidence of Helicobacter pylori-associated gastritis, coupled with a rising epidemiological and clinical impact of autoimmune gastritis. This latter gastropathy is due to autoimmune aggression targeting parietal cells through a complex interaction of auto-antibodies against the parietal cell proton pump and intrinsic factor, and sensitized T cells. Given the specific target of this aggression, autoimmune gastritis is typically restricted to the gastric corpus-fundus mucosa. In advanced cases, the oxyntic epithelia are replaced by atrophic (and metaplastic) mucosa, creating the phenotypic background in which both gastric neuroendocrine tumors and (intestinal-type) adenocarcinomas may develop. Despite improvements in our understanding of the phenotypic changes or cascades occurring in this autoimmune setting, no reliable biomarkers are available for identifying patients at higher risk of developing a gastric neoplasm. The standardization of autoimmune gastritis histology reports and classifications in diagnostic practice is a prerequisite for implementing definitive secondary prevention strategies based on multidisciplinary diagnostic approaches integrating endoscopy, serology, histology and molecular profiling.
Ronald E. Domen MD
Full Text Available The role of the humanities (eg, philosophy, bioethics, literature, music, theater, religion, anthropology in medical education has been argued long and hard for decades. It is argued that the study of subjects included in the humanities can enhance critical thinking skills, foster a deeper level of learning and understanding, and help to enhance one’s level of compassion, empathy, and moral/ethical reasoning. It is the author’s contention that writing and reading poetry (as an example of a personal pursuit in the humanities can help achieve these goals not only in our contact with patients but also in our contact with other humans and cultures in the world at large.
Intervjuu Euroopa Välissuhete Nõukogu tegevdirektoriga, kes vastab küsimustele, mis puudutavad USA ja Euroopa suhteid, Euroopa Liidu välispoliitikat, Venemaa ja Euroopa Liidu suhteid pärast Gruusia konflikti. Ta peab murettekitavaks, et Venemaa üritab takistada euroopalike väärtuste levitamist oma naaberriikides. Vt. samas: Mark Leonard. Ilmunud ka Sirp : Diplomaatia 14. nov. nr. 11 lk. 13-14
de Sainte Croix, M M; Gauld, D; Forgie, A H; Lowe, R
Human bite marks are often sustained during sexual, domestic or child abuse. Currently, analysis of these marks involves digital photography techniques along with an expert forensic odontologist opinion. Photographs often focus closely on the bite mark and give little context to the anatomical location of the injury. Due to variation in camera models and expertise of the photographer, photograph quality can affect its interpretation. Additionally, it can sometimes be days between injury and examination, allowing the injury pattern and colour to alter, making it harder to analyse. To investigate if a 3D imaging technique, creating a time-lapse image of a bite mark in three dimensions, can provide context to the injury in terms of nature and location, and also allow analysis of the change in appearance of a bite mark over time. Participants had an experimental bite mark produced on their forearm by dental casts mounted on a dental articulator. The forearms were photographed immediately following the bite, and at intervals of 3, 6, 24, 48, 72 and 96 h. A DI3D(®) (Dimensional Imaging 3D) photogrammetry system and Autodesk Maya 2015(®) software was used to create a 3D animation from the images obtained. The clearest, long lasting bite mark injuries were selected for animation, enabling the 3D imaging technique to be used optimally. 3D time-lapse animations were successfully created with the ability to be viewed on most electronic devices. With further refinement this technique could be valuable in a number of areas. We anticipate animations produced in this way to have significant benefit to the presentation of photographic evidence in a court setting, and in age estimation of injuries. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Hoeksema, Amy Beth [Iowa State Univ., Ames, IA (United States)
In forensics, fingerprints can be used to uniquely identify suspects in a crime. Similarly, a tool mark left at a crime scene can be used to identify the tool that was used. However, the current practice of identifying matching tool marks involves visual inspection of marks by forensic experts which can be a very subjective process. As a result, declared matches are often successfully challenged in court, so law enforcement agencies are particularly interested in encouraging research in more objective approaches. Our analysis is based on comparisons of profilometry data, essentially depth contours of a tool mark surface taken along a linear path. In current practice, for stronger support of a match or non-match, multiple marks are made in the lab under the same conditions by the suspect tool. We propose the use of a likelihood ratio test to analyze the difference between a sample of comparisons of lab tool marks to a field tool mark, against a sample of comparisons of two lab tool marks. Chumbley et al. (2010) point out that the angle of incidence between the tool and the marked surface can have a substantial impact on the tool mark and on the effectiveness of both manual and algorithmic matching procedures. To better address this problem, we describe how the analysis can be enhanced to model the effect of tool angle and allow for angle estimation for a tool mark left at a crime scene. With sufficient development, such methods may lead to more defensible forensic analyses.
Full Text Available Bite marks are always unique because teeth are distinctive. Bite marks are often observed at the crime scene in sexual and in physical assault cases on the skin of the victims and sometimes on edible leftovers in burglary cases. This piece of evidence is often ignored, but if properly harvested and investigated, bite marks may prove useful in apprehending and successfully prosecuting the criminals. Due to the importance of bite marks, we conducted a progressive randomised experimental study conducted on volunteers. A total of 188 bite marks on clay were studied. Based on these findings, 93.34% of the volunteers could be identified from the bite marks on the clay. In addition, 201 impressions on skin were studied, and out of these cases, 41.01% of the same volunteers could be identified based on the bite mark impressions on the skin.
Boyle, Michael P
The purpose of this study was to investigate whether attribution theory could explain speech-language pathologists (SLPs) perceptions of children with communication disorders such as stuttering. Specifically, it was determined whether perceptions of onset and offset controllability, as well as biological and non-biological attributions for communication disorders were related to willingness to help, sympathy, and anger toward children with these disorders. It was also of interest to determine if blame for stuttering was related to perceived controllability of stuttering and negative attitudes toward people who stutter (PWS). A survey was developed to measure perceived onset and offset controllability, biological and non-biological attributions, willingness to help, sympathy, and anger toward middle school children with developmental stuttering, functional articulation disorders, and cerebral palsy. In addition, a scale was developed to measure blame and negative attitudes toward PWS in general. Surveys were mailed to 1000 school-based SLPs. Data from 330 participants were analyzed. Supporting the hypotheses of attribution theory, higher perceived onset and offset controllability of the disorder was linked to less willingness to help, lower sympathy, and more anger across conditions. Increased biological attributions were associated with more reported sympathy. Increased blame for stuttering was linked to higher perceived controllability of stuttering, more dislike of PWS, and more agreement with negative stereotypes about PWS. Educating SLPs about the variable loss of control inherent in stuttering could improve attitudes and increase understanding of PWS. Reductions in blame may facilitate feelings of sympathy and empathy for PWS and reduce environmental barriers for clients. Learning outcomes Readers should be able to: (1) identify the main principles of Weiner's attribution theory (2) identify common negative perceptions of people who stutter (3) describe how
Background Femoral vein cannulation may be required during major surgery in infants and children and may prove to be life saving under certain conditions. This study compared ultrasound (US)-guided cannulation of the femoral vein in infants with the traditional anatomical landmark-guided technique. Methods Eighty ...
In this study, we evaluated the salt concentration effect on plant growth, mineral composition, antioxidant responses and anatomical structure of two varieties of Origanum majorana after exposure to NaCl treatment. Our results show an inclusive behaviour of the two varieties, since the majority of sodium was exported and ...
Sørensen, Lauge; Lo, Pechin Chien Pau; Dirksen, Asger
A novel method for classification of abnormality in anatomical tree structures is presented. A tree is classified based on direct comparisons with other trees in a dissimilarity-based classification scheme. The pair-wise dissimilarity measure between two trees is based on a linear assignment betw...
Ogar, J. M.; Baldo, J. V.; Wilson, S. M.; Brambati, S. M.; Miller, B. L.; Dronkers, N. F.; Gorno-Tempini, M. L.
Few studies have directly compared the clinical and anatomical characteristics of patients with progressive aphasia to those of patients with aphasia caused by stroke. In the current study we examined fluent forms of aphasia in these two groups, specifically semantic dementia (SD) and persisting Wernicke's aphasia (WA) due to stroke. We compared…
Sørensen, Lauge Emil Borch Laurs; Lo, Pechin Chien Pau; Dirksen, Asger
A novel method for classification of abnormality in anatomical tree structures is presented. A tree is classified based on direct comparisons with other trees in a dissimilarity-based classification scheme. The pair-wise dissimilarity measure between two trees is based on a linear assignment...
Sally Mahmood Mohamed Hussin Omar
Jul 10, 2015 ... The tendon sheath of the posterior tibial muscle covers the posterior and ..... may be associated with avulsion fractures at either the origin or the insertion .... 14. Shibata Y, Nishi G, Masegi A. Stress test and anatomical study of.
Miles, James Edward; Westrup, Ulrik; Eriksen, Thomas
and ultrasonographic measurements of trochlear depth using the red fox hind limb as a canine surrogate, dividing the trochlea into five regions from the origin of the caudal cruciate ligament to the proximal aspect of the trochlea. We found reasonable agreement between anatomic and ultrasonographic measurements...
Feb 17, 2016 ... Curr Opin Urol 2008;18:214–9.  Lingeman JE, Siegal YI, Steele B, Nyhus AW, Woods JR. Manage- ment of lower pole nephrolithiasis: a critical analysis. J Urol 1994;151: 663–7.  Sampaio FJB, Aragao AHM. Limitations of extracorporeal shock wave lithotripsy for lower caliceal stone: anatomic insight.
Gaggiano, Andrea; Kasemi, Holta; Monti, Andrea; Laurito, Antonella; Maselli, Mauro; Manzo, Paola; Quaglino, Simone; Tavolini, Valeria
Coral reef aorta (CRA) is a rare, potential lethal disease of the visceral aorta as it can cause visceral and renal infarction. Various surgical approaches have been proposed for the CRA treatment. The purpose of this article is to report different extensive extra-anatomic CRA treatment modalities tailored on the patients' clinical and anatomic presentation. From April 2006 to October 2012, 4 symptomatic patients with extensive CRA were treated at our department. Extra-anatomic aortic revascularization with selective visceral vessels clamping was performed in all cases. Technical success was 100%. No perioperative death was registered. All patients remained asymptomatic during the follow-up period (62, 49, 25, and 94 months, respectively), with bypasses and target vessels patency. The extra-anatomic bypass with selective visceral vessels clamping reduces the aortic occlusion time and the risk of organ ischemia. All approaches available should be considered on a case-by-case basis and in high-volume centers. Copyright © 2017 Elsevier Inc. All rights reserved.
Hameed, I.; Hussain, F.; Dastgir, G.
Anatomical studies of the 6 different species of family Polygonaceae viz., Rumex hastatus D. Don, Rumex dentatus Linn, Rumex nepalensis Spreng, Rheum australe D. Don, Polygonum plebejum R. Br and Persicaria maculosa S.F. Gay are presented. The study is based on the presence and absence of epidermis, parenchyma, collenchyma, sclerenchyma, endodermis, pericycle, xylem, phloem, pith, mesophyll cells and stone cells. (author)
Chapuis, Pierre; Bokey, Les; Fahrer, Marius; Sinclair, Gael; Bogduk, Nikolai
Sound surgical technique is based on accurate anatomic knowledge. In surgery for cancer, the anatomy of the perirectal fascia and the retrorectal plane is the basis for correct mobilization of the rectum to ensure clear surgical margins and to minimize the risk of local recurrence. This review of the literature on the perirectal fascia is based on a translation of the original description by Thoma Jonnesco and a later account by Wilhelm Waldeyer. The Jonnesco description, first published in 1896 in French, is compared with the German account of 1899. These were critically analyzed in the context of our own and other techniques of mobilizing the rectum. Mobilization of the rectum for cancer can be performed along anatomic planes with minimal blood loss, preservation of the pelvic autonomic nerves and a low prevalence of local recurrence. Different techniques including total mesorectal excision are based on the same anatomic principles, however, popular words have been used to replace accepted, established terminology. In particular, the description of total mesorectal excision has been confusing because of its emphasis on the words "total" and "mesorectum." The use of the word "mesorectum" anatomically is inaccurate and the implication that total excision of all the perirectal fat contained within the perirectal fascia "en bloc" in all patients with rectal cancer will minimize local recurrence remains contentious.
Kendall-Tackett, Kathleen A.
Telephone interviews were conducted with 201 Boston-area professionals who work with child victims of sexual abuse. Questions concerned use of anatomical dolls and other techniques and behavioral indicators of sexual abuse. Results indicated that mental health professionals used significantly more techniques than did law enforcement professionals.…
Hofbauer, M.; Muller, B. [=Bart; Murawski, C. D.; van Eck, C. F.; Fu, F. H.
To describe the concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction. The PubMed/Medline database was searched using keywords pertaining to ACL reconstruction. Relevant articles were reviewed in order to summarize important concepts of individualized surgery in ACL
Eucalyptus globulus is one of the most important hardwood species used by the pulp and paper industry due to its high pulp yield, high wood density, excellent fibre quality and good handsheet properties. However, the wood is a highly variable and complex material that has different chemical, physical and anatomical ...
Baath, M.; Haakansson, M.; Boerjesson, S.; Hoeschen, C.; Tischenko, O.; Kheddache, S.; Vikgren, J.; Maansson, L. G.
The image background resulting from imaged anatomy can be divided into those components that are meaningful to the observers, in the sense that they are recognised as separate structures, and those that are not. These latter components (referred to as anatomical noise) can be removed using a method developed within the RADIUS group. The aim of the present study was to investigate whether the removal of the anatomical noise results in images where lung nodules with lower contrast can be detected. A receiver operating characteristic (ROC) study was therefore conducted using two types of images: clinical chest images and chest images in which the anatomical noise had been removed. Simulated designer nodules with a full-width-at-fifth-maximum of 10 mm but with varying contrast were added to the images. The contrast needed to obtain an area under the ROC curve of 0.80, C0.8, was used as a measure of detectability (a low value of C0.8 represents a high delectability). Five regions of the chest X ray were investigated and it was found that in all regions the removal of anatomical noise led to images with lower C0.8 than the original images. On average, C0.8 was 20% higher in the original images, ranging from 7% (the lateral pulmonary regions) to 41% (the upper mediastinal regions). (authors)
Dalpiaz, Orietta; Mitterberger, Michael; Kerschbaumer, Andrea; Pinggera, Germar M; Bartsch, Georg; Strasser, Hannes
To investigate, in a morphological study, the anatomy of the male rhabdosphincter and the relation between the membranous urethra, the rhabdosphincter and the neurovascular bundles (NVBs) to provide the anatomical basis for surgical approach of the posterior urethra as successful outcomes in urethral reconstructive surgery still remain a challenging issue. In all, 11 complete pelves and four tissue blocks of prostate, rectum, membranous urethra and the rhabdosphincter were studied. Besides anatomical preparations, the posterior urethra and their relationship were studied by means of serial histological sections. In the histological cross-sections, the rhabdosphincter forms an omega-shaped loop around the anterior and lateral aspects of the membranous urethra. Ventrally and laterally, it is separated from the membranous urethra by a delicate sheath of connective tissue. Through a midline approach displacing the nerves and vessels laterally, injuries to the NVBs can be avoided. With meticulous dissection of the delicate ventral connective tissue sheath between the ventral wall of the membranous urethra and the rhabdosphincter, the two structures can be separated without damage to either of them. This anatomical approach can be used for dissection of the anterior urethral wall in urethral surgery. Based on precise anatomical knowledge, the ventral wall of the posterior urethra can be dissected and exposed without injuring the rhabdosphincter and the NVBs. This approach provides the basis for sparing of the rhabdosphincter and for successful outcomes in urethral surgery for the treatment of bulbo-membranous urethral strictures.
Knowledge of the anatomy of median arteries is important in the diagnosis and management of carpal tunnel and pronator teres syndromes, reconstructive surgery in the forearm, minimizing inadvertent vascular injury as well as in limiting operative complications due to unexpected bleeding. The anatomical pattern displays ...
Gross and morphometric anatomical changes of the thyroid gland in the West African Dwarf Goat ( Capra hircus ) during the foetal and post-natal periods of development. ... The right lobe was more cranially located on the larynx and trachea than the left lobe in all age groups. Thyroid isthmus was absent in few foetal thyroid ...
Conclusion: There were some similarities and some differences of the anatomical structures of the syrinx of goose and that of other bird species. No differences between male and female syrinx were observed. [J Adv Vet Anim Res 2017; 4(4.000: 343-347
Objective: To evaluate the colorectal cancer clinical data with respect to the anatomical location and stage of disease. Design: Retrospective observational study. Setting: Kenyatta National Hospital (KNH), Nairobi, Kenya. Subjects: Two hundred and fifty three tumours were categorised as right colonic (RCC), left colonic ...
A study was carried out on the gross anatomical, morphometric features and histology of the gastrointestinal tract of the Striped Sand Snake (Psammophis sibilans). Ten snakes (five males and five females) were euthanized and dissected for the study. The gastrointestinal tract appeared as a straight tubular organ from oral ...
Corcoles-Parada, M.; Müller, N.C.J.; Ubero, M.; Serrano-Del-Pueblo, V.M.; Mansilla, F.; Marcos-Rabal, P.; Artacho-Perula, E.; Dresler, M.; Insausti, R.; Fernandez, G.; Munoz-Lopez, M.
The medial prefrontal areas 32, 24, 14, and 25 (mPFC) form part of the limbic memory system, but little is known about their functional specialization in humans. To add anatomical precision to structural and functional magnetic resonance imaging (MRI) data, we aimed to identify these mPFC subareas
Uzun, C; Atman, E D; Ustuner, E; Mirjalili, S A; Oztuna, D; Esmer, T S
Surface anatomy and anatomical planes are widely used in education and clinical practice. The planes are largely derived from cadaveric studies and their projections on the skin show discrepancies between and within anatomical reference textbooks. In this study, we reassessed the accuracy of common thoracic and abdominopelvic anatomical planes using computed tomography (CT) imaging in the live adult Turkish population. After patients with distorting pathologies had been excluded, CT images of 150 supine patients at the end tidal inspiration were analyzed. Sternal angle, transpyloric, subcostal, supracristal and pubic crest planes and their relationships to anatomical structures were established by dual consensus. The tracheal bifurcation, azygos vein/superior vena cava (SVC) junction and pulmonary bifurcation were usually below the sternal angle while the concavity of the aortic arch was generally within the plane. The tip of the tenth rib, the superior mesenteric artery and the portal vein were usually within the transpyloric plane while the renal hila and the fundus of the gallbladder were below it. The inferior mesenteric artery was below the subcostal plane and the aortic bifurcation was below the supracristal plane in most adults. Projectional surface anatomy is fundamental to medical education and clinical practice. Modern cross-sectional imaging techniques allow large groups of live patients to be examined. Classic textbook information regarding anatomy needs to be reviewed and updated using the data gathered from these recent studies, taking ethnic differences into consideration. © 2015 Wiley Periodicals, Inc.
Granite, Guinevere; Pugh, Kristy; Chen, Hegang; Longinaker, Nyaradzo; Garofalo, Evan; Shackelford, Stacy; Shalin, Valerie; Puche, Adam; Pasley, Jason; Sarani, Babak; Henry, Sharon; Bowyer, Mark; Mackenzie, Colin
Surgical residents express confidence in performing specific vascular exposures before training, but such self-reported confidence did not correlate with co-located evaluator ratings. This study reports residents' self-confidence evaluated before and after Advanced Surgical Skills for Exposure in Trauma (ASSET) cadaver-based training, and 12-18 mo later. We hypothesize that residents will better judge their own skill after ASSET than before when compared with evaluator ratings. Forty PGY2-7 surgical residents performed four procedures: axillary artery (AA), brachial artery (BA), femoral artery exposure and control (FA), and lower extremity fasciotomy (FAS) at the three evaluations. Using 5-point Likert scales, surgeons self-assessed their confidence in anatomical understanding and procedure performance after each procedure and evaluators rated each surgeon accordingly. For all the three evaluations, residents consistently rated their anatomical understanding (p < 0.04) and surgical performance (p < 0.03) higher than evaluators for both FA and FAS. Residents rated their anatomical understanding and surgical performance higher (p < 0.005) than evaluators for BA after training and up to 18 mo later. Only for third AA evaluation were there no rating differences. Residents overrate their anatomical understanding and performance abilities for BA, FA, and FAS even after performing the procedures and being debriefed three times in 18 mo.
Morphological and anatomical structure of Tansy (Tanacetum vulgare L.) from two specific locations in one town, depending on environmental conditions, were carried out: anthropogenic Ada Huja (polluted zone) and non anthropogenic Topcider park (unpolluted). Study included the diferences in the structure of leaves, ...
This clinical feature was in conformity with a lesion of inferior primary trunk. All diagnoses were made based on the clinical findings. These cases demonstrate the significance of a through anatomical knowledge in the clinical examination if one has to avoid confusing the signs of terminal nerves lesion with the trunk's lesion.
Full Text Available In the paper is represented anatomical characteristic of vegetative organs of the rare, endangered and endemic species – Ikonnikovia kaufmanniana, which has been studied in conditions of three different coenopopulations. As a result, it was established that vegetative organs of these plants are characterized by different stage of development of its tissues dependently from the habitat.
Full Text Available While advances in magnetic resonance imaging (MRI throughout the last decades have enabled the detailed anatomical and functional inspection of the human brain non-invasively, to date there is no consensus regarding the precise subdivision and topography of the areas forming the human auditory cortex. Here, we propose a topography of the human auditory areas based on insights on the anatomical and functional properties of human auditory areas as revealed by studies of cyto- and myelo-architecture and fMRI investigations at ultra-high magnetic field (7 Tesla. Importantly, we illustrate that - whereas a group-based approach to analyze functional (tonotopic maps is appropriate to highlight the main tonotopic axis - the examination of tonotopic maps at single subject level is required to detail the topography of primary and non-primary areas that may be more variable across subjects. Furthermore, we show that considering multiple maps indicative of anatomical (i.e. myelination as well as of functional properties (e.g. broadness of frequency tuning is helpful in identifying auditory cortical areas in individual human brains. We propose and discuss a topography of areas that is consistent with old and recent anatomical post mortem characterizations of the human auditory cortex and that may serve as a working model for neuroscience studies of auditory functions.
The wall thickness of wood fibres of rubber (Hevea brasiliensis) grown and tapped for latex in south eastern Nigeria were investigated to determine anatomical variation. The rubber trees which were overmature for tapping and keeping were sampled in hierarchical order of plantations, bud classes, trees, discs, cardinal ...
Mourente Miguel Mariana Correia
Full Text Available Written language is undoubtedly more often used than oral language in a variety of contexts, including both the professional and academic life. Consequently, developing strategies for correcting compositions and improving students’ written production is of vital importance. This article describes an experiment aimed at assessing the two most widely used methods of correction for compositions –traditional teacher correction and peer marking and their effect on the frequency of errors. Data was collected by asking students to write and revise a text. Statistical tests were performed to analyse it. At the end of the experiment, it was found that no significant difference in efficiency existed between the two methods, contradicting expectations (cf. Davies, 2002; Levine et al., 2002 and Ward, 2001. Key words: English-Teaching, Foreign Language-Teaching Writing, Evaluation, Assessment El lenguaje escrito es sin duda usado con más frecuencia que el lenguaje oral en una variedad de situaciones o contextos, incluyendo tanto la vida profesional como la académica. En consecuencia, el desarrollo de estrategias para corregir composiciones y mejorar la producción escrita de los estudiantes es de suma importancia. Este artículo describe un experimento cuyo objetivo es evaluar los dos métodos más usados para la corrección de composiciones, la corrección tradicional por el maestro y la corrección por revisión de pares, con respecto a su efecto en la frecuencia de errores. Se recogió información haciendo que estudiantes escribieran y revisaran un texto y sobre esos textos se aplicaron pruebas estadísticas para analizar los errores. Contrario a lo esperado, al final del experimento, no se encontró ninguna diferencia significativa entre los resultados encontrados por los dos métodos, (cfr. Davies, 2002; Levine et al., 2002 y Ward, 2001. Palabras claves: Inglés-Enseñanza, Idioma Extranjero-Enseñanza, Composición, Evaluación
Toews, Matthew; Wells, William; Collins, D Louis; Arbel, Tal
This paper presents feature-based morphometry (FBM), a new fully data-driven technique for discovering patterns of group-related anatomical structure in volumetric imagery. In contrast to most morphometry methods which assume one-to-one correspondence between subjects, FBM explicitly aims to identify distinctive anatomical patterns that may only be present in subsets of subjects, due to disease or anatomical variability. The image is modeled as a collage of generic, localized image features that need not be present in all subjects. Scale-space theory is applied to analyze image features at the characteristic scale of underlying anatomical structures, instead of at arbitrary scales such as global or voxel-level. A probabilistic model describes features in terms of their appearance, geometry, and relationship to subject groups, and is automatically learned from a set of subject images and group labels. Features resulting from learning correspond to group-related anatomical structures that can potentially be used as image biomarkers of disease or as a basis for computer-aided diagnosis. The relationship between features and groups is quantified by the likelihood of feature occurrence within a specific group vs. the rest of the population, and feature significance is quantified in terms of the false discovery rate. Experiments validate FBM clinically in the analysis of normal (NC) and Alzheimer's (AD) brain images using the freely available OASIS database. FBM automatically identifies known structural differences between NC and AD subjects in a fully data-driven fashion, and an equal error classification rate of 0.80 is achieved for subjects aged 60-80 years exhibiting mild AD (CDR=1). Copyright (c) 2009 Elsevier Inc. All rights reserved.
Adam J Horn
Full Text Available Background: One of the drawbacks of studying pathology in the second year of medical school in a classroom setting is the relatively limited exposure to patient encounters/clinical rotations, making it difficult to understand and fully appreciate the significance of the course material, specifically the molecular and tissue aspects of disease. In this study, we determined if case vignettes incorporating pathologist-clinician encounters with whole slide imaging (WSI and narrated/annotated videos of whole slide (WS scans in addition to clinical data improved student understanding of pathologic disease processes. Materials and Methods: Case vignettes were created for several genitourinary disease processes that utilized clinical data including narratives of pathologist-clinician encounters, WSI, and annotated video tutorials of WS scans (designed to simulate "double-heading". The students were encouraged to view the virtual slide first, with the video tutorials being provided to offer additional assistance. The case vignettes were created to be interactive with a detailed explanation of each correct and incorrect question choice. The cases were made available to all second year medical students via a website and could be viewed only after completing a 10 question pre-test. A post-test could be completed after viewing all cases followed by a brief satisfaction survey. Results: Ninety-six students completed the pre-test with an average score of 7.7/10. Fifty-seven students completed the post-test with an average score of 9.4/10. Thirty-six students completed the satisfaction survey. 94% agreed or strongly agreed that this was a useful exercise and 91% felt that it helped them better understand the topics. Conclusion: The development of interactive case vignettes incorporating simulated pathologist-clinician encounters with WSI and video tutorials of WS scans helps to improve student enthusiasm to learn and grasp pathologic aspects of disease
This paper argues that the anatomical Cabinets of Dutch anatomist Frederik Ruysch must be understood as an early modern workshop in which preparations were continuously handled. It is claimed that preparations actively appealed to anatomists and visitors to handle, re-dissect, touch, and even kiss
The universal presence of anatomy in healthcare professions is undeniable. It is a cornerstone to each of the clinical and basic sciences. Therefore, further expansion of current anatomical knowledge and effective methods to teach anatomy is essential. In this work, the relationship of the dorsal scapular artery with the trunks of the brachial…