WorldWideScience

Sample records for coroners and medical examiners

  1. Features of commercial computer software systems for medical examiners and coroners.

    Science.gov (United States)

    Hanzlick, R L; Parrish, R G; Ing, R

    1993-12-01

    There are many ways of automating medical examiner and coroner offices, one of which is to purchase commercial software products specifically designed for death investigation. We surveyed four companies that offer such products and requested information regarding each company and its hardware, software, operating systems, peripheral devices, applications, networking options, programming language, querying capability, coding systems, prices, customer support, and number and size of offices using the product. Although the four products (CME2, ForenCIS, InQuest, and Medical Examiner's Software System) are similar in many respects and each can be installed on personal computers, there are differences among the products with regard to cost, applications, and the other features. Death investigators interested in office automation should explore these products to determine the usefulness of each in comparison with the others and in comparison with general-purpose, off-the-shelf databases and software adaptable to death investigation needs.

  2. Guidelines to implement medical examiner/coroner-based surveillance for fatal infectious diseases and bioterrorism ("Med-X").

    Science.gov (United States)

    Nolte, Kurt B; Fischer, Marc; Reagan, Sarah; Lynfield, Ruth

    2010-12-01

    Medical examiners and coroners investigate deaths that are sudden, unexplained, and violent. Oftentimes these deaths are a consequence of infections, many of which have public health consequences. Additionally, because deaths from bioterrorism are homicides, they fall under the jurisdiction of medical examiners and coroners. Surveillance for infectious disease-related deaths can enhance the opportunities to recognize these deaths. Beginning in 2000, the New Mexico Office of the Medical Investigator developed and tested a medical examiner surveillance model for bioterrorism and infectious disease mortality ("Med-X") using a set of symptoms to determine which cases should receive an autopsy and a set of pathology-based syndromes for early reporting of cases to public health authorities. This model demonstrated that many of the symptoms had a high predictive value for infections and were useful criteria for autopsy performance. The causative organism was identified for 81% of infections of which 58% were notifiable conditions by public health standards. Uniform criteria for performing autopsies and reporting cases to public health authorities enhance surveillance for notifiable infectious diseases and increase the probability of recognizing fatalities related to bioterrorism. We have developed guidelines for medical examiners, coroners and their public health partners to use in implementing Med-X surveillance in their jurisdictions. These guidelines encompass definitions of symptoms and syndromes, specimen collection and storage procedures, laboratory diagnostic approaches, and processes for case flow, case reporting, and data collection. We also suggest resources for autopsy biosafety information and funding.

  3. 77 FR 5057 - Draft Guidelines for Coroner/Medical Examiner Media Relations

    Science.gov (United States)

    2012-02-01

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF JUSTICE Office of Justice Programs Draft Guidelines for Coroner/Medical Examiner Media Relations AGENCY: National... general public a draft document entitled, ``Guidelines for Media Relations: Dissemination of...

  4. Stainable hepatic iron in 341 African American adults at coroner/medical examiner autopsy

    Directory of Open Access Journals (Sweden)

    Acton Ronald T

    2005-01-01

    Full Text Available Abstract Background Results of previous autopsy studies indicate that increased hepatic iron stores or hepatic iron overload is common in African Americans dying in hospitals, but there are no reports of hepatic iron content in other cohorts of African Americans. Methods We investigated the prevalence of heavy liver iron deposition in African American adults. Using established histochemical criteria, we graded Perls' acid ferrocyanide-reactive iron in the hepatocytes and Kupffer cells of 341 consecutive African American adults who were autopsied in the coroner/medical examiner office. Heavy staining was defined as grade 3 or 4 hepatocyte iron or grade 3 Kupffer cell iron. Results There were 254 men and 85 women (mean age ± 1 SD: 44 ± 13 y vs. 48 ± 14 y, respectively; p = 0.0255; gender was unstated or unknown in two subjects. Approximately one-third of subjects died of natural causes. Heavy staining was observed in 10.2% of men and 4.7% of women. 23 subjects had heavy hepatocyte staining only, six had heavy Kupffer cell staining only, and one had a mixed pattern of heavy staining. 15 subjects had histories of chronic alcoholism; three had heavy staining confined to hepatocytes. We analyzed the relationships of three continuous variables (age at death in years, hepatocyte iron grade, Kupffer cell iron grade and two categorical variables (sex, cause of death (natural and non-natural causes in all 341 subjects using a correlation matrix with Bonferroni correction. This revealed two positive correlations: hepatocyte with Kupffer cell iron grades (p Conclusions The present results confirm and extend previous observations that heavy liver iron staining is relatively common in African Americans. The pertinence of these observations to genetic and acquired causes of iron overload in African Americans is discussed.

  5. Mass fatality preparedness among medical examiners/coroners in the United States: a cross-sectional study.

    Science.gov (United States)

    Gershon, Robyn R M; Orr, Mark G; Zhi, Qi; Merrill, Jacqueline A; Chen, Daniel Y; Riley, Halley E M; Sherman, Martin F

    2014-12-15

    In the United States (US), Medical Examiners and Coroners (ME/Cs) have the legal authority for the management of mass fatality incidents (MFI). Yet, preparedness and operational capabilities in this sector remain largely unknown. The purpose of this study was twofold; first, to identify appropriate measures of preparedness, and second, to assess preparedness levels and factors significantly associated with preparedness. Three separate checklists were developed to measure different aspects of preparedness: MFI Plan Elements, Operational Capabilities, and Pre-existing Resource Networks. Using a cross-sectional study design, data on these and other variables of interest were collected in 2014 from a national convenience sample of ME/C using an internet-based, anonymous survey. Preparedness levels were determined and compared across Federal Regions and in relation to the number of Presidential Disaster Declarations, also by Federal Region. Bivariate logistic and multivariable models estimated the associations between organizational characteristics and relative preparedness. A large proportion (42%) of respondents reported that less than 25 additional fatalities over a 48-hour period would exceed their response capacities. The preparedness constructs measured three related, yet distinct, aspects of preparedness, with scores highly variable and generally suboptimal. Median scores for the three preparedness measures also varied across Federal Regions and as compared to the number of Presidential Declared Disasters, also by Federal Region. Capacity was especially limited for activating missing persons call centers, launching public communications, especially via social media, and identifying temporary interment sites. The provision of staff training was the only factor studied that was significantly (positively) associated (p < .05) with all three preparedness measures. Although ME/Cs ranked local partners, such as Offices of Emergency Management, first responders, and

  6. Examining the Properties of Jets in Coronal Holes

    Science.gov (United States)

    Gaulle, Owen; Adams, Mitzi L.; Tennant, A. F.

    2012-01-01

    We examined both X-ray and Magnetic field data in order to determine if there is a correlation between emerging magnetic flux and the production of Coronal jets. It was proposed that emerging flux can be a trigger to a coronal jet. The jet is thought to be caused when local bipoles reconnect or when a region of magnetic polarity emerges through a uniform field. In total we studied 15 different jets that occurred over a two day period starting 2011-02-27 00:00:00 UTC and ending 2011-02-28 23:59:55 UTC. All of the jets were contained within a coronal hole that was centered on the disk. Of the 15 that we studied 6 were shown to have an increase of magnetic flux within one hour prior to the creation of the jet and 10 were within 3 hours before the event.

  7. Medical examiner and medical toxicologist agreement on cause of death

    Science.gov (United States)

    Manini, Alex F.; Nelson, Lewis S.; Olsen, Dean; Vlahov, David; Hoffman, Robert S.

    2014-01-01

    Poisoning is a significant public health threat as the second leading cause of injury-related death in the US. Disagreements on cause of death determination may have widespread implications across several realms of public health including policy and prevention efforts, interpretation of the poisoning literature, epidemiologic data analysis, medical-legal case outcomes, and individualized autopsy interpretation. We aimed to test agreement between the cause of death determined by the medical examiner (ME) and a medical toxicologist (MT) adjudication panel (MTAP) in cases of poisoning. This retrospective 7-year study evaluated all deaths attributed to poisoning in one large urban catchment area. Cross-matched data were obtained from Department of Vital Statistics and the Poison Control Center (PCC). Out of >380,000 deaths in the catchment area over the study period, there were 7050 poisonings in the Vital Statistics database and 414 deaths reported to PCC. Cross-matching yielded 321 cases for analysis. The ME and MTAP concurred on cause of death in 66%, which was only fair agreement (κ 0.25, CI 0.14–0.38). Factors associated with the likelihood of agreement were peri-mortem fire exposures, prehospital cardiac arrest, and timing of drug toxicity (chronic versus acute). In conclusion, agreement for poisoning cause of death between specialties was much lower than expected. We recommend an improved formal process of information sharing and consultation between specialties to assure that all existing information is analyzed thoroughly to enhance cause of death certainty. PMID:20655675

  8. Coronal Waves and Oscillations

    Directory of Open Access Journals (Sweden)

    Nakariakov Valery M.

    2005-07-01

    Full Text Available Wave and oscillatory activity of the solar corona is confidently observed with modern imaging and spectral instruments in the visible light, EUV, X-ray and radio bands, and interpreted in terms of magnetohydrodynamic (MHD wave theory. The review reflects the current trends in the observational study of coronal waves and oscillations (standing kink, sausage and longitudinal modes, propagating slow waves and fast wave trains, the search for torsional waves, theoretical modelling of interaction of MHD waves with plasma structures, and implementation of the theoretical results for the mode identification. Also the use of MHD waves for remote diagnostics of coronal plasma - MHD coronal seismology - is discussed and the applicability of this method for the estimation of coronal magnetic field, transport coefficients, fine structuring and heating function is demonstrated.

  9. National Association of Medical Examiners position paper on the medical examiner release of organs and tissues for transplantation.

    Science.gov (United States)

    Pinckard, J Keith; Wetli, Charles V; Graham, Michael A

    2007-09-01

    The medical examiner community plays a key role in the organ and tissue procurement process for transplantation. Since many, if not most, potential organ or tissue donors fall under medicolegal jurisdiction, the medical examiner bears responsibility to authorize or deny the procurement of organs or tissues on a case-by-case basis. This responsibility engenders a basic dichotomy for the medical examiner's decision-making process. In cases falling under his/her jurisdiction, the medical examiner must balance the medicolegal responsibility centered on the decedent with the societal responsibility to respect the wishes of the decedent and/or next of kin to help living patients. Much has been written on this complex issue in both the forensic pathology and the transplantation literature. Several studies and surveys of medical examiner practices, as well as suggested protocols for handling certain types of cases, are available for reference when concerns arise that procurement may potentially hinder medicolegal death investigation. It is the position of the National Association of Medical Examiners (NAME) that the procurement of organs and/or tissues for transplantation can be accomplished in virtually all cases, without detriment to evidence collection, postmortem examination, determination of cause and manner of death, or the conducting of criminal or civil legal proceedings. The purpose of this position paper is to review the available data, the arguments for and against medical examiner release, and to encourage the release of organs and tissues in all but the rarest of circumstances.

  10. Coronal leakage of provisional restorative materials used in endodontics with and without intracanal medication after exposure to human saliva

    Directory of Open Access Journals (Sweden)

    P Udayakumar

    2016-01-01

    Full Text Available Aim: To determine the coronal leakage of various provisional restorations with and without intracanal medication over time after being exposed to human saliva. Materials and Methods: This study investigated Coltosol F, Cavit, Ketac Molar, and IRM as provisional restorative material. Calcium hydroxide and chlorhexidine were used as an intracanal medicament. Ninety-eight single rooted teeth were randomly selected and then mounted in an apparatus that isolated the crown portion of the tooth. Provisional restorative materials were placed in the access cavity following manufacturer guidelines after placement of intracanal medicament. Human saliva and brain heart infusion broth in 3:1 ratio were applied to the samples, incubated at 37°C, and results were tabulated over the course of 4 weeks by the appearance of turbidity in the lower part of the apparatus. Statistical Analysis: The data were statistically analyzed using proportional Z-test. The level of significance was set at 0.05. Results: Coltosol F and Cavit could significantly prevent the bacterial leakage up to a period of 7 days with a P value of 0.01 and 0.005, respectively. Bacterial recontamination was relatively less in the samples treated with intracanal medicaments up to 14 days. After 14 days, however, all materials leaked in over half of the samples. Conclusion: No provisional restorative material can be considered superior in providing a reliable seal after 14 days. Inter-appointments schedule should not extend beyond 2 weeks and after endodontic therapy final restoration should be completed within 1 week.

  11. 'Natural' and 'Unnatural' medical deaths and coronial law: A UK and international review of the medical literature on natural and unnatural death and how it applies to medical death certification and reporting deaths to coroners: Natural/Unnatural death: A Scientific Review.

    Science.gov (United States)

    Harris, Andrew

    2017-07-01

    In the United Kingdom, when people die, either a doctor writes an acceptable natural cause of death medical certificate, or a coroner (fiscal in Scotland) investigates the case, usually with an autopsy. An inquest may or may not follow. The concept of 'natural or unnatural cause' death is not internationally standardized. This article reviews scientific evidence as to what is a natural death or unnatural death and how that relates to the international classification of deaths. Whilst there is some consensus on the definition, its application in considering whether to report to the coroner is more difficult. Depictions of deaths in terminal care, medical emergencies and post-operative care highlight these difficulties. It secondly reviews to what extent natural and unnatural are criteria for notification of deaths in England and Wales and internationally. It concludes with consideration of how medical concepts of unnatural death relate in England and Wales to coroners' legal concepts of what is unnatural. Deaths that appear natural to clinicians and pathologists may be legally unnatural and vice versa. It is argued that the natural/unnatural dichotomy is not a good criterion for reporting deaths under medical care to coroners, but the notification of a medical cause of death, using the International Classification of Disease Codes and the medical professional view as to whether it is scientifically natural, is of great value to the coroner in deciding whether it is legally unnatural.

  12. Coronal Seismology -- Achievements and Perspectives

    Science.gov (United States)

    Ruderman, Michael

    Coronal seismology is a new and fast developing branch of the solar physics. The main idea of coronal seismology is the same as of any branches of seismology: to determine basic properties of a medium using properties of waves propagating in this medium. The waves and oscillations in the solar corona are routinely observed in the late space missions. In our brief review we concentrate only on one of the most spectacular type of oscillations observed in the solar corona - the transverse oscillations of coronal magnetic loops. These oscillations were first observed by TRACE on 14 July 1998. At present there are a few dozens of similar observations. Shortly after the first observation of the coronal loop transverse oscillations they were interpreted as kink oscillations of magnetic tubes with the ends frozen in the dense photospheric plasma. The frequency of the kink oscillation is proportional to the magnetic field magnitude and inversely proportional to the tube length times the square root of the plasma density. This fact was used to estimate the magnetic field magnitude in the coronal loops. In 2004 the first simultaneous observation of the fundamental mode and first overtone of the coronal loop transverse oscillation was reported. If we model a coronal loop as a homogeneous magnetic tube, then the ratio of the frequencies of the first overtone and the fundamental mode should be equal to 2. However, the ratio of the observed frequencies was smaller than 2. This is related to the density variation along the loop. If we assume that the corona is isothermal and prescribe the loop shape (usually it is assumed that it has the shape of half-circle), then, using the ratio of the two frequencies, we can determine the temperature of the coronal plasma. The first observation of transverse oscillations of the coronal loops showed that they were strongly damped. This phenomenon was confirmed by the subsequent observations. At present, the most reliable candidate for the

  13. Coronal Jet Plasma Properties and Acceleration Mechanisms

    Science.gov (United States)

    Farid, Samaiyah; Reeves, Kathy; Savcheva, Antonia; Soto, Natalia

    2017-08-01

    Coronal jets are transient eruptions of plasma typically characterized by aprominent long spire and a bright base, and sometimes accompanied by a small filament. Jets are thought to be produced by magnetic reconnection when small-scale bipolar magnetic fields emerge into an overlying coronal field or move into a locally unipolar region. Coronal jets are commonly divided into two categories: standard jets and blowout jets, and are found in both quiet and active regions. The plasma properties of jets vary across type and location, therefore understanding the underlying acceleration mechanisms are difficult to pin down. In this work, we examine both blow-out and standard jets using high resolution multi-wavelength data. Although reconnection is commonly accepted as the primary acceleration mechanism, we also consider the contribution chromospheric evaporation to jet formation. We use seven coronal channels from SDO/AIA , Hinode/XRT Be-thin and IRIS slit-jaw data. In addition, we separate the Fe-XVIII line from the SDO/94Å channel. We calculate plasma properties including velocity, Alfven speed, and density as a function of wavelength and Differential Emission Measure (DEM). Finally, we explore the magnetic topology of the jets using Coronal Modeling System (CMS) to construct potential and non-linear force free models based on the flux rope insertion method.

  14. Coronal Fourier power spectra: implications for coronal seismology and coronal heating

    CERN Document Server

    Ireland, Jack; Inglis, Andrew R

    2014-01-01

    The dynamics of regions of the solar corona are investigated using Atmospheric Imaging Assembly (AIA) 171\\AA\\ and 193\\AA\\ data. The coronal emission from the quiet Sun, coronal loop footprints, coronal moss, and from above a sunspot is studied. It is shown that the mean Fourier power spectra in these regions can be described by a power law at lower frequencies that tails to flat spectrum at higher frequencies, plus a Gaussian-shaped contribution that varies depending on the region studied. This Fourier spectral shape is in contrast to the commonly-held assumption that coronal time-series are well described by the sum of a long time-scale background trend plus Gaussian-distributed noise, with some specific locations also showing an oscillatory signal. The implications of this discovery to the field of coronal seismology and the automated detections of oscillations are discussed. The power law contribution to the shape of the Fourier power spectrum is interpreted as being due to the summation of a distribution ...

  15. [Diagnosis and examination for COPD; medical interview/physical finding/ blood examination].

    Science.gov (United States)

    Sato, Susumu; Mishima, Michiaki

    2016-05-01

    Chronic obstructive pulmonary disease(COPD) is common disease. To diagnose COPD, pulmonary function test is required, however, usual physical examination and medical interview are both crucial. From both of them, we can acquire very important information and also this information will tell us much rather than pulmonary function test or images. In this article, we would like to summarize recent update about these topics. We focused on history taking from patients, examination of physical finding, and some possible biomarkers from blood examination. All of them may represent several important information of each patients, such as severity of disease, risk of future events, and also prognosis. For all physicians, it is necessary to evaluate these things.

  16. Public opinion and medical cannabis policies: examining the role of underlying beliefs and national medical cannabis policies

    OpenAIRE

    SZNITMAN, SHARON R.; Bretteville-Jensen, Anne Line

    2015-01-01

    Background Debate about medical cannabis legalization are typically informed by three beliefs: (1) cannabis has medical effects, (2) medical cannabis is addictive and (3) medical cannabis legalization leads to increased used of cannabis for recreational purposes (spillover effects). We examined how strongly these beliefs are associated with public support for medical cannabis legalization and whether this association differs across divergent medical cannabis policy regimes. Methods Robust reg...

  17. Targeting Oral and Cultural Proficiency for Medical Personnel: An Examination of Current Medical Spanish Textbooks

    Science.gov (United States)

    Hardin, Karol

    2012-01-01

    Demand for medical Spanish courses has grown with the rising needs of Spanish-speaking patients in the United States, but while there is no shortage of beginning medical Spanish textbooks, very few target the intermediate level. This article examines eighteen medical Spanish texts published in the last twenty years with respect to seven factors:…

  18. 20 CFR 725.406 - Medical examinations and tests.

    Science.gov (United States)

    2010-04-01

    ... chest roentgenogram and, unless medically contraindicated, a blood gas study. (b) As soon as possible..., found liable for the payment of benefits to the claimant. If an operator fails to repay such...

  19. Chemical Fractionation and Abundances in Coronal Plasma

    CERN Document Server

    Drake, J J

    2003-01-01

    Much of modern astrophysics is grounded on the observed chemical compositions of stars and the diffuse plasma that pervades the space between stars, galaxies and clusters of galaxies. X-ray and EUV spectra of the hot plasma in the outer atmospheres of stars have demonstrated that these environments are subject to chemical fractionation in which the abundances of elements can be enhanced and depleted by an order of magnitude or more. These coronal abundance anomalies are discussed and some of the physical mechanisms that might be responsible for producing them are examined. It is argued that coronal abundances can provide important new diagnostics on physical processes at work in solar and stellar coronae. It seems likely that other hot astrophysical plasmas will be subject to similar effects.

  20. 77 FR 55221 - Agency Information Collection Activities: Report of Medical Examination and Vaccination Record...

    Science.gov (United States)

    2012-09-07

    ... Medical Examination and Vaccination Record, Form I-693; Revision of a Currently Approved Collection ACTION...: Report of Medical Examination and Vaccination Record. (3) Agency form number, if any, and the...

  1. Students friendly medical examination

    Directory of Open Access Journals (Sweden)

    Rakesh Chandra Chaurasia

    2014-04-01

    always a burden. The professional exams of universities are the matter of their norms and regulation, but we have day-to-day assessment through-out duration; this is enough to moralize them and prepare before final professional examination. [Int J Basic Clin Pharmacol 2014; 3(2.000: 412-412

  2. Medical Student Examination Questions for Thoracic and Cardiovascular Surgery of Almost 60 Years Ago.

    Science.gov (United States)

    Kim, Won-Gon

    2016-08-01

    Medical student examination questions of 60 years ago are very rare to find irrespective of medical specialty. Recently, medical student examination questions for thoracic and cardiovascular surgery were found, which were presented between 1957 and 1959 at Seoul National University Medical College. All examination questions were hand-written in six pages by a professor as examiner. Among the six pages, four examination papers were dated and/or the target grade was identified, while the remaining two did not offer any information. These materials are thought to have a valuable historical meaning for the Korean medical community as well as the Department of Thoracic and Cardiovascular Surgery at Seoul National University Hospital.

  3. EIT waves and coronal magnetic field diagnostics

    Institute of Scientific and Technical Information of China (English)

    CHEN PengFei

    2009-01-01

    Magnetic field in the solar lower atmosphere can be measured by the use of the Zeeman and Hanle effects. By contrast, the coronal magnetic field well above the solar surface, which directly controls various eruptive phenomena, can not be precisely measured with the traditional techniques. Several attempts are being made to probe the coronal magnetic field, such as force-free extrapolation based on the photospheric magnetograms, gyroresonance radio emissions, and coronal seismology based on MHD waves in the corona. Compared to the waves trapped in the localized coronal loops, EIT waves are the only global-scale wave phenomenon, and thus are the ideal tool for the coronal global seismology. In this paper, we review the observations and modelings of EIT waves, and illustrate how they can be applied to probe the global magnetic field in the corona.

  4. Use of NBME and USMLE Examinations to Evaluate Medical Education Programs.

    Science.gov (United States)

    Williams, Reed G.

    1993-01-01

    Criteria are presented for determining whether licensure and/or achievement test results should be used for making various types of comparisons and judgments about medical education programs. The United States Medical Licensing Examination (USMLE) and National Board of Medical Examiners tests (NBME) are then considered as data sources. (Author/MSE)

  5. Examination of crime and similar concepts in the medical law.

    Science.gov (United States)

    Fathi, Mohammad Javad

    2016-01-01

    Crime is a human behavior that has captivated the thoughts of scholars of various disciplines throughout history. Philosophers, sociologists, psychologists and others have investigated and analyzed the concept of crime from different aspects. Crime is the main topic of criminal law, and in its legal meaning is a well-known term with a certain conceptual load that should not be confused with similar concepts such as guilt, civil crime (quasi tort), and particularly, the disciplinary transgression. Although crime has common points with all the above, it is an independent concept with unique effects, features, and descriptions that distinguish it from similar acts. This article aims to determine the difference between the concepts of crime, guilt, civil crime and disciplinary transgression through enumeration of the related issues as well as examples of medical disciplinary crimes and transgressions. Identifying and distinguishing these concepts can improve the procedure of prosecuting crimes and disciplinary transgression, bring punishment to criminals and transgressors, and facilitate compensation of pecuniary and non-pecuniary losses due to committers' fault or failure. Thus we may avoid taking a wrong route that can lead to infringement of individuals' rights.

  6. Examination of crime and similar concepts in the medical law

    Science.gov (United States)

    Fathi, Mohammad Javad

    2016-01-01

    Crime is a human behavior that has captivated the thoughts of scholars of various disciplines throughout history. Philosophers, sociologists, psychologists and others have investigated and analyzed the concept of crime from different aspects. Crime is the main topic of criminal law, and in its legal meaning is a well-known term with a certain conceptual load that should not be confused with similar concepts such as guilt, civil crime (quasi tort), and particularly, the disciplinary transgression. Although crime has common points with all the above, it is an independent concept with unique effects, features, and descriptions that distinguish it from similar acts. This article aims to determine the difference between the concepts of crime, guilt, civil crime and disciplinary transgression through enumeration of the related issues as well as examples of medical disciplinary crimes and transgressions. Identifying and distinguishing these concepts can improve the procedure of prosecuting crimes and disciplinary transgression, bring punishment to criminals and transgressors, and facilitate compensation of pecuniary and non-pecuniary losses due to committers’ fault or failure. Thus we may avoid taking a wrong route that can lead to infringement of individuals’ rights. PMID:27471587

  7. Medical Knowledge Assessment by Hematology and Medical Oncology In-Training Examinations Are Better Than Program Director Assessments at Predicting Subspecialty Certification Examination Performance.

    Science.gov (United States)

    Collichio, Frances A; Hess, Brian J; Muchmore, Elaine A; Duhigg, Lauren; Lipner, Rebecca S; Haist, Steven; Hawley, Janine L; Morrison, Carol A; Clayton, Charles P; Raymond, Marilyn J; Kayoumi, Karen M; Gitlin, Scott D

    2017-09-01

    The Accreditation Council for Graduate Medical Education's Next Accreditation System requires training programs to demonstrate that fellows are achieving competence in medical knowledge (MK), as part of a global assessment of clinical competency. Passing American Board of Internal Medicine (ABIM) certification examinations is recognized as a metric of MK competency. This study examines several in-training MK assessment approaches and their ability to predict performance on the ABIM Hematology or Medical Oncology Certification Examinations. Results of a Hematology In-Service Examination (ISE) and an Oncology In-Training Examination (ITE), program director (PD) ratings, demographic variables, United States Medical Licensing Examination (USMLE), and ABIM Internal Medicine (IM) Certification Examination were compared. Stepwise multiple regression and logistic regression analyses evaluated these assessment approaches as predictors of performance on the Hematology or Medical Oncology Certification Examinations. Hematology ISE scores were the strongest predictor of Hematology Certification Examination scores (β = 0.41) (passing odds ratio [OR], 1.012; 95 % confidence interval [CI], 1.008-1.015), and the Oncology ITE scores were the strongest predictor of Medical Oncology Certification Examination scores (β = 0.45) (passing OR, 1.013; 95 % CI, 1.011-1.016). PD rating of MK was the weakest predictor of Medical Oncology Certification Examination scores (β = 0.07) and was not significantly predictive of Hematology Certification Examination scores. Hematology and Oncology ITEs are better predictors of certification examination performance than PD ratings of MK, reinforcing the effectiveness of ITEs for competency-based assessment of MK.

  8. The use of interpreters in medical settings and forensic medical examinations in Australia: the relationship between medicine and linguistics.

    Science.gov (United States)

    Schreiber, Jason R; Odell, Morris S

    2014-07-01

    Medical examinations are dependent on combining communication with professional competence. In the development of a global multicultural community with the use of multiple languages, doctors have become increasingly dependent on language facilitation such as interpreting and translation. Despite professional studies, the use of language facilitation with its associated problems has not been fully explored in graduate and post-graduate medical and forensic medical training. There may still be some lack of reciprocal understanding between the medical and linguistic fields, their ethics, obligations and limits although both fields and their ethical frameworks are closer related than might be expected. This article is a discussion that aims at providing a basic understanding of guidelines as to the origin and appropriate use of language interpretation in medical and forensic medical examinations.

  9. Space weather and coronal mass ejections

    CERN Document Server

    Howard, Tim

    2013-01-01

    Space weather has attracted a lot of attention in recent times. Severe space weather can disrupt spacecraft, and on Earth can be the cause of power outages and power station failure. It also presents a radiation hazard for airline passengers and astronauts. These ""magnetic storms"" are most commonly caused by coronal mass ejections, or CMES, which are large eruptions of plasma and magnetic field from the Sun that can reach speeds of several thousand km/s. In this SpringerBrief, Space Weather and Coronal Mass Ejections, author Timothy Howard briefly introduces the coronal mass ejection, its sc

  10. Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination Performance

    Science.gov (United States)

    Perez, Jose A., Jr.; Greer, Sharon

    2009-01-01

    The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical…

  11. Coronal Magnetism and Forward Solarsoft Idl Package

    Science.gov (United States)

    Gibson, S. E.

    2014-12-01

    The FORWARD suite of Solar Soft IDL codes is a community resource for model-data comparison, with a particular emphasis on analyzing coronal magnetic fields. FORWARD may be used both to synthesize a broad range of coronal observables, and to access and compare to existing data. FORWARD works with numerical model datacubes, interfaces with the web-served Predictive Science Inc MAS simulation datacubes and the Solar Soft IDL Potential Field Source Surface (PFSS) package, and also includes several analytic models (more can be added). It connects to the Virtual Solar Observatory and other web-served observations to download data in a format directly comparable to model predictions. It utilizes the CHIANTI database in modeling UV/EUV lines, and links to the CLE polarimetry synthesis code for forbidden coronal lines. FORWARD enables "forward-fitting" of specific observations, and helps to build intuition into how the physical properties of coronal magnetic structures translate to observable properties.

  12. Examining Career Success of Minority and Women Emergency Medical Technicians (EMTs): A LEADS Project

    Science.gov (United States)

    Russ-Eft, Darlene F.; Dickison, Philip D.; Levine, Roger

    2008-01-01

    Emergency medical technicians (EMTs) are a critical segment in prehospital medical care. This study examined EMT-paramedic career success focused on minorities and women, as part of the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS). The LEADS data come from a representative sampling of EMTs throughout the…

  13. An Estimate of Solar Wind Density and Velocity Profiles in a Coronal Hole and a Coronal Streamer

    Science.gov (United States)

    Patzold, M.; Tsurutani, B. T.; Bird, M. K.

    1996-01-01

    Using the total electron content data obtained by the Ulysses Solar Corona Experiment (SCE) during the first solar conjunction in summer 1991, two data sets were selected, one associated with a coronal hole and the other associated with coronal streamer crossings. In order to determine coronal streamer density profiles, the electron content of the tracking passes embedded in a coronal streamer were corrected for the contributions from coronal hole densities.

  14. Framing medical tourism: an examination of appeal, risk, convalescence, accreditation, and interactivity in medical tourism web sites.

    Science.gov (United States)

    Mason, Alicia; Wright, Kevin B

    2011-02-01

    This exploratory study analyzed the content of medical tourism Web sites in an attempt to examine how they convey information about benefits and risks of medical procedures, how they frame credibility, and the degree to which these Web sites include interactive features for consumers. Drawing upon framing theory, the researchers content analyzed a sample of 66 medical tourism Web sites throughout the world. The results indicated that medical tourism Web sites largely promote the benefits of medical procedures while downplaying the risks, and relatively little information regarding the credibility of these services appears. In addition, the presentation of benefits/risks, credibility, and Web site interactivity were found to differ by region and type of facility. The authors discuss the implications of these findings concerning the framing of medical tourism Web site content, future directions for research, and limitations.

  15. Relation between incremental lines and tensile strength of coronal dentin.

    Science.gov (United States)

    Inoue, Toshiko; Saito, Makoto; Yamamoto, Masato; Nishimura, Fumio; Miyazaki, Takashi

    2012-01-01

    In one aspect, this study examined the tensile strength of coronal dentin, as a function of the location of incremental lines, in two types of teeth: human molar versus bovine incisor. In another aspect, tensile strength in coronal dentin was examined with tensile loading in two different orientations to the incremental lines: parallel versus perpendicular. There were four experimental groups in this study: HPa, human molar dentin with tensile orientation parallel to the incremental lines; HPe, human molar dentin with tensile orientation perpendicular to the incremental lines; BPa, bovine incisor dentin with tensile orientation parallel to the incremental lines; BPe, bovine incisor dentin with tensile orientation perpendicular to the incremental lines. Tensile strengths of the parallel group (HPa and BPa) were significantly higher (pincremental lines, was thus confirmed in coronal dentin. However, there were no differences in anisotropy effect between the two tooth types.

  16. Predictive value of grade point average (GPA), Medical College Admission Test (MCAT), internal examinations (Block) and National Board of Medical Examiners (NBME) scores on Medical Council of Canada qualifying examination part I (MCCQE-1) scores.

    Science.gov (United States)

    Roy, Banibrata; Ripstein, Ira; Perry, Kyle; Cohen, Barry

    2016-01-01

    To determine whether the pre-medical Grade Point Average (GPA), Medical College Admission Test (MCAT), Internal examinations (Block) and National Board of Medical Examiners (NBME) scores are correlated with and predict the Medical Council of Canada Qualifying Examination Part I (MCCQE-1) scores. Data from 392 admitted students in the graduating classes of 2010-2013 at University of Manitoba (UofM), College of Medicine was considered. Pearson's correlation to assess the strength of the relationship, multiple linear regression to estimate MCCQE-1 score and stepwise linear regression to investigate the amount of variance were employed. Complete data from 367 (94%) students were studied. The MCCQE-1 had a moderate-to-large positive correlation with NBME scores and Block scores but a low correlation with GPA and MCAT scores. The multiple linear regression model gives a good estimate of the MCCQE-1 (R2 =0.604). Stepwise regression analysis demonstrated that 59.2% of the variation in the MCCQE-1 was accounted for by the NBME, but only 1.9% by the Block exams, and negligible variation came from the GPA and the MCAT. Amongst all the examinations used at UofM, the NBME is most closely correlated with MCCQE-1.

  17. Knowledge brokers, companions, and navigators: a qualitative examination of informal caregivers' roles in medical tourism.

    Science.gov (United States)

    Casey, Victoria; Crooks, Valorie A; Snyder, Jeremy; Turner, Leigh

    2013-12-01

    Many studies examining the phenomena of medical tourism have identified health equity issues associated with this global health services practice. However, there is a notable lack of attention in this existing research to the informal care provided by the friends and family members who typically accompany medical tourists abroad. To date, researchers have not examined the care roles filled by informal caregivers travelling with medical tourists. In this article, we fill this gap by examining these informal caregivers and the roles they take on towards supporting medical tourists' health and wellbeing. We conducted 21 interviews with International Patient Coordinators (IPCs) working at medical tourism hospitals across ten countries. IPCs work closely with informal caregivers as providers of non-medical personal assistance, and can therefore offer broad insight on caregiver roles. The interviews were coded and analyzed thematically. Three roles emerged: knowledge broker, companion, and navigator. As knowledge brokers, caregivers facilitate the transfer of information between the medical tourist and formal health care providers as well as other staff members at medical tourism facilities. The companion role involves providing medical tourists with physical and emotional care. Meanwhile, responsibilities associated with handling documents and coordinating often complex journeys are part of the navigation role. This is the first study to examine informal caregiving roles in medical tourism. Many of the roles identified are similar to those of conventional informal caregivers while others are specific to the transnational context. We conclude that these roles make informal caregivers an integral part of the larger phenomenon of medical tourism. We further contend that examining the roles taken on by a heretofore-unconsidered medical tourism stakeholder group sheds valuable insight into how this industry operates and that such knowledge is necessary in order to respond to

  18. Knowledge brokers, companions, and navigators: a qualitative examination of informal caregivers’ roles in medical tourism

    Science.gov (United States)

    2013-01-01

    Introduction Many studies examining the phenomena of medical tourism have identified health equity issues associated with this global health services practice. However, there is a notable lack of attention in this existing research to the informal care provided by the friends and family members who typically accompany medical tourists abroad. To date, researchers have not examined the care roles filled by informal caregivers travelling with medical tourists. In this article, we fill this gap by examining these informal caregivers and the roles they take on towards supporting medical tourists’ health and wellbeing. Methods We conducted 21 interviews with International Patient Coordinators (IPCs) working at medical tourism hospitals across ten countries. IPCs work closely with informal caregivers as providers of non-medical personal assistance, and can therefore offer broad insight on caregiver roles. The interviews were coded and analyzed thematically. Results Three roles emerged: knowledge broker, companion, and navigator. As knowledge brokers, caregivers facilitate the transfer of information between the medical tourist and formal health care providers as well as other staff members at medical tourism facilities. The companion role involves providing medical tourists with physical and emotional care. Meanwhile, responsibilities associated with handling documents and coordinating often complex journeys are part of the navigation role. Conclusions This is the first study to examine informal caregiving roles in medical tourism. Many of the roles identified are similar to those of conventional informal caregivers while others are specific to the transnational context. We conclude that these roles make informal caregivers an integral part of the larger phenomenon of medical tourism. We further contend that examining the roles taken on by a heretofore-unconsidered medical tourism stakeholder group sheds valuable insight into how this industry operates and that such

  19. Arthroscopic Treatment of Medial Femoral Condylar Coronal Fractures and Nonunions

    Science.gov (United States)

    Ercin, Ersin; Bilgili, M. Gokhan; Basaran, S. Hakan; Baca, Emre; Kural, Cemal; Avkan, M. Cevdet

    2013-01-01

    Nonunion of medial femoral condylar coronal fractures are uncommon. In neglected Hoffa fractures despite nonunion, there is a risk of missing accompanying ligamentous and intra-articular injuries. Neither preoperative clinical examination nor magnetic resonance imaging showed these injuries before arthroscopy. Arthroscopy before internal fixation gives additional information and changes the surgical protocol for these fractures and nonunions. PMID:24400191

  20. Magnetohydrodynamic Modeling of Coronal Evolution and Disruption

    Science.gov (United States)

    Linker, Jon

    2002-01-01

    Flux cancellation, defined observationally as the mutual disappearance of magnetic fields of opposite polarity at the neutral line separating them, has been found to occur frequently at the site of filaments (called prominences when observed on the limb of the Sun). During the second year of this project, we have studied theoretically the role that flux cancellation may play in prominence formation, prominence eruption, and the initiation of coronal mass ejections. This work has been in published in two papers: "Magnetic Field Topology in Prominences" by Lionello, Mikic, Linker, and Amari and "Flux Cancellation and Coronal Mass Ejections" by Linker, Mikic, Riley, Lionello, Amari, and Odstrcil.

  1. Free Magnetic Energy and Coronal Heating

    Science.gov (United States)

    Winebarger, Amy; Moore, Ron; Falconer, David

    2012-01-01

    Previous work has shown that the coronal X-ray luminosity of an active region increases roughly in direct proportion to the total photospheric flux of the active region's magnetic field (Fisher et al. 1998). It is also observed, however, that the coronal luminosity of active regions of nearly the same flux content can differ by an order of magnitude. In this presentation, we analyze 10 active regions with roughly the same total magnetic flux. We first determine several coronal properties, such as X-ray luminosity (calculated using Hinode XRT), peak temperature (calculated using Hinode EIS), and total Fe XVIII emission (calculated using SDO AIA). We present the dependence of these properties on a proxy of the free magnetic energy of the active region

  2. Charge States of Solar Cosmic Rays and Constraints on Acceleration Times and Coronal Transport

    CERN Document Server

    Ruffolo, D

    1997-01-01

    We examine effects on the charge states of energetic ions associated with gradual solar flares due to shock heating and stripping at high ion velocities. Recent measurements of the mean charges of various elements after the flares of 1992 Oct 30 and 1992 Nov 2 allow one to place limits on the product of the electron density times the acceleration or coronal residence time. In particular, any residence in coronal loops must be for < 0.03 s, which rules out models of coronal transport in loops, such as the bird cage model. The results do not contradict models of shock acceleration of energetic ions from coronal plasma at various solar longitudes.

  3. Medical students' experience of performing female pelvic examinations: Opportunities and barriers.

    Science.gov (United States)

    Bhoopatkar, Harsh; Wearn, Andy; Vnuk, Anna

    2017-10-01

    Teaching and learning female pelvic examination within the undergraduate medical curriculum offers some potential challenges. One such is the extent to which students are provided practice opportunities with patients in the clinical setting. To quantify how many pelvic examinations, on real patients, have been performed by medical students at the point of graduation, and to explore opportunities and barriers to performing these examinations. A retrospective study using a self-completed, anonymous, electronic survey was developed as part of a multi-centre study. Data were collected in the immediate period after graduation from the medical programs at the University of Auckland and Flinders University in 2013. An ordinal set of range categories was used for recording numbers of examinations. The combined response rate for the survey was 42.9% (134/312). The median range category for the number of pelvic examinations performed in patients who were not in labour was 6-9 and in labour was 2-3. Thirty-three percent of medical students had never performed a pelvic examination in labour. Male medical students performed significantly fewer pelvic examinations compared with female students. Self-reported barriers to performing the pelvic exam include: gender of the student, 'gate-keeping' by other health professionals, lack of confidence and patient factors. The majority of medical students have performed several pelvic examinations on real patients at graduation. Male gender and access being limited by midwives were the main barriers to performing female pelvic examinations. Medical curricula need to address these issues in the learning environment. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  4. Perspectives of patients with disabilities on the accessibility of medical equipment: examination tables, imaging equipment, medical chairs, and weight scales.

    Science.gov (United States)

    Story, Molly Follette; Schwier, Erin; Kailes, June Isaacson

    2009-10-01

    In a prior survey, patients with disabilities reported difficulty using many common types of medical equipment. The purpose of this study was to conduct focus groups to explore in greater detail the most common difficulties mentioned by survey participants in order to identify critical issues related to accessibility and usability and to inform subsequent research. Participants of eight focus groups discussed medical equipment accessibility and safety issues experienced when using or attempting to access four specific categories of medical devices: examination tables, imaging equipment, medical chairs, and weight scales. Content of the transcript of each focus group was categorized according to five major themes: safety issues, equipment issues, health care provider issues, patient issues, and environmental issues. The results were then aggregated. The focus group participants reported that characteristics of the equipment's contact surfaces could cause difficulty and discomfort. Participants commented on lack of physical support for patients with disabilities to transfer their bodies onto and off the equipment and lack of support to achieve and maintain body positions while on the equipment. Wheelchair scales were reported as rarely available, and scales without voice output were inaccessible to blind individuals. Health care provider issues and patient issues are discussed in relation to the accessibility and safety of the equipment. Some types of medical devices and technologies present substantial barriers for some medical patients with disabilities, which may negatively affect their access to health care. Recommendations for improved designs are provided to enhance medical equipment accessibility and safety.

  5. 20 CFR 404.1519k - Purchase of medical examinations, laboratory tests, and other services.

    Science.gov (United States)

    2010-04-01

    ... psychological examinations, X-rays and laboratory tests (including specialized tests, such as pulmonary function... tests, and other services. 404.1519k Section 404.1519k Employees' Benefits SOCIAL SECURITY... Standards for the Type of Referral and for Report Content § 404.1519k Purchase of medical examinations...

  6. 20 CFR 416.919k - Purchase of medical examinations, laboratory tests, and other services.

    Science.gov (United States)

    2010-04-01

    ... psychological examinations, X-rays and laboratory tests (including specialized tests, such as pulmonary function... tests, and other services. 416.919k Section 416.919k Employees' Benefits SOCIAL SECURITY ADMINISTRATION... for the Type of Referral and for Report Content § 416.919k Purchase of medical examinations...

  7. Genesis Solar Wind Interstream, Coronal Hole and Coronal Mass Ejection Samples: Update on Availability and Condition

    Science.gov (United States)

    Allton, J. H.; Gonzalez, C. P.; Allums, K. K.

    2017-01-01

    Recent refinement of analysis of ACE/SWICS data (Advanced Composition Explorer/Solar Wind Ion Composition Spectrometer) and of onboard data for Genesis Discovery Mission of 3 regimes of solar wind at Earth-Sun L1 make it an appropriate time to update the availability and condition of Genesis samples specifically collected in these three regimes and currently curated at Johnson Space Center. ACE/SWICS spacecraft data indicate that solar wind flow types emanating from the interstream regions, from coronal holes and from coronal mass ejections are elementally and isotopically fractionated in different ways from the solar photosphere, and that correction of solar wind values to photosphere values is non-trivial. Returned Genesis solar wind samples captured very different kinds of information about these three regimes than spacecraft data. Samples were collected from 11/30/2001 to 4/1/2004 on the declining phase of solar cycle 23. Meshik, et al is an example of precision attainable. Earlier high precision laboratory analyses of noble gases collected in the interstream, coronal hole and coronal mass ejection regimes speak to degree of fractionation in solar wind formation and models that laboratory data support. The current availability and condition of samples captured on collector plates during interstream slow solar wind, coronal hole high speed solar wind and coronal mass ejections are de-scribed here for potential users of these samples.

  8. Association of classroom participation and examination performance in a first-year medical school course.

    Science.gov (United States)

    Millis, Richard M; Dyson, Sharon; Cannon, Dawn

    2009-09-01

    The advent of internet-based delivery of basic medical science lectures may unintentionally lead to decreased classroom attendance and participation, thereby creating a distance learning paradigm. In this study, we tested the hypothesis that classroom attendance/participation may be positively correlated with performance on a written examination for first-year medical school instruction. The study subjects consisted of 115 first-year medical students. The introductory respiratory structure-function instruction was designed to include one noncompulsory pretest, four short postinstruction noncompulsory self-evaluation tests that were unannounced as to date and time, and one compulsory comprehensive examination. The relationship between attendance/participation, measured by the number of noncompulsory tests taken, and performance on the comprehensive examination was determined by Pearson's correlation coefficient, one-way ANOVA, and a chi(2)-test of significance. The average score on the pretest was 28%; for the same items on the comprehensive examination (posttest), the average score was 73%. For the 80 students who took the pretest, this translated to an overall score increase of 161%. Attendance/participation in four or five of the noncompulsory tests resulted in an 83.3% pass rate on the comprehensive exam compared with a rate of 52.9% for attendance/participation in three, two, one, or none of the five noncompulsory tests; the overall pass rate was 60.9%. There was a significant association between a high rate of classroom attendance/participation and a high score on the comprehensive examination (Pearson's chi(2) = 8.599, P attendance/participation may be a significant determinant of performance of medical students on comprehensive examinations in first-year basic medical science courses. It is concluded that a substantial number of first-year medical students in this study could be at risk for poor performance because they may believe that there is an

  9. Touching the private parts: how gender and sexuality norms affect medical students' first pelvic examination.

    Science.gov (United States)

    Sörensdotter, Renita; Siwe, Karin

    2016-11-01

    Gynaecologists are in a position to challenge norms about gender and sexuality in relation to female genitals. Through their work they have the opportunity to educate patients, which is why teaching medical students to perform examinations in a gender sensitive way is significant. Medical students performing their first pelvic examination often experience the examination as uncomfortable because it is a body part that is connected to sex and to something private. This paper uses medical students' interpretations of performing their first pelvic examination as a means to discuss how cultural norms for gender, sexuality and female genitals affect these examinations. Issues raised include how cultural connotations of female genitals affect the pelvic examination, how female and male students relate differently to examining female genitals and the interpretations they make in relation to themselves. Findings show that the female genitals are perceived as a special body part connected to sexuality and intimacy. Students' gender also affects the interpretations they make during pelvic examinations. Norms of gender, sexuality and female genitals need to be challenged in the teaching and performance of pelvic examination in order to demystify this experience.

  10. [History Of forensic medicine and the coroner system in the town of Bjelovar].

    Science.gov (United States)

    Habek, Dubravko

    2013-09-01

    This review analyses historical sources on the development of forensic medicine and the coroner system in the town of Bjelovar over the past two centuries. The development of these two professional fields in the context of public health was regulated through a number of bylaws, such as Normativum Sanitatum from the time of the Habsburg Monarchy. Coroner examinations were performed by physicians, surgeons, and laymen using special instructions such as the famous booklet by nobleman and county medical officer Vilim Peičić from 1914. Forensic autopsy was performed by surgeons, primary or secondary hospital physicians in case of sudden or suspicious in-hospital deaths, whereas outpatient forensic autopsies were performed by county or town medical officers and district physicians at the request of investigating authorities (police, court, or general attorney's office). This historical review should serve as the basis for further historical research into this field in Croatia so as to obtain deeper insight into the development of forensic medicine and the coroner system, two professions that have always been a vital factor in public health.

  11. Coronal temperature profiles obtained from kinetic models and from coronal brightness measurements obtained during solar eclipses

    CERN Document Server

    Pierrard, V; Lemaire, J F

    2012-01-01

    Coronal density, temperature and heat flux distributions for the equatorial and polar corona have been deduced by Lemaire [2012] from Saito's model of averaged coronal white light (WL) brightness and polarization observations. They are compared with those determined from a kinetic collisionless/exospheric model of the solar corona. This comparison indicates rather similar distributions at large radial distances (> 7 Rs) in the collisionless region. However, rather important differences are found close to the Sun in the acceleration region of the solar wind. The exospheric heat flux is directed away from the Sun, while that inferred from all WL coronal observations is in the opposite direction, i.e., conducting heat from the inner corona toward the chromosphere. This could indicate that the source of coronal heating rate extends up into the inner corona where it maximizes at r > 1.5 Rs well above the transition region.

  12. Reconnection and Spire Drift in Coronal Jets

    Science.gov (United States)

    Moore, Ronald; Sterling, Alphonse; Falconer, David

    2015-04-01

    It is observed that there are two morphologically-different kinds of X-ray/EUV jets in coronal holes: standard jets and blowout jets. In both kinds: (1) in the base of the jet there is closed magnetic field that has one foot in flux of polarity opposite that of the ambient open field of the coronal hole, and (2) in coronal X-ray/EUV images of the jet there is typically a bright nodule at the edge of the base. In the conventional scenario for jets of either kind, the bright nodule is a compact flare arcade, the downward product of interchange reconnection of closed field in the base with impacted ambient open field, and the upper product of this reconnection is the jet-outflow spire. It is also observed that in most jets of either kind the spire drifts sideways away from the bright nodule. We present the observed bright nodule and spire drift in an example standard jet and in two example blowout jets. With cartoons of the magnetic field and its reconnection in jets, we point out: (1) if the bright nodule is a compact flare arcade made by interchange reconnection, then the spire should drift toward the bright nodule, and (2) if the bright nodule is instead a compact flare arcade made, as in a filament-eruption flare, by internal reconnection of the legs of the erupting sheared-field core of a lobe of the closed field in the base, then the spire, made by the interchange reconnection that is driven on the outside of that lobe by the lobe’s internal convulsion, should drift away from the bright nodule. Therefore, from the observation that the spire usually drifts away from the bright nodule, we infer: (1) in X-ray/EUV jets of either kind in coronal holes the interchange reconnection that generates the jet-outflow spire usually does not make the bright nodule; instead, the bright nodule is made by reconnection inside erupting closed field in the base, as in a filament eruption, the eruption being either a confined eruption for a standard jet or a blowout eruption (as

  13. Interchange Reconnection and Coronal Hole Dynamics

    Science.gov (United States)

    2010-05-01

    calculate the time-dependent dynamics of coronal hole boundaries rigorously and test our conjectures. We describe below our numerical simulations of...radiation and thermal conduction are needed in order to test such a model. It is tempting to conjecture that this process of releasing the closed-field... HTP , TR&T, and SR&T Programs, and has benefited greatly from the authors’ participation in the NASA TR&T focused science team on the solar

  14. Solar Coronal Jets: Observations, Theory, and Modeling

    CERN Document Server

    Raouafi, N E; Pariat, E; Young, P R; Sterling, A C; Savcheva, A; Shimojo, M; Moreno-Insertis, F; DeVore, C R; Archontis, V; Török, T; Mason, H; Curdt, W; Meyer, K; Dalmasse, K; Matsui, Y

    2016-01-01

    Coronal jets represent important manifestations of ubiquitous solar transients, which may be the source of significant mass and energy input to the upper solar atmosphere and the solar wind. While the energy involved in a jet-like event is smaller than that of "nominal" solar flares and coronal mass ejections (CMEs), jets share many common properties with these phenomena, in particular, the explosive magnetically driven dynamics. Studies of jets could, therefore, provide critical insight for understanding the larger, more complex drivers of the solar activity. On the other side of the size-spectrum, the study of jets could also supply important clues on the physics of transients close or at the limit of the current spatial resolution such as spicules. Furthermore, jet phenomena may hint to basic process for heating the corona and accelerating the solar wind; consequently their study gives us the opportunity to attack a broad range of solar-heliospheric problems.

  15. Medical Student Performance on the National Board of Medical Examiners Emergency Medicine Advanced Clinical Examination and the National Emergency Medicine M4 Exams

    OpenAIRE

    Hiller, Katherine; House, Joseph; Lawson, Luan; Poznanski, Stacey; Morrissey, Thomas K.

    2015-01-01

    Introduction: In April 2013, the National Board of Medical Examiners (NBME) released an Advanced Clinical Examination (ACE) in emergency medicine (EM). In addition to this new resource, CDEM (Clerkship Directors in EM) provides two online, high-quality, internally validated examinations. National usage statistics are available for all three examinations, however, it is currently unknown how students entering an EM residency perform as compared to the entire national cohort. This information m...

  16. A comparison of performances of consultant surgeons, NCHDs and medical students in a modified HPAT examination.

    LENUS (Irish Health Repository)

    Quinn, A

    2010-06-01

    Following the implementation of the Fottrell report, entry to medical school in Ireland has undergone significant change. Medical school studentship is now awarded based on a combination of points obtained from the final examination of Irish secondary schools (the leaving certificate) combined with HPAT scores (Health Professions Admissions Test). The HPAT is designed to test a candidate\\'s knowledge in several different fields including problem solving skills, logical and non verbal reasoning. A sample HPAT was administered to a test group composed of consultant surgeons, non consultant hospital doctors, and medical students. Statistical analysis was performed and no significant difference was found between the performances of the groups. This is surprising as it was expected that groups with greater experience at medical problem solving would have translated to higher scores. This exposes a flaw within the HPAT system and a potential weakness in the process of doctor selection.

  17. Topics on shock waves and coronal seismology

    Energy Technology Data Exchange (ETDEWEB)

    Costa, A, E-mail: acosta@mail.oac.uncor.edu [Instituto de AstronomIa Teorica y Experimental, CONICET-Cordoba, Laprida 922, 5000 Cordoba (Argentina); Facultad de Ciencias Exactas, Fisica y Naturales, Universidad Nacional de Cordoba, Av. Velez Sarsfield 1611, 5000 Cordoba (Argentina)

    2011-07-15

    The usual strong and sudden energy release sources that necessarily lead to mode excitation suggest the importance of shocks and nonlinear waves in the corona. We discuss the importance of nonlinear waves as an alternative capable of accurately matching the observational cases of coronal seismology usually interpreted as linear waves. We present two case studies where we explore the goodness of the shock wave interpretation in magnetic structures of the low corona.

  18. Dichotomy of Solar Coronal Jets: Standard Jets and Blowout Jets

    Science.gov (United States)

    Moore, R. L.; Cirtain, J. W.; Sterling, A. C.; Falconer, D. A.

    2010-01-01

    By examining many X-ray jets in Hinode/XRT coronal X-ray movies of the polar coronal holes, we found that there is a dichotomy of polar X-ray jets. About two thirds fit the standard reconnection picture for coronal jets, and about one third are another type. We present observations indicating that the non-standard jets are counterparts of erupting-loop H alpha macrospicules, jets in which the jet-base magnetic arch undergoes a miniature version of the blowout eruptions that produce major CMEs. From the coronal X-ray movies we present in detail two typical standard X-ray jets and two typical blowout X-ray jets that were also caught in He II 304 Angstrom snapshots from STEREO/EUVI. The distinguishing features of blowout X-ray jets are (1) X-ray brightening inside the base arch in addition to the outside bright point that standard jets have, (2) blowout eruption of the base arch's core field, often carrying a filament of cool (T 10(exp 4) - 10(exp 5) K) plasma, and (3) an extra jet-spire strand rooted close to the bright point. We present cartoons showing how reconnection during blowout eruption of the base arch could produce the observed features of blowout X-ray jets. We infer that (1) the standard-jet/blowout-jet dichotomy of coronal jets results from the dichotomy of base arches that do not have and base arches that do have enough shear and twist to erupt open, and (2) there is a large class of spicules that are standard jets and a comparably large class of spicules that are blowout jets.

  19. Examining influential factors in providers’ chronic pain treatment decisions: a comparison of physicians and medical students

    OpenAIRE

    2015-01-01

    Background Chronic pain treatment guidelines are unclear and conflicting, which contributes to inconsistent pain care. In order to improve pain care, it is important to understand the various factors that providers rely on to make treatment decisions. The purpose of this study was to examine factors that reportedly influence providers’ chronic pain treatment decisions. A secondary aim was to examine differences across participant training level. Methods Eighty-five participants (35 medical st...

  20. Coronal dynamics

    Science.gov (United States)

    Nakariakov, V. M.

    2007-07-01

    The lectures present the foundation of solar coronal physics with the main emphasis on the MHD theory and on wave and oscillatory phenomena. We discuss major challenges of the modern coronal physics; the main plasma structures observed in the corona and the conditions for their equilibrium; phenomenology of large scale long period oscillatory coronal phenomena and their theoretical modelling as MHD waves. The possibility of the remote diagnostics of coronal plasmas with the use of MHD oscillations is demonstrated.

  1. Relationship of EUV Irradiance Coronal Dimming Slope and Depth to Coronal Mass Ejection Speed and Mass

    CERN Document Server

    Mason, James Paul; Webb, David F; Thompson, Barbara J; Colaninno, Robin C; Vourlidas, Angelos

    2016-01-01

    Extreme ultraviolet (EUV) coronal dimmings are often observed in response to solar eruptive events. These phenomena can be generated via several different physical processes. For space weather, the most important of these is the temporary void left behind by a coronal mass ejection (CME). Massive, fast CMEs tend to leave behind a darker void that also usually corresponds to minimum irradiance for the cooler coronal emissions. If the dimming is associated with a solar flare, as is often the case, the flare component of the irradiance light curve in the cooler coronal emission can be isolated and removed using simultaneous measurements of warmer coronal lines. We apply this technique to 37 dimming events identified during two separate two-week periods in 2011, plus an event on 2010 August 7 analyzed in a previous paper, to parameterize dimming in terms of depth and slope. We provide statistics on which combination of wavelengths worked best for the flare-removal method, describe the fitting methods applied to t...

  2. Periodic Variations in the Coronal Green Line Intensity and their Connection with the White-light Coronal Structures

    Indian Academy of Sciences (India)

    Milan Minarovjech; Milan Rybansky; Vojtech Rusin

    2000-09-01

    We present an analysis of short time-scale intensity variations in the coronal green line as obtained with high time resolution observations. The observed data can be divided into two groups. The first one shows periodic intensity variations with a period of 5 min. the second one does not show any significant intensity variations. We studied the relation between regions of coronal intensity oscillations and the shape of whitelight coronal structures. We found that the coronal green-line oscillations occur mainly in regions where open white-light coronal structures are located.

  3. Utility of a grief services program for medical examiners' offices.

    Science.gov (United States)

    Berry, Ryan S; Aurelius, Michelle B; Barickman, Nancy; Lathrop, Sarah L

    2013-03-01

    Medical examiner/coroner's (ME/C) offices investigate sudden, violent, and unexpected deaths, leaving those close to the deceased suffering traumatic loss with little in terms of support and counseling. We investigated a grief services program (GSP) at the New Mexico Office of the Medical Investigator (OMI) to better understand the needs of bereaved individuals, identify the services provided, and propose our findings as a model for others. A total of 1085 contacts occurred over 1 year, with the majority occurring at OMI (60.5%), followed by telephone (23.1%). Support was primarily provided to those suffering a loss due to homicide (28.8%) and suicide (26.1%). The roles grief counselors play in the setting of a GSP and ME/C office are multiple. Given the frequent utilization of OMI's GSP and diverse reasons for visits, it is apparent there is a need for GSPs at ME/C offices, particularly given the traumatic nature of deaths investigated by ME/Cs. © 2012 American Academy of Forensic Sciences.

  4. Frequency of medical and dental x-ray examinations in the UK. 1997/98

    Energy Technology Data Exchange (ETDEWEB)

    Tanner, R.; Wall, B.; Shrimpton, P. [and others

    2000-12-01

    A survey has been performed to assess the numbers of all types of radiological x-ray examination conducted in the UK during the period from April 1997 to March 1998. The survey covers all diagnostic and interventional procedures using x-rays for medical and dental purposes, both within and outside the National Health Service (NHS), but excludes a detailed analysis of magnetic resonance imaging (MRI), ultrasound and nuclear medicine. This is the first such national survey conducted by NRPB since 1983. The results provide a current picture of the pattern of medical x-ray imaging practice in the UK and will allow revised estimates to be made of the collective dose to the population from these procedures. The survey has utilised detailed information available from radiology management systems at a selected sample of 38 English NHS trusts. The different classifications of x-ray procedure have been re-arranged into 62 standardised categories based on anatomical location and whether they were conventional, computed tomography (CT) or interventional procedures. Extrapolation of the sample data to the whole of England was carried out using broad NHS radiology statistics (KH12 returns) for the period of the survey from the Department of Health. Additional data have been obtained covering NHS radiology practice in Wales and Northern Ireland and also for x-ray imaging practice outside NHS hospitals such as that performed in independent hospitals and by dentists and chiropractors. Results are presented giving the annual numbers and relative frequencies of x-ray examinations in the 62 categories and the contributions from radiology practice outside NHS hospitals and from the whole of the UK. Altogether, about 41.5 million medical and dental x-ray examinations were conducted in the UK in 1997/98, corresponding to 704 examinations per 1000 inhabitants. The increase since 1983 for medical examinations conducted in NHS hospitals has just kept pace with the increase in population

  5. [Evaluations and examinations at the Tromsø medical school. Evaluation by students after graduation].

    Science.gov (United States)

    Tollan, A; Magnus, J H

    1993-01-10

    The medical curriculum at the University of Tromsø is based on an organ-system model with full integration of the three main disciplines (basic science, clinical and community medicine). There are only three examinations during the six-year course. We present the results of a survey among the first 417 physicians educated at the Medical School in Tromsø. A mailed questionnaire was answered by 84.2%. More than 80% stated that it was of great importance to evaluate the form and contents of the lectures and their supervisors' teaching abilities. More than 96% found that integration of the examinations was achieved in accordance with the intention. Furthermore, the examinations were also relevant for them as physicians.

  6. Bridging the Gap between Coronal and Non-Coronal Evolved Stars

    Science.gov (United States)

    Carpenter, Kenneth G.; Nielsen, Krister E.; Kober, Gladys V.

    2017-01-01

    The Hubble Space Telescope (HST) Treasury Program "Advanced Spectral Library (ASTRAL)" enables investigations of a broad range of problems including the character and dynamics of the wind and chromosphere of cool stars. This paper presents an investigation of the change in spectral characteristics when transitioning from the cool non-coronal objects with fluorescent emission spectra from the iron group elements, molecular hydrogen, and carbon monoxide to the warmer stars on the blue side of the Linsky-Haish dividing line in the HR diagram. These warmer objects exhibit chromospheric emission from significantly hotter environments in addition to coronal signatures, while the hybrid stars overlap in the HR-diagram with some of the non-coronal objects and share many spectral characteristics but show differences in the wind properties. We show how the wind, fluorescent features, and hot stellar signatures dramatically change with spectral class by comparing the already analyzed non-coronal objects (Alpha Ori, Gamma Cru) with the hybrid stars (Gamma Dra, Beta Gem and Alpha Aqr) and the coronal object Beta Dra. We aim to gain understanding of the physical processes in these objects' outer atmospheres and their evolutionary tracks.

  7. The Association between Medical Education Accreditation and Examination Performance of Internationally Educated Physicians Seeking Certification in the United States

    Science.gov (United States)

    van Zanten, Marta; Boulet, John R.

    2013-01-01

    The purposes of this research were to examine medical education accreditation practices around the world, with special focus on the Caribbean, and to explore the association between medical school accreditation and graduates' examination performance. In addition to other requirements, graduates of international medical schools seeking to…

  8. Medical and psychological support and psycho-physiological examination of extreme activities specialists

    Directory of Open Access Journals (Sweden)

    A. V. Starkov

    2015-01-01

    Full Text Available The essence of medical and psychological support is a continuous monitoring of functional and mental state of specialists and the system of mental health interventions aimed at maintaining the optimal level of occupational performance. The scientific basis of this direction is the idea of an integrated system of professional psychological and physiological adaptation in normal conditions, in condition of pre-pathology and pathology. Psychophysiological (professional and psychological examination of specialists is an integral part of medical and psychological support, and presents a set of measures aimed at in-depth study of individual psychological characteristics of personality and evaluation of the specialists' organism functional reserves in the process of their occupational duties implementation to determine the conformity of their professionally important qualities to the requirements of specific occupational activity.

  9. On The Fourier And Wavelet Analysis Of Coronal Time Series

    CERN Document Server

    Auchère, F; Bocchialini, K; Buchlin, E; Solomon, J

    2016-01-01

    Using Fourier and wavelet analysis, we critically re-assess the significance of our detection of periodic pulsations in coronal loops. We show that the proper identification of the frequency dependence and statistical properties of the different components of the power spectra provies a strong argument against the common practice of data detrending, which tends to produce spurious detections around the cut-off frequency of the filter. In addition, the white and red noise models built into the widely used wavelet code of Torrence & Compo cannot, in most cases, adequately represent the power spectra of coronal time series, thus also possibly causing false positives. Both effects suggest that several reports of periodic phenomena should be re-examined. The Torrence & Compo code nonetheless effectively computes rigorous confidence levels if provided with pertinent models of mean power spectra, and we describe the appropriate manner in which to call its core routines. We recall the meaning of the default c...

  10. An examination of the bleeding complications associated with herbal supplements, antiplatelet and anticoagulant medications.

    Science.gov (United States)

    Spolarich, A E; Andrews, L

    2007-01-01

    Dental professionals routinely treat patients taking prescription, nonprescription, and herbal medications that are known or have the potential to alter bleeding. Prescription anticoagulant and antiplatelet medications, as well as over-the-counter drugs such as aspirin, are typically taken to reduce the risk of thromboembolic events, including stroke. Herbal supplements are widely used for a variety of indications, and both patients and health care practitioners are often unaware of the anticoagulant and antiplatelet effects that occur as either predictable pharmacologic effects or adverse side effects of herbal medicines. In addition, patient use of these herbal supplements is usually undisclosed to health care providers. The purpose of this literature review is to examine the mechanisms of action of drugs and herbs that alter bleeding, and to educate dental professionals as to the proper care and management of patients using these medications. Decision-making strategies, including interpretation of laboratory tests, and when to discontinue the use of these medications are discussed. Patients undergoing routine dental and dental hygiene procedures do not need to discontinue the use of anticoagulant and antiplatelet medications. However, alterations in drug use may be required for those patients undergoing invasive surgical procedures. It is recommended that herbal supplements must be discontinued 2 weeks prior to receiving invasive surgical procedures. Dental practitioners must learn to weigh the risks of discontinuing drug therapy against the potential risks to patients, and implement risk reduction strategies to minimize adverse bleeding complications associated with dental treatment.

  11. Standing Slow-Mode Waves in Hot Coronal Loops: Observations, Modeling, and Coronal Seismology

    CERN Document Server

    Wang, Tongjiang

    2010-01-01

    Strongly damped Doppler shift oscillations are observed frequently associated with flarelike events in hot coronal loops. In this paper, a review of the observed properties and the theoretical modeling is presented. Statistical measurements of physical parameters (period, decay time, and amplitude) have been obtained based on a large number of events observed by SOHO/SUMER and Yohkoh/BCS. Several pieces of evidence are found to support their interpretation in terms of the fundamental standing longitudinal slow mode. The high excitation rate of these oscillations in small- or micro-flares suggest that the slow mode waves are a natural response of the coronal plasma to impulsive heating in closed magnetic structure. The strong damping and the rapid excitation of the observed waves are two major aspects of the waves that are poorly understood, and are the main subject of theoretical modeling. The slow waves are found mainly damped by thermal conduction and viscosity in hot coronal loops. The mode coupling seems ...

  12. Examining the link between burnout and medical error: A checklist approach

    Directory of Open Access Journals (Sweden)

    Evangelia Tsiga

    2017-09-01

    Conclusions: The Medical Error Checklists developed in this study advance the study of medical errors by proposing a comprehensive, valid and reliable self-assessment tool. The results highlight the importance of hospital organizational factors in preventing medical errors.

  13. Medical and psychological examination of women seeking asylum: documentation of human rights abuses.

    Science.gov (United States)

    Laws, A; Patsalides, B

    1997-01-01

    Human rights abuses of women are ubiquitous throughout the world. Those perpetrated by governments entitle women to seek political asylum, and many women refugees do so in the United States. The asylum process often requires medical or psychological evaluations to corroborate women's reports of torture or other abuses. This article provides an overview of how to conduct such examinations and how to document findings for the asylum process.

  14. Simulations of Emerging Magnetic Flux. II. The Formation of Unstable Coronal Flux Ropes and the Initiation of Coronal Mass Ejections

    Science.gov (United States)

    Leake, James E.; Linton, Mark G.; Antiochos, Spiro K.

    2014-01-01

    We present results from three-dimensional magnetohydrodynamic simulations of the emergence of a twisted convection zone flux tube into a pre-existing coronal dipole field. As in previous simulations, following the partial emergence of the sub-surface flux into the corona, a combination of vortical motions and internal magnetic reconnection forms a coronal flux rope. Then, in the simulations presented here, external reconnection between the emerging field and the pre-existing dipole coronal field allows further expansion of the coronal flux rope into the corona. After sufficient expansion, internal reconnection occurs beneath the coronal flux rope axis, and the flux rope erupts up to the top boundary of the simulation domain (approximately 36 Mm above the surface).We find that the presence of a pre-existing field, orientated in a direction to facilitate reconnection with the emerging field, is vital to the fast rise of the coronal flux rope. The simulations shown in this paper are able to self-consistently create many of the surface and coronal signatures used by coronal mass ejection (CME) models. These signatures include surface shearing and rotational motions, quadrupolar geometry above the surface, central sheared arcades reconnecting with oppositely orientated overlying dipole fields, the formation of coronal flux ropes underlying potential coronal field, and internal reconnection which resembles the classical flare reconnection scenario. This suggests that proposed mechanisms for the initiation of a CME, such as "magnetic breakout," are operating during the emergence of new active regions.

  15. Information Status of the Patients about Radiological Examinations and Encountered Ethical and Medical Issues

    Directory of Open Access Journals (Sweden)

    Ramazan Büyükkaya1

    2015-03-01

    Full Text Available Aim: It is observed that the patient compliance and technical quality is increased in sufficiently informed patients by the doctor at the examinations requested from the radiology clinics. We aimed to point to rate of the patients have been informed by the doctor about ultrasound and interventional radiological examinations requested from the clinical disciplines and accordingly encountered medical and ethic problems. Methods: Simple yes or no questions were asked to 1000 patients (550 male, mean age 44, 450 women, mean age 42 admitted to our clinic to assess their level of information about the investigation. Whether the patients were informed by the doctor, know why and what is the examination wanted and knowledge about the way of technique were asked to the patients simply and clearly. Results: 880 of 1000 (88% patients were not informed by the doctor about tests, 710 patients (71% had no information about the examination. Patients with information about research (290 patients classified according to source of the information; 120 patients were informed by the physician (41.4%, 90 patients (31% had examination before, 44 patients (15.2% received information from the relatives and other patients examined, while the remaining 36 patients (12.4% were found information from a variety of media organs and from the internet. Conclusion: As a result of our research it is concluded that information status of the patients about radiological examinations is insufficient and the patients are not informed adequately by clinicians. Patient non-compliance during the examination because of having no information or false information decreases the quality of the investigation and makes it difficult to reach the diagnosis.

  16. Medical licensing examination (uigwa) and the world of the physician officers (uigwan) in Korea's Joseon Dynasty.

    Science.gov (United States)

    Lee, Nam Hee

    2015-01-01

    Physicians for ordinary people in Korea's Joseon Dynasty (1392-1910) did not need to pass the national medical licensing examination. They were able to work after a sufficient apprenticeship period. Only physician officers were licensed as technical civil servants. These physician officers were middle class, located socially between the nobility and the commoner. They had to pass a national licensing examination to be considered for high-ranking physician officer positions, that is, those at the rank equal to or above the 6th level out of a total of 9 ranks, where the first rank was highest. Royal physicians also had to pass this examination before accepting responsibility for the King's healthcare. This article aims to describe the world of physician officers during the Joseon Dynasty. Physician officers enjoyed considerable social status because they dealt with matters of life and death. Owing to the professional nature of their fields and a strong sense of group identity, they came to compose a distinct social class. The physician officers' world was marked by strong group allegiances based on shared professional knowledge; the use of marriage to gain and maintain social status; and the establishment of hereditary technical posts within the medical profession that were handed down from one generation to the next. The medical licensing examination persisted until 1894 when the civil service examination agency, of which it was part, was abolished. Until that time, the testing agency, the number of candidates who were accepted, two-step test procedures, and the method of test item selection were maintained and enforced.

  17. Validity and Reliability of pre-internship Objective Structured Clinical Examination in Shiraz Medical School

    Directory of Open Access Journals (Sweden)

    NARGES VASEGHI

    2013-07-01

    Full Text Available Introduction: Objective Structured Clinical Examination (OSCE is one of the most appropriate methods for assessment of clinical skills.Validity and reliability assurance is a mandatory factor for any assessment tool. In Shiraz University of Medical Sciences, medical students’ clinical competences are evaluated by a pre-internship OSCE. This study is designed to examine the validity and reliability of this exam. Validity is the extent to which the test measures what it intends to measure. Reliability refers to the accuracy of measurement and the consistency of test results. Methods: Content validity was evaluated by expert opinion about blueprinting and station checklists. To determine the construct validity, station scores correlation with the total OSCE score and inter station correlations were calculated. The inter examiner reliability was assessed by coefficient of correlation. Results: Content validity was established by alignment between the curriculum and the blueprint using expert opinion. Correlation of the station scores with the total OSCE score were positive and statistically significant in all stations except the 16th station (suturing. Inter examiner reliability coefficients of correlations ranged 0.33 – 0.99, with an average of 0.83. Conclusions: Our findings support the assumption that the pre-internship OSCE is valid, reliable and suitable to assess students’ clinical competence. Validity and reliability studies should be performed for all new assessment tools, particularly in high-stakes assessments.

  18. A modified electronic key feature examination for undergraduate medical students: validation threats and opportunities.

    Science.gov (United States)

    Fischer, Martin R; Kopp, Veronika; Holzer, Matthias; Ruderich, Franz; Jünger, Jana

    2005-08-01

    The purpose of our study was the development and validation of a modified electronic key feature exam of clinical decision-making skills for undergraduate medical students. Therefore, the reliability of the test (15 items), the item difficulty level, the item-total correlations and correlations to other measures of knowledge (40 item MC-test and 580 items of German MC-National Licensing Exam, Part II) were calculated. Based on the guidelines provided by the Medical Council of Canada, a modified electronic key feature exam for internal medicine consisting of 15 key features (KFs) was developed for fifth year German medical students. Long menu (LM) and short menu (SM) question formats were used. Acceptance was assessed through a questionnaire. Thirty-seven students from four medical schools voluntarily participated in the study. The reliability of the key feature exam was 0.65 (Cronbach's alpha). The items' difficulty level scores were between 0.3 and 0.8 and the item-total correlations between 0.0 and 0.4. Correlations between the results of the KF exam and the other measures of knowledge were intermediate (r between 0.44 and 0.47) as well as the learners' level of acceptance. The modified electronic KF examination is a feasible and reliable evaluation tool that may be implemented for the assessment of clinical undergraduate training.

  19. Relationship of EUV Irradiance Coronal Dimming Slope and Depth to Coronal Mass Ejection Speed and Mass

    Science.gov (United States)

    Mason, James Paul; Woods, Thomas N.; Webb, David F.; Thompson, Barbara J.; Colaninno, Robin C.; Vourlidas, Angelos

    2016-10-01

    Extreme ultraviolet (EUV) coronal dimmings are often observed in response to solar eruptive events. These phenomena can be generated via several different physical processes. For space weather, the most important of these is the temporary void left behind by a coronal mass ejection (CME). Massive, fast CMEs tend to leave behind a darker void that also usually corresponds to minimum irradiance for the cooler coronal emissions. If the dimming is associated with a solar flare, as is often the case, the flare component of the irradiance light curve in the cooler coronal emission can be isolated and removed using simultaneous measurements of warmer coronal lines. We apply this technique to 37 dimming events identified during two separate two-week periods in 2011 plus an event on 2010 August 7, analyzed in a previous paper to parameterize dimming in terms of depth and slope. We provide statistics on which combination of wavelengths worked best for the flare-removal method, describe the fitting methods applied to the dimming light curves, and compare the dimming parameters with corresponding CME parameters of mass and speed. The best linear relationships found are \\begin{eqnarray*}{v}{CME} ≤ft[\\displaystyle \\frac{{km}}{{{s}}}\\right] & ≈ & 2.36× {10}6 ≤ft[\\displaystyle \\frac{{km}}{ % }\\right]× {s}\\dim ≤ft[\\displaystyle \\frac{ % }{{{s}}}\\right]\\ {m}{CME} [{{g}}] & ≈ & 2.59× {10}15≤ft[\\displaystyle \\frac{g}{ % }\\right]× \\sqrt{{d}\\dim } [ % ].\\end{eqnarray*} These relationships could be used for space weather operations of estimating CME mass and speed using near-real-time irradiance dimming measurements.

  20. Radiation exposure of the UK population from medical and dental x-ray examinations

    Energy Technology Data Exchange (ETDEWEB)

    Hart, D.; Wall, B.F

    2002-03-01

    Knowledge of recent trends in the radiation doses from x-ray examinations and their distribution for the UK population provides useful guidance on where best to concentrate efforts on patient dose reduction in order to optimise the protection of the population in a cost-effective manner. In this report, the results of a recent survey of the frequency of medical and dental x-ray examinations in the UK and contemporary data on the radiation doses typically received by patients, are used to assess trends in the extent and the pattern of the population exposure. Individual patient doses, expressed in terms of the effective dose, range from a few microsieverts for simple radiographic examinations of the teeth, limbs or chest to tens of millisieverts for prolonged fluoroscopic procedures or some computed tomography (CT) examinations. A total of about 41.5 million medical and dental x-ray examinations are now conducted each year in the UK (0.70 examination per head of population) resulting in an annual per caput effective dose of 330 {mu}Sv. This is not significantly different from the previous rough estimate of 350 {mu}Sv for 1991. However, over the last ten years CT has more than doubled its contribution and is now responsible for 40% of the total dose to the population from medical x-rays. In contrast, the contribution from conventional radiographic and fluoroscopic examinations has nearly halved to about 44%. Interventional and angiographic procedures together contribute the remaining 16%. The annual per caput dose of 330 {mu}Sv is low in comparison with other countries having similarly developed systems of health care. This is due to both a lower frequency of x-ray examinations per head of population and generally lower doses in the UK than in other developed countries. However, the much increased contributions of CT, angiography and interventional procedures to the UK population dose indicate an urgent need to develop radiation protection and optimisation activities

  1. A Moreton Wave and its Coronal Counterparts

    Science.gov (United States)

    Francile, Carlos N.; Mandrini, Cristina H.; Long, David; Cremades, Hebe; Lopez, Fernando M.; Luoni, Maria Luisa

    2016-07-01

    On 29 March 2014, a Moreton wave was detected in AR 12017 with the Halpha Solar Telescope for Argentina (HASTA) in association with an X1 flare. Several phenomena took place in various regimes in connection with this event, such as low coronal waves and a coronal mass ejection (CME). We investigate their role and relationship with the Moreton wave to shed light on issues so far under debate. We analyze its connection with waves observed in the low corona with the Atmospheric Imaging Assembly aboard the Solar Dynamics Observatory (SDO/AIA), as well as with the ensuing CME, via kinematics analyses. We build stack plots from sequences of images obtained at different wavelengths to track wave fronts along several directions and find links between the features observed in the chromosphere and low corona, as well as in the associated CME. We also derive the shock front properties. We propose a geometrical model of the wave to explain the observed wave fronts as the photospheric and chromospheric traces of an expanding and outward-traveling bubble intersecting the Sun.

  2. Examining influential factors in providers' chronic pain treatment decisions: a comparison of physicians and medical students.

    Science.gov (United States)

    Hollingshead, Nicole A; Meints, Samantha; Middleton, Stephanie K; Free, Charnelle A; Hirsh, Adam T

    2015-10-01

    Chronic pain treatment guidelines are unclear and conflicting, which contributes to inconsistent pain care. In order to improve pain care, it is important to understand the various factors that providers rely on to make treatment decisions. The purpose of this study was to examine factors that reportedly influence providers' chronic pain treatment decisions. A secondary aim was to examine differences across participant training level. Eighty-five participants (35 medical students, 50 physicians) made treatment decisions for 16 computer-simulated patients with chronic pain. Participants then selected from provided lists the information they used and the information they would have used (had it been available) to make their chronic pain treatment decisions for the patient vignettes. Frequency analyses indicated that most participants reported using patients' pain histories (97.6 %) and pain description (95.3 %) when making treatment decisions, and they would have used information about patients' previous treatments (97.6 %) and average and current pain ratings (96.5 %) had this information been available. Compared to physicians, medical students endorsed more frequently that they would have used patients' employment and/or disability status (p medical students wanted information on patients' use of illicit drugs and alcohol to make treatment decisions; while a greater proportion of physicians reported using personal experience to inform their decisions. This study found providers use patients' information and their own experiences and intuition to make chronic pain treatment decisions. Also, participants of different training levels report using different patient and personal factors to guide their treatment decisions. These results highlight the complexity of chronic pain care and suggest a need for more chronic pain education aimed at medical students and practicing providers.

  3. Re-examining medical modernization

    DEFF Research Database (Denmark)

    Tupasela, Aaro Mikael

    2007-01-01

    Despite recent evidence that suggests that knowledge production within the medical community is increasingly based on knowledge-making coalitions or what some have called the co-production of knowledge, there remains a strong expert led policy agenda in many countries in relation to human genome...

  4. Solar jet-coronal hole collision and a related coronal mass ejection

    CERN Document Server

    Zheng, Ruisheng; Du, Guohui; Li, Chuanyang

    2016-01-01

    Jets are defined as impulsive, well-collimated upflows, occurring in different layers of the solar atmosphere with different scales. Their relationship with coronal mass ejections (CMEs), another type of solar impulsive events, remains elusive. Using the high-quality imaging data of AIA/SDO, here we show a well-observed coronal jet event, in which part of the jets, with the embedding coronal loops, runs into a nearby coronal hole (CH) and gets bounced towards the opposite direction. This is evidenced by the flat-shape of the jet front during its interaction with the CH and the V-shaped feature in the time-slice plot of the interaction region. About a half-hour later, a CME initially with a narrow and jet-like front is observed by the LASCO C2 coronagraph, propagating along the direction of the post-collision jet. We also observe some 304 A dark material flowing from the jet-CH interaction region towards the CME. We thus suggest that the jet and the CME are physically connected, with the jet-CH collision and t...

  5. SOLAR JET–CORONAL HOLE COLLISION AND A CLOSELY RELATED CORONAL MASS EJECTION

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Ruisheng; Chen, Yao; Du, Guohui; Li, Chuanyang, E-mail: ruishengzheng@sdu.edu.cn [Shandong Provincial Key Laboratory of Optical Astronomy and Solar-Terrestrial Environment, and Institute of Space Sciences, Shandong University, 264209, Weihai (China)

    2016-03-10

    Jets are defined as impulsive, well-collimated upflows, occurring in different layers of the solar atmosphere with different scales. Their relationship with coronal mass ejections (CMEs), another type of solar impulsive events, remains elusive. Using high-quality imaging data from the Atmospheric Imaging Assembly/Solar Dynamics Observatory, we show a well-observed coronal jet event, in which the part of the jet with embedding coronal loops runs into a nearby coronal hole (CH) and gets bounced in the opposite direction. This is evidenced by the flat shape of the jet front during its interaction with the CH and the V-shaped feature in the time-slice plot of the interaction region. About a half-hour later, a CME with an initially narrow and jet-like front is observed by the LASCO C2 coronagraph propagating along the direction of the post-collision jet. We also observe some 304 Å dark material flowing from the jet–CH interaction region toward the CME. We thus suggest that the jet and the CME are physically connected, with the jet–CH collision and the large-scale magnetic topology of the CH being important in defining the eventual propagating direction of this particular jet–CME eruption.

  6. On-Line Booking Policies and Competitive Analysis of Medical Examination in Hospital

    Directory of Open Access Journals (Sweden)

    Li Luo

    2014-01-01

    Full Text Available From the on-line point, we consider the hospital’s medical examination appointment problem with hierarchical machines. This approach eliminates the need for both demand forecasts and a risk-neutrality assumption. Due to different unit revenue, uncertain demand, and arrival of patients, we design on-line booking policies for two kinds of different situations from the perspective of on-line policy and competitive analysis. After that, we prove the optimal competitive ratios. Through numerical examples, we compare advantages and disadvantages between on-line policies and traditional policies, finding that there is different superiority for these two policies under different arrival sequences.

  7. Physical activity and better medication compliance improve mini-mental state examination scores in the elderly.

    Science.gov (United States)

    Guimarães, Fabiana Costa; Amorim, Paulo Roberto dos Santos; Reis, Fernando Fonseca dos; Bonoto, Robson Teixeira; Oliveira, Wederson Candido de; Moura, Tiago Augusto da Silva; Assis, Cláudia Loures de; Palotás, András; Lima, Luciana Moreira

    2015-01-01

    In addition to hypertension, dyslipidemia, atherosclerosis, and diabetes, a sedentary lifestyle plays a pivotal role in cerebro- and cardiovascular disease and progressive cognitive decline, including vascular dementia and Alzheimer's disease. The present study investigated whether controlling the key risks and participating in physical activity have a beneficial impact on these disorders. Elderly volunteers were enrolled in a 3-month program that consisted of structured exercise three times per week. The daily routine, medical treatment, and vital parameters were evaluated and correlated with the subjects' neuropsychiatric status. High blood pressure was found in 40% of the participants, with no significant differences between the sexes. A higher proportion of females (55%) than males (18%) forgot to take their medication during the observation period. Significant negative correlations were found between Mini-Mental State Examination (MMSE) scores and age, lack of a caregiver, and increased pulse rate before or after exercise. These results suggest that the presence of home assistance and subsequent improvement in medication compliance, vital parameter optimization, and regular physical activity may yield better MMSE results and a lower risk for cerebro- and cardiovascular disease. © 2014 S. Karger AG, Basel.

  8. Examining the relationship between marijuana use, medical marijuana dispensaries, and abusive and neglectful parenting.

    Science.gov (United States)

    Freisthler, Bridget; Gruenewald, Paul J; Wolf, Jennifer Price

    2015-10-01

    The current study extends previous research by examining whether and how current marijuana use and the physical availability of marijuana are related to child physical abuse, supervisory neglect, or physical neglect by parents while controlling for child, caregiver, and family characteristics in a general population survey in California. Individual level data on marijuana use and abusive and neglectful parenting were collected during a telephone survey of 3,023 respondents living in 50 mid-size cities in California. Medical marijuana dispensaries and delivery services data were obtained via six websites and official city lists. Data were analyzed using negative binomial and linear mixed effects multilevel models with individuals nested within cities. Current marijuana use was positively related to frequency of child physical abuse and negatively related to physical neglect. There was no relationship between supervisory neglect and marijuana use. Density of medical marijuana dispensaries and delivery services was positively related to frequency of physical abuse. As marijuana use becomes more prevalent, those who work with families, including child welfare workers must screen for how marijuana use may affect a parent's ability to provide for care for their children, particularly related to physical abuse.

  9. Stellar Coronal Response to Differential Rotation and Flux Emergence

    CERN Document Server

    Gibb, G P S; Jardine, M M; Yeates, A R

    2016-01-01

    We perform a numerical parameter study to determine what effect varying differential rotation and flux emergence has on a star's non-potential coronal magnetic field. In particular we consider the effects on the star's surface magnetic flux, open magnetic flux, mean azimuthal field strength, coronal free magnetic energy, coronal heating and flux rope eruptions. To do this, we apply a magnetic flux transport model to describe the photospheric evolution, and couple this to the non-potential coronal evolution using a magnetofrictional technique. A flux emergence model is applied to add new magnetic flux onto the photosphere and into the corona. The parameters of this flux emergence model are derived from the solar flux emergence profile, however the rate of emergence can be increased to represent higher flux emergence rates than the Sun's. Overall we find that flux emergence has a greater effect on the non-potential coronal properties compared to differential rotation, with all the aforementioned properties incr...

  10. Re-examining medical modernization

    DEFF Research Database (Denmark)

    Tupasela, Aaro Mikael

    2007-01-01

    Despite recent evidence that suggests that knowledge production within the medical community is increasingly based on knowledge-making coalitions or what some have called the co-production of knowledge, there remains a strong expert led policy agenda in many countries in relation to human genome...... research. This article reports on the role of experts in defining the scope of discussion in relation to the biomedical use of human tissue sample collections or biobanks in Finland using the case of the Genome Information Center. It is argued that the rhetorical strategies should not be understood simply...

  11. Solar Eruptions: Coronal Mass Ejections and Flares

    Science.gov (United States)

    Gopalswamy, Nat

    2012-01-01

    This lecture introduces the topic of Coronal mass ejections (CMEs) and solar flares, collectively known as solar eruptions. During solar eruptions, the released energy flows out from the Sun in the form of magnetized plasma and electromagnetic radiation. The electromagnetic radiation suddenly increases the ionization content of the ionosphere, thus impacting communication and navigation systems. Flares can be eruptive or confined. Eruptive flares accompany CMEs, while confined flares hav only electromagnetic signature. CMEs can drive MHD shocks that accelerate charged particles to very high energies in the interplanetary space, which pose radiation hazard to astronauts and space systems. CMEs heading in the direction of Earth arrive in about two days and impact Earth's magnetosphere, producing geomagnetic storms. The magnetic storms result in a number of effects including induced currnts that can disrupt power grids, railroads, and underground pipelines

  12. 78 FR 50136 - Notice of Information Collection Under Emergency Review: Medical History and Examination for...

    Science.gov (United States)

    2013-08-16

    ... proposed collection instrument and supporting documents, to Susan B. Summers, Chief of Medical Clearances... automated collection techniques or other forms of information technology. Please note that comments...: August 6, 2013. Susan B. Summers, Chief Medical Clearance Section, Office of Medical Services,...

  13. Coronal Partings

    CERN Document Server

    Nikulin, Igor F

    2015-01-01

    The basic observational properties of the 'coronal partings'--the special type of the coronal magnetic structures, identified by a comparison of the coronal X-ray images and solar magnetograms--are considered. They represent channels inside the unipolar large-scale magnetic fields, formed by the rows of magnetic arcs directed to the neighboring fields of opposite polarity. The most important characteristics of the partings are revealed. It is found that--from the evolutionary and spatial point of view--the partings can transform to the coronal holes and visa versa. The classes of global, intersecting, and complex partings are identified.

  14. Psychiatry resident-led tutorials increase medical student knowledge and improve national board of medical examiners shelf exam scores.

    Science.gov (United States)

    McKean, A J S; Palmer, B A

    2015-06-01

    Psychiatry residents have tremendous potential as educators. The authors envisioned residents as small-group tutors, efficiently assessing and correcting knowledge deficits using cases with discussion prompts and teaching points. They empirically tested whether this improves knowledge acquisition. Senior residents delivered eight tutorials during clerkship, which covered child and adolescent psychiatry, anxiety, mood, psychotic, cognitive, and substance use disorders. A 50-item multiple-choice quiz was administered at the beginning and end of clerkship. National Board of Medical Examiners (NBME) shelf exam scores from intervention year were compared to the 4 years prior to resident involvement. Mean score on the initial quiz was 34.5 ± 3.7 and 41.8 ± 3.5 on second attempt (p < 0.001). Mean score for NBME psychiatry subject exam during intervention year was 83.2 ± 8.9 and for the four prior years was 78.0 ± 9.3, which was significant (p = 0.002). Resident-led tutorials provide an effective means of increasing psychiatric knowledge and improving performance on NBME subject exams.

  15. Assessment of obesity management in medical examination

    Directory of Open Access Journals (Sweden)

    Treyzon Leo

    2005-03-01

    Full Text Available Abstract Obesity is a growing international health problem that has already reached epidemic proportions, particularly within the United States where a majority of the population is overweight or obese. Effective methods of treatment are needed, and should be taught to physicians by efficient means. There exists a disconnect between the rising obesity prevalence with its high toll on medical resources, and the lack of obesity education provided to practitioners in the course of their training. One particular shortfall is the lack of representation of obesity on standardized medical examinations. Physician attitudes toward obesity are influenced by their lack of familiarity with the management of the disease. This may include dietary restriction, increasing physical activity, behavior modification, pharmacotherapy, and surgical interventions. Thus, curricular changes in the medical education of obesity could help reduce morbidity and mortality associated with this disease.

  16. An Estimate of Solar Wind Velocity Profiles in a Coronal Hole and Coronal Streamer Area (6-40R)

    Science.gov (United States)

    Patzold, M.; Tsurutani, B. T.; Bird, M. K.

    1995-01-01

    Using the total electron content data obtained by the Ulysses Solar Corona Experiment during the first solar conjunction in summer 1991 (Bird et al., 1994), an estimate is presented of solar wind velocity profiles in a coronal hole and a coronal streamer area in the range between 6 and 40 solar radii.

  17. Coronal leakage of four intracanal medications after exposure to human saliva in the presence of a temporary filling material

    Directory of Open Access Journals (Sweden)

    Verissimo Rebeca

    2010-01-01

    Full Text Available Aim: To determine the time required for the recontamination of root canals medicated with four different materials. Materials and Methods: A total of 60 intact, caries-free, human single-rooted teeth with straight roots were selected for this study. After chemo-mechanical preparation they must be changed in the specimens into seven groups: 10 teeth medicated with calcium hydroxide (Ca(OH 2 + Camphorated paramonochlorophanol (CPMC (G.1; 10 medicated with 2.5% Sodium hypochlorite (NaOCL (G.2; 10 medicated with 2% Chlorhexidine gluconate (CHX in gel (G.3; 10 medicated with 2% CHX in gel + Ca(OH 2 (G.4; 10 without intracanal medicament and sealed with a coronal temporary filling (G.5. Five teeth were without intracanal medicament and coronally unsealed, used as the positive control group (PC (G.6 and 5 teeth with intact crowns used as the negative control group (NC (G.7. Glass vials with rubber stoppers were adjusted for use. The medicaments were prepared and injected into the root canals using sterile plastic syringes. An apparatus was used to evaluate for 30 days leakage. The chamber was filled with 3 ml of human saliva and Brain Heart Infusion (BHI broth, incubated at 37°C and checked daily for the appearance of turbidity in the BHI broth. Results: Recontamination was detected after an average time of 2.6 days in group 2, 15.9 days in group 3, 30 days in group 1, 27.6 days in group 4, 2.9 days in group 5, 1 day in the positive control, and there was no contamination in the negative control group. Conclusion : The NaOCl group showed the highest worst average of recontamination; on the other hand, high averages were also shown by Ca(OH 2 + CPMC and Ca(OH 2 + 2% CHX in gel.

  18. The cost of postgraduate medical education and continuing medical education: re-examining the status fifty years back.

    Science.gov (United States)

    Walsh, Kieran

    2015-03-01

    The subject of the cost and value of medical education is becoming increasingly important. However, this subject is not a new one. Fifty years ago, Mr. DH Patey, Dr. OF Davies, and Dr. John Ellis published a report on the state of postgraduate medical education in the UK. The report was wide-ranging, but it made a considerable mention of cost. In this short article, I have presented the documentary research that I conducted on their report. I have analyzed it from a positivist perspective and have concentrated on the subject of cost, as it appears in their report. The authors describe reforms within postgraduate medical education; however, they are clear from the start that the issue of cost can often be a barrier to such reforms. They state the need for basic facilities for medical education, but then outline the financial barriers to their development. The authors then discuss the costs of library services for education. They state that the "annual spending on libraries varies considerably throughout the country." The authors also describe the educational experiences of newly graduated doctors. According to them, the main problem is that these doctors do not have time to attend formal educational events, and that this will not be possible until there is "a more graduated approach to responsible clinical work," something which is not possible without financial investment. While concluding their report, the authors state that the limited money invested in postgraduate medical education and continuing medical education has been well spent, and that this has had a dual effect on improving medical education as well as the standards of medical care.

  19. The Value of Outsourcing Selected Cases in a Medical Examiner Population: A 10-Year Experience.

    Science.gov (United States)

    McCleskey, Brandi C; Reilly, Stephanie D; Atherton, Dan

    2017-01-01

    Due to increasing caseloads and inadequate staffing, the burden on Coroner/Medical Examiner Offices to comply with recommended autopsy limits for forensic pathologists (FPs) has been difficult. Since 2006, pathologists at the University of Alabama at Birmingham have performed select autopsies for the Alabama Department of Forensic Sciences. Each case was reviewed by a state FP and scene investigator to determine appropriateness for referral. All referred cases received full postmortem examination including microscopic examination and collection of toxicological samples, and toxicology was ordered by the referring FP as appropriate. The final cause and manner of death were determined by the referring state FP after review of all findings. A majority of the 421 cases were ruled accidental deaths (233), most due to drug toxicity. Of the 178 natural deaths, 118 were attributed to cardiovascular disease. Outsourcing select forensic cases can be educational and an effective tool to manage workflow without compromising quality. © 2016 American Academy of Forensic Sciences.

  20. Electroweak Hall Effect of Neutrino and Coronal Heating

    CERN Document Server

    Ishikawa, Kenzo

    2015-01-01

    The inversion of temperature at the solar corona is hard to understand from classical physics, and the coronal heating mechanism remains unclear. The heating in the quiet region seems contradicting with the thermodynamics and is a keen problem for physicists. A new mechanism for the coronal heating based on the neutrino radiative transition unique in the corona region is studied. The probability is enormously amplified by an electroweak Chern-Simons form and overlapping waves, and the sufficient energy is transfered. Thus the coronal heating is understood from the quantum effects of the solar neutrino.

  1. [The keys to success in French Medical National Ranking Examination: Integrated training activities in teaching hospital and medical school].

    Science.gov (United States)

    Gillois, Pierre; Fourcot, Marie; Genty, Céline; Morand, Patrice; Bosson, Jean-Luc

    2015-12-01

    The National Ranking Examination (NRE) is the key to the choice of career and specialty for future physicians; it lets them choose their place of employment in a specialty and an hospital for their internship. It seems interesting to model the success factors to this exam for the medical students from Grenoble University. For each of the medical students at Grenoble University who did apply to the NRE in 2012, data have been collected about their academic background and personal details from the administration of the University. A simple logistic regression with success set as being ranked in the first 2000 students, then a polytomous logistic regression, have been performed. The 191 students in the models are 59% female, 25 years old in average (SD 1.8). The factors associated to a ranking in the first 2000 are: not repeating the PCEM1 class (odds ratio [OR] 2.63, CI95: [1.26; 5.56]), performing nurse practice during internships (OR=1.27 [1.00; 1.62]), being ranked in the first half of the class for S3 pole (OR=6.04 [1.21; 30.20] for the first quarter, OR=5.65 [1.15; 27.74] for the second quarter) and being in the first quarter at T5 pole (OR=3.42 [1.08; 10.82]). Our study finds four factors independently contributing to the success at NRE: not repeating PCEM1, performing nurse practice and being ranked in the top of the class at certain academic fields. The AUC is 0.76 and student accuracy is more than 80%. However, some items, for example repeating DCEM4 or participating in NRE mock exams, have no influence on success. A different motivation should be a part of the explanation… As these analysed data are mainly institutional, they are accurate and reliable. The polytomic logistic model, sharing 3 factors with the simple logistic model, replace a performing nurse practice factor's by a grant recipient factor. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Magnetohydrodynamic waves and coronal seismology: an overview of recent results.

    Science.gov (United States)

    De Moortel, Ineke; Nakariakov, Valery M

    2012-07-13

    Recent observations have revealed that magnetohydrodynamic (MHD) waves and oscillations are ubiquitous in the solar atmosphere, with a wide range of periods. We give a brief review of some aspects of MHD waves and coronal seismology that have recently been the focus of intense debate or are newly emerging. In particular, we focus on four topics: (i) the current controversy surrounding propagating intensity perturbations along coronal loops, (ii) the interpretation of propagating transverse loop oscillations, (iii) the ongoing search for coronal (torsional) Alfvén waves, and (iv) the rapidly developing topic of quasi-periodic pulsations in solar flares.

  3. MHD Waves and Coronal Seismology: an overview of recent results

    CERN Document Server

    De Moortel, Ineke

    2012-01-01

    Recent observations have revealed that MHD waves and oscillations are ubiquitous in the solar atmosphere, with a wide range of periods. We give a brief review of some aspects of MHD waves and coronal seismology which have recently been the focus of intense debate or are newly emerging. In particular, we focus on four topics: (i) the current controversy surrounding propagating intensity perturbations along coronal loops, (ii) the interpretation of propagating transverse loop oscillations, (iii) the ongoing search for coronal (torsional) Alfven waves and (iv) the rapidly developing topic of quasi-periodic pulsations (QPP) in solar flares.

  4. Inbound medical tourism to Barbados: a qualitative examination of local lawyers' prospective legal and regulatory concerns.

    Science.gov (United States)

    Crooks, Valorie A; Cohen, I Glenn; Adams, Krystyna; Whitmore, Rebecca; Morgan, Jeffrey

    2015-07-28

    Enabled by globalizing processes such as trade liberalization, medical tourism is a practice that involves patients' intentional travel to privately obtain medical care in another country. Empirical legal research on this issue is limited and seldom based on the perspectives of destination countries receiving medical tourists. We consulted with diverse lawyers from across Barbados to explore their views on the prospective legal and regulatory implications of the developing medical tourism industry in the country. We held a focus group in February 2014 in Barbados with lawyers from across the country. Nine lawyers with diverse legal backgrounds participated. Focus group moderators summarized the study objective and engaged participants in identifying the local implications of medical tourism and the anticipated legal and regulatory concerns. The focus group was transcribed verbatim and analyzed thematically. Five dominant legal and regulatory themes were identified through analysis: (1) liability; (2) immigration law; (3) physician licensing; (4) corporate ownership; and (5) reputational protection. Two predominant legal and ethical concerns associated with medical tourism in Barbados were raised by participants and are reflected in the literature: the ability of medical tourists to recover medical malpractice for adverse events; and the effects of medical tourism on access to health care in the destination country. However, the participants also identified several topics that have received much less attention in the legal and ethical literature. Overall this analysis reveals that lawyers, at least in Barbados, have an important role to play in the medical tourism sector beyond litigation - particularly in transactional and gatekeeper capacities. It remains to be seen whether these findings are specific to the ecology of Barbados or can be extrapolated to the legal climate of other medical tourism destination countries.

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

    OpenAIRE

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

    2016-01-01

    Objective: To determine the association between family-centered rounds (FCR) and medical student knowledge acquisition as assessed by the National Board of Medical Examiners (NBME) pediatric subject (shelf) exam.Methods: A retrospective cohort study was conducted of third-year medical students who graduated from Virginia Commonwealth University School of Medicine between 2009 and 2014. This timeframe represented the transition from ‘traditional’ rounds to FCR on the pediatric inpatient unit. ...

  6. 20 CFR 404.1519n - Informing the medical source of examination scheduling, report content, and signature requirements.

    Science.gov (United States)

    2010-04-01

    ... scheduling, report content, and signature requirements. 404.1519n Section 404.1519n Employees' Benefits... medical source of examination scheduling, report content, and signature requirements. The medical sources... report containing all of the elements in paragraph (c). (e) Signature requirements. All...

  7. Cyclical Variation of the Quiet Corona and Coronal Holes

    Indian Academy of Sciences (India)

    Takashi Sakurai

    2000-09-01

    Recent advances in the understanding of the quiet corona and coronal holes are reviewed. The review is based on long-term accumulation of data from eclipse observations, coronagraph observations, helium 10830 Å spectroheliograms, and X-ray observations.

  8. Culex coronator Dyar and Knab: a new Florida species record.

    Science.gov (United States)

    Smith, John P; Walsh, Jimmy D; Cope, Eric H; Tennant, Richard A; Kozak, John A; Darsie, Richard F

    2006-06-01

    We report the first finding of Culex coronator Dyar and Knab in Florida, based on multiple adult collections from several locations in the western panhandle of Florida. GPS coordinates and habitat descriptions are given and disease implications are discussed. These records extend the known distribution of Cx. coronator from six other states (Arizona, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas), and from Mexico to Argentina.

  9. Stellar Differential Rotation and Coronal Timescales

    CERN Document Server

    Gibb, G P S; Mackay, D H

    2014-01-01

    We investigate the timescales of evolution of stellar coronae in response to surface differential rotation and diffusion. To quantify this we study both the formation time and lifetime of a magnetic flux rope in a decaying bipolar active region. We apply a magnetic flux transport model to prescribe the evolution of the stellar photospheric field, and use this to drive the evolution of the coronal magnetic field via a magnetofrictional technique. Increasing the differential rotation (i.e. decreasing the equator-pole lap time) decreases the flux rope formation time. We find that the formation time is dependent upon the geometric mean of the lap time and the surface diffusion timescale. In contrast, the lifetime of flux ropes are proportional to the lap time. With this, flux ropes on stars with a differential rotation of more than eight times the solar value have a lifetime of less than two days. As a consequence, we propose that features such as solar-like quiescent prominences may not be easily observable on s...

  10. Surface Flux Emergence and Coronal Eruption

    Science.gov (United States)

    Fang, Fang

    2016-05-01

    Among various active regions, delta-sunspots of aggregated spots of opposite polarities, are of particular interest due to their high productivity in energetic and recurrent eruptive events, such as X-class flares and homologous eruptions. We here study the formation of such complex magnetic structures by numerical simulations of magnetic flux emergence from the convection zone into the corona in an active-region scale domain. In our simulation, two pairs of bipolar sunspots form on the surface, originating from two buoyant segments of a single subsurface twisted flux rope. Expansion and rotation of the emerging fields in the two bipoles drive the two opposite polarities into each other with apparent rotating motion, producing a compact delta-sunspot with a sharp polarity inversion line (PIL). The formation of the delta-sunspot in such a realistic-scale domain produces emerging patterns similar to those formed in observations, e.g. the inverted polarity against Hale’s law, the curvilinear motion of the spot, strong transverse field with highly sheared magnetic and velocity fields at the PIL. Strong current builds up at the PIL, giving rise to reconnection, which produces a complex coronal magnetic connectivity with non-potential fields in the delta-spot overlaid by more relaxed fields connecting the two polarities at the two ends.

  11. Active Longitude and Coronal Mass Ejection Occurrences

    Science.gov (United States)

    Gyenge, N.; Singh, T.; Kiss, T. S.; Srivastava, A. K.; Erdélyi, R.

    2017-03-01

    The spatial inhomogeneity of the distribution of coronal mass ejection (CME) occurrences in the solar atmosphere could provide a tool to estimate the longitudinal position of the most probable CME-capable active regions in the Sun. The anomaly in the longitudinal distribution of active regions themselves is often referred to as active longitude (AL). In order to reveal the connection between the AL and CME spatial occurrences, here we investigate the morphological properties of active regions. The first morphological property studied is the separateness parameter, which is able to characterize the probability of the occurrence of an energetic event, such as a solar flare or CME. The second morphological property is the sunspot tilt angle. The tilt angle of sunspot groups allows us to estimate the helicity of active regions. The increased helicity leads to a more complex buildup of the magnetic structure and also can cause CME eruption. We found that the most complex active regions appear near the AL and that the AL itself is associated with the most tilted active regions. Therefore, the number of CME occurrences is higher within the AL. The origin of the fast CMEs is also found to be associated with this region. We concluded that the source of the most probably CME-capable active regions is at the AL. By applying this method, we can potentially forecast a flare and/or CME source several Carrington rotations in advance. This finding also provides new information for solar dynamo modeling.

  12. United States Medical Licensing Examination and Its Illumination to Chinese Medical Schools and Examinations%中美两国医师执业考试述评及对中国医学教育的启示

    Institute of Scientific and Technical Information of China (English)

    陈梁

    2012-01-01

    从美国医师执照考试,展现美国医师培养的优势,对中国大陆的医学教育引起思考,获得启示。将美国医师执照考试和中国医师资格考试进行一定程度的比较,从而指出两者的不同之处和差距,以利于改进我国执业医师考试。%To demonstrate the advantage of the deep thoughts of medical education of China, examination of United States to China, to find out training system of so that to gain ill American umination physicians from USMLE, to induce the differences between them, so compare the medical licensing that we can improve the medical licensing examination and medical education of Chinese medical schools.

  13. Cannabis, possible cardiac deaths and the coroner in Ireland.

    LENUS (Irish Health Repository)

    Tormey, W P

    2012-01-10

    BACKGROUND: The elevated risk of triggering a myocardial infarction by smoking cannabis is limited to the first 2 h after smoking. AIM: To examine the possible role of cannabis in cardiac deaths. CASES AND RESULTS: From 3,193 coroners\\' cases over 2 years, there were 13 cases where the clinical information was compatible with a primary cardiac cause of death. An inquest was held in three cases. Myocardial infarction was the primary cause of death in 54%. Other causes were sudden adult death syndrome, sudden death in epilepsy, and poisoning by alcohol and diazepam. Cannabis was mentioned once only on a death certificate, but not as a cause of death. Blood delta9-tetrahydrocannabinol-carboxylic acid was recorded in one case and in no case was plasma tetrahydrocannabinol (THC) measured. CONCLUSIONS: To attribute sudden cardiac death to cannabis, plasma THC should be measured in the toxicology screen in coroners\\' cases where urine cannabinoids are positive. A positive urine cannabinoids immunoassay alone is insufficient evidence in the linkage of acute cardiac death and cannabis.

  14. On the Fourier and Wavelet Analysis of Coronal Time Series

    Science.gov (United States)

    Auchère, F.; Froment, C.; Bocchialini, K.; Buchlin, E.; Solomon, J.

    2016-07-01

    Using Fourier and wavelet analysis, we critically re-assess the significance of our detection of periodic pulsations in coronal loops. We show that the proper identification of the frequency dependence and statistical properties of the different components of the power spectra provides a strong argument against the common practice of data detrending, which tends to produce spurious detections around the cut-off frequency of the filter. In addition, the white and red noise models built into the widely used wavelet code of Torrence & Compo cannot, in most cases, adequately represent the power spectra of coronal time series, thus also possibly causing false positives. Both effects suggest that several reports of periodic phenomena should be re-examined. The Torrence & Compo code nonetheless effectively computes rigorous confidence levels if provided with pertinent models of mean power spectra, and we describe the appropriate manner in which to call its core routines. We recall the meaning of the default confidence levels output from the code, and we propose new Monte-Carlo-derived levels that take into account the total number of degrees of freedom in the wavelet spectra. These improvements allow us to confirm that the power peaks that we detected have a very low probability of being caused by noise.

  15. Evolving Coronal Holes and Interplanetary Erupting Stream Disturbances

    Indian Academy of Sciences (India)

    Rajendra Shelke

    2006-06-01

    Coronal holes and interplanetary disturbances are important aspects of the physics of the Sun and heliosphere. Interplanetary disturbances are identified as an increase in the density turbulence compared with the ambient solar wind. Erupting stream disturbances are transient large-scale structures of enhanced density turbulence in the interplanetary medium driven by the high-speed flows of low-density plasma trailing behind for several days. Here, an attempt has been made to investigate the solar cause of erupting stream disturbances, mapped by Hewish & Bravo (1986) from interplanetary scintillation (IPS) measurements made between August 1978 and August 1979 at 81.5 MHz. The position of the sources of 68 erupting stream disturbances on the solar disk has been compared with the locations of newborn coronal holes and/or the areas that have been coronal holes previously. It is found that the occurrence of erupting stream disturbances is linked to the emergence of newcoronal holes at the eruption site on the solar disk. A coronal hole is indicative of a radial magnetic field of a predominant magnetic polarity. The newborn coronal hole emerges on the Sun, owing to the changes in magnetic field configuration leading to the opening of closed magnetic structure into the corona. The fundamental activity for the onset of an erupting stream seems to be a transient opening of pre-existing closed magnetic structures into a new coronal hole, which can support high-speed flow trailing behind the compression zone of the erupting stream for several days.

  16. Mitochondrial genomes and comparative analyses of Culex camposi, Culex coronator, Culex usquatus and Culex usquatissimus (Diptera:Culicidae), members of the coronator group

    National Research Council Canada - National Science Library

    Demari-Silva, Bruna; Foster, Peter G; de Oliveira, Tatiane M P; Bergo, Eduardo S; Sanabani, Sabri S; Pessôa, Rodrigo; Sallum, Maria Anice M

    2015-01-01

    The Coronator Group currently encompasses six morphologically similar species (Culex camposi Dyar, Culex coronator Dyar and Knab, Culex covagarciai Forattini, Culex usquatus Dyar, Culex usquatissimus Dyar, and Culex ousqua Dyar...

  17. Virginity Testing Beyond a Medical Examination.

    Science.gov (United States)

    Robatjazi, Mehri; Simbar, Masoumeh; Nahidi, Fatemeh; Gharehdaghi, Jaber; Emamhadi, Mohammadali; Vedadhir, Abou-Ali; Alavimajd, Hamid

    2015-11-18

    Apart from religious values, virginity is important in different communities because of its prominent role in reducing sexually transmitted diseases and teen pregnancies. Even though virginity testing has been proclaimed an example of violence against women by the World Health Organization, it is still conducted in many countries, including Iran. 16 in-depth, semi-structured interviews were conducted with participants aged 32 to 60 years to elucidate the perceptions and experiences of Iranian examiners of virginity testing.The perception and experience of examiners were reflected in five main themes. The result of this study indicated that virginity testing is more than a medical examination, considering the cultural factors involved and its overt and covert consequences. In Iran, testing is performed for both formal and informal reasons, and examiners view such testing with ambiguity about the accuracy and certainty of the diagnosis and uncertainty about ethics and reproductive rights. Examiners are affected by the overt and covert consequences of virginity testing, beliefs and cultural values underlying virginity testing, and informal and formal reasons for virginity testing.

  18. Integrative medical therapy: examination of meditation's therapeutic and global medicinal outcomes via nitric oxide (review).

    Science.gov (United States)

    Stefano, George B; Esch, Tobias

    2005-10-01

    Relaxation techniques are part of the integrative medicine movement that is of growing importance for mainstream medicine. Complementary medical therapies have the potential to affect many physiological systems. Repeatedly studies show the benefits of the placebo response and relaxation techniques in the treatment of hypertension, cardiac arrhythmias, chronic pain, insomnia, anxiety and mild and moderate depression, premenstrual syndrome, and infertility. In itself, relaxation is characterized by a decreased metabolism, heart rate, blood pressure, and rate of breathing as well as an increase in skin temperature. Relaxation approaches, such as progressive muscle relaxation, autogenic training, meditation and biofeedback, are effective in lowering systolic and diastolic blood pressure in hypertensive patients by a significant margin. Given this association with changes in vascular tone, we have hypothesized that nitric oxide, a demonstrated vasodilator substance, contribute to physiological activity of relaxation approaches. We examined the scientific literature concerning the disorders noted earlier for their nitric oxide involvement in an attempt to provide a molecular rationale for the positive effects of relaxation approaches, which are physiological and cognitive process. We conclude that constitutive nitric oxide may crucially contribute to potentially beneficial outcomes and effects in diverse pathologies, exerting a global healing effect.

  19. The study of Equatorial coronal hole during maximum phase of Solar Cycle 21, 22, 23 and 24

    Science.gov (United States)

    Karna, Mahendra; Karna, Nishu

    2017-08-01

    The 11-year Solar Cycle (SC) is characterized by the periodic change in the solar activity like sunspot numbers, coronal holes, active regions, eruptions such as flares and coronal mass ejections. We study the relationship between equatorial coronal holes (ECH) and the active regions (AR) as coronal whole positions and sizes change with the solar cycle. We made a detailed study of equatorial coronal hole for four solar maximum: Solar Cycle 21 (1979,1980,1981 and 1982), Solar Cycle 22 (1989, 1990, 1991 and 1992), Solar Cycle 23 (1999, 2000, 2001 and 2002) and Solar Cycle 24 (2012, 2013, 2014 and 2015). We used publically available NOAA solar coronal hole data for cycle 21 and 22. We measured the ECH region using the EIT and AIA synoptic map for cycle 23 and 24. We noted that in two complete 22-year cycle of solar activity, the equatorial coronal hole numbers in SC 22 is greater than SC 21 and similarly, SC 24 equatorial coronal hole numbers are greater than SC 23. Moreover, we also compared the position of AR and ECH during SC 23 and 24. We used daily Solar Region Summary (SRS) data from SWPC/NOAA website. Our goal is to examine the correlation between equatorial holes, active regions, and flares.

  20. Do general medical practitioners examine injured runners?

    DEFF Research Database (Denmark)

    Andersen, Solvej Videbæk; Jensen, A V; Rasmussen, Sten

    2017-01-01

    BACKGROUND: General Medical Practitioners (GMP) in Denmark perform clinical examinations of patients with musculoskeletal pain. However, the prevalence proportion of examinations caused by running-related injuries remains unknown. PURPOSE: The primary purpose of the present study was to estimate...... the prevalence proportion of consultations in general medical practice caused by running-related injuries. The secondary purpose was to estimate the prevalence proportion of injured runners, who consult their GMP, that are referred to additional examinations or treatments. STUDY DESIGN: A survey-based study...

  1. Correlations between the scores of computerized adaptive testing, paper and pencil tests, and the Korean Medical Licensing Examination

    Directory of Open Access Journals (Sweden)

    Mee Young Kim

    2005-06-01

    Full Text Available To evaluate the usefulness of computerized adaptive testing (CAT in medical school, the General Examination for senior medical students was administered as a paper and pencil test (P&P and using CAT. The General Examination is a graduate examination, which is also a preliminary examination for the Korean Medical Licensing Examination (KMLE. The correlations between the results of the CAT and P&P and KMLE were analyzed. The correlation between the CAT and P&P was 0.8013 (p=0.000; that between the CAT and P&P was 0.7861 (p=0.000; and that between the CAT and KMLE was 0.6436 (p=0.000. Six out of 12 students with an ability estimate below 0.52 failed the KMLE. The results showed that CAT could replace P&P in medical school. The ability of CAT to predict whether students would pass the KMLE was 0.5 when the criterion of the theta value was set at -0.52 that was chosen arbitrarily for the prediction of pass or failure.

  2. Electric currents and coronal heating in NOAA active region 6952

    Science.gov (United States)

    Metcalf, T. R.; Canfield, R. C.; Hudson, H. S.; Mickey, D. L.; Wulser, J. -P.; Martens, P. C. H.; Tsuneta, S.

    1994-01-01

    We examine the spatial and temporal relationship between coronal structures observed with the soft X-ray telescope (SXT) on board the Yohkoh spacecraft and the vertical electric current density derived from photospheric vector magnetograms obtained using the Stokes Polarimeter at the Mees Solar Observatory. We focus on a single active region: AR 6952 which we observed on 7 days during 1991 December. For 11 independent maps of the vertical electric current density co-aligned with non-flaring X-ray images, we search for a morphological relationship between sites of high vertical current density in the photosphere and enhanced X-ray emission in the overlying corona. We find no compelling spatial or temporal correlation between the sites of vertical current and the bright X-ray structures in this active region.

  3. ON THE RELATIONSHIP BETWEEN THE CORONAL MAGNETIC DECAY INDEX AND CORONAL MASS EJECTION SPEED

    Energy Technology Data Exchange (ETDEWEB)

    Xu Yan; Liu Chang; Jing Ju; Wang Haimin, E-mail: yx2@njit.edu [Space Weather Research Lab, Center for Solar-Terrestrial Research, New Jersey Institute of Technology, 323 Martin Luther King Boulevard, Newark, NJ 07102-1982 (United States)

    2012-12-10

    Numerical simulations suggest that kink and torus instabilities are two potential contributors to the initiation and prorogation of eruptive events. A magnetic parameter called the decay index (i.e., the coronal magnetic gradient of the overlying fields above the eruptive flux ropes) could play an important role in controlling the kinematics of eruptions. Previous studies have identified a threshold range of the decay index that distinguishes between eruptive and confined configurations. Here we advance the study by investigating if there is a clear correlation between the decay index and coronal mass ejection (CME) speed. Thirty-eight CMEs associated with filament eruptions and/or two-ribbon flares are selected using the H{alpha} data from the Global H{alpha} Network. The filaments and flare ribbons observed in H{alpha} associated with the CMEs help to locate the magnetic polarity inversion line, along which the decay index is calculated based on the potential field extrapolation using Michelson Doppler Imager magnetograms as boundary conditions. The speeds of CMEs are obtained from the LASCO C2 CME catalog available online. We find that the mean decay index increases with CME speed for those CMEs with a speed below 1000 km s{sup -1} and stays flat around 2.2 for the CMEs with higher speeds. In addition, we present a case study of a partial filament eruption, in which the decay indices show different values above the erupted/non-erupted part.

  4. "Heidelberg standard examination" and "Heidelberg standard procedures" - Development of faculty-wide standards for physical examination techniques and clinical procedures in undergraduate medical education.

    Science.gov (United States)

    Nikendei, C; Ganschow, P; Groener, J B; Huwendiek, S; Köchel, A; Köhl-Hackert, N; Pjontek, R; Rodrian, J; Scheibe, F; Stadler, A-K; Steiner, T; Stiepak, J; Tabatabai, J; Utz, A; Kadmon, M

    2016-01-01

    The competent physical examination of patients and the safe and professional implementation of clinical procedures constitute essential components of medical practice in nearly all areas of medicine. The central objective of the projects "Heidelberg standard examination" and "Heidelberg standard procedures", which were initiated by students, was to establish uniform interdisciplinary standards for physical examination and clinical procedures, and to distribute them in coordination with all clinical disciplines at the Heidelberg University Hospital. The presented project report illuminates the background of the initiative and its methodological implementation. Moreover, it describes the multimedia documentation in the form of pocketbooks and a multimedia internet-based platform, as well as the integration into the curriculum. The project presentation aims to provide orientation and action guidelines to facilitate similar processes in other faculties.

  5. [Forensic medical examinations and teaching: disagreements and discussions within the Brazilian Society of Neurology, Psychiatry, and Forensic Medicine].

    Science.gov (United States)

    Cerqueira, Ede

    2015-01-01

    In order to observe the influence wielded by forensic medicine in the development of the field of psychiatry in Brazil, this research note analyzes the debates that took place from May to July 1918 within the Brazilian Society of Neurology, Psychiatry, and Forensic Medicine over the use of forensic medical examinations as course material in the study of Public Medicine at the Rio de Janeiro School of Medicine. The focus is on how the controversy unfolded within the Society and how this scientific organization influenced the institution of the theoretical and practical training of medical experts.

  6. Anatomy and Humanity: Examining the Effects of a Short Documentary Film and First Anatomy Laboratory Experience on Medical Students

    Science.gov (United States)

    Dosani, Farah; Neuberger, Lindsay

    2016-01-01

    Medical students begin their education inside a laboratory dissecting cadavers to learn human gross anatomy. Many schools use the course experience as a way to instill empathy and some have begun integrating video and recorded interviews with body donors to humanize the experience, but their impact has yet to be measured. This study examines the…

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

    Science.gov (United States)

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

    2016-01-01

    Objective To determine the association between family-centered rounds (FCR) and medical student knowledge acquisition as assessed by the National Board of Medical Examiners (NBME) pediatric subject (shelf) exam. Methods A retrospective cohort study was conducted of third-year medical students who graduated from Virginia Commonwealth University School of Medicine between 2009 and 2014. This timeframe represented the transition from ‘traditional’ rounds to FCR on the pediatric inpatient unit. Data collected included demographics, United States Medical Licensing Examination (USMLE) Step 1 and 2 scores, and NBME subject examinations in pediatrics (PSE), medicine (MSE), and surgery (SSE). Results Eight hundred and sixteen participants were included in the analysis. Student performance on the PSE could not be statistically differentiated from performance on the MSE for any year except 2011 (z-score=−0.17, p=0.02). Average scores on PSE for years 2009, 2010, 2013, and 2014 were significantly higher than for SSE, but not significantly different for all other years. The PSE was highly correlated with USMLE Step 1 and Step 2 examinations (correlation range 0.56–0.77) for all years. Conclusions Our results showed no difference in PSE performance during a time in which our institution transitioned to FCR. These findings should be reassuring for students, attending physicians, and medical educators. PMID:27087016

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

    Directory of Open Access Journals (Sweden)

    Tiffany N. Kimbrough

    2016-04-01

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

  9. Association of Classroom Participation and Examination Performance in a First-Year Medical School Course

    Science.gov (United States)

    Millis, Richard M.; Dyson, Sharon; Cannon, Dawn

    2009-01-01

    The advent of internet-based delivery of basic medical science lectures may unintentionally lead to decreased classroom attendance and participation, thereby creating a distance learning paradigm. In this study, we tested the hypothesis that classroom attendance/participation may be positively correlated with performance on a written examination…

  10. Context, evidence and attitude: the case for photography in medical examinations of asylum seekers in the Netherlands.

    Science.gov (United States)

    Park, Rebekah; Oomen, Janus

    2010-07-01

    Can photographs of scars serve as evidence of torture? Amnesty International's Medical Examination Group in the Netherlands (AI-MEG) has, for more than a decade, been photographing torture scars to supplement the testimonies of asylum seekers who have been denied refuge. AI-MEG only intervenes at this point, when asylum seekers face extradition. Proving allegations of torture is of vital importance, as asylum seekers face rising anti-immigrant sentiment in European countries. All victims examined by AI-MEG present a combination of mental, physical and emotional scars. We summarize five cases where AI-MEG used photography in their medical examinations, and consider the ethical role physicians play in helping asylum seekers obtain refuge. Though photographs cannot capture all forms of trauma, as visual documents, they are a compelling form of concrete evidence of torture. In this way, photographs complement verbal testimonies and help doctors and immigration authorities to see and understand physical scars left by various forms of torture. AI-MEG explains in medical terms the connections between the visible late sequelae of torture and victims' testimonies. They then assess whether or not the physical scars are consistent with the forms of torture recounted by victims, using the terminology of the Istanbul Protocol (1999), the United Nations-adopted manual of guidelines that explains how to document torture. This paper outlines the medical examination process and argues for the use of photography as medical evidence on behalf of asylum seekers. Copyright 2010 Elsevier Ltd. All rights reserved.

  11. Optimization of regular medical examination of patients with arterial hypertension and metabolic disorders

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    V.V. Blinova

    2010-06-01

    Full Text Available The scientific work is devoted to examination of 180 patients with arterial hypertension in case of metabolic syndrome during the period of 12 months. By the end of initial examination patients were divided into 3 groups. The first group (72 men and women was regularly checked by cardiologist once in 3 months, the second one (60 patients -once in 6 months, the third group (48 patients was observed once a year. Accordingly regular clinical examination provides more effective conditions for observation and treatment, improvement of health state and hemodynamic indices allowing to cosider the given way of clinical examination as a rational and effective method

  12. An evaluation of the performance in the UK Royal College of Anaesthetists primary examination by UK medical school and gender

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    Watmough Simon D

    2009-06-01

    Full Text Available Abstract Background There has been comparatively little consideration of the impact that the changes to undergraduate curricula might have on postgraduate academic performance. This study compares the performance of graduates by UK medical school and gender in the Multiple Choice Question (MCQ section of the first part of the Fellowship of the Royal College of Anaesthetists (FRCA examination. Methods Data from each sitting of the MCQ section of the primary FRCA examination from June 1999 to May 2008 were analysed for performance by medical school and gender. Results There were 4983 attempts at the MCQ part of the examination by 3303 graduates from the 19 United Kingdom medical schools. Using the standardised overall mark minus the pass mark graduates from five medical schools performed significantly better than the mean for the group and five schools performed significantly worse than the mean for the group. Males performed significantly better than females in all aspects of the MCQ – physiology, mean difference = 3.0% (95% CI 2.3, 3.7, p Conclusion Graduates from each of the medical schools in the UK do show differences in performance in the MCQ section of the primary FRCA, but significant curriculum change does not lead to deterioration in post graduate examination performance. Whilst females now outnumber males taking the MCQ, they are not performing as well as the males.

  13. Statistical study on the relationship between halo CME and coronal dimming

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The data from SOHO/EIT and SOHO/LASCO observations are used to determine the relationship between coronal dimming and full halo CME (coronal mass ejection). The events of full halo CME examined in this study were observed by LASCO co-ronagraphs and taken from the CD AW CME catalog from 1996 to 2008. Dimming events are identified by using difference images taken by EIT at the 195 A passband. We found strong relationship between full halo CMEs and the coronal dimming events, with up to 93.3% of the front-side halo CMEs associated with the EIT 195 A dimming events. Full halo CMEs that show no clear signatures of dimming usually have lower sky plane velocities (<700 km/s) compared to the mean velocity of CMEs associated with dimming.

  14. Preparing and Conducting Objective Structured Clinical Examination for Oman Medical Specialty Board R1-R4 Residents

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    Hamed Al Sinawi

    2012-05-01

    Full Text Available The Objective Structured Clinical Examination (OSCE has been a common tool of assessment in both undergraduate and postgraduate medicine, and has been reported to have both higher reliability and validity over the oral exam. In addition, another advantage is that it reduces luck by standardizing both examiners and patients. This article describes our experience in organizing and conducting an OSCE for Oman Medical Specialty Board residents in Psychiatry.

  15. Introduction and Administration of the Clinical Skill Test of the Medical Licensing Examination, Republic of Korea (2009

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    Kun Sang Kim

    2010-12-01

    Full Text Available The first trial of the clinical skill test as part of the Korean Medical Licensing Examination was done from September 23 to December 1, 2009, in the clinical skill test center located in the National Health Personnel Licensing Examination Board (NHPLEB building, Seoul. Korea is the first country to introduce the clinical skill test as part of the medical licensing examination in Asia. It is a report on the introduction and administration of the test. The NHPLEB launched researches on the validity of introducing the clinical skill test and on the best implementation methods in 2000. Since 2006, lists of subjects of test items for the clinical skill test has been developed. The test consisted of two types of evaluation, i.e., a clinical performance examination (CPX with a standardized patient (SP and objective structured clinical examination (OSCE. The proctor (medical faculty member and SP rate the examinees??proficiency for the OSCE and CPX respectively. Out of 3,456 applicants, 3,289 examinees (95.2% passed the test. Out of 167 examinees who failed the clinical skill test, 142 passed the written test. This means that the clinical skill test showed characteristics independent from the written test. This successful implementation of the clinical skill test is going to improve the medical graduates??performance of clinical skills.

  16. Coronal seismology waves and oscillations in stellar coronae

    CERN Document Server

    Stepanov, Alexander; Nakariakov, Valery M

    2012-01-01

    This concise and systematic account of the current state of this new branch of astrophysics presents the theoretical foundations of plasma astrophysics, magneto-hydrodynamics and coronal magnetic structures, taking into account the full range of available observation techniques -- from radio to gamma. The book discusses stellar loops during flare energy releases, MHD waves and oscillations, plasma instabilities and heating and charged particle acceleration. Current trends and developments in MHD seismology of solar and stellar coronal plasma systems are also covered, while recent p

  17. Coronal Loop Evolution Observed with AIA and Hi-C

    Science.gov (United States)

    Mulu-Moore, Fana; Winebarger, A.; Cirtain, J.; Kobayashi, K.; Korreck, K.; Golub, L.; Kuzin. S.; Walsh, R.; DeForest, C.; DePontieu, B.; Weber, M.

    2012-01-01

    Despite much progress toward understanding the dynamics of the solar corona, the physical properties of coronal loops are not yet fully understood. Recent investigations and observations from different instruments have yielded contradictory results about the true physical properties of coronal loops. In the past, the evolution of loops has been used to infer the loop substructure. With the recent launch of High Resolution Coronal Imager (Hi-C), this inference can be validated. In this poster we discuss the first results of loop analysis comparing AIA and Hi-C data. We find signatures of cooling in a pixel selected along a loop structure in the AIA multi-filter observations. However, unlike previous studies, we find that the cooling time is much longer than the draining time. This is inconsistent with previous cooling models.

  18. Immigration, Statecraft and Public Health: The 1920 Aliens Order, Medical Examinations and the Limitations of the State in England

    Science.gov (United States)

    Taylor, Becky

    2016-01-01

    This article considers the medical measures of the 1920 Aliens Order barring aliens from Britain. Building on existing local and port public health inspection, the requirement for aliens to be medically inspected before landing significantly expanded the duties of these state agencies and necessitated the creation of a new level of physical infrastructure and administrative machinery. This article closely examines the workings and limitations of alien medical inspection in two of England’s major ports—Liverpool and London—and sheds light on the everyday working of the Act. In doing so it reflects on the ambitions, actions and limitations of the state and so extends research by historians of the nineteenth and early twentieth century on the disputed histories of public health and the complexities of statecraft. Overall it suggests the importance of developing nuanced understandings of the gaps and failures arising from the translation of legislation into practice. PMID:27482146

  19. Kinematics and amplitude evolution of global coronal extreme ultraviolet waves

    Institute of Scientific and Technical Information of China (English)

    Ting Li; Jun Zhang; Shu-Hong Yang; Wei Liu

    2012-01-01

    With the observations of the Solar-Terrestrial Relations Observatory (STEREO) and the Solar Dynamics Observatory (SDO),we analyze in detail the kinematics of global coronal waves together with their intensity amplitudes (so-called "perturbation profiles").We use a semi-automatic method to investigate the perturbation profiles of coronal waves.The location and amplitude of the coronal waves are calculated over a 30° sector on the sphere,where the wave signal is strongest.The position with the strongest perturbation at each time is considered as the location of the wave front.In all four events,the wave velocities vary with time for most of their lifetime,up to 15 min,while in the event observed by the Atmospheric Imaging Assembly there is an additional early phase with a much higher velocity.The velocity varies greatly between different waves from 216 to 440 km s-1.The velocity of the two waves initially increases,subsequently decreases,and then increases again.Two other waves show a deceleration followed by an acceleration.Three categories of amplitude evolution of global coronal waves are found for the four events.The first is that the amplitude only shows a decrease.The second is that the amplitude initially increases and then decreases,and the third is that the amplitude shows an orderly increase,a decrease,an increase again and then a decrease.All the extreme ultraviolet waves show a decrease in amplitude while propagating farther away,probably because the driver of the global coronal wave (coronal mass ejection) is moving farther away from the solar surface.

  20. Patients′ attitudes towards the participation of medical students in clinical examination and care in Western Saudi Arabia

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    Sarah B Aljoudi

    2016-01-01

    Full Text Available Background and Objectives: Patients are essential for the acquisition and development of medical students clinical skills for their tasks. The study aimed to identify factors that influence patients′ attitudes towards the involvement of medical students in clinical examination and care in Western Saudi Arabia. Methods: A cross-sectional study using self-administered questionnaire was conducted among Saudi and non-Saudi patients at two university hospitals in Jeddah, Western Saudi Arabia. Information sought included demographic characteristics (age, gender, educational level, job, income, and marital status; patients′ attitude and comfort level towards different types of students′ involvement; factors influencing patients′ cooperation with medical students (students′ level of training, manner, skills, and attire. All these were assessed on a five-point Likert scale. Data was entered and analyzed using SPSS v 19. Results: Four hundred and seventeen adult patients participated. Fifty-one percent indicated a positive attitude towards involving medical students in clinical examination and care. Female and young patients (<45 years old were more likely to be negative in their attitude and be less comfortable towards involving medical students in their care. The highest overall mean comfort score was with medical students taking history followed by observations and less invasive examination. Patients′ mean confidence scores regarding students′ attire were the highest for female traditional attire and for scrub suit for males. Conclusion: Of the influential factors that could affect patients′ willingness to cooperate with medical students, clinical skills followed by manner and level of training ranked first. Ensuring that students mastered specific procedures before coming into direct contact with patients using patient simulators, for example, would improve patients′ acceptance of student participation.

  1. A near-peer teaching program designed, developed and delivered exclusively by recent medical graduates for final year medical students sitting the final objective structured clinical examination (OSCE

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    Sobowale Oluwaseun

    2011-03-01

    Full Text Available Abstract Background The General Medical Council states that teaching doctors and students is important for the care of patients. Our aim was to deliver a structured teaching program to final year medical students, evaluate the efficacy of teaching given by junior doctors and review the pertinent literature. Methods We developed a revision package for final year medical students sitting the Objective Structured Clinical Examination (OSCE. The package was created and delivered exclusively by recent medical graduates and consisted of lectures and small group seminars covering the core areas of medicine and surgery, with a focus on specific OSCE station examples. Students were asked to complete a feedback questionnaire during and immediately after the program. Results One hundred and eighteen completed feedback questionnaires were analysed. All participants stated that the content covered was relevant to their revision. 73.2% stated that junior doctors delivered teaching that is comparable to that of consultant - led teaching. 97.9% stated the revision course had a positive influence on their learning. Conclusions Our study showed that recent medical graduates are able to create and deliver a structured, formal revision program and provide a unique perspective to exam preparation that was very well received by our student cohort. The role of junior doctors teaching medical students in a formal structured environment is very valuable and should be encouraged.

  2. Examining the link between cash flow, market value, and research and development investment spending in the medical device industry.

    Science.gov (United States)

    Schmutz, Bryan P; Santerre, Rexford E

    2013-02-01

    Unlike the pharmaceutical industry, no empirical research has focused on the factors influencing research and development (R&D) spending in the medical device industry. To fill that gap, this study examines how R&D spending is influenced by prior year cash flow and corporate market value using multiple regression analysis and a panel data set of medical device companies over the period 1962-2008. The empirical findings suggest that the elasticities of R&D spending with respect to cash flow and corporate market value equal 0.58 and 0.31, respectively. Moreover, based upon these estimates, simulations show that the recently enacted excise tax on medical devices, taken alone, will reduce R&D spending by approximately $4 billion and thereby lead to a minimum loss of $20 billion worth of human life years over the first 10 years of its enactment.

  3. Testicular Cancer and Testicular Self-Examination; Knowledge, Attitudes and Practice in Final Year Medical Students in Nigeria

    Science.gov (United States)

    Ugwumba, Fred O; Ekwueme, Osa Eloka C; Okoh, Agharighom D

    2016-11-01

    The testicular cancer (TCa) incidence is increasing in many countries, with age-standardized incidence rates up to 7.8/100,000 men in the Western world, although reductions in mortality and increasingly high cure rates are being witnessed at the same time. In Africa, where rates are lower, presentation is often late and morbidity and mortality high. Given this scenario, awareness of testicular cancer and practice of testicular self-examination among future first response doctors is very important. This study was conducted to determine knowledge and attitude to testicular cancer, and practice of testicular self-examination (TSE) among final (6th) year medical students. In addition, the effect of an intervention in the form of a single PowerPoint® lecture, lasting 40 minutes with image content on testicular cancer and testicular self examination was assessed. Pre and post intervention administration of a self-administered structured pre tested questionnaire was performed on 151 medical students, 101 of whom returned answers (response rate of 66.8%). In the TC domain, there was a high level of awareness of testicular cancer, but poor knowledge of the age group most affected, with significant improvement post intervention (ptesticular self-examination pre-intervention was found considering the nature of the study group..Respondents had surprisingly weak/poor responses to the question “How important to men’s health is regular testicular self-examination?” Answers to the questions “Do you think it is worthwhile to examine your testis regularly?” and “Would you be interested in more information on testicular cancer and testicular self-examination?” were also suboptimal, but improved post intervention ptesticular cancer in the curricula of medical schools and other training institutions for health care personnel.

  4. Forensic Medical Examination in Civil Cases: Status, Problems, Perspectives

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    E. Kh. Barinov

    2011-01-01

    Full Text Available The state of forensic medical examinations in civil cases related to health harm while rendering medical services is not shown to meet the need for a legal procedure. Key words: forensic medical examination, civil procedure, medical cases.

  5. Examination of correlation between medical expenses with average life expectancy according to municipality and gender.

    Science.gov (United States)

    Nakajima, Hisato; Yano, Kouya; Nagasawa, Kaoko; Kobayashi, Eiji; Uetake, Shinichirou; Takagi, Ichirou; Yokota, Kuninobu

    2014-01-01

    To determine the influence of medical expenses on life expectancy. The expenses of 1,718 municipalities were divided into total expenses, hospitalization expenses and expenses other than hospitalization and dental expenses. 1) The correlation of life expectancy with sex was considered. 2) The correlation between expenses and life expectancy was considered. 3) The correlation of life expectancy or expenses with the numbers of doctors, dentists, facilities and beds was considered. 4) Using the Mahalanobis-Taguchi method, a unit space was formed by 10 municipalities with a high life expectancy, and D(2) was calculated. When D(2) was outside the unit space, the expenses were not as much as those of the 10 municipalities with a high life expectancy. 1) Life expectancy showed a positive correlation with gender. 2) Male life expectancy showed a negative correlation with total and hospitalization expenses, and a positive correlation with dental expenses. A positive correlation was found between each of expenses and female life expectancy. Total expenses, hospitalization expenses and expenses other than those on hospitalization showed a negative correlations with life expectancy in Hokkaido. Dental expenses showed a negative correlation with life expectancy in Chubu, hospitalization expenses showed a negative correlation with life expectancy in Kyushu. Total, hospitalization and dental expenses showed positive correlations with life expectancy in Tohoku, and dental expenses showed a positive correlation with life expectancy in Kanto and Chubu. 3) Total expenses, hospitalization expenses and expenses other than those on hospitalization were found to correlate with the number of doctors. Dental expenses were found to correlate with the numbers of doctors, facilities, and beds. 4) The difference in among estranged municipalities was considered. Life expectancy was significantly short in estranged municipalities, and the total expenses and hospitalization expenses were large

  6. Emergency medical services and "psych calls": Examining the work of urban EMS providers.

    Science.gov (United States)

    Prener, Christopher; Lincoln, Alisa K

    2015-11-01

    Emergency medical technicians and paramedics form the backbone of the United States' Emergency Medical Service (EMS) system. Despite the frequent involvement of EMS with people with mental health and substance abuse problems, the nature and content of this work, as well as how EMS providers think about this work, have not been fully explored. Using data obtained through observations and interviews with providers at an urban American EMS agency, this paper provides an analysis of the ways in which EMS providers interact with people with mental illness and substance abuse problems, as well as providers' experiences with the mental health care system. Results demonstrate that EMS providers share common beliefs and frustrations about "psych calls" and the types of calls that involve people with behavioral health problems. In addition, providers described their understandings of the ways in which people with mental health and substance use problems "abuse the system" and the consequences of this abuse. Finally, EMS providers discuss the system-level factors that impact their work and specific barriers and challenges to care. These results suggest that additional work is needed to expand our understanding of the role of EMS providers in the care of people with behavioral health problems and that mental health practitioners and policy makers should include consideration of the important role of EMS and prehospital care in providing community-based supports for people with behavioral health needs. (PsycINFO Database Record

  7. Coronal MR imaging of the normal 3rd, 4th, and 5th lumbar and 1st sacral nerve roots

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    Hald, J.K.; Nakstad, P.H.; Hauglum, B.E. (National Hospital, Oslo (Norway). Dept. of Radiology)

    1991-05-01

    Seven healthy volunteers underwent coronal MR imaging at 1.5 tesla of the normal 3rd, 4th, and 5th lumbar, and 1st sacral nerve roots. Coronal slices, 3-mm-thick with a 0.3-mm gap between the slices were obtained (TR/TE 600/22) through the lumbar spinal canal. All the nerve roots were visible on at least one image. One can routinely expect to demonstrate the 3rd, 4th, and 5th lumbar, and 1st sacral nerve roots on T1-weighted, 3-mm-thick coronal MR scans. We found no correlation between the degree of lumbar lordosis and the lengths of the visible nerve roots. Five patients with one of the following spinal problems: anomaly, tumor, disk herniation, and failed back surgery syndrome were examined according to our protocol. In all these cases coronal MR imaging gave the correct diagnosis. (orig.).

  8. An examination of periodontal treatment and per member per month (PMPM medical costs in an insured population

    Directory of Open Access Journals (Sweden)

    Papapanou Panos

    2006-08-01

    Full Text Available Abstract Background Chronic medical conditions have been associated with periodontal disease. This study examined if periodontal treatment can contribute to changes in overall risk and medical expenditures for three chronic conditions [Diabetes Mellitus (DM, Coronary Artery Disease (CAD, and Cerebrovascular Disease (CVD]. Methods 116,306 enrollees participating in a preferred provider organization (PPO insurance plan with continuous dental and medical coverage between January 1, 2001 and December 30, 2002, exhibiting one of three chronic conditions (DM, CAD, or CVD were examined. This study was a population-based retrospective cohort study. Aggregate costs for medical services were used as a proxy for overall disease burden. The cost for medical care was measured in Per Member Per Month (PMPM dollars by aggregating all medical expenditures by diagnoses that corresponded to the International Classification of Diseases, 9th Edition, (ICD-9 codebook. To control for differences in the overall disease burden of each group, a previously calculated retrospective risk score utilizing Symmetry Health Data Systems, Inc. Episode Risk Groups™ (ERGs were utilized for DM, CAD or CVD diagnosis groups within distinct dental services groups including; periodontal treatment (periodontitis or gingivitis, dental maintenance services (DMS, other dental services, or to a no dental services group. The differences between group means were tested for statistical significance using log-transformed values of the individual total paid amounts. Results The DM, CAD and CVD condition groups who received periodontitis treatment incurred significantly higher PMPM medical costs than enrollees who received gingivitis treatment, DMS, other dental services, or no dental services (p Conclusion This two-year retrospective examination of a large insurance company database revealed a possible association between periodontal treatment and PMPM medical costs. The findings suggest that

  9. Undergraduate educational environment, perceived preparedness for postgraduate clinical training, and pass rate on the National Medical Licensure Examination in Japan

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    Ishida Yasushi

    2010-05-01

    Full Text Available Abstract Background We investigated the views of newly graduating physicians on their preparedness for postgraduate clinical training, and evaluated the relationship of preparedness with the educational environment and the pass rate on the National Medical Licensure Examination (NMLE. Methods Data were obtained from 2429 PGY-1 physicians-in-training (response rate, 36% using a mailed cross-sectional survey. The Dundee Ready Education Environment Measure (DREEM inventory was used to assess the learning environment at 80 Japanese medical schools. Preparedness was assessed based on 6 clinical areas related to the Association of American Medical Colleges Graduation Questionnaire. Results Only 17% of the physicians-in-training felt prepared in the area of general clinical skills, 29% in basic knowledge of diagnosis and management of common conditions, 48% in communication skills, 19% in skills associated with evidence-based medicine, 54% in professionalism, and 37% in basic skills required for a physical examination. There were substantial differences among the medical schools in the perceived preparedness of their graduates. Significant positive correlations were found between preparedness for all clinical areas and a better educational environment (all p 0.05. Conclusion Different educational environments among universities may be partly responsible for the differences in perceived preparedness of medical students for postgraduate clinical training. This study also highlights the poor correlation between self-assessed preparedness for practice and the NMLE.

  10. Sea monsters & whirlpools: Navigating between examination and reflection in medical education.

    Science.gov (United States)

    Hodges, Brian David

    2015-03-01

    The 16th International Ottawa Conference/Canadian Conference on Medical Education (2014) featured a keynote deconstructing the rising discourse of competence-as-reflection in medical education. This paper, an elaborated version of the presentation, is an investigation into the theoretical roots of the diverse forms of reflective practice that are being employed by medical educators. It also raises questions about the degree to which any of these practices is compatible with assessment.

  11. Teaching post-mortem external examination in undergraduate medical education--the formal and the informal curriculum.

    Science.gov (United States)

    Anders, Sven; Fischer-Bruegge, Dorothee; Fabian, Merle; Raupach, Tobias; Petersen-Ewert, Corinna; Harendza, Sigrid

    2011-07-15

    In undergraduate medical education, the training of post-mortem external examination on dead bodies might evoke strong emotional reactions in medical students that could counteract the intended learning goals. We evaluated student perception of a forensic medicine course, their perceived learning outcome (via self-assessment) and possible tutor-dependent influences on the overall evaluation of the course by a questionnaire-based survey among 150 medical students in Hamburg, Germany. The majority of students identified post-mortem external examination as an important learning objective in undergraduate medical education and did not feel that the dignity of the deceased was offended by the course procedures. After the course, more than 70% of the students felt able to perform an external examination and to fill in a death certificate. Respectful behavior of course tutors towards the deceased entailed better overall course ratings by students (pformal curriculum) as well as tutor behavior (informal curriculum) in undergraduate education in forensic medicine. Furthermore, we suggest embedding teaching in forensic medicine in longitudinal curricula on death and dying and on the health consequences of interpersonal violence.

  12. Cyberchondria and intolerance of uncertainty: examining when individuals experience health anxiety in response to Internet searches for medical information.

    Science.gov (United States)

    Fergus, Thomas A

    2013-10-01

    Individuals frequently use the Internet to search for medical information. However, for some individuals, searching for medical information on the Internet is associated with an exacerbation of health anxiety. Researchers have termed this phenomenon as cyberchondria. The present research sought to shed further light onto the phenomenology of cyberchondria. In particular, the moderating effect of intolerance of uncertainty (IU) on the relationship between the frequency of Internet searches for medical information and health anxiety was examined using a large sample of medically healthy community adults located in the United States (N=512). The purported moderating effect of IU was supported. More specifically, the relationship between the frequency of Internet searches for medical information and health anxiety grew increasingly stronger as IU increased. This moderating effect of IU was not attributable to general distress. These results suggest that IU is important for better understanding the exacerbation of health anxiety in response to Internet searches for medical information. Conceptual and therapeutic implications of these results are discussed.

  13. Competition between shock and turbulent heating in coronal loop system

    Science.gov (United States)

    Matsumoto, Takuma

    2016-11-01

    2.5-dimensional magnetohydrodynamic (MHD) simulations are performed with high spatial resolution in order to distinguish between competing models of the coronal heating problem. A single coronal loop powered by Alfvén waves excited in the photosphere is the target of this study. The coronal structure is reproduced in our simulations as a natural consequence of the transportation and dissipation of Alfvén waves. Further, the coronal structure is maintained as the spatial resolution is changed from 25 to 3 km, although the temperature at the loop top increases with the spatial resolution. The heating mechanisms change gradually across the magnetic canopy at a height of 4 Mm. Below the magnetic canopy, both the shock and the MHD turbulence are dominant heating processes. Above the magnetic canopy, the shock heating rate reduces to less than 10 per cent of the total heating rate while the MHD turbulence provides significant energy to balance the radiative cooling and thermal conduction loss or gain. The importance of compressibility shown in this study would significantly impact on the prospects of successful MHD turbulence theory in the solar chromosphere.

  14. Competition between shock and turbulent heating in coronal loop system

    CERN Document Server

    Matsumoto, Takuma

    2016-01-01

    2.5-dimensional magnetohydrodynamic (MHD) simulations are performed with high spatial resolution in order to distinguish between competing models of the coronal heating problem. A single coronal loop powered by Alfv\\'{e}n waves excited in the photosphere is the target of the present study. The coronal structure is reproduced in our simulations as a natural consequence of the transportation and dissipation of Alfv\\'{e}n waves. Further, the coronal structure is maintained as the spatial resolution is changed from 25 to 3 km, although the temperature at the loop top increases with the spatial resolution. The heating mechanisms change gradually across the magnetic canopy at a height of 4 Mm. Below the magnetic canopy, both the shock and the MHD turbulence are dominant heating processes. Above the magnetic canopy, the shock heating rate reduces to less than 10 % of the total heating rate while the MHD turbulence provides significant energy to balance the radiative cooling and thermal conduction loss or gain. The i...

  15. The Development and Assessment of a New Examination of the Clinical Competence of Medical Students.

    Science.gov (United States)

    Newble, David I.

    1982-01-01

    A problem-based, criterion-referenced examination of clinical competence was developed in order to positively influence students' learning in the direction of the faculty's clinical objectives. High satisfaction and high perceived relevance among students accompanied high reliability and validity. (MSE)

  16. The need for national medical licensing examination in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Alzahrani Khalid

    2008-11-01

    Full Text Available Abstract Background Medical education in Saudi Arabia is facing multiple challenges, including the rapid increase in the number of medical schools over a short period of time, the influx of foreign medical graduates to work in Saudi Arabia, the award of scholarships to hundreds of students to study medicine in various countries, and the absence of published national guidelines for minimal acceptable competencies of a medical graduate. Discussion We are arguing for the need for a Saudi national medical licensing examination that consists of two parts: Part I (Written which tests the basic science and clinical knowledge and Part II (Objective Structured Clinical Examination which tests the clinical skills and attitudes. We propose this examination to be mandated as a licensure requirement for practicing medicine in Saudi Arabia. Conclusion The driving and hindering forces as well as the strengths and weaknesses of implementing the licensing examination are discussed in details in this debate.

  17. Coronal type III radio bursts and their X-ray flare and interplanetary type III counterparts

    CERN Document Server

    Reid, Hamish A S

    2016-01-01

    Type III bursts and hard X-rays are both produced by flare energetic electron beams. The link between both emissions has been investigated in many previous studies, but no statistical studies have compared both coronal and interplanetary type III bursts with X-ray flares. Using coronal radio events above 100 MHz exclusively from type III bursts, we revisited long-standing questions: Do all coronal type III bursts have X-ray counterparts. What correlation, if any, occurs between radio and X-ray intensities. What X-ray and radio signatures above 100 MHz occur in connection with interplanetary type III bursts below 14 MHz. We analysed data from 2002 to 2011 starting with coronal type III bursts above 100 MHz. We used RHESSI X-ray data greater than 6 keV to make a list of 321 events that have associated type III bursts and X-ray flares, encompassing at least 28 percent of the initial sample of type III events. We examined the timings, intensities, associated GOES class, and any interplanetary radio signature. For...

  18. Evolution of an equatorial coronal hole structure and the released coronal hole wind stream: Carrington rotations 2039 to 2050

    Science.gov (United States)

    Heidrich-Meisner, Verena; Peleikis, Thies; Kruse, Martin; Berger, Lars; Wimmer-Schweingruber, Robert F.

    2017-07-01

    Context. The Sun is a highly dynamic environment that exhibits dynamic behavior on many different timescales. Variability is observed both in closed and in open field line regions in the solar corona. In particular, coronal holes exhibit temporal and spatial variability. Signatures of these coronal dynamics are inherited by the coronal hole wind streams that originate in these regions and can effect the Earth's magnetosphere. Both the cause of the observed variabilities and how these translate to fluctuations in the in situ observed solar wind is not yet fully understood. Aims: During solar activity minimum the structure of the magnetic field typically remains stable over several Carrington rotations (CRs). But how stable is the solar magnetic field? Here, we address this question by analyzing the evolution of a coronal hole structure and the corresponding coronal hole wind stream emitted from this source region over 12 consecutive CRs in 2006. Methods: To this end, we link in situ observations of Solar Wind Ion Composition Spectrometer (SWICS) onboard the Advanced Composition Explorer (ACE) with synoptic maps of Michelson Doppler imager (MDI) on the Solar and Heliospheric Observatory (SOHO) at the photospheric level through a combination of ballistic back-mapping and a potential field source surface (PFSS) approach. Together, these track the evolution of the open field line region that is identified as the source region of a recurring coronal hole wind stream. Under the assumptions of the freeze-in scenario for charge states in the solar wind, we derive freeze-in temperatures and determine the order in which the different charge state ratios of ion pairs appear to freeze-in. We call the combination of freeze-in temperatures derived from in situ observed ion density ratios and freeze-in order a minimal electron temperature profile and investigate its variability. Results: The in situ properties and the PFSS model together probe the lateral magnetic field

  19. The physiatrists' crucial role in the development and implementation of a longitudinal musculoskeletal physical examination curriculum in a medical school.

    Science.gov (United States)

    Newcomer, Karen L; Laskowski, Edward R; Grande, Joseph P; Dyrbye, Liselotte N

    2013-01-01

    The musculoskeletal physical examination (MSK PE) is a critical clinical skill that should be mastered by all medical students. The authors believe that physiatrists should have a crucial role in undergraduate musculoskeletal education. This article outlines the successful integration of an MSK PE curriculum taught by physiatrists into the first 2 yrs of medical school. During year 1, a basic MSK PE is taught concomitantly with the human anatomy course and focuses on anatomical correlation with physical examination maneuvers. In year 2, the MSK PE is taught concomitantly with the musculoskeletal didactic block. Special musculoskeletal tests, basic neurologic evaluation, and case correlation are also added to expand on the examination skills learned in the first year. At the end of the second year and before beginning third-year clinical rotations, students take a practical test to demonstrate their competency in the MSK PE. The authors believe that an important component of their MSK PE educational sessions is a low student-to-instructor ratio (4:1), with ample hands-on supervision of physical examination skills practice. Residents in the Department of Physical Medicine and Rehabilitation assist with the teaching. With their intensive training and clinical experience in musculoskeletal medicine, physiatric staff and residents are ideal faculty for teaching the MSK PE. The authors are hopeful that this article encourages other physiatrists to construct similar programs aimed to develop MSK PE skills in medical students.

  20. Clutter in electronic medical records: examining its performance and attentional costs using eye tracking.

    Science.gov (United States)

    Moacdieh, Nadine; Sarter, Nadine

    2015-06-01

    The objective was to use eye tracking to trace the underlying changes in attention allocation associated with the performance effects of clutter, stress, and task difficulty in visual search and noticing tasks. Clutter can degrade performance in complex domains, yet more needs to be known about the associated changes in attention allocation, particularly in the presence of stress and for different tasks. Frequently used and relatively simple eye tracking metrics do not effectively capture the various effects of clutter, which is critical for comprehensively analyzing clutter and developing targeted, real-time countermeasures. Electronic medical records (EMRs) were chosen as the application domain for this research. Clutter, stress, and task difficulty were manipulated, and physicians' performance on search and noticing tasks was recorded. Several eye tracking metrics were used to trace attention allocation throughout those tasks, and subjective data were gathered via a debriefing questionnaire. Clutter degraded performance in terms of response time and noticing accuracy. These decrements were largely accentuated by high stress and task difficulty. Eye tracking revealed the underlying attentional mechanisms, and several display-independent metrics were shown to be significant indicators of the effects of clutter. Eye tracking provides a promising means to understand in detail (offline) and prevent (in real time) major performance breakdowns due to clutter. Display designers need to be aware of the risks of clutter in EMRs and other complex displays and can use the identified eye tracking metrics to evaluate and/or adjust their display. © 2015, Human Factors and Ergonomics Society.

  1. Are We Learning Enough Pathology in Medical School to Prepare Us for Postgraduate Training and Examinations?

    Directory of Open Access Journals (Sweden)

    Emma Marsdin

    2013-01-01

    Full Text Available Medical schools responded to the first publication of Tomorrow’s Doctors with an abbreviated syllabus and a reduction in didactic teaching hours. Prescribing errors, however, have increased, and there is a perception amongst clinicians that junior doctors know less about the pathological basis of disease. We asked junior doctors how useful they thought their undergraduate teaching in pathology had been in their postgraduate training. We had 70 questionnaire responses from junior doctors within a single deanery and found that although almost every doctor, (96%, thought that pathology formed a major component of their postgraduate exams, most, (67%, thought that their undergraduate teaching left them unprepared for their postgraduate careers, and they had to learn basic principles, as they revised for postgraduate exams. Few used a pathology text for learning, most doctors, (91%, relying on question and answer revision resources for exam preparation. Perhaps, as revision materials are used so widely, they might be adapted for long-term deep learning, alongside clinical work. This presents an opportunity for pathologists, deaneries, royal colleges, and publishing houses to work together in the preparation of quality written and online material readily accessible to junior doctors in their workplace.

  2. Assessing musculoskeletal examination skills and diagnostic reasoning of 4th year medical students using a novel objective structured clinical exam.

    Science.gov (United States)

    Stansfield, R Brent; Diponio, Lisa; Craig, Cliff; Zeller, John; Chadd, Edmund; Miller, Joshua; Monrad, Seetha

    2016-10-14

    Medical students have difficulty performing and interpreting musculoskeletal physical examinations and interpreting the findings. Research has focused on students' knowledge deficits, but there are few direct assessments of students' ability to perform a hypothesis-driven physical examination (HDPE). We developed a novel musculoskeletal Objective Structured Clinical Exam (OSCE) focusing on HDPE skills for disorders of the shoulder, back and knee, and used it to explore medical student diagnostic reasoning. A multidisciplinary group of musculoskeletal specialists developed and gathered validity evidence for a three station OSCE focusing on the HDPE of the shoulder, back and knee, emphasizing the ability to anticipate (identify pre-encounter) expected physical exam findings, and subsequently perform discriminatory physical examination maneuvers. The OSCE was administered to 45 final year medical students. Trained faculty observed and scored students' ability to anticipate exam findings and perform diagnostic examination maneuvers on simulated patients. Encounters were digitally recorded and scored again by another trained faculty member. Inter-rater reliability for each maneuver was estimated using type-2 intra-class correlations (ICC). Percentages of perfect scores for anticipation and performance were calculated. Pearson's correlation between anticipation and performance scores was computed for each maneuver and their relationship to diagnostic accuracy was tested with logistic regression. Inter-rater reliability was good (ICC between .69 and .87) for six exam maneuvers. Maneuver performance was overall poor, with no discriminatory maneuver performed correctly by more than two thirds of students, and one maneuver only performed correctly by 4 % of students. For the shoulder and knee stations, students were able to anticipate necessary discriminatory exam findings better than they could actually perform relevant exam maneuvers. The ability to anticipate a

  3. An Examination of Safety Management Systems and Aviation Technologies in the Helicopter Emergency Medical Services Industry

    Science.gov (United States)

    Buckner, Steven A.

    The Helicopter Emergency Medical Service (HEMS) industry has a significant role in the transportation of injured patients, but has experienced more accidents than all other segments of the aviation industry combined. With the objective of addressing this discrepancy, this study assesses the effect of safety management systems implementation and aviation technologies utilization on the reduction of HEMS accident rates. Participating were 147 pilots from Federal Aviation Regulations Part 135 HEMS operators, who completed a survey questionnaire based on the Safety Culture and Safety Management System Survey (SCSMSS). The study assessed the predictor value of SMS implementation and aviation technologies to the frequency of HEMS accident rates with correlation and multiple linear regression. The correlation analysis identified three significant positive relationships. HEMS years of experience had a high significant positive relationship with accident rate (r=.90; pNVG) (r=.38; pNVG, TAWS, and SMS, HEMS years of experience explained 81.4% of the variance in accident rate scores (p<.05), and HEMS years of experience was found to be a significant predictor of accident rates (p<.05). Additional quantitative regression analysis was recommended to replicate the results of this study and to consider the influence of these variables for continued reduction of HEMS accidents, and to induce execution of SMS and aviation technologies from a systems engineering application. Recommendations for practice included the adoption of existing regulatory guidance for a SMS program. A qualitative analysis was also recommended for future study SMS implementation and HEMS accident rate from the pilot's perspective. A quantitative longitudinal study would further explore inferential relationships between the study variables. Current strategies should include the increased utilization of available aviation technology resources as this proactive stance may be beneficial for the establishment of

  4. A snapshot of patients' awareness of radiation dose and risks associated with medical imaging examinations at an Australian radiology clinic.

    Science.gov (United States)

    Singh, N; Mohacsy, A; Connell, D A; Schneider, M E

    2017-05-01

    Cumulative radiation exposure is linked to increasing the lifetime attributable risk of cancer. To avoid unnecessary radiation exposure and facilitate shared decision making, patients should be aware of these issues. This paper examines patients' awareness of radiation dose and risks associated with medical imaging examinations. Consecutive patients attending a private radiology clinic over a nine week period in 2014 in Metropolitan Melbourne were surveyed while waiting to undergo an imaging examination. Patients who were under 18 years of age, did not speak English and/or were referred for interventional imaging procedures were excluded from participation. Survey questions addressed patients' awareness of radiation dose associated with various imaging modalities' and patients' experience and preferences regarding communication of information about radiation. Data was analysed using SPSS (Ver 20.1). A total of 242 surveys were completed. Most participants were male (143/239, 59.8%) and aged between 33 and 52 years (109/242, 45%). Over half of participants were not concerned about radiation from medical imaging (130/238, 54.6%). Only a third of participants (80/234, 34.2%) correctly reported that CT has a higher radiation dose than X-ray. Very few participants correctly identified mammography, DEXA, PET and PET/CT as radiation emitting examinations. The majority of participants (202/236, 85.6%) indicated that they were not informed about radiation dose and risks by their referring doctor in advance. This paper provides information relevant to a single private radiology clinic in Australia. Nevertheless, our results have shown that patients presenting for medical imaging have little awareness of radiation dose and risks associated with these examinations and received little information by their referring physicians or staff at the radiology clinic. Copyright © 2016 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  5. Sexual assault: review of a national model protocol for forensic and medical evaluation. New Hampshire Sexual Assault Medical Examination Protocol Project Committee.

    Science.gov (United States)

    Young, W W; Bracken, A C; Goddard, M A; Matheson, S

    1992-11-01

    A national hospital/community model protocol was developed for the forensic and medical examination of victims of sexual assault. This review is designed to assist states in the development of sexual assault protocols. Controversial issues were addressed, including the collection of hair evidence, the importance of semen, mandatory reporting, pregnancy testing and prophylaxis, and sexually transmitted diseases including human immunodeficiency virus. The current role of DNA profiling is reviewed. These issues at the interface of medicine, forensic science, victim advocacy, and the law are analyzed. Representatives of the medical, legal, law enforcement, victim advocacy, and forensic science communities contributed to the development of the protocols at the national and state levels. The importance of a collaborative effort is emphasized. The broad protocol goals are to minimize the physical and psychological trauma to the victim while maximizing the probability of collecting and preserving physical evidence for potential use in the legal system.

  6. Voluntary Medical Male Circumcision: A Cross-Sectional Study Comparing Circumcision Self-Report and Physical Examination Findings in Lesotho

    Science.gov (United States)

    2011-11-29

    During the physical examination, with a study nurse present, a medical doctor examined the penis for extent of circumcision, using a four-point scale...However, this does not appear to have biased the study results, as the average MC prevalence in the LDHS is similar across all men aged 20 y and older (57.9...Rakai, Uganda ( size matters). AIDS 23: 2209–2213. 24. Lagarde E, Dirk T, Puren A, Reathe RT, Bertran A (2003) Acceptability of male circumcision as a

  7. The plasma structure of coronal hole solar wind: Origins and evolution

    Science.gov (United States)

    Borovsky, Joseph E.

    2016-06-01

    Whereas slow solar wind is known to be highly structured, the fast (coronal hole origin) wind is usually considered to be homogeneous. Using measurements from Helios 1 + 2, ACE, Wind, and Ulysses, structure in the coronal hole origin solar wind is examined from 0.3 AU to 2.3 AU. Care is taken to collect and analyze intervals of "unperturbed coronal hole plasma." In these intervals, solar wind structure is seen in the proton number density, proton temperature, proton specific entropy, magnetic field strength, magnetic field to density ratio, electron heat flux, helium abundance, heavy-ion charge-state ratios, and Alfvenicity. Typical structure amplitudes are factors of 2, far from homogeneous. Variations are also seen in the solar wind radial velocity. Using estimates of the motion of the solar wind origin footpoint on the Sun for the various spacecraft, the satellite time series measurements are converted to distance along the photosphere. Typical variation scale lengths for the solar wind structure are several variations per supergranule. The structure amplitude and structure scale sizes do not evolve with distance from the Sun from 0.3 to 2.3 AU. An argument is quantified that these variations are the scale expected for solar wind production in open magnetic flux funnels in coronal holes. Additionally, a population of magnetic field foldings (switchbacks, reversals) in the coronal hole plasma is examined: this population evolves with distance from the Sun such that the magnetic field is mostly Parker spiral aligned at 0.3 AU and becomes more misaligned with distance outward.

  8. Medical regulation and health outcomes: the effect of the physician examination requirement.

    Science.gov (United States)

    Cotet, Anca M; Benjamin, Daniel K

    2013-04-01

    This article investigates the effect on health outcomes of the regulation prohibiting physicians from prescribing drugs without a prior physical examination. This requirement could improve health by reducing illegal access to prescription drugs. However, it reduces access to health care by making it more difficult for patients and physicians to use many forms of telemedicine. Thus, this regulation generates a trade-off between access and safety. Using matching techniques, we find that the physician examination requirement leads to an increase of 1% in mortality rates from disease, the equivalent of 8.5 more deaths per 100,000 people, and a decrease of 6.7% in injury mortality, the equivalent of 2.5 deaths per 100,000 people. The magnitude of these effects is larger in rural areas and in areas with low physician density and is accompanied by an 18% increase in the number of days lost each month to illness. Copyright © 2012 John Wiley & Sons, Ltd.

  9. Medical licensing examination (uigwa and the world of the physician officers (uigwan in Korea’s Joseon Dynasty

    Directory of Open Access Journals (Sweden)

    Nam Hee Lee

    2015-05-01

    Full Text Available Physicians for ordinary people in Korea’s Joseon Dynasty (1392-1910 did not need to pass the national medical licensing examination. They were able to work after a sufficient apprenticeship period. Only physician officers were licensed as technical civil servants. These physician officers were middle class, located socially between the nobility and the commoner. They had to pass a national licensing examination to be considered for high-ranking physician officer positions, that is, those at the rank equal to or above the 6th level out of a total of 9 ranks, where the first rank was highest. Royal physicians also had to pass this examination before accepting responsibility for the King’s healthcare. This article aims to describe the world of physician officers during the Joseon Dynasty. Physician officers enjoyed considerable social status because they dealt with matters of life and death. Owing to the professional nature of their fields and a strong sense of group identity, they came to compose a distinct social class. The physician officers’ world was marked by strong group allegiances based on shared professional knowledge; the use of marriage to gain and maintain social status; and the establishment of hereditary technical posts within the medical profession that were handed down from one generation to the next. The medical licensing examination persisted until 1894 when the civil service examination agency, of which it was part, was abolished. Until that time, the testing agency, the number of candidates who were accepted, two-step test procedures, and the method of test item selection were maintained and enforced.

  10. Laughing through This Pain: Medical Clowning during Examination of Sexually Abused Children--An Innovative Approach

    Science.gov (United States)

    Tener, Dafna; Lev-Wiesel, Rachel; Franco, Nessia Lang; Ofir, Shoshi

    2010-01-01

    This study examined the role of medical clowns during medical examinations of children who were sexually abused. Three case studies are described, illustrating diverse interactions among the victimized child, the medical clown, and the medical forensical examiner during medical forensic examinations held at the Tene Center for Sexually Abused…

  11. Coronal magnetometry

    CERN Document Server

    Zhang, Jie; Bastian, Timothy

    2014-01-01

    This volume is a collection of research articles on the subject of the solar corona, and particularly, coronal magnetism. The book was motivated by the Workshop on Coronal Magnetism: Connecting Models to Data and the Corona to the Earth, which was held 21 - 23 May 2012 in Boulder, Colorado, USA. This workshop was attended by approximately 60 researchers. Articles from this meeting are contained in this topical issue, but the topical issue also contains contributions from researchers not present at the workshop. This volume is aimed at researchers and graduate students active in solar physics. Originally published in Solar Physics, Vol. 288, Issue 2, 2013 and Vol. 289, Issue 8, 2014.

  12. Coronal Mass Ejections and Non-recurrent Forbush Decreases

    Science.gov (United States)

    Belov, A.; Abunin, A.; Abunina, M.; Eroshenko, E.; Oleneva, V.; Yanke, V.; Papaioannou, A.; Mavromichalaki, H.; Gopalswamy, N.; Yashiro, S.

    2014-10-01

    Coronal mass ejections (CMEs) and their interplanetary counterparts (interplanetary coronal mass ejections, ICMEs) are responsible for large solar energetic particle events and severe geomagnetic storms. They can modulate the intensity of Galactic cosmic rays, resulting in non-recurrent Forbush decreases (FDs). We investigate the connection between CME manifestations and FDs. We used specially processed data from the worldwide neutron monitor network to pinpoint the characteristics of the recorded FDs together with CME-related data from the detailed online catalog based upon the Solar and Heliospheric Observatory (SOHO)/ Large Angle and Spectrometric Coronagraph (LASCO) data. We report on the correlations of the FD magnitude to the CME initial speed, the ICME transit speed, and the maximum solar wind speed. Comparisons between the features of CMEs (mass, width, velocity) and the characteristics of FDs are also discussed. FD features for halo, partial halo, and non-halo CMEs are presented and discussed.

  13. Stellar Activity and Coronal Heating: an overview of recent results

    CERN Document Server

    Testa, Paola; Drake, Jeremy

    2015-01-01

    Observations of the coronae of the Sun and of solar-like stars provide complementary information to advance our understanding of stellar magnetic activity, and of the processes leading to the heating of their outer atmospheres. While solar observations allow us to study the corona at high spatial and temporal resolution, the study of stellar coronae allows us to probe stellar activity over a wide range of ages and stellar parameters. Stellar studies therefore provide us with additional tools for understanding coronal heating processes, as well as the long-term evolution of solar X-ray activity. We discuss how recent studies of stellar magnetic fields and coronae contribute to our understanding of the phenomenon of activity and coronal heating in late-type stars.

  14. Stellar activity and coronal heating: an overview of recent results

    Science.gov (United States)

    Testa, Paola; Saar, Steven H.; Drake, Jeremy J.

    2015-01-01

    Observations of the coronae of the Sun and of solar-like stars provide complementary information to advance our understanding of stellar magnetic activity, and of the processes leading to the heating of their outer atmospheres. While solar observations allow us to study the corona at high spatial and temporal resolution, the study of stellar coronae allows us to probe stellar activity over a wide range of ages and stellar parameters. Stellar studies therefore provide us with additional tools for understanding coronal heating processes, as well as the long-term evolution of solar X-ray activity. We discuss how recent studies of stellar magnetic fields and coronae contribute to our understanding of the phenomenon of activity and coronal heating in late-type stars. PMID:25897087

  15. EUV and Coronagraphic Observations of Coronal Mass Ejections

    Indian Academy of Sciences (India)

    Durgesh Tripathi

    2006-06-01

    The Large Angle Spectrometric Coronagraph (LASCO) and Extreme-ultraviolet Imaging Telescope (EIT) onboard Solar and Heliospheric Observatory (SOHO) provide us with unprecedented multi-wavelength observations helping us to understand different dynamic phenomena on the Sun and in the corona. In this paper we discuss the association between post-eruptive arcades (PEAs) detected by EIT and white-light coronal mass ejections (CMEs) detected by LASCO/C2 telescope.

  16. Coronal Streamers and Their Associated Solar Wind Streams

    Science.gov (United States)

    Miralles, M. P.; Landi, E.; Cranmer, S. R.; Cohen, O.; Raymond, J. C.

    2012-12-01

    We use the EUV spectrometers aboard SOHO and Hinode and white-light coronagraphs to characterize the physical properties of coronal streamers during Earth/Ulysses quadrature configurations for the previous two solar minimum periods. In addition, comparisons between coronal observations and in situ measurements of solar wind plasma properties are being used to further characterize the origins of slow wind streams. In order to investigate slow solar wind heating and acceleration, we also compare with predictions from three-dimensional MHD models. We aim to use the empirical measurements to distinguish between different proposed physical processes for slow wind acceleration (e.g., waves/turbulence versus reconnection). This work is supported by NASA grant NNX10AQ58G to the Smithsonian Astrophysical Observatory.

  17. Polar Coronal Holes During Solar Cycles 22 and 23

    Institute of Scientific and Technical Information of China (English)

    Jun Zhang; J. Woch; S. Solanki

    2005-01-01

    Data from the Solar Wind Ion Composition Spectrometer (SWICS) on Ulysses and synoptic maps from Kitt Peak are used to analyze the polar coronal holes of solar activity cycles 22 and 23 (from 1990 to end of 2003). In the beginning of the declining phase of solar cycles 22 and 23, the north polar coronal holes (PCHs) appear about one year earlier than the ones in the south polar region.The solar wind velocity and the solar wind ionic charge composition exhibit a characteristic dependence on the solar wind source position within a PCH. From the center toward the boundary of a young PCH, the solar wind velocity decreases,coinciding with a shift of the ionic charge composition toward higher charge states.However, for an old PCH, the ionic charge composition does not show any obvious change, although the latitude evolution of the velocity is similar to that of a young PCH.

  18. The politics of a ‘Poncy Pillowcase’: Migration and borders in Coronation Street

    OpenAIRE

    Innes, Alexandria J; Topinka, Robert J.

    2016-01-01

    This article examines the ways in which popular culture stages and supplies resources for agency in everyday life, with particular attention to migration and borders. Drawing upon cultural studies, and specific insights originating from the Birmingham Centre for Contemporary Cultural Studies, we explore how intersectional identities such as race, ethnicity, class, and gender are experienced in relation to the globalisation of culture and identity in a 2007 Coronation Street storyline. The soa...

  19. Energetic characterisation and statistics of solar coronal brightenings

    Science.gov (United States)

    Buchlin, Eric; Solomon, Jacques; Joulin, Vincent; Guennou, Chloé

    2016-07-01

    To explain the high temperature of the corona, much attention has been paid to the distribution of energy in dissipation events, which might be caused by turbulent reconnection. Indeed, if the event energy distribution is steep enough, the smallest, unobservable events could be the largest contributors to the total energy dissipation in the corona. Previous observations have shown a wide distribution of energies but remain inconclusive about the precise slope. Furthermore, these results rely on a very crude estimate of the energy. On the other hand, more detailed spectroscopic studies of structures such as coronal bright points do not provide enough statistical information to derive their total contribution to heating. We aim at getting a better estimate of the distributions of the energy dissipated in coronal heating events using high-resolution, multi-channel Extreme Ultra-Violet (EUV) data. To estimate the energies corresponding to heating events and deduce their distribution, we detect brightenings in five EUV channels of the Atmospheric Imaging Assembly (AIA) on-board the Solar Dynamics Observatory (SDO). We combine the results of these detections and we use maps of temperature and emission measure derived from the same observations to compute the energies. We obtain distributions of areas, durations, intensities, and energies (thermal, radiative, and conductive) of events. These distributions are power-laws, and we find also power-law correlations between event parameters. The energy distributions indicate that the energy from a population of events like the ones we detect represents a small contribution to the total coronal heating, even when extrapolating to smaller scales. The main explanations for this are how heating events can be extracted from observational data, and the incomplete knowledge of the thermal structure and processes in the coronal plasma attainable from available observations.

  20. Stellar Coronal Response to Differential Rotation and Flux Emergence

    OpenAIRE

    Gibb, G. P. S.; Mackay, D. H.; Jardine, M. M.; Yeates, A. R.

    2016-01-01

    GPSG would like to thank the STFC for financial support. DHM would like to thank the STFC and the Leverhulme Trust for financial support. Simulations were carried out on a STFC/SRIF funded UKMHD cluster at St Andrews. We perform a numerical parameter study to determine what effect varying differential rotation and flux emergence has on a star's non-potential coronal magnetic field. In particular we consider the effects on the star's surface magnetic flux, open magnetic flux, mean azimuthal...

  1. Projection Effects in Coronal Dimmings and Associated EUV Wave Event

    Science.gov (United States)

    Dissauer, K.; Temmer, M.; Veronig, A. M.; Vanninathan, K.; Magdalenić, J.

    2016-10-01

    We investigate the high-speed (v > 1000 km s‑1) extreme-ultraviolet (EUV) wave associated with an X1.2 flare and coronal mass ejection (CME) from NOAA active region 11283 on 2011 September 6 (SOL2011-09-06T22:12). This EUV wave features peculiar on-disk signatures in particular, we observe an intermittent “disappearance” of the front for 120 s in Solar Dynamics Observatory (SDO)/AIA 171, 193, 211 Å data, whereas the 335 Å filter, sensitive to hotter plasmas (T ∼ 2.5 MK), shows a continuous evolution of the wave front. The eruption was also accompanied by localized coronal dimming regions. We exploit the multi-point quadrature position of SDO and STEREO-A, to make a thorough analysis of the EUV wave evolution, with respect to its kinematics and amplitude evolution and reconstruct the SDO line-of-sight (LOS) direction of the identified coronal dimming regions in STEREO-A. We show that the observed intensities of the dimming regions in SDO/AIA depend on the structures that are lying along their LOS and are the combination of their individual intensities, e.g., the expanding CME body, the enhanced EUV wave, and the CME front. In this context, we conclude that the intermittent disappearance of the EUV wave in the AIA 171, 193, and 211 Å filters, which are channels sensitive to plasma with temperatures below ∼2 MK is also caused by such LOS integration effects. These observations clearly demonstrate that single-view image data provide us with limited insight to correctly interpret coronal features.

  2. Evaluation of the acceptability of Peer Physical Examination (PPE) in medical and osteopathic students: a cross sectional survey

    Science.gov (United States)

    2013-01-01

    Background Peer physical examination (PPE) is a method of training in medical and osteopathic curricula. The aim of this study was to compare the acceptability of PPE in two classes of medical and osteopathic students after their first experience, to obtain comparative information useful for an understanding of the different professional approaches. The leading hypothesis was that osteopathic students enter the curriculum with a more positive attitude to bodily contact. As a secondary aim, this study validated the new version of a questionnaire to assess the acceptability of PPE. Methods A new version of a previously validated questionnaire and an instrument from the literature (the Examining Fellow Student [EFS] questionnaire) were used for a cross-sectional survey in a class of 129 3rd year medical students and in two parallel classes of 1st year osteopathic students (total of 112 students). Results The mean score of the new questionnaire was significantly higher for the osteopathic students than for the medical students (53.4 ± 6.3 vs. 43.4 ± 8.9; p questionnaire identified three factors (appropriateness and usefulness, sexual implications and passive role) accounting for 62.8% of the variance. Criterion validity was assessed by correlation with the EFS (Pearson’s r coefficient = 0.61). Reliability was expressed in terms of Cronbach’s alpha coefficient, which equals 0.86. Conclusions These quantitative results are consistent with previous qualitative research on the process of embodiment both in medicine and osteopathy. The new questionnaire proved to be valid and reliable. The objective assessment of the acceptability of PPE is a way to determine differences in students’ attitudes towards contact with the body and can be used for counselling students regarding career choice. This study can also highlight differences between students from different professions and serve as a basis for reflection for improved mutual interprofessional

  3. Turbulent coronal heating and the distribution of nanoflares

    CERN Document Server

    Dmitruk, P; Dmitruk, Pablo; Gomez, Daniel O.

    1997-01-01

    We perform direct numerical simulations of an externally driven two-dimensional magnetohydrodynamic system over extended periods of time to simulate the dynamics of a transverse section of a solar coronal loop. A stationary and large-scale magnetic forcing was imposed, to model the photospheric motions at the magnetic loop footpoints. A turbulent stationary regime is reached, which corresponds to energy dissipation rates consistent with the heating requirements of coronal loops. The temporal behavior of quantities such as the energy dissipation rate show clear indications of intermittency, which are exclusively due to the strong nonlinearity of the system. We tentatively associate these impulsive events of magnetic energy dissipation to the so-called nanoflares. A statistical analysis of these events yields a power law distribution as a function of their energies with a negative slope of 1.5, which is consistent with those obtained for flare energy distributions reported from X-ray observations.

  4. Energetic characterisation and statistics of solar coronal brightenings

    CERN Document Server

    Joulin, Vincent; Solomon, Jacques; Guennou, Chloé

    2016-01-01

    To explain the high temperature of the corona, much attention has been paid to the distribution of energy in dissipation events. Indeed, if the event energy distribution is steep enough, the smallest, unobservable events could be the largest contributors to the total energy dissipation in the corona. Previous observations have shown a wide distribution of energies but remain inconclusive about the precise slope. Furthermore, these results rely on a very crude estimate of the energy. On the other hand, more detailed spectroscopic studies of structures such as coronal bright points do not provide enough statistical information to derive their total contribution to heating. We aim at getting a better estimate of the distributions of the energy dissipated in coronal heating events using high-resolution, multi-channel Extreme Ultra-Violet (EUV) data. To estimate the energies corresponding to heating events and deduce their distribution, we detect brightenings in five EUV channels of the Atmospheric Imaging Assembl...

  5. Microflaring in Low-Lying Core Fields and Extended Coronal Heating in the Quiet Sun

    Science.gov (United States)

    Porter, Jason G.; Falconer, D. A.; Moore, Ronald L.

    1999-01-01

    We have previously reported analyses of Yohkoh SXT data examining the relationship between the heating of extended coronal loops (both within and stemming from active regions) and microflaring in core fields lying along neutral lines near their footpoints (J. G. Porter, D. A. Falconer, and R. L. Moore 1998, in Solar Jets and Coronal Plumes, ed. T. Guyenne, ESA SP-421, and references therein). We found a surprisingly poor correlation of intensity variations in the extended loops with individual microflares in the compact heated areas at their feet, despite considerable circumstancial evidence linking the heating processes in these regions. Now, a study of Fe XII image sequences from SOHO EIT show that similar associations of core field structures with the footpoints of very extended coronal features can be found in the quiet Sun. The morphology is consistent with the finding of Wang et al. (1997, ApJ 484, L75) that polar plumes are rooted at sites of mixed polarity in the magnetic network. We find that the upstairs/downstairs intensity variations often follow the trend, identified in the active region observations, of a weak correspondence. Apparently much of the coronal heating in the extended loops is driven by a type of core field magnetic activity that is "cooler" than the events having the coronal signature of microflares, i.e., activity that results in little heating within the core fields themselves. This work was funded by the Solar Physics Branch of NASA's Office of Space Science through the SR&T Program and the SEC Guest Investigator Program.

  6. Projection effects in coronal dimmings and associated EUV wave event

    CERN Document Server

    Dissauer, Karin; Veronig, Astrid M; Vanninathan, Kamalam; Magdalenić, Jasmina

    2016-01-01

    We investigate the high-speed ($v >$ 1000 km s$^{-1}$) extreme-ultraviolet (EUV) wave associated with an X1.2 flare and coronal mass ejection (CME) from NOAA active region 11283 on 2011 September 6 (SOL2011-09-06T22:12). This EUV wave features peculiar on-disk signatures, in particular we observe an intermittent "disappearance" of the front for 120 s in SDO/AIA 171, 193, 211 {\\AA} data, whereas the 335 {\\AA} filter, sensitive to hotter plasmas (T$\\sim$2.5 MK), shows a continuous evolution of the wave front. The eruption was also accompanied by localized coronal dimming regions. We exploit the multi-point quadrature position of SDO and STEREO-A, to make a thorough analysis of the EUV wave evolution, with respect to its kinematics and amplitude evolution and reconstruct the SDO line-of-sight (LOS) direction of the identified coronal dimming regions in STEREO-A. We show that the observed intensities of the dimming regions in SDO/AIA depend on the structures that are lying along their LOS and are the combination ...

  7. Solar coronal plumes and the fast solar wind

    CERN Document Server

    Dwivedi, B N

    2015-01-01

    The spectral profiles of the coronal Ne viii line at 77 nm have different shapes in quiet-Sun regions and coronal holes (CHs). A single Gaussian fit of the line profile provides an adequate approximation in quiet-Sun areas, whereas a strong shoulder on the long-wavelength side is a systematic feature in CHs. Although this has been noticed since 1999, no physical reason for the peculiar shape could be given. In an attempt to identify the cause of this peculiarity, we address three problems that could not be conclusively resolved in a review article by a study team of the International Space Science Institute (ISSI; Wilhelm et al. 2011) : (1) The physical processes operating at the base and inside of plumes as well as their interaction with the solar wind (SW). (2) The possible contribution of plume plasma to the fast SW streams. (3) The signature of the first-ionization potential (FIP) effect between plumes and inter-plume regions (IPRs). Before the spectroscopic peculiarities in IPRs and plumes in polar coron...

  8. [Perceptions on item disclosure for the Korean medical licensing examination].

    Science.gov (United States)

    Yang, Eunbae B

    2015-09-01

    This study analyzed the perceptions of medical students and faculty regarding disclosure of test items on the Korean medical licensing examination. I conducted a survey of medical students from medical colleges and professional medical schools nationwide. Responses were analyzed from 718 participants as well as 69 faculty members who participated in creating the medical licensing examination item sets. Data were analyzed using descriptive statistics and the chi-square test. It is important to maintain test quality and to keep the test items unavailable to the public. There are also concerns among students that disclosure of test items would prompt increasing difficulty of test items (48.3%). Further, few students found it desirable to disclose test items regardless of any considerations (28.5%). The professors, who had experience in designing the test items, also expressed their opposition to test item disclosure (60.9%). It is desirable not to disclose the test items of the Korean medical licensing examination to the public on the condition that students are provided with a sufficient amount of information regarding the examination. This is so that the exam can appropriately identify candidates with the required qualifications.

  9. Validity of the SMS, Phone, and medical staff Examination sports injury surveillance system for time-loss and medical attention injuries in sports

    DEFF Research Database (Denmark)

    Møller, M.; Wedderkopp, Niels; Myklebust, G.

    2017-01-01

    The accurate measurement of sport exposure time and injury occurrence is key to effective injury prevention and management. Current measures are limited by their inability to identify all types of sport-related injury, narrow scope of injury information, or lack the perspective of the injured...... athlete. The aims of the study were to evaluate the proportion of injuries and the agreement between sport exposures reported by the SMS messaging and follow-up telephone part of the SMS, Phone, and medical staff Examination (SPEx) sports injury surveillance system when compared to measures obtained...... measures of injury consequences beyond time-loss from sport. However, this needs to be further evaluated in large-scale studies....

  10. Do Clinical Breast Examination Skills Improve During Medical School?

    Science.gov (United States)

    Lee, Karen C.; Dunlop, Dorothy; Dolan, Nancy C.

    1998-01-01

    A study assessed the effect of training stage, gender, and specialty interest on 493 Northwestern University (Illinois) medical students' breast cancer knowledge, attitudes, and clinical breast examination skills. Results suggest knowledge and attitudes are not related to clinical breast examination proficiency, which is a practiced tactile skill.…

  11. Examination performances of German and international medical students in the preclinical studying-term--a descriptive study.

    Science.gov (United States)

    Huhn, D; Resch, F; Duelli, R; Möltner, A; Huber, J; Karimian Jazi, K; Amr, A; Eckart, W; Herzog, W; Nikendei, C

    2014-01-01

    Medical students with a migration background face several specific problems during their studies. International surveys show first indications that this group of students performs worse in written, oral or practical exams. However, so far, nothing is known about the performance of international students in written pre-clinical tests as well as in pre-clinical State Examinations for German-speaking countries. A descriptive, retrospective analysis of the exam performances of medical students in the pre-clinical part of their studies was conducted at the Faculty of Medicine of Heidelberg in for the year 2012. Performance in written tests of the final exams in the second (N=276), third (N=292) and fourth semester (N=285) were compared between German students, students from EU countries and students from non-EU countries. Same comparison was drawn for the performance in the oral exam of the First State Examination in the period from 2009 - 2012 (N=1137). German students performed significantly better than students with a non-EU migration background both in all written exams and in the oral State Examination (all pstudents with an EU migration background was significantly better than that of students with a non-EU background in the written exam at the end of the third and fourth semester (pstudents completed the oral exam of the First State Examination significantly earlier than students with a non-EU migration background (students with a country of origin outside of the European Union has to be seen as a high-risk group among students with a migration background. For this group, there is an urgent need for early support to prepare for written and oral examinations.

  12. Examination performances of German and international medical students in the preclinical studying-term – A descriptive study

    Science.gov (United States)

    Huhn, D.; Resch, F.; Duelli, R.; Möltner, A.; Huber, J.; Karimian Jazi, K.; Amr, A.; Eckart, W.; Herzog, W.; Nikendei, C.

    2014-01-01

    Introduction: Medical students with a migration background face several specific problems during their studies. International surveys show first indications that this group of students performs worse in written, oral or practical exams. However, so far, nothing is known about the performance of international students in written pre-clinical tests as well as in pre-clinical State Examinations for German-speaking countries. Method: A descriptive, retrospective analysis of the exam performances of medical students in the pre-clinical part of their studies was conducted at the Faculty of Medicine of Heidelberg in for the year 2012. Performance in written tests of the final exams in the second (N=276), third (N=292) and fourth semester (N=285) were compared between German students, students from EU countries and students from non-EU countries. Same comparison was drawn for the performance in the oral exam of the First State Examination in the period from 2009 - 2012 (N=1137). Results: German students performed significantly better than students with a non-EU migration background both in all written exams and in the oral State Examination (all pstudents with an EU migration background was significantly better than that of students with a non-EU background in the written exam at the end of the third and fourth semester (pstudents completed the oral exam of the First State Examination significantly earlier than students with a non-EU migration background (students with a country of origin outside of the European Union has to be seen as a high-risk group among students with a migration background. For this group, there is an urgent need for early support to prepare for written and oral examinations. PMID:25228931

  13. Network Coronal Bright Points: Coronal Heating Concentrations Found in the Solar Magnetic Network

    Science.gov (United States)

    Falconer, D. A.; Moore, R. L.; Porter, J. G.; Hathaway, D. H.

    1998-01-01

    We examine the magnetic origins of coronal heating in quiet regions by combining SOHO/EIT Fe xii coronal images and Kitt Peak magnetograms. Spatial filtering of the coronal images shows a network of enhanced structures on the scale of the magnetic network in quiet regions. Superposition of the filtered coronal images on maps of the magnetic network extracted from the magnetograms shows that the coronal network does indeed trace and stem from the magnetic network. Network coronal bright points, the brightest features in the network lanes, are found to have a highly significant coincidence with polarity dividing lines (neutral lines) in the network and are often at the feet of enhanced coronal structures that stem from the network and reach out over the cell interiors. These results indicate that, similar to the close linkage of neutral-line core fields with coronal heating in active regions (shown in previous work), low-lying core fields encasing neutral lines in the magnetic network often drive noticeable coronal heating both within themselves (the network coronal bright points) and on more extended field lines rooted around them. This behavior favors the possibility that active core fields in the network are the main drivers of the heating of the bulk of the quiet corona, on scales much larger than the network lanes and cells.

  14. Good practice in occupational health services: Recommendations for prophylactic examinations and medical certifications in persons with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Andrzej Marcinkiewicz

    2014-02-01

    Full Text Available The prevalence of diabetes and a significant proportion of unawareness of its risk among the patients indicate the need to include into general prophylactic examinations the standards of medical certification, which would prevent discrimination and ensure public safety. In certifying medical predispositions to work in a person with diabetes mellitus the key issue is to distinguish 2 categories of medical requirements: the higher - related to qualifying workers for jobs demanding psychophysical abilities, which affect the safety of the workers and their environment and the lower - related to qualifying workers for jobs characterized by harmful factors and nuisances, which might have a negative effect on the course of diabetes. The very fact of having diabetes cannot be the reason for the patient being disqualified and the decision on certifying the capacity to perform a particular job should always be based on an individual health assessment of the patient, taking into account the risk of hypoglycemia, metabolic control, the progression and dynamics of chronic complications, as well as the level of health awareness in patients. The objective assessment of the health status of the patient with diabetes involves the judgment of an attending physician, additionally supported by the consultation of a diabetes specialist to ensure that the patient is able to perform properly the job, requiring psychomotor abilities. Med Pr 2014;65(1:131–141

  15. How do I ask about your disability? An examination of interpersonal communication processes between medical students and patients with disabilities.

    Science.gov (United States)

    Duggan, Ashley; Bradshaw, Ylisabyth S; Altman, Wayne

    2010-04-01

    Medical student behaviors were examined through digital recordings of interpersonal skills communication training framed around a brief curriculum on disability within a family medicine clerkship. This analysis focuses on interpersonal communication processes and ways medical students ask standardized patient educators about visually apparent disability (N = 142). Primary themes of asking about or avoiding disability were identified with regard to language and nonverbal communication in how medical students asked and whether they integrated chronic disability with new musculoskeletal pain complaints. Secondary themes related to timing and communication further contextualized the primary themes. Seventy-four percent of students asked about the disability. Analysis of feedback sessions immediately following the interactions revealed that more than half the students who did not ask about disability spontaneously recognized that they avoided disability language. Results suggest that some ways of asking about disability may inhibit patient disclosure and restrict relationship building. In particular, asking about disability, but then avoiding integrating disability disclosure into the treatment plan, or responding to disability-related disclosure with overly positive, infantilizing-type communication, may pose more difficult dilemmas than never asking about the disability. On the contrary, students who ignored disability altogether often also recognized they missed disability cues, thus providing a learning experience of considerable value. Underlying student attitudes and possibilities for integrating biomedical concerns with social-psychological impacts of disability are addressed.

  16. Teaching musculoskeletal examination skills to UK medical students: a comparative survey of Rheumatology and Orthopaedic education practice.

    Science.gov (United States)

    Blake, Tim

    2014-03-28

    Specialists in Rheumatology and Orthopaedics are frequently involved in undergraduate teaching of musculoskeletal (MSK) examination skills. Students often report that specialty-led teaching is inconsistent, confusing and bears little resemblance to the curricula. The Gait, Arms, Legs and Spine (GALS) is a MSK screening tool that provides a standardised approach to examination despite it being fraught with disapproval and low uptake. Recent studies would appear to support innovative instructional methods of engaging learners such as patient educators and interactive small group teaching. This comparative cross-sectional survey evaluates the current state of undergraduate teaching in Rheumatology and Orthopaedics, including preferred teaching methods, attitudes towards GALS, and barriers to effective teaching. An electronic questionnaire was sent to specialist trainees and Consultants in the East and West Midlands region, representing 5 UK medical schools. Descriptive statistical data analysis was performed. There were 76 respondents representing 5 medical schools. There was a request for newer teaching methodologies to be used: multi-media computer-assisted learning (35.5%), audio-visual aids (31.6%), role-playing (19.7%), and social media (3.9%). It is evident that GALS is under-utilised with 50% of clinicians not using GALS in their teaching. There is a genuine desire for clinical educators to improve their teaching ability, collaborate more with curriculum planners, and feel valued by institutions. There remains a call for implementing a standardised approach to MSK clinical teaching to supersede GALS.

  17. Coronal Holes

    Directory of Open Access Journals (Sweden)

    Steven R. Cranmer

    2009-09-01

    Full Text Available Coronal holes are the darkest and least active regions of the Sun, as observed both on the solar disk and above the solar limb. Coronal holes are associated with rapidly expanding open magnetic fields and the acceleration of the high-speed solar wind. This paper reviews measurements of the plasma properties in coronal holes and how these measurements are used to reveal details about the physical processes that heat the solar corona and accelerate the solar wind. It is still unknown to what extent the solar wind is fed by flux tubes that remain open (and are energized by footpoint-driven wave-like fluctuations, and to what extent much of the mass and energy is input intermittently from closed loops into the open-field regions. Evidence for both paradigms is summarized in this paper. Special emphasis is also given to spectroscopic and coronagraphic measurements that allow the highly dynamic non-equilibrium evolution of the plasma to be followed as the asymptotic conditions in interplanetary space are established in the extended corona. For example, the importance of kinetic plasma physics and turbulence in coronal holes has been affirmed by surprising measurements from the UVCS instrument on SOHO that heavy ions are heated to hundreds of times the temperatures of protons and electrons. These observations point to specific kinds of collisionless Alfvén wave damping (i.e., ion cyclotron resonance, but complete theoretical models do not yet exist. Despite our incomplete knowledge of the complex multi-scale plasma physics, however, much progress has been made toward the goal of understanding the mechanisms ultimately responsible for producing the observed properties of coronal holes.

  18. An Estimate of Solar Wind Velocity Profiles in a Coronal Hole and a Coronal Streamer Area (6-40 R(radius symbol)

    Science.gov (United States)

    Patzold, M.; Tsurutani, B. T.; Bird, M. K.

    1995-01-01

    Total electron content data obtained from the Ulysses Solar Corona Experiment (SCE) in 1991 were used to select two data sets, one associated with a coronal hole and the other with coronal streamer crossings. (This is largely equatorial data shortly after solar maximum.) The solar wind velocity profile is estimated for these areas.

  19. Recent perspectives in solar physics - Elemental composition, coronal structure and magnetic fields, solar activity

    Science.gov (United States)

    Newkirk, G., Jr.

    1975-01-01

    Elemental abundances in the solar corona are studied. Abundances in the corona, solar wind and solar cosmic rays are compared to those in the photosphere. The variation in silicon and iron abundance in the solar wind as compared to helium is studied. The coronal small and large scale structure is investigated, emphasizing magnetic field activity and examining cosmic ray generation mechanisms. The corona is observed in the X-ray and EUV regions. The nature of coronal transients is discussed with emphasis on solar-wind modulation of galactic cosmic rays. A schematic plan view of the interplanetary magnetic field during sunspot minimum is given showing the presence of magnetic bubbles and their concentration in the region around 4-5 AU by a fast solar wind stream.

  20. An estimate of solar wind velocity profiles in an coronal hole and a coronal streamer area (6-40 solar radius)

    Science.gov (United States)

    Paetzold, M.; Tsurutani, B. T.; Bird, M. K.

    1995-01-01

    Using the total electron content data obtained by the Ulysses Solar Corona Experiment during the superior solar conjunction in summer 1991, we selected two data sets, one associated with a coronal hole and the other one with coronal streamer crossings. By doing this data splitting, we find two entirely different density profiles varying as r(exp -2.7) and r(exp -2.3) for the coronal hole and coronal streamers, respectively. Assuming mass flux conservation from the inner corona to one AU, an estimate for the velocity profiles or acceleration in these two different regions can be determined. The more negative exponent of the coronal hole density profile indicates a more extended heating and acceleration region or more flaring, or both. Various possible explanations will be discussed.

  1. Interaction between emerging magnetic flux and the ambient solar coronal field

    Science.gov (United States)

    Cheung, M.; Derosa, M.

    2008-12-01

    We study the interaction between emerging magnetic flux and pre-existing coronal field by means of numerical simulations using the magneto-frictional method. By advancing the induction equation, the magneto-frictional method models the coronal magnetic field as a quasi-static sequence of non-linear force- free field configurations evolving in response to photospheric driving. A general feature of the simulations is the spontaneous formation of tangential discontinuities, interfaces where the field line torsional coefficient changes abruptly across separate domains of connectivity. Since the method evolves the vector potential, we can follow the evolution of the relative magnetic helicity and examine its relation to the magnetic free energy. Other tools, such as the squashing factor of Titov and Démoulin, are also used to study the topology of the field configurations.

  2. 28 CFR 90.14 - Forensic medical examination payment requirement.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Forensic medical examination payment... Program § 90.14 Forensic medical examination payment requirement. (a) For the purpose of this subpart B, a... entity incurs the full out-of-pocket costs of forensic medical examinations for victims of sexual...

  3. Coronal structure analysis based on the potential field source surface modeling and total solar eclipse observation

    Science.gov (United States)

    Muhamad, Johan; Mumtahana, Farahhati; Sutastio, Heri; Imaduddin, Irfan; Putri, Gerhana P.

    2016-11-01

    We constructed global coronal magnetic fields of the Sun during the Total Solar Eclipse (TSE) 9 March 2016 by using Potential Field Source Surface (PFSS) model. Synoptic photospheric magnetogram data from Helioseismic and Magnetic Imager (HMI) onboard Solar Dynamics Observatory (SDO) was used as a boundary condition to extrapolate the coronal magnetic fields of the Sun. This extrapolated structure was analyzed by comparing the alignment of the fields from the model with coronal structure from the observation. We also used observational data of coronal structure during the total solar eclipse to know how well the model agree with the observation. As a result, we could identify several coronal streamers which were produced by the large closed loops in the lower regime of the corona. This result verified that the PFSS extrapolation can be used as a tool to model the inner corona with several constraints. We also discussed how the coronal structure can be used to deduce the phase of the solar cycle.

  4. Coronal Loops: Observations and Modeling of Confined Plasma

    Directory of Open Access Journals (Sweden)

    Fabio Reale

    2014-07-01

    Full Text Available Coronal loops are the building blocks of the X-ray bright solar corona. They owe their brightness to the dense confined plasma, and this review focuses on loops mostly as structures confining plasma. After a brief historical overview, the review is divided into two separate but not independent parts: the first illustrates the observational framework, the second reviews the theoretical knowledge. Quiescent loops and their confined plasma are considered and, therefore, topics such as loop oscillations and flaring loops (except for non-solar ones, which provide information on stellar loops are not specifically addressed here. The observational section discusses the classification, populations, and the morphology of coronal loops, its relationship with the magnetic field, and the loop stranded structure. The section continues with the thermal properties and diagnostics of the loop plasma, according to the classification into hot, warm, and cool loops. Then, temporal analyses of loops and the observations of plasma dynamics, hot and cool flows, and waves are illustrated. In the modeling section, some basics of loop physics are provided, supplying fundamental scaling laws and timescales, a useful tool for consultation. The concept of loop modeling is introduced and models are divided into those treating loops as monolithic and static, and those resolving loops into thin and dynamic strands. More specific discussions address modeling the loop fine structure and the plasma flowing along the loops. Special attention is devoted to the question of loop heating, with separate discussion of wave (AC and impulsive (DC heating. Large-scale models including atmosphere boxes and the magnetic field are also discussed. Finally, a brief discussion about stellar coronal loops is followed by highlights and open questions.

  5. The Evolution and Space Weather Effects of Solar Coronal Holes

    Science.gov (United States)

    Krista, Larisza; Gallagher, P.

    2011-05-01

    As solar activity is the foremost important aspect of space weather, the forecasting of flare and CME related transient geomagnetic storms has become a primary initiative. Minor magnetic storms caused by coronal holes (CHs) have also proven to be important due to their long-lasting and recurrent geomagnetic effects. In order to forecast CH related geomagnetic storms, the author developed the Coronal Hole Automated Recognition and Monitoring (CHARM) algorithm to replace the user-dependent CH detection methods commonly used. CHARM uses an intensity thresholding method to identify low intensity regions in EUV or X-ray images. Since CHs are regions of "open” magnetic field and predominant polarity, magnetograms were used to differentiate CHs from other low intensity regions. The Coronal Hole Evolution (CHEVOL) algorithm was developed and used in conjunction with CHARM to study the boundary evolution of CHs. It is widely accepted that the short-term changes in CH boundaries are due to the interchange reconnection between the CH open field lines and small loops. We determined the magnetic reconnection rate and the diffusion coefficient at CH boundaries in order to test the interchange reconnection model. The author also developed the Minor Storm (MIST) package to link CHs to high-speed solar wind (HSSW) periods detected at Earth. Using the algorithm the relationship between CHs, the corresponding HSSW properties, and geomagnetic indices were studied between 2000-2009. The results showed a strong correlation between the velocity and HSSW proton plasma temperature, which indicates that the heating and acceleration of the solar wind plasma in CHs are closely related, and perhaps caused by the same mechanism. The research presented here includes analysis of CHs on small and large spatial/temporal scales, allowing us to further our understanding of CHs as a whole.

  6. Magnetic fields, plasmas, and coronal holes - The inner solar system

    Science.gov (United States)

    Burlaga, L. F.

    1979-01-01

    Recent results concerning streams and magnetic fields in the inner solar system are reviewed. Observations have shown that MHD streams are bounded by thin shear layers within 1 AU, probably because they originate in coronal holes which have sharp boundaries. The properties of Alfvenic fluctuations in streams cannot be fully explained on the basis of the hypothesis that they are plane, transverse Alfven waves. A more complete and accurate description might be that they represent nonplanar general Alfven waves weakly coupled to a compressive mode and moving through a medium containing tangential discontinuities and other convected inhomogeneities.

  7. An examination of how women and underrepresented racial/ethnic minorities experience barriers in biomedical research and medical programs

    Science.gov (United States)

    Chakraverty, Devasmita

    Women in medicine and biomedical research often face challenges to their retention, promotion, and advancement to leadership positions (McPhillips et al., 2007); they take longer to advance their careers, tend to serve at less research-intensive institutions and have shorter tenures compared to their male colleagues (White, McDade, Yamagata, & Morahan, 2012). Additionally, Blacks and Hispanics are the two largest minority groups that are vastly underrepresented in medicine and biomedical research in the United States (AAMC, 2012; NSF, 2011). The purpose of this study is to examine specific barriers reported by students and post-degree professionals in the field through the following questions: 1. How do women who are either currently enrolled or graduated from biomedical research or medical programs define and make meaning of gender-roles as academic barriers? 2. How do underrepresented groups in medical schools and biomedical research institutions define and make meaning of the academic barriers they face and the challenges these barriers pose to their success as individuals in the program? These questions were qualitatively analyzed using 146 interviews from Project TrEMUR applying grounded theory. Reported gender-role barriers were explained using the "Condition-Process-Outcome" theoretical framework. About one-third of the females (across all three programs; majority White or Black between 25-35 years of age) reported gender-role barriers, mostly due to poor mentoring, time constraints, set expectations and institutional barriers. Certain barriers act as conditions, causing gender-role issues, and gender-role issues influence certain barriers that act as outcomes. Strategies to overcome barriers included interventions mostly at the institutional level (mentor support, proper specialty selection, selecting academia over medicine). Barrier analysis for the two largest URM groups indicated that, while Blacks most frequently reported racism, gender barriers

  8. The promise and challenge of including multimedia items in medical licensure examinations: some insights from an empirical trial.

    Science.gov (United States)

    Shen, Linjun; Li, Feiming; Wattleworth, Roberta; Filipetto, Frank

    2010-10-01

    The Comprehensive Osteopathic Medical Licensing Examination conducted a trial of multimedia items in the 2008-2009 Level 3 testing cycle to determine (1) if multimedia items were able to test additional elements of medical knowledge and skills and (2) how to develop effective multimedia items. Forty-four content-matched multimedia and text multiple-choice items were randomly delivered to Level 3 candidates. Logistic regression and paired-samples t tests were used for pairwise and group-level comparisons, respectively. Nine pairs showed significant differences in either difficulty or/and discrimination. Content analysis found that, if text narrations were less direct, multimedia materials could make items easier. When textbook terminologies were replaced by multimedia presentations, multimedia items could become more difficult. Moreover, a multimedia item was found not uniformly difficult for candidates at different ability levels, possibly because multimedia and text items tested different elements of a same concept. Multimedia items may be capable of measuring some constructs different from what text items can measure. Effective multimedia items with reasonable psychometric properties can be intentionally developed.

  9. Huge Coronal Structure and Heating Constraints Determined from Serts Observations

    Science.gov (United States)

    Falconer, D. A.; Davila, J. M.

    2001-01-01

    Intensities of the extreme-ultraviolet (EUV) spectral lines were measured as a function of radius off the solar limb by two flights of the Goddard's Solar Extreme-Ultraviolet Rocket Telescope and Spectrograph (SERTS) for three quiet-Sun regions. Density scale heights were determined for the different spectral lines. Limits on the filling factor were determined. In the one case where an upper limit was determined it was much less than unity. coronal heating above 1.15 solar radii is required for all three regions studied. For reasonable filling factors, local heating is needed.

  10. SERVICE ATTRIBUTES AND THE CHOICE FOR STD HEALTH-SERVICES IN PERSONS SEEKING A MEDICAL-EXAMINATION FOR AN STD

    NARCIS (Netherlands)

    LEENAARS, PEM; ROMBOUTS, R; KOK, G

    1994-01-01

    This article examines choice for STD health services among patients suspecting a STD. A total of 825 patients who sought medical treatment at an STD clinic, a Family Planning Clinic or a General Practitioner participated in this study. Special STD clinics are not well known among patients visiting t

  11. SERVICE ATTRIBUTES AND THE CHOICE FOR STD HEALTH-SERVICES IN PERSONS SEEKING A MEDICAL-EXAMINATION FOR AN STD

    NARCIS (Netherlands)

    LEENAARS, PEM; ROMBOUTS, R; KOK, G

    This article examines choice for STD health services among patients suspecting a STD. A total of 825 patients who sought medical treatment at an STD clinic, a Family Planning Clinic or a General Practitioner participated in this study. Special STD clinics are not well known among patients visiting

  12. Smooth coronal surface, resin restoration and microleakage.

    Science.gov (United States)

    Yanikoğlu, F; Türkmen, C; Kartal, N; Başaran, B

    1997-09-01

    The space between the resin and the cavity walls has always become interesting to search. The aim of this study was to evaluate any differences on leakage values of Class 5 type resin restorations prepared on surrounding surfaces of the tooth crown. Ninety human teeth were prepared as Class 5 cavities on buccal, lingual, mesial and distal surfaces and were randomly divided into groups for bevelling, groove preparation and as control. The subgroups were arranged as fluoride gel and/or sealant applications. Fluoride gel was applied following the cavity preparations. Sealant was applied over composite resin restorations. Treated teeth were thermocycled and immersed into dye solution for 96 hours. The restorations were evaluated in a stereo-microscope following the sectioning. Bevelling of the cavosurfaces and/or preparation of a groove addition to cavity procedures did not make any difference on the microleakage scores of the restorations done on either surfaces statistically.

  13. Initiation and Propagation of Coronal Mass Ejections

    Indian Academy of Sciences (India)

    P. F. Chen

    2008-03-01

    This paper reviews recent progress in the research on the initiation and propagation of CMEs. In the initiation part, several trigger mechanisms are discussed; in the propagation part, the observations and modelings of EIT waves/dimmings, as the EUV counterparts of CMEs, are described.

  14. Reliability and Validity of Objective Structured Clinical Examination for Residents of Obstetrics and Gynecology at Kermanshah University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Nasrin Jalilian

    2012-11-01

    Full Text Available Introduction: Objective structured clinical examination (OSCE is used for the evaluation of the clinical competence in medicine for which it is essential to measure validity and reliability. This study aimed to investigate the validity and reliability of OSCE for residents of obstetrics and gynecology at Kermanshah University of Medical Sciences in 2011.Methods: A descriptive-correlation study was designed and the data of OSCE for obstetrics and gynecology were collected via learning behavior checklists in method stations and multiple choice questions in question stations. The data were analyzed through Pearson correlation coefficient and Cronbach's alpha, using SPSS software (version 16. To determine the criterion validity, correlation of OSCE scores with scores of resident promotion test, direct observation of procedural skills, and theoretical knowledge was determined; for reliability, however, Cronbach's alpha was used. Total sample consisted of 25 participants taking part in 14 stations. P value of less than 0.05 was considered as significant.Results: The mean OSCE scores was 22.66 (±6.85. Criterion validity of the stations with resident promotion theoretical test, first theoretical knowledge test, second theoretical knowledge, and direct observation of procedural skills (DOPS was 0.97, 0.74, 0.49, and 0.79, respectively. In question stations, criterion validity was 0.15, and total validity of OSCE was 0.77.Conclusion: Findings of the present study indicated acceptable validity and reliability of OSCE for residents of obstetrics and gynecology.

  15. Studies of Solar Flares and Coronal Loops.

    Science.gov (United States)

    1984-07-10

    atmosphere. In the 9:7:0 atmosphere, for exam- radiative loss rates depend. It should also be emphasized pIe , T, is 47 K less than the VAL/F r,,. This result...i( Tipo + T pl) and equations (5) and (8), we get P (D - w t P = + 0 (9j where 0 = o ’-, +T (k" -B,)- (o fTQ 10R B0 . G!) = ( - 1 ) R p + T ( k

  16. Impulsively Driven Waves And Flows In Coronal Active Regions

    Science.gov (United States)

    Ofman, Leon; Wang, T.; Davila, J. M.; Liu, W.

    2012-05-01

    Recent SDO/AIA and Hinode EIS observations indicate that both (super) fast and slow magnetosonic waves are present in active region (AR) magnetic structures. Evidence for fast (100-300 km/s) impulsive flows is found in spectroscopic and imaging observations of AR loops. The super-fast waves were observed in magnetic funnels of ARs. The observations suggest that waves and flow are produced by impulsive events, such as (micro) flares. We have performed three-dimensional magnetohydrodynamic (3D MHD) simulations of impulsively generated flows and waves in coronal loops of a model bi-polar active region (AR). The model AR is initiated with a dipole magnetic field and gravitationally stratified density, with impulsively driven flow at the coronal base of the AR in localized magnetic field structures. We model the excitation of the flows in hot (6MK) and cold (1MK) active region plasma, and find slow and fast magnetosonic waves produced by these events. We also find that high-density (compared to surrounding corona) loops are produced as a result of the upflows. We investigate the parametric dependence between the properties of the impulsive flows and the waves. The results of the 3D MHD modeling study supports the conjecture that slow magnetosonic waves are often produced by impulsive upflows along the magnetic field, and fast magnetosonic waves can result from impulsive transverse field line perturbations associated with reconnection events. The waves and flows can be used for diagnostic of AR structure and dynamics.

  17. Coronal Holes and Open Magnetic Flux over Cycles 23 and 24

    Science.gov (United States)

    Lowder, Chris; Qiu, Jiong; Leamon, Robert

    2017-01-01

    As the observational signature of the footprints of solar magnetic field lines open into the heliosphere, coronal holes provide a critical measure of the structure and evolution of these lines. Using a combination of Solar and Heliospheric Observatory/Extreme ultraviolet Imaging Telescope (SOHO/EIT), Solar Dynamics Observatory/Atmospheric Imaging Assembly (SDO/AIA), and Solar Terrestrial Relations Observatory/Extreme Ultraviolet Imager (STEREO/EUVI A/B) extreme ultraviolet (EUV) observations spanning 1996 - 2015 (nearly two solar cycles), coronal holes are automatically detected and characterized. Coronal hole area distributions show distinct behavior in latitude, defining the domain of polar and low-latitude coronal holes. The northern and southern polar regions show a clear asymmetry, with a lag between hemispheres in the appearance and disappearance of polar coronal holes.

  18. First Record of Culex Coronator in Virginia, with Notes on Its Rapid Dispersal, Trapping Methods, and Biology.

    Science.gov (United States)

    Akaratovic, Karen I; Kiser, Jay P

    2017-09-01

    Culex coronator is a Neotropical mosquito species that was first described in Trinidad in the early 20th century. Since then, the species has been discovered from Patagonia to the southern USA. A single adult female Cx. coronator was collected on November 1, 2016, in Suffolk, VA, in a BG-Sentinel 2® trap during routine mosquito surveillance. This represents the 1st record of this species in the state of Virginia and the northernmost record in the USA. Based on male specimens examined from Texas and Mississippi, Cx. coronator sensu stricto seems to be the only species from the complex expanding into the southeastern USA. A comprehensive review of the available literature from the southern and southeastern USA is provided describing trapping methods, ecological, and biological information.

  19. Global Energetics in Solar Flares and Coronal Mass Ejections

    Science.gov (United States)

    Aschwanden, Markus J.

    2017-08-01

    We present a statistical study of the energetics of coronal mass ejections (CME) and compare it with the magnetic, thermal, and nonthermal energy dissipated in flares. The physical parameters of CME speeds, mass, and kinetic energies are determined with two different independent methods, i.e., the traditional white-light scattering method using LASCO/SOHO data, and the EUV dimming method using AIA/SDO data. We analyze all 860 GOES M- and X-class flare events observed during the first 7 years (2010-2016) of the SDO mission. The new ingredients of our CME modeling includes: (1) CME geometry in terms of a self-similar adiabatic expansion, (2) DEM analysis of CME mass over entire coronal temperature range, (3) deceleration of CME due to gravity force which controls the kinetic and potentail CME energy as a function of time, (4) the critical speed that controls eruptive and confined CMEs, (5) the relationship between the center-of-mass motion during EUV dimming and the leading edge motion observed in white-light coronagraphs. Novel results are: (1) Physical parameters obtained from both the EUV dimming and white-light method can be reconciled; (2) the equi-partition of CME kinetic and thermal flare energy; (3) the Rosner-Tucker-Vaiana scaling law. We find that the two methods in EUV and white-light wavelengths are highly complementary and yield more complete models than each method alone.

  20. Posterior coronal plating for tibial fractures: technique and advantages

    Directory of Open Access Journals (Sweden)

    Montu Jain

    2014-04-01

    Full Text Available Objective:Tibial shaft fractures are straightforward to treat but when associated with soft tissue injury particularly at the nail entry/plate insertion site or there is significant comminution proximally or a large butterfly fragment/a second split component in the posterior coronal plane, it is a challenge to the treating surgeon. The aim of the present report is to describe the technique of posterior coronal plating in such a scenario and its advantages. Methods:Between July 2008 and June 2011, 12 patients were pro spectively treated by this approach using 4.5 mm broad dynamic compression plates. Results:The time of bony consolidation and full weight bearing averaged 21.7 weeks (range, 16-26 weeks. Patients were followed up for at least 24 months (range, 24-48 months. At 1 year postoper atively, no loss in reduction or alignment was observed. Mean Hospital for Lower Extremity Measurement Functional Score was 72.8 (range, 64-78. All patients were satisfied with their treatment outcomes. Conclusion:Direct posterior approach and fixation using prone position helps to visualise the fracture fragments and provide rigid fixation. The approach is simple and extensile easily, apart from advantages of less soft tissue and hardware problems compared to standard medial or lateral plating. Key words: Tibial fractures; Bone plates; Orthopedic procedures

  1. A survey of front-line paramedics examining the professional relationship between paramedics and physician medical oversight.

    Science.gov (United States)

    Foerster, Christopher R; Tavares, Walter; Virkkunen, Ilkka; Kämäräinen, Antti

    2017-06-07

    Paramedicine is often dependent on physician medical directors and their associated programs for direction and oversight. A positive relationship between paramedics and their oversight physicians promotes safety and quality care while a strained or ineffective one may threaten these goals. The objective of this study was to explore and understand the professional relationship between paramedics and physician medical oversight as viewed by front-line paramedics. All active front-line paramedics from four municipal paramedic services involving three medical oversight groups in Ontario were invited to complete an online survey. Five hundred and four paramedics were invited to participate in the study, with 242 completing the survey (48% response rate); 66% male, 76% primary care paramedics with an average of 13 (SD=9) years of experience. Paramedics had neutral or positive perceptions regarding their autonomy, opportunities to interact with their medical director, and medical director understanding of the prehospital setting. Paramedics perceived medical directives as rigid and ambiguous. A significant amount of respondents reported a perception of having provided suboptimal patient care due to fear of legal or disciplinary consequences. Issues of a lack of support for critical thinking and a lack of trust between paramedics and medical oversight groups were often raised. Paramedic perceptions of physician medical oversight were mixed. Concerning areas identified were perceptions of ambiguous written directives and concerns related to the level of trust and support for critical thinking. These perceptions may have implications for the system of care and should be explored further.

  2. Coronal Holes

    CERN Document Server

    Cranmer, Steven R

    2009-01-01

    Coronal holes are the darkest and least active regions of the Sun, as observed both on the solar disk and above the solar limb. Coronal holes are associated with rapidly expanding open magnetic fields and the acceleration of the high-speed solar wind. This paper reviews measurements of the plasma properties in coronal holes and how these measurements are used to reveal details about the physical processes that heat the solar corona and accelerate the solar wind. It is still unknown to what extent the solar wind is fed by flux tubes that remain open (and are energized by footpoint-driven wave-like fluctuations), and to what extent much of the mass and energy is input intermittently from closed loops into the open-field regions. Evidence for both paradigms is summarized in this paper. Special emphasis is also given to spectroscopic and coronagraphic measurements that allow the highly dynamic non-equilibrium evolution of the plasma to be followed as the asymptotic conditions in interplanetary space are establish...

  3. ON THE OBSERVATION AND SIMULATION OF SOLAR CORONAL TWIN JETS

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Jiajia; Wang, Yuming; Zhang, Quanhao [CAS Key Laboratory of Geospace Environment, School of Earth and Space Sciences, University of Science and Technology of China, NO. 96, Jinzhai Road, Hefei, Anhui 230026 (China); Fang, Fang [Laboratory for Atmospheric and Space Physics, University of Colorado at Boulder, 1234 Innovation Drive, Boulder, CO 80303 (United States); McIntosh, Scott W.; Fan, Yuhong [High Altitude Observatory, National Center for Atmospheric Research, P.O. Box 3000, Boulder, CO 80307 (United States)

    2016-02-01

    We present the first observation, analysis, and modeling of solar coronal twin jets, which occurred after a preceding jet. Detailed analysis on the kinetics of the preceding jet reveals its blowout-jet nature, which resembles the one studied in Liu et al. However, the erupting process and kinetics of the twin jets appear to be different from the preceding one. Lacking detailed information on the magnetic fields in the twin jet region, we instead use a numerical simulation using a three-dimensional (3D) MHD model as described in Fang et al., and find that in the simulation a pair of twin jets form due to reconnection between the ambient open fields and a highly twisted sigmoidal magnetic flux, which is the outcome of the further evolution of the magnetic fields following the preceding blowout jet. Based on the similarity between the synthesized and observed emission, we propose this mechanism as a possible explanation for the observed twin jets. Combining our observation and simulation, we suggest that with continuous energy transport from the subsurface convection zone into the corona, solar coronal twin jets could be generated in the same fashion addressed above.

  4. Medical Students’ First Male Urogenital Examination: Investigating the Effects of Instruction and Gender on Anxiety

    Directory of Open Access Journals (Sweden)

    Lisa D. Howley

    2003-06-01

    Full Text Available Objectives: To investigate the effect that standardized instruction of the male urogenital examination had on the anxiety levels of students and to determine what influence, if any, the gender of the student had on this experience. Methods: One hundred thirty six second year medical students were asked to report their level of anxiety before and after participation in a small group teaching session on the male urogenital examination. We gathered both qualitative and quantitative information to better understand students’ anxiety surrounding this instruction. Results: Students had significantly lower state-anxiety scores following the instruction than before (F(1, 76=102.353, p=.000, eta2=.574 and female students were more likely to have greater state-anxiety than male students (F=6.952, p=.010, eta2=.084. Ninety-nine percent of students reported that the teaching associates successfully reduced their anxiety. This decrease was attributed predominantly to the personal qualities of the teaching associates and to the format of the instruction. Conclusions: This study provides both quantitative and qualitative evidence that the use of male teaching associates to provide standardized instruction on the urogenital exam is effective at reducing students’ anxiety, particularly with regard to female students. Added standardized instruction may lead to increased confidence, skill, and future compliance with intimate physical exam screening practices

  5. 21 CFR 880.6320 - AC-powered medical examination light.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false AC-powered medical examination light. 880.6320... Miscellaneous Devices § 880.6320 AC-powered medical examination light. (a) Identification. An AC-powered medical examination light is an AC-powered device intended for medical purposes that is used to illuminate...

  6. Converging Supergranular Flows and the Formation of Coronal Plumes

    Science.gov (United States)

    Wang, Y.-M.; Warren, H. P.; Muglach, K.

    2016-01-01

    Earlier studies have suggested that coronal plumes are energized by magnetic reconnection between unipolar flux concentrations and nearby bipoles, even though magnetograms sometimes show very little minority-polarity flux near the footpoints of plumes. Here we use high-resolution extreme-ultraviolet (EUV) images and magnetograms from the Solar Dynamics Observatory (SDO) to clarify the relationship between plume emission and the underlying photospheric field. We find that plumes form where unipolar network elements inside coronal holes converge to form dense clumps, and fade as the clumps disperse again. The converging flows also carry internetwork fields of both polarities. Although the minority-polarity flux is sometimes barely visible in the magnetograms, the corresponding EUV images almost invariably show loop-like features in the core of the plumes, with the fine structure changing on timescales of minutes or less. We conclude that the SDO observations are consistent with a model in which plume emission originates from interchange reconnection in converging flows, with the plume lifetime being determined by the approximately 1-day evolutionary timescale of the supergranular network. Furthermore, the presence of large EUV bright points and/or ephemeral regions is not a necessary precondition for the formation of plumes, which can be energized even by the weak, mixed-polarity internetwork fields swept up by converging flows.

  7. CONVERGING SUPERGRANULAR FLOWS AND THE FORMATION OF CORONAL PLUMES

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Y.-M.; Warren, H. P. [Space Science Division, Naval Research Laboratory, Washington, DC 20375 (United States); Muglach, K., E-mail: yi.wang@nrl.navy.mil, E-mail: harry.warren@nrl.navy.mil, E-mail: karin.muglach@nasa.gov [Code 674, NASA Goddard Space Flight Center, Greenbelt, MD 20771 (United States)

    2016-02-20

    Earlier studies have suggested that coronal plumes are energized by magnetic reconnection between unipolar flux concentrations and nearby bipoles, even though magnetograms sometimes show very little minority-polarity flux near the footpoints of plumes. Here we use high-resolution extreme-ultraviolet (EUV) images and magnetograms from the Solar Dynamics Observatory (SDO) to clarify the relationship between plume emission and the underlying photospheric field. We find that plumes form where unipolar network elements inside coronal holes converge to form dense clumps, and fade as the clumps disperse again. The converging flows also carry internetwork fields of both polarities. Although the minority-polarity flux is sometimes barely visible in the magnetograms, the corresponding EUV images almost invariably show loop-like features in the core of the plumes, with the fine structure changing on timescales of minutes or less. We conclude that the SDO observations are consistent with a model in which plume emission originates from interchange reconnection in converging flows, with the plume lifetime being determined by the ∼1 day evolutionary timescale of the supergranular network. Furthermore, the presence of large EUV bright points and/or ephemeral regions is not a necessary precondition for the formation of plumes, which can be energized even by the weak, mixed-polarity internetwork fields swept up by converging flows.

  8. The Fate of Cool Material in the Hot Corona: Solar Prominences and Coronal Rain

    Science.gov (United States)

    Liu, Wei; Antolin, Patrick; Sun, Xudong; Vial, Jean-Claude; Berger, Thomas

    2017-08-01

    As an important chain of the chromosphere-corona mass cycle, some of the million-degree hot coronal mass undergoes a radiative cooling instability and condenses into material at chromospheric or transition-region temperatures in two distinct forms - prominences and coronal rain (some of which eventually falls back to the chromosphere). A quiescent prominence usually consists of numerous long-lasting, filamentary downflow threads, while coronal rain consists of transient mass blobs falling at comparably higher speeds along well-defined paths. It remains puzzling why such material of similar temperatures exhibit contrasting morphologies and behaviors. We report recent SDO/AIA and IRIS observations that suggest different magnetic environments being responsible for such distinctions. Specifically, in a hybrid prominence-coronal rain complex structure, we found that the prominence material is formed and resides near magnetic null points that favor the radiative cooling process and provide possibly a high plasma-beta environment suitable for the existence of meandering prominence threads. As the cool material descends, it turns into coronal rain tied onto low-lying coronal loops in a likely low-beta environment. Such structures resemble to certain extent the so-called coronal spiders or cloud prominences, but the observations reported here provide critical new insights. We will discuss the broad physical implications of these observations for fundamental questions, such as coronal heating and beyond (e.g., in astrophysical and/or laboratory plasma environments).

  9. Computed tomography of the sella turcica content in coronal and axial plane

    Energy Technology Data Exchange (ETDEWEB)

    Lovrencic, M.; Kalousek, M.; Klaric, R.; Sekso, M.

    1984-10-01

    Computed tomography of the pituitary fossa in the axial and coronal plane have been performed in 40 patients. The use of both planes has improved diagnostic accuracy through a more exact spatial demonstration. The method has also been reliable in the detection of pituitary microadenomas. The use of both planes has a limited diagnostic accuracy due artefacts in coronal plane.

  10. Development and examination of a rubric for evaluating point-of-care medical applications for mobile devices.

    Science.gov (United States)

    Butcher, Robyn; MacKinnon, Martin; Gadd, Kathleen; LeBlanc-Duchin, Denise

    2015-01-01

    The rapid development and updates of mobile medical resource applications (apps) highlight the need for an evaluation tool to assess the content of these resources. The purpose of the study was to develop and test a new evaluation rubric for medical resource apps. The evaluation rubric was designed using existing literature and through a collaborative effort between a hospital and an academic librarian. Testing found scores ranging from 23% to 88% for the apps. The evaluation rubric proved able to distinguish levels of quality within each content component of the apps, demonstrating potential for standardization of medical resource app evaluations.

  11. Decay of Activity Complexes, Formation of Unipolar Magnetic Regions and Coronal Holes in their Causal Relation

    CERN Document Server

    Golubeva, Elena

    2016-01-01

    North-south asymmetry of sunspot activity resulted in an asynchronous reversal of the Sun's polar fields in the current cycle. The asymmetry is also observed in the formation of polar coronal holes. A stable coronal hole was first formed at the South Pole, despite the later polar-field reversal there. The aim of this study is to understand processes making this situation possible. Synoptic magnetic maps from the Global Oscillation Network Group and corresponding coronal-hole maps from the Extreme ultraviolet Imaging Telescope aboard the Solar and Heliospheric Observatory and the Atmospheric Imaging Assembly aboard the Solar Dynamics Observatory are analyzed here to study a causal relationship between the decay of activity complexes, evolution of large-scale magnetic fields, and formation of coronal holes. Ensembles of coronal holes associated with decaying active regions and activity complexes are presented. These ensembles take part in global rearrangements of the Sun's open magnetic flux. In particular, the...

  12. High-spatial-resolution microwave and related observations as diagnostics of coronal loops

    Science.gov (United States)

    Holman, Gordon D.

    1986-01-01

    High spatial resolution microwave observations of coronal loops, together with theoretical models for the loop emission, can provide detailed information about the temperature, density, and magnetic field within the loop, as well as the environment around the loop. The capability for studying magnetic fields is particularly important, since there is no comparable method for obtaining direct information about coronal magnetic fields. Knowledge of the magnetic field strength and structure in coronal loops is important for understanding both coronal heating and flares. With arc-second-resolution microwave observations from the Very Large Array (VLA), supplemental high-spectral-resolution microwave data from a facility such as the Owens Valley frequency-agile interferometer, and the ability to obtain second-of-arc resolution EUV aor soft X ray images, the capability already exists for obtaining much more detailed information about coronal plasma and magnetic structures than is presently available. This capability is discussed.

  13. Attitudes on cost-effectiveness and equity: a cross-sectional study examining the viewpoints of medical professionals.

    Science.gov (United States)

    Li, David G; Wong, Gordon X; Martin, David T; Tybor, David J; Kim, Jennifer; Lasker, Jeffrey; Mitty, Roger; Salem, Deeb

    2017-08-01

    To determine the attitudes of physicians and trainees in regard to the roles of both cost-effectiveness and equity in clinical decision making. In this cross-sectional study, electronic surveys containing a hypothetical decision-making scenario were sent to medical professionals to select between two colon cancer screening tests for a population. Three Greater Boston academic medical institutions: Tufts University School of Medicine, Tufts Medical Centre and Lahey Hospital and Medical Centre. 819 medical students, 497 residents-in-training and 671 practising physicians were contacted electronically using institutional and organisational directories. Stratified opinions of medical providers and trainee subgroups regarding cost-effectiveness and equity. A total of 881 respondents comprising 512 medical students, 133 medical residents-in-training and 236 practising physicians completed the survey (total response rate 44.3%). Thirty-six per cent of medical students, 44% of residents-in-training and 53% of practising physicians favoured the less effective and more equitable screening test. Residents-in-training (OR 1.49, CI 1.01 to 2.21; p=0.044) and practising physicians (OR 2.12, CI 1.54 to 2.92; pmedical students. Moreover, female responders across all three cohorts favoured the more equitable screening test to a greater degree than did male responders (OR 1.70, CI 1.29 to 2.24; pmedical professionals place on equity. Among medical professionals, practising physicians appear to be more egalitarian than residents-in-training, while medical students appear to be most utilitarian and cost-effective. Meanwhile, female respondents in all three cohorts favoured the more equitable option to a greater degree than their male counterparts. Healthcare policies that trade off equity in favour of cost-effectiveness may be unacceptable to many medical professionals, especially practising physicians and women. © Article author(s) (or their employer(s) unless otherwise stated

  14. Voluntary medical male circumcision: a cross-sectional study comparing circumcision self-report and physical examination findings in Lesotho.

    Directory of Open Access Journals (Sweden)

    Anne Goldzier Thomas

    Full Text Available BACKGROUND: Overwhelming evidence, including three clinical trials, shows that male circumcision (MC reduces the risk of HIV infection among men. However, data from recent Lesotho Demographic and Health Surveys do not demonstrate MC to be protective against HIV. These contradictory findings could partially be due to inaccurate self-reported MC status used to estimate MC prevalence. This study describes MC characteristics among men applying for Lesotho Defence Force recruitment and seeks to assess MC self-reported accuracy through comparison with physical-examination-based data. METHODS AND FINDINGS: During Lesotho Defence Force applicant screening in 2009, 241 (77% of 312 men, aged 18-25 y, consented to a self-administered demographic and MC characteristic survey and physician-performed genital examination. The extent of foreskin removal was graded on a scale of 1 (no evidence of MC to 4 (complete MC. MC was self-reported by 27% (n = 64/239 of participants. Of the 64 men self-reporting being circumcised, physical exam showed that 23% had no evidence of circumcision, 27% had partial circumcision, and 50% had complete circumcision. Of the MCs reportedly performed by a medical provider, 3% were Grade 1 and 73% were Grade 4. Of the MCs reportedly performed by traditional circumcisers, 41% were Grade 1, while 28% were Grade 4. Among participants self-reporting being circumcised, the odds of MC status misclassification were seven times higher among those reportedly circumcised by initiation school personnel (odds ratio = 7.22; 95% CI = 2.29-22.75. CONCLUSIONS: Approximately 27% of participants self-reported being circumcised. However, only 50% of these men had complete MC as determined by a physical exam. Given this low MC self-report accuracy, countries scaling up voluntary medical MC (VMMC should obtain physical-exam-based MC data to guide service delivery and cost estimates. HIV prevention messages promoting VMMC should provide

  15. Chromospheric and Coronal Activity in the 500 Myr old Open Cluster M37: Evidence for Coronal Stripping?

    Science.gov (United States)

    Núñez, Alejandro; Agüeros, Marcel A.; Covey, Kevin R.; López-Morales, Mercedes

    2017-01-01

    We present the results of a spectroscopic survey to characterize chromospheric activity, as measured by {{H}}α emission, in low-mass members of the 500 Myr old open cluster M37. Combining our new measurements of {{H}}α luminosities ({L}{{H}α }) with previously cataloged stellar properties, we identify saturated and unsaturated regimes in the dependence of the {L}{{H}α }-to-bolometric luminosity ratio, {L}{{H}α }/{L}{bol}, on the Rossby number R o . All rotators with R o smaller than 0.03 ± 0.01 converge to an activity level of {L}{{H}α }/{L}{bol}=(1.27+/- 0.02)× {10}-4. This saturation threshold ({R}o,{sat}=0.03+/- 0.01) is statistically smaller than that found in most studies of the rotation–activity relation. In the unsaturated regime, slower rotators have lower levels of chromospheric activity, with {L}{{H}α }/{L}{bol}(R o ) following a power-law of index β =-0.51+/- 0.02, slightly shallower than that found for a combined ≈650 Myr old sample of Hyades and Praesepe stars. By comparing this unsaturated behavior to that previously found for coronal activity in M37 (as measured via the X-ray luminosity, {L}{{X}}), we confirm that chromospheric activity decays at a much slower rate than coronal activity with increasing R o . While a comparison of {L}{{H}α } and {L}{{X}} for M37 members with measurements of both reveals a nearly 1:1 relation, removing the mass-dependencies by comparing instead {L}{{H}α }/{L}{bol} and {L}{{X}}/{L}{bol} does not provide clear evidence for such a relation. Finally, we find that {R}o,{sat} is smaller for our chromospheric than for our coronal indicator of activity ({R}o,{sat}=0.03+/- 0.01 versus 0.09 ± 0.01). We interpret this as possible evidence for coronal stripping.

  16. Characteristics of Populations of the Russian Federation over the Panel of Fifteen Loci Used for DNA Identification and in Forensic Medical Examination.

    Science.gov (United States)

    A Stepanov, V; Balanovsky, O P; Melnikov, A V; Lash-Zavada, A Yu; Khar'kov, V N; Tyazhelova, T V; Akhmetova, V L; Zhukova, O V; Shneider, Yu V; Shil'nikova, I N; Borinskaya, S A; Marusin, A V; Spiridonova, M G; Simonova, K V; Khitrinskaya, I Yu; Radzhabov, M O; Romanov, A G; Shtygasheva, O V; Koshel', S M; Balanovskaya, E V; Rybakova, A V; Khusnutdinova, E K; Puzyrev, V P; Yankovsky, N K

    2011-04-01

    Seventeen population groups within the Russian Federation were characterized for the first time using a panel of 15 genetic markers that are used for DNA identification and in forensic medical examinations. The degree of polymorphism and population diversity of microsatellite loci within the Power Plex system (Promega) in Russian populations; the distribution of alleles and genotypes within the populations of six cities and 11 ethnic groups of the Russian Federation; the levels of intra- and interpopulation genetic differentiation of population; genetic relations between populations; and the identification and forensic medical characteristics of the system of markers under study were determined. Significant differences were revealed between the Russian populations and the U.S. reference base that was used recently in the forensic medical examination of the RF. A database of the allelic frequencies of 15 microsatellite loci that are used for DNA identification and forensic medical examination was created; the database has the potential of becoming the reference for performing forensic medical examinations in Russia. The spatial organization of genetic diversity over the panel of the STR markers that are used for DNA identification was revealed. It represents the general regularities of geographical clusterization of human populations over various types of genetic markers. The necessity to take into account a population's genetic structure during forensic medical examinations and DNA identification of criminal suspects was substantiated.

  17. Examining the Feasibility and Predictive Validity of the SAGAT Tool to Assess Situation Awareness Among Medical Trainees.

    Science.gov (United States)

    Gardner, Aimee K; Kosemund, Matthew; Martinez, Joseph

    2017-02-01

    Situational awareness (SA) describes a team's ability to perceive environmental elements, comprehend their meaning, and anticipate future events. Although SA is consistently described as a critical competency among surgical teams, there is a dearth of research identifying efficacious methods to assess and develop SA in such settings. The aim of this study was to investigate the feasibility of implementing an objective tool that has been used to measure SA in other intense and dynamic environments -the Situation Awareness Global Assessment Technique (SAGAT)-and to examine its ability to predict surgical trainee team performance. Ten team-training sessions were conducted involving 2 standardized high-fidelity trauma simulation scenarios. Teams consisted of 4 or 5 participants, and roles were randomly assigned. Team situational awareness was assessed using the SAGAT method, which involves intermittent freezes to probe trainee awareness of the situation. Team performance was assessed using the Mayo High-Performance Teamwork Scale. Hierarchical regression was used to examine SA-performance relationships for each scenario. Forty-three third-year medical students participated in the training sessions. Team SA ranged from 45% to 79% and 46% to 97% for the first and second scenarios, respectively. Additionally, team SA significantly predicted team performance for both the first scenario (F(1, 42)=19.57; P<0.001; R=0.30) and second scenario (F(1,42)=26.18, P<0.001; R=0.38). The SAGAT is a valid, reliable tool for assessing surgical trainee SA. Information provided by the SAGAT can help diagnose team performance problems, inform debriefing discussion points, and inform curriculum development endeavors.

  18. Coronal Mass Ejections and Dimmings: A Comparative Study using MHD Simulations and SDO Observations

    Science.gov (United States)

    Jin, Meng; Cheung, Mark; DeRosa, Marc L.; Nitta, Nariaki; Schrijver, Karel

    2017-08-01

    Solar coronal dimmings have been observed extensively in the past two decades. Due to their close association with coronal mass ejections (CMEs), there is a critical need to improve our understanding of the physical processes that cause dimmings and determine their relationship with CMEs. In this study, we investigate coronal dimmings by combining simulation and observational efforts. By utilizing a data-driven global magnetohydrodynamics model (AWSoM: Alfven-wave Solar Model), we simulate coronal dimmings resulting from different CME energetics and flux rope configurations. We synthesize the emissions of different EUV spectral bands/lines and compare with SDO/AIA and EVE observations. A detailed analysis of simulation and observation data suggests that the “core” dimming is mainly caused by the mass loss from the CME, while the “remote” dimming could have a different origin (e.g., plasma heating). Moreover, the interaction between the erupting flux rope with different orientations and the global solar corona could significantly influence the coronal dimming patterns. Using metrics such as dimming depth, dimming slope, and recovery time, we investigate the relationship between dimmings and CME properties (e.g., CME mass, CME speed) in the simulation. Our result suggests that coronal dimmings encode important information about CMEs. We also discuss how our knowledge about solar coronal dimmings could be extended to the study of stellar CMEs.

  19. Suicide and the Therapeutic Coroner: Inquests, Governance and the Grieving Family

    Directory of Open Access Journals (Sweden)

    Gordon Tait

    2013-11-01

    Full Text Available This study of English Coronial practice raises a number of questions about the role played by the Coroner within contemporary governance. Following observations at over 20 inquests into possible suicides and in-depth interviews with six Coroners, three preliminary issue emerged, all of which pointed to a broader and, in many ways, more significant issue. These preliminary issues are concerned with (1 the existence of considerable slippages between different Coroners over which deaths are likely to be classified as suicide; (2 the high standard of proof required and immense pressure faced by Coroners from family members at inquest to reach any verdict other than suicide, which significantly depresses likely suicide rates; and (3 Coroners feeling no professional obligation, either individually or collectively, to contribute to the production of consistent and useful social data regarding suicide, arguably rendering comparative suicide statistics relatively worthless. These concerns lead, ultimately, to the second more important question about the role expected of Coroners within social governance and within an effective, contemporary democracy. That is, are Coroners the principal officers in the public administration of death; or are they, first and foremost, a crucial part of the grieving process, one that provides important therapeutic interventions into the mental and emotional health of the community?

  20. The Kinematics and Morphology of Solar Coronal Mass Ejections

    CERN Document Server

    Byrne, Jason P

    2012-01-01

    Solar coronal mass ejections (CMEs) are large-scale eruptions of plasma and magnetic field from the Sun into the corona and interplanetary space. They are the most significant drivers of adverse space weather at Earth and other locations in the heliosphere, so it is important to understand the physics governing their eruption and propagation. However the diffuse morphology and transient nature of CMEs makes them difficult to identify and track using traditional image processing techniques. In this thesis the implementation of multiscale image processing techniques to identify and track the CME front through coronagraph images is detailed. An ellipse characterisation of the CME front is used to determine the CME kinematics and morphology with increased precision as compared to techniques used in current CME catalogues, and efforts are underway to automate this procedure for applying to a large number of CME observations for future analysis. It was found that CMEs do not simply undergo constant acceleration, bu...

  1. Introduction of the HAM-Nat examination – applicants and students admitted to the Medical Faculty in 2012-2014

    Directory of Open Access Journals (Sweden)

    Werwick, Katrin

    2015-11-01

    Full Text Available Background/aim: In the 2012/13 winter semester, the Magdeburg Medical Faculty introduced a test of knowledge for the selection of applicants. The Hamburg Assessment Test for Medicine - Natural Sciences (HAM-Nat comprises a multiple-choice test with questions on the aspects of biology, physics, chemistry and mathematics relevant to medicine, which was specifically developed for the selection of medicine applicants. The aim is to study how the HAM-Nat influences student selection, the reasons why students decide to take the test as part of their application procedure and what expectations they have of their course of study.Methods: The selection procedures applied at the university in 2011 (without HAM-Nat and in 2012-2014 (with HAM-Nat are compared. On the basis of the results of exploratory interviews, university entrants in winter semester 2013/2014 participated in a written survey on why they chose their subject and place of study and their expectations of their course of study. Results: No problems were encountered in introducing the extended selection procedure that included the HAM-Nat Test. The HAM-Nat had a great influence on the selection decision. About 65% of the students admitted would not have obtained a place if the decision had been based exclusively on their Abitur grade [grade obtained in the German school-leaving examination]. On average, male applicants obtained better HAM-Nat results than female ones. The questionnaire was answered by 147 out of 191 university entrants (77%. In the case of applicants from Saxony-Anhalt, the principle reasons for choosing the regional capital are its proximity, the social environment offered, good conditions for studying and the feel-good factor at the university. For the majority of applicants, however, particularly applicants from other federal states, the relatively good chances of admission in Magdeburg were the main reason. Conclusion: The Magdeburg Medical Faculty regards the HAM-Nat as a

  2. Microbiological and serological monitoring in hooded crow (Corvus corone cornix in the Region Lombardia, Italy

    Directory of Open Access Journals (Sweden)

    Guido Grilli

    2010-01-01

    Full Text Available The health status of 276 hooded crows (Corvus corone cornix from various provinces of Lombardy was monitored for three years. Bacteriological examination detected E. coli (76%, Campylobacter jejuni (17%, Salmonella typhimurium (11.6%, Yersinia spp. (6.5%, Clamydophila abortus and C. psittaci (2.6%; from six birds showing severe prostration Pasteurella multocida was isolated. Virological and serological tests were negative for Avian Influenza virus (AIV, West Nile virus (WNV and only three samples were positive for Newcastle disease virus (NDV but only at serology (titre 1:16.

  3. Examining patterns in medication documentation of trade and generic names in an academic family practice training centre.

    Science.gov (United States)

    Summers, Alexander; Ruderman, Carly; Leung, Fok-Han; Slater, Morgan

    2017-09-22

    Studies in the United States have shown that physicians commonly use brand names when documenting medications in an outpatient setting. However, the prevalence of prescribing and documenting brand name medication has not been assessed in a clinical teaching environment. The purpose of this study was to describe the use of generic versus brand names for a select number of pharmaceutical products in clinical documentation in a large, urban academic family practice centre. A retrospective chart review of the electronic medical records of the St. Michael's Hospital Academic Family Health Team (SMHAFHT). Data for twenty commonly prescribed medications were collected from the Cumulative Patient Profile as of August 1, 2014. Each medication name was classified as generic or trade. Associations between documentation patterns and physician characteristics were assessed. Among 9763 patients prescribed any of the twenty medications of interest, 45% of patient charts contained trade nomenclature exclusively. 32% of charts contained only generic nomenclature, and 23% contained a mix of generic and trade nomenclature. There was large variation in use of generic nomenclature amongst physicians, ranging from 19% to 93%. Trade names in clinical documentation, which likely reflect prescribing habits, continue to be used abundantly in the academic setting. This may become part of the informal curriculum, potentially facilitating undue bias in trainees. Further study is needed to determine characteristics which influence use of generic or trade nomenclature and the impact of this trend on trainees' clinical knowledge and decision-making.

  4. Familiarity with the experimenter influences the performance of Common ravens (Corvus corax) and Carrion crows (Corvus corone corone) in cognitive tasks.

    Science.gov (United States)

    Cibulski, Lara; Wascher, Claudia A F; Weiss, Brigitte M; Kotrschal, Kurt

    2014-03-01

    When humans and animals interact with one another over an extended time span they familiarise and may develop a relationship, which can exert an influence on both partners. For example, the behaviour of an animal in experiments may be affected by its relationship to the human experimenter. However, few studies have systematically examined the impact of human-animal relationships on experimental results. In the present study we investigated if familiarity with a human experimenter influences the performance of Common ravens (Corvus corax) and Carrion crows (Corvus corone corone) in interactive tasks. Birds were tested in two interactive cognitive tasks (exchange, object choice) by several experimenters representing different levels of familiarity (long and short-term). Our findings show that the birds participated more often in both tasks and were more successful in the exchange task when working with long-term experimenters than when working with short-term experimenters. Behavioural observations indicate that anxiety did not inhibit experimental performance but that the birds' motivation to work differed between the two kinds of experimenters, familiar and less familiar. We conclude that human-animal relationships (i.e. familiarity) may affect the experimental performance of corvids in interactive cognitive tasks.

  5. Laughing through this pain: medical clowning during examination of sexually abused children: an innovative approach.

    Science.gov (United States)

    Tener, Dafna; Lev-Wiesel, Rachel; Franco, Nessia Lang; Ofir, Shoshi

    2010-03-01

    This study examined the role of medical clowns during medical examinations of children who were sexually abused. Three case studies are described, illustrating diverse interactions among the victimized child, the medical clown, and the medical forensical examiner during medical forensic examinations held at the Tene Center for Sexually Abused Children, Poria-Pade Medical Center, Israel. The results indicated that medical clowns play a unique role both in lowering anxiety and fear among children before and during the unpleasant forensic examination as well as in mitigating potential retraumatization of the sexual abuse event resulting from the medical examination. The medical clown was found to assist in creating a pleasant and calm atmosphere, thus improving the child's cooperation during the examination.

  6. Stellar winds, dead zones, and coronal mass ejections

    CERN Document Server

    Keppens, R

    1999-01-01

    Axisymmetric stellar wind solutions are presented, obtained by numerically solving the ideal magnetohydrodynamic (MHD) equations. Stationary solutions are critically analysed using the knowledge of the flux functions. These flux functions enter in the general variational principle governing all axisymmetric stationary ideal MHD equilibria. The magnetized wind solutions for (differentially) rotating stars contain both a `wind' and a `dead' zone. We illustrate the influence of the magnetic field topology on the wind acceleration pattern, by varying the coronal field strength and the extent of the dead zone. This is evident from the resulting variations in the location and appearance of the critical curves where the wind speed equals the slow, Alfven, and fast speed. Larger dead zones cause effective, fairly isotropic acceleration to super-Alfvenic velocities as the polar, open field lines are forced to fan out rapidly with radial distance. A higher field strength moves the Alfven transition outwards. In the ecl...

  7. Interplanetary Coronal Mass Ejections observed by MESSENGER and Venus Express

    CERN Document Server

    Good, S W

    2015-01-01

    Interplanetary coronal mass ejections (ICMEs) observed by the MESSENGER (MES) and Venus Express (VEX) spacecraft have been catalogued and analysed. The ICMEs were identified by a relatively smooth rotation of the magnetic field direction consistent with a flux rope structure, coinciding with a relatively enhanced magnetic field strength. A total of 35 ICMEs were found in the surveyed MES data (primarily from March 2007 to April 2012), and 84 ICMEs in the surveyed VEX data (from May 2006 to December 2013). The ICME flux rope configurations have been determined. Ropes with northward leading edges were about four times more common than ropes with southward leading edges, in agreement with a previously established solar cycle dependence. Ropes with low inclinations to the solar equatorial plane were about four times more common than ropes with high inclinations, possibly an observational effect. Left and right-handed ropes were observed in almost equal numbers. In addition, data from MES, VEX, STEREO-A, STEREO-B ...

  8. Volvulus of the gall bladder diagnosed by ultrasonography, computed tomography, coronal magnetic resonance imaging and magnetic resonance cholangio-pancreatography

    Institute of Scientific and Technical Information of China (English)

    Nobuhisa Matsuhashi; Chihiro Tanaka; Atsushi Misao; Shinji Ogura; Shinichi Satake; Kazunori Yawata; Eri Asakawa; Takashi Mizoguchi; Masayuki Kanematsu; Hiroshi Kondo; Ichiro Yasuda; Kenichi Nonaka

    2006-01-01

    A 54-year-old woman was admitted to our hospital with the complaint of right upper quadrant pain. Upon physical examination the vital signs of the patient were within normal ranges. Ultrasonography and computed tomography (CT) examination of the abdomen was obtained, which demonstrated a large dilatated cystic structure, measuring approximately 68.6 mm ×48.6 mm, with marked distension and inflammation.Additionally, the enhanced CT was characterized by the non-enhanced wall of the gallbladder. As the third examination in this study, magnetic resonance imaging(MRI), namely coronal MRI and magnetic resonance cholangio-pancreatography (MRCP), were performed.The MRCP demonstrated a dilatation of the gallbladder but detected no neck of the gallbladder. Simple cholecystectomy was performed. Macroscopic findings included a distended and gangrenous gallbladder, and closer examination revealed a counterclockwise torsion of 360 degrees on the gallbladder mesentery. Coronal MRI and MRCP showing characteristic radiography may be useful in making a definitive diagnosis.

  9. PAH and soot emissions from burning components of medical waste: examination/surgical gloves and cotton pads.

    Science.gov (United States)

    Levendis, Y A; Atal, A; Carlson, J B; Quintana, M D

    2001-01-01

    This is a laboratory investigation on the emissions from batch combustion of representative infectious ("red bag") medical waste components, such as medical examination latex gloves and sterile cotton pads. Plastics and cloth account for the majority of the red bag wastes by mass and, certainly, by volume. An electrically heated, horizontal muffle furnace was used for batch combustion of small quantities of shredded fuels (0.5-1.5 g) at a gas temperature of approximately 1000 degrees C. The residence time of the post-combustion gases in the furnace was approximately 1 s. At the exit of the furnace, the following emissions were measured: CO, CO2, NOx, particulates and polynuclear aromatic compounds (PACs). The first three gaseous emissions were measured with continuous gas analyzers. Soot and PAC emissions were simultaneously measured by passing the furnace effluent through a filter (to collect condensed-phase PACs) and a bed of XAD-4 adsorbent (to capture gaseous-phase PACs). Analysis involved soxhlet extraction, followed by gas chromatography-mass spectrometry (GC-MS). Results were contrasted with previously measured emissions from batch combustion of pulverized coal and tire-derived fuel (TDF) under similar conditions. Results showed that the particulate soot) and cumulative PAC emissions from batch combustion of latex gloves were more than an order of magnitude higher than those from cotton pads. The following values are indicative of the relative trends (but not necessarily absolute values) in emission yields: 26% of the mass of the latex was converted to soot, 11% of which was condensed PAC. Only 2% of the mass of cotton pads was converted to soot, and only 3% of the weight of that soot was condensed PAC. The PAC yields from latex were comparable to those from TDF. The PAC yields from cotton were higher than those from coal. A notable exception to this trend was that the three-ring gas-phase PAC yields from cotton were more significant than those from latex

  10. Coronal influence on dynamos

    CERN Document Server

    Warnecke, Jörn

    2013-01-01

    We report on turbulent dynamo simulations in a spherical wedge with an outer coronal layer. We apply a two-layer model where the lower layer represents the convection zone and the upper layer the solar corona. This setup is used to study the coronal influence on the dynamo action beneath the surface. Increasing the radial coronal extent gradually to three times the solar radius and changing the magnetic Reynolds number, we find that dynamo action benefits from the additional coronal extent in terms of higher magnetic energy in the saturated stage. The flux of magnetic helicity can play an important role in this context.

  11. Coronal Magnetic Flux Rope Equilibria and Magnetic Helicity

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Using a 2.5-dimensional (2.5-D) ideal MHD model, this paper ana lyzes the equilibrium properties of coronal magnetic flux ropes in a bipolar ambient magnetic field. It is found that the geometrical features of the magnetic flux rope,including the height of the rope axis, the half-width of the rope, and the length of the vertical current sheet below the rope, are determined by a single magnetic parameter, the magnetic helicity, which is the sum of the self-helicity of the rope and the mutual helicity between the rope field and the ambient magnetic field. All the geometrical parameters increase monotonically with increasing magnetic helicity.The implication of this result in solar active phenomena is briefly discussed.

  12. A cloud-based electronic medical record for scheduling, tracking, and documenting examinations and treatment of retinopathy of prematurity.

    Science.gov (United States)

    Arnold, Robert W; Jacob, Jack; Matrix, Zinnia

    2012-01-01

    Screening by neonatologists and staging by ophthalmologists is a cost-effective intervention, but inadvertent missed examinations create a high liability. Paper tracking, bedside schedule reminders, and a computer scheduling and reminder program were compared for speed of input and retrospective missed examination rate. A neonatal intensive care unit (NICU) process was then programmed for cloud-based distribution for inpatient and outpatient retinopathy of prematurity monitoring. Over 11 years, 367 premature infants in one NICU were prospectively monitored. The initial paper system missed 11% of potential examinations, the Windows server-based system missed 2%, and the current cloud-based system missed 0% of potential inpatient and outpatient examinations. Computer input of examinations took the same or less time than paper recording. A computer application with a deliberate NICU process improved the proportion of eligible neonates getting their scheduled eye examinations in a timely manner. Copyright 2012, SLACK Incorporated.

  13. Outbound medical tourism from Mongolia: a qualitative examination of proposed domestic health system and policy responses to this trend.

    Science.gov (United States)

    Snyder, Jeremy; Byambaa, Tsogtbaatar; Johnston, Rory; Crooks, Valorie A; Janes, Craig; Ewan, Melanie

    2015-05-03

    Medical tourism is the practice of traveling across international boundaries in order to access medical care. Residents of low-to-middle income countries with strained or inadequate health systems have long traveled to other countries in order to access procedures not available in their home countries and to take advantage of higher quality care elsewhere. In Mongolia, for example, residents are traveling to China, Japan, Thailand, South Korea, and other countries for care. As a result of this practice, there are concerns that travel abroad from Mongolia and other countries risks impoverishing patients and their families. In this paper, we present findings from 15 interviews with Mongolian medical tourism stakeholders about the impacts of, causes of, and responses to outbound medical tourism. These findings were developed using a case study methodology that also relied on tours of health care facilities and informal discussions with citizens and other stakeholders during April, 2012. Based on these findings, health policy changes are needed to address the outflow of Mongolian medical tourists. Key areas for reform include increasing funding for the Mongolian health system and enhancing the efficient use of these funds, improving training opportunities and incentives for health workers, altering the local culture of care to be more supportive of patients, and addressing concerns of corruption and favouritism in the health system. While these findings are specific to the Mongolian health system, other low-to-middle income countries experiencing outbound medical tourism will benefit from consideration of how these findings apply to their own contexts. As medical tourism is increasing in visibility globally, continued research on its impacts and context-specific policy responses are needed.

  14. The Coronal Loop Inventory Project: Expanded Analysis and Results

    Science.gov (United States)

    Schmelz, J. T.; Christian, G. M.; Chastain, R. A.

    2016-11-01

    We have expanded upon earlier work that investigates the relative importance of coronal loops with isothermal versus multithermal cross-field temperature distributions. These results are important for determining if loops have substructure in the form of unresolved magnetic strands. We have increased the number of loops targeted for temperature analysis from 19 to 207 with the addition of 188 new loops from multiple regions. We selected all loop segments visible in the 171 Å images of the Atmospheric Imaging Assembly (AIA) that had a clean background. Eighty-six of the new loops were rejected because they could not be reliably separated from the background in other AIA filters. Sixty-one loops required multithermal models to reproduce the observations. Twenty-eight loops were effectively isothermal, that is, the plasma emission to which AIA is sensitive could not be distinguished from isothermal emission, within uncertainties. Ten loops were isothermal. Also, part of our inventory was one small flaring loop, one very cool loop whose temperature distribution could not be constrained by the AIA data, and one loop with inconclusive results. Our survey can confirm an unexpected result from the pilot study: we found no isothermal loop segments where we could properly use the 171-to-193 ratio method, which would be similar to the analysis done for many loops observed with TRACE and EIT. We recommend caution to observers who assume the loop plasma is isothermal, and hope that these results will influence the direction of coronal heating models and the effort modelers spend on various heating scenarios.

  15. 76 FR 44086 - Agency Information Collection (Report of Medical Examination for Disability Evaluation) Activity...

    Science.gov (United States)

    2011-07-22

    ... AFFAIRS Agency Information Collection (Report of Medical Examination for Disability Evaluation) Activity.... 2900-0052.'' SUPPLEMENTARY INFORMATION: Title: Report of Medical Examination for Disability Evaluation... submit the collection of information abstracted below to the Office of Management and Budget (OMB)...

  16. Validity and reliability of a novel written examination to assess knowledge and clinical decision making skills of medical students on the surgery clerkship.

    Science.gov (United States)

    Reinert, Anna; Berlin, Ana; Swan-Sein, Aubrie; Nowygrod, Roman; Fingeret, Abbey

    2014-02-01

    The Surgery Clerkship Clinical Skills Examination (CSE) is a novel written examination developed to assess the surgical knowledge, clinical decision making, communication skills, and professionalism of medical students on the surgery clerkship. This study was undertaken to determine its validity. Data were prospectively collected from July 2011 through February 2013. Multivariate linear and logistic regression analyses were used to assess score trend; convergent validity with National Board of Medical Examiners surgery and medicine subject scores, United States Medical Licensing Examination Step 1 and Step 2 Clinical Knowledge scores, and evaluation of clinical reasoning and fund of knowledge; and the effect of clerkship order. Exam reliability was assessed using a modified Cronbach's α statistic. During the study period, 262 students completed the CSE, with a normal distribution of performance. United States Medical Licensing Examination Step 2 Clinical Knowledge score and end-of-clerkship evaluations of fund of knowledge and clinical reasoning predicted CSE score. Performance on the CSE was independent of clerkship order or prior clerkships. The modified Cronbach's α value for the exam was .67. The CSE is an objective, valid, reliable instrument for assessing students on the surgery clerkship, independent of clerkship order. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. CORONAL MAGNETIC FIELDS DERIVED FROM SIMULTANEOUS MICROWAVE AND EUV OBSERVATIONS AND COMPARISON WITH THE POTENTIAL FIELD MODEL

    Energy Technology Data Exchange (ETDEWEB)

    Miyawaki, Shun; Nozawa, Satoshi [Department of Science, Ibaraki University, Mito, Ibaraki 310-8512 (Japan); Iwai, Kazumasa; Shibasaki, Kiyoto [Nobeyama Solar Radio Observatory, National Astronomical Observatory of Japan, Minamimaki, Nagano 384-1305 (Japan); Shiota, Daikou, E-mail: shunmi089@gmail.com [Solar-Terrestrial Environment Laboratory, Nagoya University, Nagoya, Aichi 464-8601 (Japan)

    2016-02-10

    We estimated the accuracy of coronal magnetic fields derived from radio observations by comparing them to potential field calculations and the differential emission measure measurements using EUV observations. We derived line-of-sight components of the coronal magnetic field from polarization observations of the thermal bremsstrahlung in the NOAA active region 11150, observed around 3:00 UT on 2011 February 3 using the Nobeyama Radioheliograph at 17 GHz. Because the thermal bremsstrahlung intensity at 17 GHz includes both chromospheric and coronal components, we extracted only the coronal component by measuring the coronal emission measure in EUV observations. In addition, we derived only the radio polarization component of the corona by selecting the region of coronal loops and weak magnetic field strength in the chromosphere along the line of sight. The upper limits of the coronal longitudinal magnetic fields were determined as 100–210 G. We also calculated the coronal longitudinal magnetic fields from the potential field extrapolation using the photospheric magnetic field obtained from the Helioseismic and Magnetic Imager. However, the calculated potential fields were certainly smaller than the observed coronal longitudinal magnetic field. This discrepancy between the potential and the observed magnetic field strengths can be explained consistently by two reasons: (1) the underestimation of the coronal emission measure resulting from the limitation of the temperature range of the EUV observations, and (2) the underestimation of the coronal magnetic field resulting from the potential field assumption.

  18. Observations and Numerical Models of Solar Coronal Heating Associated with Spicules

    Science.gov (United States)

    De Pontieu, B.; De Moortel, I.; Martinez-Sykora, J.; McIntosh, S. W.

    2017-08-01

    Spicules have been proposed as significant contributors to the mass and energy balance of the corona. While previous observations have provided a glimpse of short-lived transient brightenings in the corona that are associated with spicules, these observations have been contested and are the subject of a vigorous debate both on the modeling and the observational side. Therefore, it remains unclear whether plasma is heated to coronal temperatures in association with spicules. We use high-resolution observations of the chromosphere and transition region (TR) with the Interface Region Imaging Spectrograph and of the corona with the Atmospheric Imaging Assembly on board the Solar Dynamics Observatory to show evidence of the formation of coronal structures associated with spicular mass ejections and heating of plasma to TR and coronal temperatures. Our observations suggest that a significant fraction of the highly dynamic loop fan environment associated with plage regions may be the result of the formation of such new coronal strands, a process that previously had been interpreted as the propagation of transient propagating coronal disturbances. Our observations are supported by 2.5D radiative MHD simulations that show heating to coronal temperatures in association with spicules. Our results suggest that heating and strong flows play an important role in maintaining the substructure of loop fans, in addition to the waves that permeate this low coronal environment.

  19. How can we ensure that the coroner's autopsy is not an invasion of human rights?

    Science.gov (United States)

    Leadbeatter, Stephen; James, Ryk

    2017-06-23

    Despite public inquiries, and some changes to legislation following high-profile multiple homicides that were not detected by autopsy, coroners continue to rely largely on the autopsy. Regardless of the extent of quality failings and excess deaths at some hospitals, not detected through the coroner system, the autopsy is scarcely used by hospitals to monitor standards and educate. To explore when a compulsory medicolegal autopsy should, and should not, be used. Two hundred and thirty-six cases referred to a senior coroner were evaluated by pathologists with long experience of forensic, coronial and hospital autopsies, using detailed antecedent medical and circumstantial information: after their advice, the senior coroner decided what kind of autopsy provided sufficient information for his purposes. In nearly 40% (n=88) of deaths where the senior coroner accepted jurisdiction, issues raised could be resolved through analysis of medical records and antecedent information, supplemented only by detailed external examination of the body. Timely provision of sufficient information allows informed decisions about the requirement for, and nature and extent of, medical investigations into a death: unnecessary post mortem dissection is avoided, protecting the rights, under Articles 8 and 9 of the Human Rights Act 1998, of the bereaved to privacy, family life and religious practice. Although improvements in healthcare can undoubtedly result from detailed coroners' inquiries, those deaths where the matters investigated relate only to the accuracy of a natural cause of death or sit with a healthcare provider's internal quality assurance, should be investigated by the healthcare system in collaboration with the bereaved. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Decay of Activity Complexes, Formation of Unipolar Magnetic Regions, and Coronal Holes in Their Causal Relation

    Science.gov (United States)

    Golubeva, E. M.; Mordvinov, A. V.

    2016-12-01

    The peculiar development of solar activity in the current cycle resulted in an asynchronous reversal of the Sun's polar fields. The asymmetry is also observed in the formation of polar coronal holes. A stable coronal hole was first formed at the South Pole, despite the later polar-field reversal there. The aim of this study is to understand the processes making this situation possible. Synoptic magnetic maps from the Global Oscillation Network Group and corresponding coronal-hole maps from the Extreme ultraviolet Imaging Telescope onboard the Solar and Heliospheric Observatory and the Atmospheric Imaging Assembly onboard the Solar Dynamics Observatory are analyzed here to study the causal relationship between the decay of activity complexes, evolution of large-scale magnetic fields, and formation of coronal holes. Ensembles of coronal holes associated with decaying active regions and activity complexes are presented. These ensembles take part in global rearrangements of the Sun's open magnetic flux. In particular, the south polar coronal hole was formed from an ensemble of coronal holes that came into existence after the decay of multiple activity complexes observed during 2014.

  1. Graduates of different UK medical schools show substantial differences in performance on MRCP(UK Part 1, Part 2 and PACES examinations

    Directory of Open Access Journals (Sweden)

    Mollon Jennifer

    2008-02-01

    Full Text Available Abstract Background The UK General Medical Council has emphasized the lack of evidence on whether graduates from different UK medical schools perform differently in their clinical careers. Here we assess the performance of UK graduates who have taken MRCP(UK Part 1 and Part 2, which are multiple-choice assessments, and PACES, an assessment using real and simulated patients of clinical examination skills and communication skills, and we explore the reasons for the differences between medical schools. Method We perform a retrospective analysis of the performance of 5827 doctors graduating in UK medical schools taking the Part 1, Part 2 or PACES for the first time between 2003/2 and 2005/3, and 22453 candidates taking Part 1 from 1989/1 to 2005/3. Results Graduates of UK medical schools performed differently in the MRCP(UK examination between 2003/2 and 2005/3. Part 1 and 2 performance of Oxford, Cambridge and Newcastle-upon-Tyne graduates was significantly better than average, and the performance of Liverpool, Dundee, Belfast and Aberdeen graduates was significantly worse than average. In the PACES (clinical examination, Oxford graduates performed significantly above average, and Dundee, Liverpool and London graduates significantly below average. About 60% of medical school variance was explained by differences in pre-admission qualifications, although the remaining variance was still significant, with graduates from Leicester, Oxford, Birmingham, Newcastle-upon-Tyne and London overperforming at Part 1, and graduates from Southampton, Dundee, Aberdeen, Liverpool and Belfast underperforming relative to pre-admission qualifications. The ranking of schools at Part 1 in 2003/2 to 2005/3 correlated 0.723, 0.654, 0.618 and 0.493 with performance in 1999–2001, 1996–1998, 1993–1995 and 1989–1992, respectively. Conclusion Candidates from different UK medical schools perform differently in all three parts of the MRCP(UK examination, with the

  2. 3D Global Coronal Density Structure and Associated Magnetic Field near Solar Maximum

    Directory of Open Access Journals (Sweden)

    Maxim Kramar

    2016-08-01

    Full Text Available Measurement of the coronal magnetic field is a crucial ingredient in understanding the nature of solar coronal dynamic phenomena at all scales. We employ STEREO/COR1 data obtained near maximum of solar activity in December 2012 (Carrington rotation, CR 2131 to retrieve and analyze the three-dimensional (3D coronal electron density in the range of heights from $1.5$ to $4 R_odot$ using a tomography method and qualitatively deduce structures of the coronal magnetic field. The 3D electron density analysis is complemented by the 3D STEREO/EUVI emissivity in 195 AA band obtained by tomography for the same CR period. We find that the magnetic field configuration during CR 2131 has a tendency to become radially open at heliocentric distances below $sim 2.5 R_odot$. We compared the reconstructed 3D coronal structures over the CR near the solar maximum to the one at deep solar minimum. Results of our 3D density reconstruction will help to constrain solar coronal field models and test the accuracy of the magnetic field approximations for coronal modeling.

  3. 3D Global Coronal Density Structure and Associated Magnetic Field near Solar Maximum

    Science.gov (United States)

    Kramar, Maxim; Airapetian, Vladimir; Lin, Haosheng

    2016-08-01

    Measurement of the coronal magnetic field is a crucial ingredient in understanding the nature of solar coronal dynamic phenomena at all scales. We employ STEREO/COR1 data obtained near maximum of solar activity in December 2012 (Carrington rotation, CR 2131) to retrieve and analyze the three-dimensional (3D) coronal electron density in the range of heights from 1.5 to 4 R_⊙ using a tomography method and qualitatively deduce structures of the coronal magnetic field. The 3D electron density analysis is complemented by the 3D STEREO/EUVI emissivity in 195 Å band obtained by tomography for the same CR period. We find that the magnetic field configuration during CR 2131 has a tendency to become radially open at heliocentric distances below ˜ 2.5 R_⊙. We compared the reconstructed 3D coronal structures over the CR near the solar maximum to the one at deep solar minimum. Results of our 3D density reconstruction will help to constrain solar coronal field models and test the accuracy of the magnetic field approximations for coronal modeling.

  4. MAGNETOHYDRODYNAMIC WAVES AND CORONAL HEATING: UNIFYING EMPIRICAL AND MHD TURBULENCE MODELS

    Energy Technology Data Exchange (ETDEWEB)

    Sokolov, Igor V.; Van der Holst, Bart; Oran, Rona; Jin, Meng; Manchester, Ward B. IV; Gombosi, Tamas I. [Department of AOSS, University of Michigan, 2455 Hayward Street, Ann Arbor, MI 48109 (United States); Downs, Cooper [Predictive Science Inc., 9990 Mesa Rim Road, Suite 170, San Diego, CA 92121 (United States); Roussev, Ilia I. [Institute for Astronomy, University of Hawaii, 2680 Woodlawn Drive, Honolulu, HI 96822 (United States); Evans, Rebekah M., E-mail: igorsok@umich.edu [NASA Goddard Space Flight Center, Space Weather Lab, 8800 Greenbelt Road, Greenbelt, MD 20771 (United States)

    2013-02-10

    We present a new global model of the solar corona, including the low corona, the transition region, and the top of the chromosphere. The realistic three-dimensional magnetic field is simulated using the data from the photospheric magnetic field measurements. The distinctive feature of the new model is incorporating MHD Alfven wave turbulence. We assume this turbulence and its nonlinear dissipation to be the only momentum and energy source for heating the coronal plasma and driving the solar wind. The difference between the turbulence dissipation efficiency in coronal holes and that in closed field regions is because the nonlinear cascade rate degrades in strongly anisotropic (imbalanced) turbulence in coronal holes (no inward propagating wave), thus resulting in colder coronal holes, from which the fast solar wind originates. The detailed presentation of the theoretical model is illustrated with the synthetic images for multi-wavelength EUV emission compared with the observations from SDO AIA and STEREO EUVI instruments for the Carrington rotation 2107.

  5. 78 FR 27343 - Medical Examiner's Certification Integration

    Science.gov (United States)

    2013-05-10

    ... Information System CLP Commercial Leaner's Permit CMV Commercial Motor Vehicle DC Doctors of Chiropractic DO... changes in the standards or advisory guidelines relating to hypertension and use of Schedule I drugs...

  6. The Sun's Global Photospheric and Coronal Magnetic Fields: Observations and Models

    Directory of Open Access Journals (Sweden)

    Duncan Mackay

    2012-11-01

    Full Text Available In this review, our present day understanding of the Sun’s global photospheric and coronal magnetic fields is discussed from both observational and theoretical viewpoints. Firstly, the large-scale properties of photospheric magnetic fields are described, along with recent advances in photospheric magnetic flux transport models. Following this, the wide variety of theoretical models used to simulate global coronal magnetic fields are described. From this, the combined application of both magnetic flux transport simulations and coronal modeling techniques to describe the phenomena of coronal holes, the Sun’s open magnetic flux and the hemispheric pattern of solar filaments is discussed. Finally, recent advances in non-eruptive global MHD models are described. While the review focuses mainly on solar magnetic fields, recent advances in measuring and modeling stellar magnetic fields are described where appropriate. In the final section key areas of future research are identified.

  7. THE COOLING OF CORONAL PLASMAS. IV. CATASTROPHIC COOLING OF LOOPS

    Energy Technology Data Exchange (ETDEWEB)

    Cargill, P. J. [Space and Atmospheric Physics, The Blackett Laboratory, Imperial College, London SW7 2BW (United Kingdom); Bradshaw, S. J., E-mail: p.cargill@imperial.ac.uk [Department of Physics and Astronomy, Rice University, Houston, TX 77005 (United States)

    2013-07-20

    We examine the radiative cooling of coronal loops and demonstrate that the recently identified catastrophic cooling is due to the inability of a loop to sustain radiative/enthalpy cooling below a critical temperature, which can be >1 MK in flares, 0.5-1 MK in active regions, and 0.1 MK in long tenuous loops. Catastrophic cooling is characterized by a rapid fall in coronal temperature, while the coronal density changes by a small amount. Analytic expressions for the critical temperature are derived and show good agreement with numerical results. This effect considerably limits the lifetime of coronal plasmas below the critical temperature.

  8. Exam preparation course in obstetrics and gynecology for the German Medical State Examination: proof of concept and implications for the recruitment of future residents.

    Science.gov (United States)

    Riedel, Fabian; Fremd, Carlo; Tabatabai, Patrik; Smetanay, Katharina; Doster, Anne; Heil, Joerg; Schuetz, Florian; Sohn, Christof; Hennigs, André

    2016-11-01

    Today´s written part of the medical state examination requires students to retrieve a comprehensive amount of knowledge in a limited period of time. Therefore, the main study objectives were to implement and to evaluate a two-day exam preparation course for the German Medical State Examination in obstetrics and gynecology. The project evaluation focused on acceptability, satisfaction and the gain of knowledge for the participants of such a face-to-face course. The two-day intensive training for senior medical students offered a review of the entire exam-relevant content in the field of obstetrics and gynecology in combination with interactive discussions along selected exam questions. Skill gains were assessed using pre- and post-course multiple choice tests. In addition, a qualitative questionnaire assessed attitudes and satisfaction of course participants. A total of 101 fifth year senior medical students from Heidelberg University Medical School participated in the two pilot courses (summer 2014 and winter 2015). Pre- and post-course tests showed a significant skill-gain from 14.9 to 18.0 points [of a maximum of 20; pre-post difference 95 % CI (2.21; 3.98), t test: p obstetrics and gynecology is feasible, effective and highly appreciated by senior medical students preparing for the Second German Medical State Examination. It further suggests surplus value for academic clinical departments to recruit future residents. Methods and tools presented in this paper are intended to inspire and guide clinical colleagues in implementing the format at their respective universities.

  9. Evaluation of reformatted sagittal CT images for measurement of condylar position. Comparison between original axial and coronal images

    Energy Technology Data Exchange (ETDEWEB)

    Hiruma, Takayoshi; Funato, Masahiko; Suganuma, Takeshi; Shinya, Akiyuki; Furuya, Ryoichi; Kawawa, Tadaharu; Seki, Kenji; Okano, Tomohiro [Showa Univ., Tokyo (Japan). School of Dentistry

    1995-09-01

    Accurate measurement of the condylar position is important for diagnosis and treatment of temporomandibular joint dysfunction. Conventional radiographic techniques have been used for this purpose and the recent advance of computed tomography (CT) is applicable to temporomandibular joints. The accuracy of CT in the measurement of the condylar position is still unclear. The purpose of this study was to evaluate the measurement accuracy of the condylar position on reformatted sagittal CT images. Six TMJs obtained from dried skulls were used. The TMJs were examined using a CT scanner with 1 mm thickness/interval in the axial and coronal directions. The visibility of the condyle and fossa on the reformatted sagittal images created were evaluated by measuring the joint space defined in our study. The results were as follows: (1) The superior surface of the condyle and the deepest part of the fossa were obscured in the reformatted images created from the axial scan and coronal scan projected at 60deg to the F-H plane. (2) The reformatted images from the coronal scan projected at 90deg, 80deg or 70deg to the F-H plane clearly depicted the condyle and fossa, the reproducibility of the measurement on these images mentioned above was less than 0.1 mm. The results indicated that the coronal scan from 90deg to 70deg to the F-H plane is more accurate than the axial scan for determining the condylar position on the reformatted sagittal images. (author).

  10. Coronal holes near the equatorial plane and the solar wind abundance of iron

    Science.gov (United States)

    Ogilvie, K. W.; Coplan, M. A.; Yellin, K. A.

    1996-03-01

    Composition analysis of the solar wind from two equatorial coronal holes has been carried out with the Ion Composition Instrument on the ISEE-3 spacecraft. The abundances of oxygen, neon and iron were determined as coronal hole-related material flowed past the spacecraft. The results show that the edges of the hole-related flow are sharply defined with abundances closer to the abundances in the photosphere than in the slower solar wind. These results are similar to those found in flows from the southern polar coronal hole and suggest an underlying unity between the polar and equatorial regions of the sun.

  11. Self-Consistent MHD Modeling of a Coronal Mass Ejection, Coronal Dimming, and a Giant Cusp-Shaped Arcade Formation

    CERN Document Server

    Shiota, D; Chen, P F; Yamamoto, T T; Sakajiri, T; Shibata, K; Shiota, Daikou; Isobe, Hiroaki; Yamamoto, Tetsuya T.; Sakajiri, Takuma; Shibata, Kazunari

    2005-01-01

    We performed magnetohydrodynamic simulation of coronal mass ejections (CMEs) and associated giant arcade formations, and the results suggested new interpretations of observations of CMEs. We performed two cases of the simulation: with and without heat conduction. Comparing between the results of the two cases, we found that reconnection rate in the conductive case is a little higher than that in the adiabatic case and the temperature of the loop top is consistent with the theoretical value predicted by the Yokoyama-Shibata scaling law. The dynamical properties such as velocity and magnetic fields are similar in the two cases, whereas thermal properties such as temperature and density are very different.In both cases, slow shocks associated with magnetic reconnectionpropagate from the reconnection region along the magnetic field lines around the flux rope, and the shock fronts form spiral patterns. Just outside the slow shocks, the plasma density decreased a great deal. The soft X-ray images synthesized from t...

  12. Associations of Undergoing a Routine Medical Examination or Not with Prevalence Rates of Hypertension and Diabetes Mellitus: A Cross-Sectional Study.

    Science.gov (United States)

    Zhang, Lin; Zhang, Wei; Zhang, Lingling; Tian, Danping; Li, Li; Deng, Xin; Deng, Jing; Ning, Peishan; Hu, Guoqing

    2016-06-23

    Undergoing a routine medical examination may be associated with the prevalence rate of chronic diseases from a population-based household interview survey. However, this important issue has not been examined so far. Data came from the first health service household interview of Hunan province, China, in 2013. A Rao-Scott chi-square test was performed to examine the difference in prevalence rates between subgroups. Adjusted odds ratio (OR) was calculated using the PROC SURVEYLOGISTIC procedure of SAS9.1 statistical software. In total, 24,282 residents of 8400 households were surveyed. A higher proportion of elderly adults had undergone a medical examination within the prior 12 months compared with young adults (≥65 years, 60%; 45-64 years, 46%; 18-44 years, 37%). After controlling for location, sex, and household income per capita, undergoing a medical examination was significantly associated with high prevalence rates of hypertension (adjusted OR: 2.0, 95% CI: 1.1-3.5) and of diabetes mellitus (adjusted OR: 3.3, 95% CI: 1.7-6.5) for young adults aged 18-44 years. The associations were not statistically significant for age groups 45-64 years and 65 years or older. The prevalence rates of hypertension and diabetes mellitus may be seriously underestimated for young adults not undergoing a routine medical examination in a health household interview survey.

  13. Associations of Undergoing a Routine Medical Examination or Not with Prevalence Rates of Hypertension and Diabetes Mellitus: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Lin Zhang

    2016-06-01

    Full Text Available Background: Undergoing a routine medical examination may be associated with the prevalence rate of chronic diseases from a population-based household interview survey. However, this important issue has not been examined so far. Methods: Data came from the first health service household interview of Hunan province, China, in 2013. A Rao–Scott chi-square test was performed to examine the difference in prevalence rates between subgroups. Adjusted odds ratio (OR was calculated using the PROC SURVEYLOGISTIC procedure of SAS9.1 statistical software. Results: In total, 24,282 residents of 8400 households were surveyed. A higher proportion of elderly adults had undergone a medical examination within the prior 12 months compared with young adults (≥65 years, 60%; 45–64 years, 46%; 18–44 years, 37%. After controlling for location, sex, and household income per capita, undergoing a medical examination was significantly associated with high prevalence rates of hypertension (adjusted OR: 2.0, 95% CI: 1.1–3.5 and of diabetes mellitus (adjusted OR: 3.3, 95% CI: 1.7–6.5 for young adults aged 18–44 years. The associations were not statistically significant for age groups 45–64 years and 65 years or older. Conclusion: The prevalence rates of hypertension and diabetes mellitus may be seriously underestimated for young adults not undergoing a routine medical examination in a health household interview survey.

  14. [Psychological aspects of public activity of a forensic medical examiner].

    Science.gov (United States)

    Bashkireva, E A; Buromskiĭ, I V

    2009-01-01

    In the recent years, professional activity of forensic medical examiners has been gaining publicity which necessitates knowledge of individual psychologic personality traits, the ability to effectively communicate, and high vocational culture on the part of each specialist. The specific character of professional contacts of a forensic medical expert is self-evident taking into consideration that he (she) has to deal with a great variety of persons including law enforcement officials, law breakers and criminal offence victims, men and women, young and aged people, representatives of different social groups, subjects in a specific emotional state, etc. In order to organize efficacious cooperation with all these individuals, the expert must develop high communicative competence, possess knowledge of psychology of communication, abilities and skills necessary for the establishment and maintenance of professional and business contacts.

  15. A study of the academic performance of medical students in the comprehensive examination of the basic sciences according to the indices of emotional intelligence and educational status

    Science.gov (United States)

    Moslehi, Mohsen; Samouei, Rahele; Tayebani, Tayebeh; Kolahduz, Sima

    2015-01-01

    Background: Considering the increasing importance of emotional intelligence (EI) in different aspects of life, such as academic achievement, the present survey is aimed to predict academic performance of medical students in the comprehensive examination of the basic sciences, according to the indices of emotional intelligence and educational status. Materials and Methods: The present survey is a descriptive, analytical, and cross-sectional study performed on the medical students of Isfahan, Tehran, and Mashhad Universities of Medical Sciences. Sampling the universities was performed randomly after which selecting the students was done, taking into consideration the limitation in their numbers. Based on the inclusion criteria, all the medical students, entrance of 2005, who had attended the comprehensive basic sciences examination in 2008, entered the study. The data collection tools included an Emotional Intelligence Questionnaire (standardized in Isfahan), the average score of the first to fifth semesters, total average of each of the five semesters, and the grade of the comprehensive basic sciences examination. The data were analyzed through stepwise regression coefficient by SPSS software version 15. Results: The results indicated that the indicators of independence from an emotional intelligence test and average scores of the first and third academic semesters were significant in predicting the students’ academic performance in the comprehensive basic sciences examination. Conclusion: According to the obtained results, the average scores of students, especially in the earlier semesters, as well as the indicators of independence and the self-esteem rate of students can influence their success in the comprehensive basic sciences examination. PMID:26430693

  16. An atlas of coronal electron density at 5Rs I: Data processing and calibration

    CERN Document Server

    Morgan, Huw

    2015-01-01

    Tomography of the solar corona can provide cruicial constraints for models of the low corona, unique information on changes in coronal structure and rotation rates, and a valuable boundary condition for models of the heliospheric solar wind. This is the first of a series of three papers which aim to create a set of maps of the coronal density over an extended period (1996-present). The papers will describe the data processing and calibration (this paper), the tomography method (\\paperii) and resulting atlas of coronal electron density at a height of 5\\Rs\\ between years 1996-2014 (\\paperiii). This first paper presents a detailed description of data processing and calibration for the Large-Angle and Spectrometric Coronagraph (LASCO) C2 instrument onboard the Solar and Heliospheric Observatory (SOHO) and the COR2 instruments of the Sun Earth Connection Coronal and Heliospheric Investigation (SECCHI) package aboard the Solar Terrestial Relations Observatory (STEREO) A \\& B spacecraft. The methodology includes...

  17. Thermal and non-thermal emission from reconnecting twisted coronal loops

    CERN Document Server

    Pinto, R; Browning, P K; Vilmer, N

    2016-01-01

    Twisted magnetic fields should be ubiquitous in the solar corona. The magnetic energy contained in such twisted fields can be released during solar flares and other explosive phenomena. Reconnection in helical magnetic coronal loops results in plasma heating and particle acceleration distributed within a large volume, including the lower coronal and chromospheric sections of the loops, and can be a viable alternative to the standard flare model, where particles are accelerated only in a small volume located in the upper corona. The goal of this study is to investigate the observational signatures of plasma heating and particle acceleration in kink-unstable twisted coronal loops using combination of MHD simulations and test-particle methods. The simulations describe the development of kink instability and magnetic reconnection in twisted coronal loops using resistive compressible MHD, and incorporate atmospheric stratification and large-scale loop curvature. The resulting distributions of hot plasma let us est...

  18. Forensic medical examination of victims of trafficking in human beings.

    Science.gov (United States)

    Alempijevic, Djordie; Jecmenica, Dragan; Pavlekic, Snezana; Savic, Slobodan; Aleksandric, Branimir

    2007-01-01

    Trafficking in human beigns (THB) is recognized as a global public health issue as well as a violation of human rights. Trafficking has been identified to be associated with several health risks including psychological trauma, injuries from violence, and substance misuse. Public and media reports suggest that the morbidity and mortality associated with trafficking are substantial. The need of medico-legal healthcare for THB victims is being neglected. Forensic medical examination, as specific intervention, is a highly desirable element of ermegency health care provided for victims of tracking. Acting in such a way, the investigation should establish the facts related to the allegatation of trafficking, thereby assisting in identifying those responsible, but also contributing to the procedures designed to obtain redress for the victims. Local anti-trafficking policies and interventions, however, have not acknowledged these needs. Therefore, the agenda of anti-trafficking policies needs to be redrawn to include forensic medical assessment of victims for legal purposes.

  19. [Development and correlation of work-related behavior and experience patterns, burnout and quality of life in medical students from their freshmanship to the first state examination].

    Science.gov (United States)

    Scholz, Michael; Neumann, Carolin; Steinmann, Cornelia; Hammer, Christian M; Schröder, Antje; Eßel, Nicole; Paulsen, Friedrich; Burger, Pascal H M

    2015-03-01

    Symptoms of burnout are common among medical students. Although they usually start with a good health status, their condition deteriorates over the course of their studies. In our study ESTRELLAS we examined 530 medical students in the preclinical semesters with validated psychological questionnaires. The longer the students were studying, the more showed risky working habits. Cognitive and emotional burnout symptoms increased coincidentally in their intensity, whereas the mental quality of life continuously deteriorated. Medical students' cognitive and emotional burnout symptoms are constantly increasing from the beginning of their studies. Contemporaneously, the mental quality of life is deteriorating. This might be based on a drastic change towards risky working habits. We suggest to actively work against this process to keep our motivated students and prospective physicians productive and in good mental health.

  20. HOW MEDICAL UNDERGRADUATES PREPARE FOR UNIVERSITY EXAMINATION: LESSON FROM A TEACHING MEDICAL INSTITUTION IN SOUTH INDIA

    Directory of Open Access Journals (Sweden)

    Shib Sekhar Datta

    2013-01-01

    Full Text Available Background: Medical colleges in India conventionally follow a curriculum overfed with large volume of information expecting students will imbibe such curriculum unquestionably overlooking what and how they progress. There have been many attempts to improve the learning process of medical students, neglecting the process which students adopt towards such learning and prepare for their exams aiming better performance. Objective: To explore qualitatively the way medical undergraduates prepare for their university examination. Methods: Present qualitative research was undertaken among medical interns during Nov-2011 to March-2012. FGDs were conducted by trained moderator using semi-structured guidelines and note taker recorded each FGD. Content analysis of FGDs was primarily oriented towards behaviour of medical undergraduates during preparatory phase before their university examinations like study pattern, study material, eating behaviour, level of stress, addiction etc. Qualitative content analysis of textual level of data was undertaken using Atlas.ti.5.0 software package. Results: Students are serious about studies just before examinations and refer to notes prepared by seniors, small books with important topics, and self-made notes. Girls depend predominantly on self-made notes. Students primarily focus on important topics in each subject. Time-in-hand decides what they study and try to remember before exams. They become casual about their diet, clothing and self-care. Stress, fear and high academic expectation often drive them towards addictive substances. They often suffer from loneliness and seek empathy from opposite sex batch mates, seniors, teachers and family members and start believing in their fortune and examiners' will rather than actual preparation. Conclusion: Students' psychology and culture should be addressed in harmony with curriculum reform for better learning by medical undergraduates.

  1. Coronal Pseudo-Streamer and Bipolar Streamer Observed by SOHO/UVCS in March 2008

    CERN Document Server

    Abbo, Lucia; Riley, Pete; Wang, Yi-Ming

    2015-01-01

    The last solar minimum is characterized by several peculiar aspects and by the presence of a complex magnetic topology with two different kinds of coronal streamers: pseudo-streamers and bipolar streamers. Pseudo-streamers or unipolar streamer are coronal structures which separate coronal holes of the same polarity, without a current sheet in the outer corona; unlike bipolar streamer that separate coronal holes of opposite magnetic polarity. In this study, two examples of these structures have been identified in the period of Carrington rotation 2067, by applying a potential-field source-surface extrapolation of the photospheric field measurements. We present a spectroscopic analysis of a pseudo-streamer and a bipolar streamer observed in the period 12-17 March 2008 at high spectral and spatial resolution by the Ultraviolet Coronagraph Spectrometer (UVCS; Kohl et al., 1995) onboard Solar and Heliospheric Observatory (SOHO). The solar wind plasma parameters, such as kinetic temperature, electron density and ou...

  2. Medical science and the Cruelty to Animals Act 1876: A re-examination of anti-vivisectionism in provincial Britain.

    Science.gov (United States)

    Finn, Michael A; Stark, James F

    2015-02-01

    The Cruelty to Animals Act 1876 was an important but ambiguous piece of legislation. For researchers it stymied British science, yet ensured that vivisection could continue under certain restrictions. For anti-vivisection protestors it was positive proof of the influence of their campaigns, yet overly deferent to Britain's scientific elite. In previous accounts of the Act and the rise of anti-vivisectionism, scientific medicine central to these debates has been treated as monolithic rather than a heterogeneous mix of approaches; and this has gone hand-in-hand with the marginalizing of provincial practices, as scholarship has focused largely on the 'Golden Triangle' of London, Oxford and Cambridge. We look instead at provincial research: brain studies from Wakefield and anthrax investigations in Bradford. The former case elucidates a key role for specific medical science in informing the anti-vivisection movement, whilst the latter demonstrates how the Act affected the particular practices of provincial medical scientists. It will be seen, therefore, how provincial medical practices were both influential upon, and profoundly affected by, the growth of anti-vivisectionism and the passing of the Act. This paper emphasises how regional and varied medico-scientific practices were central to the story of the creation and impact of the Cruelty to Animals Act. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Fast Collisionless Reconnection Condition and Self-Organization of Solar Coronal Heating

    CERN Document Server

    Uzdensky, Dmitri A

    2007-01-01

    I propose that solar coronal heating is a self-regulating process that keeps the coronal plasma roughly marginally collisionless. The self-regulating mechanism is based on the interplay of two effects. First, plasma density controls coronal energy release via the transition between the slow collisional Sweet--Parker regime and the fast collisionless reconnection regime. This transition takes place when the Sweet--Parker layer becomes thinner than the characteristic collisionless reconnection scale. I present a simple criterion for this transition in terms of the upstream plasma density and magnetic field and the global length of the reconnection layer. Second, coronal energy release by reconnection raises the ambient plasma density via chromospheric evaporation and this, in turn, temporarily inhibits subsequent reconnection involving the newly-reconnected loops. Over time, however, radiative cooling gradually lowers the density again below the critical value and fast reconnection again becomes possible. As a ...

  4. [Selection of medical talents under the influence of imperial examination system in the Tang Dynasty.

    Science.gov (United States)

    Wang, Zhen-Guo; Zang, Shou-Hu

    2005-10-01

    The Tang Dynasty was an important period in which China's ancient imperial examination system was formed and perfected. The medical examination at that time was influenced by imperial examination system, too. Medical talents were chosen according to a clear regulation of exam subjects imitating "Examination based on Imperial College law", "Ming Jing" and "Ming Fa" in the Tang Dynasty. The ways of choosing sheng tu, gong jü, zhi jü, dai zhao were also used for choosing medical talents, and the practical subjects of medical examination and qualified standard were also made, which can be used as a reference for TCM education, examination, selecting and checking of TCM talents today.

  5. Coronal and Local Thermodynamic Equilibriums in a Hollow Cathode Discharge

    Institute of Scientific and Technical Information of China (English)

    ZHENG Xu-Tao

    2005-01-01

    @@ A characteristic two-section profile of excited-state populations is observed in a hollow cathode discharge and is explained by coexistence of the coronal equilibrium (CE) and the local thermodynamic equilibrium (LTE).At helium pressure 0.1 Torr and cathode current 200-300 mA, vacuum ultraviolet radiations from He I 1snp 1 P (n = 2-16) and He Ⅱ np2P (n = 2-14) axe resolved with a 2.2-M McPherson spectrometer. Relative populations of these states are deduced from the discrete line intensities and are plotted against energy levels. For both the He Ⅰ and He Ⅱ series, as energy level increases, populations of high-n (n > 10) states are found to decrease much more quickly than low-n (n < 7) populations. While low-n populations are described with the CE dominated by direct electron-impact excitations, high-n populations are fitted with the LTE to calculate the population temperatures of gas atoms and ions. Validities of the CE and LTE in different n-ranges are considered on the competition between radiative decays of the excited states and their collisions with gas atoms.

  6. Coronal mass ejections and geomagnetic storms: Seasonal variations

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, J.L.; Gosling, J.T.; McComas, D.J.

    1992-07-01

    The well-established semiannual geomagnetic cycle, with peak activity near the equinoxes, has been attributed to the angle between the solar rotation axis and the geomagnetic dipole, which modulates the GSM Bz component in the interplanetary magnetic field (MF). This effect is predicted to be accentuated in the shocked plasma ahead of fast coronal mass ejections (CMESs); its relevance to the internal fields of the ejecta is unclear. CMEs, particularly fast events driving interplanetary shocks, are the cause of almost all large geomagnetic storms near solar maximum. We use a set of CMEs identified by ISEE-3 observations of bidirectional electron streaming, plus IMF and geomagnetic data, to investigate the semiannual geomagnetic variation and its relation to CMEs. We find that the geomagnetic effectiveness of CMEs and post-shock solar wind is well-ordered by speed and by the southward component of the IMF in GSM coordinates, as well as by preexisting geomagnetic conditions. The post-shock seasonal effect, with geomagnetic effectiveness maximizing near April 5 for negative GSEQ By and near October 5 for positive GSEQ By, is identifiable in shock and shock/CME events, but not for CME events without leading shocks. When used to complement the more fundamental causal parameter of CME speed, the seasonal effect appears to have value for prediction of geomagnetic storms.

  7. Coronal mass ejections and geomagnetic storms: Seasonal variations

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, J.L.; Gosling, J.T.; McComas, D.J.

    1992-01-01

    The well-established semiannual geomagnetic cycle, with peak activity near the equinoxes, has been attributed to the angle between the solar rotation axis and the geomagnetic dipole, which modulates the GSM Bz component in the interplanetary magnetic field (MF). This effect is predicted to be accentuated in the shocked plasma ahead of fast coronal mass ejections (CMESs); its relevance to the internal fields of the ejecta is unclear. CMEs, particularly fast events driving interplanetary shocks, are the cause of almost all large geomagnetic storms near solar maximum. We use a set of CMEs identified by ISEE-3 observations of bidirectional electron streaming, plus IMF and geomagnetic data, to investigate the semiannual geomagnetic variation and its relation to CMEs. We find that the geomagnetic effectiveness of CMEs and post-shock solar wind is well-ordered by speed and by the southward component of the IMF in GSM coordinates, as well as by preexisting geomagnetic conditions. The post-shock seasonal effect, with geomagnetic effectiveness maximizing near April 5 for negative GSEQ By and near October 5 for positive GSEQ By, is identifiable in shock and shock/CME events, but not for CME events without leading shocks. When used to complement the more fundamental causal parameter of CME speed, the seasonal effect appears to have value for prediction of geomagnetic storms.

  8. Regarding the detectability and measurement of coronal mass ejections

    Directory of Open Access Journals (Sweden)

    Howard Timothy A.

    2015-01-01

    Full Text Available In this review I discuss the problems associated with the detection and measurement of coronal mass ejections (CMEs. CMEs are important phenomena both scientifically, as they play a crucial role in the evolution of the solar corona, and technologically, as their impact with the Earth leads to severe space weather activity in the form of magnetic storms. I focus on the observation of CMEs using visible white light imagers (coronagraphs and heliospheric imagers, as they may be regarded as the binding agents between different datasets and different models that are used to reconstruct them. Our ability to accurately measure CMEs observed by these imagers is hampered by many factors, from instrumental to geometrical to physical. Following a brief review of the history of CME observation and measurement, I explore the impediments to our ability to measure them and describe possible means for which we may be able to mitigate those impediments. I conclude with a discussion of the claim that we have reached the limit of the information that we can extract from the current generation of white light imagers, and discuss possible ways forward regarding future instrument capabilities.

  9. Relationship Between Solar Wind Speed and Coronal Magnetic Field Properties

    CERN Document Server

    Fujiki, Ken'ichi; Iju, Tomoya; Hakamada, Kazuyuki; Kojima, Masayoshi

    2015-01-01

    We have studied the relationship between the solar-wind speed $[V]$ and the coronal magnetic-field properties (a flux expansion factor [$f$] and photospheric magnetic-field strength [$B_{\\mathrm{S}}$]) at all latitudes using data of interplanetary scintillation and solar magnetic field obtained for 24 years from 1986 to 2009. Using a cross-correlation analyses, we verified that $V$ is inversely proportional to $f$ and found that $V$ tends to increase with $B_{\\mathrm{S}}$ if $f$ is the same. As a consequence, we find that $V$ has extremely good linear correlation with $B_{\\mathrm{S}}/f$. However, this linear relation of $V$ and $B_{\\mathrm{S}}/f$ cannot be used for predicting the solar-wind velocity without information on the solar-wind mass flux. We discuss why the inverse relation between $V$ and $f$ has been successfully used for solar-wind velocity prediction, even though it does not explicitly include the mass flux and magnetic-field strength, which are important physical parameters for solar-wind accele...

  10. Comparing High-speed Transition Region Jets in Coronal Holes and Quiet Sun Regions

    Science.gov (United States)

    Tate Arbacher, Rebecca; Tian, Hui; Cranmer, Steven R.

    2015-01-01

    The complicated energy transfer and plasma motion in the transition region, between the photosphere and the corona, may play a significant role in the formation and acceleration of the solar wind. New observations from the Interface Region Imaging Spectrograph (IRIS) have revealed unprecedented levels of detail in this less-studied region. Coronal holes in particular are a likely source of solar wind material, though the formation and acceleration mechanisms of the fast solar wind are still largely unknown. In our previous work, we have reported the prevalence of small-scale high-speed (~80-250 km/s) jets with transition region temperatures from the network structures of coronal holes. Here we undertake a comparative study of these short-lived episodic network jets in a coronal hole region and a quiet sun region using IRIS sit-and-stare slit-jaw imaging in the 1330 Angstrom (C II) passband. The pointing coordinates, exposure time, observing cadence, and field of view of both observations are all identical. Our preliminary study suggests that the speeds and lengths of the network jets may differ between quiet sun and coronal hole regions. The quiet sun region exhibits many compact bright regions with sizes of 5-10 arcseconds which produce very few jets. The jets that do exist tend to propagate at much slower speeds over smaller distances than their coronal hole counterparts. Comparatively, in the coronal hole, such compact regions are almost absent and all network patches are permeated by the intermittent high-reaching jets. Such a difference suggests that magnetic loops are much smaller in the coronal hole and the network jets are produced at low heights. The recurrence frequency seems to be higher in the coronal hole region, with many of the isolated quiet sun region jets demonstrating curved trajectories.This work is supported under contract 8100002705 from Lockheed-Martin to SAO and by the NSF-REU solar physics program at SAO, grant number AGS-1263241.

  11. Comparing Coronal and Heliospheric Magnetic Fields over Several Solar Cycles

    Science.gov (United States)

    Koskela, J. S.; Virtanen, I. I.; Mursula, K.

    2017-01-01

    Here we use the PFSS model and photospheric data from Wilcox Solar Observatory, SOHO/MDI, SDO/HMI, and SOLIS to compare the coronal field with heliospheric magnetic field measured at 1 au, compiled in the NASA/NSSDC OMNI 2 data set. We calculate their mutual polarity match and the power of the radial decay, p, of the radial field using different source surface distances and different number of harmonic multipoles. We find the average polarity match of 82% for the declining phase, 78%–79% for maxima, 76%–78% for the ascending phase, and 74%–76% for minima. On an average, the source surface of 3.25 RS gives the best polarity match. We also find strong evidence for solar cycle variation of the optimal source surface distance, with highest values (3.3 RS) during solar minima and lowest values (2.6 RS–2.7 RS) during the other three solar cycle phases. Raising the number of harmonic terms beyond 2 rarely improves the polarity match, showing that the structure of the HMF at 1 au is most of the time rather simple. All four data sets yield fairly similar polarity matches. Thus, polarity comparison is not affected by photospheric field scaling, unlike comparisons of the field intensity.

  12. On the Observation and Simulation of Solar Coronal Twin Jets

    CERN Document Server

    Liu, Jiajia; Wang, Yuming; McIntosh, Scott W; Fan, Yuhong; Zhang, Quanhao

    2016-01-01

    We present the first observation, analysis and modeling of solar coronal twin jets, which occurred after a preceding jet. Detailed analysis on the kinetics of the preceding jet reveals its blowout-jet nature, which resembles the one studied in Liu et al. 2014. However the erupting process and kinetics of the twin jets appear to be different from the preceding one. In lack of the detailed information on the magnetic fields in the twin jet region, we instead use a numerical simulation using a three-dimensional (3D) MHD model as described in Fang et al. 2014, and find that in the simulation a pair of twin jets form due to reconnection between the ambient open fields and a highly twisted sigmoidal magnetic flux which is the outcome of the further evolution of the magnetic fields following the preceding blowout jet. Based on the similarity between the synthesized and observed emission we propose this mechanism as a possible explanation for the observed twin jets. Combining our observation and simulation, we sugges...

  13. A spectacular coronal mass ejection event and associated phenomena

    Science.gov (United States)

    Ma, Yuan; Li, Chun-Sheng; Song, Qian

    Based on the data taken from S. G. D. and relevant simultaneous observations of solar radio bursts, gamma-ray emission and geophysical effects on June 15, 1991 the relationships among these phenomena are discussed in this paper. Through the analyses it is considered that proton events and GLE events occurred on June 15 in 1991, which were the geophysic responses caused by CME (V>=750 km/s). Simultaneous observation of the bursts at the centimetric and decimetric wavelengths can obtain the U-shape spectrum of speak fluxes, which is still one of the effective tools for predicting proton events and its production mechanism can be explained by using the acceleration of the direct current field parallel to the magnetic field in the electric current sheet formed in the process of the production of spray prominences. However, the process in which electrons are accelerated up to the high energy state remains to be explained. The whole event of June 15 1991, from the coronal matter ejection (or the spray prominences in active regions) to the production of various geophysic effects, has explained and verified.

  14. Applying the Resources and Supports in Self-Management Framework to Examine Ophthalmologist-Patient Communication and Glaucoma Medication Adherence

    Science.gov (United States)

    Sleath, B.; Carpenter, D. M.; Blalock, S. J.; Sayner, R.; Muir, K. W.; Slota, C.; Giangiacomo, A. L.; Hartnett, M. E.; Tudor, G.; Robin, A. L.

    2015-01-01

    Little is known about how ophthalmologist-patient communication over time is associated with glaucoma patient long-term adherence. The purpose of our study was to examine the association between provider use of components of the resources and supports in self-management model when communicating with patients and adherence to glaucoma medications…

  15. Equilibrium models of coronal loops that involve curvature and buoyancy

    CERN Document Server

    Hindman, Bradley W

    2013-01-01

    We construct magnetostatic models of coronal loops in which the thermodynamics of the loop is fully consistent with the shape and geometry of the loop. This is achieved by treating the loop as a thin, compact, magnetic fibril that is a small departure from a force-free state. The density along the loop is related to the loop's curvature by requiring that the Lorentz force arising from this deviation is balanced by buoyancy. This equilibrium, coupled with hydrostatic balance and the ideal gas law, then connects the temperature of the loop with the curvature of the loop without resorting to a detailed treatment of heating and cooling. We present two example solutions: one with a spatially invariant magnetic Bond number (the dimensionless ratio of buoyancy to Lorentz forces) and the other with a constant radius of curvature of the loop's axis. We find that the density and temperature profiles are quite sensitive to curvature variations along the loop, even for loops with similar aspect ratios.

  16. Equilibrium Models of Coronal Loops That Involve Curvature and Buoyancy

    Science.gov (United States)

    Hindman, Bradley W.; Jain, Rekha

    2013-12-01

    We construct magnetostatic models of coronal loops in which the thermodynamics of the loop is fully consistent with the shape and geometry of the loop. This is achieved by treating the loop as a thin, compact, magnetic fibril that is a small departure from a force-free state. The density along the loop is related to the loop's curvature by requiring that the Lorentz force arising from this deviation is balanced by buoyancy. This equilibrium, coupled with hydrostatic balance and the ideal gas law, then connects the temperature of the loop with the curvature of the loop without resorting to a detailed treatment of heating and cooling. We present two example solutions: one with a spatially invariant magnetic Bond number (the dimensionless ratio of buoyancy to Lorentz forces) and the other with a constant radius of the curvature of the loop's axis. We find that the density and temperature profiles are quite sensitive to curvature variations along the loop, even for loops with similar aspect ratios.

  17. Chromospheric and Coronal Wave Generation in a Magnetic Flux Sheath

    Science.gov (United States)

    Kato, Yoshiaki; Steiner, Oskar; Hansteen, Viggo; Gudiksen, Boris; Wedemeyer, Sven; Carlsson, Mats

    2016-08-01

    Using radiation magnetohydrodynamic simulations of the solar atmospheric layers from the upper convection zone to the lower corona, we investigate the self-consistent excitation of slow magneto-acoustic body waves (slow modes) in a magnetic flux concentration. We find that the convective downdrafts in the close surroundings of a two-dimensional flux slab “pump” the plasma inside it in the downward direction. This action produces a downflow inside the flux slab, which encompasses ever higher layers, causing an upwardly propagating rarefaction wave. The slow mode, excited by the adiabatic compression of the downflow near the optical surface, travels along the magnetic field in the upward direction at the tube speed. It develops into a shock wave at chromospheric heights, where it dissipates, lifts the transition region, and produces an offspring in the form of a compressive wave that propagates further into the corona. In the wake of downflows and propagating shock waves, the atmosphere inside the flux slab in the chromosphere and higher tends to oscillate with a period of ν ≈ 4 mHz. We conclude that this process of “magnetic pumping” is a most plausible mechanism for the direct generation of longitudinal chromospheric and coronal compressive waves within magnetic flux concentrations, and it may provide an important heat source in the chromosphere. It may also be responsible for certain types of dynamic fibrils.

  18. Position and width of normal adult optic chiasm as measured in coronal MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Myung Soon; Park, Jin Sook [Wonju College of Medicine, Yonsei University, Wonju (Korea, Republic of)

    1994-06-15

    To evaluate the position and transverse dimension of the adult optic chiasm in normal Korean adult. The authors analysed 3D coronal volume images (TR/TE=30/13, flip angle=30 .deg. ) of 136 normal adult subjects without known visual abnormality. All MRI examinations were performed using a 0.5T system. MRI was reviewed retrospectively to determine the position (horizontal and tilted) of the potic chiosm and the transverse dimension of the optic chiasm was measured. Seventy- five (55%) of the 136 normal subjects had horizontal position, and sixty-one (45%) had tilted position. Thirty- eight (62%) of 61 with tilted position showed higher position on the right side, and twenty-three (38%) showed higher position on the side. The average transverse dimension(mean SD) was 15.2 {+-} 0.7mm in men and 14.6 {+-} 1.0mm in women. The difference of transverse dimension between men and women was statistically significant. Tilted position of the adult optic chiasm on coronal MRI was seen in approximately half of normal adults. The average of transverse dimension of normal optic chiasm was 15mm.

  19. Solar Coronal Structures and Stray Light in TRACE

    CERN Document Server

    DeForest, C E; Wills-Davey, M J

    2008-01-01

    Using the 2004 Venus transit of the Sun to constrain a semi-empirical point-spread function for the TRACE EUV solar telescope, we have measured the effect of stray light in that telescope. We find that 43% of 171A EUV light that enters TRACE is scattered, either through diffraction off the entrance filter grid or through other nonspecular effects. We carry this result forward, via known-PSF deconvolution of TRACE images, to identify its effect on analysis of TRACE data. Known-PSF deconvolution by this derived PSF greatly reduces the effect of visible haze in the TRACE 171A images, enhances bright features, and reveals that the smooth background component of the corona is considerably less bright (and hence much more rarefied) than commonly supposed. Deconvolution reveals that some prior conlclusions about the Sun appear to have been based on stray light in the images. In particular, the diffuse background "quiet corona" becomes consistent with hydrostatic support of the coronal plasma; feature contrast is gre...

  20. Interplanetary Coronal Mass Ejection (ICME) and Cosmic rays transmission during Forbush decreases

    Science.gov (United States)

    Okpala, K. C.

    2015-12-01

    Forbush decrease (FD) is an observed reduction in galactic cosmic ray (GCR) intensity as measured by ground neutron monitors often associated energetic events on the Sun such as coronal mass ejections (CME). FD is associated with increased activity of the sun as reflected in the size of the interplanetary coronal mass ejections passing around the Earth and the corotating regions in the Heliosphere. Since the interplanetary anisotropy evolves itself during a geomagnetic storm in addition to the reconfiguration of external magnetospheric currents, it is expected that changes in transmissivity of cosmic rays of galactic origin will occur during Geomagnetic storms. In this study we examine sixty-three (63) FD events and associated geomagnetic storms over the last three solar cycles from 1970 to 2013. The negative peaks of the FDs and the Dst coincided for most of the events (~70%). There was good correlation (>0.67) between the FDs and Dst. Signatures of influence of external magnetospheric currents on the count rates of the neutron monitors stations during periods of Forbush decreases (FDs) is provided. This evidence is observed as sudden increases in the count rates during the main phase of simultaneous FD. The magnitude of the sudden rise in the count rates of Neutron monitors and peak dst correlated well (>0.50) both for high latitude and mid latitude stations.

  1. Deflections of Fast Coronal Mass Ejections and the Properties of Associated Solar Energetic Particle Events

    Science.gov (United States)

    Kahler, S. W.; Akiyama, S.; Gopalswamy, N.

    2012-01-01

    The onset times and peak intensities of solar energetic particle (SEP) events at Earth have long been thought to be influenced by the open magnetic fields of coronal holes (CHs). The original idea was that a CH lying between the solar SEP source region and the magnetic footpoint of the 1 AU observer would result in a delay in onset and/or a decrease in the peak intensity of that SEP event. Recently, Gopalswamy et al. showed that CHs near coronal mass ejection (CME) source regions can deflect fast CMEs from their expected trajectories in space, explaining the appearance of driverless shocks at 1 AU from CMEs ejected near solar central meridian (CM). This suggests that SEP events originating in CME-driven shocks may show variations attributable to CH deflections of the CME trajectories. Here, we use a CH magnetic force parameter to examine possible effects of CHs on the timing and intensities of 41 observed gradual E approx 20 MeV SEP events with CME source regions within 20 deg. of CM. We find no systematic CH effects on SEP event intensity profiles. Furthermore, we find no correlation between the CME leading-edge measured position angles and SEP event properties, suggesting that the widths of CME-driven shock sources of the SEPs are much larger than the CMEs. Independently of the SEP event properties, we do find evidence for significant CME deflections by CH fields in these events

  2. Effects of field-aligned flows on standing kink and sausage modes supported by coronal loops

    CERN Document Server

    Chen, S -X; Xia, L -D; Chen, Y -J; Yu, H

    2013-01-01

    Fundamental standing modes and their overtones play an important role in coronal seismology. We examine how a significant field-aligned flow affects standing modes supported by coronal loops, modeled here as cold magnetic slabs. Of particular interest are the period ratios of the fundamental to its $(n-1)$-th overtone ($P_1/nP_n$) for both kink and sausage modes, and the threshold half-width-to-length ratio for sausage modes. For standing kink modes, the flow significantly reduces $P_1/nP_n$ in general, the effect being particularly strong for larger $n$ and when the density contrast $\\rho_0/\\rho_e$ between loops and their surroundings is weak. That said, even when $\\rho_0/\\rho_e$ approaches infinity, this effect is still substantial, reducing the minimal $P_1/nP_n$ by up to 13.7% (24.5%) for $n=2$ ($n=4$) relative to the static case, when the Alfv\\'en Mach number $M_A$ reaches 0.8 where $M_A$ measures the loop flow speed in units of the internal Alfv\\'en speed. For standing sausage modes, though not negligib...

  3. Examination of the Link Between Medication Adherence and Use of Mail-Order Pharmacies in Chronic Disease States.

    Science.gov (United States)

    Fernandez, Elena V; McDaniel, Jennifer A; Carroll, Norman V

    2016-11-01

    Higher medication adherence is associated with positive health outcomes, including reduction in hospitalizations and costs, and many interventions have been implemented to increase patient adherence. To determine whether patients experience higher medication adherence by using mail-order or retail pharmacies. Articles pertaining to retail and mail-order pharmacies and medication adherence were collected from 3 literature databases: MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and International Pharmaceutical Abstracts (IPA). Searches were created for each database and articles were compiled. Articles were screened for exclusion factors, and final articles (n=15) comparing medication adherence in patients utilizing mail and retail pharmacies were analyzed. For each study, various factors were identified including days supply, patients' out-of-pocket costs, prior adherence behavior, therapeutic class, measure of adherence, limitations, and results. Studies were then categorized by disease state, and relevant information from each study was compared and contrasted. The majority of studies-14 out of the 15 reviewed-supported higher adherence through the mail-order dispensing channel rather than through retail pharmacies. There are a number of reasons for the differences in adherence between the channels. Study patients who used mail-order pharmacies were more likely to have substantially higher prior adherence behavior, socioeconomic status, and days supply of medicines received and were likely to be offered financial incentives to use mail-order. The few studies that attempted to statistically control for these factors also found that patients using mail-order services were more adherent but the size of the differences was smaller. The extent to which these results indicate an inherent adherence advantage of mail-order pharmacy (as distinct from adherence benefits due to greater days supply, lower copays, or more adherent patients

  4. Formation and evolution of coronal rain observed by SDO/AIA on February 22, 2012

    CERN Document Server

    Vashalomidze, Z; Zaqarashvili, T V; Oliver, R; Shergelashvili, B; Ramishvili, G; Poedts, S; De Causmaecker, P

    2015-01-01

    The formation and dynamics of coronal rain are currently not fully understood. Coronal rain is the fall of cool and dense blobs formed by thermal instability in the solar corona towards the solar surface with acceleration smaller than gravitational free fall. We aim to study the observational evidence of the formation of coronal rain and to trace the detailed dynamics of individual blobs. We used time series of the 171 \\AA\\, and 304 \\AA\\, spectral lines obtained by the Atmospheric Imaging Assembly (AIA) on board the Solar Dynamic Observatory (SDO) above active region AR 11420 on February 22, 2012. Observations show that a coronal loop disappeared in the 171 \\AA\\ channel and appeared in the 304 \\AA\\ line$\\text{}\\text{}$ more than one hour later, which indicates a rapid cooling of the coronal loop from 1 MK to 0.05 MK. An energy estimation shows that the radiation is higher than the heat input, which indicates so-called catastrophic cooling. The cooling was accompanied by the formation of coronal rain in the fo...

  5. A Comparison of Second- and Fourth-Year Medical Students on a Standardized-Patient Examination of Clinical Competence: A Construct Validity Study.

    Science.gov (United States)

    Barnhart, Amber J.; And Others

    The construct validity of the standardized-patient (SP) examination used at Southern Illinois University (Springfield) School of Medicine was assessed by comparing 66 second-year and 70 fourth-year medical students on 5 SP cases. The results show sizable differences between the groups. The usefulness of passing rates the effect-size measures as a…

  6. Diagnostics of Coronal Magnetic Fields Through the Hanle Effect in UV and IR Lines

    CERN Document Server

    Raouafi, N E; Gibson, S; Fineschi, S; Solanki, S K

    2016-01-01

    The plasma thermodynamics in the solar upper atmosphere, particularly in the corona, are dominated by the magnetic field, which controls the flow and dissipation of energy. The relative lack of knowledge of the coronal vector magnetic field is a major handicap for progress in coronal physics. This makes the development of measurement methods of coronal magnetic fields a high priority in solar physics. The Hanle effect in the UV and IR spectral lines is a largely unexplored diagnostic. We use magnetohydrodynamic (MHD) simulations to study the magnitude of the signal to be expected for typical coronal magnetic fields for selected spectral lines in the UV and IR wavelength ranges, namely the H I Ly-$\\alpha$ and the He I 10830 {\\AA} lines. We show that the selected lines are useful for reliable diagnosis of coronal magnetic fields. The results show that the combination of polarization measurements of spectral lines with different sensitivities to the Hanle effect may be most appropriate for deducing coronal magne...

  7. 3D Global Coronal Density Structure and Associated Magnetic Field near Solar Maximum

    CERN Document Server

    Kramar, Maxim; Lin, Haosheng

    2016-01-01

    Measurement of the coronal magnetic field is a crucial ingredient in understanding the nature of solar coronal dynamic phenomena at all scales. We employ STEREO/COR1 data obtained near maximum of solar activity in December 2012 (Carrington rotation, CR 2131) to retrieve and analyze the three-dimensional (3D) coronal electron density in the range of heights from $1.5$ to $4\\ \\mathrm{R}_\\odot$ using a tomography method and qualitatively deduce structures of the coronal magnetic field. The 3D electron density analysis is complemented by the 3D STEREO/EUVI emissivity in 195 \\AA \\ band obtained by tomography for the same CR period. We find that the magnetic field configuration during CR 2131 has a tendency to become radially open at heliocentric distances below $\\sim 2.5 \\ \\mathrm{R}_\\odot$. We compared the reconstructed 3D coronal structures over the CR near the solar maximum to the one at deep solar minimum. Results of our 3D density reconstruction will help to constrain solar coronal field models and test the a...

  8. Coronal energy input and dissipation in a solar active region 3D MHD model

    CERN Document Server

    Bourdin, Philippe-A; Peter, Hardi

    2015-01-01

    Context. We have conducted a 3D MHD simulation of the solar corona above an active region in full scale and high resolution, which shows coronal loops, and plasma flows within them, similar to observations. Aims. We want to find the connection between the photospheric energy input by field-line braiding with the coronal energy conversion by Ohmic dissipation of induced currents. Methods. To this end we compare the coronal energy input and dissipation within our simulation domain above different fields of view, e.g. for a small loops system in the active region (AR) core. We also choose an ensemble of field lines to compare, e.g., the magnetic energy input to the heating per particle along these field lines. Results. We find an enhanced Ohmic dissipation of currents in the corona above areas that also have enhanced upwards-directed Poynting flux. These regions coincide with the regions where hot coronal loops within the AR core are observed. The coronal density plays a role in estimating the coronal temperatur...

  9. Acute and chronic stress increase salivary cortisol: a study in the real-life setting of a national examination undertaken by medical graduates.

    Science.gov (United States)

    González-Cabrera, J; Fernández-Prada, M; Iribar-Ibabe, C; Peinado, J M

    2014-03-01

    Spanish medical graduates who apply for a medical specialty training position (MIR) must take an examination that will shape their future personal and professional lives. Preparation for the test represents an important stressor that persists for several months. The aim of this study was to elucidate the stress pattern of this group and evaluate possible changes in the circadian rhythm of cortisol release in medical graduates preparing for this test. A repeated-measures longitudinal study was performed, measuring the salivary cortisol concentrations in 36 medical graduates (13 males and 23 females; mean age of 24.2 years) on five sampling days. Five cortisol samples were collected from 07:00 to 21:00 h in order to monitor changes in the circadian rhythm. On all sampling days (except on the day of the official examination), anxiety and psychological stress were evaluated with the Spanish versions of the State-Trait Anxiety Inventory (STAI) and the Perceived Stress Scale (PSS). During the study period, participants showed higher levels of anxiety than the Spanish reference population as well as a progressive increase in self-perceived stress. A significant increase in salivary cortisol concentration was observed in both chronic (study and examination preparation) and acute (examinations) situations. Our results suggest that the cortisol awakening response (CAR) may be a good indicator of anticipatory stress but is unaffected by long-term examination preparation. Comparison of results between the official examination day and the mock examination days yielded evidence that learning may modulate the behavior of the hypothalamic-pituitary-adrenal axis.

  10. Selection of medical students--are all matriculation examinations equivalent?

    Science.gov (United States)

    Mitchell, G; Mitchell, D; McGregor, M; Fridjohn, P

    1987-09-19

    The marks achieved by students vary significantly with the type of matriculation examination written. In particular, students who write the examination set by the Transvaal Education Department score significantly higher matriculation marks than other students but score the same in the first year at medical school as other students. These students have an undeserved advantage in the selection process.

  11. Three controversies over item disclosure in medical licensure examinations

    Directory of Open Access Journals (Sweden)

    Yoon Soo Park

    2015-09-01

    Full Text Available In response to views on public's right to know, there is growing attention to item disclosure – release of items, answer keys, and performance data to the public – in medical licensure examinations and their potential impact on the test's ability to measure competence and select qualified candidates. Recent debates on this issue have sparked legislative action internationally, including South Korea, with prior discussions among North American countries dating over three decades. The purpose of this study is to identify and analyze three issues associated with item disclosure in medical licensure examinations – 1 fairness and validity, 2 impact on passing levels, and 3 utility of item disclosure – by synthesizing existing literature in relation to standards in testing. Historically, the controversy over item disclosure has centered on fairness and validity. Proponents of item disclosure stress test takers’ right to know, while opponents argue from a validity perspective. Item disclosure may bias item characteristics, such as difficulty and discrimination, and has consequences on setting passing levels. To date, there has been limited research on the utility of item disclosure for large scale testing. These issues requires ongoing and careful consideration.

  12. Preparation and analysis of dust samples for medical examinations; Praeparation und Analytik der Staubproben fuer medizinische Untersuchungen

    Energy Technology Data Exchange (ETDEWEB)

    Armbruster, L. [Deutsche Montan Technologie GmbH, Essen (Germany). Gas and Fire Div.

    2004-07-01

    For medical research within this project three respirable dust samples have been prepared and analysed. The original bulk material came from three different stratigraphic horizons, for the preparation a multiplex classifier was used. The respirable samples showed the same size distribution as the samples used in former projects. The quartz content was rather low, but within the normal variability. Pure quartz particles without surface contamination are not present in the three samples. Nickel, lead, cobalt, and arsenic are the most significant trace elements in the samples. (orig.)

  13. [A comprehensive prevention programs on AIDS, HBV and syphilis among pregnant women and couples experienced premarital medical examination].

    Science.gov (United States)

    Gui, Xi-En; Zhang, Yuan-Zhen; Yang, Rong-Rong; Rezivan, Silafu; Li, Feng-Liang; Qin, Ai-Hua; Li, Li; Wu, Li-Zhen; Zong, Li-Li

    2010-08-01

    To evaluate the effect of comprehensive prevention programs on HIV, HBV and syphilis transmission from mother to child and between premarital couples. HIV, HBV and syphilis were screened among pregnant women with interventional measure for infected women; HIV, HBV and syphilis (TP) were screened among premarital couples with medical advice. The HIV, HBsAg and TP positive rates were 8.4‰ (111/13 280), 54‰ (711/13 186) and 12.8‰ (159/12 401) respectively among pregnant women and the total positive rate of the three diseases was 73.8‰ which was significantly higher than HIV positive rate (P premarital couples and the total positive rate of the three diseases was 131.5‰ which was significantly higher than HIV positive rate alone (P < 0.001). Comprehensive prevention was more economical than prevention for HIV alone. The comprehensive strategies for prevention of HIV, HBV and syphilis was feasible, effective and economical that could help to actively conduct the preventive measures.

  14. Using therapeutic jurisprudence and preventive law to examine disputants' best interests in mediating cases about physicians' practices: a guide for medical regulators.

    Science.gov (United States)

    Ferris, Lorraine E

    2004-01-01

    Therapeutic jurisprudence (TJ) and preventive law (PL) are used as two theoretical perspectives from which to examine the best interests of parties in mediation because of a dispute about a physician's practice. The focus is mediation provided by and/or for the medical regulator. The paper reviews the literature on TJ and PL, and their relationship to mediation, and demonstrates how medical regulators could benefit by working within a framework reflecting both these perspectives providing it does not involve an egregious matter. A TJ and PL framework would be of particular value in identifying cases for mediation and in evaluating resolutions to mediated disputes.

  15. Non-WKB Models of the FIP Effect: Implications for Solar Coronal Heating and the Coronal Helium and Neon Abundances

    CERN Document Server

    Laming, J Martin

    2009-01-01

    We revisit in more detail a model for element abundance fractionation in the solar chromosphere, that gives rise to the "FIP Effect" in the solar corona and wind. Elements with first ionization potential below about 10 eV, i.e. those that are predominantly ionized in the chromosphere, are enriched in the corona by a factor 3-4. We model the propagation of Alfven waves through the chromosphere using a non-WKB treatment, and evaluate the ponderomotive force associated with these waves. Under solar conditions, this is generally pointed upwards in the chromosphere, and enhances the abundance of chromospheric ions in the corona. Our new approach captures the essentials of the solar coronal abundance anomalies, including the depletion of He relative to H, and also the putative depletion of Ne, recently discussed in the literature. We also argue that the FIP effect provides the strongest evidence to date for energy fluxes of Alfven waves sufficient to heat the corona. However it appears that these waves must also be...

  16. Does Interviewer Status Matter? An examination of Lay Interviewers and Medical Doctor Interviewers in an Epidemiological Study in Vietnam

    Science.gov (United States)

    Amstadter, Ananda B.; Richardson, Lisa; Acierno, Ron; Kilpatrick, Dean G.; Gaboury, Mario T.; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc

    2010-01-01

    In 2006, typhoon Xangsane disrupted a large-scale multi-agency mental health study of 4,982 individuals in the DaNang province of Vietnam. Following this disaster, 795 of the original 4,982 participants were randomly assigned to be re-interviewed by either a medical doctor or a lay interviewer using structured clinical interviews to determine prevalence of lifetime and post-typhoon post-traumatic stress disorder (PTSD), major depressive disorder (MDD), panic disorder (PD), and generalized anxiety disorder (GAD) according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (APA, 1994). The aim of the present study was to determine if prevalence of disorders differed by interviewer type. Bivariate analyses and multivariable analyses, as well as internal reliability estimates, all indicated no significant differences between the medical doctor interviewers versus the lay interviewers. This held for both lifetime prevalence as well as post-typhoon prevalence of disorders. This study has implications for epidemiologic studies, as it indicates that with adequate training, the use of lay interviewers may be a valid means of data collection. PMID:24683551

  17. Using the Theory of Planned Behaviour to examine health professional students' behavioural intentions in relation to medication safety and collaborative practice.

    Science.gov (United States)

    Lapkin, Samuel; Levett-Jones, Tracy; Gilligan, Conor

    2015-08-01

    Safe medication practices depend upon, not only on individual responsibilities, but also effective communication and collaboration between members of the medication team. However, measurement of these skills is fraught with conceptual and practical difficulties. The aims of this study were to explore the utility of a Theory of Planned Behaviour-based questionnaire to predict health professional students' behavioural intentions in relation to medication safety and collaborative practice; and to determine the contribution of attitudes, subjective norms, and perceived control to behavioural intentions. A descriptive cross-sectional survey based upon the Theory of Planned Behaviour was designed and tested. A convenience sample of 65 undergraduate pharmacy, nursing and medicine students from one semi-metropolitan Australian university were recruited for the study. Participants' behavioural intentions, attitudes, subjective norms, and perceived control to behavioural intentions in relation to medication safety were measured using an online version of the Theory of Planned Behaviour Medication Safety Questionnaire. The Questionnaire had good internal consistency with a Cronbach's alpha of 0.844. The three predictor variables of attitudes, subjective norms, and perceived control accounted for between 30 and 46% of the variance in behavioural intention; this is a strong prediction in comparison to previous studies using the Theory of Planned Behaviour. Data analysis also indicated that attitude was the most significant predictor of participants' intention to collaborate with other team members to improve medication safety. The results from this study provide preliminary support for the Theory of Planned Behaviour-Medication Safety Questionnaire as a valid instrument for examining health professional students' behavioural intentions in relation to medication safety and collaborative practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Understanding Solar Coronal Heating through Atomic and Plasma Physics Experiments

    Science.gov (United States)

    Savin, Daniel Wolf; Arthanayaka, Thusitha; Bose, Sayak; Hahn, Michael; Beiersdorfer, Peter; Brown, Gregory V.; Gekelman, Walter; Vincena, Steve

    2017-08-01

    Recent solar observations suggest that the Sun's corona is heated by Alfven waves that dissipate at unexpectedly low heights in the corona. These observations raise a number of questions. Among them are the problems of accurately quantifying the energy flux of the waves and that of describing the physical mechanism that leads to the wave damping. We are performing laboratory experiments to address both of these issues.The energy flux depends on the electron density, which can be measured spectroscopically. However, spectroscopic density diagnostics have large uncertainties, because they depend sensitively on atomic collisional excitation, de-excitation, and radiative transition rates for multiple atomic levels. Essentially all of these data come from theory and have not been experimentally validated. We are conducting laboratory experiments using the electron beam ion trap (EBIT) at Lawrence Livermore National Laboratory that will provide accurate empirical calibrations for spectroscopic density diagnostics and which will also help to guide theoretical calculations.The observed rapid wave dissipation is likely due to inhomogeneities in the plasma that drive flows and currents at small length scales where energy can be more efficiently dissipated. This may take place through gradients in the Alfvén speed along the magnetic field, which causes wave reflection and generates turbulence. Alternatively, gradients in the Alfvén speed across the field can lead to dissipation through phase-mixing. Using the Large Plasma Device (LAPD) at the University of California Los Angeles, we are studying both of these dissipation mechanisms in the laboratory in order to understand their potential roles in coronal heating.

  19. Intermittency in MHD turbulence and coronal nanoflares modelling

    Directory of Open Access Journals (Sweden)

    P. Veltri

    2005-01-01

    Full Text Available High resolution numerical simulations, solar wind data analysis, and measurements at the edges of laboratory plasma devices have allowed for a huge progress in our understanding of MHD turbulence. The high resolution of solar wind measurements has allowed to characterize the intermittency observed at small scales. We are now able to set up a consistent and convincing view of the main properties of MHD turbulence, which in turn constitutes an extremely efficient tool in understanding the behaviour of turbulent plasmas, like those in solar corona, where in situ observations are not available. Using this knowledge a model to describe injection, due to foot-point motions, storage and dissipation of MHD turbulence in coronal loops, is built where we assume strong longitudinal magnetic field, low beta and high aspect ratio, which allows us to use the set of reduced MHD equations (RMHD. The model is based on a shell technique in the wave vector space orthogonal to the strong magnetic field, while the dependence on the longitudinal coordinate is preserved. Numerical simulations show that injected energy is efficiently stored in the loop where a significant level of magnetic and velocity fluctuations is obtained. Nonlinear interactions give rise to an energy cascade towards smaller scales where energy is dissipated in an intermittent fashion. Due to the strong longitudinal magnetic field, dissipative structures propagate along the loop, with the typical speed of the Alfvén waves. The statistical analysis on the intermittent dissipative events compares well with all observed properties of nanoflare emission statistics. Moreover the recent observations of non thermal velocity measurements during flare occurrence are well described by the numerical results of the simulation model. All these results naturally emerge from the model dynamical evolution without any need of an ad-hoc hypothesis.

  20. Temperature and Density Measurements in a Quiet Coronal Streamer

    Science.gov (United States)

    Warren, Harry P.; Warshall, Andrew D.

    2002-06-01

    Many previous studies have used emission line or broadband filter ratios to infer the presence of temperature gradients in the quiet solar corona. Recently it has been suggested that these temperature gradients are not real, but result from the superposition of isothermal loops with different temperatures and density scale heights along the line of sight. A model describing this hydrostatic weighting bias has been developed by Aschwanden & Acton. In this paper we present the application of the Aschwanden & Acton differential emission measure model to Solar and Heliospheric Observatory Solar Ultraviolet Measurement of Emitted Radiation (SUMER) observations of a quiet coronal streamer. Simultaneous Yohkoh soft X-ray telescope (SXT) observations show increases in the filter ratios with height above the limb, indicating an increase in temperature. The application of the Aschwanden & Acton model to these SUMER data, however, show that the temperature is constant with height and that the distribution of temperatures in the corona is much too narrow for the hydrostatic weighting bias to have any effect on the SXT filter ratios. We consider the possibility that there is a tenuous hot component (~3 MK) that accounts for the SXT observations. We find that a hot plasma with an emission measure sufficient to reproduce the observed SXT fluxes would also produce significant count rates in the high-temperature emission lines in the SUMER wavelength range. These lines are not observed, and we conclude that the SUMER spectra are not consistent with the SXT filter ratio temperatures. Calculations from a hydrodynamic loop model suggest that nonuniform footpoint heating may be consistent with the temperatures and densities observed at most heights, consistent with the recent analysis of relatively cool (~1 MK) active region loops. We also find, however, that at the lowest heights the observed densities are smaller than those predicted by uniform or footpoint heating.

  1. North south asymmetry in the coronal and photospheric magnetic fields

    Science.gov (United States)

    Virtanen, I.; Mursula, K.

    2013-12-01

    Several recent studies have shown that the Heliospheric current sheet (HCS) is southward shifted during about three years in the solar declining phase (the so-called bashful ballerina phenomenon). We study the hemispherical asymmetry in the photospheric and coronal magnetic fields using Wilcox Solar Observatory (WSO) measurements of the photospheric magnetic field since 1976 and the potential field source surface (PFSS) model. Multipole analysis of the photospheric magnetic field shows that during the late declining phase of solar cycles since 1970s, bashful ballerina phenomenon is a consequence of g02 quadrupole term, signed oppositely to the dipole moment. Surges of new flux transport magnetic field from low latitudes to the poles, thus leading to a systematically varying contribution to the g02-term from different latitudes. In the case of a north-south asymmetric flux production this is seen as a quadrupole contribution traveling towards higher latitudes. When the quadrupole term is largest the main contribution comes from the polar latitudes. At least during the four recent solar cycles the g02-term arises because the magnitude of the southern polar field is larger than in the north in the declining phase of the cycle. Magnetic flux is transported polewards by the meridional flow and it is most likely that besides the north-south asymmetric production of the magnetic flux, also the asymmetric transportation may significantly contribute to the observed asymmetry of polar field intensities. The overall activity during solar cycle is not significantly different in the northern and southern hemispheres, but hemispheres tend to develop in a different phase.

  2. Ultrafest: A Novel Approach to Ultrasound in Medical Education Leads to Improvement in Written and Clinical Examinations

    Directory of Open Access Journals (Sweden)

    Langdorf, Mark I.

    2014-12-01

    Full Text Available Introduction: Our objective was to evaluate the effectiveness of hands-on training at a bedside ultrasound (US symposium (“Ultrafest” to improve both clinical knowledge and image acquisition skills of medical students. Primary outcome measure was improvement in multiple choice questions on pulmonary or Focused Assessment with Sonography in Trauma (FAST US knowledge. Secondary outcome was improvement in image acquisition for either pulmonary or FAST. Methods: Prospective cohort study of 48 volunteers at “Ultrafest,” a free symposium where students received five contact training hours. Students were evaluated before and after training for proficiency in either pulmonary US or FAST. Proficiency was assessed by clinical knowledge through written multiple-choice exam, and clinical skills through accuracy of image acquisition. We used paired sample t-tests with students as their own controls. Results: Pulmonary knowledge scores increased by a mean of 10.1 points (95% CI [8.9-11.3], p<0.00005, from 8.4 to a posttest average of 18.5/21 possible points. The FAST knowledge scores increased by a mean of 7.5 points (95% CI [6.3-8.7] p<0.00005, from 8.1 to a posttest average of 15.6/ 21. We analyzed clinical skills data on 32 students. The mean score was 1.7 pretest and 4.7 posttest of 12 possible points. Mean improvement was 3.0 points (p<0.00005 overall, 3.3 (p=0.0001 for FAST, and 2.6 (p=0.003 for the pulmonary US exam. Conclusion: This study suggests that a symposium on US can improve clinical knowledge, but is limited in achieving image acquisition for pulmonary and FAST US assessments. US training external to official medical school curriculum may augment students’ education. [West J Emerg Med. 2015;16(1:143–148.

  3. Estimate of the exposition to the ionizing radiation of the medical veterinarians and its assistants in radiology examinations veterinary medicine

    Energy Technology Data Exchange (ETDEWEB)

    Lima, G.; Braz, D.; Lopez, R. [Rio de Janeiro Univ. Federal, COPPE (Brazil); Mauricia, C. [Rio de Janeiro Univ. Federal, Instituto de Radioprotecao e Dosimetria (Brazil); Barroso, R. [Rio de Janeiro Univ. Federal, Universidade Estadual do Rio de Janeiro (Brazil)

    2006-07-01

    The absorbed ionizing radiation outside of the permissible limits, can cause biological damages e, therefore it must necessarily be monitored. The dosimetry thermoluminescent is a technique very used to detect expositions in operatorserefore they are sensible crystals the ionizing radiation and allows to evaluate if the dose of radiation is or not below of the restriction levels. In scientific literature many information do not exist on the exposition of a medical veterinarian, with this do not have many data of the individual monitoring of these workers, becoming the work it important for posterior studies. Ahead of this, it was carried through measured of the doses, using the thermoluminescence dosemeters LiF: Mg, Cu, P (TLD-100 H) in the position of the crystalline lens, thyroid, hand and thorax, in three clinics of radiology veterinary medicine, different, having the objective to determine the dose distribution that the workers of radiology veterinary medicine are submitted in one day of work. (authors)

  4. Who Do Hospital Physicians and Nurses Go to for Advice About Medications? A Social Network Analysis and Examination of Prescribing Error Rates.

    Science.gov (United States)

    Creswick, Nerida; Westbrook, Johanna Irene

    2015-09-01

    To measure the weekly medication advice-seeking networks of hospital staff, to compare patterns across professional groups, and to examine these in the context of prescribing error rates. A social network analysis was conducted. All 101 staff in 2 wards in a large, academic teaching hospital in Sydney, Australia, were surveyed (response rate, 90%) using a detailed social network questionnaire. The extent of weekly medication advice seeking was measured by density of connections, proportion of reciprocal relationships by reciprocity, number of colleagues to whom each person provided advice by in-degree, and perceptions of amount and impact of advice seeking between physicians and nurses. Data on prescribing error rates from the 2 wards were compared. Weekly medication advice-seeking networks were sparse (density: 7% ward A and 12% ward B). Information sharing across professional groups was modest, and rates of reciprocation of advice were low (9% ward A, 14% ward B). Pharmacists provided advice to most people, and junior physicians also played central roles. Senior physicians provided medication advice to few people. Many staff perceived that physicians rarely sought advice from nurses when prescribing, but almost all believed that an increase in communication between physicians and nurses about medications would improve patient safety. The medication networks in ward B had higher measures for density, reciprocation, and fewer senior physicians who were isolates. Ward B had a significantly lower rate of both procedural and clinical prescribing errors than ward A (0.63 clinical prescribing errors per admission [95%CI, 0.47-0.79] versus 1.81/ admission [95%CI, 1.49-2.13]). Medication advice-seeking networks among staff on hospital wards are limited. Hubs of advice provision include pharmacists, junior physicians, and senior nurses. Senior physicians are poorly integrated into medication advice networks. Strategies to improve the advice-giving networks between senior

  5. Modern state and prospects of dermatoglyphics research in practice of medical-psychological examination of students and youth

    Directory of Open Access Journals (Sweden)

    P. M. Polushkin

    2012-02-01

    Full Text Available The modern state and prospects of the medico-psychological examination of students and young people are analysed by a dermatoglyphics that allows drawing up the psychological portrait of a person. On the basis of typology of digital dermatoglyphics the development of the criteria system for prognostic estimation of physical capabilities of a human being is possible. According to the ratio of norm and pathology areas of the skin markings the hereditary diseases for future posterity, developmental abnormalities, different gene mutations, congenital development defects (limbs development defects as the special case, gender anomalies (sex determination, possible lethal cases, chromosome diseases and other cases can be forecasted with 99 % confidence.

  6. What can we learn about solar coronal mass ejections, coronal dimmings, and Extreme-Ultraviolet jets through spectroscopic observations?

    CERN Document Server

    Tian, Hui; Xia, Lidong; He, Jiansen; Wang, Xin

    2012-01-01

    We analyze several data sets obtained by Hinode/EIS and find various types of flows during CMEs and EUV jet eruptions. CME-induced dimming regions are found to be characterized by significant blueshift and enhanced line width by using a single Gaussian fit. While a red-blue (RB) asymmetry analysis and a RB-guided double Gaussian fit of the coronal line profiles indicate that these are likely caused by the superposition of a strong background emission component and a relatively weak (~10%) high-speed (~100 km s-1) upflow component. This finding suggests that the outflow velocity in the dimming region is probably of the order of 100 km s-1, not ~20 km s-1 as reported previously. Density and temperature diagnostics suggest that dimming is primarily an effect of density decrease rather than temperature change. The mass losses in dimming regions as estimated from different methods are roughly consistent with each other and they are 20%-60% of the masses of the associated CMEs. With the guide of RB asymmetry analys...

  7. Self-reported study habits for enhancing medical students’ performance in the National Medical Unified Examination

    Science.gov (United States)

    Idris, Amr; Al Saadi, Tareq; Edris, Basel; Sawaf, Bisher; Zakaria, Mhd. Ismael; Alkhatib, Mahmoud; Turk, Tarek

    2016-01-01

    Background: The National Medical Unified Examination (NMUE) is currently required for graduation, joining postgraduate medical training, and practicing medicine in Syria. Objective: To investigate self-reported study habits that correlate with high performance on the NMUE. Methods: First through 3rd year residents at the three main hospitals in Damascus, Syria, were asked to complete a retrospective cross-sectional survey investigating their study habits and previous scores. Results: Significantly higher score was associated with >15 study h/day and allocating 1–40% of study time for practicing questions. Mean NMUE score was not significantly different in relation to preparation months for examination or for those who reported spending all their time studying alone compared with spending any amount of time in a group setting. Scores of 231–240 on the Syrian scientific high school exam correlated with significantly higher NMUE performance compared with fewer scores, except scores of 221–230. For every 10 point increase in medical school cumulative grades, the NMUE score increased 3.6 (95% confidence interval 2.5–4.8). Conclusion: The NMUE score was significantly affected by hours spent studying per day, number of practice questions completed, percentage of study time allocated for doing questions, Syrian scientific high school exam scores, and the cumulative medical school class grades. It was not significantly affected by preparation months or studying in a group setting. More studies are needed to further describe and investigate the factors that might affect performance in the NMUE. PMID:27144140

  8. Classification and Physical parameters EUV coronal jets with STEREO/SECCHI.

    Science.gov (United States)

    Nistico, Giuseppe; Bothmer, Volker; Patsourakos, Spiro; Zimbardo, Gaetano

    In this work we present observations of EUV coronal jets, detected with the SECCHI (Sun Earth Connection Coronal and Heliospheric Investigation) imaging suites of the two STEREO spacecraft. Starting from catalogues of polar and equatorial coronal hole jets (Nistico' et al., Solar Phys., 259, 87, 2009; Ann. Geophys. in press), identified from simultaneous EUV and white-light coronagraph observations, taken during the time period March 2007 to April 2008 when solar activity was at minimum, we perfom a detailed study of some events. A basic char-acterisation of the magnetic morphology and identification of the presence of helical structure were established with respect to recently proposed models for their origin and temporal evo-lution. A classification of the events with respect to previous jet studies shows that amongst the 79 events, identified into polar coronal holes, there were 37 Eiffel tower -type jet events commonly interpreted as a small-scale ( 35 arcsec) magnetic bipole reconnecting with the ambi-ent unipolar open coronal magnetic fields at its looptops, 12 lambda-type jet events commonly interpreted as reconnection with the ambient field happening at the bipoles footpoints. Five events were termed micro-CME type jet events because they resembled classical three-part structured coronal mass ejections (CMEs) but on much smaller scales. The remainig 25 cases could not be uniquely classified. Thirty-one of the total number of events exhibited a helical magnetic field structure, indicative for a torsional motion of the jet around its axis of propaga-tion. The jet events are found to be also present in equatorial coronal holes. We also present the 3-D reconstruction, temperature, velocity, and density measurements of a number of jets during their evolution.

  9. Narrow CSF space at high convexity and high midline areas in idiopathic normal pressure hydrocephalus detected by axial and coronal MRI

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, Makoto [Iwate Medical University, Department of Radiology, Morioka (Japan); Honda, Satoshi [St. Luke' s International Hospital, Department of Radiology, Tokyo (Japan); Yuasa, Tatsuhiko; Iwamura, Akihide [Kohnodai Hospital, National Center of Neurology and Psychiatry, Department of Neurology, Ichikawa (Japan); Shibata, Eri [Iwate Medical University, Department of Neuropsychiatry, Morioka (Japan); Ohba, Hideki [Iwate Medical University, Department of Neurology, Morioka (Japan)

    2008-02-15

    The aim of this study was to determine the performance of axial and coronal magnetic resonance imaging (MRI) in detecting the narrowing of the cerebrospinal fluid (CSF) space at the high convexity and high midline areas, which is speculated to be one of the clinical characteristics of idiopathic normal pressure hydrocephalus (iNPH). We retrospectively examined axial and coronal T1-weighted images of 14 iNPH patients and 12 age-matched controls. The narrowness of the CSF space at the high convexity/midline was blindly evaluated by five raters using a continuous confidence rating scale for receiver operating characteristic (ROC) analysis. Axial and coronal imaging accurately determined the presence of the narrow cisterns/sulci at the high convexity/midline and was capable of predicting probable/definite iNPH with a high degree of accuracy. there were also no significant differences in the detection of this finding between the axial and coronal images. Both axial and coronal T1-weighted MRI can detect the narrow CSF space at the high convexity/midline accurately and may therefore facilitate clinicians in choosing a management strategy for iNPH patients. (orig.)

  10. Periods and damping rates of fast sausage oscillations in multi-shelled coronal loops

    CERN Document Server

    Chen, Shao-Xia; Xia, Li-Dong; Yu, Hui

    2015-01-01

    Standing sausage modes are important in interpreting quasi-periodic pulsations in the lightcurves of solar flares. Their periods and damping times play an important role in seismologically diagnosing key parameters like the magnetic field strength in regions where flare energy is released. Usually such applications are based on theoretical results neglecting unresolved fine structures in magnetized loops. However, the existence of fine structuring is suggested on both theoretical and observational grounds. Adopting the framework of cold magnetohydrodynamics (MHD), we model coronal loops as magnetized cylinders with a transverse equilibrium density profile comprising a monolithic part and a modulation due to fine structuring in the form of concentric shells. The equation governing the transverse velocity perturbation is solved with an initial-value-problem approach, and the effects of fine structuring on the periods $P$ and damping times $\\tau$ of global, leaky, standing sausage modes are examined. A parameter...

  11. Characteristics of Populations of the Russian Federation over the Panel of Fifteen Loci Used for DNA Identification and in Forensic Medical Examination

    OpenAIRE

    Stepanov, V.; Balanovsky, O.; Melnikov, A; Lash-zavada, A.; Khar'kov, V.; Tyazhelova, T.; Akhmetova, V.; Zhukova, O.; Shneider, Yu; Shil'nikova, I.; S Borinskaya; Marusin, A.; Spiridonova, M.; Simonova, K.; Khitrinskaya, I.

    2011-01-01

    Seventeen population groups within the Russian Federation were characterized for the first time using a panel of 15 genetic markers that are used for DNA identification and in forensic medical examinations. The degree of polymorphism and population diversity of microsatellite loci within the Power Plex system (Promega) in Russian populations; the distribution of alleles and genotypes within the populations of six cities and 11 ethnic groups of the Russian Federation; the levels of intra- and ...

  12. Forensic medical examinations conducted on complainants of sexual assault in the Forensic Medicine Institute, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, between 2006 and 2013.

    Science.gov (United States)

    Engelgardt, P; Cychowska, M; Bloch-Bogusławska, E

    2014-01-01

    A total of 46 cases of alleged sexual assault were analysed from the years 2006-2013 where forensic medical examinations were conducted. The material was compared with data from literature. All the victims were female. In 9 cases (20%) a sexual assault by sexual touching was alleged, 67% of complainants (31 cases) had alleged non-consensual sexual intercourse, 6 complainants (13%) had no recollection of events. Genital area injuries were reported in 26% of sexual assault victims. Injuries of other parts of the body were found in 73% of victims. None of the subjects were positive for severe injuries such as fractures, wounds, and head trauma with loss of consciousness. The majority of complainants (29 cases, 63%) were examined within 24 hours after the incident and 6 examinees (13%) were assessed between 24 and 48 hours after the alleged sexual assault. Eleven forensic medical examinations (24%) were conducted after the lapse of more than 48 hours since the alleged incident. Twenty nine complainants admitted that they had washed their genital area after the sexual assault. Forensic swabs were taken during all forensic medical examinations.

  13. Use of medical tourism for hip and knee surgery in osteoarthritis: a qualitative examination of distinctive attitudinal characteristics among Canadian patients.

    Science.gov (United States)

    Crooks, Valorie A; Cameron, Keri; Chouinard, Vera; Johnston, Rory; Snyder, Jeremy; Casey, Victoria

    2012-11-21

    Medical tourism is the term that describes patients' international travel with the intention of seeking medical treatment. Some medical tourists go abroad for orthopaedic surgeries, including hip and knee resurfacing and replacement. In this article we examine the findings of interviews with Canadian medical tourists who went abroad for such surgeries to determine what is distinctive about their attitudes when compared to existing qualitative research findings about patients' decision-making in and experiences of these same procedures in their home countries. Fourteen Canadian medical tourists participated in semi-structured phone interviews, all of whom had gone abroad for hip or knee surgery to treat osteoarthritis. Transcripts were coded and thematically analysed, which involved comparing emerging findings to those in the existing qualitative literature on hip and knee surgery. Three distinctive attitudinal characteristics among participants were identified when interview themes were compared to findings in the existing qualitative research on hip and knee surgery in osteoarthritis. These attitudinal characteristics were that the medical tourists we spoke with were: (1) comfortable health-related decision-makers; (2) unwavering in their views about procedure necessity and urgency; and (3) firm in their desires to maintain active lives. Compared to other patients reported on in the existing qualitative hip and knee surgery literature, medical tourists are less likely to question their need for surgery and are particularly active in their pursuit of surgical intervention. They are also comfortable with taking control of health-related decisions. Future research is needed to identify motivators behind patients' pursuit of care abroad, determine if the attitudinal characteristics identified here hold true for other patient groups, and ascertain the impact of these attitudinal characteristics on surgical outcomes. Arthritis care providers can use the attitudinal

  14. Use of medical tourism for hip and knee surgery in osteoarthritis: a qualitative examination of distinctive attitudinal characteristics among Canadian patients

    Directory of Open Access Journals (Sweden)

    Crooks Valorie A

    2012-11-01

    Full Text Available Abstract Background Medical tourism is the term that describes patients’ international travel with the intention of seeking medical treatment. Some medical tourists go abroad for orthopaedic surgeries, including hip and knee resurfacing and replacement. In this article we examine the findings of interviews with Canadian medical tourists who went abroad for such surgeries to determine what is distinctive about their attitudes when compared to existing qualitative research findings about patients’ decision-making in and experiences of these same procedures in their home countries. Methods Fourteen Canadian medical tourists participated in semi-structured phone interviews, all of whom had gone abroad for hip or knee surgery to treat osteoarthritis. Transcripts were coded and thematically analysed, which involved comparing emerging findings to those in the existing qualitative literature on hip and knee surgery. Results Three distinctive attitudinal characteristics among participants were identified when interview themes were compared to findings in the existing qualitative research on hip and knee surgery in osteoarthritis. These attitudinal characteristics were that the medical tourists we spoke with were: (1 comfortable health-related decision-makers; (2 unwavering in their views about procedure necessity and urgency; and (3 firm in their desires to maintain active lives. Conclusions Compared to other patients reported on in the existing qualitative hip and knee surgery literature, medical tourists are less likely to question their need for surgery and are particularly active in their pursuit of surgical intervention. They are also comfortable with taking control of health-related decisions. Future research is needed to identify motivators behind patients’ pursuit of care abroad, determine if the attitudinal characteristics identified here hold true for other patient groups, and ascertain the impact of these attitudinal characteristics on

  15. Can Examination of WWW Usage Statistics and other Indirect Quality Indicators Help to Distinguish the Relative Quality of Medical websites?

    Science.gov (United States)

    Macías-Cervi, Pablo; Gaspar-Guardado, María Asunción; DeArcaya, María Luisa Torres-Álvarez; Ruiz-Rabaza, Ana; Jiménez-Sosa, Alejandro

    1999-01-01

    Background The Internet offers a great amount of health related websites, but concern has been raised about their reliability. Several subjective evaluation criteria and websites rating systems have been proposed as a help for the Internet users to distinguish among web resources with different quality, but their efficacy has not been proven. Objective To evaluate the agreement of a subset of Internet rating systems editorial boards regarding their evaluations of a sample of pediatric websites. To evaluate certain websites characteristics as possible quality indicators for pediatric websites. Methods Comparative survey of the results of systematic evaluations of the contents and formal aspects of a sample of pediatric websites, with the number of daily visits to those websites, the time since their last update, the impact factor of their authors or editors, and the number of websites linked to them. Results 363 websites were compiled from eight rating systems. Only 25 were indexed and evaluated by at least two rating systems. This subset included more updated and more linked websites. There was no correlation among the results of the evaluation of these 25 websites by the rating systems. The number of inbound links to the websites significantly correlated with their updating frequency (p<.001), with the number of daily visits (p=.005), and with the results of their evaluation by the largest rating system, HealthAtoZ (p<.001). The websites updating frequency also significantly correlated with the results of the websites evaluation by HealthAtoZ, both about their contents (p=.001) and their total values (p<.05). The number of daily visits significantly correlated (p<.05) with the results of the evaluations by Medical Matrix. Conclusions Some websites characteristics as the number of daily visits, their updating frequency and, overall, the number of websites linked to them, correlate with their evaluation by some of the largest rating systems on the Internet, what

  16. Coronal structure and brightness profile of the total solar eclipse on August 1,2008

    Institute of Scientific and Technical Information of China (English)

    ZHAO HaiBin; LIN QiSheng; CHEN YiPing; JIN Sheng; GUAN ZhenBiao; HU Zhongwei

    2009-01-01

    Solar corona is the outermost part of the solar atmosphere.Coronal activities influence space environment between the Sun and the Earth,space weather and the Earth itself.The total solar eclipse (TSE) is the best opportunity to observe the solar corona on ground.During the TSE 2008,a series of images of the corona and partial eclipse of solar disk were obtained using telescope and CCD camera.After image processing,preliminary results of coronal structure are given,and radial brightness profiles of the corona in directions of pole and equator of the Sun are measured.Though in solar activity minimum,the shape and structure of the corona are not symmetry.The equatorial regions are more extent than the polar one,and there are also larger differences between the east and west equatorial regions and between the south and north polar regions.Coronal streamers on east side of the equator,particularly the largest one in east-south direction,are very obvious.The coronal plume in south polar region consists of more polar rays than that in north polar region.These structures are also shown in other observations and data of SOHO.The radial brightness profiles in directions of pole and equator are similar to those of the Van de Hulst model in solar minimum,but there are a few differences due to coronal activity,which is shown in the isophote map of the corona.

  17. Best-fit model of exploratory and confirmatory factor analysis of the 2010 Medical Council of Canada Qualifying Examination Part I clinical decision-making cases.

    Science.gov (United States)

    Champlain, André F De

    2015-01-01

    This study aims to assess the fit of a number of exploratory and confirmatory factor analysis models to the 2010 Medical Council of Canada Qualifying Examination Part I (MCCQE1) clinical decision-making (CDM) cases. The outcomes of this study have important implications for a range of domains, including scoring and test development. The examinees included all first-time Canadian medical graduates and international medical graduates who took the MCCQE1 in spring or fall 2010. The fit of one- to five-factor exploratory models was assessed for the item response matrix of the 2010 CDM cases. Five confirmatory factor analytic models were also examined with the same CDM response matrix. The structural equation modeling software program Mplus was used for all analyses. Out of the five exploratory factor analytic models that were evaluated, a three-factor model provided the best fit. Factor 1 loaded on three medicine cases, two obstetrics and gynecology cases, and two orthopedic surgery cases. Factor 2 corresponded to pediatrics, and the third factor loaded on psychiatry cases. Among the five confirmatory factor analysis models examined in this study, three- and four-factor lifespan period models and the five-factor discipline models provided the best fit. The results suggest that knowledge of broad disciplinary domains best account for performance on CDM cases. In test development, particular effort should be placed on developing CDM cases according to broad discipline and patient age domains; CDM testlets should be assembled largely using the criteria of discipline and age.

  18. Bone marrow evaluation in small cell carcinoma of the lung. [Radiographic and nuclear medical examinations also performed

    Energy Technology Data Exchange (ETDEWEB)

    Giaccone, G.; Ciuffreda, L.; Donadio, M.; Ferrati, P.; Risio, M.; Leria, G.; Bonardi, G.; Calciati, A.

    1987-01-01

    Bone marrow examination is commonly included in the staging of small cell lung carcinoma (SCLC). We reviewed marrow samples of 103 patients. Marrow examination was mainly performed by unilateral or bilateral biopsy of iliac crests, using a Jamshidi needle. Only 6 of 97 evaluable cases (6.2%) were positive for marrow metastases at staging, and in 3 cases (3%) bone marrow was the only metastatic site. No focal metastases were found in additional sections made from the blocks of negative samples. In our experience bone marrow biopsy was of little value in staging SCLC. Bilateral biopsy plus aspirate, with the addition of more sophisticated staining techniques might, however, provide a higher yield of positive marrow involvement.

  19. The predictive validity of three versions of the MCAT in relation to performance in medical school, residency, and licensing examinations: a longitudinal study of 36 classes of Jefferson Medical College.

    Science.gov (United States)

    Callahan, Clara A; Hojat, Mohammadreza; Veloski, Jon; Erdmann, James B; Gonnella, Joseph S

    2010-06-01

    The Medical College Admission Test (MCAT) has undergone several revisions for content and validity since its inception. With another comprehensive review pending, this study examines changes in the predictive validity of the MCAT's three recent versions. Study participants were 7,859 matriculants in 36 classes entering Jefferson Medical College between 1970 and 2005; 1,728 took the pre-1978 version of the MCAT; 3,032 took the 1978-1991 version, and 3,099 took the post-1991 version. MCAT subtest scores were the predictors, and performance in medical school, attrition, scores on the medical licensing examinations, and ratings of clinical competence in the first year of residency were the criterion measures. No significant improvement in validity coefficients was observed for performance in medical school or residency. Validity coefficients for all three versions of the MCAT in predicting Part I/Step 1 remained stable (in the mid-0.40s, P < .01). A systematic decline was observed in the validity coefficients of the MCAT versions in predicting Part II/Step 2. It started at 0.47 for the pre-1978 version, decreased to between 0.42 and 0.40 for the 1978-1991 versions, and to 0.37 for the post-1991 version. Validity coefficients for the MCAT versions in predicting Part III/Step 3 remained near 0.30. These were generally larger for women than men. Although the findings support the short- and long-term predictive validity of the MCAT, opportunities to strengthen it remain. Subsequent revisions should increase the test's ability to predict performance on United States Medical Licensing Examination Step 2 and must minimize the differential validity for gender.

  20. Solar Wind Associated with Near Equatorial Coronal Hole

    Indian Academy of Sciences (India)

    M. Hegde; K. M. Hiremath; Vijayakumar H. Doddamani; Shashanka R. Gurumath

    2015-09-01

    Present study probes temporal changes in the area and radiative flux of near equatorial coronal hole associated with solar wind parameters such as wind speed, density, magnetic field and temperature. Using high temporal resolution data from SDO/AIA for the two wave-lengths 193 Å and 211 Å, area and radiative flux of coronal holes are extracted and are examined for the association with high speed solar wind parameters. We find a strong association between different parameters of coronal hole and solar wind. For both the wavelength bands, we also compute coronal hole radiative energy near the earth and it is found to be of similar order as that of solar wind energy. However, for the wavelength 193 Å, owing to almost similar magnitudes of energy emitted by coronal hole and energy due to solar wind, it is conjectured that solar wind might have originated around the same height where 193 Å line is formed in the corona.

  1. Coronal loop detection and salient contour group extraction from solar images

    Science.gov (United States)

    Durak, Nurcan

    2011-01-01

    This dissertation addresses two different problems: 1) coronal loop detection from solar images: and 2) salient contour group extraction from cluttered images. In the first part, we propose two different solutions to the coronal loop detection problem. The first solution is a block-based coronal loop mining method that detects coronal loops from solar images by dividing the solar image into fixed sized blocks, labeling the blocks as "Loop" or "Non-Loop", extracting features from the labeled blocks, and finally training classifiers to generate learning models that can classify new image blocks. The block-based approach achieves 64% accuracy in 10-fold cross validation experiments. To improve the accuracy and scalability, we propose a contour-based coronal loop detection method that extracts contours from cluttered regions, then labels the contours as "Loop" and "Non-Loop", and extracts geometric features from the labeled contours. The contour-based approach achieves 85% accuracy in 10-fold cross validation experiments, which is a 20% increase compared to the block-based approach. In the second part, we propose a method to extract semi-elliptical open curves from cluttered regions. Our method consists of the following steps: obtaining individual smooth contours along with their saliency measures; then starting from the most salient contour, searching for possible grouping options for each contour; and continuing the grouping until an optimum solution is reached. Our work involved the design and development of a complete system for coronal loop mining in solar images, which required the formulation of new Gestalt perceptual rules and a systematic methodology to select and combine them in a fully automated judicious manner using machine learning techniques that eliminate the need to manually set various weight and threshold values to define an effective cost function. After finding salient contour groups, we close the gaps within the contours in each group and perform

  2. Zimbabwe's Medical Brain Drain: Impact Assessment on Health Service Delivery and Examination of Policy Responses: A Literature Review

    Directory of Open Access Journals (Sweden)

    Conrad Chibango

    2013-06-01

    Full Text Available The migration of health professionals to greener pastures negatively impacts on the healthservice delivery of the source countries. The trend is that doctors and nurses migrate fromrural areas to urban areas or from developing countries to developed countries in search ofbetter economic welfare and working conditions. In search of the same conditions, healthprofessionals also migrate from the public sector to the private sector. The causes for thismigration, which are largely viewed to be of economic nature, constitute the ‘push’ and‘pull’ factors. It is these factors that policy-makers should carefully study in order to arrestthe medical brain drain. Zimbabwe has not been spared of this phenomenon. In theprocess, the poor, and especially in rural areas, have been the worst victims. ZimbabweanGovernment policies, though well-intended, have not been adequate enough to arrest thesituation. This paper argues that an integrated policy approach is best positioned toaddress the brain drain problem, which has negatively impacted on the health servicedelivery system. The integrated policy approach takes cognizance of the various factorsthat constitute the complex nature of the brain drain. Such factors include global, regional,national, international market labour, development theory and practice, and human rightsand justice issues, which, unfortunately, are not usually given much consideration duringthe policy formulation process.

  3. Tuberculosis in Dr Granville's mummy: a molecular re-examination of the earliest known Egyptian mummy to be scientifically examined and given a medical diagnosis.

    Science.gov (United States)

    Donoghue, Helen D; Lee, Oona Y-C; Minnikin, David E; Besra, Gurdyal S; Taylor, John H; Spigelman, Mark

    2010-01-07

    'Dr Granville's mummy' was described to the Royal Society of London in 1825 and was the first ancient Egyptian mummy to be subjected to a scientific autopsy. The remains are those of a woman, Irtyersenu, aged about 50, from the necropolis of Thebes and dated to about 600 BC. Augustus Bozzi Granville (1783-1872), an eminent physician and obstetrician, described many organs still in situ and attributed the cause of death to a tumour of the ovary. However, subsequent histological investigations indicate that the tumour is a benign cystadenoma. Histology of the lungs demonstrated a potentially fatal pulmonary exudate and earlier studies attempted to associate this with particular disease conditions. Palaeopathology and ancient DNA analyses show that tuberculosis was widespread in ancient Egypt, so a systematic search for tuberculosis was made, using specific DNA and lipid biomarker analyses. Clear evidence for Mycobacterium tuberculosis complex DNA was obtained in lung tissue and gall bladder samples, based on nested PCR of the IS6110 locus. Lung and femurs were positive for specific M. tuberculosis complex cell-wall mycolic acids, demonstrated by high-performance liquid chromatography of pyrenebutyric acid-pentafluorobenzyl mycolates. Therefore, tuberculosis is likely to have been the major cause of death of Irtyersenu.

  4. Impulsively Generated Linear and Non-linear Alfven Waves in the Coronal Funnels

    Science.gov (United States)

    Chmielewski, P.; Srivastava, A. K.; Murawski, K.; Musielak, Z. E.

    2014-01-01

    We present simulation results of the impulsively generated linear and non-linear Alfvén waves in the weakly curved coronal magnetic flux-tubes (coronal funnels) and discuss their implications for the coronal heating and solar wind acceleration. We solve numerically the time-dependent magnetohydrodynamic equations to find the temporal signatures of the small and large-amplitude Alfvén waves in the model atmosphere of open and expanding magnetic field configuration with a realistic temperature distribution. We compute the maximum transversal velocity of both linear and non-linear Alfvén waves at different heights of the model atmosphere, and study their response in the solar corona during the time of their propagation. We infer that the pulse-driven non-linear Alfvén waves may carry sufficient wave energy fluxes to heat the coronal funnels and also to power the solar wind that originates in these funnels. Our study of linear Alfvén waves shows that they can contribute only to the plasma dynamics and heating of the funnel-like magnetic flux-tubes associated with the polar coronal holes.

  5. Future space missions and ground observatory for measurements of coronal magnetic fields

    Science.gov (United States)

    Fineschi, Silvano; Gibson, Sarah; Bemporad, Alessandro; Zhukov, Andrei; Damé, Luc; Susino, Roberto; Larruquert, Juan

    2016-07-01

    This presentation gives an overview of the near-future perspectives for probing coronal magnetism from space missions (i.e., SCORE and ASPIICS) and ground-based observatory (ESCAPE). Spectro-polarimetric imaging of coronal emission-lines in the visible-light wavelength-band provides an important diagnostics tool of the coronal magnetism. The interpretation in terms of Hanle and Zeeman effect of the line-polarization in forbidden emission-lines yields information on the direction and strength of the coronal magnetic field. As study case, this presentation will describe the Torino Coronal Magnetograph (CorMag) for the spectro-polarimetric observation of the FeXIV, 530.3 nm, forbidden emission-line. CorMag - consisting of a Liquid Crystal (LC) Lyot filter and a LC linear polarimeter. The CorMag filter is part of the ESCAPE experiment to be based at the French-Italian Concordia base in Antarctica. The linear polarization by resonance scattering of coronal permitted line-emission in the ultraviolet (UV)can be modified by magnetic fields through the Hanle effect. Space-based UV spectro-polarimeters would provide an additional tool for the disgnostics of coronal magnetism. As a case study of space-borne UV spectro-polarimeters, this presentation will describe the future upgrade of the Sounding-rocket Coronagraphic Experiment (SCORE) to include new generation, high-efficiency UV polarizer with the capability of imaging polarimetry of the HI Lyman-α, 121.6 nm. SCORE is a multi-wavelength imager for the emission-lines, HeII 30.4 nm and HI 121.6 nm, and visible-light broad-band emission of the polarized K-corona. SCORE has flown successfully in 2009. The second lauch is scheduled in 2016. Proba-3 is the other future solar mission that would provide the opportunity of diagnosing the coronal magnetic field. Proba-3 is the first precision formation-flying mission to launched in 2019). A pair of satellites will fly together maintaining a fixed configuration as a 'large rigid

  6. Coronal Mass Ejections

    Science.gov (United States)

    Crooker, Nancy; Joselyn, Jo Ann; Feynman, Joan

    The early 1970's can be said to mark the beginning of The Enlightenment in the history of the Space Age, literally as well as by analogy to European history. Instruments blinded by Earth's atmosphere were lifted above and, for the first time, saw clearly and continuously the ethereal white light and sparkling x-rays from the solar corona. From these two bands of the light spectrum came images of coronal mass ejections and coronal holes, respectively. But whereas coronal holes were immediately identified as the source of high-speed solar wind streams, at first coronal mass ejections were greeted only by a sense of wonder. It took years of research to identify their signatures in the solar wind before the fastest ones could be identified with the well-known shock disturbances that cause the most violent space storms.

  7. Flare Prediction Using Photospheric and Coronal Image Data

    Science.gov (United States)

    Jonas, E.; Shankar, V.; Bobra, M.; Recht, B.

    2016-12-01

    We attempt to forecast M-and X-class solar flares using a machine-learning algorithm and five years of image data from both the Helioseismic and Magnetic Imager (HMI) and Atmospheric Imaging Assembly (AIA) instruments aboard the Solar Dynamics Observatory. HMI is the first instrument to continuously map the full-disk photospheric vector magnetic field from space (Schou et al., 2012). The AIA instrument maps the transition region and corona using various ultraviolet wavelengths (Lemen et al., 2012). HMI and AIA data are taken nearly simultaneously, providing an opportunity to study the entire solar atmosphere at a rapid cadence. Most flare forecasting efforts described in the literature use some parameterization of solar data - typically of the photospheric magnetic field within active regions. These numbers are considered to capture the information in any given image relevant to predicting solar flares. In our approach, we use HMI and AIA images of solar active regions and a deep convolutional kernel network to predict solar flares. This is effectively a series of shallow-but-wide random convolutional neural networks stacked and then trained with a large-scale block-weighted least squares solver. This algorithm automatically determines which patterns in the image data are most correlated with flaring activity and then uses these patterns to predict solar flares. Using the recently-developed KeystoneML machine learning framework, we construct a pipeline to process millions of images in a few hours on commodity cloud computing infrastructure. This is the first time vector magnetic field images have been combined with coronal imagery to forecast solar flares. This is also the first time such a large dataset of solar images, some 8.5 terabytes of images that together capture over 3000 active regions, has been used to forecast solar flares. We evaluate our method using various flare prediction windows defined in the literature (e.g. Ahmed et al., 2013) and a novel per

  8. Studies on Three-Dimensional Dynamic Evolution of Filaments and Coronal EUV Waves

    Science.gov (United States)

    Li, T.

    2014-01-01

    In recent years, it becomes a popular topic to explore various solar eruptive activities in three-dimensional space. The main reason is that three-dimensional evolution of eruptive activities reflects their true physical processes, which is of great importance to understand the occurrence and evolution of various activities. Filament eruption and coronal mass ejection (CME) are two important solar activities. Coronal EUV wave is a phenomenon associated with CME, and the study of coronal EUV wave provides important clues for understanding CME entirely. Since previous observations are from one single viewpoint, the studies of filament eruption and coronal EUV wave are two-dimensional, and suffer from the projection effect. Recently, the multi-viewpoint and high-quality observations from the STEREO and SDO provide us a good opportunity to investigate the three-dimensional evolution of filament eruption and coronal EUV wave. We make full use of the advantages of current observations from STEREO and SDO, and study in detail the three-dimensional shape and evolution of filament eruption, the interaction of coronal EUV waves with coronal structures, and so on. The novel results of our study are listed as below. Using the two-viewpoint observations from the STEREO, we reconstruct two eruptive filaments, locate their positions in three-dimensional space, investigate their true dynamic evolution, and display the evolution of reconstructed filaments seen from different viewpoints with a new visualization method. For the first time, we analyze the true kinematic characteristics of different parts of the filament, and find that the highest part corresponds to the largest velocity during the early phase, which is implied to be the initially perturbed location; afterwards, other parts of the filament move the fastest, which should be accelerated by some mechanisms. With the increasing separation angle between the two STEREO satellites, the reconstruction becomes more difficult

  9. The MEDIGATE graphical user interface for entry of physical findings: design principles and implementation. Medical Examination Direct Iconic and Graphic Augmented Text Entry System.

    Science.gov (United States)

    Yoder, J W; Schultz, D F; Williams, B T

    1998-10-01

    The solution to many of the problems of the computer-based recording of the medical record has been elusive, largely due to difficulties in the capture of those data elements that comprise the records of the Present Illness and of the Physical Findings. Reliable input of data has proven to be more complex than originally envisioned by early work in the field. This has led to more research and development into better data collection protocols and easy to use human-computer interfaces as support tools. The Medical Examination Direct Iconic and Graphic Augmented Text Entry System (MEDIGATE System) is a computer enhanced interactive graphic and textual record of the findings from physical examinations designed to provide ease of user input and to support organization and processing of the data characterizing these findings. The primary design objective of the MEDIGATE System is to develop and evaluate different interface designs for recording observations from the physical examination in an attempt to overcome some of the deficiencies in this major component of the individual record of health and illness.

  10. Investigation and Study on Medical College Students' Attitudes to Examin ation%医学生考试态度的调查研究

    Institute of Scientific and Technical Information of China (English)

    刘欣; 孙国仁

    2001-01-01

    Taking undergraduate medical college students as main ob jects of study ,we investigated their attitudes to present examination method through fact-find ing paper.Results The study showed that the negative influence of present exami nation method is obvious on medical students in psychology and physiology.The hi gh er the grade is,the more students have negative attitudes to present examination method.Speaking of how to reform the present examination method,medical college students require that the reform should be started from lightening the burden o n the students,paying attention to the combination of theory and practice,traini ng the students' creativeness.%以在校医学生为主要对象,采用问卷的形式,对现存考试方式的态度 进行调查。结果 发现:现存考试方式对医学生的心理和生理方面的消极影响是明显的;医学生对现存考试的 评价随年级的升高持否定态度的人增多;对于改革现存考试方式,医学生要求以减轻学生负 担,注重理论与实践相结合,培养创造性为出发点。

  11. Knowledge towards post-mortem examination and reasons for not specialising in morbid anatomy: study among medical undergraduate students

    Directory of Open Access Journals (Sweden)

    Inderjit Singh Bagga

    2016-07-01

    Conclusions: Students possess a reasonable knowledge about post-mortem but knowledge alone may not be enough for increasing the post-mortem/autopsy rate, unless they acquire the skills required for the procedure as currently they are not provided with any training during their medical curriculum. [Int J Res Med Sci 2016; 4(7.000: 2792-2795

  12. Assessment of periapical health, quality of root canal filling, and coronal restoration by using cone-beam computed tomography.

    Science.gov (United States)

    Cakici, E B; Yildirim, E; Cakici, F; Erdogan, A S

    2016-01-01

    The purpose of this study is to use cone-beam computed tomography (CBCT) to describe the prevalence of apical health, the quality of root canal filling, and coronal restorations of endodontically treated teeth in the east Anatolian subpopulation of Turkey. CBCT scans were taken from 748 patients attending for the 1st time to the clinic at the Oral Diagnosis and Radiology Department at Ataturk University's Faculty of Dentistry in Erzurum, Turkey. All images were analyzed by two research assistants who were trained using examples of CBCT images with and without the presence of periapical radiolucency. The two examiners assessed images from the experiment independently, and the readings were then compared. All data were entered on an MS Excel 2007 spreadsheet and SPSS software 15.0 which was used for statistical analysis. The Chi-square test was used to determine if a patient's periapical status was associated with the technical quality of root filling, coronal status, and to evaluate differences between tooth subgroups. In total, 147 teeth from 748 patients were found to have been treated endodontically. Sixty three teeth were found to have short root canal fillings, whereas 74 teeth had adequate root canal fillings, and the remaining 10 teeth had over extended root canal filling. A significant correlation was observed between the length of root filling and apical periodontitis (P = 0,023). Inadequately dense root canal filling was observed in 141 teeth, whereas adequately dense filling was found in only six teeth. There was a significant correlation between the density of root filling and apical periodontitis (P = 0.044). Coronal restoration was found in 90 teeth, but was not observed in all the three teeth. A crown was present in 54 teeth. There was a significant correlation between coronal restoration and apical periodontitis (P = 0.028). The results indicate that the quality of both the root filling and restoration were found to have impact on the periapical

  13. Mechanisms of Coronal Heating

    Indian Academy of Sciences (India)

    S. R. Verma

    2006-06-01

    The Sun is a mysterious star. The high temperature of the chromosphere and corona present one of the most puzzling problems of solar physics. Observations show that the solar coronal heating problem is highly complex with many different facts. It is likely that different heating mechanisms are at work in solar corona. Recent observations show that Magnetic Carpet is a potential candidate for solar coronal heating.

  14. Mental health symptoms in combat medic training: a longitudinal examination.

    Science.gov (United States)

    Robinson, Michael E; Teyhen, Deydre S; Wu, Samuel S; Dugan, Jessica L; Wright, Alison C; Childs, John D; Yang, Guijun; George, Steven Z

    2009-06-01

    Mental health symptoms in military populations are rising and constitute a significant health concern. This study examined the prevalence of depression, anxiety, and suicidal ideation in soldiers (N = 3,792) undergoing combat medic training. At the start of training, 10.4%, 15.5%, and 4.1% of soldiers had clinically significant depression, anxiety, or suicidal ideation, respectfully. These percentages increased to 12.2%, 20.3%, and 5.7% at completion of training, respectfully. Worsening of depression, anxiety, and suicidal ideation occurred for 7.7%, 11.4%, and 4% of soldiers. Higher percentages of symptoms were associated with females, lower education, and lower income. Active duty personnel were more likely to worsen following training with respect to suicidal ideation (OR = 1.9, 95% CI = 1.2-2.9) compared to reservists. The identification of these significant predictors of mental health status may serve to identify individuals at risk. Additional work to examine the relative contribution of anticipatory (impending deployment) factors vs. training-related factors is warranted.

  15. Examining assumptions regarding valid electronic monitoring of medication therapy: development of a validation framework and its application on a European sample of kidney transplant patients

    Directory of Open Access Journals (Sweden)

    Steiger Jürg

    2008-02-01

    Full Text Available Abstract Background Electronic monitoring (EM is used increasingly to measure medication non-adherence. Unbiased EM assessment requires fulfillment of assumptions. The purpose of this study was to determine assumptions needed for internal and external validity of EM measurement. To test internal validity, we examined if (1 EM equipment functioned correctly, (2 if all EM bottle openings corresponded to actual drug intake, and (3 if EM did not influence a patient's normal adherence behavior. To assess external validity, we examined if there were indications that using EM affected the sample representativeness. Methods We used data from the Supporting Medication Adherence in Renal Transplantation (SMART study, which included 250 adult renal transplant patients whose adherence to immunosuppressive drugs was measured during 3 months with the Medication Event Monitoring System (MEMS. Internal validity was determined by assessing the prevalence of nonfunctioning EM systems, the prevalence of patient-reported discrepancies between cap openings and actual intakes (using contemporaneous notes and interview at the end of the study, and by exploring whether adherence was initially uncharacteristically high and decreased over time (an indication of a possible EM intervention effect. Sample representativeness was examined by screening for differences between participants and non-participants or drop outs on non-adherence. Results Our analysis revealed that some assumptions were not fulfilled: 1 one cap malfunctioned (0.4%, 2 self-reported mismatches between bottle openings and actual drug intake occurred in 62% of the patients (n = 155, and 3 adherence decreased over the first 5 weeks of the monitoring, indicating that EM had a waning intervention effect. Conclusion The validity assumptions presented in this article should be checked in future studies using EM as a measure of medication non-adherence.

  16. Observational Signatures of Coronal Loop Heating and Cooling Driven by Footpoint Shuffling

    CERN Document Server

    Dahlburg, R B; Taylor, B D; Ugarte-Urra, I; Warren, H P; Rappazzo, A F; Velli, M

    2016-01-01

    The evolution of a coronal loop is studied by means of numerical simulations of the fully compressible three-dimensional magnetohydrodynamic equations using the HYPERION code. The footpoints of the loop magnetic field are advected by random motions. As a consequence the magnetic field in the loop is energized and develops turbulent nonlinear dynamics characterized by the continuous formation and dissipation of field-aligned current sheets: energy is deposited at small scales where heating occurs. Dissipation is non-uniformly distributed so that only a fraction of the coronal mass and volume gets heated at any time. Temperature and density are highly structured at scales which, in the solar corona, remain observationally unresolved: the plasma of our simulated loop is multi-thermal, where highly dynamical hotter and cooler plasma strands are scattered throughout the loop at sub-observational scales. Numerical simulations of coronal loops of 50000 km length and axial magnetic field intensities ranging from 0.01...

  17. Time-resolved Spectroscopy of Active Binary Stars: Coronal Structure and Flares (Part II)

    Science.gov (United States)

    Brown, Alexander

    EUVE has provided the first stellar coronal spectra showing individual emission lines, thereby allowing coronal modelling at a level of sophistication previously unattainable. Long EUVE observations have shown that large-scale flaring is prevalent in the coronae of active binary stars. We propose to obtain EUVE DSS spectra and photometry for 4 active binaries, one of which has never been observed by EUVE (V478 Lyr) and three EUV-bright systems that merit reobservation (Sigma CrB, Sigma Gem, Xi UMa). We shall use these observations to derive high quality quiescent coronal spectra for measuring emission measure distributions and modelling, and to obtain new flare data. We shall try to coordinate these observations with ground-based radio observations and other spacecraft, if the scheduling allows. The Sigma CrB spectra may be coordinated with AXAF GTO observations. The proposed observations will significantly increase the available EUVE spectroscopy of active binaries.

  18. Comparative study on United States Medical Licensing Examination and physician qualification examinations in China%中国和美国执业医师资格考试比较与启示

    Institute of Scientific and Technical Information of China (English)

    曹霞

    2010-01-01

    美国医师执照考试已经进行了90多年,其系统、稳定、科学和规范的考试体系对美国医学教育产生了积极的作用.本文概述性地介绍了中国和美国执业医师资格考试的特点,并从考试模式、考试内容、考题设计、考试形式及考试资料等方面进行了比较与分析,希望中国执业医师资格考试能够从我国实际出发,借鉴美国医师执照考试的经验和做法,进一步改进和提高.%For more than 90 years, USMLE ( United States Medical Licensing Examination) has influenced the medical education of United States actively by its systemic, sustainable, scientific and standardized qualification system. This paper briefly summarized the characteristics of physician qualification examinations in America and China. Then a comparative analysis from test model, content, testing method and reviews of the above two exams was presented. Learning some experiences and methods from USMLE will be beneficial for the development of physician qualification examinations in China.

  19. Observing the Unobservable: identification and Characterization of Stealth Coronal Mass Ejections

    Science.gov (United States)

    D'Huys, Elke

    2016-01-01

    In this doctoral thesis we study stealth CMEs: solar coronal mass ejections that are clearly observed in coronagraph data but do not show significant low-coronal or on-disk signatures of eruption. This lack of coronal signatures makes it challenging to determine their source region and predict their trajectory throughout interplanetary space. Combining PROBA2/SWAP data with that of other instruments, we identify 40 such events and investigate their properties both observationally and statistically. We find that our sample size is insufficient to determine the scaling law for the CME angular width reliably. We therefore analyze in general what the effect is of a limited sample size on the estimation of a power law parameter. Armed with this knowledge, we return to our sample of stealth CMEs, re-analyze the power law for their angular widths and compare the results to the power law found for normal CMEs.

  20. Observing the Unobservable: Identification and Characterisation of Stealth Coronal Mass Ejections

    Science.gov (United States)

    D'Huys, Elke; Seaton, Daniel B.; Poedts, Stefaan; Berghmans, David

    2016-05-01

    I will present my doctoral thesis research on stealth CMEs: solar coronal mass ejections that are clearly observed in coronagraph data but do not show significant low-coronal or on-disk signatures of eruption. This lack of coronal signatures makes it challenging to determine their source region and predict their trajectory throughout interplanetary space. We identified 40 such events and investigated their properties both observationally and statistically. We found that our sample size was insufficient to determine the scaling law for the CME angular width reliably. We therefore analyzed in general what the effect is of a limited sample size on the estimation of a power law parameter. Armed with this knowledge, we returned to our sample of stealth CMEs, re-analyzed the power law for their angular widths and compared the results to the power law found for normal CMEs.

  1. Data-mining to build a knowledge representation store for clinical decision support. Studies on curation and validation based on machine performance in multiple choice medical licensing examinations.

    Science.gov (United States)

    Robson, Barry; Boray, Srinidhi

    2016-06-01

    Extracting medical knowledge by structured data mining of many medical records and from unstructured data mining of natural language source text on the Internet will become increasingly important for clinical decision support. Output from these sources can be transformed into large numbers of elements of knowledge in a Knowledge Representation Store (KRS), here using the notation and to some extent the algebraic principles of the Q-UEL Web-based universal exchange and inference language described previously, rooted in Dirac notation from quantum mechanics and linguistic theory. In a KRS, semantic structures or statements about the world of interest to medicine are analogous to natural language sentences seen as formed from noun phrases separated by verbs, prepositions and other descriptions of relationships. A convenient method of testing and better curating these elements of knowledge is by having the computer use them to take the test of a multiple choice medical licensing examination. It is a venture which perhaps tells us almost as much about the reasoning of students and examiners as it does about the requirements for Artificial Intelligence as employed in clinical decision making. It emphasizes the role of context and of contextual probabilities as opposed to the more familiar intrinsic probabilities, and of a preliminary form of logic that we call presyllogistic reasoning. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Reproductive biology and susceptibility of Florida Culex coronator to infection with West Nile virus.

    Science.gov (United States)

    Alto, Barry W; Connelly, C Roxanne; O'Meara, George F; Hickman, Dustin; Karr, Nicholas

    2014-08-01

    Abstract Ornithophilic Culex species are considered the primary amplification vectors of West Nile virus (WNV) in bird hosts as well as vectors responsible for epidemic transmission. Culex coronator was first collected from Okaloosa, Santa Rosa, Walton, and Washington Counties in Florida in 2005 and has since spread throughout the state. The vector competence of Cx. coronator for WNV, known to be infected in nature, has not been assessed. Without this knowledge, we are unable to assess this species' potential as an enzootic and epidemic vector of WNV in Florida. In the current study, we investigate the reproductive biology and susceptibility to WNV infection, dissemination, and transmission by Cx. coronator. We show that Cx. coronator is capable of delaying oviposition for several weeks after blood feeding and that the number of eggs laid is greater for avian than mammalian hosts. Cx. coronator were highly susceptible to infection (∼80-100%) and dissemination (∼65-85% by 18 days since exposure) with lower rates of transmission (0-17% at 25°C and 28-67% at 28°C), suggesting that it is a competent vector of WNV under some conditions. The proportion of mosquitoes with disseminated infections related to the time since exposure and was higher at 28°C than at 25°C. The rapid and statewide distribution of Cx. coronator throughout Florida poses as a potential public health risk. This baseline knowledge is essential information for mosquito control and public health agencies to assess current and future disease risk to Southeastern United States.

  3. Reconnection-Driven Coronal-Hole Jets with Gravity and Solar Wind

    Science.gov (United States)

    Karpen, J. T.; Devore, C. R.; Antiochos, S. K.; Pariat, E.

    2017-01-01

    Coronal-hole jets occur ubiquitously in the Sun's coronal holes, at EUV and X-ray bright points associated with intrusions of minority magnetic polarity. The embedded-bipole model for these jets posits that they are driven by explosive, fast reconnection between the stressed closed field of the embedded bipole and the open field of the surrounding coronal hole. Previous numerical studies in Cartesian geometry, assuming uniform ambient magnetic field and plasma while neglecting gravity and solar wind, demonstrated that the model is robust and can produce jet-like events in simple configurations. We have extended these investigations by including spherical geometry,gravity, and solar wind in a nonuniform, coronal hole-like ambient atmosphere. Our simulations confirm that the jet is initiated by the onset of a kink-like instability of the internal closed field, which induces a burst of reconnection between the closed and external open field, launching a helical jet. Our new results demonstrate that the jet propagation is sustained through the outer corona, in the form of a traveling nonlinear Alfven wave front trailed by slower-moving plasma density enhancements that are compressed and accelerated by the wave. This finding agrees well with observations of white-light coronal-hole jets, and can explain microstreams and torsional Alfven waves detected in situ in the solar wind. We also use our numerical results to deduce scaling relationships between properties of the coronal source region and the characteristics of the resulting jet, which can be tested against observations.

  4. Reconnection-Driven Coronal-Hole Jets with Gravity and Solar Wind

    Science.gov (United States)

    Karpen, J. T.; DeVore, C. R.; Antiochos, S. K.; Pariat, E.

    2017-01-01

    Coronal-hole jets occur ubiquitously in the Sun's coronal holes, at EUV and X-ray bright points associated with intrusions of minority magnetic polarity. The embedded-bipole model for these jets posits that they are driven by explosive, fast reconnection between the stressed closed field of the embedded bipole and the open field of the surrounding coronal hole. Previous numerical studies in Cartesian geometry, assuming uniform ambient magnetic field and plasma while neglecting gravity and solar wind, demonstrated that the model is robust and can produce jet-like events in simple configurations. We have extended these investigations by including spherical geometry, gravity, and solar wind in a nonuniform, coronal hole-like ambient atmosphere. Our simulations confirm that the jet is initiated by the onset of a kink-like instability of the internal closed field, which induces a burst of reconnection between the closed and external open field, launching a helical jet. Our new results demonstrate that the jet propagation is sustained through the outer corona, in the form of a traveling nonlinear Alfvén wave front trailed by slower-moving plasma density enhancements that are compressed and accelerated by the wave. This finding agrees well with observations of white-light coronal-hole jets, and can explain microstreams and torsional Alfvén waves detected in situ in the solar wind. We also use our numerical results to deduce scaling relationships between properties of the coronal source region and the characteristics of the resulting jet, which can be tested against observations.

  5. Effect of alignment changes on sagittal and coronal socket reaction moment interactions in transtibial prostheses.

    Science.gov (United States)

    Kobayashi, Toshiki; Orendurff, Michael S; Zhang, Ming; Boone, David A

    2013-04-26

    Alignment is important for comfortable and stable gait of lower-limb prosthesis users. The magnitude of socket reaction moments in the multiple planes acting simultaneously upon the residual limb may be related to perception of comfort in individuals using prostheses through socket interface pressures. The aim of this study was to investigate the effect of prosthetic alignment changes on sagittal and coronal socket reaction moment interactions (moment-moment curves) and to characterize the curves in 11 individuals with transtibial amputation using novel moment-moment interaction parameters measured by plotting sagittal socket reaction moments versus coronal ones under various alignment conditions. A custom instrumented prosthesis alignment component was used to measure socket reaction moments during walking. Prosthetic alignment was tuned to a nominally aligned condition by a prosthetist, and from this position, angular (3° and 6° of flexion, extension, abduction or adduction of the socket) and translational (5mm and 10mm of anterior, posterior, medial or lateral translation of the socket) alignment changes were performed in either the sagittal or the coronal plane in a randomized manner. A total of 17 alignment conditions were tested. Coronal angulation and translation alignment changes demonstrated similar consistent changes in the moment-moment curves. Sagittal alignment changes demonstrated more complex changes compared to the coronal alignment changes. Effect of sagittal angulations and translations on the moment-moment curves was different during 2nd rocker (mid-stance) with extension malalignment appearing to cause medio-lateral instability. Presentation of coronal and sagittal socket reaction moment interactions may provide useful visual information for prosthetists to understand the biomechanical effects of malalignment of transtibial prostheses.

  6. The relationship between the magnetic field and the coronal activities in the polar region

    Science.gov (United States)

    Shimojo, Masumi

    The image of the polar region of the sun is changing based on the observations taken by the three telescopes aboard the Hinode satellite. Based on the data of Solar Optical Telescope (SOT) aboard Hinode, Tsuneta et al. (2007) reported that there are many localized magnetic poles in the polar region, and the magnetic strength of the magnetic poles is over thousand Gauss. They called the strong magnetic pole in the polar region "kG-pathce". And, Cirtain, et al. (2007) and Savcheva, et al. (2007) presented that the occurrence rate of X-ray jets in the polar region is very high and 10 events/hour. Their result was obtained by the high resolution observations by X-ray Telescope (XRT) aboard Hinode. These results are very important for understanding the fast solar wind that blows from the polar region. On the other hand, in order to understand the activities in the polar region, it is very important to investigate the relationship between the magnetic environments and the coronal structures/activities. In the paper, for the purpose, we aligned the photospheric images (G-band, Stoke-IQUV of FeI), the chromospheric images (Ca II H line, Stokes-V of Na) and coronal images (X-ray) obtained by Hinode, and investigate the relationship. Basically, the co-alignment process was done based on the alignment information of the telescopes reported by Shimizu et al. (2007). And, we aligned the images using the curve of the solar limb, finally. As the result of the co-alignments, we found the following things. 1) On most kG-patches in the polar coronal hole, there is any coronal structure. 2) X-ray jets in the polar coronal hole are not always associated with the kG-patches. Some X-ray jets are associated with very weak magnetic field. And, the jets are strongly associated with the emerging/cancelling magnetic flux. The first one suggests that the coronal heating is not effective only in the magnetic field strong, such as the center of the sunspot. The second result indicates that the

  7. History of the medical licensing examination (uieop in Korea’s Goryeo Dynasty (918-1392

    Directory of Open Access Journals (Sweden)

    Kyung-Lock Lee

    2015-05-01

    Full Text Available This article aims to describe the training and medical licensing system (uieop for becoming a physician officer (uigwan during Korea’s Goryeo Dynasty (918-1392. In the Goryeo Dynasty, although no license was necessary to provide medical services to the common people, there was a licensing examination to become a physician officer. No other national licensing system for healthcare professionals existed in Korea at that time. The medical licensing examination was administered beginning in 958. Physician officers who passed the medical licensing examination worked in two main healthcare institutions: the Government Hospital (Taeuigam and Pharmacy for the King (Sangyakguk. The promotion and expansion of medical education differed depending on the historical period. Until the reign of King Munjong (1046-1083, medical education as a path to licensure was encouraged in order to increase the number of physician officers qualifying for licensure by examination; thus, the number of applicants sitting for the examination increased. However, in the late Goryeo Dynasty, after the officer class of the local authorities (hyangri showed a tendency to monopolize the examination, the Goryeo government limited the examination applications by this group. The medical licensing examination was divided into two parts: medicine and ‘feeling the pulse and acupuncture’ (jugeumeop. The Goryeo Dynasty followed the Chinese Dang Dynasty’s medical system while also taking a strong interest in the Chinese Song Dynasty’s ideas about medicine.

  8. Observations of a Coronal Cavity and Prominence with Hinode, IRIS, and AIA

    Science.gov (United States)

    Jibben, Patricia R.; Reeves, Katharine

    2015-04-01

    Coronal cavities are low emission regions above quiescent prominences. The interaction of the prominence material and coronal cavity is still poorly understood. We present observations of a coronal cavity and prominence system observed on 9 October 2014. The observations are part of a joint observation program (HOP264) including Hinode and the Interface Region Imaging Spectrograph (IRIS). A small cavity is seen just above the prominence in the Hinode X-ray Telescope (XRT) images. Using data from the Solar Dynamic Observatory (SDO) Atmospheric Imaging Assembly (AIA), Hinode Solar Optical Telescope (SOT) and IRIS, multi-thermal plasma can be seen traveling along the cavity loops. During this time, a brightening is seen near the center of the cavity in the XRT images suggesting hot material has been trapped inside the cavity. In addition to presenting the cavity dynamics, we characterize the cavity velocity structures using the Hinode EUV Imaging Spectrometer (EIS) and discuss the magnetic structure of the cavity using data from the Coronal Multichannel Polarimeter (CoMP). This work is supported by under contract SP02H1701R from Lockheed-Martin to SAO, contract NNM07AB07C from NASA to SAO and grant number NNX12AI30G from NASA to SAO.

  9. Investigation of the Large Scale Evolution and Topology of Coronal Mass Ejections in the Solar Wind

    Science.gov (United States)

    Riley, Peter

    1999-12-01

    This investigation is concerned with the large-scale evolution and topology of Coronal Mass Ejections (CMEs) in the solar wind. During this reporting period we have analyzed a series of low density intervals in the ACE (Advanced Composition Explorer) plasma data set that bear many similarities to CMEs. We have begun a series of 3D, MHD (Magnetohydrodynamics) coronal models to probe potential causes of these events. We also edited two manuscripts concerning the properties of CMEs in the solar wind. One was re-submitted to the Journal of Geophysical Research.

  10. Hydrogen Lyman-alpha and Lyman-beta radiances and profiles in polar coronal holes

    CERN Document Server

    Tian, Hui; Curdt, Werner; Vial, Jean-Claude

    2009-01-01

    The hydrogen Lyman-alpha plays a dominant role in the radiative energy transport in the lower transition region, and is important for the stud- ies of transition-region structure as well as solar wind origin. We investigate the Ly-alpha profiles obtained by SUMER in coronal holes and quiet Sun. In a subset of these observations, also the Hi Lyman-beta, Si iii, and O vi lines were (quasi-) simultaneously recorded. We find that the distances between the two peaks of Ly-alpha profiles are larger in coronal holes than in the quiet Sun, indicating a larger opacity in coronal holes. This difference might result from the different magnetic structures or the different radiation fields in the two regions. Most of the Ly-beta profiles in the coronal hole have a stronger blue peak, in contrast to those in quiet-Sun regions. Whilst in both regions the Ly-alpha profiles are stronger in the blue peak. Although the asymmetries are likely to be produced by differential flows in the solar atmosphere, their detailed formation ...

  11. Round table on initiatives, achievements and perspectives with regard to the Council Directive of 3 September 1984 laying down basic measures for the radiation protection of persons undergoing medical examination or treatment

    Energy Technology Data Exchange (ETDEWEB)

    Teunen, D. [Commission of the European Communities, Luxembourg (Luxembourg). Directorate General Environment, Nuclear Safety and Civil Protection

    1995-12-31

    Experts from the 12 Member States have presented their experiences with the implementation and the impact of the Council Directive of 3rd September 1984 on the radiation protection of patients undergoing medical examination or treatment. The lynchpin of this Directive is that ``all medical exposures must be medically justified and kept as low as reasonably achievable. (UK).

  12. Medical Examination of Aliens--Revisions to Medical Screening Process. Final rule.

    Science.gov (United States)

    2016-01-26

    The Centers for Disease Control and Prevention (CDC), within the Department of Health and Human Services (HHS), is issuing this final rule (FR) to amend its regulations governing medical examinations that aliens must undergo before they may be admitted to the United States. Based on public comment received, HHS/CDC did not make changes from the NPRM published on June 23, 2015. Accordingly, this FR will: Revise the definition of communicable disease of public health significance by removing chancroid, granuloma inguinale, and lymphogranuloma venereum as inadmissible health-related conditions for aliens seeking admission to the United States; update the notification of the health-related grounds of inadmissibility to include proof of vaccinations to align with existing requirements established by the Immigration and Nationality Act (INA); revise the definitions and evaluation criteria for mental disorders, drug abuse and drug addiction; clarify and revise the evaluation requirements for tuberculosis; clarify and revise the process for the HHS/CDC-appointed medical review board that convenes to reexamine the determination of a Class A medical condition based on an appeal; and update the titles and designations of federal agencies within the text of the regulation.

  13. The Rasch Model: Its Use by the National Board of Medical Examiners.

    Science.gov (United States)

    Kelley, Paul R.; Schumacher, Charles F.

    1984-01-01

    The National Board of Medical Examiners uses the Rasch model to calibrate test items, maintain item banks, equate scores, and monitor the consistency of examiner item response patterns. The model is also being used in the study of patient management problems examinations, standard-setting, and computer-based examinations. (Author/BS)

  14. Best-fit model of exploratory and confirmatory factor analysis of the 2010 Medical Council of Canada Qualifying Examination Part I clinical decision-making cases

    Directory of Open Access Journals (Sweden)

    André F. De Champlain

    2015-04-01

    Full Text Available Purpose: This study aims to assess the fit of a number of exploratory and confirmatory factor analysis models to the 2010 Medical Council of Canada Qualifying Examination Part I (MCCQE1 clinical decision-making (CDM cases. The outcomes of this study have important implications for a range of domains, including scoring and test development. Methods: The examinees included all first-time Canadian medical graduates and international medical graduates who took the MCCQE1 in spring or fall 2010. The fit of one- to five-factor exploratory models was assessed for the item response matrix of the 2010 CDM cases. Five confirmatory factor analytic models were also examined with the same CDM response matrix. The structural equation modeling software program Mplus was used for all analyses. Results: Out of the five exploratory factor analytic models that were evaluated, a three-factor model provided the best fit. Factor 1 loaded on three medicine cases, two obstetrics and gynecology cases, and two orthopedic surgery cases. Factor 2 corresponded to pediatrics, and the third factor loaded on psychiatry cases. Among the five confirmatory factor analysis models examined in this study, three- and four-factor lifespan period models and the five-factor discipline models provided the best fit. Conclusion: The results suggest that knowledge of broad disciplinary domains best account for performance on CDM cases. In test development, particular effort should be placed on developing CDM cases according to broad discipline and patient age domains; CDM testlets should be assembled largely using the criteria of discipline and age.

  15. The effects of violating standard item writing principles on tests and students: the consequences of using flawed test items on achievement examinations in medical education.

    Science.gov (United States)

    Downing, Steven M

    2005-01-01

    The purpose of this research was to study the effects of violations of standard multiple-choice item writing principles on test characteristics, student scores, and pass-fail outcomes. Four basic science examinations, administered to year-one and year-two medical students, were randomly selected for study. Test items were classified as either standard or flawed by three independent raters, blinded to all item performance data. Flawed test questions violated one or more standard principles of effective item writing. Thirty-six to sixty-five percent of the items on the four tests were flawed. Flawed items were 0-15 percentage points more difficult than standard items measuring the same construct. Over all four examinations, 646 (53%) students passed the standard items while 575 (47%) passed the flawed items. The median passing rate difference between flawed and standard items was 3.5 percentage points, but ranged from -1 to 35 percentage points. Item flaws had little effect on test score reliability or other psychometric quality indices. Results showed that flawed multiple-choice test items, which violate well established and evidence-based principles of effective item writing, disadvantage some medical students. Item flaws introduce the systematic error of construct-irrelevant variance to assessments, thereby reducing the validity evidence for examinations and penalizing some examinees.

  16. Commentary on the Liquid Metallic Hydrogen Model of the Sun II. Insight Relative to Coronal Rain and Splashdown Events

    Directory of Open Access Journals (Sweden)

    Robitaille P.-M.

    2013-04-01

    Full Text Available Coronal rain represents blobs of solar material with a width of ∼ 300 km and a length of ∼ 700 km which are falling from the active region of the corona towards the solar surface along loop-like paths. Conversely, coronal showers are com prised of much larger bulks of matter, or clumps of solar rain. Beyond coronal rain and showers, the expulsion of solar matter from the surface, whether through flares, pro minences, or coronal mass ejections, can result in massive disruptions which have bee n observed to rise far into the corona, return towards the Sun, and splashdown onto the phot osphere. The existence of coronal rain and the splashdown of mass ejections onto the so lar surface constitute the twenty-third and twenty-fourth lines of evidence that the S un is condensed matter.

  17. ASSESSMENT OF UNDERGRADUATE MEDICAL STUDENTS USING OBJECTIVE STRUCTURED CLINICAL EXAMINATION IN GENERAL MEDICINE: STUDENT’S AND TEACHER’S PERCEPTION

    Directory of Open Access Journals (Sweden)

    Sudhir

    2015-12-01

    Full Text Available BACKGROUND Objective Structured Clinical Examinations (OSCEs have become one of the most widely used methods of assessing aspects of clinical competency in healthcare education. Objective Structured Clinical Examinations (OSCEs is also introduced in our newly formed medical college Indira Gandhi Institute of Medical Sciences (IGIMS, Patna, for last few years in different departments, but this is first study to know the perception of this evaluation method among students and faculties. AIM AND OBJECTIVE The aim of this study was to introduce the newer method of assessment Objective Structured Clinical Examinations (OSCEs. Objective of the study is to assess the perceptions of teachers and students regarding OSCE in general medicine. METHODOLOGY After obtaining permission from ethics committee, this cross-sectional study was conducted in Department of General Medicine; 84 students and 9 faculty members were briefed about OSCEs. At the end of 8th semester, OSCE was conducted and immediate feedback regarding this method of examination was taken using Likert’s scale. Perceptions of students and teachers were collected with suitable statements. Their suggestions and remarks were also collected. RESULTS A 55.55% of faculty members agreed that OSCE covered a wide range of knowledge compared with conventional examination; 66% of faculty members agreed that OSCE assessed the various domain of student’s knowledge in a better way compared with conventional examination; 88% of teachers agreed that checklist in OSCE provided a fair system of marking which removed variability of examiner; 84 out of 87 students of 8th semester undergraduate answered the questionnaire based on Likert’s scale; 67% students strongly agreed that OSCE was a fair method of assessment compared with conventional examination; 58% students found that OSCE tested a wide range of knowledge compared with conventional method. They were disagreed about OSCE being stressful and

  18. What Are You Measuring? Dimensionality and Reliability Analysis of Ability and Speed in Medical School Didactic Examinations.

    Science.gov (United States)

    Thompson, James J

    2016-01-01

    Summative didactic evaluation often involves multiple choice questions which are then aggregated into exam scores, course scores, and cumulative grade point averages. To be valid, each of these levels should have some relationship to the topic tested (dimensionality) and be sufficiently reproducible between persons (reliability) to justify student ranking. Evaluation of dimensionality is difficult and is complicated by the classic observation that didactic performance involves a generalized component (g) in addition to subtest specific factors. In this work, 183 students were analyzed over two academic years in 13 courses with 44 exams and 3352 questions for both accuracy and speed. Reliability at all levels was good (>0.95). Assessed by bifactor analysis, g effects dominated most levels resulting in essential unidimensionality. Effect sizes on predicted accuracy and speed due to nesting in exams and courses was small. There was little relationship between person ability and person speed. Thus, the hierarchical grading system appears warrented because of its g-dependence.

  19. How does the quality of life and the underlying biochemical indicators correlate with the performance in academic examinations in a group of medical students of Sri Lanka?

    Directory of Open Access Journals (Sweden)

    Manjula Hettiarachchi

    2014-02-01

    Full Text Available Background: Individual variation of examination performance depends on many modifiable and non-modifiable factors, including pre-examination anxiety. Medical students’ quality of life (QoL and certain biochemical changes occurring while they are preparing for examinations has not been explored. Purpose: We hypothesize that these parameters would determine the examination performance among medical students. Methods: Fourth-year medical students (n=78 from the University of Ruhuna, Sri Lanka, were invited. Their pre- and post-exam status of QoL, using the World Health Organization Quality of Life (WHOQOL-BREF questionnaire, and the level of biochemical marker levels (i.e., serum levels of thyroid profile including thyroglobulin, cortisol and ferritin were assessed. Differences between the scores of QoL and serum parameters were compared with their performance at the examination. Results: The mean QoL score was significantly lower at pre-exam (56.19±8.1 when compared with post-exam (61.7±7.1 levels (p<0.001. The median serum TSH level prior to the exam (0.9 mIU/L; interquartile range 0.74–1.4 mIU/L was significantly lower (p=0.001 when compared with the level after the exam (median of 2.7 mIU/L; IQR 1.90–3.60. The mean±SD fT4 level was significantly higher before the exam (19.48±0.4 pmol/L at study entry vs. 17.43±0.3 pmol/L after the exam; p<0.001. Median serum ferritin (SF level prior to the exam (43.15 (23.5–63.3 µg/L was significantly lower (p≤0.001 when compared with after-exam status (72.36 (49.9–94.9 µg/L. However, there was no difference in mean serum cortisol levels (16.51±0.7 at pre-exam and 15.88±0.7 at post-exam, respectively; p=0.41. Conclusions: Students had higher fT4 and low ferritin levels on pre-exam biochemical assessment. It was evident that students who perform better at the examination had significantly higher QoL scores at each domain tested through the questionnaire (Physical health, Psychological

  20. Near infrared spectral and polarization imaging observation of coronal emission lines during the 2008 total solar eclipse

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    During the 2008 total solar eclipse, the coronal emission lines were observed by using optical fibre spectrometric and polarization imaging system in near infrared waveband. The profiles of the coronal emission lines including Fe XIII 10747 , 10798  and He I 10830  were obtained with dispersion of 0.5 /pix. The intensity of Fe XIII 10747  remained unchanged in the two different coronal regions while the intensity of He I 10830  varied considerably in the two coronal locations no matter whether the prominence appeared or not. The coronal polarization images were observed at Fe XI 7892  with a bandpass of 30  in a series of exposure times.

  1. Near infrared spectral and polarization imaging observation of coronal emission lines during the 2008 total solar eclipse

    Institute of Scientific and Technical Information of China (English)

    BAO XingMing; WANG XiaoFan; ZHANG ZhiYong; DENG Jian; HU KeLiang; XUAN WeiJia; LIU YangBing; ZHANG HongQi; DENG YuanYong; WANG DongGuang

    2009-01-01

    During the 2008 total solar eclipse, the coronal emission lines were observed by using optical fibre spectrometric and polarization imaging system in near infrared waveband. The profiles of the coronal emission lines Including Fe ⅩⅢ 10747 A, 10798 A and He 1 10830 A were obtained with dispersion of 0.5 A/pix. The intensity of Fe ⅩⅢ 10747 A remained unchanged In the two different coronal regions while the intensity of He I 10830 A varied considerably in the two coronal locations no matter whether the prominence appeared or not. The coronal polarization images were observed at Fe XI 7892 A with a bandpass of 30 A in a series of exposure times.

  2. Automated assessment of joint synovitis activity from medical ultrasound and power doppler examinations using image processing and machine learning methods

    National Research Council Canada - National Science Library

    Original paper

    2016-01-01

    .... Material and methods: This paper focus on a computer aided diagnostic system that was developed within joint Polish-Norwegian research project related to the automated assessment of the severity of synovitis...

  3. Discrimination of Coronal Stops by Bilingual Adults: The Timing and Nature of Language Interaction

    Science.gov (United States)

    Sundara, Megha; Polka, Linda

    2008-01-01

    The current study was designed to investigate the timing and nature of interaction between the two languages of bilinguals. For this purpose, we compared discrimination of Canadian French and Canadian English coronal stops by simultaneous bilingual, monolingual and advanced early L2 learners of French and English. French /d/ is phonetically…

  4. The Strength and Radial Profile of the Coronal Magnetic Field from the Standoff Distance of a Coronal Mass Ejection-driven Shock

    Science.gov (United States)

    Gopalswamy, Nat; Yashiro, Seiji

    2011-07-01

    We determine the coronal magnetic field strength in the heliocentric distance range 6-23 solar radii (Rs) by measuring the shock standoff distance and the radius of curvature of the flux rope during the 2008 March 25 coronal mass ejection imaged by white-light coronagraphs. Assuming the adiabatic index, we determine the Alfvén Mach number, and hence the Alfvén speed in the ambient medium using the measured shock speed. By measuring the upstream plasma density using polarization brightness images, we finally get the magnetic field strength upstream of the shock. The estimated magnetic field decreases from ~48 mG around 6 Rs to 8 mG at 23 Rs. The radial profile of the magnetic field can be described by a power law in agreement with other estimates at similar heliocentric distances.

  5. The Strength and Radial Profile of the Coronal Magnetic Field from the Standoff Distance of a Coronal Mass Ejection-Driven Shock

    Science.gov (United States)

    Gopalswamy, Nat; Yashiro, Seiji

    2011-01-01

    We determine the coronal magnetic field strength in the heliocentric distance range 6-23 solar radii (Rs) by measuring the shock standoff distance and the radius of curvature of the flux rope during the 2008 March 25 coronal mass ejection imaged by white-light coronagraphs. Assuming the adiabatic index, we determine the Alfven Mach number, and hence the Alfven speed in the ambient medium using the measured shock speed. By measuring the upstream plasma density using polarization brightness images, we finally get the magnetic field strength upstream of the shock. The estimated magnetic field decreases from approximately 48 mG around 6 Rs to 8 mG at 23 Rs. The radial profile of the magnetic field can be described by a power law in agreement with other estimates at similar heliocentric distances.

  6. Observations of high and low Fe charge states in individual solar wind streams with coronal-hole origin

    Science.gov (United States)

    Heidrich-Meisner, Verena; Peleikis, Thies; Kruse, Martin; Berger, Lars; Wimmer-Schweingruber, Robert

    2016-09-01

    Context. The solar wind originating from coronal holes is comparatively well-understood and is characterized by lower densities and average charge states compared to the so-called slow solar wind. Except for wave perturbations, the average properties of the coronal-hole solar wind are passably constant. Aims: In this case study, we focus on observations of the Solar Wind Ion Composition Spectrometer (SWICS) on the Advanced Composition Explorer (ACE) of individual streams of coronal-hole solar wind that illustrate that although the O and C charge states are low in coronal-hole wind, the Fe charge distribution is more variable. In particular, we illustrate that the Fe charge states in coronal-hole solar wind are frequently as high as in slow solar wind. Methods: We selected individual coronal-hole solar wind streams based on their collisional age as well as their respective O and C charge states and analyzed their Fe charge-state distributions. Additionally, with a combination of simple ballistic back-mapping and the potential field source surface model, transitions between streams with high and low Fe charge states were mapped back to the photosphere. The relative frequency of high and low Fe charge-state streams is compared for the years 2004 and 2006. Results: We found several otherwise typical coronal-hole streams that include Fe charge states either as high as or lower than in slow solar wind. Eight such transitions in 2006 were mapped back to equatorial coronal holes that were either isolated or connected to the northern coronal-hole. Attempts to identify coronal structures associated with the transitions were so far inconclusive.

  7. Analysis of Two Coronal Loops with Combined TRACE and SOHO/CDS Data

    Science.gov (United States)

    Scott, J. T.; Martens, P. C. H.; Cirtain, J. W.

    2008-11-01

    We use an innovative research technique to analyze combined images from the Coronal Diagnostic Spectrometer (CDS) on the Solar and Heliospheric Observatory (SOHO) and the Transition Region and Coronal Explorer (TRACE). We produce a high spatial and temporal resolution simulated CDS raster or “composite” map from TRACE data and use this composite map to jointly analyze data from both instruments. We show some of the advantages of using the “composite” map method for coronal loop studies. We investigate two postflare loop structures. We find cool material (250 000 K) concentrated at the tips or apex of the loops. This material is found to be above its scale height and therefore not in hydrostatic equilibrium. The exposure times of the composite map and TRACE images are used to give an estimate of another loop’s cooling time. The contribution to the emission in the TRACE images for the spectral lines present in its narrow passband is estimated by using the CDS spectral data and CHIANTI to derive synthetic spectra. We obtain cospatial and cotemporal data collected by both instruments in SOHO Joint Observations Program (JOP) 146 and show how the combination of these data can be utilized to obtain more accurate measurements of coronal plasmas than if analyzed individually.

  8. Damped large amplitude oscillations in a solar prominence and a bundle of coronal loops

    CERN Document Server

    Zhang, Quanhao; Liu, Rui; Shen, Chenglong; Zhang, Min; Gou, Tingyu; Liu, Jiajia; Liu, Kai; Zhou, Zhenjun; Wang, Shui

    2016-01-01

    We investigate the evolutions of two prominences (P1,P2) and two bundles of coronal loops (L1,L2), observed with SDO/AIA near the east solar limb on 2012 September 22. It is found that there were large-amplitude oscillations in P1 and L1, but no detectable motions in P2 and L2. These transverse oscillations were triggered by a large-scale coronal wave, originating from a large flare in a remote active region behind the solar limb. By carefully comparing the locations and heights of these oscillating and non-oscillating structures, we conclude that the propagating height of the wave is between 50 Mm and 130 Mm. The wave energy deposited in the oscillating prominence and coronal loops is at least of the order of $10^{28}$ erg. Furthermore, local magnetic field strength and Alfv\\'{e}n speeds are derived from the oscillating periods and damping time scales, which are extracted from the time series of the oscillations. It is demonstrated that oscillations can be used in not only coronal seismology, but also reveal...

  9. Impulsively Generated Linear and Non-linear Alfven Waves in the Coronal Funnels

    CERN Document Server

    Chmielewski, P; Murawski, K; Musielak, Z E

    2014-01-01

    We present simulation results of the impulsively generated linear and non-linear Alfven waves in the weakly curved coronal magnetic flux-tubes (coronal funnels) and discuss their implications for the coronal heating and solar wind acceleration. We solve numerically the time-dependent magnetohydrodynamic equations to find the temporal signatures of the small and large-amplitude Alfven waves in the model atmosphere of open and expanding magnetic field configuration with a realistic temperature distribution. We compute the maximum transversal velocity of both linear and non-linear Alfven waves at different heights of the model atmosphere, and study their response in the solar corona during the time of their propagation. We infer that the pulse-driven non-linear Alfven waves may carry sufficient wave energy fluxes to heat the coronal funnels and also to power the solar wind that originates in these funnels. Our study of linear Alfven waves show that they can contribute only to the plasma dynamics and heating of t...

  10. The Inquiry into the Waterfall train crash: implications for medical examinations of safety-critical workers.

    Science.gov (United States)

    Hocking, Bruce

    2006-02-06

    The implications arising from the Inquiry into the Waterfall train crash for medical examinations of safety-critical workers are discussed. Examinations need to be appropriate for the level of risk in the job and apply current medical thinking. A careful balance is required between the various legal obligations, including duty of care, disability discrimination and privacy. The frequency of examinations depends on a combination of medical, economic and logistical factors. Health professionals who conduct examinations should be familiar with the occupation of the person being examined. Ethical relationships with the worker's general practitioner or specialist(s) must be observed. The procedures associated with the examinations are as important in achieving safety as the actual examinations. These include complying with relevant standards; providing all relevant documentation with a referral for an examination; acting on the doctor's report appropriately; and auditing the process.

  11. The coronal fricative problem

    Science.gov (United States)

    Dinnsen, Daniel A.; Dow, Michael C.; Gierut, Judith A.; Morrisette, Michele L.; Green, Christopher R.

    2013-01-01

    This paper examines a range of predicted versus attested error patterns involving coronal fricatives (e.g. [s, z, θ, ð]) as targets and repairs in the early sound systems of monolingual English-acquiring children. Typological results are reported from a cross-sectional study of 234 children with phonological delays (ages 3 years; 0 months to 7;9). Our analyses revealed different instantiations of a putative developmental conspiracy within and across children. Supplemental longitudinal evidence is also presented that replicates the cross-sectional results, offering further insight into the life-cycle of the conspiracy. Several of the observed typological anomalies are argued to follow from a modified version of Optimality Theory with Candidate Chains (McCarthy, 2007). PMID:24790247

  12. Reconnection-Driven Coronal-Hole Jets with Gravity and Solar Wind

    CERN Document Server

    Karpen, J T; Antiochos, S K; Pariat, E

    2016-01-01

    Coronal-hole jets occur ubiquitously in solar coronal holes, at EUV and X-ray bright points associated with intrusions of minority magnetic polarity. The embedded-bipole model for these jets posits that they are driven by explosive, fast reconnection between the stressed closed field of the embedded bipole and the open field of the surrounding coronal hole. Previous numerical studies in Cartesian geometry, assuming uniform ambient magnetic field and plasma while neglecting gravity and solar wind, demonstrated that the model is robust and can produce jet-like events in simple configurations. We have extended these investigations by including spherical geometry, gravity, and solar wind in a nonuniform, coronal hole-like ambient atmosphere. Our simulations confirm that the jet is initiated by the onset of a kink-like instability of the internal closed field, which induces a burst of reconnection between the closed and external open field, launching a helical jet. Our new results demonstrate that the jet propagat...

  13. Multifractal Solar EUV Intensity Fluctuations and their Implications for Coronal Heating Models

    Science.gov (United States)

    Cadavid, A. C.; Rivera, Y. J.; Lawrence, J. K.; Christian, D. J.; Jennings, P. J.; Rappazzo, A. F.

    2016-11-01

    We investigate the scaling properties of the long-range temporal evolution and intermittency of Atmospheric Imaging Assembly/Solar Dynamics Observatory intensity observations in four solar environments: an active region core, a weak emission region, and two core loops. We use two approaches: the probability distribution function (PDF) of time series increments and multifractal detrended fluctuation analysis (MF-DFA). Noise taints the results, so we focus on the 171 Å waveband, which has the highest signal-to-noise ratio. The lags between pairs of wavebands distinguish between coronal versus transition region (TR) emission. In all physical regions studied, scaling in the range of 15-45 minutes is multifractal, and the time series are anti-persistent on average. The degree of anti-correlation in the TR time series is greater than that for coronal emission. The multifractality stems from long-term correlations in the data rather than the wide distribution of intensities. Observations in the 335 Å waveband can be described in terms of a multifractal with added noise. The multiscaling of the extreme-ultraviolet data agrees qualitatively with the radiance from a phenomenological model of impulsive bursts plus noise, and also from ohmic dissipation in a reduced magnetohydrodynamic model for coronal loop heating. The parameter space must be further explored to seek quantitative agreement. Thus, the observational “signatures” obtained by the combined tests of the PDF of increments and the MF-DFA offer strong constraints that can systematically discriminate among models for coronal heating.

  14. Lumbosacral transitional vertebra and S1 radiculopathy: the value of coronal MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bezuidenhout, Abraham Fourie; Lotz, Jan Willem [Stellenbosch University, Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Tygerberg (South Africa)

    2014-06-15

    The association of a lumbosacral transitional vertebra with accelerated degeneration of the disc above has been described. Lumbosacral transitional vertebrae have also been reported as a cause of extraforaminal entrapment of the L5 nerve root between the transverse segment of the transitional vertebra and the sacral ala optimally demonstrated by coronal MRI. The association of the lumbosacral transitional vertebra pseudoarthroses and S1 nerve root entrapment due to degenerative stenosis of the nerve root canal has never been described. We present 12 patients with lumbosacral transitional vertebrae that were referred for symptoms and signs of S1 nerve root radiculopathy in which the sagittal and axial MRI sequences failed to identify a plausible cause for the patients' S1 nerve root symptoms. A coronal T1-weighted imaging (T1WI) MRI sequence was consequently added to the investigation. The coronal T1WI MRI sequence demonstrated hypertrophic degenerative stenosis of the S1 nerve root canal at the level of the lumbosacral transitional vertebra pseudoarthrosis, with entrapment of the respective S1 nerve root in all patients. We emphasize the value of coronal T1WI MRI of the lumbosacral junction and sacrum if the cause for S1 radicular symptoms was not identified on conventional sagittal and axial MRI sequences in patients with lumbosacral transitional vertebrae. (orig.)

  15. A unified view of coronal loop contraction and oscillation in flares

    CERN Document Server

    Russell, Alexander J B; Fletcher, Lyndsay

    2015-01-01

    Context: Transverse loop oscillations and loop contractions are commonly associated with solar flares, but the two types of motion have traditionally been regarded as separate phenomena. Aims: We present an observation of coronal loops contracting and oscillating following onset of a flare. We aim to explain why both behaviours are seen together and why only some of the loops oscillate. Methods: A time sequence of SDO/AIA 171 \\r{A} images is analysed to identify positions of coronal loops following the onset of M6.4 flare SOL2012-03-09T03:53. We focus on five loops in particular, all of which contract during the flare, with three of them oscillating as well. A simple model is then developed for contraction and oscillation of a coronal loop. Results: We propose that coronal loop contractions and oscillations can occur in a single response to removal of magnetic energy from the corona. Our model reproduces the various types of loop motion observed and explains why the highest loops oscillate during their contra...

  16. Dynamics of coronal rain and descending plasma blobs in solar prominences. I. Fully ionized case

    Energy Technology Data Exchange (ETDEWEB)

    Oliver, R.; Soler, R.; Terradas, J. [Departament de Física, Universitat de les Illes Balears, E-07122 Palma de Mallorca (Spain); Zaqarashvili, T. V.; Khodachenko, M. L., E-mail: ramon.oliver@uib.es [Space Research Institute, Austrian Academy of Sciences, Schmiedlstrasse 6, A-8042 Graz (Austria)

    2014-03-20

    Observations of active regions and limb prominences often show cold, dense blobs descending with an acceleration smaller than that of free fall. The dynamics of these condensations falling in the solar corona is investigated in this paper using a simple fully ionized plasma model. We find that the presence of a heavy condensation gives rise to a dynamical rearrangement of the coronal pressure that results in the formation of a large pressure gradient that opposes gravity. Eventually this pressure gradient becomes so large that the blob acceleration vanishes or even points upward. Then, the blob descent is characterized by an initial acceleration phase followed by an essentially constant velocity phase. These two stages can be identified in published time-distance diagrams of coronal rain events. Both the duration of the first stage and the velocity attained by the blob increase for larger values of the ratio of blob to coronal density, for larger blob mass, and for smaller coronal temperature. Dense blobs are characterized by a detectable density growth (up to 60% in our calculations) and by a steepening of the density in their lower part, that could lead to the formation of a shock. They also emit sound waves that could be detected as small intensity changes with periods of the order of 100 s and lasting between a few and about 10 periods. Finally, the curvature of falling paths with large radii is only relevant when a very dense blob falls along inclined magnetic field lines.

  17. The formation heights of coronal shocks from 2D density and Alfv\\'en speed maps

    CERN Document Server

    Zucca, Pietro; Bloomfield, D Shaun; Gallagher, Peter T

    2014-01-01

    Super-Alfv\\'enic shock waves associated with coronal mass ejections (CMEs) can produce radio emission known as Type II bursts. In the absence of direct imaging, accurate estimates of coronal electron densities, magnetic field strengths and Alfv\\'en speeds are required in order to calculate the kinematics of shocks. To date, 1D radial models have been used, but these are not appropriate for shocks propagating in non-radial directions. Here, we study a coronal shock wave associated with a CME and Type II radio burst using 2D electron density and Alfv\\'en speed maps to determine the locations that shocks are excited as the CME expands through the corona. Coronal density maps were obtained from emission measures derived from the Atmospheric Imaging Assembly (AIA) on board the Solar Dynamic Observatory ($SDO$) and polarized brightness measurements from the Large Angle and Spectrometric Coronagraph (LASCO) on board the Solar and Heliospheric Observatory ($SOHO$). Alfv\\'en speed maps were calculated using these dens...

  18. Hinode, SDO AIA, and CoMP Observations of a Coronal Cavity with a Hot Core

    Science.gov (United States)

    Reeves, K.; Jibben, P.

    2014-12-01

    Coronal cavities are low emission regions often situated around quiescent prominences. Prominences may exist for days or months prior to eruption and the magnetic structure of the cavity during the quiescent period is important to understanding the pre-eruption phase. We describe observations of a coronal cavity with a hot core situated above a polar crown prominence. The cavity, visible on the southwest limb, was observed for a period of three hours as a Hinode Coordinated Observation (HOP 114). Using Hinode's X-ray Telescope (XRT) and EUV Imaging Spectrometer (EIS) we present the thermal emission properties and coronal velocity structures of the cavity. We find the core has hotter temperatures than the surrounding plasma and there is evidence of turbulent velocities within the cavity. We also investigate the interaction of the cavity with the prominence material using Solar Dynamic Observatory (SDO) Atmospheric Imaging Assembly (AIA) data and H-alpha data from Hinode's Solar Optical Telescope (SOT). We find evidence of hot plasma at the spine of the prominence reaching into the cavity. These observations suggest a cylindrical flux tube best represents the cavity structure. The magnetic structure of the cavity is further discussed using data from the Coronal Multichannel Polarimeter (CoMP). This work is supported by under contract SP02H1701R from Lockheed-Martin to SAO, contract NNM07AB07C from NASA to SAO and grant number NNX12AI30G from NASA to SAO.

  19. Ectopic folliculosebaceous units at the coronal sulcus.

    Science.gov (United States)

    Fernandez-Flores, Angel

    2014-12-01

    Tyson glands were described in the 17th century as modified sebaceous glands of the coronal sulcus of the penis. However, this description and other early texts supporting the existence of Tyson glands were not accompanied by illustrations. The existence of such glands has been passing through the literature without adequate graphical demonstration, which has contributed to controversial debates. Herein we present a case of a partial penectomy performed on a 65-year-old man with a squamous cell carcinoma of the penis. In this case we identified sebaceous glands as well as folliculosebaceous units in the coronal sulcus. We also comparatively examined 12 cases of partial penectomy to search for sebaceous glands or folliculosebaceous units in the coronal sulcus or the preputium. We found neither sebaceous glands nor folliculosebaceous units at the coronal sulcus or the mucosal aspect of the prepuce. We conclude that: (1) folliculosebaceous units are possible in the coronal sulcus, as the current case illustrates for the first time in literature and (2) the current case is an oddity, probably induced by the accompanying squamous cell carcinoma, and therefore it may represent an ectopic folliculosebaceous unit rather than an anatomic variation.

  20. Re-examining the value of medical grand rounds.

    Science.gov (United States)

    Hebert, Randy S; Wright, Scott M

    2003-12-01

    To study medical grand rounds, the cornerstone of a department of medicine's educational programs. Between April and June 2001, a questionnaire was sent to chairs of departments of medicine at the 389 U.S. hospitals with medicine residency programs accredited by the Accreditation Council for Graduate Medical Education. Data were collected on the objectives and attendance, educational structure, perceived quality, and costs of medical grand rounds. Three hundred questionnaires were returned (77%). Grand rounds were offered by 97% of departments and accredited for continuing medical education in 96% of hospitals. The most important objectives were to educate, showcase faculty role models, and promote a collegial atmosphere. Patients were present at grand rounds less than 3% of the time. Grand rounds were predominantly lecture based; only 10% were clinical case presentations or interactive workshops/small groups, the formats proven most effective for facilitating adult learning and a humanistic approach to patients. Curricular tenets of needs assessment, program evaluation, and knowledge assessment were performed in only 73%, 59%, and 17% of programs, respectively. University hospitals were less likely to incorporate these principles (p <.01). Although respondents attested to the high quality of grand rounds, many potential attendees missed more than half the sessions. Grand rounds were the most expensive conference in 78% of departments, with the pharmaceutical industry providing the majority of the funding. Medical grand rounds are costly and often do not take into account learners' needs. Departments of medicine should reevaluate their commitment to grand rounds.

  1. The Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS). An analysis of pass rates of the July 1984 through July 1987 examinations.

    Science.gov (United States)

    Mick, S S; Mou, T W

    1991-03-01

    This report examines the experience of 48,509 (40,393 foreign nationals and 8,116 U.S. citizens) foreign medical students and graduates (FMGs) who took any part of the first seven Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS) administered by the Educational Commission for Foreign Medical Graduates. The pass rate on all three sections (basic science, clinical science, and English) was 23.0%. Almost one-half (47.2%) of all FMGEMS examinees were between 25 and 29 years of age, 73.9% were men, 71.5% took FMGEMS after medical school graduation, and 79.7% claimed as their native tongue languages other than English. Correlates of pass rates included taking FMGEMS before medical school graduation (30.0% pass) and being a native English speaker (37.5% pass). The rates for foreign national FMGs (FNFMGs) and United States FMGs (USFMGs) were 22.5% and 25.2%, respectively. Native English-speaking FNFMGs achieved a 43.3% pass rate; native English-speaking USFMGs, 32.6%; non-native English-speaking FNFMGs, 19.9%; and non-native English-speaking USFMGs, 11.2%. Whereas FMGs were educated in 114 countries, 74.2% of USFMGs were educated in just eight countries, all located in the West Indies and Mexico. Logistical regression analysis showed that the strongest factors predicting full pass rates were being both younger than 30 years of age and a native English speaker. Conclusions are that approximately 3,200 FMGs per year pass FMGEMS and that FMGs with the highest probability of passing share characteristics of U.S. and Canadian medical graduates who pass the National Board medical examinations, which suggests that the latter examinations, when offered to FMGs, may have limited effect on overall pass rates.

  2. Normative segment-specific axial and coronal angulation corridors of subaxial cervical column in axial rotation.

    Science.gov (United States)

    Yoganandan, Narayan; Stemper, Brian D; Pintar, Frank A; Baisden, Jamie L; Shender, Barry S; Paskoff, Glenn

    2008-03-01

    In contrast to clinical studies wherein loading magnitudes are indeterminate, experiments permit controlled and quantifiable moment applications, record kinematics in multiple planes, and allow derivation of moment-angulation corridors. Axial and coronal moment-angulation corridors were determined at every level of the subaxial cervical spine, expressed as logarithmic functions, and level-specificity of range of motion and neutral zones were evaluated. segmental primary axial and coupled coronal motions do not vary by level. Although it is known that cervical spine responses are coupled, segment-specific corridors of axial and coronal kinematics under axial twisting moments from healthy normal spines are not reported. Ten human cadaver columns (23-44 years, mean: 34 +/- 6.8) were fixed at the ends and targets were inserted to each vertebra to obtain kinematics in axial and coronal planes. The columns were subjected to pure axial twisting moments. Range of motion and neutral zone for primary-axial and coupled-coronal rotation components were determined at each spinal level. Data were analyzed using factorial analysis of variance. Moment-rotation angulations were expressed using logarithmic functions, and mean +/-1 standard deviation corridors were derived at each level for both components. Moment-angulations responses were nonlinear. Each segmental curve for both components was well represented by a logarithmic function (r2 > 0.95). Factorial analysis of variance indicated that the biomechanical metrics are spinal level-specific (P specific responses. The presentation of moment-angulation corridors for both metrics forms a dataset for the normal population. These segment-specific nonlinear corridors may help clinicians assess dysfunction or instability. These data will assist mathematical models of the spine in improved validation and lead to efficacious design of stabilizing systems.

  3. Standing sausage modes in coronal loops with plasma flow

    CERN Document Server

    Li, Bo; Xia, Li-Dong; Yu, Hui

    2014-01-01

    Magnetohydrodynamic waves are important for diagnosing the physical parameters of coronal plasmas. Field-aligned flows appear frequently in coronal loops.We examine the effects of transverse density and plasma flow structuring on standing sausage modes trapped in coronal loops, and examine their observational implications. We model coronal loops as straight cold cylinders with plasma flow embedded in a static corona. An eigen-value problem governing propagating sausage waves is formulated, its solutions used to construct standing modes. Two transverse profiles are distinguished, one being the generalized Epstein distribution (profile E) and the other (N) proposed recently in Nakariakov et al.(2012). A parameter study is performed on the dependence of the maximum period $P_\\mathrm{max}$ and cutoff length-to-radius ratio $(L/a)_{\\mathrm{cutoff}}$ in the trapped regime on the density parameters ($\\rho_0/\\rho_\\infty$ and profile steepness $p$) and flow parameters (magnitude $U_0$ and profile steepness $u$). For e...

  4. Transition-Region/Coronal Signatures of Penumbral Microjets: Hi-C, SDO/AIA and Hinode (SOT/FG) Observations

    Science.gov (United States)

    Tiwari, Sanjiv K.; Alpert, Shane E.; Moore, Ronald L.; Winebarger, Amy R.

    2014-01-01

    Penumbral microjets are bright, transient features seen in the chromosphere of sunspot penumbrae. Katsuaka et al. (2007) noted their ubiquity and characterized them using the Ca II H-line filter on Hinode's Solar Optical Telescope (SOT). The jets are 1000{4000 km in length, 300{400 km in width, and last less than one minute. It was proposed that these penumbral microjets could contribute to the transition-region and coronal heating above sunspots. We examine whether these microjets appear in the transition-region (TR) and/or corona or are related{ temporally and spatially{ to similar brightenings in the TR and/or corona. First, we identify penumbral microjets with the SOT's Ca II H-line filter. The chosen sunspot is observed on July 11, 2012 from 18:50:00 UT to 20:00:00 UT at approx. 14 inches, -30 inches. We then examine the sunspot in the same field of view and at the same time in other wavelengths. We use the High Resolution Coronal Imager Telescope (Hi-C) at 193A and the 1600A, 304A, 171A, 193A, and 94A passbands of the Atmospheric Imaging Assembly (AIA) onboard the Solar Dynamic Observatory. We include examples of these jets and where they should appear in the other passbands, but find no signifcant association, except for a few jets with longer lifetimes and bigger sizes seen at locations in the penumbra with repeated stronger brightenings. We conclude that the normal microjets are not heated to transition-region/coronal temperatures, but the larger jets are.

  5. OBSERVATIONAL SIGNATURES OF CORONAL LOOP HEATING AND COOLING DRIVEN BY FOOTPOINT SHUFFLING

    Energy Technology Data Exchange (ETDEWEB)

    Dahlburg, R. B.; Taylor, B. D. [LCP and FD, Naval Research Laboratory, Washington, DC 20375 (United States); Einaudi, G. [Berkeley Research Associates, Inc., Beltsville, MD 20705 (United States); Ugarte-Urra, I. [College of Science, George Mason University, Fairfax, VA 22030 (United States); Warren, H. P. [Space Science Division, Naval Research Laboratory, Washington, DC 20375 (United States); Rappazzo, A. F. [Advanced Heliophysics, Pasadena, CA 91106 (United States); Velli, M., E-mail: rdahlbur@lcp.nrl.navy.mil [EPSS, UCLA, Los Angeles, CA 90095 (United States)

    2016-01-20

    The evolution of a coronal loop is studied by means of numerical simulations of the fully compressible three-dimensional magnetohydrodynamic equations using the HYPERION code. The footpoints of the loop magnetic field are advected by random motions. As a consequence, the magnetic field in the loop is energized and develops turbulent nonlinear dynamics characterized by the continuous formation and dissipation of field-aligned current sheets: energy is deposited at small scales where heating occurs. Dissipation is nonuniformly distributed so that only a fraction of the coronal mass and volume gets heated at any time. Temperature and density are highly structured at scales that, in the solar corona, remain observationally unresolved: the plasma of our simulated loop is multithermal, where highly dynamical hotter and cooler plasma strands are scattered throughout the loop at sub-observational scales. Numerical simulations of coronal loops of 50,000 km length and axial magnetic field intensities ranging from 0.01 to 0.04 T are presented. To connect these simulations to observations, we use the computed number densities and temperatures to synthesize the intensities expected in emission lines typically observed with the Extreme Ultraviolet Imaging Spectrometer on Hinode. These intensities are used to compute differential emission measure distributions using the Monte Carlo Markov Chain code, which are very similar to those derived from observations of solar active regions. We conclude that coronal heating is found to be strongly intermittent in space and time, with only small portions of the coronal loop being heated: in fact, at any given time, most of the corona is cooling down.

  6. Oral antioxidants for radioprotection during medical imaging examinations

    Science.gov (United States)

    Velauthapillai, Nivethan

    The oncogenic effect of ionizing radiation (IR) is clearly established and occurs in response to DNA damage. Many diagnostic imaging exams make use of IR and the oncogenic risk of IR-based imaging has been calculated. We hypothesized that the DNA damage sustained from IR exposure during medical imaging exams could be reduced by pre-medicating patients with antioxidants. First, we tested and validated a method for measuring DNA double-strand breaks (DSBs) in peripheral blood mononuclear cells (PBMCs) exposed to low doses of ionizing radiation. Afterwards, we conducted a pilot clinical study in which we administered oral antioxidants to patients undergoing bone scans, prior to radiotracer injection. We showed that oral antioxidant pre-medication reduced the number of DSBs in PBMCs induced by radiotracer injection. Our study shows proof-of-principle for this simple and inexpensive approach to radioprotection in the clinical setting.

  7. Coronal physics and the chandra emission line project

    Directory of Open Access Journals (Sweden)

    N. S. Brickhouse

    2000-01-01

    Full Text Available Con el lanzamiento del observatorio de rayos-X Chandra se ha iniciado la espectroscop a de alta resoluci on en rayos-X de las fuentes c osmicas. Observa- ciones profundas de tres fuentes estelares con emisi on coronal|Capela, Proci on y HR 1099|est an dando no s olo datos de calibraci on invaluables sino tambi en medios de comparaci on para los modelos de emisi on de plasmas. Estos modelos, que han sido cuestionados por los problemas para entender los datos de baja y moderada re- soluci on de ASCA y del EUVE, son necesarios para interpretar los datos de coronas estelares, galaxias y c umulos de galaxias, remanentes de supernova y otras fuentes. El Proyecto de L neas de Emisi on es una colaboraci on para mejorar los modelos y su primera fase es la comparaci on de los modelos con los espectros observados de Capela, Proci on y HR 1099. Las metas de la comparaci on son (1 determinar y veri car la precisi on y fortaleza de los diagn osticos y (2 identi car y priorizar los elementos de la espectroscop a que requieran m as trabajo tanto te orico como de laboratorio. Uno de los puntos cr ticos de esta labor es entender hasta que punto se pueden aplicar las hip otesis simpli cadoras comunmente usadas (equilibrio coro- nal, baja opacidad. Discutimos, en este contexto, los avances m as recientes en el entendimiento de las coronas estelares.

  8. Global Coronal Waves

    CERN Document Server

    Chen, P F

    2016-01-01

    After the {\\em Solar and Heliospheric Observatory} ({\\em SOHO}) was launched in 1996, the aboard Extreme Ultraviolet Imaging Telescope (EIT) observed a global coronal wave phenomenon, which was initially named "EIT wave" after the telescope. The bright fronts are immediately followed by expanding dimmings. It has been shown that the brightenings and dimmings are mainly due to plasma density increase and depletion, respectively. Such a spectacular phenomenon sparked long-lasting interest and debates. The debates were concentrated on two topics, one is about the driving source, and the other is about the nature of this wavelike phenomenon. The controversies are most probably because there may exist two types of large-scale coronal waves that were not well resolved before the {\\em Solar Dynamics Observatory} ({\\em SDO}) was launched: one is a piston-driven shock wave straddling over the erupting coronal mass ejection (CME), and the other is an apparently propagating front, which may correspond to the CME frontal...

  9. Gamma-hydroxybutyrate concentrations in the blood of impaired drivers, users of illicit drugs, and medical examiner cases.

    Science.gov (United States)

    Jones, A Wayne; Holmgren, Anita; Kugelberg, Fredrik C

    2007-01-01

    Gamma-hydroxybutyrate (GHB) was determined in blood samples from impaired drivers, people arrested for petty drug offenses (non-traffic cases), and GHB-related deaths. The method of analysis involved conversion of GHB into gamma-butyrolactone and determination of the latter by gas chromatography with a flame ionization detector, and with gamma-valerolactone as the internal standard. The mean and median concentrations of GHB in blood from impaired drivers (N=473) were 90 and 84 mg/L, respectively, and offenders were predominantly men (96%) with an average age of 26 year (range 15-50 year). In 185 cases, GHB was the only drug present in blood at mean and median concentrations of 92 and 86 mg/L, respectively. People arrested for petty drug offenses (N=1061) had slightly higher GHB concentrations in their blood: median 118 mg/L for men and 111 mg/L for women. In GHB-related deaths (N=33), the mean and median concentrations were considerably higher: 307 mg/L and 190 mg/L, respectively, and the highest was 2200 mg/L. The typical signs of drug influence noted by the arresting police officers included sedation, agitation, slurred speech, irrational behaviour, jerky movements, and spitting. The short elimination half-life of GHB means that the concentrations in blood decrease rapidly and are probably a lot lower than at the time of driving, which was 30-90 min earlier.

  10. [Before you diagnose a patient with a conversion disorder, perform a thorough general medical and neurological examination. Case study].

    Science.gov (United States)

    Pawełczyk, Tomasz; Pawełczyk, Agnieszka; Rabe-Jabłońska, Jolanta

    2012-01-01

    Dissociative and conversion disorders are classified together according to ICD-10 as states that are not confirmed by the presence of somatic diseases, which they suggest. According to the DSM-IV, both disorders are classified separately. Conversion disorders are a group of psychiatric disorders whose symptoms mimic the presence of malfunction or loss of motor or sensory function, whereas the nature and dynamics of the observed symptoms is not fully explained by the results of objective assessments and consultations, nor is the direct effect of a psychoactive substance. Impaired mental integration of different functions which normally interact simultaneously in the perception of reality and inner experience of the individual is found in dissociative disorders. The article describes the case of 25-year old man, in whom after initial suspicion of myasthenia gravis and its exclusion, a diagnosis of conversion disorder was made on the basis of the clinical picture and treatment with an SSRI antidepressant and individual psychotherapy were recommended. No improvement in mental and neurological status after six month therapy resulted in an in-depth diagnostics in a clinical setting and diagnosis of brain stem tumor (aastrocytoma fibrillare). (a) Neuroimaging is a source of important clinical data and in many cases should constitute an inherent element of a psychiatric diagnosis. (b) Diagnosis of conversion (dissociative) disorders requires a precise differential diagnosis, excluding the somatic causes of observed neurological ailments. (c) A late diagnosis of neurological or somatic causes of symptoms which arouse a suspicion of conversion (dissociative) disorders may make a radical treatment impossible or may considerably aggravate the remote prognosis and quality of the patients' life.

  11. 20 CFR 416.919n - Informing the medical source of examination scheduling, report content, and signature requirements.

    Science.gov (United States)

    2010-04-01

    ... examination—at least 60 minutes (Additional time may be required depending on types of psychological tests... Disability and Blindness Standards for the Type of Referral and for Report Content § 416.919n Informing the... any needed tests. The following minimum scheduling intervals (i.e., time set aside for the individual...

  12. Impact of Online Learning Modules on Medical Student Microbiology Examination Scores

    OpenAIRE

    Mary T. Johnson

    2009-01-01

    Medical students have a limited amount of time in which to acquire working knowledge of an enormous amount of information, and this is especially relevant for microbiology. One large midwestern medical school is unique in having medical microbiology taught at nine regional campuses using a single core curriculum. A committee of statewide course directors writes a licensure board-style final examination that is referenced to the core and used at all campuses. To prepare for the final examinati...

  13. Solar wind and coronal structure near sunspot minimum - Pioneer and SMM observations from 1985-1987

    Science.gov (United States)

    Mihalov, J. D.; Barnes, A.; Hundhausen, A. J.; Smith, E. J.

    1990-01-01

    Changes in solar wind speed and magnetic polarity observed at the Pioneer spacecraft are discussed here in terms of the changing magnetic geometry implied by SMM coronagraph observations over the period 1985-1987. The pattern of recurrent solar wind streams, the long-term average speed, and the sector polarity of the interplanetary magnetic field all changed in a manner suggesting both a temporal variation, and a changing dependence on heliographic latitude. Coronal observations during this epoch show a systematic variation in coronal structure and the magnetic structure imposed on the expanding solar wind. These observations suggest interpretation of the solar wind speed variations in terms of the familiar model where the speed increases with distance from a nearly flat interplanetary current sheet, and where this current sheet becomes aligned with the solar equatorial plane as sunspot minimum approaches, but deviates rapidly from that orientation after minimum.

  14. The usefulness of combined axial and coronal computed tomography for the evaluation of metastatic supraclavicular lymph nodes.

    Science.gov (United States)

    Choi, Hyun Jin; Lee, Kyung Hee; Kim, Na Hee; Kim, Jun Ho; Hyun, In Young; Ryu, Jeong-Seon

    2015-01-01

    The purpose is to assess the value of adding coronal images for the identification of metastatic supraclavicular lymph nodes (LNs). Two radiologists reviewed axial images and combined axial and coronal images using thoracic computed tomography (CT) of 386 patients whose maximum standardized uptake value measured in a supraclavicular LN was ≥2.0 on a positron emission tomography. We compared sensitivity and agreement between readers before and after the addition of coronal images. For combined images, agreement was almost perfect (κ=0.982), and sensitivity was significantly higher (90.4%, Psupraclavicular metastasis. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Are Spicules the Primary Source of Hot Coronal Plasma?

    Science.gov (United States)

    Klimchuk, James A.

    2011-01-01

    The recent discovery of Type II spicules has generated considerable excitement. It has even been suggested that these ejections can account for a majority of the hot plasma observed in the corona, thus obviating the need for "coronal" heating. If this is the case, however, then there should be observational consequences. We have begun to examine some of these consequences and find reason to question the idea that spicules are the primary source of hot coronal plasma.

  16. [Usefulness of the initial medical examination on matters relating to persons suspected of driving under the influence of amphetamine and its analogs or delta9-tetrahydrocannabinol based on the materials the Department of Forensic Medicine, Pomeranian Medical University in Szczecin].

    Science.gov (United States)

    Wolski, Stanisław; Lewandowska, Ewa; Kurzejamska-Parafiniuk, Małgorzata

    2013-01-01

    Polish law forbids persons to drive under the influence of intoxicating substances, and those after the use of substances producing effects similar to alcohol. Therefore, there is a need to give an opinion based on a blood test, to establish whether or not the person from whom the blood was taken was under the influence of an intoxicating substance or after use of the drug while driving. Some authors reported that the final opinion should take into account chemical and toxicology test results identifying the parent compound and/or the metabolite only, but also the sampling time of the material to be analyzed in relation to the driving time, the result of the medical examination conducted prior to the collection of material for analysis, and the results of screening tests executed at the scene. Circumstances relating to the event, the findings and observations of third parties, and the testimony of the suspect are also relevant. The aim of this study was to evaluate the results of the medical examination in the evaluation of cases concerning driving by persons who were potentially under the influence of amphetamine and its analogs, or delta9-tetrahydrocannabinol, (delta9-THC) and conformity assessment of these results with the results of blood tests. An additional aim was to determine the factors considered by doctors when making their evaluation of patient's condition. The study group consisted of 350 persons suspected of driving while under the influence of amphetamine and its analogs, and/or delta9-THC, from whom blood samples were taken to test amphetamine content or its analogues and/or delta9-tetrahydrocannabinol. Blood tests were carried out according to the existing procedure developed by the department. Blood samples were initially analyzed with immunochemical methods. Positive preliminary results were verified by gas chromatography-mass spectrometry. Statistical analysis was conducted with independent tests for multi-way tables, i.e. the Pearson chi2 test

  17. HOW MEDICAL UNDERGRADUATES PREPARE FOR UNIVERSITY EXAMINATION: LESSON FROM A TEACHING MEDICAL INSTITUTION IN SOUTH INDIA

    OpenAIRE

    Shib Sekhar Datta; Boratne, Abhijit V; Rajkumar Patil

    2013-01-01

    Background: Medical colleges in India conventionally follow a curriculum overfed with large volume of information expecting students will imbibe such curriculum unquestionably overlooking what and how they progress. There have been many attempts to improve the learning process of medical students, neglecting the process which students adopt towards such learning and prepare for their exams aiming better performance. Objective: To explore qualitatively the way medical undergraduates prepare ...

  18. Seriously clowning: Medical clowning interaction with children undergoing invasive examinations in hospitals.

    Science.gov (United States)

    Tener, Dafna; Ofir, Shoshi; Lev-Wiesel, Rachel; Franco, Nessia L; On, Avi

    2016-04-01

    This qualitative study examined the subjective experience of children undergoing an invasive examination in the hospital when accompanied by a medical clown. In-depth semi-structured interviews were conducted with nine such children and nine of their accompanying parents. The children were patients in two outpatient departments (Pediatric Gastroenterology and a Center for the Sexually Abused) in a hospital in Israel. Interviews were coded thematically using an Atlas.ti software program. Analysis of the interviews indicated that the intervention of the clown positively changed the children's perceptions of the hospital, of experiencing the examination, and of their life narrative. Medical clowns thus appear to be a central, meaningful, and therapeutic source for children undergoing invasive examinations in hospital, as well as for their parents. Therefore, it may be advisable to incorporate medical clowns as an integral part of medical teams performing invasive procedures and to include the clowns in all stages of the hospital visit.

  19. Prevalence of Pancreatic Cystic Lesions Is Associated With Diabetes Mellitus and Obesity: An Analysis of 5296 Individuals Who Underwent a Preventive Medical Examination.

    Science.gov (United States)

    Mizuno, Suguru; Isayama, Hiroyuki; Nakai, Yousuke; Yoshikawa, Takeharu; Ishigaki, Kazunaga; Matsubara, Saburo; Yamamoto, Natsuyo; Ijichi, Hideaki; Tateishi, Keisuke; Tada, Minoru; Hayashi, Naoto; Koike, Kazuhiko

    2017-07-01

    Pancreatic cystic lesions (PCLs) are considered precursors of pancreatic cancer. Diabetes mellitus (DM) and obesity are known as risk factors for pancreatic cancer. We investigated the prevalence of PCLs in the general population and the relationship between PCLs and DM/obesity. This cross-sectional analysis included 5296 individuals who underwent a preventive medical examination between October 2006 and June 2013 at our institution. Magnetic resonance imaging, including magnetic resonance cholangiopancreatography, was performed using a 3.0-T system as part of a comprehensive health screening program. We investigated the prevalence and risk factors of PCLs. The prevalence of PCLs was 13.7%, which was increased according to age. Individuals with PCLs were more prone to obesity (body mass index, 24.0 vs 23.7 kg/m [P = 0.015]; waist circumference, 87.4 vs 85.5 cm [P Pancreatic cystic lesions were significantly associated with DM and obesity.

  20. [Euthanasia: medications and medical procedures].

    Science.gov (United States)

    Lossignol, D

    2008-09-01

    The Belgian law relative to euthanasia has been published in 2002. A physician is allowed to help a patient with intractable suffering (physical or psychological). Legal conditions are clear. However, nothing is said about medical procedures or medications to be used. The present paper will present specific clinical situations at the end of life, practical procedures and medications. A special focus is made on psychological impact of euthanasia.

  1. Periods and Damping Rates of Fast Sausage Oscillations in Multishelled Coronal Loops

    Science.gov (United States)

    Chen, Shao-Xia; Li, Bo; Xia, Li-Dong; Yu, Hui

    2015-08-01

    Standing sausage modes are important in interpreting quasi-periodic pulsations in the light curves of solar flares. Their periods and damping times play an important role in seismologically diagnosing key parameters like the magnetic field strength in regions where flare energy is released. Usually, such applications are based on theoretical results neglecting unresolved fine structures in magnetized loops. However, the existence of fine structuring is suggested on both theoretical and observational grounds. Adopting the framework of cold magnetohydrodynamics (MHD), we model coronal loops as magnetized cylinders with a transverse equilibrium density profile comprising a monolithic part and a modulation due to fine structuring in the form of concentric shells. The equation governing the transverse velocity perturbation is solved with an initial-value-problem approach, and the effects of fine structuring on the periods P and damping times τ of global, leaky, standing sausage modes are examined. A parameter study shows that fine structuring, be it periodically or randomly distributed, brings changes of only a few percents to P and τ when there are more than about ten shells. The monolithic part, its steepness in particular, plays a far more important role in determining P and τ. We conclude that when measured values of P and τ of sausage modes are used for seismological purposes, it is justified to use theoretical results where the effects due to fine structuring are neglected.

  2. Health assessment of children and adolescents living in a residential area of production for the disposal of rocket fuel: according to the results of the medical examination

    Directory of Open Access Journals (Sweden)

    Uiba V.V.

    2014-12-01

    Full Text Available Aim: to determine the real prevalence separate nosological forms in the child population living in residential zone installations for the disposal of rocket fuel. Materials and methods. By mobile teams of pediatric physicians there was conducted a comprehensive medical examination of 1621 children in the area of the site location for disposal of rocket engines solid fuel. Results. The surveyed contingent of the most common diseases of the endocrine system, disorders of nutrition and metabolism (21.2% of diagnoses, diseases of the musculoskeletal and connective tissue (19.2 percent, as well as individual symptoms, signs and deviations from the norm by 14.4%. Conclusion. Data indicating the pronounced impact of adverse environmental factors, not identified.

  3. Tracing the Chromospheric and Coronal Magnetic Field with AIA, IRIS, IBIS, and ROSA Data

    Science.gov (United States)

    Aschwanden, Markus J.; Reardon, Kevin; Jess, Dave B.

    2016-07-01

    The aim of this study is to explore the suitability of chromospheric images for magnetic modeling of active regions. We use high-resolution images (≈ 0\\buildrel{\\prime\\prime}\\over{.} 2{--}0\\buildrel{\\prime\\prime}\\over{.} 3), from the Interferometric Bidimensional Spectrometer in the Ca ii 8542 Å line, the Rapid Oscillations in the Solar Atmosphere instrument in the Hα 6563 Å line, the Interface Region Imaging Spectrograph in the 2796 Å line, and compare non-potential magnetic field models obtained from those chromospheric images with those obtained from images of the Atmospheric Imaging Assembly in coronal (171 Å, etc.) and in chromospheric (304 Å) wavelengths. Curvi-linear structures are automatically traced in those images with the OCCULT-2 code, to which we forward-fitted magnetic field lines computed with the Vertical-current Approximation Nonlinear Force Free Field code. We find that the chromospheric images: (1) reveal crisp curvi-linear structures (fibrils, loop segments, spicules) that are extremely well-suited for constraining magnetic modeling; (2) that these curvi-linear structures are field-aligned with the best-fit solution by a median misalignment angle of {μ }2≈ 4^\\circ -7° (3) the free energy computed from coronal data may underestimate that obtained from cromospheric data by a factor of ≈ 2-4, (4) the height range of chromospheric features is confined to h≲ 4000 km, while coronal features are detected up to h = 35,000 km; and (5) the plasma-β parameter is β ≈ {10}-5{--}{10}-1 for all traced features. We conclude that chromospheric images reveal important magnetic structures that are complementary to coronal images and need to be included in comprehensive magnetic field models, something that is currently not accomodated in standard NLFFF codes.

  4. TRANSITION-REGION/CORONAL SIGNATURES AND MAGNETIC SETTING OF SUNSPOT PENUMBRAL JETS: HINODE (SOT/FG), Hi-C, AND SDO/AIA OBSERVATIONS

    Energy Technology Data Exchange (ETDEWEB)

    Tiwari, Sanjiv K.; Moore, Ronald L.; Winebarger, Amy R. [NASA Marshall Space Flight Center, Mail Code ZP 13, Huntsville, AL 35812 (United States); Alpert, Shane E., E-mail: sanjiv.k.tiwari@nasa.gov [Department of Physics and Astronomy, Rice University, Houston, TX 77005 (United States)

    2016-01-10

    Penumbral microjets (PJs) are transient narrow bright features in the chromosphere of sunspot penumbrae, first characterized by Katsukawa et al. using the Ca ii H-line filter on Hinode's Solar Optical Telescope (SOT). It was proposed that the PJs form as a result of reconnection between two magnetic components of penumbrae (spines and interspines), and that they could contribute to the transition region (TR) and coronal heating above sunspot penumbrae. We propose a modified picture of formation of PJs based on recent results on the internal structure of sunspot penumbral filaments. Using data of a sunspot from Hinode/SOT, High Resolution Coronal Imager, and different passbands of the Atmospheric Imaging Assembly (AIA) on board the Solar Dynamics Observatory, we examine whether PJs have signatures in the TR and corona. We find hardly any discernible signature of normal PJs in any AIA passbands, except for a few of them showing up in the 1600 Å images. However, we discovered exceptionally stronger jets with similar lifetimes but bigger sizes (up to 600 km wide) occurring repeatedly in a few locations in the penumbra, where evidence of patches of opposite-polarity fields in the tails of some penumbral filaments is seen in Stokes-V images. These tail PJs do display signatures in the TR. Whether they have any coronal-temperature plasma is unclear. We infer that none of the PJs, including the tail PJs, directly heat the corona in active regions significantly, but any penumbral jet might drive some coronal heating indirectly via the generation of Alfvén waves and/or braiding of the coronal field.

  5. Reconsidering the Cut Score of Korean National Medical Licensing Examination

    OpenAIRE

    Duck Sun Ahn; Sowon Ahn

    2007-01-01

    After briefly reviewing theories of standard setting we analyzed the problems of the current cut scores. Then, we reported the results of need assessment on the standard setting among medical educators and psychometricians. Analyses of the standard setting methods of developed countries were reported as well. Based on these findings, we suggested the Bookmark and the modified Angoff methods as alternative methods for setting standard. Possible problems and challenges were discussed when these...

  6. Comparative Study between Axial and Coronal Planes of CT Enterography in Evaluation of Disease Activity and Complications of Crohn Disease

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Sung Eun; Park, Seong Jin; Moon, Soung Kyung; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae; Kim, Hyo Jong [Dept. of Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2013-02-15

    To retrospectively compare the accuracy of axial and coronal planes of CT enterography for detection of pathologic findings of Crohn disease. 168 patients who were suspected of having Crohn disease underwent CT enterography. 66 patients who were diagnosed Crohn disease were retrospectively evaluated (endoscopic biopsy of terminal ileum: 12 patients, segmental resection of small bowel: 6 patients, diagnosed based on a combination of clinical, histopathological and imaging findings: 48 patients). 2 radiologists reviewed axial planes of CT enterography and one month later reviewed coronal planes. CT enterography findings of active phase, chronic phase and complications of Crohn disease were evaluated and then compared with axial and coronal planes by using chi-square test. Mucosal hyperenhancement, wall thickening, and mesenteric fat stranding were more detected on axial planes, which were CT findings of active Crohn disease. Pseudosacculation, fibrotic strictures, fistulas, abscesses were more detected on coronal planes, which were CT findings of chronic Crohn disease or complications. In particular, pseudosacculation and fibrotic strictures were significantly more detected on coronal planes. When evaluating CT enterography in Crohn disease, coronal planes provide more useful diagnostic information of pseudosacculation and fibrotic strictures.

  7. Introduction to an open source internet-based testing program for medical student examinations.

    Science.gov (United States)

    Lee, Yoon-Hwan

    2009-12-20

    The author developed a freely available open source internet-based testing program for medical examination. PHP and Java script were used as the programming language and postgreSQL as the database management system on an Apache web server and Linux operating system. The system approach was that a super user inputs the items, each school administrator inputs the examinees' information, and examinees access the system. The examinee's score is displayed immediately after examination with item analysis. The set-up of the system beginning with installation is described. This may help medical professors to easily adopt an internet-based testing system for medical education.

  8. Evolution of Magnetic Helicity During Eruptive Flares and Coronal Mass Ejections

    CERN Document Server

    Priest, Eric; Janvier, Miho

    2016-01-01

    During eruptive solar flares and coronal mass ejections, a non-pot{\\-}ential magnetic arcade with much excess magnetic energy goes unstable and reconnects. It produces a twisted erupting flux rope and leaves behind a sheared arcade of hot coronal loops. We suggest that: the twist of the erupting flux rope can be determined from conservation of magnetic flux and magnetic helicity and equipartition of magnetic helicity. It depends on the geometry of the initial pre-eruptive structure. Two cases are considered, in the first of which a flux rope is not present initially but is created during the eruption by the reconnection. In the second case, a flux rope is present under the arcade in the pre-eruptive state, and the effect of the eruption and reconnection is to add an amount of magnetic helicity that depends on the fluxes of the rope and arcade and the geometry.

  9. Understanding the Global Structure and Evolution of Coronal Mass Ejections in the Solar Wind

    Science.gov (United States)

    Riley, Pete

    2004-01-01

    This report summarizes the technical progress made during the first six months of the second year of the NASA Living with a Star program contract Understanding the global structure and evolution of coronal mass ejections in the solar wind, between NASA and Science Applications International Corporation, and covers the period November 18, 2003 - May 17,2004. Under this contract SAIC has conducted numerical and data analysis related to fundamental issues concerning the origin, intrinsic properties, global structure, and evolution of coronal mass ejections in the solar wind. During this working period we have focused on a quantitative assessment of 5 flux rope fitting techniques. In the following sections we summarize the main aspects of this work and our proposed investigation plan for the next reporting period. Thus far, our investigation has resulted in 6 refereed scientific publications and we have presented the results at a number of scientific meetings and workshops.

  10. Fast-mode Coronal EUV Wave Trains Associated with Solar Flares and CMEs

    Science.gov (United States)

    Liu, Wei; Ofman, Leon; Downs, Cooper; Karlicky, Marian; Chen, Bin

    2017-08-01

    As a new observational phenomenon, Quasi-periodic, Fast Propagating EUV wave trains (QFPs) are fast-mode magnetosonic waves closely related to quasi-periodic pulsations commonly detected in solar flares (traditionally with non-imaging observations). They can provide critical clues to flare energy release and serve as new tools for coronal seismology. We report recent advances in observing and modeling QFPs, including evidence of heating and cooling cycles revealed with differential emission measure (DEM) analysis that are consistent with alternating compression and rarefaction expected for magnetosonic waves. Through a statistical survey, we found a preferential association of QFPs with eruptive flares (with CMEs) rather than confined flares (without CMEs). We also identified some correlation with quasi-periodic radio bursts observed at JVLA and Ondrejov observatories. We will discuss the implications of these results and the potential roles of QFPs in coronal heating and energy transport.

  11. Plasma Sloshing in Pulse-heated Solar and Stellar Coronal Loops

    Science.gov (United States)

    Reale, F.

    2016-08-01

    There is evidence that coronal heating is highly intermittent, and flares are the high energy extreme. The properties of the heat pulses are difficult to constrain. Here, hydrodynamic loop modeling shows that several large amplitude oscillations (˜20% in density) are triggered in flare light curves if the duration of the heat pulse is shorter than the sound crossing time of the flaring loop. The reason for this is that the plasma does not have enough time to reach pressure equilibrium during heating, and traveling pressure fronts develop. The period is a few minutes for typical solar coronal loops, dictated by the sound crossing time in the decay phase. The long period and large amplitude make these oscillations different from typical magnetohydrodynamic (MHD) waves. This diagnostic can be applied both to observations of solar and stellar flares and to future observations of non-flaring loops at high resolution.

  12. Plasma sloshing in pulse-heated solar and stellar coronal loops

    CERN Document Server

    Reale, F

    2016-01-01

    There is evidence that coronal heating is highly intermittent, and flares are the high energy extreme. The properties of the heat pulses are difficult to constrain. Here hydrodynamic loop modeling shows that several large amplitude oscillations (~ 20% in density) are triggered in flare light curves if the duration of the heat pulse is shorter that the sound crossing time of the flaring loop. The reason is that the plasma has not enough time to reach pressure equilibrium during the heating and traveling pressure fronts develop. The period is a few minutes for typical solar coronal loops, dictated by the sound crossing time in the decay phase. The long period and large amplitude make these oscillations different from typical MHD waves. This diagnostic can be applied both to observations of solar and stellar flares and to future observations of non-flaring loops at high resolution.

  13. Policy implications of medical tourism development in destination countries: revisiting and revising an existing framework by examining the case of Jamaica

    NARCIS (Netherlands)

    Johnston, R.; Crooks, V.A.; Ormond, M.E.

    2015-01-01

    Background - Medical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on a regional scale, but interest in the practice is growing in

  14. Policy implications of medical tourism development in destination countries: revisiting and revising an existing framework by examining the case of Jamaica

    NARCIS (Netherlands)

    Johnston, R.; Crooks, V.A.; Ormond, M.E.

    2015-01-01

    Background - Medical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on a regional scale, but interest in the practice is growing in

  15. Examination Management and Examination Malpractice: The Nexus

    Science.gov (United States)

    Ogunji, James A.

    2011-01-01

    Examination malpractice or cheating has become a global phenomenon. In different countries of the world today, developed and developing, academic dishonesty especially cheating in examinations has heightened and taken frightening dimension. In many countries of the world this phenomenon has become a serious matter of concern that has left many…

  16. Structure of the Solar Dust Corona and its Interaction with the other Coronal Components

    CERN Document Server

    Shopov, Y Y; Stoitchkova, K; Tsankov, L T; Tanev, A; Burin, Kl; Belchev, St; Rusanov, V; Ivanov, D; Stoev, A; Muglova, P; Iliev, I

    2009-01-01

    We developed a new technique for registration of the far solar corona from ground-based observations at distances comparable to those obtained from space coronagraphs. It makes possible visualization of fine details of studied objects invisible by naked eye. Here we demonstrate that streamers of the electron corona sometimes punch the dust corona and that the shape of the dust corona may vary with time. We obtained several experimental evidences that the far coronal streamers (observed directly only from the space or stratosphere) emit only in discrete regions of the visible spectrum like resonance fluorescence of molecules and ions in comets. We found that interaction of the coronal streamers with the dust corona can produce molecules and radicals, which are known to cause the resonance fluorescence in comets.

  17. Modelling the Global Solar Corona II: Coronal Evolution and Filament Chirality Comparison

    CERN Document Server

    Yeates, A R; Van Ballegooijen, A A

    2007-01-01

    The hemispheric pattern of solar filaments is considered using newly-developed simulations of the real photospheric and 3D coronal magnetic fields over a 6-month period, on a global scale. The magnetic field direction in the simulation is compared directly with the chirality of observed filaments, at their observed locations. In our model the coronal field evolves through a continuous sequence of nonlinear force-free equilibria, in response to the changing photospheric boundary conditions and the emergence of new magnetic flux. In total 119 magnetic bipoles with properties matching observed active regions are inserted. These bipoles emerge twisted and inject magnetic helicity into the solar atmosphere. When we choose the sign of this active-region helicity to match that observed in each hemisphere, the model produces the correct chirality for up to 96% of filaments, including exceptions to the hemispheric pattern. If the emerging bipoles have zero helicity, or helicity of the opposite sign, then this percenta...

  18. Polar Coronal Hole Ephemeral Regions, the Fast Solar Wind and the Global Magnetic Dynamo

    Science.gov (United States)

    Cirtain, Jonathan W.

    2010-01-01

    The X-Ray Telescope aboard Hinode has been regularly observing both the north and south solar polar coronal holes from November 2006 through March 2009. We use the observations of emerged flux regions within the coronal hole as evidenced by small x-ray bright points to study the physical properties of these regions. The width of the emerged flux region loop footpoints, the duration of the x-ray emission lifetime for the emerged flux region, the latitude of formation and whether an x-ray or EUV jet was observed were all recorded. In the present work we detail these observations and show a dependence on the width of the emerged flux region (bright point) to the number of x-ray jets observed. The distribution of base width is then related to a power law for number of emerged flux regions as a function of base width.

  19. Shock Formation and Energy Dissipation of Slow Magnetosonic Waves in Coronal Plumes

    Science.gov (United States)

    Cuntz, M.; Suess, S. T.

    2003-01-01

    We study the shock formation and energy dissipation of slow magnetosonic waves in coronal plumes. The wave parameters and the spreading function of the plumes as well as the base magnetic field strength are given by empirical constraints mostly from SOHO/UVCS. Our models show that shock formation occurs at low coronal heights, i.e., within 1.3 bun, depending on the model parameters. In addition, following analytical estimates, we show that scale height of energy dissipation by the shocks ranges between 0.15 and 0.45 Rsun. This implies that shock heating by slow magnetosonic waves is relevant at most heights, even though this type of waves is apparently not a solely operating energy supply mechanism.

  20. Exploration of examinees’ traits that affect the score of Korean Medical Licensing Examination

    Directory of Open Access Journals (Sweden)

    Mi Kyoung Yim

    2015-03-01

    Full Text Available Purpose: It aims to identify the effect of five variables to score of the Korean Medical Licensing Examinations (KMLE for three consecutive years from 2011 to 2013. Methods: The number of examinees for each examination was 3,364 in 2011 3,177 in 2012, and 3,287 in 2013. Five characteristics of examinees were set as variables: gender, age, graduation status, written test result (pass or fail, and city of medical school. A regression model was established, with the score of a written test as a dependent variable and with examinees’ traits as variables. Results: The regression coefficients in all variables, except the city of medical school, were statistically significant. The variable’s effect in three examinations appeared in the following order: result of written test, graduation status, age, gender, and city of medical school. Conclusion: written test scores of the KMLE revealed that female students, younger examinees, and first-time examinees had higher performances.

  1. [Medical exposure from computed tomographic examination -a recommendation of dosimetry by film method-].

    Science.gov (United States)

    Yasutomo, Motokatsu; Yagi, Hirofumi

    2002-01-01

    Already, the 30 year have passed since that the CT scanner was developed by Hunsfield. And now above 16,000 sets are at work. On the other hand, as the improvements of image reconstruction algorithm and variations os scan method, the medical exposure is increasing. For example, in the case of computed radiography, medical exposure is stability by using an auto exposure controller but in the case of CT, there is no unit and usually the exposure condition of CT examination are used that of recommended an exposure condition by maker. So the medical exposure greatly differs according to the operators or the kinds of CT scanner. In addition, there is the close connection between the x-ray intensity and the image quality. Especially, in the case of CT scanner there is no saturation of x-ray intensity like the optical density of film screen system because the digital radiographic systems have the wide dynamic range. So the increase in x-ray intensity makes a contribution to improvement of the image quality. But the increase in x-ray intensity makes a contribution to the increase in medical exposure. Therefore it is very important that the CT operators grasp the medical exposure per each CT examination and patient. There are many methods of medical exposure dosimetry on CT examination. But almost all the methods except the film method are impossible to get the medical exposure per each CT examination and patient. So in this paper the film method is recommended. Because the film method is low-priced, simple, easy and immediately shows the medical exposure per each CT examination and patient. Furthermore, it is confirmed that the film method is getting the correct medical exposure because that values gotten by the film method and ionization chamber are almost equivalent.

  2. Laryngeal muscle activity in unilateral vocal fold paralysis patients using electromyography and coronal reconstructed images.

    Science.gov (United States)

    Sanuki, Tetsuji; Yumoto, Eiji; Nishimoto, Kohei; Minoda, Ryosei

    2014-04-01

    To assess laryngeal muscle activity in unilateral vocal fold paralysis (UVFP) patients using laryngeal electromyography (LEMG) and coronal images. Case series with chart review. University hospital. Twenty-one patients diagnosed with UVFP of at least 6 months in duration with paralytic dysphonia, underwent LEMG, phonatory function tests, and coronal imaging. A 4-point scale was used to grade motor unit (MU) recruitment: absent = 4+, greatly decreased = 3+, moderately decreased = 2+, and mildly decreased = 1+. Maximum phonation time (MPT) and mean flow rate (MFR) were employed. Coronal images were assessed for differences in thickness and vertical position of the vocal folds during phonation and inhalation. MU recruitment in thyroarytenoid/lateral cricoarytenoid (TA/LCA) muscle complex results were 1+ for 4 patients, 2+ for 5, 3+ for 6, and 4+ for 6. MPT was positively correlated with MU recruitment. Thinning of the affected fold was evident during phonation in 19 of the 21 subjects. The affected fold was at an equal level with the healthy fold in all 9 subjects with MU recruitment of 1+ and 2+. Eleven of 12 subjects with MU recruitments of 3+ and 4+ showed the affected fold at a higher level than the healthy fold. There was a significant difference between MU recruitment and the vertical position of the affected fold. Synkinetic reinnervation may occur in some cases with UVFP. MU recruitments of TA/LCA muscle complex in UVFP patients may be related to phonatory function and the vertical position of the affected fold.

  3. Three-Dimensional MHD Models of Waves and Flows in Coronal Active Region Loops

    Science.gov (United States)

    Ofman, L.; Wang, T.; Davila, J. M.

    2011-12-01

    Recent observations show that slow magnetosonic waves are present in active region loops, and are often associated with subsonic up-flows of coronal material. In order to study the relation between up-flows and waves we develop a 3D MHD model of an idealized bi-polar active region with flows in coronal loops. The model is initiated with a dipole magnetic field and gravitationally stratified isothermal atmosphere. To model the effects of flares, coronal material is injected in small-scale regions at the base of the model active region. The up-flows have sub-sonic speeds of ˜100 km/s and are steady or periodic, producing higher density loops by filling magnetic flux-tubes with injected material. We find that the up-flows produce fast and slow magnetosonic waves that propagate in the coronal loops. We perform a parametric study of up-flow magnitude and periodicity, and the relation with the resulting waves. As expected, we find that the up-flow speed decreases with loop height due to the diverge of the flux tubes, while the slow magnetosonic speed is independent of height. When the amplitude of the driving pulses is increased above the sound speed, we find that slow shocks are produced in the loops. Using the results of the 3D MHD model we show that observed slow magnetosonic waves in active region loops can be driven by impulsive flare-produced up-flows at the transition region/corona interface of active regions.

  4. Coronal and Intraradicular Appearances Affect Radiographic Perception of the Periapical Region.

    Science.gov (United States)

    Strong, Julie W; Woodmansey, Karl F; Khademi, John A; Hatton, John F

    2017-05-01

    The influence of the radiographic appearances of the coronal and intraradicular areas on periapical radiographic interpretation has been minimally evaluated in dentistry and endodontics. The purpose of this study was to evaluate the effects that the coronal and intraradicular radiographic appearance has on endodontists' radiographic interpretations of periapical areas. In a split-group study design using an online survey format, 2 pairs of digital periapical radiographic images were evaluated by 2 groups (A and B) of endodontist readers for the presence of a periapical finding. The images in each pair were identical except that 1 image of each image pairs had coronal restorations and/or root canal fillings altered using Adobe Photoshop software (Adobe Systems, San Jose, CA). The periapical areas were not altered. Using a 5-point Likert scale, the endodontist readers were asked to "Please evaluate the periapical area(s)." A Mann-Whitney U test was used to statistically evaluate the difference between the groups. Significance was set at P < .01. There were 417 readers in group A and 442 readers in group B. The Mann-Whitney U test showed a significant difference in the responses between the groups for both image pairs (P < .01). Because the periapical areas of the image pairs were unaltered, the differing coronal and intraradicular areas of the radiographs appear to have influenced endodontists' interpretations of the periapical areas. This finding has implications for all radiographic outcome assessments. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  5. Restoration of endodontically treated anterior teeth: an evaluation of coronal microleakage of glass ionomer and composite resin materials.

    Science.gov (United States)

    Diaz-Arnold, A M; Wilcox, L R

    1990-12-01

    A glass ionomer material was evaluated for coronal microleakage in permanent lingual access restorations of endodontically treated anterior teeth. The material was tested as a restoration, placed over a zinc oxide-eugenol base, and as a base with an acid-etched composite resin veneer and a dentinal bonding agent. Restored teeth were thermocycled, immersed in silver nitrate, developed, and sectioned to assess microleakage. Significant coronal leakage was observed with all materials used.

  6. CORONAL SOURCES, ELEMENTAL FRACTIONATION, AND RELEASE MECHANISMS OF HEAVY ION DROPOUTS IN THE SOLAR WIND

    Energy Technology Data Exchange (ETDEWEB)

    Weberg, Micah J. [PhD Candidate in Space Science, Department of Atmospheric, Oceanic, and Space Sciences, University of Michigan, 2134A Space Research Building, 2455 Hayward Street, Ann Arbor, MI 48109-2143, USA. (United States); Lepri, Susan T. [Associate Professor, Department of Atmospheric, Oceanic, and Space Sciences, University of Michigan, 2429 Space Research Building, 2455 Hayward Street, Ann Arbor, MI 48109-2143, USA. (United States); Zurbuchen, Thomas H., E-mail: mjweberg@umich.edu, E-mail: slepri@umich.edu, E-mail: thomasz@umich.edu [Professor, Space Science and Aerospace Engineering, Associate Dean for Entrepreneurship Senior Counselor of Entrepreneurship Education, Department of Atmospheric, Oceanic, and Space Sciences, University of Michigan, 2431 Space Research Building, 2455 Hayward Street, Ann Arbor, MI 48109-2143, USA. (United States)

    2015-03-10

    The elemental abundances of heavy ions (masses larger than He) in the solar wind provide information about physical processes occurring in the corona. Additionally, the charge state distributions of these heavy ions are sensitive to the temperature profiles of their respective source regions in the corona. Heavy ion dropouts are a relatively new class of solar wind events identified by both elemental and ionic charge state distributions. We have shown that their origins lie in large, closed coronal loops where processes such as gravitational settling dominate and can cause a mass-dependent fractionation pattern. In this study we consider and attempt to answer three fundamental questions concerning heavy ion dropouts: (1) 'where are the source loops located in the large-scale corona?'; (2) 'how does the interplay between coronal processes influence the end elemental abundances?'; and (3) 'what are the most probable release mechanisms'? We begin by analyzing the temporal and spatial variability of heavy ion dropouts and their correlation with heliospheric plasma and magnetic structures. Next we investigate the ordering of the elements inside dropouts with respect to mass, ionic charge state, and first ionization potential. Finally, we discuss these results in the context of the prevailing solar wind theories and the processes they posit that may be responsible for the release of coronal plasma into interplanetary space.

  7. Oblique Propagation and Dissipation of Alfv´en Waves in Coronal Holes

    Indian Academy of Sciences (India)

    A. K. Srivastava; B. N. Dwivedi

    2007-03-01

    We investigate the effect of viscosity and magnetic diffusivity on the oblique propagation and dissipation of Alfvén waves with respect to the normal outward direction, making use of MHD equations, density, temperature and magnetic field structure in coronal holes and underlying magnetic funnels. We find reduction in the damping length scale, group velocity and energy flux density as the propagation angle of Alfvén waves increases inside the coronal holes. For any propagation angle, the energy flux density and damping length scale also show a decrement in the source region of the solar wind (< 1.05 R⊙) where these may be one of the primary energy sources, which can convert the inflow of the solar wind into the outflow. In the outer region (> 1.21 R⊙), for any propagation angle, the energy flux density peaks match with the peaks of MgX 609.78 Å and 624.78 Å linewidths observed from the Coronal Diagnostic Spectrometer (CDS) on SOHO and the non-thermal velocity derived from these observations, justify the observed spectroscopic signature of the Alfvén wave dissipation.

  8. Use of Curricular and Extracurricular Assessments to Predict Performance on the United States Medical Licensing Examination (USMLE) Step 1: A Multi-Year Study

    Science.gov (United States)

    Gandy, Robyn A.; Herial, Nabeel A.; Khuder, Sadik A.; Metting, Patricia J.

    2008-01-01

    This paper studies student performance predictions based on the United States Medical Licensure Exam (USMLE) Step 1. Subjects were second-year medical students from academic years of 2002 through 2006 (n = 711). Three measures of basic science knowledge (two curricular and one extracurricular) were evaluated as predictors of USMLE Step 1 scores.…

  9. Comparative phylogeography of two crow species: jungle crow Corvus macrorhynchos and carrion crow Corvus corone.

    Science.gov (United States)

    Kryukov, Alexey; Spiridonova, Liudmila; Nakamura, Sumio; Haring, Elisabeth; Suzuki, Hitoshi

    2012-08-01

    The jungle crow Corvus macrorhynchos Wagler, 1827, and the carrion crow Corvus corone L., 1758, are two closely related species with similar ecological requirements that occupy wide distribution ranges in the Palearctic. We studied patterns of their genetic variation by using sequences of the mitochondrial cytochrome b gene. Corvus macrorhynchos demonstrates a low level of variation and differentiation throughout its range, except for a highly diverged population of Cheju Island (Korea). The haplotype network shows two haplogroups. The island group comprises populations of Sakhalin, Hokkaido, Honshu, and Kyushu, while the haplotypes of Taiwan and Ryukyu Islands proved to be closer to the mainland group, which also includes populations from the Primorye, Khabarovsk, Amur, and Magadan regions in the Russian Far East. This pattern allowed us to develop a phylogeographic hypothesis regarding the two modes of settling of the island populations. Concerning C. corone, the presence of two distinct haplogroups was confirmed within the range of C. c. orientalis. Both haplogroups are found within the same populations in Kamchatka and North Sakhalin, which implies secondary contacts there. Populations of C. corone are found to be rather stable in the western parts of its range, while in the Far East populations experienced recent growth, as was observed for C. macrorhynchos in general. The two species appear to have passed through different evolutionary scenarios.

  10. Turbulent cross-field transport of non-thermal electrons in coronal loops: theory and observations

    CERN Document Server

    Bian, N; McKinnon, A

    2011-01-01

    A fundamental problem in astrophysics is the interaction between magnetic turbulence and charged particles. It is now possible to use \\emph{Ramaty High Energy Solar Spectroscopic Imager (RHESSI)} observations of hard X-rays (HXR) emitted by electrons to identify the presence of turbulence and to estimate the magnitude of the magnetic field line diffusion coefficient at least in dense coronal flaring loops.} {We discuss the various possible regimes of cross-field transport of non-thermal electrons resulting from broadband magnetic turbulence in coronal loops. The importance of the Kubo number $K$ as a governing parameter is emphasized and results applicable in both the large and small Kubo number limits are collected.} {Generic models, based on concepts and insights developed in the statistical theory of transport, are applied to the coronal loops and to the interpretation of hard X-ray imaging data in solar flares. The role of trapping effects, which become important in the non-linear regime of transport, is ...

  11. Coronal sources and in situ properties of the solar winds sampled by ACE during 1999-2008

    CERN Document Server

    Fu, Hui; Li, Xing; Huang, Zhenghua; Mou, Chaozhou; Jiao, Fangran; Xia, Lidong

    2015-01-01

    We identify the coronal sources of the solar winds sampled by the ACE spacecraft during 1999-2008, and examine the in situ solar wind properties as a function of wind sources. The standard two-step mapping technique is adopted to establish the photospheric footpoints of the magnetic flux tubes along which the ACE winds flow. The footpoints are then placed in the context of EIT 284~\\AA\\ images and photospheric magnetograms, allowing us to categorize the sources into four groups: coronal holes (CHs), active regions (ARs), the quiet Sun (QS), and "Undefined". This practice also enables us to establish the response to solar activity of the fractions occupied by each kind of solar winds, and of their speeds and O$^{7+}$/O$^{6+}$ ratios measured in situ. We find that during the maximum phase, the majority of ACE winds originate from ARs. During the declining phase, CHs and ARs are equally important contributors to the ACE solar winds. The QS contribution increases with decreasing solar activity, and maximizes in th...

  12. New analytical and numerical models of solar coronal loop: I. Application to forced vertical kink oscillations

    CERN Document Server

    Murawski, K; Kraskiewicz, J; Srivastava, A K

    2014-01-01

    Aims. We construct a new analytical model of a solar coronal loop that is embedded in a gravitationally stratified and magnetically confined atmosphere. On the basis of this analytical model, we devise a numerical model of solar coronal loops. We adopt it to perform the numerical simulations of its vertical kink oscillations excited by an external driver. Methods. Our model of the solar atmosphere is constructed by adopting a realistic temperature distribution and specifying the curved magnetic field lines that constitute a coronal loop. This loop is described by 2D, ideal magnetohydro- dynamic equations that are numerically solved by the FLASH code. Results. The vertical kink oscillations are excited by a periodic driver in the vertical component of velocity, acting at the top of the photosphere. For this forced driver with its amplitude 3 km/s, the excited oscillations exhibit about 1.2 km/s amplitude in their velocity and the loop apex oscillates with its amplitude in displacement of about 100 km. Conclusi...

  13. Self modulation of slow magnetosonic waves and turbulence generation in solar coronal loops

    Science.gov (United States)

    Sharma, R. P.; Sharma, Prachi; Yadav, Nitin

    2017-01-01

    A mechanism based on turbulence for solar coronal heating has been introduced in the present work. Turbulence is considered as an important tool for heating. In the present work, turbulence generation takes place due to the nonlinear interaction of the magnetohydrodynamic waves. Slow magnetosonic waves get localized due to the density perturbations, which are assumed to be present in the background. These perturbations are associated with the low frequency slow magnetosonic waves that are supposed to be propagating in the coronal environment. The dynamics of high (0.01 Hz) and low frequency (0.001 Hz) slow magnetosonic waves have been studied by the two-fluid model and simulate numerically with the pseudo-spectral method. The power law index having a value of nearly -5/3 is obtained, which represents Kolmogorov scaling before the first break point. Based on the fact that the energy flux calculated from the Kolmogorov scaling is sufficient to heat the coronal loops as mentioned in the literature, the proposed interaction can be considered a source for turbulence generation having Kolmogorov scaling.

  14. Population exposure to ionizing radiation from medical examinations in France.

    Science.gov (United States)

    Scanff, P; Donadieu, J; Pirard, P; Aubert, B

    2008-03-01

    This study was carried out to update data concerning both the nature and the frequency of X-ray diagnostic procedures and to reassess the associated per caput effective dose in France, given that the only nationwide survey was carried out over 15 years ago. Relevant data concerning examinations in conventional radiology, computed tomography, interventional radiology and nuclear medicine were obtained for the year 2002 from two main sources: the main health insurance records for private practices and the statistics of healthcare establishments on hospital activity. Doses associated with different types of examination were obtained from the diagnostic reference levels (DRL) campaign, together with data from the European Commission and from the Health Protection Agency in the UK. The results show that between 55.4 and 65.9 million procedures were performed in 2002 in conventional radiology (one-third for dental) and between 4.2 and 6 million in computed tomography. There were 850,000 and 900,000 procedures in nuclear medicine and interventional radiology respectively. Conventional radiology accounts for 90% of the total number of procedures but only 37% of the collective dose, whereas examinations in computed tomography account for 8% of total examinations but 39% of the collective dose. Examinations in nuclear medicine and interventional radiology account for 2% of procedures but 7% and 17% of the collective dose respectively. Finally, the per caput effective dose in 2002 was between 0.66 and 0.83 mSv.

  15. Impact of the quality of coronal restoration and root canal filling on the periapical health in adult syrian subpopulation.

    Science.gov (United States)

    Alafif, Hisham

    2014-04-01

    The purpose of this study was to determine the status of periapical tissues of endodontically treated teeth according to coronal restorations and root canal fillings separately and in concomitant in adult Syrian subpopulation. 784 endodontically treated teeth from two hundred randomly selected Syrian adult patients were radiographically evaluated. According to predetermined criteria, the quality of coronal restorations and root canal filling of each tooth was scored as adequate or inadequate. The status of periapical tissues was also classified as healthy or diseased. Results were analyzed using Chi-squared test. Adequate coronal restorations were determined in 58.54% of cases which was accompanied with less periapical pathosis than that in teeth with inadequate restorations (P health. 18.5% of endodontic treatments were evaluated as adequate with less number of periapical radiolucencies than that of inadequate root canal fillings (P fillings. The rate was 88.5% in cases with only adequate root canals fillings, and about 70% in cases with only adequate coronal restorations. When the treatment was inadequate in both coronal and root canals fillings, success rate was only observed in 48.8%. The most important factor with regard to the periradicular tissue health is the quality of root canal filling without neglecting the influence of coronal restoration (regardless of its type). There is a high prevalence rate of periapical pathosis in Syrian subpopulation due to poor dental practice.

  16. Computer-delivered patient simulations in the United States Medical Licensing Examination (USMLE).

    Science.gov (United States)

    Dillon, Gerard F; Clauser, Brian E

    2009-01-01

    To obtain a full and unrestricted license to practice medicine in the United States, students and graduates of the MD-granting US medical schools and of medical schools located outside of the United States must take and pass the United States Medical Licensing Examination. United States Medical Licensing Examination began as a series of paper-and-pencil examinations in the early 1990s and converted to computer-delivery in 1999. With this change to the computerized format came the opportunity to introduce computer-simulated patients, which had been under development at the National Board of Medical Examiners for a number of years. This testing format, called a computer-based case simulation, requires the examinee to manage a simulated patient in simulated time. The examinee can select options for history-taking and physical examination. Diagnostic studies and treatment are ordered via free-text entry, and the examinee controls the advance of simulated time and the location of the patient in the health care setting. Although the inclusion of this format has brought a number of practical, psychometric, and security challenges, its addition has allowed a significant expansion in ways to assess examinees on their diagnostic decision making and therapeutic intervention skills and on developing and implementing a reasonable patient management plan.

  17. Analysis of coronal and chromospheric hard X-ray sources in an eruptive solar flare

    Science.gov (United States)

    Zimovets, Ivan; Golovin, Dmitry; Livshits, Moisey; Vybornov, Vadim; Sadykov, Viacheslav; Mitrofanov, Igor

    We have analyzed hard X-ray emission of an eruptive solar flare on 3 November 2010. The entire flare region was observed by the STEREO-B spacecraft. This gave us an information that chromospheric footpoints of flare magnetic loops were behind the east solar limb for an earth observer. Hard X-ray emission from the entire flare region was detected by the High Energy Neutron Detector (HEND) onboard the 2001 Mars Odyssey spacecraft while hard X-rays from the coronal part of the flare region were detected by the RHESSI. This rare situation has allowed us to investigate both coronal and chromospheric sources of hard X-ray emission separately. Flare impulsive phase was accompanied by eruption of a magnetic flux rope and formation of a plasmoid detected by the AIA/SDO in the EUV range. Two coronal hard X-ray sources (S_{1} and S_{2}) were detected by the RHESSI. The upper source S_{1} coincided with the plasmoid and the lower source S_{2} was near the tops of the underlying flare loops that is in accordance with the standard model of eruptive flares. Imaging spectroscopy with the RHESSI has allowed to measure energetic spectra of hard X-ray emission from the S_{1} and S_{2} sources. At the impulsive phase peak they have power-law shape above ≈ 15 keV with spectral slopes gamma_{S_{1}}=3.46 ± 1.58 and gamma_{S_{2}}=4.64 ± 0.12. Subtracting spatially integrated spectrum of coronal hard X-ray emission measured by the RHESSI from the spectrum measured by the HEND we found spectrum of hard X-rays emitted from the footpoints of the flare loops (source S_{0}). This spectrum has a power-law shape with gamma_{S_{0}}=2.21 ± 0.57. It is shown that it is not possible to explain the measured spectra of the S_{2} and S_{0} sources in frames of the thin and thick target models respectively if we assume that electrons were accelerated in the energy release site situated below the plasmoid and above the flare loops as suggested by the standard flare model. To resolve the contradiction

  18. Evaluation of the effectiveness of postgraduate general medicine training by objective structured clinical examination---pilot study and reflection on the experiences of Kaohsiung Medical University Hospital.

    Science.gov (United States)

    Tsai, Jer-Chia; Liu, Keh-Min; Lee, Kun-Tai; Yen, Jo-Chu; Yen, Jeng-Hsien; Liu, Ching-Kuan; Lai, Chung-Sheng

    2008-12-01

    Objective structured clinical examination (OSCE) is an effective assessment method to evaluate medical students' clinical competencies performance. Postgraduate year 1 (PGY1) residents have been initiated in a general medicine training program in Taiwan since 2003. However, little is known about the learning effectiveness of trainees from this program. This pilot study aimed to evaluate the clinical core competencies of PGY1 residents using OSCE, and to reflect on the strengths and weaknesses of this pilot assessment project. OSCE was conducted for five PGY1 examinees (4 men, 1 woman) with five stations covering core themes, including history taking, physical examination, clinical procedure of airway intubation, clinical reasoning, and communication skills for informing bad news. Itemized checklists and five-point Likert scale global ratings were used for evaluating performance. The results showed that the performance of our PGY1 residents on history taking was significantly better after about 2 months of postgraduate training on general internal medicine. Self-evaluation on performance by examinees revealed significantly lower global ratings on post-course OSCE (4.14 +/- 0.80 vs. 3.68 +/- 0.66; p OSCEs showed consistently favorable responses on the purposes, content, process, and environment of this assessment (4.0 +/- 0.17 vs. 4.0 +/- 0.12, nonsignificant). However, a survey of the examinees completed at pre- and post-course OSCEs showed relatively unfavorable responses to the same aspects, and to tutors and SPs (4.1 +/- 0.09 vs. 3.7 +/- 0.18; p clinical reasoning performance, communication skills (giving bad news) and self-confidence were unsatisfactory. In conclusion, this pilot study has demonstrated that OSCE is a rational and feasible assessment method for evaluating the effectiveness of our PGY general medicine training program. The quantitative data and qualitative information provide a foundation to improve the quality of the program design and evaluation

  19. Magnetic Topology of Coronal Hole Linkages

    Science.gov (United States)

    Titov, V. S.; Mikic, Z.; Linker, J. A.; Lionello, R.; Antiochos, S. K.

    2010-01-01

    In recent work, Antiochos and coworkers argued that the boundary between the open and closed field regions on the Sun can be extremely complex with narrow corridors of open ux connecting seemingly disconnected coronal holes from the main polar holes, and that these corridors may be the sources of the slow solar wind. We examine, in detail, the topology of such magnetic configurations using an analytical source surface model that allows for analysis of the eld with arbitrary resolution. Our analysis reveals three important new results: First, a coronal hole boundary can join stably to the separatrix boundary of a parasitic polarity region. Second, a single parasitic polarity region can produce multiple null points in the corona and, more important, separator lines connecting these points. Such topologies are extremely favorable for magnetic reconnection, because it can now occur over the entire length of the separators rather than being con ned to a small region around the nulls. Finally, the coronal holes are not connected by an open- eld corridor of finite width, but instead are linked by a singular line that coincides with the separatrix footprint of the parasitic polarity. We investigate how the topological features described above evolve in response to motion of the parasitic polarity region. The implications of our results for the sources of the slow solar wind and for coronal and heliospheric observations are discussed.

  20. A new method for teaching physical examination to junior medical students

    Directory of Open Access Journals (Sweden)

    Sayma M

    2016-02-01

    Full Text Available Meelad Sayma, Hywel Rhys Williams Peninsula College of Medicine and Dentistry, Plymouth, UK Introduction: Teaching effective physical examination is a key component in the education of medical students. Preclinical medical students often have insufficient clinical knowledge to apply to physical examination recall, which may hinder their learning when taught through certain understanding-based models. This pilot project aimed to develop a method to teach physical examination to preclinical medical students using “core clinical cases”, overcoming the need for “rote” learning. Methods: This project was developed utilizing three cycles of planning, action, and reflection. Thematic analysis of feedback was used to improve this model, and ensure it met student expectations. Results and discussion: A model core clinical case developed in this project is described, with gout as the basis for a “foot and ankle” examination. Key limitations and difficulties encountered on implementation of this pilot are discussed for future users, including the difficulty encountered in “content overload”. Conclusion: This approach aims to teach junior medical students physical examination through understanding, using a simulated patient environment. Robust research is now required to demonstrate efficacy and repeatability in the physical examination of other systems. Keywords: physical examination, undergraduate, case-based approach 

  1. Impact of online learning modules on medical student microbiology examination scores.

    Science.gov (United States)

    Johnson, Mary T

    2008-01-01

    Medical students have a limited amount of time in which to acquire working knowledge of an enormous amount of information, and this is especially relevant for microbiology. One large midwestern medical school is unique in having medical microbiology taught at nine regional campuses using a single core curriculum. A committee of statewide course directors writes a licensure board-style final examination that is referenced to the core and used at all campuses. To prepare for the final examination, students traditionally utilize print-based board examination review books. The purpose of the present study was to determine whether students who train using web-based quizzes score differently as a group on this statewide examination than students who do not utilize the materials online for exam preparation. The study included 71 learners from two different campuses who were taught by the same instructor and were admitted to medical school with similar exemplary credentials. Results were aggregated for three consecutive years. A standard medical microbiology textbook was used to assign the same suggested readings for all students and similar laboratory sessions were provided for all learners. The independent variable was use of the web-based quizzes to prepare before examinations, as indicated by student web usage logs. The dependent variable was score on the statewide final examination. Results support the hypothesis that students who use preparation modules online score higher on the final examination than students who do not. Moreover, students who prepared online scored higher on questions designed to test synthesis of knowledge and analysis of data. The significant difference in final examination outcome (P medical microbiology.

  2. Korean American women's perceptions about physical examinations and cancer screening services offered in Korea: the influences of medical tourism on Korean Americans.

    Science.gov (United States)

    Oh, Kyeung Mi; Jun, Jungmi; Zhou, Qiuping; Kreps, Gary

    2014-04-01

    Cancer is the leading cause of death for Korean-Americans (KAs), while cancer screening rates among KAs have been consistently low. Seven semi-structured focus group interviews with 34 KA women aged 40 or older in the Washington, DC metropolitan area were conducted to explore the perceptions of KA women about seeking physical examinations and cancer screening services in Korea. Data were analyzed using a framework approach. Informants positively perceived the use of health screening services in Korea in comparison to seeking such services in the US. Decision-making factors included cost benefits, high quality services, and more convenient screening procedures in Korea. These benefits outweighed the risks of delaying health care and travelling a vast distance with incurring additional travel costs. Motivations to seek these services in Korea included opportunities to visit their homeland and to enjoy comfortable communication with their native language. The increase of available information about Korean medical services due to the industry's aggressive marketing/PR was identified as a facilitator. Most informants did not recognize possible negative health outcomes of obtaining services in Korea such as inappropriate follow up care if having abnormal findings. Educational programs are needed to educate KAs about the benefits and risks of getting the services in Korea and proper follow up care in the US. Health care providers need to know the different cancer risks and screening needs for this population.

  3. Structural Violence and Migrant Deaths in Southern Arizona: Data from the Pima County Office of the Medical Examiner, 1990-2013

    Directory of Open Access Journals (Sweden)

    Daniel E. Martínez

    2014-10-01

    Full Text Available This article analyzes numeric trends and demographic characteristics of undocumented border crossers (UBCs who have perished in southern Arizona between 1990 and 2013 in the area covered by the Pima County Office of the Medical Examiner (PCOME in Tucson, Arizona. Of 2,413 UBC decedents investigated during this period, 95 percent died after 1999 and 65 percent after 2005. The rate of UBC deaths in the Tucson Border Patrol Sector has been consistently high, with an average of nearly 163 deaths investigated per year between 1999 and 2013. The increase in border enforcement during the mid-to-late 1990s, which led to a shifting of unauthorized migration flows into more desolate areas, coincided with an increase in migrant remains investigated by the PCOME. Despite a decrease in the number of unauthorized crossers traversing the area as measured by the number of Border Patrol apprehensions in the Tucson Sector, the number of remains examined for every 100,000 apprehensions nearly doubled between 2009 and 2011. These findings suggest that migrants are being forced to travel for longer periods of time through remote areas in an attempt to avoid detection by US authorities, thus increasing the probability of death.The typical UBC decedent can be described as a male near the age of 30 from central or southern Mexico who perished in a remote area of southern Arizona after attempting to cross into the United States. Nevertheless, the share of non-Mexican UBCs in the region has increased notably over time. The findings show other important differences in UBC decedent characteristics across time periods, which speak to the dynamic nature of unauthorized migration as a social process. The authors contend that these deaths and demographic changes are the result of structural and political transformations over the past two decades. They argue that the tragic, yet mostly preventable, migrant deaths in southern Arizona constitute a form of structural violence.

  4. 5D CNS+ Software for Automatically Imaging Axial, Sagittal, and Coronal Planes of Normal and Abnormal Second-Trimester Fetal Brains.

    Science.gov (United States)

    Rizzo, Giuseppe; Capponi, Alessandra; Persico, Nicola; Ghi, Tullio; Nazzaro, Giovanni; Boito, Simona; Pietrolucci, Maria Elena; Arduini, Domenico

    2016-10-01

    The purpose of this study was to test new 5D CNS+ software (Samsung Medison Co, Ltd, Seoul, Korea), which is designed to image axial, sagittal, and coronal planes of the fetal brain from volumes obtained by 3-dimensional sonography. The study consisted of 2 different steps. First in a prospective study, 3-dimensional fetal brain volumes were acquired in 183 normal consecutive singleton pregnancies undergoing routine sonographic examinations at 18 to 24 weeks' gestation. The 5D CNS+ software was applied, and the percentage of adequate visualization of brain diagnostic planes was evaluated by 2 independent observers. In the second step, the software was also tested in 22 fetuses with cerebral anomalies. In 180 of 183 fetuses (98.4%), 5D CNS+ successfully reconstructed all of the diagnostic planes. Using the software on healthy fetuses, the observers acknowledged the presence of diagnostic images with visualization rates ranging from 97.7% to 99.4% for axial planes, 94.4% to 97.7% for sagittal planes, and 92.2% to 97.2% for coronal planes. The Cohen κ coefficient was analyzed to evaluate the agreement rates between the observers and resulted in values of 0.96 or greater for axial planes, 0.90 or greater for sagittal planes, and 0.89 or greater for coronal planes. All 22 fetuses with brain anomalies were identified among a series that also included healthy fetuses, and in 21 of the 22 cases, a correct diagnosis was made. 5D CNS+ was efficient in successfully imaging standard axial, sagittal, and coronal planes of the fetal brain. This approach may simplify the examination of the fetal central nervous system and reduce operator dependency.

  5. A New Method for Modeling the Coronal Magnetic Field with STEREO and Submerged Dipoles

    Science.gov (United States)

    Sandman, A. W.; Aschwanden, M. J.

    2011-06-01

    Recent magnetic modeling efforts have shown substantial misalignment between theoretical models and observed coronal loop morphology as observed by STEREO/EUVI, regardless of the type of model used. Both potential field and non-linear force-free field (NLFFF) models yielded overall misalignment angles of 20 - 40 degrees, depending on the complexity of the active region (Sandman et al., Solar Phys. 259, 1, 2009; DeRosa et al., Astrophys. J. 696, 1780, 2009) We demonstrate that with new, alternative forward-fitting techniques, we can achieve a significant reduction in the misalignment angles compared with potential field source surface (PFSS) models and NLFFF models. Fitting a series of submerged dipoles to the field directions of stereoscopically triangulated loops in four active regions (30 April, 9 May, 19 May, and 11 December 2007), we find that 3 - 5 dipoles per active region yield misalignment angles of ˜ 11° - 18°, a factor of two smaller than those given by previously established extrapolation methods. We investigate the spatial and temporal variation of misalignment angles with subsets of loops for each active region, as well as loops observed prior to and following a flare and filament eruption, and find that the spatial variation of median misalignment angles within an active region (up to 75%) exceeds the temporal variation associated with the flare (up to 40%). We also examine estimates of the stereoscopic error of our analysis. The corrected values yield a residual misalignment of 7° - 13°, which is attributed to the non-potentiality due to currents in the active regions.

  6. Association of the pre-internship objective structured clinical examination in final year medical students with comprehensive written examinations.

    Science.gov (United States)

    Eftekhar, Hasan; Labaf, Ali; Anvari, Pasha; Jamali, Arsia; Sheybaee-Moghaddam, Farshad

    2012-01-01

    The purpose of this study is to evaluate the association of the pre-internship Objective Structured Clinical Examination (OSCE) in final year medical students with comprehensive written examinations. SUBJECTS AND MATERIAL: All medical students of October 2004 admission who took part in the October 2010 National Comprehensive Pre-internship Examination (NCPE) and pre-internship OSCE were included in the study (n = 130). OSCE and NCPE scores and medical grade point average (GPA) were collected. GPA was highly correlated with NCPE (r = 0.76 and P<0.001) and moderately with OSCE (r = 0.68 and P < 0.001). Similarly a moderate correlation was observed between NCPE and OSCE scores(r = 0.6 and P < 0.001).Linear stepwise regression shows r(2) of a model applying GPA as predictor of OSCE score is 0.46 (β = 0.68 and P < 0.001), while addition of gender to the model increases r(2) to 0.59 (β = 0.61 and 0.36, for GPA and male gender, respectively and P < 0.001). Logistic forward regression models shows male gender and GPA are the only dependent predictors of high score in OSCE. OR of GPA and male gender for high OSCE score are 4.89 (95% CI = 2.37-10.06) and 6.95 (95% CI = 2.00-24.21), respectively (P < 0.001). Our findings indicate OSCE and examination which mainly evaluate knowledge, judged by GPA and NCPE are moderately to highly correlated. Our results illustrate the interwoven nature of knowledge and clinical skills. In other words, certain level of knowledge is crucial for appropriate clinical performance. Our findings suggest neither OSCE nor written forms of assessments can replace each other. They are complimentary and should also be combined by other evaluations to cover all attributes of clinical competence efficiently.

  7. Two-step forecast of geomagnetic storm using coronal mass ejection and solar wind condition