PSYCHE: An Object-Oriented Approach to Simulating Medical Education

Science.gov (United States)

Mullen, Jamie A.

1990-01-01

Traditional approaches to computer-assisted instruction (CAI) do not provide realistic simulations of medical education, in part because they do not utilize heterogeneous knowledge bases for their source of domain knowledge. PSYCHE, a CAI program designed to teach hypothetico-deductive psychiatric decision-making to medical students, uses an object-oriented implementation of an intelligent tutoring system (ITS) to model the student, domain expert, and tutor. It models the transactions between the participants in complex transaction chains, and uses heterogeneous knowledge bases to represent both domain and procedural knowledge in clinical medicine. This object-oriented approach is a flexible and dynamic approach to modeling, and represents a potentially valuable tool for the investigation of medical education and decision-making.

76 FR 71577 - Guidance for Industry on Medication Guide Distribution Requirements and Inclusion of Medication...

Science.gov (United States)

2011-11-18

...] Guidance for Industry on Medication Guide Distribution Requirements and Inclusion of Medication Guides in... guidance for industry entitled ``Medication Guides-- Distribution Requirements and Inclusion in Risk... Requirements and Inclusion in Risk Evaluation and Mitigation Strategies (REMS).'' This guidance provides...

Telemedicine and distributed medical intelligence.

Science.gov (United States)

Warner, D; Tichenor, J M; Balch, D C

1996-01-01

Recent trends in health care informatics and telemedicine indicate that systems are being developed with a primary focus on technology and business, not on the process of medicine itself. The authors present a new model of health care information, distributed medical intelligence, which promotes the development of an integrative medical communication system addressing the process of providing expert medical knowledge to the point of need. The model incorporates audio, video, high-resolution still images, and virtual reality applications into an integrated medical communications network. Three components of the model (care portals, Docking Station, and the bridge) are described. The implementation of this model at the East Carolina University School of Medicine is also outlined.

UNBIASED INCLINATION DISTRIBUTIONS FOR OBJECTS IN THE KUIPER BELT

International Nuclear Information System (INIS)

Gulbis, A. A. S.; Elliot, J. L.; Adams, E. R.; Benecchi, S. D.; Buie, M. W.; Trilling, D. E.; Wasserman, L. H.

2010-01-01

Using data from the Deep Ecliptic Survey (DES), we investigate the inclination distributions of objects in the Kuiper Belt. We present a derivation for observational bias removal and use this procedure to generate unbiased inclination distributions for Kuiper Belt objects (KBOs) of different DES dynamical classes, with respect to the Kuiper Belt plane. Consistent with previous results, we find that the inclination distribution for all DES KBOs is well fit by the sum of two Gaussians, or a Gaussian plus a generalized Lorentzian, multiplied by sin i. Approximately 80% of KBOs are in the high-inclination grouping. We find that Classical object inclinations are well fit by sin i multiplied by the sum of two Gaussians, with roughly even distribution between Gaussians of widths 2.0 +0.6 -0.5 0 and 8.1 +2.6 -2.1 0 . Objects in different resonances exhibit different inclination distributions. The inclinations of Scattered objects are best matched by sin i multiplied by a single Gaussian that is centered at 19.1 +3.9 -3.6 0 with a width of 6.9 +4.1 -2.7 0 . Centaur inclinations peak just below 20 0 , with one exceptionally high-inclination object near 80 0 . The currently observed inclination distribution of the Centaurs is not dissimilar to that of the Scattered Extended KBOs and Jupiter-family comets, but is significantly different from the Classical and Resonant KBOs. While the sample sizes of some dynamical classes are still small, these results should begin to serve as a critical diagnostic for models of solar system evolution.

The absolute magnitude distribution of Kuiper Belt objects

International Nuclear Information System (INIS)

Fraser, Wesley C.; Brown, Michael E.; Morbidelli, Alessandro; Parker, Alex; Batygin, Konstantin

2014-01-01

Here we measure the absolute magnitude distributions (H-distribution) of the dynamically excited and quiescent (hot and cold) Kuiper Belt objects (KBOs), and test if they share the same H-distribution as the Jupiter Trojans. From a compilation of all useable ecliptic surveys, we find that the KBO H-distributions are well described by broken power laws. The cold population has a bright-end slope, α 1 =1.5 −0.2 +0.4 , and break magnitude, H B =6.9 −0.2 +0.1 (r'-band). The hot population has a shallower bright-end slope of, α 1 =0.87 −0.2 +0.07 , and break magnitude H B =7.7 −0.5 +1.0 . Both populations share similar faint-end slopes of α 2 ∼ 0.2. We estimate the masses of the hot and cold populations are ∼0.01 and ∼3 × 10 –4 M ⊕ . The broken power-law fit to the Trojan H-distribution has α 1 = 1.0 ± 0.2, α 2 = 0.36 ± 0.01, and H B = 8.3. The Kolmogorov-Smirnov test reveals that the probability that the Trojans and cold KBOs share the same parent H-distribution is less than 1 in 1000. When the bimodal albedo distribution of the hot objects is accounted for, there is no evidence that the H-distributions of the Trojans and hot KBOs differ. Our findings are in agreement with the predictions of the Nice model in terms of both mass and H-distribution of the hot and Trojan populations. Wide-field survey data suggest that the brightest few hot objects, with H r ′ ≲3, do not fall on the steep power-law slope of fainter hot objects. Under the standard hierarchical model of planetesimal formation, it is difficult to account for the similar break diameters of the hot and cold populations given the low mass of the cold belt.

A distributed garbage collector for active objects

OpenAIRE

Puaut , Isabelle

1993-01-01

This paper introduces an algorithm that performs garbage collection in distributed systems of active objects (i.e., objects having their own threads of control). The proposed garbage collector is made of a set of local garbage collectors, one per node, loosely coupled to a global garbage collector. The novelties of the proposed garbage collector come from the fact that local garbage collectors need not be synchronized with each other for detecting garbage objects and that faulty communication...

The absolute magnitude distribution of Kuiper Belt objects

Energy Technology Data Exchange (ETDEWEB)

Fraser, Wesley C. [Herzberg Institute of Astrophysics, 5071 West Saanich Road, Victoria, BC V9E 2E7 (Canada); Brown, Michael E. [Division of Geological and Planetary Sciences, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125 (United States); Morbidelli, Alessandro [Laboratoire Lagrange, UMR7293, Université de Nice Sophia-Antipolis, CNRS, Observatoire de la Côte d' Azur, BP 4229, F-06304 Nice (France); Parker, Alex [Department of Astronomy, University of California at Berkeley, Berkeley, CA 94720 (United States); Batygin, Konstantin, E-mail: wesley.fraser@nrc.ca [Institute for Theory and Computation, Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, MS 51, Cambridge, MA 02138 (United States)

2014-02-20

Here we measure the absolute magnitude distributions (H-distribution) of the dynamically excited and quiescent (hot and cold) Kuiper Belt objects (KBOs), and test if they share the same H-distribution as the Jupiter Trojans. From a compilation of all useable ecliptic surveys, we find that the KBO H-distributions are well described by broken power laws. The cold population has a bright-end slope, α{sub 1}=1.5{sub −0.2}{sup +0.4}, and break magnitude, H{sub B}=6.9{sub −0.2}{sup +0.1} (r'-band). The hot population has a shallower bright-end slope of, α{sub 1}=0.87{sub −0.2}{sup +0.07}, and break magnitude H{sub B}=7.7{sub −0.5}{sup +1.0}. Both populations share similar faint-end slopes of α{sub 2} ∼ 0.2. We estimate the masses of the hot and cold populations are ∼0.01 and ∼3 × 10{sup –4} M {sub ⊕}. The broken power-law fit to the Trojan H-distribution has α{sub 1} = 1.0 ± 0.2, α{sub 2} = 0.36 ± 0.01, and H {sub B} = 8.3. The Kolmogorov-Smirnov test reveals that the probability that the Trojans and cold KBOs share the same parent H-distribution is less than 1 in 1000. When the bimodal albedo distribution of the hot objects is accounted for, there is no evidence that the H-distributions of the Trojans and hot KBOs differ. Our findings are in agreement with the predictions of the Nice model in terms of both mass and H-distribution of the hot and Trojan populations. Wide-field survey data suggest that the brightest few hot objects, with H{sub r{sup ′}}≲3, do not fall on the steep power-law slope of fainter hot objects. Under the standard hierarchical model of planetesimal formation, it is difficult to account for the similar break diameters of the hot and cold populations given the low mass of the cold belt.

Development of total medical material distribution management system.

Science.gov (United States)

Uto, Y; Kumamoto, I

1994-07-01

Since September 1992, attempts have been made at Kagoshima University Hospital to develop the Medical Material Distribution Management System which helps to realize optimal hospital management as a subsystem of the Total Hospital Information System of Kagoshima University (THINK). As this system has been established, it has become possible for us to have an accurate grasp of the flow and stock of medical materials at our hospital. Furthermore, since September 1993, the Medical Material Distribution Management System has been improved and the Total Medical Material Distribution Management System has been smoothly introduced into the site of clinical practice. This system enables automatic demands for fees for treatment with specific instruments and materials covered by health insurance. It was difficult to predict the effect of this system, because no similar system had been developed in Japan. However, more satisfactory results than expected have been obtained since its introduction.

Distributed Generation Planning using Peer Enhanced Multi-objective Teaching-Learning based Optimization in Distribution Networks

Science.gov (United States)

Selvam, Kayalvizhi; Vinod Kumar, D. M.; Siripuram, Ramakanth

2017-04-01

In this paper, an optimization technique called peer enhanced teaching learning based optimization (PeTLBO) algorithm is used in multi-objective problem domain. The PeTLBO algorithm is parameter less so it reduced the computational burden. The proposed peer enhanced multi-objective based TLBO (PeMOTLBO) algorithm has been utilized to find a set of non-dominated optimal solutions [distributed generation (DG) location and sizing in distribution network]. The objectives considered are: real power loss and the voltage deviation subjected to voltage limits and maximum penetration level of DG in distribution network. Since the DG considered is capable of injecting real and reactive power to the distribution network the power factor is considered as 0.85 lead. The proposed peer enhanced multi-objective optimization technique provides different trade-off solutions in order to find the best compromise solution a fuzzy set theory approach has been used. The effectiveness of this proposed PeMOTLBO is tested on IEEE 33-bus and Indian 85-bus distribution system. The performance is validated with Pareto fronts and two performance metrics (C-metric and S-metric) by comparing with robust multi-objective technique called non-dominated sorting genetic algorithm-II and also with the basic TLBO.

DOLCLAN – Middleware Support for Peer-to-Peer Distributed Shared Objects

DEFF Research Database (Denmark)

Bardram, Jakob; Mogensen, Martin

2007-01-01

Contemporary object-oriented programming seeks to enable distributed computing by accessing remote objects using blocking remote procedure calls. This technique, however, suffers from several drawbacks because it relies on the assumption of stable network connections and synchronous method...... invocations. In this paper we present an approach to support distributed programming, which rely on local object replicas keeping themselves synchronized using an underlying peer-to-peer infrastructure. We have termed our approach Peer-to-peer Distributed Shared Objects (PDSO). This PDSO approach has been...

Developing Canadian oncology education goals and objectives for medical students: a national modified Delphi study.

Science.gov (United States)

Tam, Vincent C; Ingledew, Paris-Ann; Berry, Scott; Verma, Sunil; Giuliani, Meredith E

2016-01-01

Studies have shown that there is a deficiency in focused oncology teaching during medical school in Canada. This study aimed to develop oncology education goals and objectives for medical students through consensus of oncology educators from across Canada. In 2014 we created a comprehensive list of oncology education objectives using existing resources. Experts in oncology education and undergraduate medical education from all 17 Canadian medical schools were invited to participate in a 3-round modified Delphi process. In round 1, the participants scored the objectives on a 9-point Likert scale according to the degree to which they agreed an objective should be taught to medical students. Objectives with a mean score of 7.0 or greater were retained, those with a mean score of 1.0-3.9 were excluded, and those with a mean score of 4.0-6.9 were discussed at a round 2 Web meeting. In round 3, the participants voted on inclusion and exclusion of the round 2 objectives. Thirty-four (92%) of the 37 invited oncology educators, representing 14 medical schools, participated in the study. They included oncologists, family physicians, members of undergraduate medical education curriculum committees and a psychologist. Of the 214 objectives reviewed in round 1, 146 received a mean score of 7.0 or greater, and 68 were scored 4.0-6.9; no objective received a mean score below 4.0. Nine new objectives were suggested. The main themes of participants' comments were to minimize the number of objectives and to aim objectives at the knowledge level required for family physicians. In round 2, the participants were able to combine 28 of the objectives with other existing objectives. In round 3, 7 of the 49 objectives received consensus of at least 75% for inclusion. The final Canadian Oncology Goals and Objectives for Medical Students contained 10 goals and 153 objectives. Through a systematic process, we created a comprehensive, consensus-based set of oncology goals and objectives to

Contemporary Issues in Medicine--Medical Informatics and Population Health: Report II of the Medical School Objectives Project.

Science.gov (United States)

Academic Medicine, 1999

1999-01-01

The report of the Association of American Medical Colleges' Medical School Objectives Program presents the work of two expert panels. One, on medical informatics, identified five important physician roles: lifelong learner, clinician, educator, researcher, and manager. Another panel established a definition for "population health…

A cyclic distributed garbage collector for network objects

OpenAIRE

Rodrigues, Helena; Jones, Richard

1996-01-01

This paper presents an algorithm for distributed garbage collection and outlines its implementation within the Network Objects system. The algorithm is based on a reference listing scheme, which is augmented by partial tracing in order to collect distributed garbage cycles. Processes may be dynamically organised into groups, according to appropriate heuristics, to reclaim distributed garbage cycles. The algorithm places no overhead on local collectors and suspends local mutators only briefly....

Object-oriented design of medical imaging software.

Science.gov (United States)

Ligier, Y; Ratib, O; Logean, M; Girard, C; Perrier, R; Scherrer, J R

1994-01-01

A special software package for interactive display and manipulation of medical images was developed at the University Hospital of Geneva, as part of a hospital wide Picture Archiving and Communication System (PACS). This software package, called Osiris, was especially designed to be easily usable and adaptable to the needs of noncomputer-oriented physicians. The Osiris software has been developed to allow the visualization of medical images obtained from any imaging modality. It provides generic manipulation tools, processing tools, and analysis tools more specific to clinical applications. This software, based on an object-oriented paradigm, is portable and extensible. Osiris is available on two different operating systems: the Unix X-11/OSF-Motif based workstations, and the Macintosh family.

Surface Area Distribution Descriptor for object matching

Directory of Open Access Journals (Sweden)

Mohamed F. Gafar

2010-07-01

Full Text Available Matching 3D objects by their similarity is a fundamental problem in computer vision, computer graphics and many other fields. The main challenge in object matching is to find a suitable shape representation that can be used to accurately and quickly discriminate between similar and dissimilar shapes. In this paper we present a new volumetric descriptor to represent 3D objects. The proposed descriptor is used to match objects under rigid transformations including uniform scaling. The descriptor represents the object by dividing it into shells, acquiring the area distribution of the object through those shells. The computed areas are normalised to make the descriptor scale-invariant in addition to rotation and translation invariant. The effectiveness and stability of the proposed descriptor to noise and variant sampling density as well as the effectiveness of the similarity measures are analysed and demonstrated through experimental results.

A theory of distributed objects asynchrony, mobility, groups, components

CERN Document Server

Caromel, Denis; Henrio, Ludovic

2005-01-01

Distributed and communicating objects are becoming ubiquitous. In global, Grid and Peer-to-Peer computing environments, extensive use is made of objects interacting through method calls. So far, no general formalism has been proposed for the foundation of such systems. Caromel and Henrio are the first to define a calculus for distributed objects interacting using asynchronous method calls with generalized futures, i.e., wait-by-necessity -- a must in large-scale systems, providing both high structuring and low coupling, and thus scalability. The authors provide very generic results on expressiveness and determinism, and the potential of their approach is further demonstrated by its capacity to cope with advanced issues such as mobility, groups, and components. Researchers and graduate students will find here an extensive review of concurrent languages and calculi, with comprehensive figures and summaries. Developers of distributed systems can adopt the many implementation strategies that are presented and ana...

Sexual Health Curricula in U.S. Medical Schools: Current Educational Objectives

Science.gov (United States)

Galletly, Carol; Lechuga, Julia; Layde, Joseph B.; Pinkerton, Steven

2010-01-01

Objective: The authors identify the explicit and implicit objectives that shape decisions about what medical schools teach regarding human sexuality. Methods: The authors reviewed relevant articles in journals, physician licensing examinations, and publications by professional organizations to identify learning objectives for human sexuality in…

Objective confirmation of asthma diagnosis improves medication adherence

DEFF Research Database (Denmark)

Backer, V; Stensen, L; Sverrild, A

2017-01-01

OBJECTIVE: The impact of diagnostic work-up in asthma management on medication redemption and probably also drug adherence is largely unknown, but we hypothesized that a confirmed diagnosis of asthma in a hospital-based out-patient clinic increases the willingness to subsequent medication...... redemption in a real life setting. METHODS: In a retrospective register-based study, 300 medical records of patients referred with possible asthma during one year were examined, of whom 171 had asthma (57%). One-year data on dispensed medicine was collected using the Danish Registry of Medicinal Product...... more frequently prescribed new therapy compared to those with unverified asthma (88.9% vs. 65.0%, respectively, p time redemption of prescriptions (72% vs. 64%, respectively, p = 0.3), whereas the second (52% vs. 27%, p = 0.001) and third or more asthma...

Semantic Indexing of Medical Learning Objects: Medical Students' Usage of a Semantic Network.

Science.gov (United States)

Tix, Nadine; Gießler, Paul; Ohnesorge-Radtke, Ursula; Spreckelsen, Cord

2015-11-11

The Semantically Annotated Media (SAM) project aims to provide a flexible platform for searching, browsing, and indexing medical learning objects (MLOs) based on a semantic network derived from established classification systems. Primarily, SAM supports the Aachen emedia skills lab, but SAM is ready for indexing distributed content and the Simple Knowledge Organizing System standard provides a means for easily upgrading or even exchanging SAM's semantic network. There is a lack of research addressing the usability of MLO indexes or search portals like SAM and the user behavior with such platforms. The purpose of this study was to assess the usability of SAM by investigating characteristic user behavior of medical students accessing MLOs via SAM. In this study, we chose a mixed-methods approach. Lean usability testing was combined with usability inspection by having the participants complete four typical usage scenarios before filling out a questionnaire. The questionnaire was based on the IsoMetrics usability inventory. Direct user interaction with SAM (mouse clicks and pages accessed) was logged. The study analyzed the typical usage patterns and habits of students using a semantic network for accessing MLOs. Four scenarios capturing characteristics of typical tasks to be solved by using SAM yielded high ratings of usability items and showed good results concerning the consistency of indexing by different users. Long-tail phenomena emerge as they are typical for a collaborative Web 2.0 platform. Suitable but nonetheless rarely used keywords were assigned to MLOs by some users. It is possible to develop a Web-based tool with high usability and acceptance for indexing and retrieval of MLOs. SAM can be applied to indexing multicentered repositories of MLOs collaboratively.

Joining Distributed Complex Objects: Definition and Performance

NARCIS (Netherlands)

Teeuw, W.B.; Teeuw, Wouter B.; Blanken, Henk

1992-01-01

The performance of a non-standard distributed database system is strongly ifluenced by complex objects. The effective exploitation of parallelism in querying them and a suitable structure to store them are required in order to obtain acceptable response times in these database environments where

Preceptor engagement in distributed medical school campuses

Directory of Open Access Journals (Sweden)

Thomas Piggott

2015-12-01

Conclusions: Barriers to engagement in teaching primarily focused on differences in job structure in the community, administrative barriers both at the hospital and through the medical school, and lack of knowledge on how to teach.  As medical schools look to expand the capacity of distributed campuses, misperceptions should be addressed and opportunities to improve engagement should be further explored.

Practicing doctors' perceptions on new learning objectives for Vietnamese medical schools

NARCIS (Netherlands)

Hoat, L; Dung, DV; Wright, E.P.

2008-01-01

Background. As part of the process to develop more community-oriented medical teaching in Vietnam, eight medical schools prepared a set of standard learning objectives with attention to the needs of a doctor working with the community. Because they were prepared based on government documents and the

The analysis of distribution of the chromosome aberration breakpoints from medical diagnostic X-ray workers

International Nuclear Information System (INIS)

Wang Qin; Li Jin; Tang Weisheng; Wang Zhiquan

2003-01-01

Objective: To analyze the distribution of the chromosome aberration breakpoints from medical diagnostic x-ray workers. Methods: The breakpoints of lymphocyte chromosomes are analyzed using G-banding. Results: There are 146 breakpoints among 3545 metaphase in 37 cases of X-ray workers. There are statistically significant differences between observed values and expected values (χ 2 =42.82, df=23, P 0.05). Conclusion: The chromosome aberration breakpoints of medical diagnostic X-ray workers are non-random. The observed values of breakpoint numbers are higher than those of the expected values in 7 and 14 chromosomes (P<0.05)

EMR-based medical knowledge representation and inference via Markov random fields and distributed representation learning.

Science.gov (United States)

Zhao, Chao; Jiang, Jingchi; Guan, Yi; Guo, Xitong; He, Bin

2018-05-01

Electronic medical records (EMRs) contain medical knowledge that can be used for clinical decision support (CDS). Our objective is to develop a general system that can extract and represent knowledge contained in EMRs to support three CDS tasks-test recommendation, initial diagnosis, and treatment plan recommendation-given the condition of a patient. We extracted four kinds of medical entities from records and constructed an EMR-based medical knowledge network (EMKN), in which nodes are entities and edges reflect their co-occurrence in a record. Three bipartite subgraphs (bigraphs) were extracted from the EMKN, one to support each task. One part of the bigraph was the given condition (e.g., symptoms), and the other was the condition to be inferred (e.g., diseases). Each bigraph was regarded as a Markov random field (MRF) to support the inference. We proposed three graph-based energy functions and three likelihood-based energy functions. Two of these functions are based on knowledge representation learning and can provide distributed representations of medical entities. Two EMR datasets and three metrics were utilized to evaluate the performance. As a whole, the evaluation results indicate that the proposed system outperformed the baseline methods. The distributed representation of medical entities does reflect similarity relationships with respect to knowledge level. Combining EMKN and MRF is an effective approach for general medical knowledge representation and inference. Different tasks, however, require individually designed energy functions. Copyright © 2018 Elsevier B.V. All rights reserved.

Multi-Objective Planning Techniques in Distribution Networks: A Composite Review

Directory of Open Access Journals (Sweden)

Syed Ali Abbas Kazmi

2017-02-01

Full Text Available Distribution networks (DNWs are facing numerous challenges, notably growing load demands, environmental concerns, operational constraints and expansion limitations with the current infrastructure. These challenges serve as a motivation factor for various distribution network planning (DP strategies, such as timely addressing load growth aiming at prominent objectives such as reliability, power quality, economic viability, system stability and deferring costly reinforcements. The continuous transformation of passive to active distribution networks (ADN needs to consider choices, primarily distributed generation (DG, network topology change, installation of new protection devices and key enablers as planning options in addition to traditional grid reinforcements. Since modern DP (MDP in deregulated market environments includes multiple stakeholders, primarily owners, regulators, operators and consumers, one solution fit for all planning scenarios may not satisfy all these stakeholders. Hence, this paper presents a review of several planning techniques (PTs based on mult-objective optimizations (MOOs in DNWs, aiming at better trade-off solutions among conflicting objectives and satisfying multiple stakeholders. The PTs in the paper spread across four distinct planning classifications including DG units as an alternative to costly reinforcements, capacitors and power electronic devices for ensuring power quality aspects, grid reinforcements, expansions, and upgrades as a separate category and network topology alteration and reconfiguration as a viable planning option. Several research works associated with multi-objective planning techniques (MOPT have been reviewed with relevant models, methods and achieved objectives, abiding with system constraints. The paper also provides a composite review of current research accounts and interdependence of associated components in the respective classifications. The potential future planning areas, aiming at

Multi-objective optimization of distributed generation with voltage ...

African Journals Online (AJOL)

DR OKE

1*Department of Electrical Engineering, Kamla Nehru Institute of Technology Sultanpurr, ... of DG in distribution systems for different voltage dependent load models and .... The evaluation of the objective function depends only on location, size ...

A Collaborative Neurodynamic Approach to Multiple-Objective Distributed Optimization.

Science.gov (United States)

Yang, Shaofu; Liu, Qingshan; Wang, Jun

2018-04-01

This paper is concerned with multiple-objective distributed optimization. Based on objective weighting and decision space decomposition, a collaborative neurodynamic approach to multiobjective distributed optimization is presented. In the approach, a system of collaborative neural networks is developed to search for Pareto optimal solutions, where each neural network is associated with one objective function and given constraints. Sufficient conditions are derived for ascertaining the convergence to a Pareto optimal solution of the collaborative neurodynamic system. In addition, it is proved that each connected subsystem can generate a Pareto optimal solution when the communication topology is disconnected. Then, a switching-topology-based method is proposed to compute multiple Pareto optimal solutions for discretized approximation of Pareto front. Finally, simulation results are discussed to substantiate the performance of the collaborative neurodynamic approach. A portfolio selection application is also given.

Application of object modeling technique to medical image retrieval system

International Nuclear Information System (INIS)

Teshima, Fumiaki; Abe, Takeshi

1993-01-01

This report describes the results of discussions on the object-oriented analysis methodology, which is one of the object-oriented paradigms. In particular, we considered application of the object modeling technique (OMT) to the analysis of a medical image retrieval system. The object-oriented methodology places emphasis on the construction of an abstract model from real-world entities. The effectiveness of and future improvements to OMT are discussed from the standpoint of the system's expandability. These discussions have elucidated that the methodology is sufficiently well-organized and practical to be applied to commercial products, provided that it is applied to the appropriate problem domain. (author)

Objective Bayesian Analysis of Skew- t Distributions

KAUST Repository

BRANCO, MARCIA D'ELIA

2012-02-27

We study the Jeffreys prior and its properties for the shape parameter of univariate skew-t distributions with linear and nonlinear Student\\'s t skewing functions. In both cases, we show that the resulting priors for the shape parameter are symmetric around zero and proper. Moreover, we propose a Student\\'s t approximation of the Jeffreys prior that makes an objective Bayesian analysis easy to perform. We carry out a Monte Carlo simulation study that demonstrates an overall better behaviour of the maximum a posteriori estimator compared with the maximum likelihood estimator. We also compare the frequentist coverage of the credible intervals based on the Jeffreys prior and its approximation and show that they are similar. We further discuss location-scale models under scale mixtures of skew-normal distributions and show some conditions for the existence of the posterior distribution and its moments. Finally, we present three numerical examples to illustrate the implications of our results on inference for skew-t distributions. © 2012 Board of the Foundation of the Scandinavian Journal of Statistics.

A tale of two directories Implementing distributed shared objects in Java

CERN Document Server

Herlihy, M

1999-01-01

A directory service keep tracks of the location and status of mobile objects in a distributed system. This paper describes our experience implementing two distributed directory protocols as part of the Aleph toolkit, a distributed shared object system implemented in Java. One protocol is a conventional home-based protocol, in which a fixed node keeps track of the object's location and status. The other is a novel arrow protocol, based on a simple path-reversal algorithm. We were surprised to discover that the arrow protocol outperformed the home protocol, sometimes substantially, across a range of system sizes. This paper describes a series of experiments testing whether the discrepancy is due to an artifact of the Java run-time system (such as differences in thread management or object serialization costs), or whether it is something inherent in the protocols themselves. In the end, we use insights gained from these experimental results to design a new directory protocol that usually outperforms both. (29 re...

Adaptive Variance Scaling in Continuous Multi-Objective Estimation-of-Distribution Algorithms

NARCIS (Netherlands)

P.A.N. Bosman (Peter); D. Thierens (Dirk); D. Thierens (Dirk)

2007-01-01

htmlabstractRecent research into single-objective continuous Estimation-of-Distribution Algorithms (EDAs) has shown that when maximum-likelihood estimations are used for parametric distributions such as the normal distribution, the EDA can easily suffer from premature convergence. In this paper we

MODELING OF TECHNICAL CHANNELS OF INFORMATION LEAKAGE AT DISTRIBUTED CONTROL OBJECTS

Directory of Open Access Journals (Sweden)

Aleksander Vladimirovich Karpov

2018-05-01

Full Text Available The significant increase in requirements for distributed control objects’ functioning can’t be realized only at the expense of the widening and strengthening of security control measures. The first step in ensuring the information security at such objects is the analysis of the conditions of their functioning and modeling of technical channels of information leakage. The development of models of such channels is essentially the only method of complete study of their opportunities and it is pointed toward receiving quantitative assessments of the safe operation of compound objects. The evaluation data are necessary to make a decision on the degree of the information security from a leak according to the current criterion. The existing models are developed for the standard concentrated objects and allow to evaluate the level of information security from a leak on each of channels separately, what involves the significant increase in the required protective resource and time of assessment of information security on an object in general. The article deals with a logical-and-probabilistic method of a security assessment of structurally-compound objects. The model of a security leak on the distributed control objects is cited as an example. It is recommended to use a software package of an automated structurally-logistical modeling of compound systems, which allows to evaluate risk of information leakage in the loudspeaker. A possibility of information leakage by technical channels is evaluated and such differential characteristics of the safe operation of the distributed control objects as positive and negative contributions of the initiating events and conditions, which cause a leak are calculated. Purpose. The aim is a quantitative assessment of data risk, which is necessary for justifying the rational composition of organizational and technical protection measures, as well as a variant of the structure of the information security system from a

A prototype distributed object-oriented architecture for image-based automatic laser alignment

International Nuclear Information System (INIS)

Stout, E.A.; Kamm, V.J.M.; Spann, J.M.; Van Arsdall, P.J.

1996-01-01

Designing a computer control system for the National Ignition Facility (NIF) is a complex undertaking because of the system's large size and its distributed nature. The controls team is addressing that complexity by adopting the object-oriented programming paradigm, designing reusable software frameworks, and using the Common Object Request Broker Architecture (CORBA) for distribution. A prototype system for image-based automatic laser alignment has been developed to evaluate and gain experience with CORBA and OOP in a small distributed system. The prototype is also important in evaluating alignment concepts, image processing techniques, speed and accuracy of automatic alignment objectives for the NIF, and control hardware for aligment devices. The prototype system has met its inital objectives and provides a basis for continued development

Twelve tips for teaching in a provincially distributed medical education program.

Science.gov (United States)

Wong, Roger Y; Chen, Luke; Dhadwal, Gurbir; Fok, Mark C; Harder, Ken; Huynh, Hanh; Lunge, Ryan; Mackenzie, Mark; Mckinney, James; Ovalle, William; Rauniyar, Pooja; Tse, Luke; Villanyi, Diane

2012-01-01

As distributed undergraduate and postgraduate medical education becomes more common, the challenges with the teaching and learning process also increase. To collaboratively engage front line teachers in improving teaching in a distributed medical program. We recently conducted a contest on teaching tips in a provincially distributed medical education program and received entries from faculty and resident teachers. Tips that are helpful for teaching around clinical cases at distributed teaching sites include: ask "what if" questions to maximize clinical teaching opportunities, try the 5-min short snapper, multitask to allow direct observation, create dedicated time for feedback, there are really no stupid questions, and work with heterogeneous group of learners. Tips that are helpful for multi-site classroom teaching include: promote teacher-learner connectivity, optimize the long distance working relationship, use the reality television show model to maximize retention and captivate learners, include less teaching content if possible, tell learners what you are teaching and make it relevant and turn on the technology tap to fill the knowledge gap. Overall, the above-mentioned tips offered by front line teachers can be helpful in distributed medical education.

Agent-based Algorithm for Spatial Distribution of Objects

KAUST Repository

Collier, Nathan

2012-06-02

In this paper we present an agent-based algorithm for the spatial distribution of objects. The algorithm is a generalization of the bubble mesh algorithm, initially created for the point insertion stage of the meshing process of the finite element method. The bubble mesh algorithm treats objects in space as bubbles, which repel and attract each other. The dynamics of each bubble are approximated by solving a series of ordinary differential equations. We present numerical results for a meshing application as well as a graph visualization application.

Distribution Network Expansion Planning Based on Multi-objective PSO Algorithm

DEFF Research Database (Denmark)

Zhang, Chunyu; Ding, Yi; Wu, Qiuwei

2013-01-01

This paper presents a novel approach for electrical distribution network expansion planning using multi-objective particle swarm optimization (PSO). The optimization objectives are: investment and operation cost, energy losses cost, and power congestion cost. A two-phase multi-objective PSO...... algorithm was proposed to solve this optimization problem, which can accelerate the convergence and guarantee the diversity of Pareto-optimal front set as well. The feasibility and effectiveness of both the proposed multi-objective planning approach and the improved multi-objective PSO have been verified...

A framework for multi-object tracking over distributed wireless camera networks

Science.gov (United States)

Gau, Victor; Hwang, Jenq-Neng

2010-07-01

In this paper, we propose a unified framework targeting at two important issues in a distributed wireless camera network, i.e., object tracking and network communication, to achieve reliable multi-object tracking over distributed wireless camera networks. In the object tracking part, we propose a fully automated approach for tracking of multiple objects across multiple cameras with overlapping and non-overlapping field of views without initial training. To effectively exchange the tracking information among the distributed cameras, we proposed an idle probability based broadcasting method, iPro, which adaptively adjusts the broadcast probability to improve the broadcast effectiveness in a dense saturated camera network. Experimental results for the multi-object tracking demonstrate the promising performance of our approach on real video sequences for cameras with overlapping and non-overlapping views. The modeling and ns-2 simulation results show that iPro almost approaches the theoretical performance upper bound if cameras are within each other's transmission range. In more general scenarios, e.g., in case of hidden node problems, the simulation results show that iPro significantly outperforms standard IEEE 802.11, especially when the number of competing nodes increases.

Data Mining on Distributed Medical Databases: Recent Trends and Future Directions

Science.gov (United States)

Atilgan, Yasemin; Dogan, Firat

As computerization in healthcare services increase, the amount of available digital data is growing at an unprecedented rate and as a result healthcare organizations are much more able to store data than to extract knowledge from it. Today the major challenge is to transform these data into useful information and knowledge. It is important for healthcare organizations to use stored data to improve quality while reducing cost. This paper first investigates the data mining applications on centralized medical databases, and how they are used for diagnostic and population health, then introduces distributed databases. The integration needs and issues of distributed medical databases are described. Finally the paper focuses on data mining studies on distributed medical databases.

Factors affecting the representation of objects in distributed attention

OpenAIRE

Maxwell, Tricia Lesley

2011-01-01

Our phenomenological experience of what we see around us is of an accurate representation. However, such information is widely distributed in the brain so necessitates that some form of co-ordination of this information takes place to enable a coherent view of the world. The most prominently researched theory is Feature Integration Theory (Treisman, 1993). This proposes that accurate binding is dependent on the current spatial distribution of attention. Individual objects compete for attentio...

Object-orientated DBMS techniques for time-oriented medical record.

Science.gov (United States)

Pinciroli, F; Combi, C; Pozzi, G

1992-01-01

In implementing time-orientated medical record (TOMR) management systems, use of a relational model played a big role. Many applications have been developed to extend query and data manipulation languages to temporal aspects of information. Our experience in developing TOMR revealed some deficiencies inside the relational model, such as: (a) abstract data type definition; (b) unified view of data, at a programming level; (c) management of temporal data; (d) management of signals and images. We identified some first topics to face by an object-orientated approach to database design. This paper describes the first steps in designing and implementing a TOMR by an object-orientated DBMS.

[Learning objectives achievement in ethics education for medical school students].

Science.gov (United States)

Chae, Sujin; Lim, Kiyoung

2015-06-01

This study aimed to examine the necessity for research ethics and learning objectives in ethics education at the undergraduate level. A total of 393 fourth-year students, selected from nine medical schools, participated in a survey about learning achievement and the necessity for it. It was found that the students had very few chances to receive systematic education in research ethics and that they assumed that research ethics education was provided during graduate school or residency programs. Moreover, the students showed a relatively high learning performance in life ethics, while learning achievement was low in research ethics. Medical school students revealed low interest in and expectations of research ethics in general; therefore, it is necessary to develop guidelines for research ethics in the present situation, in which medical education mainly focuses on life ethics.

Practicing doctors' perceptions on new learning objectives for Vietnamese medical schools

Directory of Open Access Journals (Sweden)

Dung Do Van

2007-06-01

Full Text Available Abstract Background As part of the process to develop more community-oriented medical teaching in Vietnam, eight medical schools prepared a set of standard learning objectives with attention to the needs of a doctor working with the community. Because they were prepared based on government documents and the opinions of the teachers, it was necessary to check them with doctors who had already graduated and were working at different sites in the community. Methods Each of the eight medical faculties asked 100 practising recent graduates to complete a questionnaire to check the relevance of the skills that the teachers considered most important. We used mean and standard deviation to summarize the scores rated by the respondents for each skill and percentile at four points: p50, p25, p10 and p5 to describe the variation of scores among the respondents. Correlation coefficient was used to measure the relationship between skill levels set by the teachers and the perception of practicing doctors regarding frequency of using skills and priority for each skill. Additional information was taken from the records of focus group discussions to clarify, explain or expand on the results from the quantitative data. Results In many cases the skills considered important by teachers were also rated as highly necessary and/or frequently used by the respondents. There were, however, discrepancies: some skills important to teachers were seldom used and not considered important by the doctors. In focus group discussions the doctors also identified skills that are not taught at all in the medical schools but would be needed by practising doctors. Conclusion Although most of the skills and skill levels included in the learning objectives by the teachers were consistent with the opinions of their graduates, the match was not perfect. The experience of the graduates and their additional comments should be included as inputs to the definition of learning objectives for

76 FR 10908 - Draft Guidance for Industry on Medication Guides-Distribution Requirements and Inclusion of...

Science.gov (United States)

2011-02-28

...] Draft Guidance for Industry on Medication Guides--Distribution Requirements and Inclusion of Medication... a draft guidance for industry entitled ``Medication Guides--Distribution Requirements and Inclusion... Inclusion of Medication Guides in Risk Evaluation and Mitigation Strategies (REMS).'' This draft guidance is...

Gender Distribution Among American Board of Medical Specialties Boards of Directors.

Science.gov (United States)

Walker, Laura E; Sadosty, Annie T; Colletti, James E; Goyal, Deepi G; Sunga, Kharmene L; Hayes, Sharonne N

2016-11-01

Since 1995, women have comprised more than 40% of all medical school graduates. However, representation at leadership levels in medicine remains considerably lower. Gender representation among the American Board of Medical Specialties (ABMS) boards of directors (BODs) has not previously been evaluated. Our objective was to determine the relative representation of women on ABMS BODs and compare it with the in-training and in-practice gender composition of the respective specialties. The composition of the ABMS BODs was obtained from websites in March 2016 for all Member Boards. Association of American Medical Colleges and American Medical Association data were utilized to identify current and future trends in gender composition. Although represented by a common board, neurology and psychiatry were evaluated separately because of their very different practices and gender demographic characteristics. A total of 25 specialties were evaluated. Of the 25 specialties analyzed, 12 BODs have proportional gender representation compared with their constituency. Seven specialties have a larger proportion of women serving on their boards compared with physicians in practice, and 6 specialties have a greater proportion of men populating their BODs. Based on the most recent trainee data (2013), women have increasing workforce representation in almost all specialties. Although women in both training and practice are approaching equal representation, there is variability in gender ratios across specialties. Directorship within ABMS BODs has a more equitable gender distribution than other areas of leadership in medicine. Further investigation is needed to determine the reasons behind this difference and to identify opportunities to engage women in leadership in medicine. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

The use of web internet technologies to distribute medical images

International Nuclear Information System (INIS)

Deller, A.L.; Cheal, D.; Field, J.

1999-01-01

Full text: In the past, internet browsers were considered ineffective for image distribution. Today we have the technology to use internet standards for picture archive and communication systems (PACS) and teleradiology effectively. Advanced wavelet compression and state-of-the-art JAVA software allows us to distribute images on normal computer hardware. The use of vendor and database neutral software and industry-standard hardware has many advantages. This standards base approach avoids the costly rapid obsolescence of proprietary PACS and is cheaper to purchase and maintain. Images can be distributed around a hospital site, as well as outside the campus, quickly and inexpensively. It also allows integration between the Hospital Information System (HIS) and the Radiology Information System (RIS). Being able to utilize standard internet technologies and computer hardware for PACS is a cost-effective alternative. A system based on this technology can be used for image distribution, archiving, teleradiology and RIS integration. This can be done without expensive specialized imaging workstations and telecommunication systems. Web distribution of images allows you to send images to multiple places concurrently. A study can be within your Medical Imaging Department, as well as in the ward and on the desktop of referring clinicians - with a report. As long as there is a computer with an internet access account, high-quality images can be at your disposal 24 h a day. The importance of medical images for patient management makes them a valuable component of the patient's medical record. Therefore, an efficient system for displaying and distributing images can improve patient management and make your workplace more effective

Radiation Protection in Interventional Radiology. Training objectives for the medical specialists

International Nuclear Information System (INIS)

Ruiz-Cruces, R.; Vano, E.; Hernandez Armas, J.; Carrera, F.

2003-01-01

The Directive 97/43 Euratom on medical exposures and the report RP 116 published by the European Commission on Education and Training in radiation protection for medical exposures, established that interventional radiologists should have a more skilled training for handling X-Ray equipment and a better knowledge about the ways of protecting patients and staff against ionising radiation. To analyse the objectives for training in radiation protection recommended in the European Guideline and to show the most important points and modifications for a better practical application of this guide. An inquiry has been performed into the specific objectives recommended by the European Guideline RP 116 about training on Radiation Protection. Twenty interventional radiologists were requested to fill in the test, pointing out the importance of each objective (0-no necessary, 1-medium importance, 2-very important), and they were encouraged to suggest other more interesting for them not included in the European Guideline. The average scores for each of the objectives included in the European Guideline are shown, and an additional relation of suggested topics has been added to the current list. The scoring system show the priority and importance of the objectives that could be taken into account during the next training courses to be held in Spain and it could be used as a base of discussion in some European meeting in order to improve the European Guideline in the future. (Author) 13 refs

Multi-object segmentation framework using deformable models for medical imaging analysis.

Science.gov (United States)

Namías, Rafael; D'Amato, Juan Pablo; Del Fresno, Mariana; Vénere, Marcelo; Pirró, Nicola; Bellemare, Marc-Emmanuel

2016-08-01

Segmenting structures of interest in medical images is an important step in different tasks such as visualization, quantitative analysis, simulation, and image-guided surgery, among several other clinical applications. Numerous segmentation methods have been developed in the past three decades for extraction of anatomical or functional structures on medical imaging. Deformable models, which include the active contour models or snakes, are among the most popular methods for image segmentation combining several desirable features such as inherent connectivity and smoothness. Even though different approaches have been proposed and significant work has been dedicated to the improvement of such algorithms, there are still challenging research directions as the simultaneous extraction of multiple objects and the integration of individual techniques. This paper presents a novel open-source framework called deformable model array (DMA) for the segmentation of multiple and complex structures of interest in different imaging modalities. While most active contour algorithms can extract one region at a time, DMA allows integrating several deformable models to deal with multiple segmentation scenarios. Moreover, it is possible to consider any existing explicit deformable model formulation and even to incorporate new active contour methods, allowing to select a suitable combination in different conditions. The framework also introduces a control module that coordinates the cooperative evolution of the snakes and is able to solve interaction issues toward the segmentation goal. Thus, DMA can implement complex object and multi-object segmentations in both 2D and 3D using the contextual information derived from the model interaction. These are important features for several medical image analysis tasks in which different but related objects need to be simultaneously extracted. Experimental results on both computed tomography and magnetic resonance imaging show that the proposed

Multi-objective optimization with estimation of distribution algorithm in a noisy environment.

Science.gov (United States)

Shim, Vui Ann; Tan, Kay Chen; Chia, Jun Yong; Al Mamun, Abdullah

2013-01-01

Many real-world optimization problems are subjected to uncertainties that may be characterized by the presence of noise in the objective functions. The estimation of distribution algorithm (EDA), which models the global distribution of the population for searching tasks, is one of the evolutionary computation techniques that deals with noisy information. This paper studies the potential of EDAs; particularly an EDA based on restricted Boltzmann machines that handles multi-objective optimization problems in a noisy environment. Noise is introduced to the objective functions in the form of a Gaussian distribution. In order to reduce the detrimental effect of noise, a likelihood correction feature is proposed to tune the marginal probability distribution of each decision variable. The EDA is subsequently hybridized with a particle swarm optimization algorithm in a discrete domain to improve its search ability. The effectiveness of the proposed algorithm is examined via eight benchmark instances with different characteristics and shapes of the Pareto optimal front. The scalability, hybridization, and computational time are rigorously studied. Comparative studies show that the proposed approach outperforms other state of the art algorithms.

Sensorimotor memory of object weight distribution during multidigit grasp.

Science.gov (United States)

Albert, Frederic; Santello, Marco; Gordon, Andrew M

2009-10-09

We studied the ability to transfer three-digit force sharing patterns learned through consecutive lifts of an object with an asymmetric center of mass (CM). After several object lifts, we asked subjects to rotate and translate the object to the contralateral hand and perform one additional lift. This task was performed under two weight conditions (550 and 950 g) to determine the extent to which subjects would be able to transfer weight and CM information. Learning transfer was quantified by measuring the extent to which force sharing patterns and peak object roll on the first post-translation trial resembled those measured on the pre-translation trial with the same CM. We found that the overall gain of fingertip forces was transferred following object rotation, but that the scaling of individual digit forces was specific to the learned digit-object configuration, and thus was not transferred following rotation. As a result, on the first post-translation trial there was a significantly larger object roll following object lift-off than on the pre-translation trial. This suggests that sensorimotor memories for weight, requiring scaling of fingertip force gain, may differ from memories for mass distribution.

SYSTEMATIC BIASES IN THE OBSERVED DISTRIBUTION OF KUIPER BELT OBJECT ORBITS

International Nuclear Information System (INIS)

Jones, R. L.; Parker, J. Wm.; Bieryla, A.; Marsden, B. G.; Gladman, B.; Kavelaars, JJ.; Petit, J.-M.

2010-01-01

The orbital distribution of Kuiper Belt objects (KBOs) provides important tests of solar system evolution models. However, our understanding of this orbital distribution can be affected by many observational biases. An important but difficult to quantify bias results from tracking selection effects; KBOs are recovered or lost depending on assumptions made about their orbital elements when fitting the initial (short) observational arc. Quantitatively studying the effects and significance of this bias is generally difficult, because only the objects where the assumptions were correct are recovered and thus available to study 'the problem', and because different observers use different assumptions and methods. We have used a sample of 38 KBOs that were discovered and tracked, bias-free, as part of the Canada-France Ecliptic Plane Survey to evaluate the potential for losing objects based on the two most common orbit and ephemeris prediction sources: the Minor Planet Center (MPC) and the Bernstein and Khushalani (BK) orbit fitting code. In both cases, we use early discovery and recovery astrometric measurements of the objects to generate ephemeris predictions that we then compare to later positional measurements; objects that have large differences between the predicted and actual positions would be unlikely to be recovered and are thus considered 'lost'. We find systematic differences in the orbit distributions which would result from using the two orbit-fitting procedures. In our sample, the MPC-derived orbit solutions lost slightly fewer objects (five out of 38) due to large ephemeris errors at one year recovery, but the objects which were lost belonged to more 'unusual' orbits such as scattering disk objects or objects with semimajor axes interior to the 3:2 resonance. Using the BK code, more objects (seven out of 38) would have been lost due to ephemeris errors, but the lost objects came from a range of orbital regions, primarily the classical belt region. We also

Multi-objective optimal dispatch of distributed energy resources

Science.gov (United States)

Longe, Ayomide

This thesis is composed of two papers which investigate the optimal dispatch for distributed energy resources. In the first paper, an economic dispatch problem for a community microgrid is studied. In this microgrid, each agent pursues an economic dispatch for its personal resources. In addition, each agent is capable of trading electricity with other agents through a local energy market. In this paper, a simple market structure is introduced as a framework for energy trades in a small community microgrid such as the Solar Village. It was found that both sellers and buyers benefited by participating in this market. In the second paper, Semidefinite Programming (SDP) for convex relaxation of power flow equations is used for optimal active and reactive dispatch for Distributed Energy Resources (DER). Various objective functions including voltage regulation, reduced transmission line power losses, and minimized reactive power charges for a microgrid are introduced. Combinations of these goals are attained by solving a multiobjective optimization for the proposed ORPD problem. Also, both centralized and distributed versions of this optimal dispatch are investigated. It was found that SDP made the optimal dispatch faster and distributed solution allowed for scalability.

A Scientific Workflow Platform for Generic and Scalable Object Recognition on Medical Images

Science.gov (United States)

Möller, Manuel; Tuot, Christopher; Sintek, Michael

In the research project THESEUS MEDICO we aim at a system combining medical image information with semantic background knowledge from ontologies to give clinicians fully cross-modal access to biomedical image repositories. Therefore joint efforts have to be made in more than one dimension: Object detection processes have to be specified in which an abstraction is performed starting from low-level image features across landmark detection utilizing abstract domain knowledge up to high-level object recognition. We propose a system based on a client-server extension of the scientific workflow platform Kepler that assists the collaboration of medical experts and computer scientists during development and parameter learning.

Development and assessment of learning objects about intramuscular medication administration

Directory of Open Access Journals (Sweden)

Lilian Mayumi Chinen Tamashiro

2014-10-01

Full Text Available OBJECTIVES: to develop and assess a learning object about intramuscular medication administration for nursing undergraduates and nurses.METHOD: a random, intentional and non-probabilistic sample was selected of nurses from a Brazilian social network of nursing and students from the Undergraduate Program at the University of São Paulo School of Nursing to serve as research subjects and assess the object.RESULTS: the participants, 8 nurses and 8 students, studied the object and answered an assessment instrument that included the following criteria: educational aspects (relevance of the theme, objectives and texts/hypertexts, interface of the environment (navigation, accessibility and screen design and didactic resources (interactivity and presentation of resources. In total, 128 significant answers were obtained, 124 (97% of which were positive, assessed as excellent and satisfactory, considered as a flexible, dynamic, objective resources that is appropriate to the nursing learning process.CONCLUSION: the educational technology shows a clear and easily understandable language and the teaching method could be applied in other themes, contributing to the education and training of nursing professionals, positively affecting nursing teaching, stimulating the knowledge, autonomous and independent learning, aligned with the new professional education requirements.

THE RIGHT OF MEDICAL WORKERS TO CONSCIENTIOUSLY OBJECT

Directory of Open Access Journals (Sweden)

Jozo Čizmić

2016-01-01

Full Text Available Institute “conscientious” protects citizens’ freedom of each person in relation to the choice according to their own conscience. With the view of her/his ethical, religious or moral principles, medical worker has the right to refer to conscientious objection and decline to conduct health care if it is not in dissonance with professional standards or if it is not causing any permanent consequences on health or it is not danger for patient’s life. Medical worker shall inform the patient and responsible or superior person on her decision in due time. This is a multidisciplinary problem whose solution can be found only through joint and simultaneous access to several scientific disciplines and professions (physicians, lawyers, ethicists, theologians, sociologists, etc., as well as interest groups (associations of patients and health workers, chambers, etc. according to international and national regulations, the recent case law of international and domestic courts, rules and protocols of the profession, the decision of codes of ethics, the principles of religion etc.

A POSSIBLE DIVOT IN THE SIZE DISTRIBUTION OF THE KUIPER BELT'S SCATTERING OBJECTS

Energy Technology Data Exchange (ETDEWEB)

Shankman, C.; Gladman, B. J. [Department of Physics and Astronomy, University of British Columbia, 6224 Agriculture Road, Vancouver, BC V6T 1Z1 (Canada); Kaib, N. [Department of Physics and Astronomy, Queens University (Canada); Kavelaars, J. J. [National Research Council of Canada, Victoria, BC V9E 2E7 (Canada); Petit, J. M. [Institut UTINAM, CNRS-Universite de Franche-Comte, Besancon (France)

2013-02-10

Via joint analysis of a calibrated telescopic survey, which found scattering Kuiper Belt objects, and models of their expected orbital distribution, we explore the scattering-object (SO) size distribution. Although for D > 100 km the number of objects quickly rise as diameters decrease, we find a relative lack of smaller objects, ruling out a single power law at greater than 99% confidence. After studying traditional ''knees'' in the size distribution, we explore other formulations and find that, surprisingly, our analysis is consistent with a very sudden decrease (a divot) in the number distribution as diameters decrease below 100 km, which then rises again as a power law. Motivated by other dynamically hot populations and the Centaurs, we argue for a divot size distribution where the number of smaller objects rises again as expected via collisional equilibrium. Extrapolation yields enough kilometer-scale SOs to supply the nearby Jupiter-family comets. Our interpretation is that this divot feature is a preserved relic of the size distribution made by planetesimal formation, now ''frozen in'' to portions of the Kuiper Belt sharing a ''hot'' orbital inclination distribution, explaining several puzzles in Kuiper Belt science. Additionally, we show that to match today's SO inclination distribution, the supply source that was scattered outward must have already been vertically heated to the of order 10 Degree-Sign .

Objective and subjective factors of efficiency and performance of medical audit

Directory of Open Access Journals (Sweden)

V. S. Biryukov

2017-01-01

Full Text Available The work is devoted to analysis factors affecting the effective operation of quality management systems in health care institutions. It is shown important role of quality of carrying out audits, internal and external, in elimination of various kinds of risks and discrepancies in activity of medical institutions. Two main factors were revealed which influencing the quality of audit: 1. Subjective or "human" factor, consisting in sufficient motivation of the top management and internal auditors of medical institutions. 2. Objective or technological factor, consisting in sufficient training of internal auditors, adequacy selected audit methodology, etc.

Multi-Objective Scheduling of Electric Vehicles in Smart Distribution Network

Directory of Open Access Journals (Sweden)

Changhong Deng

2016-11-01

Full Text Available Due to the energy savings and environmental protection they provide, plug-in electric vehicles (PEVs are increasing in number quickly. Rapid development of PEVs brings new opportunities and challenges to the electricity distribution network’s dispatching. A high number of uncoordinated charging PEVs has significant negative impacts on the secure and economic operation of a distribution network. In this paper, a bi-level programming approach that coordinates PEVs’ charging with the network load and electricity price of the open market is presented. The major objective of the upper level model is to minimize the total network costs and the deviation of electric vehicle aggregators’ charging power and the equivalent power. The subsequent objective of the lower level model after the upper level decision is to minimize the dispatching deviation of the sum of PEVs’ charging power and their optimization charging power under the upper level model. An improved particle swarm optimization algorithm is used to solve the bi-level programming. Numerical studies using a modified IEEE 69-bus distribution test system including six electric vehicle aggregators verify the efficiency of the proposed model.

Benefit distribution of social health insurance: evidence from china's urban resident basic medical insurance.

Science.gov (United States)

Pan, Jay; Tian, Sen; Zhou, Qin; Han, Wei

2016-09-01

Equity is one of the essential objectives of the social health insurance. This article evaluates the benefit distribution of the China's Urban Residents' Basic Medical Insurance (URBMI), covering 300 million urban populations. Using the URBMI Household Survey data fielded between 2007 and 2011, we estimate the benefit distribution by the two-part model, and find that the URBMI beneficiaries from lower income groups benefited less than that of higher income groups. In other words, government subsidy that was supposed to promote the universal coverage of health care flew more to the rich. Our study provides new evidence on China's health insurance system reform, and it bears meaningful policy implication for other developing countries facing similar challenges on the way to universal coverage of health insurance. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

[Species composition and distribution of medical mollusca in Shanghai City].

Science.gov (United States)

Guo, Yun-hai; Lv, Shan; Gu, Wen-biao; Liu, He-xiang; Wu, Ying; Zhang, Yi

2015-02-01

To investigate the species diversity and distribution of medical mollusca in Shanghai City. From August 2012 to October 2013, all kinds of habitats in 8 districts and counties in Shanghai City, namely Jiading, Qingpu, Baoshan, Minhang, Songjiang, Jinshan, Chongming, Pudong, were selected for the field survey according to the distribution characteristics of the river system, and all the specimens of medical mollusca in the investigation sites were collected and classified by morphological identification. Meanwhile, the species composition, habitats as well as the fauna of the medical mollusca collected were analyzed. A total of 5,211 specimens were collected, which belonged to 2 classes, 14 families, 18 genera and 25 species, including Oncomelania hupensis hupensis, Pomacea canaliculata, Parafossarulus striatulus, Alocinma longicornis, Physa acuta, Galba pervia, Hippeutis cantori, etc. The species numbers of medical mollusca in Chongming, Jinshan, Pudong new area and Qingpu districts (counties) were 22, 22, 21 and 20, respectively, which were more than those of other areas. The habitat analysis suggested that the species numbers in the river and wetland were the most, both of which were 14 species. The main faunas of the medical mollusca in Shanghai were the cosmopolitan and oriental species. The freshwater gastropod species are paucity in Shanghai City, but almost of them can be served as the intermediate hosts of certain parasites to transmit snail-related parasitic diseases, so the surveillance of medical mollusca should be strengthened.

Multi-objective PSO based optimal placement of solar power DG in radial distribution system

Directory of Open Access Journals (Sweden)

Mahesh Kumar

2017-06-01

Full Text Available Ever increasing trend of electricity demand, fossil fuel depletion and environmental issues request the integration of renewable energy into the distribution system. The optimal planning of renewable distributed generation (DG is much essential for ensuring maximum benefits. Hence, this paper proposes the optimal placement of probabilistic based solar power DG into the distribution system. The two objective functions such as power loss reduction and voltage stability index improvement are optimized. The power balance and voltage limits are kept as constraints of the problem. The non-sorting pare to-front based multi-objective particle swarm optimization (MOPSO technique is proposed on standard IEEE 33 radial distribution test system.

A Pathophysiological Model-Driven Communication for Dynamic Distributed Medical Best Practice Guidance Systems.

Science.gov (United States)

Hosseini, Mohammad; Jiang, Yu; Wu, Poliang; Berlin, Richard B; Ren, Shangping; Sha, Lui

2016-11-01

There is a great divide between rural and urban areas, particularly in medical emergency care. Although medical best practice guidelines exist and are in hospital handbooks, they are often lengthy and difficult to apply clinically. The challenges are exaggerated for doctors in rural areas and emergency medical technicians (EMT) during patient transport. In this paper, we propose the concept of distributed executable medical best practice guidance systems to assist adherence to best practice from the time that a patient first presents at a rural hospital, through diagnosis and ambulance transfer to arrival and treatment at a regional tertiary hospital center. We codify complex medical knowledge in the form of simplified distributed executable disease automata, from the thin automata at rural hospitals to the rich automata in the regional center hospitals. However, a main challenge is how to efficiently and safely synchronize distributed best practice models as the communication among medical facilities, devices, and professionals generates a large number of messages. This complex problem of patient diagnosis and transport from rural to center facility is also fraught with many uncertainties and changes resulting in a high degree of dynamism. A critically ill patient's medical conditions can change abruptly in addition to changes in the wireless bandwidth during the ambulance transfer. Such dynamics have yet to be addressed in existing literature on telemedicine. To address this situation, we propose a pathophysiological model-driven message exchange communication architecture that ensures the real-time and dynamic requirements of synchronization among distributed emergency best practice models are met in a reliable and safe manner. Taking the signs, symptoms, and progress of stroke patients transported across a geographically distributed healthcare network as the motivating use case, we implement our communication system and apply it to our developed best practice

Exploring emerging learning needs: a UK-wide consultation on environmental sustainability learning objectives for medical education.

Science.gov (United States)

Walpole, Sarah C; Mortimer, Frances; Inman, Alice; Braithwaite, Isobel; Thompson, Trevor

2015-12-24

This study aimed to engage wide-ranging stakeholders and develop consensus learning objectives for undergraduate and postgraduate medical education. A UK-wide consultation garnered opinions of healthcare students, healthcare educators and other key stakeholders about environmental sustainability in medical education. The policy Delphi approach informed this study. Draft learning objectives were revised iteratively during three rounds of consultation: online questionnaire or telephone interview, face-to-face seminar and email consultation. Twelve draft learning objectives were developed based on review of relevant literature. In round one, 64 participants' median ratings of the learning objectives were 3.5 for relevance and 3.0 for feasibility on a Likert scale of one to four. Revisions were proposed, e.g. to highlight relevance to public health and professionalism. Thirty three participants attended round two. Conflicting opinions were explored. Added content areas included health benefits of sustainable behaviours. To enhance usability, restructuring provided three overarching learning objectives, each with subsidiary points. All participants from rounds one and two were contacted in round three, and no further edits were required. This is the first attempt to define consensus learning objectives for medical students about environmental sustainability. Allowing a wide range of stakeholders to comment on multiple iterations of the document stimulated their engagement with the issues raised and ownership of the resulting learning objectives.

Self-perceived versus objectively measured competence in performing clinical practical procedures by final year medical students

OpenAIRE

Katowa-Mukwato, Patricia; Banda, Sekelani

2016-01-01

Objectives To determine and compare the self-perceived and objectively measured competence in performing 14 core-clinical practical procedures by Final Year Medical Students of the University of Zambia. Methods The study included 56 out of 60 graduating University of Zambia Medical Students of the 2012/2013 academic year. Self-perceived competence: students rated their competence on 14 core- clinical practical procedures using a self-administered questionnaire on a 5-point Likert scale. Objec...

Software for Distributed Computation on Medical Databases: A Demonstration Project

Directory of Open Access Journals (Sweden)

Balasubramanian Narasimhan

2017-05-01

Full Text Available Bringing together the information latent in distributed medical databases promises to personalize medical care by enabling reliable, stable modeling of outcomes with rich feature sets (including patient characteristics and treatments received. However, there are barriers to aggregation of medical data, due to lack of standardization of ontologies, privacy concerns, proprietary attitudes toward data, and a reluctance to give up control over end use. Aggregation of data is not always necessary for model fitting. In models based on maximizing a likelihood, the computations can be distributed, with aggregation limited to the intermediate results of calculations on local data, rather than raw data. Distributed fitting is also possible for singular value decomposition. There has been work on the technical aspects of shared computation for particular applications, but little has been published on the software needed to support the "social networking" aspect of shared computing, to reduce the barriers to collaboration. We describe a set of software tools that allow the rapid assembly of a collaborative computational project, based on the flexible and extensible R statistical software and other open source packages, that can work across a heterogeneous collection of database environments, with full transparency to allow local officials concerned with privacy protections to validate the safety of the method. We describe the principles, architecture, and successful test results for the site-stratified Cox model and rank-k singular value decomposition.

Health Canada unveils plan to distribute marijuana for medical use.

Science.gov (United States)

Thaczuk, Derek

2003-08-01

Under pressure from the courts, Health Canada reluctantly comes up with a distribution plan to provide dried cannabis and seeds to patients using medical marijuana. The plan has been greeted with considerable criticism

Ecology and distribution of gastropod snails of medical and ...

African Journals Online (AJOL)

A study on the ecology and distribution of snails of medical importance was conducted in water bodies from four different communities (Old Karmo, Gwagwa, ... The following floras were identified from the study-sites; Megathyrsus maximus, Guinea grass and Commelina nigritana (African dayflower) were identified from the ...

A Distributed and Collaborative Intelligent System for Medical Diagnosis

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Wided LEJOUAD-CHAARI

2013-08-01

Full Text Available In this paper, we present a distributed collaborative system assisting physicians in diagnosis when processing medical images. This is a Web-based solution since the different participants and resources are on various sites. It is collaborative because these participants (physicians, radiologists, knowledgebasesdesigners, program developers for medical image processing, etc. can work collaboratively to enhance the quality of programs and then the quality of the diagnosis results. It is intelligent since it is a knowledge-based system including, but not only, a knowledge base, an inference engine said supervision engine and ontologies. The current work deals with the osteoporosis detection in bone radiographies. We rely on program supervision techniques that aim to automatically plan and control complex software usage. Our main contribution is to allow physicians, who are not experts in computing, to benefit from technological advances made by experts in image processing, and then to efficiently use various osteoporosis detection programs in a distributed environment.

Students’ perception of the learning environment in a distributed medical programme

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Kiran Veerapen

2010-09-01

Full Text Available Background : The learning environment of a medical school has a significant impact on students’ achievements and learning outcomes. The importance of equitable learning environments across programme sites is implicit in distributed undergraduate medical programmes being developed and implemented. Purpose : To study the learning environment and its equity across two classes and three geographically separate sites of a distributed medical programme at the University of British Columbia Medical School that commenced in 2004. Method : The validated Dundee Ready Educational Environment Survey was sent to all students in their 2nd and 3rd year (classes graduating in 2009 and 2008 of the programme. The domains of the learning environment surveyed were: students’ perceptions of learning, students’ perceptions of teachers, students’ academic self-perceptions, students’ perceptions of the atmosphere, and students’ social self-perceptions. Mean scores, frequency distribution of responses, and inter- and intrasite differences were calculated. Results : The perception of the global learning environment at all sites was more positive than negative. It was characterised by a strongly positive perception of teachers. The work load and emphasis on factual learning were perceived negatively. Intersite differences within domains of the learning environment were more evident in the pioneer class (2008 of the programme. Intersite differences consistent across classes were largely related to on-site support for students. Conclusions : Shared strengths and weaknesses in the learning environment at UBC sites were evident in areas that were managed by the parent institution, such as the attributes of shared faculty and curriculum. A greater divergence in the perception of the learning environment was found in domains dependent on local arrangements and social factors that are less amenable to central regulation. This study underlines the need for ongoing

Students' perception of the learning environment in a distributed medical programme.

Science.gov (United States)

Veerapen, Kiran; McAleer, Sean

2010-09-24

The learning environment of a medical school has a significant impact on students' achievements and learning outcomes. The importance of equitable learning environments across programme sites is implicit in distributed undergraduate medical programmes being developed and implemented. To study the learning environment and its equity across two classes and three geographically separate sites of a distributed medical programme at the University of British Columbia Medical School that commenced in 2004. The validated Dundee Ready Educational Environment Survey was sent to all students in their 2nd and 3rd year (classes graduating in 2009 and 2008) of the programme. The domains of the learning environment surveyed were: students' perceptions of learning, students' perceptions of teachers, students' academic self-perceptions, students' perceptions of the atmosphere, and students' social self-perceptions. Mean scores, frequency distribution of responses, and inter- and intrasite differences were calculated. The perception of the global learning environment at all sites was more positive than negative. It was characterised by a strongly positive perception of teachers. The work load and emphasis on factual learning were perceived negatively. Intersite differences within domains of the learning environment were more evident in the pioneer class (2008) of the programme. Intersite differences consistent across classes were largely related to on-site support for students. Shared strengths and weaknesses in the learning environment at UBC sites were evident in areas that were managed by the parent institution, such as the attributes of shared faculty and curriculum. A greater divergence in the perception of the learning environment was found in domains dependent on local arrangements and social factors that are less amenable to central regulation. This study underlines the need for ongoing comparative evaluation of the learning environment at the distributed sites and

Self-perceived versus objectively measured competence in performing clinical practical procedures by final year medical students.

Science.gov (United States)

Katowa-Mukwato, Patricia; Banda, Sekelani

2016-04-30

To determine and compare the self-perceived and objectively measured competence in performing 14 core-clinical practical procedures by Final Year Medical Students of the University of Zambia. The study included 56 out of 60 graduating University of Zambia Medical Students of the 2012/2013 academic year. Self-perceived competence: students rated their competence on 14 core- clinical practical procedures using a self-administered questionnaire on a 5-point Likert scale. Objective competence: it was measured by Objective Structured Clinical Examination (OSCE) by faculty using predetermined rating scales. Rank order correlation test was performed for self-perceived and objectively measured competence. Two thirds 36 (66.7%) of the participants perceived themselves as moderately competent, 15 (27.8%) rated themselves as highly competent while 3 (5.6%) had low self-perception. With objective competence, the majority 52 (92.8%) were barely competent while 4 (7.2%) were absolutely competent. When overall self-perception was compared to objectively measured competence, there was a discordance which was demonstrated by a negative correlation (Spearman rho -.123). Significant numbers of students reported low self-competence in performing procedures such as endotracheal intubation, gastric lavage and cardiopulmonary resuscitation which most never performed during the clinical years of medical education. In addition, the negative correlation between self-perceived and objectively measured competence demonstrated the inability of students to assess and rate themselves objectively due to fear that others may know their weaknesses and realize that they are not as competent as expected at a specific level of training.

Multi-objective scheduling of electric vehicles in smart distribution system

International Nuclear Information System (INIS)

Zakariazadeh, Alireza; Jadid, Shahram; Siano, Pierluigi

2014-01-01

Highlights: • Environmental/economic operational scheduling of electric vehicles. • The Vehicle to Grid capability and the actual patterns of drivers are considered. • A novel conceptual model for an electric vehicle management system is proposed. - Abstract: When preparing for the widespread adoption of Electric Vehicles (EVs), an important issue is to use a proper EVs’ charging/discharging scheduling model that is able to simultaneously consider economic and environmental goals as well as technical constraints of distribution networks. This paper proposes a multi-objective operational scheduling method for charging/discharging of EVs in a smart distribution system. The proposed multi-objective framework, based on augmented ε-constraint method, aims at minimizing the total operational costs and emissions. The Vehicle to Grid (V2G) capability as well as the actual patterns of drivers are considered in order to generate the Pareto-optimal solutions. The Benders decomposition technique is used in order to solve the proposed optimization model and to convert the large scale mixed integer nonlinear problem into mixed-integer linear programming and nonlinear programming problems. The effectiveness of the proposed resources scheduling approach is tested on a 33-bus distribution test system over a 24-h period. The results show that the proposed EVs’ charging/discharging method can reduce both of operation cost and air pollutant emissions

Integration Platform As Central Service Of Data Replication In Distributed Medical System

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Wiesław Wajs

2007-01-01

Full Text Available The paper presents the application of Java Integration Platform (JIP to data replicationin the distributed medical system. After an introductory part on the medical system’s architecture,the focus shifts to a comparison of different approaches that exist with regard totransferring data between the system’s components. A description is given of the historicaldata processing and of the whole area of the JIP application to the medical system.

Robust Multi-Objective PQ Scheduling for Electric Vehicles in Flexible Unbalanced Distribution Grids

DEFF Research Database (Denmark)

Knezovic, Katarina; Soroudi, Alireza; Marinelli, Mattia

2017-01-01

With increased penetration of distributed energy resources and electric vehicles (EVs), different EV management strategies can be used for mitigating adverse effects and supporting the distribution grid. This paper proposes a robust multi-objective methodology for determining the optimal day...... demand response programs. The method is tested on a real Danish unbalanced distribution grid with 35% EV penetration to demonstrate the effectiveness of the proposed approach. It is shown that the proposed formulation guarantees an optimal EV cost as long as the price uncertainties are lower than....... The robust formulation effectively considers the errors in the electricity price forecast and its influence on the EV schedule. Moreover, the impact of EV reactive power support on objective values and technical parameters is analysed both when EVs are the only flexible resources and when linked with other...

Multi-objective optimal power flow for active distribution network considering the stochastic characteristic of photovoltaic

Science.gov (United States)

Zhou, Bao-Rong; Liu, Si-Liang; Zhang, Yong-Jun; Yi, Ying-Qi; Lin, Xiao-Ming

2017-05-01

To mitigate the impact on the distribution networks caused by the stochastic characteristic and high penetration of photovoltaic, a multi-objective optimal power flow model is proposed in this paper. The regulation capability of capacitor, inverter of photovoltaic and energy storage system embedded in active distribution network are considered to minimize the expected value of active power the T loss and probability of voltage violation in this model. Firstly, a probabilistic power flow based on cumulant method is introduced to calculate the value of the objectives. Secondly, NSGA-II algorithm is adopted for optimization to obtain the Pareto optimal solutions. Finally, the best compromise solution can be achieved through fuzzy membership degree method. By the multi-objective optimization calculation of IEEE34-node distribution network, the results show that the model can effectively improve the voltage security and economy of the distribution network on different levels of photovoltaic penetration.

Integrating heterogeneous databases in clustered medic care environments using object-oriented technology

Science.gov (United States)

Thakore, Arun K.; Sauer, Frank

1994-05-01

The organization of modern medical care environments into disease-related clusters, such as a cancer center, a diabetes clinic, etc., has the side-effect of introducing multiple heterogeneous databases, often containing similar information, within the same organization. This heterogeneity fosters incompatibility and prevents the effective sharing of data amongst applications at different sites. Although integration of heterogeneous databases is now feasible, in the medical arena this is often an ad hoc process, not founded on proven database technology or formal methods. In this paper we illustrate the use of a high-level object- oriented semantic association method to model information found in different databases into an integrated conceptual global model that integrates the databases. We provide examples from the medical domain to illustrate an integration approach resulting in a consistent global view, without attacking the autonomy of the underlying databases.

Multi-objective optimal operation of smart reconfigurable distribution grids

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Abdollah Kavousi-Fard

2016-02-01

Full Text Available Reconfiguration is a valuable technique that can support the distribution grid from different aspects such as operation cost and loss reduction, reliability improvement, and voltage stability enhancement. An intelligent and efficient optimization framework, however, is required to reach the desired efficiency through the reconfiguration strategy. This paper proposes a new multi-objective optimization model to make use of the reconfiguration strategy for minimizing the power losses, improving the voltage profile, and enhancing the load balance in distribution grids. The proposed model employs the min-max fuzzy approach to find the most satisfying solution from a set of nondominated solutions in the problem space. Due to the high complexity and the discrete nature of the proposed model, a new optimization method based on harmony search (HS algorithm is further proposed. Moreover, a new modification method is suggested to increase the harmony memory diversity in the improvisation stage and increase the convergence ability of the algorithm. The feasibility and satisfying performance of the proposed model are examined on the IEEE 32-bus distribution system.

The electron density and temperature distributions predicted by bow shock models of Herbig-Haro objects

International Nuclear Information System (INIS)

Noriega-Crespo, A.; Bohm, K.H.; Raga, A.C.

1990-01-01

The observable spatial electron density and temperature distributions for series of simple bow shock models, which are of special interest in the study of Herbig-Haro (H-H) objects are computed. The spatial electron density and temperature distributions are derived from forbidden line ratios. It should be possible to use these results to recognize whether an observed electron density or temperature distribution can be attributed to a bow shock, as is the case in some Herbig-Haro objects. As an example, the empirical and predicted distributions for H-H 1 are compared. The predicted electron temperature distributions give the correct temperature range and they show very good diagnostic possibilities if the forbidden O III (4959 + 5007)/4363 wavelength ratio is used. 44 refs

Frequent Statement and Dereference Elimination for Imperative and Object-Oriented Distributed Programs

Science.gov (United States)

El-Zawawy, Mohamed A.

2014-01-01

This paper introduces new approaches for the analysis of frequent statement and dereference elimination for imperative and object-oriented distributed programs running on parallel machines equipped with hierarchical memories. The paper uses languages whose address spaces are globally partitioned. Distributed programs allow defining data layout and threads writing to and reading from other thread memories. Three type systems (for imperative distributed programs) are the tools of the proposed techniques. The first type system defines for every program point a set of calculated (ready) statements and memory accesses. The second type system uses an enriched version of types of the first type system and determines which of the ready statements and memory accesses are used later in the program. The third type system uses the information gather so far to eliminate unnecessary statement computations and memory accesses (the analysis of frequent statement and dereference elimination). Extensions to these type systems are also presented to cover object-oriented distributed programs. Two advantages of our work over related work are the following. The hierarchical style of concurrent parallel computers is similar to the memory model used in this paper. In our approach, each analysis result is assigned a type derivation (serves as a correctness proof). PMID:24892098

Equality in Distribution of Human Resources: the Case of Iran's Ministry of Health and Medical Education.

Science.gov (United States)

Mobaraki, H; Hassani, A; Kashkalani, T; Khalilnejad, R; Chimeh, E Ehsani

2013-01-01

Equity in access to and utilization of health services is a common goal of policy-makers in most countries. The fair allocation of human resources is one of the dimensions of equity, which was evaluated in this study. We evaluated the equity of human resources' distribution among Iran's medical science universities between 2005 and 2009 by inequality measures including Lorenze curve, Gini coefficient and Rabin hood indexes. In the distribution 60403 recruitment licenses among medical universities with 72456140 covered populations, Gini coefficient was 0.167 and Robin Hood Index 0.11. Calculations indicated Recruitment licenses are equitably distributed in MOH&ME of Iran. However a portion of recruitment licenses should redistributed for achieving perfect equal distribution among all public medical universities of Iran.

Objective structured practical examination in biochemistry: An experience in Medical College, Kolkata.

Science.gov (United States)

Kundu, Dipankar; Das, H N; Sen, Gargi; Osta, Manish; Mandal, T; Gautam, Divyendu

2013-01-01

Undergraduate medical examination is undergoing extensive re evaluation with new core educational objectives being defined. Consequently, new exam systems have also been designed to test the objectives. Objective structured practical examination (OSPE) is one of them. To introduce OSPE as a method of assessment of practical skills and learning and to determine student satisfaction regarding the OSPE. Furthermore, to explore the faculty perception of OSPE as a learning and assessment tool. The first M.B.B.S students of 2011 12 batch of Medical College, Kolkata, were the subjects for the study. OSPE was organized and conducted on "Identification of Unknown Abnormal Constituents in Urine." Coefficient of reliability of questions administered was done by calculating Cronbach's alpha. A questionnaire on various components of the OSPE was administered to get the feedback. 16 students failed to achieve an average of 50% or above in the assessment. However, 49 students on an average achieved >75%, 52 students achieved between 65% and 75%, and 29 students scored between 50% and 65%. Cronbach's alpha of the questions administered showed to be having high internal consistency with a score of 0.80. Ninety nine percent of students believed that OSPE helps them to improve and 81% felt that this type of assessment fits in as both learning and evaluation tools. Faculty feedback reflected that such assessment tested objectivity, measured practical skills better, and eliminated examiner bias to a greater extent. OSPE tests different desired components of competence better and eliminated examiner bias. Student feedback reflects that such assessment helps them to improve as it is effective both as teaching and evaluation tools.

A policy-based multi-objective optimisation framework for residential distributed energy system design★

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Wouters Carmen

2017-01-01

Full Text Available Distributed energy systems (DES are increasingly being introduced as solutions to alleviate conventional energy system challenges related to energy security, climate change and increasing demands. From a technological and economic perspective, distributed energy resources are already becoming viable. The question still remains as to how these technologies and practices can be “best” selected, sized and integrated within consumer areas. To aid decision-makers and enable widespread DES adoption, a strategic superstructure design framework is therefore still required that ensures balancing of multiple stakeholder interests and fits in with liberalised energy system objectives of competition, security of supply and sustainability. Such a design framework is presented in this work. An optimisation-based approach for the design of neighbourhood-based DES is developed that enables meeting their yearly electricity, heating and cooling needs by appropriately selecting, sizing and locating technologies and energy interactions. A pool of poly-generation and storage technologies is hereto considered combined with local energy sharing between participating prosumers through thermal pipeline design and microgrid operation, and, a bi-directional connection with the central distribution grid. A superstructure mixed-integer linear programming approach (MILP is proposed to trade off three minimisation objectives in the design process: total annualised cost, annual CO2 emissions and electrical system unavailability, aligned with the three central energy system objectives. The developed model is applied on a small South Australian neighbourhood. The approach enables identifying “knee-point” neighbourhood energy system designs through Pareto trade-offs between objectives and serves to inform decision-makers about the impact of policy objectives on DES development strategies.

Web-based Distributed Medical Information System for Chronic Viral Hepatitis

Science.gov (United States)

Yang, Ying; Qin, Tuan-fa; Jiang, Jian-ning; Lu, Hui; Ma, Zong-e.; Meng, Hong-chang

2008-11-01

To make a long-term dynamic monitoring to the chronically ill, especially patients of HBV A, we build a distributed Medical Information System for Chronic Viral Hepatitis (MISCHV). The Web-based system architecture and its function are described, and the extensive application and important role are also presented.

Use of an object model in three dimensional image reconstruction. Application in medical imaging

International Nuclear Information System (INIS)

Delageniere-Guillot, S.

1993-02-01

Threedimensional image reconstruction from projections corresponds to a set of techniques which give information on the inner structure of the studied object. These techniques are mainly used in medical imaging or in non destructive evaluation. Image reconstruction is an ill-posed problem. So the inversion has to be regularized. This thesis deals with the introduction of a priori information within the reconstruction algorithm. The knowledge is introduced through an object model. The proposed scheme is applied to the medical domain for cone beam geometry. We address two specific problems. First, we study the reconstruction of high contrast objects. This can be applied to bony morphology (bone/soft tissue) or to angiography (vascular structures opacified by injection of contrast agent). With noisy projections, the filtering steps of standard methods tend to smooth the natural transitions of the investigated object. In order to regularize the reconstruction but to keep contrast, we introduce a model of classes which involves the Markov random fields theory. We develop a reconstruction scheme: analytic reconstruction-reprojection. Then, we address the case of an object changing during the acquisition. This can be applied to angiography when the contrast agent is moving through the vascular tree. The problem is then stated as a dynamic reconstruction. We define an evolution AR model and we use an algebraic reconstruction method. We represent the object at a particular moment as an intermediary state between the state of the object at the beginning and at the end of the acquisition. We test both methods on simulated and real data, and we prove how the use of an a priori model can improve the results. (author)

Medical emergencies in a dental office: inhalation and ingestion of orthodontic objects.

Science.gov (United States)

Bilder, Leon; Hazan-Molina, Hagai; Aizenbud, Dror

2011-01-01

The authors reviewed the literature regarding inhalation and ingestion of orthodontic appliances and suggest ways to manage and prevent these events. The authors conducted literature searches of free text and Medical Subject Headings terms by using PubMed and Embase databases and selected appropriate studies. They analyzed retrieved articles according to several parameters: inhalation or ingestion event, number of cases, patient's sex and age, type of orthodontic appliance, in-office event or out-of-office event, and medical treatment. The authors found a total of 2,279 articles in their preliminary search. Eighteen reports of 24 cases from this search met all of the search criteria (that is, clinical studies, case reports or reviews limited to English, Hebrew or Arabic on any form of aspiration or inhalation of orthodontic appliances). Most cases (67 percent) involved ingested objects, and of those cases, the majority (57 percent) occurred in female patients. Most cases (85 percent) occurred outside the orthodontist's office. Seventeen patients (71 percent) had been treated with a fixed orthodontic appliance. In 60 percent of cases, the maxilla was involved. With one exception, no severe complications were reported (only seven patients were examined in a hospital emergency department), and patients were discharged uneventfully from the orthodontic office or emergency department. Orthodontists and team members should participate in medical emergency management courses that emphasize the use of guidelines in cases of inhalation or ingestion of orthodontic objects. Each orthodontist's office should develop written emergency protocols for out-of-office events and present them to patients and their parents at the start of treatment.

Coordination strategies for distribution grid congestion management in a Multi-Actor, Multi-Objective Setting

DEFF Research Database (Denmark)

Andersen, Peter Bach; Hu, Junjie; Heussen, Kai

2012-01-01

It is well understood that the electric vehicle as a distributed energy resource can provide valuable services to the power system. Such services, however, would have to co-exist with hard constraints imposed by EV user demands and distribution grid operation constraints. This paper aims to address...... the interactions between the stakeholders involved, mainly considering the distribution grid congestion problem, and conceptualize several approaches by which their diverse, potentially conflicting, objectives can be coordinated. A key aspect to be considered is the relationship between the operational planning...... and the handling of real-time events for reliable grid operation. This paper presents an analysis of key stakeholders in terms of their objectives and key operations. Three potential strategies for congestion management are presented and evaluated based on their complexity of implementation, the value and benefits...

An Object-Oriented Information Model for Policy-based Management of Distributed Applications

NARCIS (Netherlands)

Diaz, G.; Gay, V.C.J.; Horlait, E.; Hamza, M.H.

2002-01-01

This paper presents an object-oriented information model to support a policy-based management for distributed multimedia applications. The information base contains application-level information about the users, the applications, and their profile. Our Information model is described in details and

ARACHNID: A prototype object-oriented database tool for distributed systems

Science.gov (United States)

Younger, Herbert; Oreilly, John; Frogner, Bjorn

1994-01-01

This paper discusses the results of a Phase 2 SBIR project sponsored by NASA and performed by MIMD Systems, Inc. A major objective of this project was to develop specific concepts for improved performance in accessing large databases. An object-oriented and distributed approach was used for the general design, while a geographical decomposition was used as a specific solution. The resulting software framework is called ARACHNID. The Faint Source Catalog developed by NASA was the initial database testbed. This is a database of many giga-bytes, where an order of magnitude improvement in query speed is being sought. This database contains faint infrared point sources obtained from telescope measurements of the sky. A geographical decomposition of this database is an attractive approach to dividing it into pieces. Each piece can then be searched on individual processors with only a weak data linkage between the processors being required. As a further demonstration of the concepts implemented in ARACHNID, a tourist information system is discussed. This version of ARACHNID is the commercial result of the project. It is a distributed, networked, database application where speed, maintenance, and reliability are important considerations. This paper focuses on the design concepts and technologies that form the basis for ARACHNID.

Multi-Objective Distribution Network Operation Based on Distributed Generation Optimal Placement Using New Antlion Optimizer Considering Reliability

Directory of Open Access Journals (Sweden)

KHANBABAZADEH Javad

2016-10-01

Full Text Available Distribution network designers and operators are trying to deliver electrical energy with high reliability and quality to their subscribers. Due to high losses in the distribution systems, using distributed generation can improves reliability, reduces losses and improves voltage profile of distribution network. Therefore, the choice of the location of these resources and also determining the amount of their generated power to maximize the benefits of this type of resource is an important issue which is discussed from different points of view today. In this paper, a new multi-objective optimal location and sizing of distributed generation resources is performed to maximize its benefits on the 33 bus distribution test network considering reliability and using a new Antlion Optimizer (ALO. The benefits for DG are considered as system losses reduction, system reliability improvement and benefits from the sale electricity and voltage profile improvement. For each of the mentioned benefits, the ALO algorithm is used to optimize the location and sizing of distributed generation resources. In order to verify the proposed approach, the obtained results have been analyzed and compared with the results of particle swarm optimization (PSO algorithm. The results show that the ALO has shown better performance in optimization problem solution versus PSO.

A new method for the assessment of patient safety competencies during a medical school clerkship using an objective structured clinical examination

Directory of Open Access Journals (Sweden)

Renata Mahfuz Daud-Gallotti

2011-01-01

Full Text Available INTRODUCTION: Patient safety is seldom assessed using objective evaluations during undergraduate medical education. OBJECTIVE: To evaluate the performance of fifth-year medical students using an objective structured clinical examination focused on patient safety after implementation of an interactive program based on adverse events recognition and disclosure. METHODS: In 2007, a patient safety program was implemented in the internal medicine clerkship of our hospital. The program focused on human error theory, epidemiology of incidents, adverse events, and disclosure. Upon completion of the program, students completed an objective structured clinical examination with five stations and standardized patients. One station focused on patient safety issues, including medical error recognition/disclosure, the patient-physician relationship and humanism issues. A standardized checklist was completed by each standardized patient to assess the performance of each student. The student's global performance at each station and performance in the domains of medical error, the patient-physician relationship and humanism were determined. The correlations between the student performances in these three domains were calculated. RESULTS: A total of 95 students participated in the objective structured clinical examination. The mean global score at the patient safety station was 87.59 ± 1.24 points. Students' performance in the medical error domain was significantly lower than their performance on patient-physician relationship and humanistic issues. Less than 60% of students (n = 54 offered the simulated patient an apology after a medical error occurred. A significant correlation was found between scores obtained in the medical error domains and scores related to both the patient-physician relationship and humanistic domains. CONCLUSIONS: An objective structured clinical examination is a useful tool to evaluate patient safety competencies during the medical

High performance distributed objects in large hadron collider experiments

International Nuclear Information System (INIS)

Gutleber, J.

1999-11-01

This dissertation demonstrates how object-oriented technology can support the development of software that has to meet the requirements of high performance distributed data acquisition systems. The environment for this work is a system under planning for the Compact Muon Solenoid experiment at CERN that shall start its operation in the year 2005. The long operational phase of the experiment together with a tight and puzzling interaction with custom devices make the quest for an evolvable architecture that exhibits a high level of abstraction the driving issue. The question arises if an existing approach already fits our needs. The presented work casts light on these problems and as a result comprises the following novel contributions: - Application of object technology at hardware/software boundary. Software components at this level must be characterised by high efficiency and extensibility at the same time. - Identification of limitations when deploying commercial-off-the-shelf middleware for distributed object-oriented computing. - Capturing of software component properties in an efficiency model for ease of comparison and improvement. - Proof of feasibility that the encountered deficiencies in middleware can be avoided and that with the use of software components the imposed requirements can be met. - Design and implementation of an on-line software control system that allows to take into account the ever evolving requirements by avoiding hardwired policies. We conclude that state-of-the-art middleware cannot meet the required efficiency of the planned data acquisition system. Although new tool generations already provide a certain degree of configurability, the obligation to follow standards specifications does not allow the necessary optimisations. We identified the major limiting factors and argue that a custom solution following a component model with narrow interfaces can satisfy our requirements. This approach has been adopted for the current design

Architecture of distributed picture archiving and communication systems for storing and processing high resolution medical images

Science.gov (United States)

Tokareva, Victoria

2018-04-01

New generation medicine demands a better quality of analysis increasing the amount of data collected during checkups, and simultaneously decreasing the invasiveness of a procedure. Thus it becomes urgent not only to develop advanced modern hardware, but also to implement special software infrastructure for using it in everyday clinical practice, so-called Picture Archiving and Communication Systems (PACS). Developing distributed PACS is a challenging task for nowadays medical informatics. The paper discusses the architecture of distributed PACS server for processing large high-quality medical images, with respect to technical specifications of modern medical imaging hardware, as well as international standards in medical imaging software. The MapReduce paradigm is proposed for image reconstruction by server, and the details of utilizing the Hadoop framework for this task are being discussed in order to provide the design of distributed PACS as ergonomic and adapted to the needs of end users as possible.

The "Profiles" document: a modern revision of the objectives of undergraduate medical studies in Switzerland.

Science.gov (United States)

Michaud, Pierre-André; Jucker-Kupper, Patrick; The Profiles Working Group

2016-01-01

The Joint Commission of the Swiss Medical Schools (SMIFK/CIMS) decided in 2000 to establish a Swiss Catalogue of Learning Objectives (SCLO) for undergraduate medical training, which was adapted from a similar Dutch blueprint. A second version of the SCLO was developed and launched in 2008. The catalogue is a prerequisite for the accreditation of the curricula of the six Swiss medical faculties and defines the contents of the Federal Licensing Examination (FLE). Given the evolution of the field of medicine and of medical education, the SMIFK/CIMS has decided to embark on a total revision of the SCLO. This article presents the proposed structure and content of Profiles, a new document which, in the future, will direct the format of undergraduate studies and of the FLE. Profiles stands for the Principal Relevant Objectives for Integrative Learning and Education in Switzerland. It is currently being developed by a group of experts from the six Swiss faculties as well as representatives of other institutions involved in these developments. The foundations of Profiles are grounded in the evolution of medical practice and of public health and are based on up-to-date teaching concepts, such as EPAs (entrustable professional activities). An introduction will cover the concepts and a tutorial will be displayed. Three main chapters will provide a description of the seven 2015 CanMEDS roles, a list of core EPAs and a series of ≈250 situations embracing the most frequent and current conditions affecting health. As Profiles is still a work in progress, it is hoped that this paper will attract the interest of all individuals involved in the training of medical students.

The use of software agents and distributed objects to integrate enterprises: Compatible or competing technologies?

Energy Technology Data Exchange (ETDEWEB)

Pancerella, C.M.

1998-04-01

Distributed object and software agent technologies are two integration methods for connecting enterprises. The two technologies have overlapping goals--interoperability and architectural support for integrating software components--though to date little or no integration of the two technologies has been made at the enterprise level. The primary difference between these two technologies is that distributed object technologies focus on the problems inherent in connecting distributed heterogeneous systems whereas software agent technologies focus on the problems involved with coordination and knowledge exchange across domain boundaries. This paper addresses the integration of these technologies in support of enterprise integration across organizational and geographic boundaries. The authors discuss enterprise integration issues, review their experiences with both technologies, and make recommendations for future work. Neither technology is a panacea. Good software engineering techniques must be applied to integrate an enterprise because scalability and a distributed software development team are realities.

Architecture of distributed picture archiving and communication systems for storing and processing high resolution medical images

Directory of Open Access Journals (Sweden)

Tokareva Victoria

2018-01-01

Full Text Available New generation medicine demands a better quality of analysis increasing the amount of data collected during checkups, and simultaneously decreasing the invasiveness of a procedure. Thus it becomes urgent not only to develop advanced modern hardware, but also to implement special software infrastructure for using it in everyday clinical practice, so-called Picture Archiving and Communication Systems (PACS. Developing distributed PACS is a challenging task for nowadays medical informatics. The paper discusses the architecture of distributed PACS server for processing large high-quality medical images, with respect to technical specifications of modern medical imaging hardware, as well as international standards in medical imaging software. The MapReduce paradigm is proposed for image reconstruction by server, and the details of utilizing the Hadoop framework for this task are being discussed in order to provide the design of distributed PACS as ergonomic and adapted to the needs of end users as possible.

Distributed dendritic processing facilitates object detection: a computational analysis on the visual system of the fly.

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Hennig, Patrick; Möller, Ralf; Egelhaaf, Martin

2008-08-28

Detecting objects is an important task when moving through a natural environment. Flies, for example, may land on salient objects or may avoid collisions with them. The neuronal ensemble of Figure Detection cells (FD-cells) in the visual system of the fly is likely to be involved in controlling these behaviours, as these cells are more sensitive to objects than to extended background structures. Until now the computations in the presynaptic neuronal network of FD-cells and, in particular, the functional significance of the experimentally established distributed dendritic processing of excitatory and inhibitory inputs is not understood. We use model simulations to analyse the neuronal computations responsible for the preference of FD-cells for small objects. We employed a new modelling approach which allowed us to account for the spatial spread of electrical signals in the dendrites while avoiding detailed compartmental modelling. The models are based on available physiological and anatomical data. Three models were tested each implementing an inhibitory neural circuit, but differing by the spatial arrangement of the inhibitory interaction. Parameter optimisation with an evolutionary algorithm revealed that only distributed dendritic processing satisfies the constraints arising from electrophysiological experiments. In contrast to a direct dendro-dendritic inhibition of the FD-cell (Direct Distributed Inhibition model), an inhibition of its presynaptic retinotopic elements (Indirect Distributed Inhibition model) requires smaller changes in input resistance in the inhibited neurons during visual stimulation. Distributed dendritic inhibition of retinotopic elements as implemented in our Indirect Distributed Inhibition model is the most plausible wiring scheme for the neuronal circuit of FD-cells. This microcircuit is computationally similar to lateral inhibition between the retinotopic elements. Hence, distributed inhibition might be an alternative explanation of

Medical students' perception of objective structured clinical examination: a feedback for process improvement.

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Nasir, Abdulrasheed A; Yusuf, Ayodeji S; Abdur-Rahman, Lukman O; Babalola, Olasunkanmi M; Adeyeye, Ademola A; Popoola, Ademola A; Adeniran, James O

2014-01-01

Medical educators have always been desirous of the best methods for formative and summative evaluation of trainees. The Objective Structured Clinical Examination (OSCE) is an approach for student assessment in which aspects of clinical competence are evaluated in a comprehensive, consistent, and structured manner with close attention to the objectivity of the process. Though popular in most medical schools globally, its use in Nigeria medical schools appears limited. This study was conceived to explore students' perception about the acceptability of OSCE process and to provide feedback to be used to improve the assessment technique. A cross-sectional survey was conducted on final-year medical students, who participated in the final MBBS surgery examination in June 2011. A 19-item self-administered structured questionnaire was employed to obtain relevant data on demographics of respondents and questions evaluating the OSCE stations in terms of the quality of instructions and organization, learning opportunities, authenticity and transparency of the process, and usefulness of the OSCE as an assessment instrument compared with other formats. Students' responses were based on a 5-point Likert scales ranging from strongly disagree to strongly agree. The data were analyzed using SPSS, version 15 (SPSS, Inc, Chicago, IL). The study took place at the University of Ilorin, College of Health Science. A total of 187 final-year medical students were enrolled in to the survey. Of 187 eligible students, 151 completed the self-administered questionnaire representing 80.7% response rate. A total of 61 (40.4%) students felt that it was easy to understand written instructions at the OSCE stations. In total, 106 (70.2%) students felt that the time allocated to each station was adequate. A total of 89 (58.9%) students agreed that the OSCE accurately measured their knowledge and skill, and 85 (56.3%) reported that OSCE enhanced their communication skill. Of the respondents, 80 (53

Magnetoacoustic microscopic imaging of conductive objects and nanoparticles distribution

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Liu, Siyu; Zhang, Ruochong; Luo, Yunqi; Zheng, Yuanjin

2017-09-01

Magnetoacoustic tomography has been demonstrated as a powerful and low-cost multi-wave imaging modality. However, due to limited spatial resolution and detection efficiency of magnetoacoustic signal, full potential of the magnetoacoustic imaging remains to be tapped. Here we report a high-resolution magnetoacoustic microscopy method, where magnetic stimulation is provided by a compact solenoid resonance coil connected with a matching network, and acoustic reception is realized by using a high-frequency focused ultrasound transducer. Scanning the magnetoacoustic microscopy system perpendicularly to the acoustic axis of the focused transducer would generate a two-dimensional microscopic image with acoustically determined lateral resolution. It is analyzed theoretically and demonstrated experimentally that magnetoacoustic generation in this microscopic system depends on the conductivity profile of conductive objects and localized distribution of superparamagnetic iron magnetic nanoparticles, based on two different but related implementations. The lateral resolution is characterized. Directional nature of magnetoacoustic vibration and imaging sensitivity for mapping magnetic nanoparticles are also discussed. The proposed microscopy system offers a high-resolution method that could potentially map intrinsic conductivity distribution in biological tissue and extraneous magnetic nanoparticles.

Student-Led Objective Tutorial (SLOT) in Medical Education.

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Sivagnanam, Gurusamy; Saraswathi, Simansalam; Rajasekaran, Aiyalu

2006-12-01

Purpose - To assess an innovative tutoring program named 'Student-Led Objective Tutorial' (SLOT) among undergraduate medical students. Method - The program was conceptualized by the Pharmacology Unit of Faculty of Medicine and Health Sciences, Asian Institute of Medicine Science & Technology (AIMST), Malaysia and implemented in the middle of 2005. A cohort of 246 medical undergraduate students (spread across 5 consecutive batches) participated. Following a brief explanation on the purpose and nature of SLOT, each batch was divided into small groups and was given a reading assignment on 4 previously delivered lecture topics. Each group was asked to prepare 3-5 multiple choice questions (MCQs) of their own in PowerPoint format to be presented, in turns, to the whole class on the day of SLOT. The proceedings were facilitated by 2 lecturers. Student feedback on the efficacy and benefits were assessed through an anonymous self administered questionnaire. Results - About 76% (188) of the students favored SLOT. The acceptance rate of SLOT was higher among males. There was no significant difference between batches in their opinions on whether to pursue SLOT in future. The most prevalent positive comment was that SLOT enhanced learning skills, and the negative comment being, it consumed more time. Conclusions - SLOT is a novel tutorial method which can offset faculty shortage with advantages like enhanced interest among teachers and learners, uniform reach of content, opportunities for group learning, and involvement of visual aids as teaching-learning (T-L) method. SLOT unraveled the students' potential of peer tutoring both inside as well as outside the classroom. Consumer tutors (students) can be tapped as a resource for SLOT for all subjects and courses in healthcare teaching.

Dependency of energy and spatial distributions of photons on edge of object in brain SPECT

CERN Document Server

Deloar, H M; Kudomi, N; Kim, K M; Aoi, T; Iida, H

2003-01-01

Accurate mu maps are important for quantitative image reconstruction in SPECT. The Compton scatter energy window (CSW) technique has been proposed to define the outline of objects. In this technique, a lower energy window image is acquired in addition to the main photo-peak energy window. The image of the lower energy window is used to estimate the edge of the scanned object to produce a constant attenuation map. The aim of this study was to investigate the dependency of CSW on the spatial and energy distribution of radioisotope to predict the edges of objects. Two particular cases of brain study were considered, namely uniform distribution and non-uniform distribution using Monte Carlo simulation and experiments with uniform cylindrical phantom and hotspot phantom. The phantoms were filled with water and a radioactive solution of sup 9 sup 9 sup m Tc. For each phantom, 20%, 30%, 40% and 50% thresholds of the mean profile were applied to estimate E sub w sub t , the energy window for minimum difference betwee...

Medication errors in residential aged care facilities: a distributed cognition analysis of the information exchange process.

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Tariq, Amina; Georgiou, Andrew; Westbrook, Johanna

2013-05-01

Medication safety is a pressing concern for residential aged care facilities (RACFs). Retrospective studies in RACF settings identify inadequate communication between RACFs, doctors, hospitals and community pharmacies as the major cause of medication errors. Existing literature offers limited insight about the gaps in the existing information exchange process that may lead to medication errors. The aim of this research was to explicate the cognitive distribution that underlies RACF medication ordering and delivery to identify gaps in medication-related information exchange which lead to medication errors in RACFs. The study was undertaken in three RACFs in Sydney, Australia. Data were generated through ethnographic field work over a period of five months (May-September 2011). Triangulated analysis of data primarily focused on examining the transformation and exchange of information between different media across the process. The findings of this study highlight the extensive scope and intense nature of information exchange in RACF medication ordering and delivery. Rather than attributing error to individual care providers, the explication of distributed cognition processes enabled the identification of gaps in three information exchange dimensions which potentially contribute to the occurrence of medication errors namely: (1) design of medication charts which complicates order processing and record keeping (2) lack of coordination mechanisms between participants which results in misalignment of local practices (3) reliance on restricted communication bandwidth channels mainly telephone and fax which complicates the information processing requirements. The study demonstrates how the identification of these gaps enhances understanding of medication errors in RACFs. Application of the theoretical lens of distributed cognition can assist in enhancing our understanding of medication errors in RACFs through identification of gaps in information exchange. Understanding

[Distribution of the duration of nonoccupational sick leave by medical diagnosis (Catalonia, Spain, 2006-2008)].

Science.gov (United States)

Delclós, Jordi; Gimeno, David; Torá, Isabel; Martínez, José Miguel; Manzanera, Rafael; Jardí, Josefina; Alberti, Constança; G Benavides, Fernando

2013-01-01

We present a simple and practical tool that allows the usual distribution of the duration of non-occupational sick leave to be determined by medical diagnosis. A total of 2,646,352 episodes of medically certified sick leave, registered by the Catalan Institute of Medical Evaluations for the period 2006-2008, were followed to closure and were entered into a spreadsheet. Given its asymmetric distribution, the median duration of sick leave was 9 days. Musculoskeletal disorders were the most frequent diagnostic group (22.5%), while neoplasms had the longest median duration (56 days). The most common specific diagnoses were diarrhea-gastroenteritis (8.2%; median: 3 days) and acute rhinopharyngitis (5.2%; median: 4 days). The distribution of the duration of sick leave in a population varies by diagnosis and is asymmetric, with most episodes being much shorter than the mean duration. This finding is important for better clinical and administrative management of sick leave episodes. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

Developing a Mass Casualty Surge Capacity Protocol for Emergency Medical Services to Use for Patient Distribution.

Science.gov (United States)

Shartar, Samuel E; Moore, Brooks L; Wood, Lori M

2017-12-01

Metropolitan areas must be prepared to manage large numbers of casualties related to a major incident. Most US cities do not have adequate trauma center capacity to manage large-scale mass casualty incidents (MCIs). Creating surge capacity requires the distribution of casualties to hospitals that are not designated as trauma centers. Our objectives were to extrapolate MCI response research into operational objectives for MCI distribution plan development; formulate a patient distribution model based on research, hospital capacities, and resource availability; and design and disseminate a casualty distribution tool for use by emergency medical services (EMS) personnel to distribute patients to the appropriate level of care. Working with hospitals within the region, we refined emergency department surge capacity for MCIs and developed a prepopulated tool for EMS providers to use to distribute higher-acuity casualties to trauma centers and lower-acuity casualties to nontrauma hospitals. A mechanism to remove a hospital from the list of available resources, if it is overwhelmed with patients who self-transport to the location, also was put into place. The number of critically injured survivors from an MCI has proven to be consistent, averaging 7% to 10%. Moving critically injured patients to level 1 trauma centers can result in a 25% reduction in mortality, when compared with care at nontrauma hospitals. US cities face major gaps in the surge capacity needed to manage an MCI. Sixty percent of "walking wounded" casualties self-transport to the closest hospital(s) to the incident. Directing critically ill patients to designated trauma centers has the potential to reduce mortality associated with the event. When applied to MCI responses, damage-control principles reduce resource utilization and optimize surge capacity. A universal system for mass casualty triage was identified and incorporated into the region's EMS. Flagship regional coordinating hospitals were designated

Multi-objective optimization design of air distribution of grate cooler by entropy generation minimization and genetic algorithm

International Nuclear Information System (INIS)

Shao, Wei; Cui, Zheng; Cheng, Lin

2016-01-01

Highlights: • A multi-objective optimization model of air distribution of grate cooler by genetic algorithm is proposed. • Pareto Front is obtained and validated by comparing with operating data. • Optimal schemes are compared and selected by engineering background. • Total power consumption after optimization decreases 61.10%. • Thickness of clinker on three grate plates is thinner. - Abstract: The cooling air distributions of grate cooler exercise a great influence on the clinker cooling efficiency and power consumption of cooling fans. A multi-objective optimization model of air distributions of grate cooler with cross-flow heat exchanger analogy is proposed in this paper. Firstly, thermodynamic and flow models of clinker cooling process is carried out. Then based on entropy generation minimization analysis, modified entropy generation numbers caused by heat transfer and pressure drop are chosen as objective functions respectively which optimized by genetic algorithm. The design variables are superficial velocities of air chambers and thicknesses of clinker layers on different grate plates. A set of Pareto optimal solutions which two objectives are optimized simultaneously is achieved. Scattered distributions of design variables resulting in the conflict between two objectives are brought out. The final optimal air distribution and thicknesses of clinker layers are selected from the Pareto optimal solutions based on power consumption of cooling fans minimization and validated by measurements. Compared with actual operating scheme, the total air volumes of optimized schemes decrease 2.4%, total power consumption of cooling fans decreases 61.1% and the outlet temperature of clinker decreases 122.9 °C which shows a remarkable energy-saving effect on energy consumption.

Locating distribution/service centers based on multi objective decision making using set covering and proximity to stock market

Directory of Open Access Journals (Sweden)

Mazyar Dabibi

2016-09-01

Full Text Available In the present competitive world, facility location is an important aspect of the supply chain (sc optimization. It involves selecting specific locations for facility construction and allocation of the distribution channel among different SC levels. In fact, it is a strategic issue which directly affects many operational/tactical decisions. Besides the accessibility, which results in customer satisfaction, the present paper optimizes the establishment costs of a number of distribution channels by considering their proximity to the stock market of the goods they distribute, and proposes mathematical models for two objective functions using the set covering problem. Then, two objective functions are proposed into one through the ε-constraint method and solved by the metaheuristic Genetic Algorithm (GA. To test the resulted model, a smaller scale problem is solved. Results from running the algorithm with different ε-values show that, on average, a 10% increase in ε, which increases the value of the second objective function - distance covered by customers will cause a 2% decrease in the value of the first objective function including the costs of establishing distribution centers. The repeatability and solution convergence of the two-objective model presented by the GA are other results obtained in this study.

It is time to improve the quality of medical information distributed to students across social media.

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Zucker, Benjamin E; Kontovounisios, Christos

2018-01-01

The ubiquitous nature of social media has meant that its effects on fields outside of social communication have begun to be felt. The generation undergoing medical education are of the generation referred to as "digital natives", and as such routinely incorporate social media into their education. Social media's incorporation into medical education includes its use as a platform to distribute information to the public ("distributive education") and as a platform to provide information to a specific audience ("push education"). These functions have proved beneficial in many regards, such as enabling constant access to the subject matter, other learners, and educators. However, the usefulness of using social media as part of medical education is limited by the vast quantities of poor quality information and the time required to find information of sufficient quality and relevance, a problem confounded by many student's preoccupation with "efficient" learning. In this Perspective, the authors discuss whether social media has proved useful as a tool for medical education. The current growth in the use of social media as a tool for medical education seems to be principally supported by students' desire for efficient learning rather than by the efficacy of social media as a resource for medical education. Therefore, improvements in the quality of information required to maximize the impact of social media as a tool for medical education are required. Suggested improvements include an increase in the amount of educational content distributed on social media produced by academic institutions, such as universities and journals.

TK3 eBook software to author, distribute, and use electronic course content for medical education.

Science.gov (United States)

Morton, David A; Foreman, K Bo; Goede, Patricia A; Bezzant, John L; Albertine, Kurt H

2007-03-01

The methods for authoring and distributing course content are undergoing substantial changes due to advancement in computer technology. Paper has been the traditional method to author and distribute course content. Paper enables students to personalize content through highlighting and note taking but does not enable the incorporation of multimedia elements. Computers enable multimedia content but lack the capability of the user to personalize the content. Therefore, we investigated TK3 eBooks as a potential solution to incorporate the benefits of both paper and computer technology. The objective of our study was to assess the utility of TK3 eBooks in the context of authoring and distributing dermatology course content for use by second-year medical students at the University of Utah School of Medicine during the spring of 2004. We incorporated all dermatology course content into TK3 eBook format. TK3 eBooks enable students to personalize information through tools such as "notebook," "hiliter," "stickies," mark pages, and keyword search. Students were given the course content in both paper and eBook formats. At the conclusion of the dermatology course, students completed a questionnaire designed to evaluate the effectiveness of the eBooks compared with paper. Students perceived eBooks as an effective way to distribute course content and as a study tool. However, students preferred paper over eBooks to take notes during lecture. In conclusion, the present study demonstrated that eBooks provide a convenient method for authoring, distributing, and using course content but that students preferred paper to take notes during lecture.

Automatic transfer function design for medical visualization using visibility distributions and projective color mapping.

Science.gov (United States)

Cai, Lile; Tay, Wei-Liang; Nguyen, Binh P; Chui, Chee-Kong; Ong, Sim-Heng

2013-01-01

Transfer functions play a key role in volume rendering of medical data, but transfer function manipulation is unintuitive and can be time-consuming; achieving an optimal visualization of patient anatomy or pathology is difficult. To overcome this problem, we present a system for automatic transfer function design based on visibility distribution and projective color mapping. Instead of assigning opacity directly based on voxel intensity and gradient magnitude, the opacity transfer function is automatically derived by matching the observed visibility distribution to a target visibility distribution. An automatic color assignment scheme based on projective mapping is proposed to assign colors that allow for the visual discrimination of different structures, while also reflecting the degree of similarity between them. When our method was tested on several medical volumetric datasets, the key structures within the volume were clearly visualized with minimal user intervention. Copyright © 2013 Elsevier Ltd. All rights reserved.

Multi-objective analysis of impacts of distributed generation placement on the operational characteristics of networks for distribution system planning

Energy Technology Data Exchange (ETDEWEB)

Barin, Alexandre; Pozzatti, Luis F.; Canha, Luciane N.; Abaide, Alzenira R. [Federal University of Santa Maria - UFSM, Post-graduation Program of Electric Engineering - PPGEE, Center of Studies of Energy and Environment - CEEMA, Santa Maria, RS (Brazil); Machado, Ricardo Q. [University of Sao Paulo - USP, Sao Carlos, SP (Brazil); Arend, Gustavo [State Electric Energy Company - CEEE-D, Division of Distribution, Porto Alegre, RS (Brazil)

2010-12-15

Recent advances in energy technology generation and new directions in electricity regulation have made distributed generation (DG) more widespread, with consequent significant impacts on the operational characteristics of distribution networks. For this reason, new methods for identifying such impacts are needed, together with research and development of new tools and resources to maintain and facilitate continued expansion towards DG. This paper presents a study aimed at determining appropriate DG sites for distribution systems. The main considerations which determine DG sites are also presented, together with an account of the advantages gained from correct DG placement. The paper intends to define some quantitative and qualitative parameters evaluated by Digsilent registered, GARP3 registered and DSA-GD software. A multi-objective approach based on the Bellman-Zadeh algorithm and fuzzy logic is used to determine appropriate DG sites. The study also aims to find acceptable DG locations both for distribution system feeders, as well as for nodes inside a given feeder. (author)

A risk-based multi-objective model for optimal placement of sensors in water distribution system

Science.gov (United States)

Naserizade, Sareh S.; Nikoo, Mohammad Reza; Montaseri, Hossein

2018-02-01

In this study, a new stochastic model based on Conditional Value at Risk (CVaR) and multi-objective optimization methods is developed for optimal placement of sensors in water distribution system (WDS). This model determines minimization of risk which is caused by simultaneous multi-point contamination injection in WDS using CVaR approach. The CVaR considers uncertainties of contamination injection in the form of probability distribution function and calculates low-probability extreme events. In this approach, extreme losses occur at tail of the losses distribution function. Four-objective optimization model based on NSGA-II algorithm is developed to minimize losses of contamination injection (through CVaR of affected population and detection time) and also minimize the two other main criteria of optimal placement of sensors including probability of undetected events and cost. Finally, to determine the best solution, Preference Ranking Organization METHod for Enrichment Evaluation (PROMETHEE), as a subgroup of Multi Criteria Decision Making (MCDM) approach, is utilized to rank the alternatives on the trade-off curve among objective functions. Also, sensitivity analysis is done to investigate the importance of each criterion on PROMETHEE results considering three relative weighting scenarios. The effectiveness of the proposed methodology is examined through applying it to Lamerd WDS in the southwestern part of Iran. The PROMETHEE suggests 6 sensors with suitable distribution that approximately cover all regions of WDS. Optimal values related to CVaR of affected population and detection time as well as probability of undetected events for the best optimal solution are equal to 17,055 persons, 31 mins and 0.045%, respectively. The obtained results of the proposed methodology in Lamerd WDS show applicability of CVaR-based multi-objective simulation-optimization model for incorporating the main uncertainties of contamination injection in order to evaluate extreme value

Medical ethics as output of economically motivated industrial objectives

International Nuclear Information System (INIS)

Bode, U.H.; Geisler, E.P.

2002-01-01

Ethics and economics are not mutually exclusive, but rather related concepts that help the human rate in dealing with scarce resources. Safeguarding the resources employed and making a profit are general industrial objectives. Product-specific objectives, such as optimizing medicinal safety and creating benefits for the individual and society, are discussed. Healing disease, improving quality of life and prolonging length of life are very important considerations. The contributions of the pharmaceutical industry in fulfilling ethically based demands will be primarily treated as the careful use of resources (e.g. by renunciation of state support). Other ethical contributions are the early communication of research results for intersectoral use and a voluntary code of conduct to regulate the actions of pharmaceutical companies with regard to information and advertising. In the Third World pharmaceutical industry is mainly faced to potential waste of valuable medicines, due to insufficient infrastructure of logistics and distribution capacities in one region, given a shortage of these very medicines in other and better structured regions. The value of medicines is defined by a comparison of competing therapies (difference in consumption of resources). Possible ethical deficiencies arising from a lack of direct contact of the patient with industry and the quasi-penalization of patients because of faulty lifestyle are briefly discussed. (author)

Development of Geriatric Mental Health Learning Objectives for Medical Students: A Response to the Institute of Medicine 2012 Report.

Science.gov (United States)

Lehmann, Susan W; Brooks, William B; Popeo, Dennis; Wilkins, Kirsten M; Blazek, Mary C

2017-10-01

America is aging as the population of older adults increases. The shortage of geriatric mental health specialists means that most geriatric mental healthcare will be provided by physicians who do not have specialty training in geriatrics. The Institute of Medicine Report of 2012 highlighted the urgent need for development of national competencies and curricula in geriatric mental health for all clinicians. Virtually all physicians can expect to treat older patients with mental health symptoms, yet currently there are no widely accepted learning objectives in geriatric mental health specific for medical students. The authors describe the development of a set of such learning objectives that all medical students should achieve by graduation. The iterative process included initial drafting by content experts from five medical schools with input and feedback from a wider group of geriatric psychiatrists, geriatricians, internists, and medical educators. The final document builds upon previously published work and includes specific knowledge, attitudes and skills in six key domains: Normal Aging, Mental Health Assessment of the Geriatric Patient, Psychopharmacology, Delirium, Depression, and Dementia. These objectives address a pressing need, providing a framework for national standards and curriculum development. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

An Efficacious Multi-Objective Fuzzy Linear Programming Approach for Optimal Power Flow Considering Distributed Generation.

Science.gov (United States)

Warid, Warid; Hizam, Hashim; Mariun, Norman; Abdul-Wahab, Noor Izzri

2016-01-01

This paper proposes a new formulation for the multi-objective optimal power flow (MOOPF) problem for meshed power networks considering distributed generation. An efficacious multi-objective fuzzy linear programming optimization (MFLP) algorithm is proposed to solve the aforementioned problem with and without considering the distributed generation (DG) effect. A variant combination of objectives is considered for simultaneous optimization, including power loss, voltage stability, and shunt capacitors MVAR reserve. Fuzzy membership functions for these objectives are designed with extreme targets, whereas the inequality constraints are treated as hard constraints. The multi-objective fuzzy optimal power flow (OPF) formulation was converted into a crisp OPF in a successive linear programming (SLP) framework and solved using an efficient interior point method (IPM). To test the efficacy of the proposed approach, simulations are performed on the IEEE 30-busand IEEE 118-bus test systems. The MFLP optimization is solved for several optimization cases. The obtained results are compared with those presented in the literature. A unique solution with a high satisfaction for the assigned targets is gained. Results demonstrate the effectiveness of the proposed MFLP technique in terms of solution optimality and rapid convergence. Moreover, the results indicate that using the optimal DG location with the MFLP algorithm provides the solution with the highest quality.

Volumetric Medical Image Coding: An Object-based, Lossy-to-lossless and Fully Scalable Approach

Science.gov (United States)

Danyali, Habibiollah; Mertins, Alfred

2011-01-01

In this article, an object-based, highly scalable, lossy-to-lossless 3D wavelet coding approach for volumetric medical image data (e.g., magnetic resonance (MR) and computed tomography (CT)) is proposed. The new method, called 3DOBHS-SPIHT, is based on the well-known set partitioning in the hierarchical trees (SPIHT) algorithm and supports both quality and resolution scalability. The 3D input data is grouped into groups of slices (GOS) and each GOS is encoded and decoded as a separate unit. The symmetric tree definition of the original 3DSPIHT is improved by introducing a new asymmetric tree structure. While preserving the compression efficiency, the new tree structure allows for a small size of each GOS, which not only reduces memory consumption during the encoding and decoding processes, but also facilitates more efficient random access to certain segments of slices. To achieve more compression efficiency, the algorithm only encodes the main object of interest in each 3D data set, which can have any arbitrary shape, and ignores the unnecessary background. The experimental results on some MR data sets show the good performance of the 3DOBHS-SPIHT algorithm for multi-resolution lossy-to-lossless coding. The compression efficiency, full scalability, and object-based features of the proposed approach, beside its lossy-to-lossless coding support, make it a very attractive candidate for volumetric medical image information archiving and transmission applications. PMID:22606653

Distributed deep learning networks among institutions for medical imaging.

Science.gov (United States)

Chang, Ken; Balachandar, Niranjan; Lam, Carson; Yi, Darvin; Brown, James; Beers, Andrew; Rosen, Bruce; Rubin, Daniel L; Kalpathy-Cramer, Jayashree

2018-03-29

Deep learning has become a promising approach for automated support for clinical diagnosis. When medical data samples are limited, collaboration among multiple institutions is necessary to achieve high algorithm performance. However, sharing patient data often has limitations due to technical, legal, or ethical concerns. In this study, we propose methods of distributing deep learning models as an attractive alternative to sharing patient data. We simulate the distribution of deep learning models across 4 institutions using various training heuristics and compare the results with a deep learning model trained on centrally hosted patient data. The training heuristics investigated include ensembling single institution models, single weight transfer, and cyclical weight transfer. We evaluated these approaches for image classification in 3 independent image collections (retinal fundus photos, mammography, and ImageNet). We find that cyclical weight transfer resulted in a performance that was comparable to that of centrally hosted patient data. We also found that there is an improvement in the performance of cyclical weight transfer heuristic with a high frequency of weight transfer. We show that distributing deep learning models is an effective alternative to sharing patient data. This finding has implications for any collaborative deep learning study.

Technology of solving multi-objective problems of control of systems with distributed parameters

Science.gov (United States)

Rapoport, E. Ya.; Pleshivtseva, Yu. E.

2017-07-01

A constructive technology of multi-objective optimization of control of distributed parameter plants is proposed. The technology is based on a single-criterion version in the form of the minimax convolution of normalized performance criteria. The approach under development is based on the transition to an equivalent form of the variational problem with constraints, with the problem solution being a priori Pareto-effective. Further procedures of preliminary parameterization of control actions and subsequent reduction to a special problem of semi-infinite programming make it possible to find the sought extremals with the use of their Chebyshev properties and fundamental laws of the subject domain. An example of multi-objective optimization of operation modes of an engineering thermophysics object is presented, which is of independent interest.

Adding Live-Streaming to Recorded Lectures in a Non-Distributed Pre-Clerkship Medical Education Model.

Science.gov (United States)

Sandhu, Amanjot; Fliker, Aviva; Leitao, Darren; Jones, Jodi; Gooi, Adrian

2017-01-01

Live-streaming video has had increasing uses in medical education, especially in distributed education models. The literature on the impact of live-streaming in non-distributed education models, however, is scarce. To determine the attitudes towards live-streaming and recorded lectures as a resource to pre-clerkship medical students in a non-distributed medical education model. First and second year medical students were sent a voluntary cross-sectional survey by email, and were asked questions on live-streaming, recorded lectures and in person lectures using a 5-point Likert and open answers. Of the 118 responses (54% response rate), the data suggested that both watching recorded lectures (Likert 4.55) and live-streaming lectures (4.09) were perceived to be more educationally valuable than face-to-face attendance of lectures (3.60). While responses indicated a statistically significant increase in anticipated classroom attendance if both live-streaming and recorded lectures were removed (from 63% attendance to 76%, p =0.002), there was no significant difference in attendance if live-streaming lectures were removed but recorded lectures were maintained (from 63% to 66%, p=0.76). The addition of live-streaming lectures in the pre-clerkship setting was perceived to be value added to the students. The data also suggests that the removal of live-streaming lectures would not lead to a statistically significant increase in classroom attendance by pre-clerkship students.

Maximizing hosting capacity of renewable energy sources in distribution networks: A multi-objective and scenario-based approach

International Nuclear Information System (INIS)

Rabiee, Abbas; Mohseni-Bonab, Seyed Masoud

2017-01-01

Due to the development of renewable energy sources (RESs), maximization of hosting capacity (HC) of RESs has gained significant interest in the existing and future power systems. HC maximization should be performed considering various technical constraints like power flow equations, limits on the distribution feeders' voltages and currents, as well as economic constraints such as the cost of energy procurement from the upstream network and power generation by RESs. RESs are volatile and uncertain in nature. Thus, it is necessary to handle their inherent uncertainties in the HC maximization problem. Wind power is now the fastest growing RESs around the world. Hence, in this paper a stochastic multi-objective optimization model is proposed to maximize the distribution network's HC for wind power and minimize the energy procurement costs in a wind integrated power system. The following objective functions are considered: 1) Cost of the purchased energy from upstream network (to be minimized) and 2) Operation and maintenance cost of wind farms. The proposed model is examined on a standard radial 69 bus distribution feeder and a practical 152 bus distribution system. The numerical results substantiate that the proposed model is an effective tool for distribution network operators (DNOs) to consider both technical and economic aspects of distribution network's HC for RESs. - Highlights: • Hosting capacity of wind power is improved in distribution feeders. • A stochastic multi-objective optimization model is proposed. • Wind power and load uncertainties are modeled by scenario based approach. • Purchased energy cost from upstream network and O&M cost of wind farms are used.

COORDINATED LOCATION, DISTRIBUTION AND INVENTORY DECISIONS IN SUPPLY CHAIN NETWORK DESIGN: A MULTI-OBJECTIVE APPROACH

Directory of Open Access Journals (Sweden)

G. Reza Nasiri

2012-01-01

Full Text Available

ENGLISH ABSTRACT: This research presents an integrated multi-objective distribution model for use in simultaneous strategic and operational food supply chain (SC planning. The proposed method is adopted to allow use of a performance measurement system that includes conflicting objectives such as distribution costs, customer service level (safety stock holding, resource utilisation, and the total delivery time, with reference to multiple warehouse capacities and uncertain forecast demands. To deal with these objectives and enable the decision makers (DMs to evaluate a greater number of alternative solutions, three different approaches are implemented in the proposed solution procedure. A detailed case study derived from food industrial data is used to illustrate the preference of the proposed approach. The proposed method yields an efficient solution and an overall degree of DMs’ satisfaction with the determined objective values.

AFRIKAANSE OPSOMMING: Die navorsing behandel ’n geïntegreerde multidoelwit distribusiemodel vir strategiese beplanning van ’n voedseltoevoerketting. Om met die model doelmatig te werk, moet ’n versameling van randvoorwaardes hanteer word om die saamgestelde optimiseringsdoelwit te bereik teen ’n agtergrond van uiteenlopende sienings.

Surrogate Based Uni/Multi-Objective Optimization and Distribution Estimation Methods

Science.gov (United States)

Gong, W.; Duan, Q.; Huo, X.

2017-12-01

Parameter calibration has been demonstrated as an effective way to improve the performance of dynamic models, such as hydrological models, land surface models, weather and climate models etc. Traditional optimization algorithms usually cost a huge number of model evaluations, making dynamic model calibration very difficult, or even computationally prohibitive. With the help of a serious of recently developed adaptive surrogate-modelling based optimization methods: uni-objective optimization method ASMO, multi-objective optimization method MO-ASMO, and probability distribution estimation method ASMO-PODE, the number of model evaluations can be significantly reduced to several hundreds, making it possible to calibrate very expensive dynamic models, such as regional high resolution land surface models, weather forecast models such as WRF, and intermediate complexity earth system models such as LOVECLIM. This presentation provides a brief introduction to the common framework of adaptive surrogate-based optimization algorithms of ASMO, MO-ASMO and ASMO-PODE, a case study of Common Land Model (CoLM) calibration in Heihe river basin in Northwest China, and an outlook of the potential applications of the surrogate-based optimization methods.

Multi-objective optimization of water quality, pumps operation, and storage sizing of water distribution systems.

Science.gov (United States)

Kurek, Wojciech; Ostfeld, Avi

2013-01-30

A multi-objective methodology utilizing the Strength Pareto Evolutionary Algorithm (SPEA2) linked to EPANET for trading-off pumping costs, water quality, and tanks sizing of water distribution systems is developed and demonstrated. The model integrates variable speed pumps for modeling the pumps operation, two water quality objectives (one based on chlorine disinfectant concentrations and one on water age), and tanks sizing cost which are assumed to vary with location and diameter. The water distribution system is subject to extended period simulations, variable energy tariffs, Kirchhoff's laws 1 and 2 for continuity of flow and pressure, tanks water level closure constraints, and storage-reliability requirements. EPANET Example 3 is employed for demonstrating the methodology on two multi-objective models, which differ in the imposed water quality objective (i.e., either with disinfectant or water age considerations). Three-fold Pareto optimal fronts are presented. Sensitivity analysis on the storage-reliability constraint, its influence on pumping cost, water quality, and tank sizing are explored. The contribution of this study is in tailoring design (tank sizing), pumps operational costs, water quality of two types, and reliability through residual storage requirements, in a single multi-objective framework. The model was found to be stable in generating multi-objective three-fold Pareto fronts, while producing explainable engineering outcomes. The model can be used as a decision tool for both pumps operation, water quality, required storage for reliability considerations, and tank sizing decision-making. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Analysis of foreign experience of usage of automation systems of medication distribution in prevention and treatment facilities].

Science.gov (United States)

Miroshnichenko, Iu V; Umarov, S Z

2012-12-01

One of the ways of increase of effectiveness and safety of patients medication supplement is the use of automated systems of distribution, through which substantially increases the efficiency and safety of patients' medication supplement, achieves significant economy of material and financial resources for medication assistance and possibility of systematical improvement of its accessibility and quality.

Medical Assistance in Dying in Canada: An Ethical Analysis of Conscientious and Religious Objections

Directory of Open Access Journals (Sweden)

Christie, Timothy

2016-08-01

Full Text Available Background: The Supreme Court of Canada (SCC has ruled that the federal government is required to remove the provisions of the Criminal Code of Canada that prohibit medical assistance in dying (MAID. The SCC has stipulated that individual physicians will not be required to provide MAID should they have a religious or conscientious objection. Therefore, the pending legislative response will have to balance the rights of the patients with the rights of physicians, other health care professionals, and objecting institutions. Objective: The objective of this paper is to critically assess, within the Canadian context, the moral probity of individual or institutional objections to MAID that are for either religious or conscientious reasons. Methods: Deontological ethics and the Doctrine of Double Effect. Results: The religious or conscientious objector has conflicting duties, i.e., a duty to respect the “right to life” (section 7 of the Charter and a duty to respect the tenets of his or her religious or conscientious beliefs (protected by section 2 of the Charter. Conclusion: The discussion of religious or conscientious objections to MAID has not explicitly considered the competing duties of the conscientious objector. It has focussed on the fact that a conscientious objection exists and has ignored the normative question of whether the duty to respect one’s conscience or religion supersedes the duty to respect the patient’s right to life.

DIAMONDS: Engineering Distributed Object Systems

National Research Council Canada - National Science Library

Cheng, Evan

1997-01-01

This report describes DIAMONDS, a research project at Syracuse University, that is dedicated to producing both a methodology and corresponding tools to assist in the development of heterogeneous distributed software...

An efficient hybrid evolutionary algorithm based on PSO and HBMO algorithms for multi-objective Distribution Feeder Reconfiguration

Energy Technology Data Exchange (ETDEWEB)

Niknam, Taher [Electronic and Electrical Engineering Department, Shiraz University of Technology, Shiraz (Iran)

2009-08-15

This paper introduces a robust searching hybrid evolutionary algorithm to solve the multi-objective Distribution Feeder Reconfiguration (DFR). The main objective of the DFR is to minimize the real power loss, deviation of the nodes' voltage, the number of switching operations, and balance the loads on the feeders. Because of the fact that the objectives are different and no commensurable, it is difficult to solve the problem by conventional approaches that may optimize a single objective. This paper presents a new approach based on norm3 for the DFR problem. In the proposed method, the objective functions are considered as a vector and the aim is to maximize the distance (norm2) between the objective function vector and the worst objective function vector while the constraints are met. Since the proposed DFR is a multi objective and non-differentiable optimization problem, a new hybrid evolutionary algorithm (EA) based on the combination of the Honey Bee Mating Optimization (HBMO) and the Discrete Particle Swarm Optimization (DPSO), called DPSO-HBMO, is implied to solve it. The results of the proposed reconfiguration method are compared with the solutions obtained by other approaches, the original DPSO and HBMO over different distribution test systems. (author)

Impact of Mobile Dose-Tracking Technology on Medication Distribution at an Academic Medical Center.

Science.gov (United States)

Kelm, Matthew; Campbell, Udobi

2016-05-01

Medication dose-tracking technologies have the potential to improve efficiency and reduce costs associated with re-dispensing doses reported as missing. Data describing this technology and its impact on the medication use process are limited. The purpose of this study is to assess the impact of dose-tracking technology on pharmacy workload and drug expense at an academic, acute care medical center. Dose-tracking technology was implemented in June 2014. Pre-implementation data were collected from February to April 2014. Post-implementation data were collected from July to September 2014. The primary endpoint was the percent of re-dispensed oral syringe and compounded sterile product (CSP) doses within the pre- and post-implementation periods per 1,000 discharges. Secondary endpoints included pharmaceutical expense generated from re-dispensing doses, labor costs, and staff satisfaction with the medication distribution process. We observed an average 6% decrease in re-dispensing of oral syringe and CSP doses from pre- to post-implementation (15,440 vs 14,547 doses; p = .047). However, when values were adjusted per 1,000 discharges, this trend did not reach statistical significance (p = .074). Pharmaceutical expense generated from re-dispensing doses was significantly reduced from pre- to post-implementation ($834,830 vs $746,466 [savings of $88,364]; p = .047). We estimated that $2,563 worth of technician labor was avoided in re-dispensing missing doses. We also saw significant improvement in staff perception of technology assisting in reducing missing doses (p = .0003), as well as improvement in effectiveness of resolving or minimizing missing doses (p = .01). The use of mobile dose-tracking technology demonstrated meaningful reductions in both the number of doses re-dispensed and cost of pharmaceuticals dispensed.

Distributed parallel cooperative coevolutionary multi-objective large-scale immune algorithm for deployment of wireless sensor networks

DEFF Research Database (Denmark)

Cao, Bin; Zhao, Jianwei; Yang, Po

2018-01-01

-objective evolutionary algorithms the Cooperative Coevolutionary Generalized Differential Evolution 3, the Cooperative Multi-objective Differential Evolution and the Nondominated Sorting Genetic Algorithm III, the proposed algorithm addresses the deployment optimization problem efficiently and effectively.......Using immune algorithms is generally a time-intensive process especially for problems with a large number of variables. In this paper, we propose a distributed parallel cooperative coevolutionary multi-objective large-scale immune algorithm that is implemented using the message passing interface...... (MPI). The proposed algorithm is composed of three layers: objective, group and individual layers. First, for each objective in the multi-objective problem to be addressed, a subpopulation is used for optimization, and an archive population is used to optimize all the objectives. Second, the large...

A needs assessment for mobile technology use in medical education

OpenAIRE

Shahrzad Vafa; Diane E. Chico

2013-01-01

Objectives: This study investigated how medical students perceived mobile technology as a component of their learning experience and identified barriers to the use of mobile technology in education. Methods: An anonymous survey developed by EDUCAUSE was distributed to 1000 first year medical students (M1s) at two separate medical schools during three consecutive academic years, 2010 to 2013. The 25-item questionnaire assessed student use of mobile devices, student interest in mobile technolog...

Virtual memory support for distributed computing environments using a shared data object model

Science.gov (United States)

Huang, F.; Bacon, J.; Mapp, G.

1995-12-01

Conventional storage management systems provide one interface for accessing memory segments and another for accessing secondary storage objects. This hinders application programming and affects overall system performance due to mandatory data copying and user/kernel boundary crossings, which in the microkernel case may involve context switches. Memory-mapping techniques may be used to provide programmers with a unified view of the storage system. This paper extends such techniques to support a shared data object model for distributed computing environments in which good support for coherence and synchronization is essential. The approach is based on a microkernel, typed memory objects, and integrated coherence control. A microkernel architecture is used to support multiple coherence protocols and the addition of new protocols. Memory objects are typed and applications can choose the most suitable protocols for different types of object to avoid protocol mismatch. Low-level coherence control is integrated with high-level concurrency control so that the number of messages required to maintain memory coherence is reduced and system-wide synchronization is realized without severely impacting the system performance. These features together contribute a novel approach to the support for flexible coherence under application control.

Medical Students’ and Interns’ Attitudes toward Medical Ethics Education in a Thai Medical School

Directory of Open Access Journals (Sweden)

Sakda Sathirareuangchai

2016-03-01

Full Text Available Background: Medical ethics has been accepted as part of every accredited medical curriculum for the past 40 years. Medical students’ attitudes have an important role for development and improvement of the curriculum. Faculty of Medicine Siriraj Hospital is the oldest and largest medical school in Thailand, and has been teaching medical ethics since 1907. Objective: To determine attitudes among medical students and interns toward medical ethics education and understand the factors influencing their attitudes. Methods: Mixed quantitative and qualitative research was conducted with early 6th year medical students and interns. A questionnaire was adapted from previous studies and included some original items. Results: Of the 550 questionnaires distributed, 386 were returned (70.2% response rate. Males (n=180 made up 46.63 % of the sample. Interns (n=219, 56.74 % tended to have more positive attitudes toward ethics learning than did medical students (n = 167, 43.26 %. Male participants tended to agree more with negative statements about ethics learning than did females. There was no statistically significant effect of hometown (Bangkok versus elsewhere or grade point average on attitudes. The main problem cited with medical ethics education was lack of engaging methods. Conclusion: Because clinical experience has an effect on learners’ attitudes towards ethics education, medical ethics should be taught at the appropriate time and with proper techniques, such as drawing explicit ties between ethical principles and real-life situations. Attention to the more detailed aspects of these data should also facilitate improvements to curriculum content, thereby ensuring better educational outcomes.

Higher albedos and size distribution of large transneptunian objects

Science.gov (United States)

Lykawka, Patryk Sofia; Mukai, Tadashi

2005-11-01

Transneptunian objects (TNOs) orbit beyond Neptune and do offer important clues about the formation of our solar system. Although observations have been increasing the number of discovered TNOs and improving their orbital elements, very little is known about elementary physical properties such as sizes, albedos and compositions. Due to TNOs large distances (>40 AU) and observational limitations, reliable physical information can be obtained only from brighter objects (supposedly larger bodies). According to size and albedo measurements available, it is evident the traditionally assumed albedo p=0.04 cannot hold for all TNOs, especially those with approximately absolute magnitudes H⩽5.5. That is, the largest TNOs possess higher albedos (generally >0.04) that strongly appear to increase as a function of size. Using a compilation of published data, we derived empirical relations which can provide estimations of diameters and albedos as a function of absolute magnitude. Calculations result in more accurate size/albedo estimations for TNOs with H⩽5.5 than just assuming p=0.04. Nevertheless, considering low statistics, the value p=0.04 sounds still convenient for H>5.5 non-binary TNOs as a group. We also discuss about physical processes (e.g., collisions, intrinsic activity and the presence of tenuous atmospheres) responsible for the increase of albedo among large bodies. Currently, all big TNOs (>700 km) would be capable to sustain thin atmospheres or icy frosts composed of CH 4, CO or N 2 even for body bulk densities as low as 0.5 g cm -3. A size-dependent albedo has important consequences for the TNOs size distribution, cumulative luminosity function and total mass estimations. According to our analysis, the latter can be reduced up to 50% if higher albedos are common among large bodies. Lastly, by analyzing orbital properties of classical TNOs ( 42AUbodies. For both populations, distinct absolute magnitude distributions are maximized for an inclination threshold

Homeopathy as Boundary Object and Distributed Therapeutic Agency. A Discussion on the Homeopathic Placebo Response.

Science.gov (United States)

Rughiniş, Cosima; Ciocănel, Alexandra; Vasile, Sorina

2017-09-27

We discuss homeopathy's placebo effect as the result of a distributed therapeutic agency involving humans, objects, and texts. Homeopathy has been involved in controversies for centuries, and the dispute whether it is therapy or quackery is as lively as ever. Still, homeopathy has retained significant popularity and acceptance within the medical establishment. We bracket the issue of biochemical effectiveness of homeopathic remedies as we only discuss homeopathy's potential to elicit a placebo response within its therapeutic alliance, in virtue of its social, symbolic, and material features. The review is based on literature discussing homeopathic effectiveness, including historical, biographical, sociological, and epistemological perspectives. We build upon research that clarifies the therapeutic relationship, examining its activities and meanings for practitioners and patients. Previous analyses discussing homeopathy's placebo effect stress the importance of the individualized consultation that functions as psychotherapy and generates empathy and hope. We enlarge the discussion, highlighting homeopathy's distributed therapeutic agency across humans, texts, and materials. The historical evolution of homeopathy in relation to biomedicine and science is important to understand its institutional integration into mainstream medicine and its appeal to scientifically minded doctors. Anecdotes of healing and the message of no-harm encourage patients to try homeopathy and hope for the best. The esthetics and ritual of remedies, coupled with computers' scientific legitimacy and time-saving power constitute a material infrastructure of therapeutic persuasion. Through its relation with biomedicine, its doctrine, consultation design, and treatment rituals, homeopathy offers a powerful medium to elicit a placebo response in a therapeutic alliance. By virtue of its proximity and radical difference from the scientific and biomedical enterprises, its material and textual

Multi-objective optimization of distributed generation with voltage ...

African Journals Online (AJOL)

... and line power capacity limit. In this paper, it is analyzed that voltage step constraint affects the location, size and power factor of DG in distribution network. The studies are carried out for 17-bus, 38-bus and 76-bus distribution systems. Keywords: Distributed generation, distribution system, distributed generation planning, ...

The Application of Observational Practice and Educational Networking in Simulation-Based and Distributed Medical Education Contexts.

Science.gov (United States)

Welsher, Arthur; Rojas, David; Khan, Zain; VanderBeek, Laura; Kapralos, Bill; Grierson, Lawrence E M

2018-02-01

Research has revealed that individuals can improve technical skill performance by viewing demonstrations modeled by either expert or novice performers. These findings support the development of video-based observational practice communities that augment simulation-based skill education and connect geographically distributed learners. This study explores the experimental replicability of the observational learning effect when demonstrations are sampled from a community of distributed learners and serves as a context for understanding learner experiences within this type of training protocol. Participants from 3 distributed medical campuses engaged in a simulation-based learning study of the elliptical excision in which they completed a video-recorded performance before being assigned to 1 of 3 groups for a 2-week observational practice intervention. One group observed expert demonstrations, another observed novice demonstrations, and the third observed a combination of both. Participants returned for posttesting immediately and 1 month after the intervention. Participants also engaged in interviews regarding their perceptions of the usability and relevance of video-based observational practice to clinical education. Checklist (P simulation-based skill learning in a group of geographically distributed trainees. These findings support the use of Internet-mediated observational learning communities in distributed and simulation-based medical education contexts.

Pre-Hawking radiation may allow for reconstruction of the mass distribution of the collapsing object

Energy Technology Data Exchange (ETDEWEB)

Dai, De-Chang, E-mail: diedachung@gmail.com [Institute of Natural Sciences, Shanghai Key Lab for Particle Physics and Cosmology, and Center for Astrophysics and Astronomy, Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai 200240 (China); Stojkovic, Dejan [HEPCOS, Department of Physics, SUNY, University at Buffalo, Buffalo, NY 14260-1500 (United States)

2016-07-10

Hawking radiation explicitly depends only on the black hole's total mass, charge and angular momentum. It is therefore generally believed that one cannot reconstruct the information about the initial mass distribution of an object that made the black hole. However, instead of looking at radiation from a static black hole, we can study the whole time-dependent process of the gravitational collapse, and pre-Hawking radiation which is excited because of the time-dependent metric. We compare radiation emitted by a single collapsing shell with that emitted by two concentric shells of the equivalent total mass. We calculate the gravitational trajectory and the momentum energy tensor. We show that the flux of energy emitted during the collapse by a single shell is significantly different from the flux emitted by two concentric shells of the equivalent total mass. When the static black hole is formed, the fluxes become indistinguishable. This implies that an observer studying the flux of particles from a collapsing object could in principle reconstruct information not only about the total mass of the collapsing object, but also about the mass distribution.

Pre-Hawking radiation may allow for reconstruction of the mass distribution of the collapsing object

Directory of Open Access Journals (Sweden)

De-Chang Dai

2016-07-01

Full Text Available Hawking radiation explicitly depends only on the black hole's total mass, charge and angular momentum. It is therefore generally believed that one cannot reconstruct the information about the initial mass distribution of an object that made the black hole. However, instead of looking at radiation from a static black hole, we can study the whole time-dependent process of the gravitational collapse, and pre-Hawking radiation which is excited because of the time-dependent metric. We compare radiation emitted by a single collapsing shell with that emitted by two concentric shells of the equivalent total mass. We calculate the gravitational trajectory and the momentum energy tensor. We show that the flux of energy emitted during the collapse by a single shell is significantly different from the flux emitted by two concentric shells of the equivalent total mass. When the static black hole is formed, the fluxes become indistinguishable. This implies that an observer studying the flux of particles from a collapsing object could in principle reconstruct information not only about the total mass of the collapsing object, but also about the mass distribution.

Filtering for distributed mechanical systems using position measurements: perspectives in medical imaging

International Nuclear Information System (INIS)

Moireau, Philippe; Chapelle, Dominique; Tallec, Patrick Le

2009-01-01

We propose an effective filtering methodology designed to perform estimation in a distributed mechanical system using position measurements. As in a previously introduced method, the filter is inspired by robust control feedback, but here we take full advantage of the estimation specificity to choose a feedback law that can act on displacements instead of velocities and still retain the same kind of dissipativity property which guarantees robustness. This is very valuable in many applications for which positions are more readily available than velocities, as in medical imaging. We provide an in-depth analysis of the proposed procedure, as well as detailed numerical assessments using a test problem inspired by cardiac biomechanics, as medical diagnosis assistance is an important perspective for this approach. The method is formulated first for measurements based on Lagrangian displacements, but we then derive a nonlinear extension allowing us to instead consider segmented images, which of course is even more relevant in medical applications

Evaluating distributed medical education: what are the community's expectations?

Science.gov (United States)

Lovato, Chris; Bates, Joanna; Hanlon, Neil; Snadden, David

2009-05-01

This study aimed to explore community members' perceptions of present and future impacts of the implementation of an undergraduate medical education programme in an underserved community. We conducted semi-structured interviews with eight key informants representing the health, education, business, economy, media and political sectors. A two-stage approach was used. In the first stage, the interviews were analysed to identify sector-specific impacts informants perceived as already occurring or which they hoped to see in the future. The transcripts were then re-analysed to determine any underlying themes that crossed sectors. Community leaders described impacts that were already occurring in all sectors and also described changes in the community itself. Four underlying themes emerged: an increase in pride and status; partnership development; community self-efficacy, and community development. These underlying themes appear to characterise the development of social capital in the community. The implementation of distributed undergraduate medical education programmes in rural and underserved communities may impact their host communities in ways other than the production of a rural doctor workforce. Further studies to quantify impacts in diverse sectors and to explore possible links with social capital are needed.

Catalogue of Interactive Learning Objectives to improve an Integrated Medical and Dental Curriculum.

Science.gov (United States)

Mahmoodi, Benjamin; Sagheb, K; Sagheb, Ka; Schulz, P; Willershausen, B; Al-Nawas, B; Walter, C

2016-12-01

Online learning media are increasingly being incorporated into medical and dental education. However, the coordination between obligatory and facultative teaching domains still remains unsatisfying. The Catalogue of Interactive Learning Objectives of the University Clinic of Mainz (ILKUM), aims to offer knowledge transfer for students while being mindful of their individual qualifications. Its hierarchical structure is designed according to the Association for Dental Education in Europe (ADEE) levels of competence. The ILKUM was designed to establish a stronger interconnection between already existing and prospective learning strategies. All contents are linked to the current lectures as well as to e-learning modules, e.g., clinical case studies and OR videos. Students can conduct self-examinations regarding specific learning objectives. Since 2007, ILKUM has been developed and analyzed regarding its acceptance among dental students. These improved e-learning techniques foster time and location-independent access to study materials and allow an estimation of the knowledge achieved by students. Surveys of our students clearly show a large demand for upgrading ILKUM content (89%; n = 172) with integrated self-testing (89%; n = 174). In parallel to the advancement of our e-learning offering, a portion of internet-based learning is constantly rising among students. The broad acceptance and demand for the development of ILKUM show its potential. Moreover, ILKUM grants fast, topic-oriented querying of learning content without time and locale limitations as well as direct determination of the individually needed knowledge conditions. The long-term goal of the ILKUM project is to be a sustainable, important additional modality of teaching and training for dental and medical students.

Geographical distribution and profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa.

Science.gov (United States)

Ntuli, Samuel T; Maboya, Edwin

2017-09-27

The shortage and unequal distribution of medical doctors in low- and middle-income countries continues to be a public health concern. To establish the geographical distribution and demographic profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa. The PERSAL system was used to obtain information on the number of medical doctors employed in public sector hospitals of the Limpopo Province. Data were exported from PERSAL's database and then analysed using STATA version 9.0. The mean age of the 887 medical doctors was 40.1 ± 11.2 years (range 24-79 years). Sixty per cent of the doctors were male, 66% were aged ≤ 45 years and 84% were African. Most of the doctors (86%) were medical officers, of which 55% had < 5 years working experience. Overall, the doctor-to-population ratio for the five districts in the province was 16.4/100 000, with Capricorn (33.7/100 000) and Waterberg (20.2/100 000) recording the highest ratios. A large proportion (43%) of medical officers are employed in the Capricorn District, of which 71% were practising at the tertiary hospital. This study demonstrated a shortage and maldistribution of medical doctors in the public sector hospitals of the Limpopo Province. This has a potentially negative effect on the delivery of an appropriate and efficient healthcare service to the population and requires urgent attention.

Consumer-based technology for distribution of surgical videos for objective evaluation.

Science.gov (United States)

Gonzalez, Ray; Martinez, Jose M; Lo Menzo, Emanuele; Iglesias, Alberto R; Ro, Charles Y; Madan, Atul K

2012-08-01

The Global Operative Assessment of Laparoscopic Skill (GOALS) is one validated metric utilized to grade laparoscopic skills and has been utilized to score recorded operative videos. To facilitate easier viewing of these recorded videos, we are developing novel techniques to enable surgeons to view these videos. The objective of this study is to determine the feasibility of utilizing widespread current consumer-based technology to assist in distributing appropriate videos for objective evaluation. Videos from residents were recorded via a direct connection from the camera processor via an S-video output via a cable into a hub to connect to a standard laptop computer via a universal serial bus (USB) port. A standard consumer-based video editing program was utilized to capture the video and record in appropriate format. We utilized mp4 format, and depending on the size of the file, the videos were scaled down (compressed), their format changed (using a standard video editing program), or sliced into multiple videos. Standard available consumer-based programs were utilized to convert the video into a more appropriate format for handheld personal digital assistants. In addition, the videos were uploaded to a social networking website and video sharing websites. Recorded cases of laparoscopic cholecystectomy in a porcine model were utilized. Compression was required for all formats. All formats were accessed from home computers, work computers, and iPhones without difficulty. Qualitative analyses by four surgeons demonstrated appropriate quality to grade for these formats. Our preliminary results show promise that, utilizing consumer-based technology, videos can be easily distributed to surgeons to grade via GOALS via various methods. Easy accessibility may help make evaluation of resident videos less complicated and cumbersome.

How Medical Students Use Objectives.

Science.gov (United States)

Mast, Terrill A.; And Others

Two related studies were undertaken at Southern Illinois University on how students in the School of Medicine use the instructional objectives faculty prepare for them. Students in the classes of 1978 and 1979 were surveyed in their final month of training. The second survey was modified, based on responses from the first. The five research…

Optimal Allocation of Generalized Power Sources in Distribution Network Based on Multi-Objective Particle Swarm Optimization Algorithm

Directory of Open Access Journals (Sweden)

Li Ran

2017-01-01

Full Text Available Optimal allocation of generalized power sources in distribution network is researched. A simple index of voltage stability is put forward. Considering the investment and operation benefit, the stability of voltage and the pollution emissions of generalized power sources in distribution network, a multi-objective optimization planning model is established. A multi-objective particle swarm optimization algorithm is proposed to solve the optimal model. In order to improve the global search ability, the strategies of fast non-dominated sorting, elitism and crowding distance are adopted in this algorithm. Finally, tested the model and algorithm by IEEE-33 node system to find the best configuration of GP, the computed result shows that with the generalized power reasonable access to the active distribution network, the investment benefit and the voltage stability of the system is improved, and the proposed algorithm has better global search capability.

OBJECTIVE AND SUBJECTIVE FACTORS OF MEDICAL DRUG CHOICE

Directory of Open Access Journals (Sweden)

E. B. Babanskaya

2017-01-01

Full Text Available Aim. To analyze the factors of medical choice in the prescription of medicinal drug (MD for the treatment of cardiovascular diseases. Material and methods. A questionnaire survey of 212 doctors (138 physicians and 42 general practitioners was performed in Irkutsk region and Republic of Buryatia. Questions were related to the physicians’ choice of the original or generic MD and the factors that influence this choice. Results. The majority of respondents prefer the foreign MD, while they prescribed both original and generic drugs (60.4%. The determining factor in the prescription of MD is its efficacy (91.5-95.3%. The main source of information of MD for physicians is the medical literature (78.3%. Only 23.6% of doctors choose the MD based on the results of clinical trials and information about it in specialized medical literature. A half of the respondents believe that their knowledge of cardiovascular MD is insufficient. Doctors need and are interested in information on the pharmacokinetics and pharmacodynamics of MD, side effects, drug interactions and results of clinical studies. Conclusion. It is necessary to focus on the clinical pharmacology of cardiovascular MD during the training of doctors in specialized courses of continuous medical education.

Estimating distribution of hidden objects with drones: from tennis balls to manatees.

Directory of Open Access Journals (Sweden)

Julien Martin

Full Text Available Unmanned aerial vehicles (UAV, or drones, have been used widely in military applications, but more recently civilian applications have emerged (e.g., wildlife population monitoring, traffic monitoring, law enforcement, oil and gas pipeline threat detection. UAV can have several advantages over manned aircraft for wildlife surveys, including reduced ecological footprint, increased safety, and the ability to collect high-resolution geo-referenced imagery that can document the presence of species without the use of a human observer. We illustrate how geo-referenced data collected with UAV technology in combination with recently developed statistical models can improve our ability to estimate the distribution of organisms. To demonstrate the efficacy of this methodology, we conducted an experiment in which tennis balls were used as surrogates of organisms to be surveyed. We used a UAV to collect images of an experimental field with a known number of tennis balls, each of which had a certain probability of being hidden. We then applied spatially explicit occupancy models to estimate the number of balls and created precise distribution maps. We conducted three consecutive surveys over the experimental field and estimated the total number of balls to be 328 (95%CI: 312, 348. The true number was 329 balls, but simple counts based on the UAV pictures would have led to a total maximum count of 284. The distribution of the balls in the field followed a simulated environmental gradient. We also were able to accurately estimate the relationship between the gradient and the distribution of balls. Our experiment demonstrates how this technology can be used to create precise distribution maps in which discrete regions of the study area are assigned a probability of presence of an object. Finally, we discuss the applicability and relevance of this experimental study to the case study of Florida manatee distribution at power plants.

Estimating distribution of hidden objects with drones: from tennis balls to manatees.

Science.gov (United States)

Martin, Julien; Edwards, Holly H; Burgess, Matthew A; Percival, H Franklin; Fagan, Daniel E; Gardner, Beth E; Ortega-Ortiz, Joel G; Ifju, Peter G; Evers, Brandon S; Rambo, Thomas J

2012-01-01

Unmanned aerial vehicles (UAV), or drones, have been used widely in military applications, but more recently civilian applications have emerged (e.g., wildlife population monitoring, traffic monitoring, law enforcement, oil and gas pipeline threat detection). UAV can have several advantages over manned aircraft for wildlife surveys, including reduced ecological footprint, increased safety, and the ability to collect high-resolution geo-referenced imagery that can document the presence of species without the use of a human observer. We illustrate how geo-referenced data collected with UAV technology in combination with recently developed statistical models can improve our ability to estimate the distribution of organisms. To demonstrate the efficacy of this methodology, we conducted an experiment in which tennis balls were used as surrogates of organisms to be surveyed. We used a UAV to collect images of an experimental field with a known number of tennis balls, each of which had a certain probability of being hidden. We then applied spatially explicit occupancy models to estimate the number of balls and created precise distribution maps. We conducted three consecutive surveys over the experimental field and estimated the total number of balls to be 328 (95%CI: 312, 348). The true number was 329 balls, but simple counts based on the UAV pictures would have led to a total maximum count of 284. The distribution of the balls in the field followed a simulated environmental gradient. We also were able to accurately estimate the relationship between the gradient and the distribution of balls. Our experiment demonstrates how this technology can be used to create precise distribution maps in which discrete regions of the study area are assigned a probability of presence of an object. Finally, we discuss the applicability and relevance of this experimental study to the case study of Florida manatee distribution at power plants.

Attitudes toward Psychiatry: A Survey of Medical Students at the University of Nairobi, Kenya

Science.gov (United States)

Ndetei, David M.; Khasakhala, Lincoln; Ongecha-Owuor, Francisca; Kuria, Mary; Mutiso, Victoria; Syanda, Judy; Kokonya, Donald

2008-01-01

Objectives: The authors aim to determine the attitudes of University of Nairobi, Kenya, medical students toward psychiatry. Methods: The study design was cross-sectional. Self-administered sociodemographic and the Attitudes Toward Psychiatry-30 items (ATP-30) questionnaires were distributed sequentially to every third medical student in his or her…

Programming a Distributed System Using Shared Objects

NARCIS (Netherlands)

Tanenbaum, A.S.; Bal, H.E.; Kaashoek, M.F.

1993-01-01

Building the hardware for a high-performance distributed computer system is a lot easier than building its software. The authors describe a model for programming distributed systems based on abstract data types that can be replicated on all machines that need them. Read operations are done locally,

INITIAL PLANETESIMAL SIZES AND THE SIZE DISTRIBUTION OF SMALL KUIPER BELT OBJECTS

International Nuclear Information System (INIS)

Schlichting, Hilke E.; Fuentes, Cesar I.; Trilling, David E.

2013-01-01

The Kuiper Belt is a remnant from the early solar system and its size distribution contains many important constraints that can be used to test models of planet formation and collisional evolution. We show, by comparing observations with theoretical models, that the observed Kuiper Belt size distribution is well matched by coagulation models, which start with an initial planetesimal population with radii of about 1 km, and subsequent collisional evolution. We find that the observed size distribution above R ∼ 30 km is primordial, i.e., it has not been modified by collisional evolution over the age of the solar system, and that the size distribution below R ∼ 30 km has been modified by collisions and that its slope is well matched by collisional evolution models that use published strength laws. We investigate in detail the resulting size distribution of bodies ranging from 0.01 km to 30 km and find that its slope changes several times as a function of radius before approaching the expected value for an equilibrium collisional cascade of material strength dominated bodies for R ∼< 0.1 km. Compared to a single power-law size distribution that would span the whole range from 0.01 km to 30 km, we find in general a strong deficit of bodies around R ∼ 10 km and a strong excess of bodies around 2 km in radius. This deficit and excess of bodies are caused by the planetesimal size distribution left over from the runaway growth phase, which left most of the initial mass in small planetesimals while only a small fraction of the total mass is converted into large protoplanets. This excess mass in small planetesimals leaves a permanent signature in the size distribution of small bodies that is not erased after 4.5 Gyr of collisional evolution. Observations of the small Kuiper Belt Object (KBO) size distribution can therefore test if large KBOs grew as a result of runaway growth and constrained the initial planetesimal sizes. We find that results from recent KBO

[Determination and analysis of cost and production measures in physicians' practices and hospitals for the objective evaluation of medical measures].

Science.gov (United States)

Gessner, U; Horisberger, B

1981-05-01

The complete data on 7200 practising physicians in Switzerland were analyzed in the first phase of the project. The 2600 GP's and the 4600 specialists (in 18 medical specialties) were categorized as to year of graduation and geographic regions (population centres). The distributions of the practising physician of the different specialties over the population centres (defined by 30-min. catchment area) areas were evaluated. Trends towards specialization in larger settlement areas were analyzed. The results are being used as a basis for formation of samples for further studies. The inventories of medical technical equipment and medical procedures are in the process of systematization.

Datamining on distributed medical databases

DEFF Research Database (Denmark)

Have, Anna Szynkowiak

2004-01-01

This Ph.D. thesis focuses on clustering techniques for Knowledge Discovery in Databases. Various data mining tasks relevant for medical applications are described and discussed. A general framework which combines data projection and data mining and interpretation is presented. An overview...... is available. If data is unlabeled, then it is possible to generate keywords (in case of textual data) or key-patterns, as an informative representation of the obtained clusters. The methods are applied on simple artificial data sets, as well as collections of textual and medical data. In Danish: Denne ph...

Associations of objectively measured physical activity and abdominal fat distribution

DEFF Research Database (Denmark)

Philipsen, Annelotte; Hansen, Anne-Louise Smidt; Jørgensen, Marit Eika

2015-01-01

Introduction/Purpose: Visceral adipose tissue (VAT) and physical activity are both independent predictors of Type 2 diabetes. Physical activity and overall obesity are inversely associated with each other. Yet the nature of the association between objectively measured dimensions of physical...... activity and abdominal fat distribution has not been well characterized. We aimed to do so in a middle-age to elderly population at high risk of diabetes. Methods: A cross-sectional analysis of 1134 participants of the ADDITION-PRO study. VAT and subcutaneous adipose tissue (SAT) were assessed one......-dimensionally by ultrasonography and physical activity with combined accelerometry and HR monitoring. Linear regression of physical activity energy expenditure (PAEE) and time spent in different physical activity intensity levels on VAT and SAT was performed. Results: Median body mass index (BMI) was 26.6 kg.m(-2) and PAEE was 28...

New multi-objective decision support methodology to solve problems of reconfiguration in the electric distribution systems

NARCIS (Netherlands)

Santos, S.F.; Paterakis, N.G.; Catalao, J.P.S.; Camarinha-Matos, L.M.; Baldissera, T.A.; Di Orio, G.; Marques, F.

2015-01-01

The distribution systems (DS) reconfiguration problem is formulated in this paper as a multi-objective mixed-integer linear programming (MILP) multiperiod problem, enforcing that the obtained topology is radial in order to exploit several advantages those configurations offer. The effects of

NASA JPL Distributed Systems Technology (DST) Object-Oriented Component Approach for Software Inter-Operability and Reuse

Science.gov (United States)

Hall, Laverne; Hung, Chaw-Kwei; Lin, Imin

2000-01-01

The purpose of this paper is to provide a description of NASA JPL Distributed Systems Technology (DST) Section's object-oriented component approach to open inter-operable systems software development and software reuse. It will address what is meant by the terminology object component software, give an overview of the component-based development approach and how it relates to infrastructure support of software architectures and promotes reuse, enumerate on the benefits of this approach, and give examples of application prototypes demonstrating its usage and advantages. Utilization of the object-oriented component technology approach for system development and software reuse will apply to several areas within JPL, and possibly across other NASA Centers.

Preattentive representation of feature conjunctions for concurrent spatially distributed auditory objects.

Science.gov (United States)

Takegata, Rika; Brattico, Elvira; Tervaniemi, Mari; Varyagina, Olga; Näätänen, Risto; Winkler, István

2005-09-01

The role of attention in conjoining features of an object has been a topic of much debate. Studies using the mismatch negativity (MMN), an index of detecting acoustic deviance, suggested that the conjunctions of auditory features are preattentively represented in the brain. These studies, however, used sequentially presented sounds and thus are not directly comparable with visual studies of feature integration. Therefore, the current study presented an array of spatially distributed sounds to determine whether the auditory features of concurrent sounds are correctly conjoined without focal attention directed to the sounds. Two types of sounds differing from each other in timbre and pitch were repeatedly presented together while subjects were engaged in a visual n-back working-memory task and ignored the sounds. Occasional reversals of the frequent pitch-timbre combinations elicited MMNs of a very similar amplitude and latency irrespective of the task load. This result suggested preattentive integration of auditory features. However, performance in a subsequent target-search task with the same stimuli indicated the occurrence of illusory conjunctions. The discrepancy between the results obtained with and without focal attention suggests that illusory conjunctions may occur during voluntary access to the preattentively encoded object representations.

Multi-objective optimization and simulation model for the design of distributed energy systems

International Nuclear Information System (INIS)

Falke, Tobias; Krengel, Stefan; Meinerzhagen, Ann-Kathrin; Schnettler, Armin

2016-01-01

Highlights: • Development of a model for the optimal design of district energy systems. • Multi-objective approach: integrated economic and ecological optimization. • Consideration of conventional conversion technologies, RES and district heating. • Decomposition of optimization problem to reduce computation complexity. • Approach enables the investigation of districts with more than 150 buildings. - Abstract: In this paper, a multi-objective optimization model for the investment planning and operation management of distributed heat and electricity supply systems is presented. Different energy efficiency measures and supply options are taken into account, including various distributed heat and power generation units, storage systems and energy-saving renovation measures. Furthermore, district heating networks are considered as an alternative to conventional, individual heat supply for each building. The optimization problem is decomposed into three subproblems to reduce the computational complexity. This enables a high level of detail in the optimization and simultaneously the comprehensive investigation of districts with more than 100 buildings. These capabilities distinguish the model from previous approaches in this field of research. The developed model is applied to a district in a medium-sized town in Germany in order to analyze the effects of different efficiency measures regarding total costs and emissions of CO 2 equivalents. Based on the Pareto efficient solutions, technologies and efficiency measures that can contribute most efficiently to reduce greenhouse gas emissions are identified.

A multi-objective particle swarm optimization for production-distribution planning in supply chain network

Directory of Open Access Journals (Sweden)

Alireza Pourrousta

2012-04-01

Full Text Available Integrated supply chain includes different components of order, production and distribution and it plays an important role on reducing the cost of manufacturing system. In this paper, an integrated supply chain in a form of multi-objective decision-making problem is presented. The proposed model of this paper considers different parameters with uncertainty using trapezoid numbers. We first implement a ranking method to covert the fuzzy model into a crisp one and using multi-objective particle swarm optimization, we solve the resulted model. The results are compared with the performance of NSGA-II for some randomly generated problems and the preliminary results indicate that the proposed model of the paper performs better than the alternative method.

Frequency and spatial distribution of animal and object hoarder behavior in Curitiba, Paraná State, Brazil

Directory of Open Access Journals (Sweden)

Graziela Ribeiro da Cunha

Full Text Available Abstract: This study aimed to establish the frequency and spatial distribution of animal and object hoarding in Curitiba (Paraná State, the eighth most populous city in Brazil. All hoarding complaints received by the City Secretaries of Health, Environment and Social Assistance between September 2013 and April 2015 were collected (n = 226 and suspicious cases were individually investigated. A total of 113/226 (50% of complaints were confirmed as hoarding cases, representing an overall ratio of 6.45 cases per 100,000 inhabitants in Curitiba, of which 48/113 (42.5% involved object hoarders, 41/113 (36.3% animal hoarders and 24/113 (21.2% both animal and object hoarders. A correlation of total identified cases with neighborhood population density and all population stratums analyzed (total, gender, age was significantly positive (p < 0.01, and with neighborhood mean monthly income (r = -0.2; p = 0.03 significantly negative. A spatial cluster of cases was found in the north of the city (OR = 8.57; p < 0.01. Hoarding cases were relatively frequent in Curitiba and were associated with population distribution patterns and inversely related to neighborhood income.

DETERMINATION OF THE RESIDUAL OPERATING TIME OF UNRESTORABLE ELEMENT OF THE ELECTRIC POWER OBJECT AT THE WAYBALL DISTRIBUTION

International Nuclear Information System (INIS)

Namgaladze, D.; Gurgenidze, D.

2007-01-01

In practice, it is often essential to determinethe residual operating time for an unrestorable element of the electric power object which has operated without failure for a certain time. The density of probability distribution of operating time can be determined from the initial probability distribution of operating time. In this work, the relations for determination of the function of residual operating time of the unrestorable element at the exponential and Wayball distributions are analytically derived. (author)

Guest Editor's introduction: Selected papers from the 4th USENIX Conference on Object-Oriented Technologies and Systems

Science.gov (United States)

Sventek, Joe

1998-12-01

Hewlett-Packard Laboratories, 1501 Page Mill Road, Palo Alto, CA 94304, USA Introduction The USENIX Conference on Object-Oriented Technologies and Systems (COOTS) is held annually in the late spring. The conference evolved from a set of C++ workshops that were held under the auspices of USENIX, the first of which met in 1989. Given the growing diverse interest in object-oriented technologies, the C++ focus of the workshop eventually became too narrow, with the result that the scope was widened in 1995 to include object-oriented technologies and systems. COOTS is intended to showcase advanced R&D efforts in object-oriented technologies and software systems. The conference emphasizes experimental research and experience gained by using object-oriented techniques and languages to build complex software systems that meet real-world needs. COOTS solicits papers in the following general areas: application of, and experiences with, object-oriented technologies in particular domains (e.g. financial, medical, telecommunication); the architecture and implementation of distributed object systems (e.g. CORBA, DCOM, RMI); object-oriented programming and specification languages; object-oriented design and analysis. The 4th meeting of COOTS was held 27 - 30 April 1998 at the El Dorado Hotel, Santa Fe, New Mexico, USA. Several tutorials were given. The technical program proper consisted of a single track of six sessions, with three paper presentations per session. A keynote address and a provocative panel session rounded out the technical program. The program committee reviewed 56 papers, selecting the best 18 for presentation in the technical sessions. While we solicit papers across the spectrum of applications of object-oriented technologies, this year there was a predominance of distributed, object-oriented papers. The accepted papers reflected this asymmetry, with 15 papers on distributed objects and 3 papers on object-oriented languages. The papers in this special issue are

CADMIO: computer aided design for medical information objects.

Science.gov (United States)

Minarelli, D V; Ferri, F; Pisanelli, D M; Ricci, F L; Tittarelli, F

1995-01-01

The growth of the computational capability and the tools of graphic software is nowadays available in an integrated manner into the development environments, thus permitting the realization of tool kits capable of handling information that is complex and of different kinds such as the typical medical information. This has given a great impulse to the creation of electronic medical folders joining together with new and stimulating functionality with respect to the usual paper document [1]. In the present work, we propose a tool capable of defining a multimedia electronic medical folder and representing its architecture through a layout that is formed on the basis of the particular data types to be handled. This tool is capable of providing an integrated view of data that, even though they are close in cognitive sense, are often stored and represented apart in the practice. Different approaches to the browsing feature are giving within the system, thus the user can personalize the way of viewing the information stored into the folder or can let the system guide the browsing.

Medical Diplomacy: A Tool for Enabling National Security Strategy Objectives

Science.gov (United States)

2012-04-06

USGs global health portfolio includes a diverse set of programs and investments in...cultural linguistic competency, expertise in regional medical initiatives, and knowledge of joint coordination in the ability foster medical goodwill...operates medical research units in Egypt and Peru . Additionally, the Navy has operated facilities in Indonesia and maintains research capabilities

Boundary-Object Trimming

DEFF Research Database (Denmark)

Bossen, Claus; Jensen, Lotte Groth; Udsen, Flemming Witt

2014-01-01

implementation, which also coupled the work of medical secretaries more tightly to that of other staff, and led to task drift among professions. Medical secretaries have been relatively invisible to health informatics and CSCW, and we propose the term ‘boundary-object trimming’ to foreground and conceptualize...

Data management in an object-oriented distributed aircraft conceptual design environment

Science.gov (United States)

Lu, Zhijie

In the competitive global market place, aerospace companies are forced to deliver the right products to the right market, with the right cost, and at the right time. However, the rapid development of technologies and new business opportunities, such as mergers, acquisitions, supply chain management, etc., have dramatically increased the complexity of designing an aircraft. Therefore, the pressure to reduce design cycle time and cost is enormous. One way to solve such a dilemma is to develop and apply advanced engineering environments (AEEs), which are distributed collaborative virtual design environments linking researchers, technologists, designers, etc., together by incorporating application tools and advanced computational, communications, and networking facilities. Aircraft conceptual design, as the first design stage, provides major opportunity to compress design cycle time and is the cheapest place for making design changes. However, traditional aircraft conceptual design programs, which are monolithic programs, cannot provide satisfactory functionality to meet new design requirements due to the lack of domain flexibility and analysis scalability. Therefore, we are in need of the next generation aircraft conceptual design environment (NextADE). To build the NextADE, the framework and the data management problem are two major problems that need to be addressed at the forefront. Solving these two problems, particularly the data management problem, is the focus of this research. In this dissertation, in light of AEEs, a distributed object-oriented framework is firstly formulated and tested for the NextADE. In order to improve interoperability and simplify the integration of heterogeneous application tools, data management is one of the major problems that need to be tackled. To solve this problem, taking into account the characteristics of aircraft conceptual design data, a robust, extensible object-oriented data model is then proposed according to the

Constructing Common Information Space across Distributed Emergency Medical Teams

DEFF Research Database (Denmark)

Zhang, Zhan; Sarcevic, Aleksandra; Bossen, Claus

2017-01-01

This paper examines coordination and real-time information sharing across four emergency medical teams in a high-risk and distributed setting as they provide care to critically injured patients within the first hour after injury. Through multiple field studies we explored how common understanding...... of critical patient data is established across these heterogeneous teams and what coordination mechanisms are being used to support information sharing and interpretation. To analyze the data, we drew on the concept of Common Information Spaces (CIS). Our results showed that teams faced many challenges...... in achieving efficient information sharing and coordination, including difficulties in locating and assembling team members, communicating and interpreting information from the field, and accommodating differences in team goals and information needs, all while having minimal technology support. We reflect...

PARENTAL ATTITUDES TOWARD THE PRESCRIPTION OF PSYCHOTROPIC MEDICATIONS FOR THEIR CHILDREN

OpenAIRE

Al-Haidar, Fatima A.

2008-01-01

Objective: To explore parental attitudes towards the prescription of psychotropic medication for their children. Method: A questionnaire built to collect socio-demographic data of parents and their attitudes was distributed among parents. Results: One thousand and ten questionnaires were filled by parents. Fathers who completed the questionnaire were double the number of mothers. Eight hundred and eighteen parents (84.3%) agreed to the dispensing psychotropic medication to their child...

A new technique for dynamic load distribution when two manipulators mutually lift a rigid object. Part 1, The proposed technique

Energy Technology Data Exchange (ETDEWEB)

Unseren, M.A.

1994-04-01

A general framework for solving the dynamic load distribution when two manipulators hold a rigid object is proposed. The underspecified problem of solving for the contact forces and torques based on the object`s equations of motion is transformed into a well specified problem. This is accomplished by augmenting the object`s equations of motion with additional equations which relate a new vector variable quantifying the internal contact force and torque degrees of freedom (DOF) as a linear function of the contact forces and torques. The resulting augmented system yields a well specified solution for the contact forces and torques in which they are separated into their motion inducing and internal components. A particular solution is suggested which enables the designer to conveniently specify what portion of the payload`s mass each manipulator is to bear. It is also shown that the results of the previous work are just a special case of the general load distribution framework described here.

Improving the human readability of Arden Syntax medical logic modules using a concept-oriented terminology and object-oriented programming expressions.

Science.gov (United States)

Choi, Jeeyae; Bakken, Suzanne; Lussier, Yves A; Mendonça, Eneida A

2006-01-01

Medical logic modules are a procedural representation for sharing task-specific knowledge for decision support systems. Based on the premise that clinicians may perceive object-oriented expressions as easier to read than procedural rules in Arden Syntax-based medical logic modules, we developed a method for improving the readability of medical logic modules. Two approaches were applied: exploiting the concept-oriented features of the Medical Entities Dictionary and building an executable Java program to replace Arden Syntax procedural expressions. The usability evaluation showed that 66% of participants successfully mapped all Arden Syntax rules to Java methods. These findings suggest that these approaches can play an essential role in the creation of human readable medical logic modules and can potentially increase the number of clinical experts who are able to participate in the creation of medical logic modules. Although our approaches are broadly applicable, we specifically discuss the relevance to concept-oriented nursing terminologies and automated processing of task-specific nursing knowledge.

Methodology for the Efficient Progressive Distribution and Visualization of 3D Building Objects

Directory of Open Access Journals (Sweden)

Bo Mao

2016-10-01

Full Text Available Three-dimensional (3D, city models have been applied in a variety of fields. One of the main problems in 3D city model utilization, however, is the large volume of data. In this paper, a method is proposed to generalize the 3D building objects in 3D city models at different levels of detail, and to combine multiple Levels of Detail (LODs for a progressive distribution and visualization of the city models. First, an extended structure for multiple LODs of building objects, BuildingTree, is introduced that supports both single buildings and building groups; second, constructive solid geometry (CSG representations of buildings are created and generalized. Finally, the BuildingTree is stored in the NoSQL database MongoDB for dynamic visualization requests. The experimental results indicate that the proposed progressive method can efficiently visualize 3D city models, especially for large areas.

Binomial Distribution Sample Confidence Intervals Estimation 1. Sampling and Medical Key Parameters Calculation

Directory of Open Access Journals (Sweden)

Tudor DRUGAN

2003-08-01

Full Text Available The aim of the paper was to present the usefulness of the binomial distribution in studying of the contingency tables and the problems of approximation to normality of binomial distribution (the limits, advantages, and disadvantages. The classification of the medical keys parameters reported in medical literature and expressing them using the contingency table units based on their mathematical expressions restrict the discussion of the confidence intervals from 34 parameters to 9 mathematical expressions. The problem of obtaining different information starting with the computed confidence interval for a specified method, information like confidence intervals boundaries, percentages of the experimental errors, the standard deviation of the experimental errors and the deviation relative to significance level was solves through implementation in PHP programming language of original algorithms. The cases of expression, which contain two binomial variables, were separately treated. An original method of computing the confidence interval for the case of two-variable expression was proposed and implemented. The graphical representation of the expression of two binomial variables for which the variation domain of one of the variable depend on the other variable was a real problem because the most of the software used interpolation in graphical representation and the surface maps were quadratic instead of triangular. Based on an original algorithm, a module was implements in PHP in order to represent graphically the triangular surface plots. All the implementation described above was uses in computing the confidence intervals and estimating their performance for binomial distributions sample sizes and variable.

Distributed medical services within the ATM-based Berlin regional test bed

Science.gov (United States)

Thiel, Andreas; Bernarding, Johannes; Krauss, Manfred; Schulz, Sandra; Tolxdorff, Thomas

1996-05-01

The ATM-based Metropolitan Area Network (MAN) of Berlin connects two university hospitals (Benjamin Franklin University Hospital and Charite) with the computer resources of the Technical University of Berlin (TUB). Distributed new medical services have been implemented and will be evaluated within the highspeed MAN of Berlin. The network with its data transmission rates of up to 155 Mbit/s renders these medical services externally available to practicing physicians. Resource and application sharing is demonstrated by the use of two software systems. The first software system is an interactive 3D reconstruction tool (3D- Medbild), based on a client-server mechanism. This structure allows the use of high- performance computers at the TUB from the low-level workstations in the hospitals. A second software system, RAMSES, utilizes a tissue database of Magnetic Resonance Images. For the remote control of the software, the developed applications use standards such as DICOM 3.0 and features of the World Wide Web. Data security concepts are being tested and integrated for the needs of the sensitive medical data. The highspeed network is the necessary prerequisite for the clinical evaluation of data in a joint teleconference. The transmission of digitized real-time sequences such as video and ultrasound and the interactive manipulation of data are made possible by Multi Media tools.

Weaving together peer assessment, audios and medical vignettes in teaching medical terms

Science.gov (United States)

Khan, Lateef M.

2015-01-01

Objectives The current study aims at exploring the possibility of aligning peer assessment, audiovisuals, and medical case-report extracts (vignettes) in medical terminology teaching. In addition, the study wishes to highlight the effectiveness of audio materials and medical history vignettes in preventing medical students' comprehension, listening, writing, and pronunciation errors. The study also aims at reflecting the medical students' attitudes towards the teaching and learning process. Methods The study involved 161 medical students who received an intensive medical terminology course through audio and medical history extracts. Peer assessment and formative assessment platforms were applied through fake quizzes in a pre- and post-test manner. An 18-item survey was distributed amongst students to investigate their attitudes and feedback towards the teaching and learning process. Quantitative and qualitative data were analysed using the SPSS software. Results The students did better in the posttests than on the pretests for both the quizzes of audios and medical vignettes showing a t-test of -12.09 and -13.60 respectively. Moreover, out of the 133 students, 120 students (90.22%) responded to the survey questions. The students gave positive attitudes towards the application of audios and vignettes in the teaching and learning of medical terminology and towards the learning process. Conclusions The current study revealed that the teaching and learning of medical terminology have more room for the application of advanced technologies, effective assessment platforms, and active learning strategies in higher education. It also highlights that students are capable of carrying more responsibilities of assessment, feedback, and e-learning. PMID:26637986

Medication reconciliation is a prerequisite for obtaining a valid medication review

DEFF Research Database (Denmark)

Bjeldbak-Olesen, Mette; Danielsen, Anja Gadsbølle; Tomsen, Dorthe Vilstrup

2013-01-01

The objective of this study was to compare medication reconciliation and medication review based on number, type and severity of discrepancies and drug-related problems (DRPs), denoted errors.......The objective of this study was to compare medication reconciliation and medication review based on number, type and severity of discrepancies and drug-related problems (DRPs), denoted errors....

Distribution of microorganisms in medical devices and their inactivation effects by gamma-irradiation

International Nuclear Information System (INIS)

Ito, Hitoshi; Ishigaki, Isao

1986-01-01

Radiation treatment is getting important position for sterilizing medical devices and for packaging films of foods. Recently, survey of bioburden is an important technique for evaluation of sterility doses for medical devices. However, many studies have been done mainly on the irradiation effects of spore-forming bacteria in medical devices. In this study, radiation sensitivity of spore-forming bacteria and fungi were examined after the survey on distribution of microorganisms in several kinds of medical devices. The main contaminant in disposable syringes, needles and conical flasks were consisted of Bacillus, with lesser amount of Micrococcus, Pseudomonas, Peptococcaceae and fungi as positive of 5 - 60 % in the medical devices which cultivated in thioglycolate broth. Bacillus group were identified as B. pumilus, B. sphaericus, B. coagulans, B. megaterium and etc. Fungi were isolated a lesser amounts compared with spore-forming bacteria and identified as Blastomyces, Penicillium, Haplosporangium, Euricoa and Audeobasidium. Peptococaceae were not isolated after irradiation with a dose of 0.1 Mrad even the samples were contaminated with high percentage. The D 10 values of dryed endospores of Bacillus-isolates which attached to the filter paper with pepton-glycerin were obtained to be 0.11 - 0.19 Mrad. The D 10 values of many isolates of fungi in dry condition were obtained below 0.08 Mrad. However, the isolate of Aureobasidium is radiation-resistant, and it's D 10 values was obtained as 0.28 Mrad under aerobic and anaerobic dry condition. (author)

The Self-Perception and Usage of Medical Apps amongst Medical Students in the United States: A Cross-Sectional Survey

Directory of Open Access Journals (Sweden)

Cara Quant

2016-01-01

Full Text Available Background. Mobile medical software applications (apps are used for clinical decision-making at the point of care. Objectives. To determine (1 the usage, reliability, and popularity of mobile medical apps and (2 medical students’ perceptions of app usage effect on the quality of patient-provider interaction in healthcare settings. Methods. An anonymous web-based survey was distributed to medical students. Frequency of use, type of app used, and perceptions of reliability were assessed via univariate analysis. Results. Seven hundred thirty-one medical students responded, equating to a response rate of 29%. The majority (90% of participants thought that medical apps enhance clinical knowledge, and 61% said that medical apps are as reliable as textbooks. While students thought that medical apps save time, improve the care of their patients, and improve diagnostic accuracy, 53% of participants believed that mobile device use in front of colleagues and patients makes one appear less competent. Conclusion. While medical students believe in the utility and reliability of medical apps, they were hesitant to use them out of fear of appearing less engaged. Higher levels of training correlated with a greater degree of comfort when using medical apps in front of patients.

The distribution of P-values in medical research articles suggested selective reporting associated with statistical significance.

Science.gov (United States)

Perneger, Thomas V; Combescure, Christophe

2017-07-01

Published P-values provide a window into the global enterprise of medical research. The aim of this study was to use the distribution of published P-values to estimate the relative frequencies of null and alternative hypotheses and to seek irregularities suggestive of publication bias. This cross-sectional study included P-values published in 120 medical research articles in 2016 (30 each from the BMJ, JAMA, Lancet, and New England Journal of Medicine). The observed distribution of P-values was compared with expected distributions under the null hypothesis (i.e., uniform between 0 and 1) and the alternative hypothesis (strictly decreasing from 0 to 1). P-values were categorized according to conventional levels of statistical significance and in one-percent intervals. Among 4,158 recorded P-values, 26.1% were highly significant (P values values equal to 1, and (3) about twice as many P-values less than 0.05 compared with those more than 0.05. The latter finding was seen in both randomized trials and observational studies, and in most types of analyses, excepting heterogeneity tests and interaction tests. Under plausible assumptions, we estimate that about half of the tested hypotheses were null and the other half were alternative. This analysis suggests that statistical tests published in medical journals are not a random sample of null and alternative hypotheses but that selective reporting is prevalent. In particular, significant results are about twice as likely to be reported as nonsignificant results. Copyright © 2017 Elsevier Inc. All rights reserved.

How learning might strengthen existing visual object representations in human object-selective cortex.

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Brants, Marijke; Bulthé, Jessica; Daniels, Nicky; Wagemans, Johan; Op de Beeck, Hans P

2016-02-15

Visual object perception is an important function in primates which can be fine-tuned by experience, even in adults. Which factors determine the regions and the neurons that are modified by learning is still unclear. Recently, it was proposed that the exact cortical focus and distribution of learning effects might depend upon the pre-learning mapping of relevant functional properties and how this mapping determines the informativeness of neural units for the stimuli and the task to be learned. From this hypothesis we would expect that visual experience would strengthen the pre-learning distributed functional map of the relevant distinctive object properties. Here we present a first test of this prediction in twelve human subjects who were trained in object categorization and differentiation, preceded and followed by a functional magnetic resonance imaging session. Specifically, training increased the distributed multi-voxel pattern information for trained object distinctions in object-selective cortex, resulting in a generalization from pre-training multi-voxel activity patterns to after-training activity patterns. Simulations show that the increased selectivity combined with the inter-session generalization is consistent with a training-induced strengthening of a pre-existing selectivity map. No training-related neural changes were detected in other regions. In sum, training to categorize or individuate objects strengthened pre-existing representations in human object-selective cortex, providing a first indication that the neuroanatomical distribution of learning effects depends upon the pre-learning mapping of visual object properties. Copyright © 2015 Elsevier Inc. All rights reserved.

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.

Using the iBook in medical education and healthcare settings--the iBook as a reusable learning object; a report of the author's experience using iBooks Author software.

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Payne, Karl Fb; Goodson, Alexander Mc; Tahim, Arpan; Wharrad, Heather J; Fan, Kathleen

2012-12-01

The recently launched iBooks 2 from Apple has created a new genre of 'interactive multimedia eBook'. This article aims to dscribe the benefit of the iBook in a medical education and healthcare setting. We discuss the attributes of an iBook as compared with the requirements of the conventional web-based Reusable Learning Object. The structure and user interface within an iBook is highlighted, and the iBook-creating software iBooks Author is discussed in detail. A report of personal experience developing and distributing an iBook for junior trainees in oral and maxillofacial surgery is provided, with discussion of the limitations of this approach and the need for further evidence-based studies.

OntoVIP: an ontology for the annotation of object models used for medical image simulation.

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Gibaud, Bernard; Forestier, Germain; Benoit-Cattin, Hugues; Cervenansky, Frédéric; Clarysse, Patrick; Friboulet, Denis; Gaignard, Alban; Hugonnard, Patrick; Lartizien, Carole; Liebgott, Hervé; Montagnat, Johan; Tabary, Joachim; Glatard, Tristan

2014-12-01

This paper describes the creation of a comprehensive conceptualization of object models used in medical image simulation, suitable for major imaging modalities and simulators. The goal is to create an application ontology that can be used to annotate the models in a repository integrated in the Virtual Imaging Platform (VIP), to facilitate their sharing and reuse. Annotations make the anatomical, physiological and pathophysiological content of the object models explicit. In such an interdisciplinary context we chose to rely on a common integration framework provided by a foundational ontology, that facilitates the consistent integration of the various modules extracted from several existing ontologies, i.e. FMA, PATO, MPATH, RadLex and ChEBI. Emphasis is put on methodology for achieving this extraction and integration. The most salient aspects of the ontology are presented, especially the organization in model layers, as well as its use to browse and query the model repository. Copyright © 2014 Elsevier Inc. All rights reserved.

Medical Need, Equality, and Uncertainty.

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Horne, L Chad

2016-10-01

Many hold that distributing healthcare according to medical need is a requirement of equality. Most egalitarians believe, however, that people ought to be equal on the whole, by some overall measure of well-being or life-prospects; it would be a massive coincidence if distributing healthcare according to medical need turned out to be an effective way of promoting equality overall. I argue that distributing healthcare according to medical need is important for reducing individuals' uncertainty surrounding their future medical needs. In other words, distributing healthcare according to medical need is a natural feature of healthcare insurance; it is about indemnity, not equality. © 2016 John Wiley & Sons Ltd.

Planning an objective and need based curriculum: the logistics with reference to the undergraduate medical education in biochemistry.

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Ramasamy, Ramesh; Gopal, Niranjan; Srinivasan, A R; Murugaiyan, Sathish Babu

2013-03-01

The medical education is recently being transformed into several domains in order to adapt to the need and the value based academics which is required for the quality doctors who serve the community. Presently, the biochemistry curricula for the graduate students of medicine have been questioned by as many experts, because of their multiple lacunae. In this review, we would like to highlight the scenario which is related to the existing biochemistry curricula for graduate medical students, which have been followed in several medical schools and universities and we also hope to share our ideas for implementing objective and pragmatic curricula. Evidence based research, wherein the articles which are related to innovative teaching-learning tools are collected and the pros and cons which are related to the different methods analyzed in biochemistry point of view. Rapid changes in the content of the curriculum may not be required, but a gradual introduction of the novel approach and the methods of teaching biochemistry can be adopted into the curriculum.

The economic contribution of the Northern Ontario School of Medicine to communities participating in distributed medical education.

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Hogenbirk, John C; Robinson, David R; Hill, Mary Ellen; Pong, Raymond W; Minore, Bruce; Adams, Ken; Strasser, Roger P; Lipinski, Joe

2015-01-01

The economic contribution of medical schools to major urban centres can be substantial, but there is little information on the contribution to the economy of participating communities made by schools that provide education and training away from major cities and academic health science centres. We sought to assess the economic contribution of the Northern Ontario School of Medicine (NOSM) to northern Ontario communities participating in NOSM's distributed medical education programs. We developed a local economic model and used actual expenditures from 2007/08 to assess the economic contribution of NOSM to communities in northern Ontario. We also estimated the economic contribution of medical students or residents participating in different programs in communities away from the university campuses. To explore broader economic effects, we conducted semistructured interviews with leaders in education, health care and politics in northern Ontario. The total economic contribution to northern Ontario was $67.1 million based on $36.3 million in spending by NOSM and $1.0 million spent by students. Economic contributions were greatest in the university campus cities of Thunder Bay ($26.7 million) and Sudbury ($30.4 million), and $0.8-$1.2 million accrued to the next 3 largest population centres. Communities might realize an economic contribution of $7300-$103 900 per pair of medical learners per placement. Several of the 59 interviewees remarked that the dollar amount could be small to moderate but had broader economic implications. Distributed medical education at the NOSM resulted in a substantial economic contribution to participating communities.

A life cycle multi-objective economic and environmental assessment of distributed generation in buildings

International Nuclear Information System (INIS)

Safaei, Amir; Freire, Fausto; Henggeler Antunes, Carlos

2015-01-01

Highlights: • A lifecycle optimization model for distributed energy systems is developed. • Model estimates costs and environmental impacts of meeting the building energy demand. • Design and operating strategies to reduce costs and environmental impacts are discussed. • Pareto frontiers of costs vis-à-vis environmental impacts are presented. • Distributed generation can reduce the environmental impacts of the building sector. - Abstract: Distributed generation, namely cogeneration and solar technologies, is expected to play an important role in the future energy supply mix in buildings. This calls for a methodological framework to assess the economic and environmental performance of the building sector when such technologies are employed. A life-cycle model has been developed, combining distributed generation and conventional sources to calculate the cost and environmental impacts of meeting the building energy demand over a defined planning period. Three type of cogeneration technologies, solar photovoltaic and thermal, as well as conventional boilers along with the Portuguese electricity generation mix comprise the energy systems modeled. Pareto optimal frontiers are derived, showing the trade-offs between different types of impacts (non-renewable cumulative energy demand, greenhouse gas emissions, acidification, eutrophication) and cost to meet the energy demand of a commercial building. Our analysis shows that according to the objective to employ distributed generation (reducing cost or environmental impacts), a specific design and operational strategy for the energy systems shall be adopted. The strategies to minimize each type of impact and the associated cost trade-offs by exploring the solutions located on the Pareto optimal frontiers are discussed

Distributed Large Data-Object Environments: End-to-End Performance Analysis of High Speed Distributed Storage Systems in Wide Area ATM Networks

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Johnston, William; Tierney, Brian; Lee, Jason; Hoo, Gary; Thompson, Mary

1996-01-01

We have developed and deployed a distributed-parallel storage system (DPSS) in several high speed asynchronous transfer mode (ATM) wide area networks (WAN) testbeds to support several different types of data-intensive applications. Architecturally, the DPSS is a network striped disk array, but is fairly unique in that its implementation allows applications complete freedom to determine optimal data layout, replication and/or coding redundancy strategy, security policy, and dynamic reconfiguration. In conjunction with the DPSS, we have developed a 'top-to-bottom, end-to-end' performance monitoring and analysis methodology that has allowed us to characterize all aspects of the DPSS operating in high speed ATM networks. In particular, we have run a variety of performance monitoring experiments involving the DPSS in the MAGIC testbed, which is a large scale, high speed, ATM network and we describe our experience using the monitoring methodology to identify and correct problems that limit the performance of high speed distributed applications. Finally, the DPSS is part of an overall architecture for using high speed, WAN's for enabling the routine, location independent use of large data-objects. Since this is part of the motivation for a distributed storage system, we describe this architecture.

Distributed solar photovoltaic array location and extent dataset for remote sensing object identification

Science.gov (United States)

Bradbury, Kyle; Saboo, Raghav; L. Johnson, Timothy; Malof, Jordan M.; Devarajan, Arjun; Zhang, Wuming; M. Collins, Leslie; G. Newell, Richard

2016-12-01

Earth-observing remote sensing data, including aerial photography and satellite imagery, offer a snapshot of the world from which we can learn about the state of natural resources and the built environment. The components of energy systems that are visible from above can be automatically assessed with these remote sensing data when processed with machine learning methods. Here, we focus on the information gap in distributed solar photovoltaic (PV) arrays, of which there is limited public data on solar PV deployments at small geographic scales. We created a dataset of solar PV arrays to initiate and develop the process of automatically identifying solar PV locations using remote sensing imagery. This dataset contains the geospatial coordinates and border vertices for over 19,000 solar panels across 601 high-resolution images from four cities in California. Dataset applications include training object detection and other machine learning algorithms that use remote sensing imagery, developing specific algorithms for predictive detection of distributed PV systems, estimating installed PV capacity, and analysis of the socioeconomic correlates of PV deployment.

Nationaler Kompetenzbasierter Lernzielkatalog Medizin (NKLM für Deutschland: Zusammenarbeit der Gesellschaft für Medizinische Ausbildung (GMA und des Medizinischen Fakultätentages (MFT [National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM in Germany: Cooperation of the Association for Medical Education (GMA and the Association of Medical Faculties in Germany (MFT

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Hahn, Eckhart G.

2009-08-01

Full Text Available [english] The Framework for Qualifications of the European Higher Education Area (FQ-EHEA; Bologna Process and the European Qualifications Framework for Lifelong Learning (EQF-LLL; Lisbon Process are competence-driven frameworks for vocational and higher education programmes in need for defined learning objectives. In the field of medical education, The Netherlands and Switzerland have developed national catalogues for undergraduate medical training, which are competence-based and compatible with a two-cycle curriculum comprised of a Bachelor in Medicine and a Master in Medicine. In Germany, virtually all medical organizations, last not least the Association of Medical Faculties (MFT, have voted against the application of the two-cycle (and the three-cycle curriculum to medical undergraduate education. A standstill of the European processes will not be accepted in the political arena, and a proposition was made by the Conference of German Ministers of Higher Education to develop a medical qualification framework for Germany, asking the Association for Medical Education (GMA and the MFT to join forces. This is not possible without consented national learning objectives derived from the professional context of physicians. The GMA has teamed up with the MFT to develop National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM in Germany (see Figure 1 to fulfill these needs.

Characteristics of medical teachers using student-centered teaching methods.

Science.gov (United States)

Kim, Kyong-Jee; Hwang, Jee-Young

2017-09-01

This study investigated characteristics of medical teachers who have adopted student-centered teaching methods into their teaching. A 24-item questionnaire consisted of respondent backgrounds, his or her use of student-centered teaching methods, and awareness of the school's educational objectives and curricular principles was administered of faculty members at a private medical school in Korea. Descriptive statistics and chi-square analysis were conducted to compare faculty use of student-centered approaches across different backgrounds and awareness of curricular principles. Overall response rate was 70% (N=140/200), approximately 25% (n=34) of whom were using student-centered teaching methods. Distributions in the faculty use of student-centered teaching methods were significantly higher among basic sciences faculty (versus clinical sciences faculty), with teaching experiences of over 10 years (versus less than 10 years), and who were aware of the school's educational objectives and curricular principles. Our study indicates differences in medical faculty's practice of student-centered teaching across disciplines, teaching experiences, and their understanding of the school's educational objectives curricular principles. These findings have implications for faculty development and institutional support to better promote faculty use of student-centered teaching approaches.

Experience using a distributed object oriented database for a DAQ system

International Nuclear Information System (INIS)

Bee, C.P.; Eshghi, S.; Jones, R.

1996-01-01

To configure the RD13 data acquisition system, we need many parameters which describe the various hardware and software components. Such information has been defined using an entity-relation model and stored in a commercial memory-resident database. during the last year, Itasca, an object oriented database management system (OODB), was chosen as a replacement database system. We have ported the existing databases (hs and sw configurations, run parameters etc.) to Itasca and integrated it with the run control system. We believe that it is possible to use an OODB in real-time environments such as DAQ systems. In this paper, we present our experience and impression: why we wanted to change from an entity-relational approach, some useful features of Itasca, the issues we meet during this project including integration of the database into an existing distributed environment and factors which influence performance. (author)

Impact of a regional distributed medical education program on an underserved community: perceptions of community leaders.

Science.gov (United States)

Toomey, Patricia; Lovato, Chris Y; Hanlon, Neil; Poole, Gary; Bates, Joanna

2013-06-01

To describe community leaders' perceptions regarding the impact of a fully distributed undergraduate medical education program on a small, medically underserved host community. The authors conducted semistructured interviews in 2007 with 23 community leaders representing, collectively, the education, health, economic, media, and political sectors. They reinterviewed six participants from a pilot study (2005) and recruited new participants using purposeful and snowball sampling. The authors employed analytic induction to organize content thematically, using the sectors as a framework, and they used open coding to identify new themes. The authors reanalyzed transcripts to identify program outcomes (e.g., increased research capacity) and construct a list of quantifiable indicators (e.g., number of grants and publications). Participants reported their perspectives on the current and anticipated impact of the program on education, health services, the economy, media, and politics. Perceptions of impact were overwhelmingly positive (e.g., increased physician recruitment), though some were negative (e.g., strains on health resources). The authors identified new outcomes and confirmed outcomes described in 2005. They identified 16 quantifiable indicators of impact, which they judged to be plausible and measureable. Participants perceive that the regional undergraduate medical education program in their community has broad, local impacts. Findings suggest that early observed outcomes have been maintained and may be expanding. Results may be applicable to medical education programs with distributed or regional sites in similar rural, remote, and/or underserved regions. The areas of impact, outcomes, and quantifiable indicators identified will be of interest to future researchers and evaluators.

[Experience of the development special medical technical laboratory for studies of effects caused by potent electromagnetic radiation in biologic objects].

Science.gov (United States)

Gorodetsky, B N; Kalyada, T V; Petrov, S V

2015-01-01

This article covers topics of creating special medical technical laboratory for medial and biologic studies concerning influence of potent high-frequency elecromagnetic radiation on various biologic objects. The authors gave example of such laboratory, described its construction features, purpose and main characteristics of the included devices.

About the Distribution of Metal Objects in Prepalatial Crete

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Borja Legarra Herrero

2004-11-01

Full Text Available Although metal objects have been used as evidence in different interpretations of the socioeconomic changes identified in Prepalatial Crete (c.3100-1900 BC, they constitute an understudied category of material. This paper argues that metal objects on Crete were subject to complex processes regarding the creation of meaning; a more comprehensive appraisal of metal objects on the island may cast new light on these issues. Copper-based, gold, lead and silver objects are investigated from their ore extraction locations outside Crete to their final deposition, linking the different steps of the process of creating an artefact with different layers of meanings for the metal and, subsequently, for the finished objects. This study evaluates differences in the use of metals, with a particular focus on their intra-island depositional patterns. It seeks to identify differences in the roles of metals within Cretan communities as well as regional fashions in the use of metal objects. It is suggested that metals had different characters since their depositional patterns vary, and that people consciously chose certain metals to make specific objects and also used metal objects in different ways, reflecting the socio-economic context for each region.

Medical Futility and Involuntary Passive Euthanasia.

Science.gov (United States)

Nair-Collins, Michael

2018-01-01

Conflicts between providers and patients or their families surrounding end-of-life care are both regrettable and extremely challenging, interpersonally and ethically, for all involved. These conflicts often implicate the concept of medical futility. The concept of futility is too often conflated with distinct concepts that are more ethically salient, including the fiduciary responsibility to assess surrogate decision-making, and distributive justice. By distinguishing these concepts from futility, it becomes clear that there are some situations in which forgoing life-sustaining treatment over objection is permissible, and perhaps even obligatory. But the justification lies in the constellation of rights and responsibilities surrounding surrogate decision-making, or in distributive justice, but not futility. Once futility is disambiguated from these other concepts, the practice of withholding or withdrawing life-sustaining treatment over the objection of a valid surrogate or a competent patient, based on the alleged futility of such treatment, is more clearly described as involuntary passive euthanasia.

What influences national and foreign physicians' geographic distribution? An analysis of medical doctors' residence location in Portugal.

Science.gov (United States)

Russo, Giuliano; Ferrinho, Paulo; de Sousa, Bruno; Conceição, Cláudia

2012-07-02

The debate over physicians' geographical distribution has attracted the attention of the economic and public health literature over the last forty years. Nonetheless, it is still to date unclear what influences physicians' location, and whether foreign physicians contribute to fill the geographical gaps left by national doctors in any given country. The present research sets out to investigate the current distribution of national and international physicians in Portugal, with the objective to understand its determinants and provide an evidence base for policy-makers to identify policies to influence it. A cross-sectional study of physicians currently registered in Portugal was conducted to describe the population and explore the association of physician residence patterns with relevant personal and municipality characteristics. Data from the Portuguese Medical Council on physicians' residence and characteristics were analysed, as well as data from the National Institute of Statistics on municipalities' population, living standards and health care network. Descriptive statistics, chi-square tests, negative binomial and logistic regression modelling were applied to determine: (a) municipality characteristics predicting Portuguese and International physicians' geographical distribution, and; (b) doctors' characteristics that could increase the odds of residing outside the country's metropolitan areas. There were 39,473 physicians in Portugal in 2008, 51.1% of whom male, and 40.2% between 41 and 55 years of age. They were predominantly Portuguese (90.5%), with Spanish, Brazilian and African nationalities also represented. Population, Population's Purchasing Power, Nurses per capita and Municipality Development Index (MDI) were the municipality characteristics displaying the strongest association with national physicians' location. For foreign physicians, the MDI was not statistically significant, while municipalities' foreign population applying for residence

What influences national and foreign physicians’ geographic distribution? An analysis of medical doctors’ residence location in Portugal

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Russo Giuliano

2012-07-01

Full Text Available Abstract Background The debate over physicians’ geographical distribution has attracted the attention of the economic and public health literature over the last forty years. Nonetheless, it is still to date unclear what influences physicians’ location, and whether foreign physicians contribute to fill the geographical gaps left by national doctors in any given country. The present research sets out to investigate the current distribution of national and international physicians in Portugal, with the objective to understand its determinants and provide an evidence base for policy-makers to identify policies to influence it. Methods A cross-sectional study of physicians currently registered in Portugal was conducted to describe the population and explore the association of physician residence patterns with relevant personal and municipality characteristics. Data from the Portuguese Medical Council on physicians’ residence and characteristics were analysed, as well as data from the National Institute of Statistics on municipalities’ population, living standards and health care network. Descriptive statistics, chi-square tests, negative binomial and logistic regression modelling were applied to determine: (a municipality characteristics predicting Portuguese and International physicians’ geographical distribution, and; (b doctors’ characteristics that could increase the odds of residing outside the country’s metropolitan areas. Results There were 39,473 physicians in Portugal in 2008, 51.1% of whom male, and 40.2% between 41 and 55 years of age. They were predominantly Portuguese (90.5%, with Spanish, Brazilian and African nationalities also represented. Population, Population’s Purchasing Power, Nurses per capita and Municipality Development Index (MDI were the municipality characteristics displaying the strongest association with national physicians’ location. For foreign physicians, the MDI was not statistically significant

Multi-objective optimization of cooling air distributions of grate cooler with different clinker particles diameters and air chambers by genetic algorithm

International Nuclear Information System (INIS)

Shao, Wei; Cui, Zheng; Cheng, Lin

2017-01-01

Highlights: • A multi-objective optimization model of air distributions of grate cooler by genetic algorithm is proposed. • Optimal air distributions of different conditions are obtained and validated by measurements. • The most economic average diameters of clinker particles is 0.02 m. • The most economic amount of air chambers is 9. - Abstract: The paper proposes a multi-objective optimization model of cooling air distributions of grate cooler in cement plant based on convective heat transfer principle and entropy generation minimization analysis. The heat transfer and flow models of clinker cooling process are brought out at first. Then the modified entropy generation numbers caused by heat transfer and viscous dissipation are considered as objective functions respectively which are optimized by genetic algorithm simultaneously. The design variables are superficial velocities of air chambers and thicknesses of clinker layer on different grate plates. The model is verified by a set of Pareto optimal solutions and scattered distributions of design variables. Sensitive analysis of average diameters of clinker particles and amount of air chambers are carried out based on the optimization model. The optimal cooling air distributions are compared by heat recovered, energy consumption of cooling fans and heat efficiency of grate cooler. And all of them are selected from the Pareto optimal solutions based on energy consumption of cooling fans minimization. The results show that the most effective and economic average diameter of clinker particles is 0.02 m and the amount of air chambers is 9.

Design and implementation of distributed multimedia surveillance system based on object-oriented middleware

Science.gov (United States)

Cao, Xuesong; Jiang, Ling; Hu, Ruimin

2006-10-01

Currently, the applications of surveillance system have been increasingly widespread. But there are few surveillance platforms that can meet the requirement of large-scale, cross-regional, and flexible surveillance business. In the paper, we present a distributed surveillance system platform to improve safety and security of the society. The system is constructed by an object-oriented middleware called as Internet Communications Engine (ICE). This middleware helps our platform to integrate a lot of surveillance resource of the society and accommodate diverse range of surveillance industry requirements. In the follow sections, we will describe in detail the design concepts of system and introduce traits of ICE.

Quantitative Analysis of Uncertainty in Medical Reporting: Creating a Standardized and Objective Methodology.

Science.gov (United States)

Reiner, Bruce I

2018-04-01

Uncertainty in text-based medical reports has long been recognized as problematic, frequently resulting in misunderstanding and miscommunication. One strategy for addressing the negative clinical ramifications of report uncertainty would be the creation of a standardized methodology for characterizing and quantifying uncertainty language, which could provide both the report author and reader with context related to the perceived level of diagnostic confidence and accuracy. A number of computerized strategies could be employed in the creation of this analysis including string search, natural language processing and understanding, histogram analysis, topic modeling, and machine learning. The derived uncertainty data offers the potential to objectively analyze report uncertainty in real time and correlate with outcomes analysis for the purpose of context and user-specific decision support at the point of care, where intervention would have the greatest clinical impact.

Tablet technology in medical education in South Africa: a mixed methods study

OpenAIRE

Lazarus, L; Sookrajh, R; Satyapal, K S

2017-01-01

Objective The purpose of this study was to establish the use of mobile devices by learners at a selected medical school. Distribution of mobile devices was an inaugural initiative implemented by our college. Design A mixed methodology design using a questionnaire comprising both open-ended and close-ended questions was analysed from 179 (60 male; 119 female) second year medical students registered for the Anatomy course. Open-ended questions were analysed using a thematic approach by identify...

Conducting Integrated Objective Structured Clinical Examination: Experiences at KIST Medical College, Nepal

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Rano Mal Piryani

2013-01-01

Full Text Available Background: Objective structured clinical examination (OSCE, an important tool for assessment of clinical skills, introduced more than 4 decades ago. KIST Medical College, a new medical school of Nepal, affiliated to Tribhuvan University Institute of Medicine, has made learning of physical examination skills structured and integrated with greater involvement of different clinical science departments. Students learn physical examination skills in second year MBBS as a part of early clinical exposure. Objective: To share the experiences regarding implementation of integrated OSCE. Materials and Methods: At the end of clinical posting of learning of physical examination skills, assessment was done with OSCE. Fifteen OSCE stations including each of 5 minutes were developed and arranged. Standardized patients and validated checklist were used. OSCE was conducted in novel way. Prior to the OSCE session: Suitable venue was selected, assessors were identified, standardized patients were selected, running order of the stations in circuit was developed, list of equipments/instruments required was prepared, and tasks, checklists, feedback questionnaires were printed. The day before the OSCE session: OSCE stations were inspected and clearly labeled, condition of required equipments/instruments was checked, a pack of the documents for each OSCE station were made available, and signs were displayed at proper places. On the day of the OSCE session: Reliable stop watch and loud manual bell were used, support staffs were placed to direct the candidates, examiners, and standardized patients (SPs, assessors explained SPs, students were briefed, supervisors observed the session, and feedback were taken from students, assessors, and SPs. At the end of the OSCE session: Checklists and feedback questionnaires were collected, token money was paid to SPs, and a contribution of everyone was appreciated. After the OSCE session: Score was compiled and result declared, and

A practical multi-objective PSO algorithm for optimal operation management of distribution network with regard to fuel cell power plants

Energy Technology Data Exchange (ETDEWEB)

Niknam, Taher; Meymand, Hamed Zeinoddini; Mojarrad, Hasan Doagou [Department of Electrical and Electronics Engineering, Shiraz University of Technology, Shiraz, P.O. 71555-313 (Iran, Islamic Republic of)

2011-05-15

In this paper a novel Multi-objective fuzzy self adaptive hybrid particle swarm optimization (MFSAHPSO) evolutionary algorithm to solve the Multi-objective optimal operation management (MOOM) is presented. The purposes of the MOOM problem are to decrease the total electrical energy losses, the total electrical energy cost and the total pollutant emission produced by fuel cells and substation bus. Conventional algorithms used to solve the multi-objective optimization problems convert the multiple objectives into a single objective, using a vector of the user-predefined weights. In this conversion several deficiencies can be detected. For instance, the optimal solution of the algorithms depends greatly on the values of the weights and also some of the information may be lost in the conversion process and so this strategy is not expected to provide a robust solution. This paper presents a new MFSAHPSO algorithm for the MOOM problem. The proposed algorithm maintains a finite-sized repository of non-dominated solutions which gets iteratively updated in the presence of new solutions. Since the objective functions are not the same, a fuzzy clustering technique is used to control the size of the repository, within the limits. The proposed algorithm is tested on a distribution test feeder and the results demonstrate the capabilities of the proposed approach, to generate true and well-distributed Pareto-optimal non-dominated solutions of the MOOM problem. (author)

High-Surety Telemedicine in a Distributed, 'Plug-and-Play' Environment

International Nuclear Information System (INIS)

Craft, Richard L.; Funkhouser, Donald R.; Gallagher, Linda K.; Garcia, Rudy J.; Parks, Raymond C.; Warren, Steve

1999-01-01

Commercial telemedicine systems are increasingly functional, incorporating video-conferencing capabilities, diagnostic peripherals, medication reminders, and patient education services. However, these systems (1) rarely utilize information architectures which allow them to be easily integrated with existing health information networks and (2) do not always protect patient confidentiality with adequate security mechanisms. Using object-oriented methods and software wrappers, we illustrate the transformation of an existing stand-alone telemedicine system into 'plug-and-play' components that function in a distributed medical information environment. We show, through the use of open standards and published component interfaces, that commercial telemedicine offerings which were once incompatible with electronic patient record systems can now share relevant data with clinical information repositories while at the same time hiding the proprietary implementations of the respective systems. Additionally, we illustrate how leading-edge technology can secure this distributed telemedicine environment, maintaining patient confidentiality and the integrity of the associated electronic medical data. Information surety technology also encourages the development of telemedicine systems that have both read and write access to electronic medical records containing patient-identifiable information. The win-win approach to telemedicine information system development preserves investments in legacy software and hardware while promoting security and interoperability in a distributed environment

Distributed Measurement Data Gathering about Moving Objects

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Ivan Kholod

2017-01-01

Full Text Available This paper describes approaches to gathering measurement data about moving objects in networks with low bandwidth. The first approach uses Fog computing conception and suggests moving assessing the quality of the measurement data into measuring points. The second approach uses prediction of telemetry quality by mining models. In addition, the paper presents implementation of these approaches based on actor model. As a result, it became possible not only to load balancing among edge and cloud nodes, but also to significantly reduce the network traffic, which in turn brings the possibility of decreasing the requirements for communication channels bandwidth and of using wireless networks for gathering measurement data about moving objects.

[Development and evaluation of the medical imaging distribution system with dynamic web application and clustering technology].

Science.gov (United States)

Yokohama, Noriya; Tsuchimoto, Tadashi; Oishi, Masamichi; Itou, Katsuya

2007-01-20

It has been noted that the downtime of medical informatics systems is often long. Many systems encounter downtimes of hours or even days, which can have a critical effect on daily operations. Such systems remain especially weak in the areas of database and medical imaging data. The scheme design shows the three-layer architecture of the system: application, database, and storage layers. The application layer uses the DICOM protocol (Digital Imaging and Communication in Medicine) and HTTP (Hyper Text Transport Protocol) with AJAX (Asynchronous JavaScript+XML). The database is designed to decentralize in parallel using cluster technology. Consequently, restoration of the database can be done not only with ease but also with improved retrieval speed. In the storage layer, a network RAID (Redundant Array of Independent Disks) system, it is possible to construct exabyte-scale parallel file systems that exploit storage spread. Development and evaluation of the test-bed has been successful in medical information data backup and recovery in a network environment. This paper presents a schematic design of the new medical informatics system that can be accommodated from a recovery and the dynamic Web application for medical imaging distribution using AJAX.

A Routing Mechanism for Cloud Outsourcing of Medical Imaging Repositories.

Science.gov (United States)

Godinho, Tiago Marques; Viana-Ferreira, Carlos; Bastião Silva, Luís A; Costa, Carlos

2016-01-01

Web-based technologies have been increasingly used in picture archive and communication systems (PACS), in services related to storage, distribution, and visualization of medical images. Nowadays, many healthcare institutions are outsourcing their repositories to the cloud. However, managing communications between multiple geo-distributed locations is still challenging due to the complexity of dealing with huge volumes of data and bandwidth requirements. Moreover, standard methodologies still do not take full advantage of outsourced archives, namely because their integration with other in-house solutions is troublesome. In order to improve the performance of distributed medical imaging networks, a smart routing mechanism was developed. This includes an innovative cache system based on splitting and dynamic management of digital imaging and communications in medicine objects. The proposed solution was successfully deployed in a regional PACS archive. The results obtained proved that it is better than conventional approaches, as it reduces remote access latency and also the required cache storage space.

An overview of medical informatics education in China.

Science.gov (United States)

Hu, Dehua; Sun, Zhenling; Li, Houqing

2013-05-01

country over the past 10 years. Frequent changes in the specialty's name and an unclear identity have hampered the visibility of this educational specialty and impeded its development. There is a noticeable imbalance in the distribution of degree programs in medical informatics in different disciplines, with the majority falling under information management. There is also an uneven distribution of the specialty settings of medical informatics at the various academic levels (bachelor's, master's, and doctoral). In addition, the objectives and curriculum design of medical informatics education differ from one university to another and also from those of foreign universities or colleges. It is recommended that China (1) treat medical informatics as a priority "must-have" discipline to build in China, (2) establish its own independent, balanced degree programs, (3) set up a specialty of "medical informatics" under the "medicine" category, (4) explore curriculum integration with international medical informatics education, and (5) establish and improve medical informatics education system. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Exact and Heuristic Solutions to Minimize Total Waiting Time in the Blood Products Distribution Problem

Directory of Open Access Journals (Sweden)

Amir Salehipour

2012-01-01

Full Text Available This paper presents a novel application of operations research to support decision making in blood distribution management. The rapid and dynamic increasing demand, criticality of the product, storage, handling, and distribution requirements, and the different geographical locations of hospitals and medical centers have made blood distribution a complex and important problem. In this study, a real blood distribution problem containing 24 hospitals was tackled by the authors, and an exact approach was presented. The objective of the problem is to distribute blood and its products among hospitals and medical centers such that the total waiting time of those requiring the product is minimized. Following the exact solution, a hybrid heuristic algorithm is proposed. Computational experiments showed the optimal solutions could be obtained for medium size instances, while for larger instances the proposed hybrid heuristic is very competitive.

Objective Bayesian Analysis of Skew- t Distributions

KAUST Repository

BRANCO, MARCIA D'ELIA; GENTON, MARC G.; LISEO, BRUNERO

2012-01-01

We study the Jeffreys prior and its properties for the shape parameter of univariate skew-t distributions with linear and nonlinear Student's t skewing functions. In both cases, we show that the resulting priors for the shape parameter are symmetric

Object width modulates object-based attentional selection.

Science.gov (United States)

Nah, Joseph C; Neppi-Modona, Marco; Strother, Lars; Behrmann, Marlene; Shomstein, Sarah

2018-04-24

Visual input typically includes a myriad of objects, some of which are selected for further processing. While these objects vary in shape and size, most evidence supporting object-based guidance of attention is drawn from paradigms employing two identical objects. Importantly, object size is a readily perceived stimulus dimension, and whether it modulates the distribution of attention remains an open question. Across four experiments, the size of the objects in the display was manipulated in a modified version of the two-rectangle paradigm. In Experiment 1, two identical parallel rectangles of two sizes (thin or thick) were presented. Experiments 2-4 employed identical trapezoids (each having a thin and thick end), inverted in orientation. In the experiments, one end of an object was cued and participants performed either a T/L discrimination or a simple target-detection task. Combined results show that, in addition to the standard object-based attentional advantage, there was a further attentional benefit for processing information contained in the thick versus thin end of objects. Additionally, eye-tracking measures demonstrated increased saccade precision towards thick object ends, suggesting that Fitts's Law may play a role in object-based attentional shifts. Taken together, these results suggest that object-based attentional selection is modulated by object width.

Modelling formation of disinfection by-products in water distribution: Optimisation using a multi-objective evolutionary algorithm

KAUST Repository

Radhakrishnan, Mohanasundar; Pathirana, Assela; Ghebremichael, Kebreab A.; Amy, Gary L.

2012-01-01

Concerns have been raised regarding disinfection by-products (DBPs) formed as a result of the reaction of halogen-based disinfectants with DBP precursors. In order to appreciate the chemical and biological tradeoffs, it is imperative to understand the formation trends of DBPs and their spread in the distribution network. However, the water at a point in a complex distribution system is a mixture from various sources, whose proportions are complex to estimate and requires advanced hydraulic analysis. To understand the risks of DBPs and to develop mitigation strategies, it is important to understand the distribution of DBPs in a water network, which requires modelling. The goal of this research was to integrate a steady-state water network model with a particle backtracking algorithm and chlorination as well as DBPs models in order to assess the tradeoffs between biological and chemical risks in the distribution network. A multi-objective optimisation algorithm was used to identify the optimal proportion of water from various sources, dosages of alum, and dosages of chlorine in the treatment plant and in booster locations to control the formation of chlorination DBPs and to achieve a balance between microbial and chemical risks. © IWA Publishing 2012.

Modelling formation of disinfection by-products in water distribution: Optimisation using a multi-objective evolutionary algorithm

KAUST Repository

Radhakrishnan, Mohanasundar

2012-05-01

Concerns have been raised regarding disinfection by-products (DBPs) formed as a result of the reaction of halogen-based disinfectants with DBP precursors. In order to appreciate the chemical and biological tradeoffs, it is imperative to understand the formation trends of DBPs and their spread in the distribution network. However, the water at a point in a complex distribution system is a mixture from various sources, whose proportions are complex to estimate and requires advanced hydraulic analysis. To understand the risks of DBPs and to develop mitigation strategies, it is important to understand the distribution of DBPs in a water network, which requires modelling. The goal of this research was to integrate a steady-state water network model with a particle backtracking algorithm and chlorination as well as DBPs models in order to assess the tradeoffs between biological and chemical risks in the distribution network. A multi-objective optimisation algorithm was used to identify the optimal proportion of water from various sources, dosages of alum, and dosages of chlorine in the treatment plant and in booster locations to control the formation of chlorination DBPs and to achieve a balance between microbial and chemical risks. © IWA Publishing 2012.

The structure of medical competence and results on an Objective Structured Clinical Examination

NARCIS (Netherlands)

Jacobs, A.; Denessen, E.J.P.G.; Postma, C.

2004-01-01

Background: Medical competence is a central concept in medical education. Educational efforts in medical training are directed at the achievement of a maximal medical competence. The concept of the structure of medical competence (multidimensional or one-dimensional with strongly interrelated

Development of a Dynamically Configurable,Object-Oriented Framework for Distributed, Multi-modal Computational Aerospace Systems Simulation

Science.gov (United States)

Afjeh, Abdollah A.; Reed, John A.

2003-01-01

This research is aimed at developing a neiv and advanced simulation framework that will significantly improve the overall efficiency of aerospace systems design and development. This objective will be accomplished through an innovative integration of object-oriented and Web-based technologies ivith both new and proven simulation methodologies. The basic approach involves Ihree major areas of research: Aerospace system and component representation using a hierarchical object-oriented component model which enables the use of multimodels and enforces component interoperability. Collaborative software environment that streamlines the process of developing, sharing and integrating aerospace design and analysis models. . Development of a distributed infrastructure which enables Web-based exchange of models to simplify the collaborative design process, and to support computationally intensive aerospace design and analysis processes. Research for the first year dealt with the design of the basic architecture and supporting infrastructure, an initial implementation of that design, and a demonstration of its application to an example aircraft engine system simulation.

Medical Students' Perspective Towards Their Future Medical Practice

African Journals Online (AJOL)

Objectives:To evaluate the influencing factors towards choice of the medical profession and attitude towards future medical practice. Subjects and methods: One hundred thirty four students of the Gondar College of Medical Sciences were included in the study. Data was collected by using self-administered questionnaires.

Distribution of innate psychomotor skills recognized as important for surgical specialization in unconditioned medical undergraduates.

Science.gov (United States)

Moglia, Andrea; Morelli, Luca; Ferrari, Vincenzo; Ferrari, Mauro; Mosca, Franco; Cuschieri, Alfred

2018-03-14

There is an increasing interest for a test assessing objectively the innate aptitude for surgery as a craft specialty to complement the current selection process of surgical residents. The aim of this study was to quantify the size of individuals with high, average, and low level of innate psychomotor skills among medical students. A volunteer sample of 155 medical students, without prior experience with surgical simulator, executed five tasks at a virtual simulator for robot-assisted surgery. They had to reach proficiency twice consecutively in each before moving to the next one. A weighting based on time and number of attempts needed to reach proficiency was assigned to each task. Nine students (5.8%) out of 155 significantly outperformed all the others on median (i.q.r.) weighted time [44.7 (42.2-47.3) min vs. 98.5 (70.8-131.8) min, p specialization in other (non-craft) medical specialties.

Relations between the matter density and layer thickness radial distributions in spherically symmetric objects: for high energy nuclear physics and astrophysics use

International Nuclear Information System (INIS)

Zielinska, M.; Zawislawski, Z.; Strugalska-Gola, E.; Strugalski, Z.

1991-01-01

It is shown how it is possible to transform known data on radial distribution of the matter layer thickness to unknown radial distribution of the matter density inside spherically symmetric objects. Appropriate formulas and testing of them are presented. An application of the method for the radial distribution of the matter density inside a target nucleus is discussed as an example. 2 refs.; 2 figs

Virtual patient simulator for distributed collaborative medical education.

Science.gov (United States)

Caudell, Thomas P; Summers, Kenneth L; Holten, Jim; Hakamata, Takeshi; Mowafi, Moad; Jacobs, Joshua; Lozanoff, Beth K; Lozanoff, Scott; Wilks, David; Keep, Marcus F; Saiki, Stanley; Alverson, Dale

2003-01-01

Project TOUCH (Telehealth Outreach for Unified Community Health; http://hsc.unm.edu/touch) investigates the feasibility of using advanced technologies to enhance education in an innovative problem-based learning format currently being used in medical school curricula, applying specific clinical case models, and deploying to remote sites/workstations. The University of New Mexico's School of Medicine and the John A. Burns School of Medicine at the University of Hawai'i face similar health care challenges in providing and delivering services and training to remote and rural areas. Recognizing that health care needs are local and require local solutions, both states are committed to improving health care delivery to their unique populations by sharing information and experiences through emerging telehealth technologies by using high-performance computing and communications resources. The purpose of this study is to describe the deployment of a problem-based learning case distributed over the National Computational Science Alliance's Access Grid. Emphasis is placed on the underlying technical components of the TOUCH project, including the virtual reality development tool Flatland, the artificial intelligence-based simulation engine, the Access Grid, high-performance computing platforms, and the software that connects them all. In addition, educational and technical challenges for Project TOUCH are identified. Copyright 2003 Wiley-Liss, Inc.

Knowledge of medical ethics among Nigerian medical doctors ...

African Journals Online (AJOL)

Background: The knowledge of medical ethics is essential for health care practitioners worldwide. The main objective of this study was to evaluate the knowledge of medical doctors in a tertiary care hospital in Nigeria in the area of medical ethics. Materials and Methods: A cross– sectional questionnaire‑based study ...

Perspective: Medical education in medical ethics and humanities as the foundation for developing medical professionalism.

Science.gov (United States)

Doukas, David J; McCullough, Laurence B; Wear, Stephen

2012-03-01

Medical education accreditation organizations require medical ethics and humanities education to develop professionalism in medical learners, yet there has never been a comprehensive critical appraisal of medical education in ethics and humanities. The Project to Rebalance and Integrate Medical Education (PRIME) I Workshop, convened in May 2010, undertook the first critical appraisal of the definitions, goals, and objectives of medical ethics and humanities teaching. The authors describe assembling a national expert panel of educators representing the disciplines of ethics, history, literature, and the visual arts. This panel was tasked with describing the major pedagogical goals of art, ethics, history, and literature in medical education, how these disciplines should be integrated with one another in medical education, and how they could be best integrated into undergraduate and graduate medical education. The authors present the recommendations resulting from the PRIME I discussion, centered on three main themes. The major goal of medical education in ethics and humanities is to promote humanistic skills and professional conduct in physicians. Patient-centered skills enable learners to become medical professionals, whereas critical thinking skills assist learners to critically appraise the concept and implementation of medical professionalism. Implementation of a comprehensive medical ethics and humanities curriculum in medical school and residency requires clear direction and academic support and should be based on clear goals and objectives that can be reliably assessed. The PRIME expert panel concurred that medical ethics and humanities education is essential for professional development in medicine.

A multi-objective optimization of the active and reactive resource scheduling at a distribution level in a smart grid context

DEFF Research Database (Denmark)

Sousa, Tiago; Morais, Hugo; Vale, Zita

2015-01-01

In the traditional paradigm, the large power plants supply the reactive power required at a transmission level and the capacitors and transformer tap changer were also used at a distribution level. However, in a near future will be necessary to schedule both active and reactive power...... at a distribution level, due to the high number of resources connected in distribution levels. This paper proposes a new multi-objective methodology to deal with the optimal resource scheduling considering the distributed generation, electric vehicles and capacitor banks for the joint active and reactive power...... scheduling. The proposed methodology considers the minimization of the cost (economic perspective) of all distributed resources, and the minimization of the voltage magnitude difference (technical perspective) in all buses. The Pareto front is determined and a fuzzy-based mechanism is applied to present...

Impact of fuel cell power plants on multi-objective optimal operation management of distribution network

Energy Technology Data Exchange (ETDEWEB)

Niknam, T. [Electrical and Electronic Engineering Department, Shiraz University of Technology, Shiraz (Iran, Islamic Republic of); Zeinoddini-Meymand, H. [Islamic Azad University, Kerman Branch, Kerman (Iran, Islamic Republic of)

2012-06-15

This paper presents an interactive fuzzy satisfying method based on hybrid modified honey bee mating optimization and differential evolution (MHBMO-DE) to solve the multi-objective optimal operation management (MOOM) problem, which can be affected by fuel cell power plants (FCPPs). The objective functions are to minimize total electrical energy losses, total electrical energy cost, total pollutant emission produced by sources, and deviation of bus voltages. A new interactive fuzzy satisfying method is presented to solve the multi-objective problem by assuming that the decision-maker (DM) has fuzzy goals for each of the objective functions. Through the interaction with the DM, the fuzzy goals of the DM are quantified by eliciting the corresponding membership functions. Then, by considering the current solution, the DM acts on this solution by updating the reference membership values until the satisfying solution for the DM can be obtained. The MOOM problem is modeled as a mixed integer nonlinear programming problem. Evolutionary methods are used to solve this problem because of their independence from type of the objective function and constraints. Recently researchers have presented a new evolutionary method called honey bee mating optimization (HBMO) algorithm. Original HBMO often converges to local optima, in order to overcome this shortcoming, we propose a new method that improves the mating process and also, combines the modified HBMO with DE algorithm. Numerical results for a distribution test system have been presented to illustrate the performance and applicability of the proposed method. (Copyright copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

The objectives-based logbook : a tool for evaluation of medical education

NARCIS (Netherlands)

Raghoebar-Krieger, Helga Maria Josette

2001-01-01

In the Netherlands medical schools are responsible for the quality control of medical education. Quality control of education relates to the evaluation of what students have learned (the output). Because the output depends on factors such as the learning processes of students and the input of

A multi-objective possibilistic programming approach for locating distribution centers and allocating customers demands in supply chains

Directory of Open Access Journals (Sweden)

Seyed Ahmad Yazdian

2011-01-01

Full Text Available In this paper, we present a multi-objective possibilistic programming model to locate distribution centers (DCs and allocate customers' demands in a supply chain network design (SCND problem. The SCND problem deals with determining locations of facilities (DCs and/or plants, and also shipment quantities between each two consecutive tier of the supply chain. The primary objective of this study is to consider different risk factors which are involved in both locating DCs and shipping products as an objective function. The risk consists of various components: the risks related to each potential DC location, the risk associated with each arc connecting a plant to a DC and the risk of shipment from a DC to a customer. The proposed method of this paper considers the risk phenomenon in fuzzy forms to handle the uncertainties inherent in these factors. A possibilistic programming approach is proposed to solve the resulted multi-objective problem and a numerical example for three levels of possibility is conducted to analyze the model.

Propelling Extended Objects

Science.gov (United States)

Humbert, Richard

2010-01-01

A force acting on just part of an extended object (either a solid or a volume of a liquid) can cause all of it to move. That motion is due to the transmission of the force through the object by its material. This paper discusses how the force is distributed to all of the object by a gradient of stress or pressure in it, which creates the local…

A Tutorial on Interfacing the Object Management Group (OMG) Data Distribution Service (DDS) with LabView

Science.gov (United States)

Smith, Kevin

2011-01-01

This tutorial will explain the concepts and steps for interfacing a National Instruments LabView virtual instrument (VI) running on a Windows platform with another computer via the Object Management Group (OMG) Data Distribution Service (DDS) as implemented by the Twin Oaks Computing CoreDX. This paper is for educational purposes only and therefore, the referenced source code will be simplistic and void of all error checking. Implementation will be accomplished using the C programming language.

The Perceptions and Habits of Alcohol Consumption and Smoking Among Canadian Medical Students

Science.gov (United States)

Thakore, Sidd; Ismail, Zahinoor; Jarvis, Scott; Payne, Eric; Keetbaas, Shayne; Payne, Rob; Rothenburg, Lana

2009-01-01

Objective: The authors aim to quantify the extent, and to assess student perception, of alcohol and tobacco use among medical students at the University of Calgary, and the relationship of these attitudes to problem drinking (according to the CAGE questionnaire). Methods: A questionnaire was distributed to first-, second-, and third-year medical…

Verfügbarkeit elektronischer Lehr- und Lernmodule für die Aus- und Weiterbildung in der Humanmedizin [Availability of learning objects for graduate and continuing medical education

Directory of Open Access Journals (Sweden)

Stausberg, Jürgen

2008-11-01

Full Text Available [english] A great number of learning objects is available for graduate and continuing medical education. Nevertheless, it is not known how well the range of available learning objects covers the needs of the various medical fields. To get an idea of this, the content of two catalogs of learning objects (LRSMed and KELDAmed was compared with the study regulations of the medical faculty of the University of Duisburg-Essen on the one hand and with the 2006 directory of certified medical specialists on the other hand. Spearman’s rank correlation coefficient was used as concordance measure in addition to a qualitative assessment. Correlation coefficients of 0.495 (LRSMed and 0.510 (KELDAmed show a relevant concordance with study regulations, while correlation coefficients of 0.300 and –0.182 reveal a worse concordance with continuing medical education. Therefore, the offers for graduate medical education correspond well with the medical fields, based on number of hours per semester per course. The absolute number of 1,822 learning objects from LRSMed and 1,769 from KELDAmed is excellent as well. The gap for continuing medical education can now be closed by means of funding from professional organizations and medical faculties and through healthcare policies. The quality of the learning objects offered by LRSMed and KELDAmed remains unknown, as there is yet no reliable and valid approach for assessing their quality. [german] Elektronische Lehr- und Lernmodule stehen inzwischen in großer Zahl für Aus- und Weiterbildung in der Humanmedizin zur Verfügung. Ob das Angebot die Fachgebiete in der erforderlichen Breite abdeckt ist unbekannt. Für eine erste Einschätzung wurden die Ressourcen von zwei umfassenden Katalogen, dem Learning Resource Server Medizin (LRSMed und der Kommentierten E-Learning Datenbank Medizin (KELDAmed, der Studienordnung der Medizinischen Fakultät der Universität Duisburg-Essen sowie der Ärztestatistik 2006 zu

Resilience and Psychological Distress in Psychology and Medical Students.

Science.gov (United States)

Bacchi, Stephen; Licinio, Julio

2017-04-01

The authors investigated levels of resilience and psychological distress in medical and psychology students, factors that may affect these levels, the relationship between resilience and psychological distress, and student opinion on causes of stress and possible interventions. A voluntary anonymous online survey was distributed to University of Adelaide medical and psychology students. Medical and psychology students (n = 560; response rate = 24.7%) had similar mean resilience and psychological distress scores, and 47.9% of medical students and 55.1% of psychology students were psychologically distressed. Higher levels of resilience were associated with lower levels of distress (p Students supported resilience-based interventions, greater financial support, clearer learning objectives and more continuous assessment as potential means to reduce the effects of stress. Higher levels of resilience were associated with lower levels of psychological distress. Further studies are required to determine the efficacy of resilience-based interventions in these groups.

The geography of graduate medical education: imbalances signal need for new distribution policies.

Science.gov (United States)

Mullan, Fitzhugh; Chen, Candice; Steinmetz, Erika

2013-11-01

Graduate medical education (GME) determines the overall number, specialization mix, and geographic distribution of the US physician workforce. Medicare GME payments-which represent the largest single public investment in health workforce development-are allocated based on an inflexible system whose rationale, effectiveness, and balance are increasingly being scrutinized. We analyzed Medicare cost reports from teaching hospitals and found large state-level differences in the number of Medicare-sponsored residents per 100,000 population (1.63 in Montana versus 77.13 in New York), total Medicare GME payments ($1.64 million in Wyoming versus $2 billion in New York), payments per person ($1.94 in Montana versus $103.63 in New York), and average payments per resident ($63,811 in Louisiana versus $155,135 in Connecticut). Ways to address these imbalances include revising Medicare's GME funding formulas and protecting those states that receive less Medicare GME support in case funding is decreased and making them a priority if it is increased. The GME system badly needs a coordinating body to deliberate and make policy about public investments in graduate medical education.

Multi objective Flower Pollination Algorithm for solving capacitor placement in radial distribution system using data structure load flow analysis

Directory of Open Access Journals (Sweden)

Tamilselvan V.

2016-06-01

Full Text Available The radial distribution system is a rugged system, it is also the most commonly used system, which suffers by loss and low voltage at the end bus. This loss can be reduced by the use of a capacitor in the system, which injects reactive current and also improves the voltage magnitude in the buses. The real power loss in the distribution line is the I2R loss which depends on the current and resistance. The connection of the capacitor in the bus reduces the reactive current and losses. The loss reduction is equal to the increase in generation, necessary for the electric power provided by firms. For consumers, the quality of power supply depends on the voltage magnitude level, which is also considered and hence the objective of the problem becomes the multi objective of loss minimization and the minimization of voltage deviation. In this paper, the optimal location and size of the capacitor is found using a new computational intelligent algorithm called Flower Pollination Algorithm (FPA. To calculate the power flow and losses in the system, novel data structure load flow is introduced. In this, each bus is considered as a node with bus associated data. Links between the nodes are distribution lines and their own resistance and reactance. To validate the developed FPA solutions standard test cases, IEEE 33 and IEEE 69 radial distribution systems are considered.

Development by a Large Integrated Health Care System of an Objective Methodology for Evaluation of Medical Oncology Service Sites.

Science.gov (United States)

Bjegovich-Weidman, Marija; Kahabka, Jill; Bock, Amy; Frick, Jacob; Kowalski, Helga; Mirro, Joseph

2012-03-01

Aurora Health Care (AHC) is the largest health care system in Wisconsin, with 14 acute care hospitals. In early 2010, a group of 18 medical oncologists became affiliated with AHC. This affiliation added 13 medical oncology infusion clinics to our existing 12 sites. In the era of health care reform and declining reimbursement, we need an objective method and criteria to evaluate our 25 outpatient medical oncology sites. We developed financial, clinical, and strategic tools for the evaluation and management of our cancer subservice lines and outpatient sites. The key to our success has been the direct involvement of stakeholders with a vested interest in the services in the selection of the criteria and evaluation process. We developed our objective metrics for evaluation based on strategic, financial, operational, and patient experience criteria. Strategic criteria included: population trends, full-time equivalent (FTE) medical oncologists/primary care physicians, FTE radiation oncologists, FTE oncologic surgeons, new annual cases of patients with cancer, and market share trends. Financial criteria per site included: physician work relative value units, staff FTE by type, staff salaries, and profit and loss. Operational criteria included: facility by type (clinic v hospital based), hours of operation, and facility detail (eg, No. of chairs, No. of procedure and examination rooms, square footage). Patient experience criteria included: nursing model primary/nurse navigators, multidisciplinary support at site, Press Ganey (South Bend, IN; health care performance improvement company) results, and employee engagement score. The outcome of our data analysis has resulted in the development of recommendations for AHC senior leadership and geographic market leadership to consider the consolidation of four sites (phase one, four sites; phase two, two sites) and priority strategic sites to address capacity issues that limit growth. The recommendations if implemented would

High-Surety Telemedicine in a Distributed, 'Plug-andPlan' Environment

Energy Technology Data Exchange (ETDEWEB)

Craft, Richard L.; Funkhouser, Donald R.; Gallagher, Linda K.; Garcia, Rudy J.; Parks, Raymond C.; Warren, Steve

1999-05-17

Commercial telemedicine systems are increasingly functional, incorporating video-conferencing capabilities, diagnostic peripherals, medication reminders, and patient education services. However, these systems (1) rarely utilize information architectures which allow them to be easily integrated with existing health information networks and (2) do not always protect patient confidentiality with adequate security mechanisms. Using object-oriented methods and software wrappers, we illustrate the transformation of an existing stand-alone telemedicine system into `plug-and-play' components that function in a distributed medical information environment. We show, through the use of open standards and published component interfaces, that commercial telemedicine offerings which were once incompatible with electronic patient record systems can now share relevant data with clinical information repositories while at the same time hiding the proprietary implementations of the respective systems. Additionally, we illustrate how leading-edge technology can secure this distributed telemedicine environment, maintaining patient confidentiality and the integrity of the associated electronic medical data. Information surety technology also encourages the development of telemedicine systems that have both read and write access to electronic medical records containing patient-identifiable information. The win-win approach to telemedicine information system development preserves investments in legacy software and hardware while promoting security and interoperability in a distributed environment.

Object-oriented design and programming in medical decision support.

Science.gov (United States)

Heathfield, H; Armstrong, J; Kirkham, N

1991-12-01

The concept of object-oriented design and programming has recently received a great deal of attention from the software engineering community. This paper highlights the realisable benefits of using the object-oriented approach in the design and development of clinical decision support systems. These systems seek to build a computational model of some problem domain and therefore tend to be exploratory in nature. Conventional procedural design techniques do not support either the process of model building or rapid prototyping. The central concepts of the object-oriented paradigm are introduced, namely encapsulation, inheritance and polymorphism, and their use illustrated in a case study, taken from the domain of breast histopathology. In particular, the dual roles of inheritance in object-oriented programming are examined, i.e., inheritance as a conceptual modelling tool and inheritance as a code reuse mechanism. It is argued that the use of the former is not entirely intuitive and may be difficult to incorporate into the design process. However, inheritance as a means of optimising code reuse offers substantial technical benefits.

Combining satellite data and appropriate objective functions for improved spatial pattern performance of a distributed hydrologic model

Science.gov (United States)

Demirel, Mehmet C.; Mai, Juliane; Mendiguren, Gorka; Koch, Julian; Samaniego, Luis; Stisen, Simon

2018-02-01

Satellite-based earth observations offer great opportunities to improve spatial model predictions by means of spatial-pattern-oriented model evaluations. In this study, observed spatial patterns of actual evapotranspiration (AET) are utilised for spatial model calibration tailored to target the pattern performance of the model. The proposed calibration framework combines temporally aggregated observed spatial patterns with a new spatial performance metric and a flexible spatial parameterisation scheme. The mesoscale hydrologic model (mHM) is used to simulate streamflow and AET and has been selected due to its soil parameter distribution approach based on pedo-transfer functions and the build in multi-scale parameter regionalisation. In addition two new spatial parameter distribution options have been incorporated in the model in order to increase the flexibility of root fraction coefficient and potential evapotranspiration correction parameterisations, based on soil type and vegetation density. These parameterisations are utilised as they are most relevant for simulated AET patterns from the hydrologic model. Due to the fundamental challenges encountered when evaluating spatial pattern performance using standard metrics, we developed a simple but highly discriminative spatial metric, i.e. one comprised of three easily interpretable components measuring co-location, variation and distribution of the spatial data. The study shows that with flexible spatial model parameterisation used in combination with the appropriate objective functions, the simulated spatial patterns of actual evapotranspiration become substantially more similar to the satellite-based estimates. Overall 26 parameters are identified for calibration through a sequential screening approach based on a combination of streamflow and spatial pattern metrics. The robustness of the calibrations is tested using an ensemble of nine calibrations based on different seed numbers using the shuffled complex

[Medical geography].

Science.gov (United States)

Hauri, D

2007-10-17

Hippocrates already noted that geographical factors such as climate, relief, geology but also settlement patterns had influenced the distribution of diseases. The task of medical geography is to investigate the associations between geographical factors and diseases. Thereby, geographic techniques and concepts are applied on health problems. Of particular importance is the mapping of diseases whose causes are environmental-related. In addition, epidemiological, ecological but also social scientific studies play an important part in the investigation of the associations between geographical factors and diseases. In order to understand the associations between the spatial distribution of diseases and environmental exposures, geographic information systems as well as statistical analyses have recently become more important. Some authors regard medical geography merely as supporting discipline of medicine. Nevertheless, as men and environment future and as they play an important part in the diffusion of diseases being regarded as defeated, medical geography will play an important part concerning medical questions. Especially travel medicine will rely on geographic knowledge, if a patient has to be consulted who plans to travel to an unknown country of which knowledge on the geographical distribution and ecology of diseases will be necessary.

Effect of objective function on multi-objective inverse planning of radiation therapy

International Nuclear Information System (INIS)

Li Guoli; Wu Yican; Song Gang; Wang Shifang

2006-01-01

There are two kinds of objective functions in radiotherapy inverse planning: dose distribution-based and Dose-Volume Histogram (DVH)-based functions. The treatment planning in our days is still a trial and error process because the multi-objective problem is solved by transforming it into a single objective problem using a specific set of weights for each object. This work investigates the problem of objective function setting based on Pareto multi-optimization theory, and compares the effect on multi-objective inverse planning of those two kinds of objective functions including calculation time, converge speed, etc. The basis of objective function setting on inverse planning is discussed. (authors)

The ultraviolet to infrared energy distribution of the BL Lacertae object PKS 0422+00 at two different brightness levels

Energy Technology Data Exchange (ETDEWEB)

Falomo, R.; Bouchet, P.; Maraschi, L.; Treves, A.; Tanzi, E.G. (Padova, Osservatorio Astronomico, Padua (Italy) European Southern Observatory, La Silla (Chile) Milano Universita, Milan (Italy) CNR, Istituto di Fisica Cosmica, Milan (Italy))

1989-10-01

The BL Lacertae object PKS 0422+00 was observed with IUE (International Ultraviolet Explorer) on August 31-September 1, 1987, when the visual magnitude of the object was V = 16.2, and again about 4 months later (January 10, 1988) during an active state (V = 15.6). Quasi-simultaneous optical to infrared observations allow deriving a detailed spectral flux distribution from 8 x 10 to the 13th to 2.5 x 10 the 15th Hz, for each epoch. Fits in terms of broken power laws and logarithmic parabolas are discussed. 32 refs.

The ultraviolet to infrared energy distribution of the BL Lacertae object PKS 0422+00 at two different brightness levels

International Nuclear Information System (INIS)

Falomo, R.; Bouchet, P.; Maraschi, L.; Treves, A.; Tanzi, E.G.

1989-01-01

The BL Lacertae object PKS 0422+00 was observed with IUE (International Ultraviolet Explorer) on August 31-September 1, 1987, when the visual magnitude of the object was V = 16.2, and again about 4 months later (January 10, 1988) during an active state (V = 15.6). Quasi-simultaneous optical to infrared observations allow deriving a detailed spectral flux distribution from 8 x 10 to the 13th to 2.5 x 10 the 15th Hz, for each epoch. Fits in terms of broken power laws and logarithmic parabolas are discussed. 32 refs

The "general recognition and acceptance" standard of objectivity for good faith in prescribing: legal and medical implications.

Science.gov (United States)

Brushwood, David B

2007-01-01

The United States Court of Appeals for the 4th Circuit has ruled that a jury considering charges of drug trafficking against a pain management physician should be instructed that the defendant's good faith is a defense to the charges. The court rejected a subjective standard of good faith, and instead ruled that the good faith of the defendant must be evaluated from an objective perspective. This objective standard requires that the jury determine whether the defendant was practicing in accordance with the standard generally recognized and accepted in the United States. General recognition and acceptance are determined on a case-by-case basis, within the context of a defendant's practice. Simply because a physician's practice is out of the norm for many physicians does not mean it can't be generally recognized and accepted within the standard of medical practice. Expert witness testimony of pain management physicians will assist juries in the application of this standard for good faith in prescribing.

An Objective Approach to Select Climate Scenarios when Projecting Species Distribution under Climate Change.

Directory of Open Access Journals (Sweden)

Nicolas Casajus

Full Text Available An impressive number of new climate change scenarios have recently become available to assess the ecological impacts of climate change. Among these impacts, shifts in species range analyzed with species distribution models are the most widely studied. Whereas it is widely recognized that the uncertainty in future climatic conditions must be taken into account in impact studies, many assessments of species range shifts still rely on just a few climate change scenarios, often selected arbitrarily. We describe a method to select objectively a subset of climate change scenarios among a large ensemble of available ones. Our k-means clustering approach reduces the number of climate change scenarios needed to project species distributions, while retaining the coverage of uncertainty in future climate conditions. We first show, for three biologically-relevant climatic variables, that a reduced number of six climate change scenarios generates average climatic conditions very close to those obtained from a set of 27 scenarios available before reduction. A case study on potential gains and losses of habitat by three northeastern American tree species shows that potential future species distributions projected from the selected six climate change scenarios are very similar to those obtained from the full set of 27, although with some spatial discrepancies at the edges of species distributions. In contrast, projections based on just a few climate models vary strongly according to the initial choice of climate models. We give clear guidance on how to reduce the number of climate change scenarios while retaining the central tendencies and coverage of uncertainty in future climatic conditions. This should be particularly useful during future climate change impact studies as more than twice as many climate models were reported in the fifth assessment report of IPCC compared to the previous one.

An Objective Approach to Select Climate Scenarios when Projecting Species Distribution under Climate Change.

Science.gov (United States)

Casajus, Nicolas; Périé, Catherine; Logan, Travis; Lambert, Marie-Claude; de Blois, Sylvie; Berteaux, Dominique

2016-01-01

An impressive number of new climate change scenarios have recently become available to assess the ecological impacts of climate change. Among these impacts, shifts in species range analyzed with species distribution models are the most widely studied. Whereas it is widely recognized that the uncertainty in future climatic conditions must be taken into account in impact studies, many assessments of species range shifts still rely on just a few climate change scenarios, often selected arbitrarily. We describe a method to select objectively a subset of climate change scenarios among a large ensemble of available ones. Our k-means clustering approach reduces the number of climate change scenarios needed to project species distributions, while retaining the coverage of uncertainty in future climate conditions. We first show, for three biologically-relevant climatic variables, that a reduced number of six climate change scenarios generates average climatic conditions very close to those obtained from a set of 27 scenarios available before reduction. A case study on potential gains and losses of habitat by three northeastern American tree species shows that potential future species distributions projected from the selected six climate change scenarios are very similar to those obtained from the full set of 27, although with some spatial discrepancies at the edges of species distributions. In contrast, projections based on just a few climate models vary strongly according to the initial choice of climate models. We give clear guidance on how to reduce the number of climate change scenarios while retaining the central tendencies and coverage of uncertainty in future climatic conditions. This should be particularly useful during future climate change impact studies as more than twice as many climate models were reported in the fifth assessment report of IPCC compared to the previous one.

Generation and distribution of PAHs in the process of medical waste incineration

Energy Technology Data Exchange (ETDEWEB)

Chen, Ying, E-mail: echochen327@163.com [School of Environment, Tsinghua University, Beijing 100084 (China); National Center of Solid Waste Management, Ministry of Environmental Protection, Beijing 100029 (China); Zhao, Rongzhi [Civil and Environmental Engineering School, University of Science and Technology Beijing, Beijing 100083 (China); Xue, Jun [National Center of Solid Waste Management, Ministry of Environmental Protection, Beijing 100029 (China); Li, Jinhui, E-mail: jinhui@tsinghua.edu.cn [State Key Joint Laboratory of Environment Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084 (China)

2013-05-15

Highlights: ► PAHs generation and distribution features of medical waste incineration are studied. ► More PAHs were found in fly ash than that in bottom ash. ► The highest proportion of PAHs consisted of the seven most carcinogenic ones. ► Increase of free oxygen molecule and burning temperature promote PAHs degradation. ► There is a moderate positive correlation between total PCDD/Fs and total PAHs. - Abstract: After the deadly earthquake on May 12, 2008 in Wenchuan county of China, several different incineration approaches were used for medical waste disposal. This paper investigates the generation properties of polycyclic aromatic hydrocarbons (PAHs) during the incineration. Samples were collected from the bottom ash in an open burning slash site, surface soil at the open burning site, bottom ash from a simple incinerator, bottom ash generated from the municipal solid waste (MSW) incinerator used for medical waste disposal, and bottom ash and fly ash from an incinerator exclusively used for medical waste. The species of PAHs were analyzed, and the toxicity equivalency quantities (TEQs) of samples calculated. Analysis results indicate that the content of total PAHs in fly ash was 1.8 × 10{sup 3} times higher than that in bottom ash, and that the strongly carcinogenic PAHs with four or more rings accumulated sensitively in fly ash. The test results of samples gathered from open burning site demonstrate that Acenaphthylene (ACY), Acenaphthene (ACE), Fluorene (FLU), Phenanthrene (PHE), Anthracene (ANT) and other PAHs were inclined to migrate into surrounding environment along air and surface watershed corridors, while 4- to 6-ring PAHs accumulated more likely in soil. Being consistent with other studies, it has also been confirmed that increases in both free oxygen molecules and combustion temperatures could promote the decomposition of polycyclic PAHs. In addition, without the influence of combustion conditions, there is a positive correlation between

Generation and distribution of PAHs in the process of medical waste incineration

International Nuclear Information System (INIS)

Chen, Ying; Zhao, Rongzhi; Xue, Jun; Li, Jinhui

2013-01-01

Highlights: ► PAHs generation and distribution features of medical waste incineration are studied. ► More PAHs were found in fly ash than that in bottom ash. ► The highest proportion of PAHs consisted of the seven most carcinogenic ones. ► Increase of free oxygen molecule and burning temperature promote PAHs degradation. ► There is a moderate positive correlation between total PCDD/Fs and total PAHs. - Abstract: After the deadly earthquake on May 12, 2008 in Wenchuan county of China, several different incineration approaches were used for medical waste disposal. This paper investigates the generation properties of polycyclic aromatic hydrocarbons (PAHs) during the incineration. Samples were collected from the bottom ash in an open burning slash site, surface soil at the open burning site, bottom ash from a simple incinerator, bottom ash generated from the municipal solid waste (MSW) incinerator used for medical waste disposal, and bottom ash and fly ash from an incinerator exclusively used for medical waste. The species of PAHs were analyzed, and the toxicity equivalency quantities (TEQs) of samples calculated. Analysis results indicate that the content of total PAHs in fly ash was 1.8 × 10 3 times higher than that in bottom ash, and that the strongly carcinogenic PAHs with four or more rings accumulated sensitively in fly ash. The test results of samples gathered from open burning site demonstrate that Acenaphthylene (ACY), Acenaphthene (ACE), Fluorene (FLU), Phenanthrene (PHE), Anthracene (ANT) and other PAHs were inclined to migrate into surrounding environment along air and surface watershed corridors, while 4- to 6-ring PAHs accumulated more likely in soil. Being consistent with other studies, it has also been confirmed that increases in both free oxygen molecules and combustion temperatures could promote the decomposition of polycyclic PAHs. In addition, without the influence of combustion conditions, there is a positive correlation between total

Antidopaminergic medication in healthy subjects provokes subjective and objective mental impairments tightly correlated with perturbation of biogenic monoamine metabolism and prolactin secretion

Directory of Open Access Journals (Sweden)

Veselinović T

2018-04-01

Full Text Available Tanja Veselinović,1,2 Ingo Vernaleken,1,2 Paul Cumming,3,4 Uwe Henning,5 Lina Winkler,1,2 Peter Kaleta,1,2 Michael Paulzen,1,2 Christian Luckhaus,6 Gerhard Gründer1,2,7 1Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, 2Translational Brain Medicine, Jülich Aachen Research Alliance (JARA, Jülich, Germany; 3IHBI, School of Psychology and Counselling, Queensland University of Technology, 4QIMR Berghofer Institute, Brisbane, Australia; 5Neurobiochemical Research Unit, Department of Psychiatry, Heinrich Heine University, Düsseldorf, 6LWL University Hospital Bochum, Department of Psychiatry, Division of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, Ruhr University Bochum, Bochum, 7Department of Molecular Neuroimaging, Central Institute of Mental Health, Mannheim, Germany Objectives: Off-label prescription of antipsychotics to patients without psychotic symptoms has become a routine matter for many psychiatrists and also some general practitioners. Nonetheless, little is known about the possibly detrimental effects of antidopaminergic medications on general psychopathology, subjective mental state, or a possible association with physiological parameters in nonpsychotic individuals.Methods: In this randomized, single-blinded study, groups of healthy volunteers (n=18 received low doses of reserpine, aripiprazole, haloperidol, or placebo on 7 successive days. Relevant physiological parameters (plasma prolactin, concentrations of catecholamine metabolites in plasma, and 24-hour urine and each subject’s mental state (Positive and Negative Syndrome Scale, Hamilton Rating Scale for Depression, visual analogue scale, Beck Depression Inventory II were assessed at the start and end of the trial.Results: Of the three active treatments, only reserpine caused a significant increase in some plasma- and urine-catecholamine metabolites, but all three medications evoked objective

The distribution of animal antimicrobials in British Columbia for over-the-counter and veterinary sales, 2012 to 2014.

Science.gov (United States)

Radke, Brian R

2018-03-01

Canadian Animal Health Institute (CAHI) data are used for provincial, national, and international comparisons of Canadian animal antimicrobial use. The objectives of this paper were to: i) use CAHI and British Columbia (BC) antimicrobial distribution data to group BC antimicrobial sales into the following BC retail distribution channels: over-the-counter retail outlets, livestock and poultry feed mills, aquaculture feed mills, livestock and poultry veterinarians, and companion animal veterinarians; and ii) to validate the CAHI BC distribution data and BC's antimicrobial distribution data from 2012 to 2014. Annual total antimicrobial distribution and distribution by antimicrobial class were presented for each distribution channel. The distribution of medically important antimicrobials for production animals was validated, the distribution of ionophores was not. A lack of data precluded any attempt to validate the distribution of antimicrobials for companion animals. Each distribution channel typically experienced substantial fluctuations in total antimicrobial use and use by antibiotic class at least once over the 3-year period. The validated data are useful for evidence-based analysis of a proposed Canadian policy requiring a veterinary prescription for all medically important antimicrobials.

Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE)--A Systematic Review of Rating Scales.

Science.gov (United States)

Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

2016-01-01

Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students' communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed in order to yield psychometrically

Medical Student Attitudes about Mental Illness: Does Medical-School Education Reduce Stigma?

Science.gov (United States)

Korszun, Ania; Dinos, Sokratis; Ahmed, Kamran; Bhui, Kamaldeep

2012-01-01

Background: Reducing stigma associated with mental illness is an important aim of medical education, yet evidence indicates that medical students' attitudes toward patients with mental health problems deteriorate as they progress through medical school. Objectives: Authors examined medical students' attitudes to mental illness, as compared with…

Broad band energy distribution of UV-bright BL Lac objects

International Nuclear Information System (INIS)

Maraschi, L.; Tanzi, E.G.; Treves, A.

1984-01-01

IUE satellite data in the 1200-2000 and 1900-3200 A intervals of BL Lac objects are analyzed in terms of two discernible groups. A total of 25 BL Lac objects were observed, with differences between groups displayed in terms of the power slope of the energy of the UV emissions, i.e., slopes of 1 and 2. Comparisons of the spectra with those of quasars showed that quasars have a small spectral index in the 1000-6000 A band and no correlation exists between the spectral index and UV flux of the BL Lac objects. The comparisons underscore the lack of a thermal component for BL Lac objects. Steep spectral components in both BL Lac objects and highly polarized quasars emissions could both be due to synchrotron emission. Compton scattering of relativistic electrons off synchrotron photons could produce the X ray emissions. 44 references

Broad band energy distribution of UV-bright BL Lac objects

Energy Technology Data Exchange (ETDEWEB)

Maraschi, L.; Tanzi, E.G.; Treves, A.

1984-01-01

IUE satellite data in the 1200-2000 and 1900-3200 A intervals of BL Lac objects are analyzed in terms of two discernible groups. A total of 25 BL Lac objects were observed, with differences between groups displayed in terms of the power slope of the energy of the UV emissions, i.e., slopes of 1 and 2. Comparisons of the spectra with those of quasars showed that quasars have a small spectral index in the 1000-6000 A band and no correlation exists between the spectral index and UV flux of the BL Lac objects. The comparisons underscore the lack of a thermal component for BL Lac objects. Steep spectral components in both BL Lac objects and highly polarized quasars emissions could both be due to synchrotron emission. Compton scattering of relativistic electrons off synchrotron photons could produce the X ray emissions. 44 references.

Combining satellite data and appropriate objective functions for improved spatial pattern performance of a distributed hydrologic model

Directory of Open Access Journals (Sweden)

M. C. Demirel

2018-02-01

Full Text Available Satellite-based earth observations offer great opportunities to improve spatial model predictions by means of spatial-pattern-oriented model evaluations. In this study, observed spatial patterns of actual evapotranspiration (AET are utilised for spatial model calibration tailored to target the pattern performance of the model. The proposed calibration framework combines temporally aggregated observed spatial patterns with a new spatial performance metric and a flexible spatial parameterisation scheme. The mesoscale hydrologic model (mHM is used to simulate streamflow and AET and has been selected due to its soil parameter distribution approach based on pedo-transfer functions and the build in multi-scale parameter regionalisation. In addition two new spatial parameter distribution options have been incorporated in the model in order to increase the flexibility of root fraction coefficient and potential evapotranspiration correction parameterisations, based on soil type and vegetation density. These parameterisations are utilised as they are most relevant for simulated AET patterns from the hydrologic model. Due to the fundamental challenges encountered when evaluating spatial pattern performance using standard metrics, we developed a simple but highly discriminative spatial metric, i.e. one comprised of three easily interpretable components measuring co-location, variation and distribution of the spatial data. The study shows that with flexible spatial model parameterisation used in combination with the appropriate objective functions, the simulated spatial patterns of actual evapotranspiration become substantially more similar to the satellite-based estimates. Overall 26 parameters are identified for calibration through a sequential screening approach based on a combination of streamflow and spatial pattern metrics. The robustness of the calibrations is tested using an ensemble of nine calibrations based on different seed numbers using the

Multi-modal distribution crossover method based on two crossing segments bounded by selected parents applied to multi-objective design optimization

Energy Technology Data Exchange (ETDEWEB)

Ariyarit, Atthaphon; Kanazaki, Masahiro [Tokyo Metropolitan University, Tokyo (Japan)

2015-04-15

This paper discusses airfoil design optimization using a genetic algorithm (GA) with multi-modal distribution crossover (MMDX). The proposed crossover method creates four segments from four parents, of which two segments are bounded by selected parents and two segments are bounded by one parent and another segment. After these segments are defined, four offsprings are generated. This study applied the proposed optimization to a real-world, multi-objective airfoil design problem using class-shape function transformation parameterization, which is an airfoil representation that uses polynomial function, to investigate the effectiveness of this algorithm. The results are compared with the results of the blend crossover (BLX) and unimodal normal distribution crossover (UNDX) algorithms. The objective of these airfoil design problems is to successfully find the optimal design. The outcome of using this algorithm is superior to that of the BLX and UNDX crossover methods because the proposed method can maintain higher diversity than the BLX and UNDX methods. This advantage is desirable for real-world problems.

Multi-modal distribution crossover method based on two crossing segments bounded by selected parents applied to multi-objective design optimization

International Nuclear Information System (INIS)

Ariyarit, Atthaphon; Kanazaki, Masahiro

2015-01-01

This paper discusses airfoil design optimization using a genetic algorithm (GA) with multi-modal distribution crossover (MMDX). The proposed crossover method creates four segments from four parents, of which two segments are bounded by selected parents and two segments are bounded by one parent and another segment. After these segments are defined, four offsprings are generated. This study applied the proposed optimization to a real-world, multi-objective airfoil design problem using class-shape function transformation parameterization, which is an airfoil representation that uses polynomial function, to investigate the effectiveness of this algorithm. The results are compared with the results of the blend crossover (BLX) and unimodal normal distribution crossover (UNDX) algorithms. The objective of these airfoil design problems is to successfully find the optimal design. The outcome of using this algorithm is superior to that of the BLX and UNDX crossover methods because the proposed method can maintain higher diversity than the BLX and UNDX methods. This advantage is desirable for real-world problems.

Modeling of spatial distribution for scorpions of medical importance in the São Paulo State, Brazil

Directory of Open Access Journals (Sweden)

José Brites-Neto

2015-07-01

Full Text Available Aim: In this work, we aimed to develop maps of modeling geographic distribution correlating to environmental suitability for the two species of scorpions of medical importance at São Paulo State and to develop spatial configuration parameters for epidemiological surveillance of these species of venomous animals. Materials and Methods: In this study, 54 georeferenced points for Tityus serrulatus and 86 points for Tityus bahiensis and eight environmental indicators, were used to generate species distribution models in Maxent (maximum entropy modeling of species geographic distributions version 3.3.3k using 70% of data for training (n=38 to T. serrulatus and n=60 to T. bahiensis and 30% to test the models (n=16 for T. serrulatus and n=26 for T. bahiensis. The logistic threshold used to cut models in converting the continuous probability model into a binary model was the “maximum test sensitivity plus specificity,” provided by Maxent, with results of 0.4143 to T. serrulatus and of 0.3401 to T. bahiensis. The models were evaluated by the area under the curve (AUC, using the omission error and the binomial probability. With the data generated by Maxent, distribution maps were produced using the “ESRI® ArcGIS 10.2.2 for Desktop” software. Results: The models had high predictive success (AUC=0.7698±0.0533, omission error=0.2467 and p<0.001 for T. serrulatus and AUC=0.8205±0.0390, omission error=0.1917 and p<0.001 for T. bahiensis and the resultant maps showed a high environmental suitability in the north, central, and southeast of the state, confirming the increasing spread of these species. The environmental variables that mostly contributed to the scorpions species distribution model were rain precipitation (28.9% and tree cover (28.2% for the T. serrulatus and temperature (45.8% and thermal amplitude (12.6% for the T. bahiensis. Conclusion: The distribution model of these species of medical importance scorpions in São Paulo State

Accessing OSI Managed Objects from ANSAware

OpenAIRE

Genilloud, Guy; Gay, David

1995-01-01

This paper presents a mechanism allowing an ODP compliant distributed system, ANSA, to access OSI network management objects as if they were ANSA objects. It defines a mapping from the OSI object model to the ANSA object model, and it specifies how an adapter implements this mapping.

Trends of the effective dose distribution of occupational exposures in medical and research departments for KIRAMS in Republic of Korea

International Nuclear Information System (INIS)

Park, M.; Kim, G. S.; Ji, Y. H.; Jung, M. S.; Kim, K. B.; Jung, H.

2014-01-01

This work proposes the basic reference data of occupational dose management and statistical dose distribution with the classification of radiation work groups though analysis of occupational dose distribution. Data on occupational radiation exposure from medical and scientific usage of radiation in Korea Institute of Radiological and Medical Sciences for the years 2002-11 are presented and evaluated with the characteristic tendency of radiation working groups. The results of occupational radiation exposure were measured by personal dosemeters. The monitored occupational exposure dose data were evaluated according to the average effective dose and collective dose. The most annual average effective dose for all occupational radiation workers was under 1 mSv. Considering the dose distribution of each department, most overexposure workers worked in radiopharmaceutical product facilities, nuclear medicine department and radiation oncology department. In addition, no monitored workers were found to have received an occupational exposure over 50 mSv in single year or 100 mSv in this period. Although the trend of occupational exposure was controlled <1 mSv after 2007 and the radiation protection status was sufficient, it was consistently necessary to optimise and reduce the occupational radiation exposure. (authors)

Dynamic shared state maintenance in distributed virtual environments

Science.gov (United States)

Hamza-Lup, Felix George

Advances in computer networks and rendering systems facilitate the creation of distributed collaborative environments in which the distribution of information at remote locations allows efficient communication. Particularly challenging are distributed interactive Virtual Environments (VE) that allow knowledge sharing through 3D information. The purpose of this work is to address the problem of latency in distributed interactive VE and to develop a conceptual model for consistency maintenance in these environments based on the participant interaction model. An area that needs to be explored is the relationship between the dynamic shared state and the interaction with the virtual entities present in the shared scene. Mixed Reality (MR) and VR environments must bring the human participant interaction into the loop through a wide range of electronic motion sensors, and haptic devices. Part of the work presented here defines a novel criterion for categorization of distributed interactive VE and introduces, as well as analyzes, an adaptive synchronization algorithm for consistency maintenance in such environments. As part of the work, a distributed interactive Augmented Reality (AR) testbed and the algorithm implementation details are presented. Currently the testbed is part of several research efforts at the Optical Diagnostics and Applications Laboratory including 3D visualization applications using custom built head-mounted displays (HMDs) with optical motion tracking and a medical training prototype for endotracheal intubation and medical prognostics. An objective method using quaternion calculus is applied for the algorithm assessment. In spite of significant network latency, results show that the dynamic shared state can be maintained consistent at multiple remotely located sites. In further consideration of the latency problems and in the light of the current trends in interactive distributed VE applications, we propose a hybrid distributed system architecture for

Modeling nurses' attitude toward using automated unit-based medication storage and distribution systems: an extension of the technology acceptance model.

Science.gov (United States)

Escobar-Rodríguez, Tomás; Romero-Alonso, María Mercedes

2013-05-01

This article analyzes the attitude of nurses toward the use of automated unit-based medication storage and distribution systems and identifies influencing factors. Understanding these factors provides an opportunity to explore actions that might be taken to boost adoption by potential users. The theoretical grounding for this research is the Technology Acceptance Model. The Technology Acceptance Model specifies the causal relationships between perceived usefulness, perceived ease of use, attitude toward using, and actual usage behavior. The research model has six constructs, and nine hypotheses were generated from connections between these six constructs. These constructs include perceived risks, experience level, and training. The findings indicate that these three external variables are related to the perceived ease of use and perceived usefulness of automated unit-based medication storage and distribution systems, and therefore, they have a significant influence on attitude toward the use of these systems.

Ethnographies across Virtual and Physical Spaces: A Reflexive Commentary on a Live Canadian/UK Ethnography of Distributed Medical Education

Science.gov (United States)

Tummons, Jonathan; Macleod, Anna; Kits, Olga

2015-01-01

This article draws on an ongoing ethnography of distributed medical education (DME) provision in Canada in order to explore the methodological choices of the researchers as well as the wider pluralisation of ethnographic frameworks that is reflected within current research literature. The article begins with a consideration of the technologically…

Colors of Inner Disk Classical Kuiper Belt Objects

Science.gov (United States)

Romanishin, W.; Tegler, S. C.; Consolmagno, G. J.

2010-07-01

We present new optical broadband colors, obtained with the Keck 1 and Vatican Advanced Technology telescopes, for six objects in the inner classical Kuiper Belt. Objects in the inner classical Kuiper Belt are of interest as they may represent the surviving members of the primordial Kuiper Belt that formed interior to the current position of the 3:2 resonance with Neptune, the current position of the plutinos, or, alternatively, they may be objects formed at a different heliocentric distance that were then moved to their present locations. The six new colors, combined with four previously published, show that the ten inner belt objects with known colors form a neutral clump and a reddish clump in B-R color. Nonparametric statistical tests show no significant difference between the B-R color distribution of the inner disk objects compared to the color distributions of Centaurs, plutinos, or scattered disk objects. However, the B-R color distribution of the inner classical Kuiper Belt Objects does differ significantly from the distribution of colors in the cold (low inclination) main classical Kuiper Belt. The cold main classical objects are predominately red, while the inner classical belt objects are a mixture of neutral and red. The color difference may reveal the existence of a gradient in the composition and/or surface processing history in the primordial Kuiper Belt, or indicate that the inner disk objects are not dynamically analogous to the cold main classical belt objects.

COLORS OF INNER DISK CLASSICAL KUIPER BELT OBJECTS

International Nuclear Information System (INIS)

Romanishin, W.; Tegler, S. C.; Consolmagno, G. J.

2010-01-01

We present new optical broadband colors, obtained with the Keck 1 and Vatican Advanced Technology telescopes, for six objects in the inner classical Kuiper Belt. Objects in the inner classical Kuiper Belt are of interest as they may represent the surviving members of the primordial Kuiper Belt that formed interior to the current position of the 3:2 resonance with Neptune, the current position of the plutinos, or, alternatively, they may be objects formed at a different heliocentric distance that were then moved to their present locations. The six new colors, combined with four previously published, show that the ten inner belt objects with known colors form a neutral clump and a reddish clump in B-R color. Nonparametric statistical tests show no significant difference between the B-R color distribution of the inner disk objects compared to the color distributions of Centaurs, plutinos, or scattered disk objects. However, the B-R color distribution of the inner classical Kuiper Belt Objects does differ significantly from the distribution of colors in the cold (low inclination) main classical Kuiper Belt. The cold main classical objects are predominately red, while the inner classical belt objects are a mixture of neutral and red. The color difference may reveal the existence of a gradient in the composition and/or surface processing history in the primordial Kuiper Belt, or indicate that the inner disk objects are not dynamically analogous to the cold main classical belt objects.

Agent-based Algorithm for Spatial Distribution of Objects

KAUST Repository

Collier, Nathan; Sieniek, Marcin

2012-01-01

method. The bubble mesh algorithm treats objects in space as bubbles, which repel and attract each other. The dynamics of each bubble are approximated by solving a series of ordinary differential equations. We present numerical results for a meshing

Tanzania Medical Journal

African Journals Online (AJOL)

The journal publishes any contribution that advances medical science or ... these core objectives the journal publishes papers on original scientific research, short ... The Tanzania Medical Journal is an international Journal - ISSN: 0856-0719 ...

Port Harcourt Medical Journal

African Journals Online (AJOL)

Port Harcourt Medical Journal's objectives are to disseminate medical information from the College of Health Sciences, University of Port Harcourt and the rest of the national and international medical community; act as a medium for the articulation of research and findings from same as well as proceedings of medical ...

Determinants of depression among medical students in two medical ...

African Journals Online (AJOL)

Objectives: This study aims to assess the susceptibility of depression among clinical students from two medical schools from South East Nigeria, using a screening test questionnaire. Methods: A total of 352 clinical medical students from two universities were enrolled by simple random sampling. A pretested ...

Sharing Real-Time Objects in Distributed Embedded Systems

DEFF Research Database (Denmark)

Larsen, Erland Ketil; Havn, Ib

2015-01-01

microcontrollers connected by a RS-485 bus. The demo system shows that it is relatively simple to implement a distributed embedded system with the provided API, and the latency of the communication service is predictable. A low coupling to hardware makes it easy to port to another platform and/or another network...

[Correction of light refraction and reflection in medical transmission optical tomography].

Science.gov (United States)

Tereshchenko, S A; Potapov, D A

2002-01-01

The effects of light refraction and reflection on the quality of image reconstruction in medical transmission optical tomography of high-scattering media are considered. It has been first noted that light refraction not only distorts the geometric scheme of measurements, but may lead to the appearance of object areas that cannot be scanned. Some ways of decreasing the effect of refraction on the reconstruction of spatial distribution of the extinction coefficient are stated.

Object-Oriented Econometrics with Ox

OpenAIRE

Kulaksizoglu, Tamer

2015-01-01

This article reviews the object-oriented features of the Ox matrix programming language. We discuss object-oriented programming in general and give econometric examples coded in Ox. We also discuss some useful built-in classes that come with the Ox distribution.

Medical Data Architecture Project Status

Science.gov (United States)

Krihak, M.; Middour, C.; Lindsey, A.; Marker, N.; Wolfe, S.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

2017-01-01

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current International Space Station (ISS) medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable an increasingly autonomous crew than the current ISS paradigm. The MDA will develop capabilities that support automated data collection, and the necessary functionality and challenges in executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. To attain this goal, the first year of the MDA project focused on reducing technical risk, developing documentation and instituting iterative development processes that established the basis for the first version of MDA software (or Test Bed 1). Test Bed 1 is based on a nominal operations scenario authored by the ExMC Element Scientist. This narrative was decomposed into a Concept of Operations that formed the basis for Test Bed 1 requirements. These requirements were successfully vetted through the MDA Test Bed 1 System Requirements Review, which permitted the MDA project to begin software code development and component integration. This paper highlights the MDA objectives, development processes, and accomplishments, and identifies the fiscal year 2017 milestones and

Subjective and Objective Evaluation of PBL Outcomes in Preclinical ...

African Journals Online (AJOL)

Subjective and Objective Evaluation of PBL Outcomes in Preclinical Medical Students. ... ABSTRACT: Problem based learning curriculum is widely recognized as a progressive, learner-centered, active learning approach and is currently used in the entire medical curriculum in over 10% of medical schools worldwide.

Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE) - A Systematic Review of Rating Scales

Science.gov (United States)

Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

2016-01-01

Background Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students’ communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. Methods We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Results Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Discussion Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed

The scholar role in the National Competence Based Catalogues of Learning Objectives for Undergraduate Medical Education (NKLM) compared to other international frameworks.

Science.gov (United States)

Hautz, Stefanie C; Hautz, Wolf E; Keller, Niklas; Feufel, Markus A; Spies, Claudia

2015-01-01

In Germany, a national competence based catalogue of learning objectives in medicine (NKLM) was developed by the Society for Medical Education and the Council of Medical Faculties. As many of its international counterparts the NKLM describes the qualifications of medical school graduates. The definition of such outcome frameworks indents to make medical education transparent to students, teachers and society. The NKLM aims to amend existing lists of medical topics for assessment with learnable competencies. All outcome frameworks are structured into chapters, domains or physician roles. The definition of the scholar-role poses a number of questions such as: What distinguishes necessary qualifications of a scientifically qualified physician from those of a medical scientist? 13 outcome frameworks were identified through a systematic three-step literature review and their content compared to the scholar role in the NKLM by means of a qualitative text analysis. The three steps consist of (1) search for outcome frameworks, (2) in- and exclusion, and (3) data extraction, categorization, and validation. The results were afterwards matched with the scholar role of the NKLM. Extracted contents of all frameworks may be summarized into the components Common Basics, Clinical Application, Research, Teaching and Education, and Lifelong Learning. Compared to the included frameworks the NKLM emphasises competencies necessary for research and teaching while clinical application is less prominently mentioned. The scholar role of the NKLM differs from other international outcome frameworks. Discussing these results shall increase propagation and understanding of the NKLM and thus contribute to the qualification of future medical graduates in Germany.

The scholar role in the National Competence Based Catalogues of Learning Objectives for Undergraduate Medical Education (NKLM compared to other international frameworks

Directory of Open Access Journals (Sweden)

Hautz, Stefanie C.

2015-11-01

Full Text Available Background: In Germany, a national competence based catalogue of learning objectives in medicine (NKLM was developed by the Society for Medical Education and the Council of Medical Faculties. As many of its international counterparts the NKLM describes the qualifications of medical school graduates. The definition of such outcome frameworks indents to make medical education transparent to students, teachers and society. The NKLM aims to amend existing lists of medical topics for assessment with learnable competencies. All outcome frameworks are structured into chapters, domains or physician roles. The definition of the scholar-role poses a number of questions such as: What distinguishes necessary qualifications of a scientifically qualified physician from those of a medical scientist? Methods: 13 outcome frameworks were identified through a systematic three-step literature review and their content compared to the scholar role in the NKLM by means of a qualitative text analysis. The three steps consist of (1 search for outcome frameworks, (2 in- and exclusion, and (3 data extraction, categorization, and validation. The results were afterwards matched with the scholar role of the NKLM.Results: Extracted contents of all frameworks may be summarized into the components , and . Compared to the included frameworks the NKLM emphasises competencies necessary for research and teaching while clinical application is less prominently mentioned. Conclusion: The scholar role of the NKLM differs from other international outcome frameworks. Discussing these results shall increase propagation and understanding of the NKLM and thus contribute to the qualification of future medical graduates in Germany.

Identification of core objectives for teaching sustainable healthcare education.

Science.gov (United States)

Teherani, Arianne; Nishimura, Holly; Apatira, Latifat; Newman, Thomas; Ryan, Susan

2017-01-01

Physicians will be called upon to care for patients who bear the burden of disease from the impact of climate change and ecologically irresponsible practices which harm ecosystems and contribute to climate change. However, physicians must recognize the connection between the climate, ecosystems, sustainability, and health and their responsibility and capacity in changing the status quo. Sustainable healthcare education (SHE), defined as education about the impact of climate change and ecosystem alterations on health and the impact of the healthcare industry on the aforementioned, is vital to prevention of adverse health outcomes due to the changing climate and environment. To systematically determine which and when a set of SHE objectives should be included in the medical education continuum. Fifty-two SHE experts participated in a two-part modified-Delphi study. A survey was developed based on 21 SHE objectives. Respondents rated the importance of each objective and when each objective should be taught. Descriptive statistics and an item-level content validity index (CVI) were used to analyze data. Fifteen of the objectives achieved a content validity index of 78% or greater. The remaining objectives had content validity indices between 58% and 77%. The preclinical years of medical school were rated as the optimal time for introducing 13 and the clinical years for introducing six of the objectives. Respondents noted the definition of environmental sustainability should be learned prior to medical school and identifying ways to improve the environmental sustainability of health systems in post-graduate training. This study proposes SHE objectives for the continuum of medical education. These objectives ensure the identity of the physician includes the requisite awareness and competence to care for patients who experience the impact of climate and environment on health and advocate for sustainability of the health systems in which they work. CVI: Content validity

[3D printed medical devices and anatomical models: What kind of distribution and which uses in French hospitals?

Science.gov (United States)

Pierreville, J; Serrano, C; van den Brink, H; Prognon, P; Pineau, J; Martelli, N

2018-03-01

3D printing plays an increasingly important role in the medical sector and particularly in surgery. Nowadays, numerous manufacturers benefit from this technology to produce their medical devices and some hospitals have also purchased 3D printers. In this context, the aim of the present study was to study the distribution and the use of 3D printing in French hospitals in order to its main features in surgery. By conducting a national survey, we targeted hospitals equipped with 3D printers and those using external providers to benefit from this technology. Forty-seven hospitals were identified as using 3D printing including eight equipped with in-house 3D printers. This work gives us a first picture of 3D printing for hospital use in France and it raises questions about hospital pharmacists' involvement in 3D printed medical device production. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Role of the pharmacist in preventing distribution of counterfeit medications.

Science.gov (United States)

Chambliss, Walter G; Carroll, Wesley A; Kennedy, Daniel; Levine, Donald; Moné, Michael A; Ried, L Douglas; Shepherd, Marv; Yelvigi, Mukund

2012-01-01

To provide an overview of the counterfeit medication problem and recommendations of a joint American Pharmacists Association (APhA) Academy of Pharmaceutical Research and Science and APhA Academy of Pharmacy Practice and Management taskforce. SciFinder and PubMed were searched from 1980 to March 2011 using the following keywords: counterfeit drug product, counterfeit medications, drug product authentication, drug product verification, and track-and-trace. Publications, presentations, and websites of organizations that research the counterfeit medication problem in the United States and other countries were reviewed. A representative from the security division of a pharmaceutical manufacturer and a representative from a supplier of anticounterfeiting technologies gave presentations to the taskforce. The taskforce recommends that pharmacists (1) purchase medications from known, reliable sources; (2) warn patients of the dangers of purchasing medications over the Internet; (3) confirm with distributors that products were purchased from manufacturers or other reliable sources; (4) monitor counterfeit product alerts; (5) examine products for suspicious appearance; (6) work with the pharmaceutical industry, distributors, and the Food and Drug Administration (FDA) to close gaps in the supply chain, especially for drugs in short supply; (7) use scanning technology in the pharmacy as part of a prescription verification process; (8) educate themselves, coworkers, and patients about the risks of counterfeit medications; and (9) report suspicious medications to FDA, the distributor, and the manufacturer. The consequence of a patient receiving a counterfeit medication in the United States could be catastrophic, and pharmacists must play an active role in preventing such an event from occurring.

Retrospective Analysis of Medication Adherence and Cost Following Medication Therapy Management

Directory of Open Access Journals (Sweden)

Ashley Branham, PharmD

2010-01-01

Full Text Available Objective: To determine if pharmacist-provided medication therapy management (MTM improves medication adherence in Medicare patients. A secondary objective is to compare the total monthly cost of a patient’s prescription medication regimen 6 months before and 6 months following a comprehensive medication review (CMR. Design: Retrospective analysis of medication adherence, pre-post comparison. Setting: Three independent pharmacies in North Carolina. Patients: 97 Medicare Part D beneficiaries with one or more chronic disease states who participated in a comprehensive medication review (CMR. Intervention: MTM services provided by community pharmacists. Main outcome measure: Change in adherence as measured by the proportion of days covered (PDC and change in medication costs for patients and third party payers. Results: Patients were adherent to chronic disease-state medications before and after MTM (PDC≥ 0.8. Overall, change in mean adherence before and after MTM did not change significantly (0.87 and 0.88, respectively; p = 0.43. However, patients taking medications for cholesterol management, GERD, thyroid and BPH demonstrated improved adherence following a CMR. No change in adherence was noted for patients using antihypertensives and antidiabetic agents. Average total chronic disease-state medication costs for participants were reduced from $210.74 to $193.63 (p=0.08 following the comprehensive medication review. Total costs for patient and third party payers decreased from patients prescribed antilipemics, antihypertensives, GERD and thyroid disorders following a CMR. Conclusions: Pharmacist-provided MTM services were effective at improving medication adherence for some patients managed with chronic medications. Pharmacist-provided MTM services also were effective in decreasing total medication costs.

Objectives and Outcomes

Energy Technology Data Exchange (ETDEWEB)

Segalman, D.J.

1998-11-30

a significant exposure to biomedical topics and the integration of those topics with chemical (electrical or mechanical) engineering. o We shall provide unique opportunities for our students to work with clinicians and researchers in hospitals and other medical institutions. combined criteria a-k of ABET and 1-6 of AICHE (or IEEE or ASME) in some sensible manner. Here I have just estimated the number of distinct criteria that would be extracted from the AICHE paragraphs. These criteria are necessarily included because of the objective to producing chemical (electrical or mechanical) engineers. every student who desires an internship or independent study at a medical institution will be placed. a majority of our students will take either the FE exam or the M-CAT exam. demonstrating a commitment to professionalism and to life-long learning. a majority of our students will go on to graduate school or other post-graduate school. (I do not assert that this sort of outcome is appropriate to all excellent schools. In the case of this hypothetical school though, this outcome might be a reasonable expectation.) medical schools will rank our school as among the best from which to admit

Effects of Medical Device Regulations on the Development of Stand-Alone Medical Software: A Pilot Study.

Science.gov (United States)

Blagec, Kathrin; Jungwirth, David; Haluza, Daniela; Samwald, Matthias

2018-01-01

Medical device regulations which aim to ensure safety standards do not only apply to hardware devices but also to standalone medical software, e.g. mobile apps. To explore the effects of these regulations on the development and distribution of medical standalone software. We invited a convenience sample of 130 domain experts to participate in an online survey about the impact of current regulations on the development and distribution of medical standalone software. 21 respondents completed the questionnaire. Participants reported slight positive effects on usability, reliability, and data security of their products, whereas the ability to modify already deployed software and customization by end users were negatively impacted. The additional time and costs needed to go through the regulatory process were perceived as the greatest obstacles in developing and distributing medical software. Further research is needed to compare positive effects on software quality with negative impacts on market access and innovation. Strategies for avoiding over-regulation while still ensuring safety standards need to be devised.

COAGULATION CALCULATIONS OF ICY PLANET FORMATION AT 15-150 AU: A CORRELATION BETWEEN THE MAXIMUM RADIUS AND THE SLOPE OF THE SIZE DISTRIBUTION FOR TRANS-NEPTUNIAN OBJECTS

Energy Technology Data Exchange (ETDEWEB)

Kenyon, Scott J. [Smithsonian Astrophysical Observatory, 60 Garden Street, Cambridge, MA 02138 (United States); Bromley, Benjamin C., E-mail: skenyon@cfa.harvard.edu, E-mail: bromley@physics.utah.edu [Department of Physics, University of Utah, 201 JFB, Salt Lake City, UT 84112 (United States)

2012-03-15

We investigate whether coagulation models of planet formation can explain the observed size distributions of trans-Neptunian objects (TNOs). Analyzing published and new calculations, we demonstrate robust relations between the size of the largest object and the slope of the size distribution for sizes 0.1 km and larger. These relations yield clear, testable predictions for TNOs and other icy objects throughout the solar system. Applying our results to existing observations, we show that a broad range of initial disk masses, planetesimal sizes, and fragmentation parameters can explain the data. Adding dynamical constraints on the initial semimajor axis of 'hot' Kuiper Belt objects along with probable TNO formation times of 10-700 Myr restricts the viable models to those with a massive disk composed of relatively small (1-10 km) planetesimals.

Foreign Object in the Eye: First Aid

Science.gov (United States)

... eye: First aid Foreign object in the eye: First aid By Mayo Clinic Staff If you get a foreign object in your eye Wash your hands ... et al., eds. American Medical Association Handbook of First Aid and Emergency Care. New York, N.Y.: Random ...

Ferromagnetic Objects Magnetovision Detection System.

Science.gov (United States)

Nowicki, Michał; Szewczyk, Roman

2013-12-02

This paper presents the application of a weak magnetic fields magnetovision scanning system for detection of dangerous ferromagnetic objects. A measurement system was developed and built to study the magnetic field vector distributions. The measurements of the Earth's field distortions caused by various ferromagnetic objects were carried out. The ability for passive detection of hidden or buried dangerous objects and the determination of their location was demonstrated.

Expression and cellular distribution of multidrug transporter proteins in two major causes of medically intractable epilepsy: Focal cortical dysplasia and glioneuronal tumors

NARCIS (Netherlands)

Aronica, E.; Gorter, J. A.; Jansen, G. H.; van Veelen, C. W. M.; van Rijen, P. C.; Leenstra, S.; Ramkema, M.; Scheffer, G. L.; Scheper, R. J.; Troost, D.

2003-01-01

The cell-specific distribution of multidrug resistance extrusion pumps was studied in developmental glioneuronal lesions, including focal cortical dysplasia (15 cases) and ganglioglioma (15 cases) from patients with medically intractable epilepsy. Lesional, perilesional, as well as normal brain

National awareness campaign to prevent medication-overuse headache in Denmark.

Science.gov (United States)

Carlsen, Louise Ninett; Westergaard, Maria Lurenda; Bisgaard, Mette; Schytz, Julie Brogaard; Jensen, Rigmor Højland

2017-01-01

Background Medication-overuse headache is prevalent, but in principle preventable. Objective To describe the Danish national awareness campaign for medication-overuse headache. Methods The Danish Headache Center, the Association of Danish Pharmacies, and headache patient organizations implemented a four-month medication-overuse headache awareness campaign in 2016. Target groups were the general public, general practitioners, and pharmacists. Key messages were: Overuse of pain-medication can worsen headaches; pain-medication should be used rationally; and medication-overuse headache is treatable. A range of communication technologies was used. A survey on the public's awareness of medication-overuse headache was conducted. Results The Danish adult population is 4.2 million. Online videos were viewed 297,000 times in three weeks. All 400 pharmacies received campaign materials. Over 28,000 leaflets were distributed. Two radio interviews were conducted. A television broadcast about headache reached an audience of 520,000. Forty articles were published in print media. Information was accessible at 32 reputable websites and five online news agencies. Three scientific papers were published. Information was available at an annual conference of general practitioners, including a headache lecture. The survey showed an increase in percentage of the public who knew about medication-overuse headache (from 31% to 38%). Conclusion A concerted campaign to prevent medication-overuse headache can be implemented through involvement of key stakeholders.

Mediman: Object oriented programming approach for medical image analysis

International Nuclear Information System (INIS)

Coppens, A.; Sibomana, M.; Bol, A.; Michel, C.

1993-01-01

Mediman is a new image analysis package which has been developed to analyze quantitatively Positron Emission Tomography (PET) data. It is object-oriented, written in C++ and its user interface is based on InterViews on top of which new classes have been added. Mediman accesses data using external data representation or import/export mechanism which avoids data duplication. Multimodality studies are organized in a simple database which includes images, headers, color tables, lists and objects of interest (OOI's) and history files. Stored color table parameters allow to focus directly on the interesting portion of the dynamic range. Lists allow to organize the study according to modality, acquisition protocol, time and spatial properties. OOI's (points, lines and regions) are stored in absolute 3-D coordinates allowing correlation with other co-registered imaging modalities such as MRI or SPECT. OOI's have visualization properties and are organized into groups. Quantitative ROI analysis of anatomic images consists of position, distance, volume calculation on selected OOI's. An image calculator is connected to mediman. Quantitation of metabolic images is performed via profiles, sectorization, time activity curves and kinetic modeling. Mediman is menu and mouse driven, macro-commands can be registered and replayed. Its interface is customizable through a configuration file. The benefit of the object-oriented approach are discussed from a development point of view

Precise Object Tracking under Deformation

International Nuclear Information System (INIS)

Saad, M.H.

2010-01-01

The precise object tracking is an essential issue in several serious applications such as; robot vision, automated surveillance (civil and military), inspection, biomedical image analysis, video coding, motion segmentation, human-machine interface, visualization, medical imaging, traffic systems, satellite imaging etc. This framework focuses on the precise object tracking under deformation such as scaling, rotation, noise, blurring and change of illumination. This research is a trail to solve these serious problems in visual object tracking by which the quality of the overall system will be improved. Developing a three dimensional (3D) geometrical model to determine the current pose of an object and predict its future location based on FIR model learned by the OLS. This framework presents a robust ranging technique to track a visual target instead of the traditional expensive ranging sensors. The presented research work is applied to real video stream and achieved high precession results. xiiiThe precise object tracking is an essential issue in several serious applications such as; robot vision, automated surveillance (civil and military), inspection, biomedical image analysis, video coding, motion segmentation, human-machine interface, visualization, medical imaging, traffic systems, satellite imaging etc. This framework focuses on the precise object tracking under deformation such as scaling, rotation, noise, blurring and change of illumination. This research is a trail to solve these serious problems in visual object tracking by which the quality of the overall system will be improved. Developing a three dimensional (3D) geometrical model to determine the current pose of an object and predict its future location based on FIR model learned by the OLS. This framework presents a robust ranging technique to track a visual target instead of the traditional expensive ranging sensors. The presented research work is applied to real video stream and achieved high

Interest in medical therapy for celiac disease

Science.gov (United States)

Tennyson, Christina A.; Simpson, Suzanne; Lebwohl, Benjamin; Lewis, Suzanne

2013-01-01

Objectives: A gluten-free diet is the treatment for celiac disease, but pharmaceutical agents are being developed. The level of interest amongst patients in using a medication to treat celiac disease is unknown. This study examined the level of interest amongst patients in medication to treat celiac disease. Methods: A questionnaire was distributed to celiac disease patients and data were collected on demographics, presentation, and interest in medication. Three validated celiac disease-specific instruments were incorporated: Celiac Disease Associated Quality of Life, the Celiac Symptom Index, and the Celiac Dietary Adherence Test. Results: Responses were received from 365 individuals with biopsy-proven celiac disease. Respondents were 78% (n = 276) female, 48% (n = 170) over 50 years of age, and experienced a classical (diarrhea predominant) presentation in 44% (n = 154). Of the 339 individuals answering the question regarding use of a medication to treat celiac disease, 66% were interested. Interest was greatest in older individuals (71% >50 years of age versus 60% symptoms with gluten exposure did not demonstrate any effect. Interest in medication was associated with a worse quality of life (CD-QOL 69.4 versus 80.1, p celiac disease are interested in using a medication. Interest was highest among men, older individuals, frequent restaurant customers, individuals dissatisfied with their weight or concerned with the cost of a gluten-free diet, and those with a worse quality of life. PMID:24003336

Medically-enhanced normality

DEFF Research Database (Denmark)

Møldrup, Claus; Traulsen, Janine Morgall; Almarsdóttir, Anna Birna

2003-01-01

Objective: To consider public perspectives on the use of medicines for non-medical purposes, a usage called medically-enhanced normality (MEN). Method: Examples from the literature were combined with empirical data derived from two Danish research projects: a Delphi internet study and a Telebus...

Effects of Carpal Tunnel Syndrome on adaptation of multi-digit forces to object mass distribution for whole-hand manipulation

Directory of Open Access Journals (Sweden)

Zhang Wei

2012-11-01

Full Text Available Abstract Background Carpal tunnel syndrome (CTS is a compression neuropathy of the median nerve that results in sensorimotor deficits in the hand. Until recently, the effects of CTS on hand function have been studied using mostly two-digit grip tasks. The purpose of this study was to investigate the coordination of multi-digit forces as a function of object center of mass (CM during whole-hand grasping. Methods Fourteen CTS patients and age- and gender-matched controls were instructed to grasp, lift, hold, and release a grip device with five digits for seven consecutive lifts while maintaining its vertical orientation. The object CM was changed by adding a mass at different locations at the base of the object. We measured forces and torques exerted by each digit and object kinematics and analyzed modulation of these variables to object CM at object lift onset and during object hold. Our task requires a modulation of digit forces at and after object lift onset to generate a compensatory moment to counteract the external moment caused by the added mass and to minimize object tilt. Results We found that CTS patients learned to generate a compensatory moment and minimized object roll to the same extent as controls. However, controls fully exploited the available degrees of freedom (DoF in coordinating their multi-digit forces to generate a compensatory moment, i.e., digit normal forces, tangential forces, and the net center of pressure on the finger side of the device at object lift onset and during object hold. In contrast, patients modulated only one of these DoFs (the net center of pressure to object CM by modulating individual normal forces at object lift onset. During object hold, however, CTS patients were able to modulate digit tangential force distribution to object CM. Conclusions Our findings suggest that, although CTS did not affect patients’ ability to perform our manipulation task, it interfered with the modulation of specific grasp

Socially responsible medical education: innovations and challenges in a minority setting.

Science.gov (United States)

Schofield, Aurel; Bourgeois, Daniel

2010-03-01

Distributed medical education sites help train, recruit and retain doctors, notably in rural and isolated areas, by providing education and training in these areas and adapting their curriculum to meet the host community's health needs. The Centre de Formation Médicale du Nouveau Brunswick (CFMNB; New Brunswick Medical Education Centre) was established by a partnership between two academic institutions, the Université de Sherbrooke (University of Sherbrooke), situated in the province of Quebec, and the Université de Moncton (University of Moncton), situated in the province of New Brunswick, in Canada. The CFMNB is specifically targeting a minority community (Acadians). Working to establish a high-quality medical education programme, the CFMNB has also set community objectives to meet not only the health needs of this population, but also its social and economic needs. This paper describes the overall objectives of this project, which are: to reduce the gap between community needs and academic institutional needs; to address ethno-cultural and language differences in a defined minority population, and to develop collaboration between the partners involved, including government and community entities which are often perceived as operating in isolation from one another. We also describe why and how the CFMNB developed community-focused objectives and the challenges that came with these innovations, and present lessons from the experience that may be relevant to other sites interested in the social responsibility of medical schools. The CFMNB has produced interesting work and innovations in the field of social responsibility and has encountered many challenges. Continuing interaction between medical education, health research and health services to better address the needs of the population has been established. The information obtained by this process has been used to build a strategic plan for the CFMNB in order to ensure that it is socially responsive and has

Ferromagnetic Objects Magnetovision Detection System

Directory of Open Access Journals (Sweden)

Michał Nowicki

2013-12-01

Full Text Available This paper presents the application of a weak magnetic fields magnetovision scanning system for detection of dangerous ferromagnetic objects. A measurement system was developed and built to study the magnetic field vector distributions. The measurements of the Earth’s field distortions caused by various ferromagnetic objects were carried out. The ability for passive detection of hidden or buried dangerous objects and the determination of their location was demonstrated.

Medical physics and challenges faced in Africa

International Nuclear Information System (INIS)

Nakatudde, R.

2010-01-01

Individual medical physicists have presented many challenges which have greatly inhibited their input in patient care and management. To improve the role and recognition of medical physicists in Africa, FAMPO was established. This is the Federation of African Medical Physics Organisations. Its main role is to bridge the gap between individual medical physicists, existing medical physicist bodies and the International Organisation of Medical Physics (IOMP). It is a non profit making organisation. A qualified medical physicist is an individual who is competent to practice independently one or more of the sub fields of medical physics. i.e. therapeutic radiological, diagnostic radiological, medical nuclear and medical health. Their time should on average be distributed equally among three areas, clinical service and consultation, research and development, and teaching. All diagnostic and radiotherapy centres should have a well established comprehensive quality assurance programme in place, which should involve machine installation and calibration, source delivery and safety, operational procedures, clinical dosimetry and the whole treatment planning process. This should be followed according to national and international recommendations. A study was carried out to identify the challenges faced by medical physicists in Africa and the objectives of the study were; To identify the number of qualified medical physicists and their working experience in hospitals in African countries. To identify the level of involvement of medical physicists in the three areas of Nuclear medicine, Radiology and Radiotherapy in hospitals in African countries.To identify countries with recognised professional bodies governing medical physicists in African countries.To identify the challenges faced by medical physicists in African countries Methods and materials The study was conducted on thirteen medical physicists from seven African countries. i.e. Nigeria, Kenya, Libya, Tanzania, Zambia

dftools: Distribution function fitting

Science.gov (United States)

Obreschkow, Danail

2018-05-01

dftools, written in R, finds the most likely P parameters of a D-dimensional distribution function (DF) generating N objects, where each object is specified by D observables with measurement uncertainties. For instance, if the objects are galaxies, it can fit a mass function (D=1), a mass-size distribution (D=2) or the mass-spin-morphology distribution (D=3). Unlike most common fitting approaches, this method accurately accounts for measurement in uncertainties and complex selection functions.

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

Science.gov (United States)

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

2017-03-01

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

Association between workarounds and medication administration errors in bar-code-assisted medication administration in hospitals

NARCIS (Netherlands)

van der Veen, Willem; van den Bemt, Patricia M L A; Wouters, Hans; Bates, David W; Twisk, Jos W R; de Gier, Johan J; Taxis, Katja

Objective: To study the association of workarounds with medication administration errors using barcode-assisted medication administration (BCMA), and to determine the frequency and types of workarounds and medication administration errors. Materials and Methods: A prospective observational study in

System of and method for transparent management of data objects in containers across distributed heterogenous resources

Science.gov (United States)

Moore, Reagan W.; Rajasekar, Arcot; Wan, Michael Y.

2007-09-11

A system of and method for maintaining data objects in containers across a network of distributed heterogeneous resources in a manner which is transparent to a client. A client request pertaining to containers is resolved by querying meta data for the container, processing the request through one or more copies of the container maintained on the system, updating the meta data for the container to reflect any changes made to the container as a result processing the re quest, and, if a copy of the container has changed, changing the status of the copy to indicate dirty status or synchronizing the copy to one or more other copies that may be present on the system.

Epidemiology of percutaneous exposure to needlestick and sharp object injuries in the Botswana public health sector: A health facility cross sectional study

Directory of Open Access Journals (Sweden)

Styn M Jamu

2016-01-01

Full Text Available Objective To evaluate the extent and distribution of needlestick and sharp object injuries in the Botswana public health sector. Methods This was a cross-section study carried out in eight hospitals and 72 clinics and health posts. Results The study comprised of 885 randomly selected healthcare workers. The sample included medical doctors, nurses, laboratory staff, and dental staff and housekeeping staff. The reference group was a sample of housekeeping staff. The lifelong prevalence of needle-stick injuries was 48.9% (95% CI: 45.6, 52.2. Life-long prevalence was significantly higher in nurses (Adjusted Odds ratio [Adj. OR] = 4.1, 95% CI: 3.0, 5.7, medical doctors (Adj. OR = 4.2, 95% CI: 2.1, 8.4 compared with the reference. The prevalence of needlestick and sharp object injuries in six-month duration was 11.8% (95% CI: 9.6%, 14.0%. Nurses (Adj. OR = 3.5, 95% CI: 2.0, 6.1 were three times likely to sustain injuries in a six-month period compared with the reference group. Most injuries occurred at patient’s bedside and in the emergency departments. Disposable syringes caused most of the injuries, often during and immediately after a medical procedure. Conclusions: Healthcare workers in Botswana remain at risk of percutaneous exposure to needlestick and sharp object injuries. They are at an increased risk of bloodborne infections including HIV.

Medical ADP Systems: Automated Medical Records Hold Promise to Improve Patient Care

Science.gov (United States)

1991-01-01

automated medical records. The report discusses the potential benefits that automation could make to the quality of patient care and the factors that impede...information systems, but no organization has fully automated one of the most critical types of information, patient medical records. The patient medical record...its review of automated medical records. GAO’s objectives in this study were to identify the (1) benefits of automating patient records and (2) factors

Income Distribution Impacts of Irrigation Water Distribution Policy

Science.gov (United States)

Sampath, Rajan K.

1984-06-01

In the majority of lesser developed countries (LDC's) there is acute inequality in income distribution in the rural sector, particularly between large and small farms on the one hand and between land owners and the landless on the other. Irrigation water distribution policy of the government is both an economic and political problem. It has both equity and efficiency implications. It has effects on both the level and distribution of income. This paper deals with the conditions under which using water redistribution as an effective governmental policy variable can reduce inequality in the distribution of income. This paper also deals with the relationship between the objectives of equity and efficiency in water distribution under different objective realities, such as dualistic versus nondualistic conditions, two-sector versus three-sector modeling, optimum versus equal water distribution, specifically to derive the conditions under which promotion of equity promotes efficiency and vice versa and the conditions under which it does not.

RTDB: A memory resident real-time object database

International Nuclear Information System (INIS)

Nogiec, Jerzy M.; Desavouret, Eugene

2003-01-01

RTDB is a fast, memory-resident object database with built-in support for distribution. It constitutes an attractive alternative for architecting real-time solutions with multiple, possibly distributed, processes or agents sharing data. RTDB offers both direct and navigational access to stored objects, with local and remote random access by object identifiers, and immediate direct access via object indices. The database supports transparent access to objects stored in multiple collaborating dispersed databases and includes a built-in cache mechanism that allows for keeping local copies of remote objects, with specifiable invalidation deadlines. Additional features of RTDB include a trigger mechanism on objects that allows for issuing events or activating handlers when objects are accessed or modified and a very fast, attribute based search/query mechanism. The overall architecture and application of RTDB in a control and monitoring system is presented

Tracking multiple objects is limited only by object spacing, not by speed, time, or capacity.

Science.gov (United States)

Franconeri, S L; Jonathan, S V; Scimeca, J M

2010-07-01

In dealing with a dynamic world, people have the ability to maintain selective attention on a subset of moving objects in the environment. Performance in such multiple-object tracking is limited by three primary factors-the number of objects that one can track, the speed at which one can track them, and how close together they can be. We argue that this last limit, of object spacing, is the root cause of all performance constraints in multiple-object tracking. In two experiments, we found that as long as the distribution of object spacing is held constant, tracking performance is unaffected by large changes in object speed and tracking time. These results suggest that barring object-spacing constraints, people could reliably track an unlimited number of objects as fast as they could track a single object.

Quantum objective realism

International Nuclear Information System (INIS)

Bednorz, Adam

2015-01-01

The question of whether quantum measurements reflect some underlying objective reality has no generally accepted answer. We show that a description of such reality is possible under natural conditions such as linearity and causality, although in terms of moments and cumulants of finite order and without relativistic invariance. The proposed construction of observations’ probability distribution originates from weak, noninvasive measurements, with detection error replaced by some external finite noise. The noise allows us to construct microscopic objective reality, but remains dynamically decoupled and hence unobservable at the macroscopic level. (paper)

Hawk: A Runtime System for Partitioned Objects

NARCIS (Netherlands)

Ben Hassen, S.; Bal, H.E.; Tanenbaum, A.S.

1997-01-01

Hawk is a language-independent runtime system for writing data-parallel programs using partitioned objects. A partitioned object is a multidimensional array of elements that can be partitioned and distributed by the programmer. The Hawk runtime system uses the user-defined partitioning of objects

Resident and program director gender distribution by specialty.

Science.gov (United States)

Long, Timothy R; Elliott, Beth A; Warner, Mary Ellen; Brown, Michael J; Rose, Steven H

2011-12-01

Although enrollment of women in U.S. medical schools has increased, women remain less likely to achieve senior academic rank, lead academic departments, or be appointed to national leadership positions. The purpose of this paper is to compare the gender distribution of residency program directors (PDs) with residents and faculty in the 10 largest specialties. The gender distribution of residents training in the 10 specialties with the largest enrollment was obtained from the annual education issue of Journal of the American Medical Association. The gender distribution of the residents was compared with the gender distribution of PDs and medical school faculty. The number of programs and the names of the PDs were identified by accessing the Accreditation Council for Graduate Medical Education web site. Gender was confirmed through electronic search of state medical board data, program web sites, or by using internet search engines. The gender distribution of medical school faculty was determined using the Association of American Medical Colleges faculty roster database (accessed June 15, 2011). The correlation between female residents and PDs was assessed using Pearson's product-moment correlation. The gender distribution of female PDs appointed June 1, 2006, through June 1, 2010, was compared with the distribution appointed before June 1, 2006, using chi square analysis. Specialties with higher percentages of female PDs had a higher percentage of female residents enrolled (r=0.81, p=0.005). The number of female PDs appointed from July 1, 2006, through June 30, 2010, was greater than the number appointed before July 1, 2006, in emergency medicine (pWomen remain underrepresented in PD appointments relative to the proportion of female medical school faculty and female residents. Mechanisms to address gender-based barriers to advancement should be considered.

21 CFR 226.110 - Distribution records.

Science.gov (United States)

2010-04-01

...: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES Records and Reports § 226.110 Distribution records. Complete records shall be maintained for each shipment of Type A medicated article(s) in... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Distribution records. 226.110 Section 226.110 Food...

Medication supply chain management through implementation of a hospital pharmacy computerized inventory program in Haiti

Directory of Open Access Journals (Sweden)

Michelle R. Holm

2015-01-01

Full Text Available Background: In the aftermath of the 2010 earthquake in Haiti, St. Luke Hospital was built to help manage the mass casualties and subsequent cholera epidemic. A major problem faced by the hospital system was the lack of an available and sustainable supply of medications. Long-term viability of the hospital system depended largely on developing an uninterrupted medication supply chain. Objective: We hypothesized that the implementation of a new Pharmacy Computerized Inventory Program (PCIP would optimize medication availability and decrease medication shortages. Design: We conducted the research by examining how medications were being utilized and distributed before and after the implementation of PCIP. We measured the number of documented medication transactions in both Phase 1 and Phase 2 as well as user logins to determine if a computerized inventory system would be beneficial in providing a sustainable, long-term solution to their medication management needs. Results: The PCIP incorporated drug ordering, filling the drug requests, distribution, and dispensing of the medications in multiple settings; inventory of currently shelved medications; and graphic reporting of ‘real-time’ medication usage. During the PCIP initiation and establishment periods, the number of medication transactions increased from 219.6 to 359.5 (p=0.055, respectively, and the mean logins per day increased from 24.3 to 31.5, p<0.0001, respectively. The PCIP allows the hospital staff to identify and order medications with a critically low supply as well as track usage for future medication needs. The pharmacy and nursing staff found the PCIP to be efficient and a significant improvement in their medication utilization. Conclusions: An efficient, customizable, and cost-sensitive PCIP can improve drug inventory management in a simplified and sustainable manner within a resource-constrained hospital.

Distributive justice and the harm to medical professionals fighting epidemics

DEFF Research Database (Denmark)

Albertsen, Andreas; Thaysen, Jens Damgaard

2017-01-01

The exposure of doctors, nurses and other medical professionals to risks in the context of epidemics is significant. While traditional medical ethics offers the thought that these dangers may limit the extent to which a duty to care is applicable in such situations, it has less to say about what we......, cure and care for the vulnerable, luck egalitarianism seems to imply that their claim of justice to medical attention in case of infection is weak or non-existent. The article demonstrates how a recent interpretation of luck egalitarianism offers a solution to this problem. Redefining luck...

Partitioning an object-oriented terminology schema.

Science.gov (United States)

Gu, H; Perl, Y; Halper, M; Geller, J; Kuo, F; Cimino, J J

2001-07-01

Controlled medical terminologies are increasingly becoming strategic components of various healthcare enterprises. However, the typical medical terminology can be difficult to exploit due to its extensive size and high density. The schema of a medical terminology offered by an object-oriented representation is a valuable tool in providing an abstract view of the terminology, enhancing comprehensibility and making it more usable. However, schemas themselves can be large and unwieldy. We present a methodology for partitioning a medical terminology schema into manageably sized fragments that promote increased comprehension. Our methodology has a refinement process for the subclass hierarchy of the terminology schema. The methodology is carried out by a medical domain expert in conjunction with a computer. The expert is guided by a set of three modeling rules, which guarantee that the resulting partitioned schema consists of a forest of trees. This makes it easier to understand and consequently use the medical terminology. The application of our methodology to the schema of the Medical Entities Dictionary (MED) is presented.

Database Independent Migration of Objects into an Object-Relational Database

CERN Document Server

Ali, A; Munir, K; Waseem-Hassan, M; Willers, I

2002-01-01

CERN's (European Organization for Nuclear Research) WISDOM project [1] deals with the replication of data between homogeneous sources in a Wide Area Network (WAN) using the extensible Markup Language (XML). The last phase of the WISDOM (Wide-area, database Independent Serialization of Distributed Objects for data Migration) project [2], indicates the future directions for this work to be to incorporate heterogeneous sources as compared to homogeneous sources as described by [3]. This work will become essential for the CERN community once the need to transfer their legacy data to some other source, other then Objectivity [4], arises. Oracle 9i - an Object-Relational Database (including support for abstract data types, ADTs) appears to be a potential candidate for the physics event store in the CERN CMS experiment as suggested by [4] & [5]. Consequently this database has been selected for study. As a result of this work the HEP community will get a tool for migrating their data from Objectivity to Oracle9i.

Characterization of medical students recall of factual knowledge using learning objects and repeated testing in a novel e-learning system.

Science.gov (United States)

Taveira-Gomes, Tiago; Prado-Costa, Rui; Severo, Milton; Ferreira, Maria Amélia

2015-01-24

Spaced-repetition and test-enhanced learning are two methodologies that boost knowledge retention. ALERT STUDENT is a platform that allows creation and distribution of Learning Objects named flashcards, and provides insight into student judgments-of-learning through a metric called 'recall accuracy'. This study aims to understand how the spaced-repetition and test-enhanced learning features provided by the platform affect recall accuracy, and to characterize the effect that students, flashcards and repetitions exert on this measurement. Three spaced laboratory sessions (s0, s1 and s2), were conducted with n=96 medical students. The intervention employed a study task, and a quiz task that consisted in mentally answering open-ended questions about each flashcard and grading recall accuracy. Students were randomized into study-quiz and quiz groups. On s0 both groups performed the quiz task. On s1 and s2, the study-quiz group performed the study task followed by the quiz task, whereas the quiz group only performed the quiz task. We measured differences in recall accuracy between groups/sessions, its variance components, and the G-coefficients for the flashcard component. At s0 there were no differences in recall accuracy between groups. The experiment group achieved a significant increase in recall accuracy that was superior to the quiz group in s1 and s2. In the study-quiz group, increases in recall accuracy were mainly due to the session, followed by flashcard factors and student factors. In the quiz group, increases in recall accuracy were mainly accounted by flashcard factors, followed by student and session factors. The flashcard G-coefficient indicated an agreement on recall accuracy of 91% in the quiz group, and of 47% in the study-quiz group. Recall accuracy is an easily collectible measurement that increases the educational value of Learning Objects and open-ended questions. This metric seems to vary in a way consistent with knowledge retention, but further

Exploration Medical Capability - Technology Watch

Science.gov (United States)

Krihak, Michael; Watkins, Sharmila; Barr, Yael; Barsten, Kristina; Fung, Paul; Baumann, David

2011-01-01

The objectives of the Technology Watch process are to identify emerging, high-impact technologies that augment current ExMC development efforts, and to work with academia, industry, and other government agencies to accelerate the development of medical care and research capabilities for the mitigation of potential health issues that could occur during space exploration missions. The establishment of collaborations with these entities is beneficial to technology development, assessment and/or insertion. Such collaborations also further NASA s goal to provide a safe and healthy environment for human exploration. The Tech Watch project addresses requirements and capabilities identified by knowledge and technology gaps that are derived from a discrete set of medical conditions that are most likely to occur on exploration missions. These gaps are addressed through technology readiness level assessments, market surveys, collaborations and distributed innovation opportunities. Ultimately, these gaps need to be closed with respect to exploration missions, and may be achieved through technology development projects. Information management is a key aspect to this process where Tech Watch related meetings, research articles, collaborations and partnerships are tracked by the HRP s Exploration Medical Capabilities (ExMC) Element. In 2011, ExMC will be introducing the Tech Watch external website and evidence wiki that will provide access to ExMC technology and knowledge gaps, technology needs and requirements documents.

Response to: 'Why medical professionals have no moral claim to conscientious objection accommodation in liberal democracies' by Schuklenk and Smalling.

Science.gov (United States)

Glick, Shimon M; Jotkowitz, Alan

2017-04-01

The recent essay by Schuklenk and Smalling opposing respect for physicians' conscientious objections to providing patients with medical services that are legally permitted in liberal democracies is based on several erroneous assumptions. Acting in this manner would have serious harmful effects on the ethos of medicine and of bioethics. A much more nuanced and balanced position is critical in order to respect physicians' conscience with minimal damage to patients' rights. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

La Seccion de Investigacion sobre Educacion Medica de la Facultad de Medicina de la Universidad National Autonoma de Mexico (The Medical Education Investigation Section of the School of Medicine of UNAM).

Science.gov (United States)

Campillo Sainz, Carlos; Alvarez, Tostado, Juan

This document is an English-language abstract (approximately 1,500 words) of a survey of Mexican medical education needs for the future. To plan for these needs, SISEM of UNAM was formed with the objectives of carrying out and promoting investigations in the different areas of medical education. It also wants to distribute the information…

Active Contour Driven by Local Region Statistics and Maximum A Posteriori Probability for Medical Image Segmentation

Directory of Open Access Journals (Sweden)

Xiaoliang Jiang

2014-01-01

Full Text Available This paper presents a novel active contour model in a variational level set formulation for simultaneous segmentation and bias field estimation of medical images. An energy function is formulated based on improved Kullback-Leibler distance (KLD with likelihood ratio. According to the additive model of images with intensity inhomogeneity, we characterize the statistics of image intensities belonging to each different object in local regions as Gaussian distributions with different means and variances. Then, we use the Gaussian distribution with bias field as a local region descriptor in level set formulation for segmentation and bias field correction of the images with inhomogeneous intensities. Therefore, image segmentation and bias field estimation are simultaneously achieved by minimizing the level set formulation. Experimental results demonstrate desirable performance of the proposed method for different medical images with weak boundaries and noise.

A multi-objective model for locating distribution centers in a supply chain network considering risk and inventory decisions

Directory of Open Access Journals (Sweden)

Sara Gharegozloo Hamedani

2013-04-01

Full Text Available This paper presents a multi-objective location problem in a three level supply chain network under uncertain environment considering inventory decisions. The proposed model of this paper considers uncertainty for different parameters including procurement, transportation costs, supply, demand and the capacity of various facilities. The proposed model presents a robust optimization model, which specifies locations of distribution centers to be opened, inventory control parameters (r, Q, and allocation of supply chain components, concurrently. The resulted mixed-integer nonlinear programming minimizes the expected total cost of such a supply chain network comprising location, procurement, transportation, holding, ordering, and shortage costs. The model also minimizes the variability of the total cost of relief chain and minimizes the financial risk or the probability of not meeting a certain budget. We use the ε-constraint method, which is a multi-objective technique with implicit trade-off information given, to solve the problem and using a couple of numerical instances, we examine the performance of the proposed approach.

Distributed nuclear medicine applications using World Wide Web and Java technology

International Nuclear Information System (INIS)

Knoll, P.; Hoell, K.; Koriska, K.; Mirzaei, S.; Koehn, H.

2000-01-01

At present, medical applications applying World Wide Web (WWW) technology are mainly used to view static images and to retrieve some information. The Java platform is a relative new way of computing, especially designed for network computing and distributed applications which enables interactive connection between user and information via the WWW. The Java 2 Software Development Kit (SDK) including Java2D API, Java Remote Method Invocation (RMI) technology, Object Serialization and the Java Advanced Imaging (JAI) extension was used to achieve a robust, platform independent and network centric solution. Medical image processing software based on this technology is presented and adequate performance capability of Java is demonstrated by an iterative reconstruction algorithm for single photon emission computerized tomography (SPECT). (orig.)

Radiation monitoring and dose distribution of medical workers in A.P. state 1999-2000

International Nuclear Information System (INIS)

Singh, D.R.; Reddy, K.S.; Kamble, M.K.; Roy, Madhumita

2001-01-01

Individual monitoring for external ionizing radiation is being conducted for all radiation workers in Andhra Pradesh State by TLD Unit located in Nuclear Fuel Complex, Hyderabad.The Unit comes under Personnel Monitoring Section of Bhabha Atomic Research Center, Mumbai. The aim of monitoring is to confirm that the radiation safety standards are strictly adhered in the institutions and also to investigate excessive exposures, if any. Personnel monitoring also provides data for epidemiological studies. In view of ICRP/AERB recommendations of 100 mSv dose limit for the five years block of 1994-98, the dose distribution among radiation workers in Andhra Pradesh State is analyzed for the period 1994-98. In continuation of above work, we have analyzed the data for the year 1999-2000 for various medical diagnostic procedures and these are presented

Digital Distributed Control System Design: Control Policy for Shared Objects in HTR-PM

International Nuclear Information System (INIS)

Zhou Shuqiao; Huang Xiaojin

2014-01-01

HTR-PM is an HTR demonstration plant with a structure of two modules feeding one steam turbine. Compared with the structure of one single reactor feeding one turbine, there are more devices shared between these two modules. When they are operated, the shared components are prone to introduce collisions or even logical deadlocks for different technical processes. The future commercial HTR-PM plants are supposed to comprise more modules for a larger turbine, thus the collision problem introduced by the shared components may become severer. Therefore, how to design suitable policies in the distributed control system (DCS) to relieve the collisions during using these shared devices is a new and also a very important problem. In this paper, the classifications of the shared devices are first addressed, and then how to identify the shared objects of an NPP is proposed. Furthermore, a general model for the control logic design is proposed, taking into consideration the collision avoidance, time delay and fairness. The example of how to apply the schemes to relieve the conflicts and deadlocks in the processes of using the shared devices in fuel element cycling system is illustrated. (author)

Preliminary survey on the distribution of medical equipment and frequency of diagnostic and therapeutic procedures in Brazil: a contribution to the UNSCEAR report

International Nuclear Information System (INIS)

Biazotto, Bruna; Taboza de Oliveira, Alexandre; Baptista de Freitas, Marcelo

2008-01-01

Information about Brazil published in the UNSCEAR 2000 report are still scarce when compared to others countries. In this study, a survey on the distribution of medical equipment (X-ray generators, ultrasound, CT and MRI scanners, nuclear medicine equipment and teletherapy and brachytherapy units) and frequency of diagnostic and therapeutic procedures at the various Brazilian States was carried out. The overall information was obtained from a national database supported by the Brazilian Ministry of Health through the Computer Science Department of the National Health System (SUS - Sistema Unico de Saude). The distribution of equipment and the annual frequency of each type of procedure were analyzed considering the five geographical regions that form the country and their respective population. Temporal and regional trends in the annual frequency of procedures for 2000-2007 were also summarized in this study. National annual frequencies for the total of all medical X-ray examinations (259.0 examinations per 1000 population) were evaluated. Some examples can be given from chest, mammography and CT examinations: 67.4, 30.2 and 7.2 per 1000 population, respectively. In addition, annual frequencies for other modalities of diagnostic imaging have also been estimated: 61.5, 1.6 and 1.4 per 1000 population for ultrasound, nuclear medicine and MRI procedures, respectively. A total of 38.7 therapeutic procedures per 1000 population (teletherapy and brachytherapy) are annually performed in the country. The health services localized in Brazil comprised a total number of 253.1 diagnostic imaging equipment per million population, without considering dental X-ray. Amongst them, X-ray equipment used in common radiological examinations (chest, skull, spine, etc.) stands for 39% (97.7 per million). As expected, a significant decrease in the offer of equipment is observed when technologically more sophisticated equipment is concerned: magnetic resonance (3.5 per million), gamma

Factors considered by undergraduate medical students when selecting specialty of their future careers.

Science.gov (United States)

Alawad, Awad Ali Mohamed Ahmed; Khan, Waleed Shabeer; Abdelrazig, Yousif Mohammed; Elzain, Yamin Ibrahim; Khalil, Hassan Osman; Ahmed, Omer Bakri Elsayed; Adam, Omeralfaroug Ahmed Ibrahim

2015-01-01

Medical students are the source of a country's physicians. Determining how medical students select their areas of specialization is the key to achieve a balanced distribution of doctors among all specialties. The objective is to identify the number of medical students who have decided their postgraduate specialty career, their career specialties preference, and factors that may influence their decision to select a particular specialty. A facility based cross-sectional study was conducted in September 2013 at Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan. A self-administered semi-structured questionnaire comprising demographic data and questions about future specialties preferences and factors influencing those preferences was distributed to 887 male and female students, (from first to fifth academic years) recruited in the study. Response rate was 73% with 647 questionnaires collected, out of 887 eligible medical students. Of the returned questionnaires, 604 were valid. The majority of students (541, 89.6%) have chosen a specialty. Surgery, medicine, paediatrics and obstetrics and gynecology were the most selected specialties. The least selected specialty was anaesthesiology. A significant association was found between gender and specialty choice using Chi-square test (p = 0.00). There was no association between undergraduate level and specialty choice (p = 0.633). The most common reason for choosing a specific specialty was "Personal Interest" (215, 39.7%) followed by being "Helpful to the community" (144, 26.6%). Surgery, medicine, paediatrics and obstetrics and gynecology were the most selected specialties.

Topics in medical image processing and computational vision

CERN Document Server

Jorge, Renato

2013-01-01

  The sixteen chapters included in this book were written by invited experts of international recognition and address important issues in Medical Image Processing and Computational Vision, including: Object Recognition, Object Detection, Object Tracking, Pose Estimation, Facial Expression Recognition, Image Retrieval, Data Mining, Automatic Video Understanding and Management, Edges Detection, Image Segmentation, Modelling and Simulation, Medical thermography, Database Systems, Synthetic Aperture Radar and Satellite Imagery.   Different applications are addressed and described throughout the book, comprising: Object Recognition and Tracking, Facial Expression Recognition, Image Database, Plant Disease Classification, Video Understanding and Management, Image Processing, Image Segmentation, Bio-structure Modelling and Simulation, Medical Imaging, Image Classification, Medical Diagnosis, Urban Areas Classification, Land Map Generation.   The book brings together the current state-of-the-art in the various mul...

Awareness of academic use of smartphones and medical apps among medical students in a private medical college?

Science.gov (United States)

Shah, Jehanzaib; Haq, Usman; Bashir, Ali; Shah, Syed Aslam

2016-02-01

To assess the awareness of medical apps and academic use of smartphones among medical students. The questionnaire-based descriptive cross-sectional study was conducted in January 2015 and comprised medical students of the Rawal Institute of Health Sciences, Islamabad, Pakistan. The self-designed questionnaire was reviewed by a panel of expert for content reliability and validity. Questionnaires were distributed in the classrooms and were filled by the students anonymously. SPSS 16 was used for statistical analysis. Among the 569 medical students in the study, 545 (95.8%) had smartphones and 24(4.2%) were using simple cell phones. Overall, 226(41.46%) of the smart phone users were using some medical apps. Besides, 137(24.08%) were aware of the medical apps but were not using them. Also, 391(71.7%) students were not using any type of medical text eBooks through their phone, and only 154(28.3%) had relevant text eBooks in their phones. Medical college students were using smartphones mostly as a means of telecommunication rather than a gadget for improving medical knowledge.

Open Issues in Object-Oriented Programming

DEFF Research Database (Denmark)

Madsen, Ole Lehrmann

1995-01-01

We discuss a number of open issues within object-oriented programming. The central mechanisms of object-oriented programming appeared with Simula, developed more than 30 years ago; these include class, subclass, virtual function, active object and the first application framework, Class Simulation....... The core parts of object-oriented programming should be well understood, but there are still a large number of issues where there is no consensus. The term object-orientation has been applied to many subjects, such as analysis, design implementation, data modeling in databases, and distribution...

[Conscientious objection in the matter of abortion].

Science.gov (United States)

Serrano Gil, A; García Casado, M L

1992-03-01

The issue of conscientious objection in Spain has been used by pro-choice groups against objecting health personnel as one of the obstacles to the implementation of the abortion law, a misnomer. At present objection is massive in the public sector; 95% of abortions are carried out in private clinics with highly lucrative returns; abortion tourism has decreased; and false objection has proliferated in the public sector when the objector performs abortions in the private sector for high fees. The legal framework for conscientious objection is absent in Spain. Neither Article 417 of the Penal Code depenalizing abortion, nor the Ministerial Decree of July 31, 1985, nor the Royal Decree of November 21, 1986 recognize such a concept. However, the ruling of the Constitutional Court on April 11, 1985 confirmed that such objection can be exercised with independence. Some authors refer to the applicability of Law No. 48 of December 16, 1984 that regulates conscientious objection in military service to health personnel. The future law concerning the fundamental right of ideological and religious liberty embodied in Article 16.1 of the Constitution has to be revised. A draft bill was submitted in the Congress or Representatives concerning this issue on May 3, 1985 that recognizes the right of medical personnel to object to abortion without career repercussions. Another draft bill was introduced on April 17, 1985 that would allow the nonparticipation of medical personnel in the interruption of pregnancy, however, they would be prohibited from practicing such in the private hospitals. Neither of these proposed bills became law. Professional groups either object unequivocally, or do not object at all, or object on an ethical level but do not object to therapeutic abortion. The resolution of this issue has to be by consensus and not by imposition.

A Bayesian alternative for multi-objective ecohydrological model specification

Science.gov (United States)

Tang, Yating; Marshall, Lucy; Sharma, Ashish; Ajami, Hoori

2018-01-01

Recent studies have identified the importance of vegetation processes in terrestrial hydrologic systems. Process-based ecohydrological models combine hydrological, physical, biochemical and ecological processes of the catchments, and as such are generally more complex and parametric than conceptual hydrological models. Thus, appropriate calibration objectives and model uncertainty analysis are essential for ecohydrological modeling. In recent years, Bayesian inference has become one of the most popular tools for quantifying the uncertainties in hydrological modeling with the development of Markov chain Monte Carlo (MCMC) techniques. The Bayesian approach offers an appealing alternative to traditional multi-objective hydrologic model calibrations by defining proper prior distributions that can be considered analogous to the ad-hoc weighting often prescribed in multi-objective calibration. Our study aims to develop appropriate prior distributions and likelihood functions that minimize the model uncertainties and bias within a Bayesian ecohydrological modeling framework based on a traditional Pareto-based model calibration technique. In our study, a Pareto-based multi-objective optimization and a formal Bayesian framework are implemented in a conceptual ecohydrological model that combines a hydrological model (HYMOD) and a modified Bucket Grassland Model (BGM). Simulations focused on one objective (streamflow/LAI) and multiple objectives (streamflow and LAI) with different emphasis defined via the prior distribution of the model error parameters. Results show more reliable outputs for both predicted streamflow and LAI using Bayesian multi-objective calibration with specified prior distributions for error parameters based on results from the Pareto front in the ecohydrological modeling. The methodology implemented here provides insight into the usefulness of multiobjective Bayesian calibration for ecohydrologic systems and the importance of appropriate prior

SYVAC3 parameter distribution package

Energy Technology Data Exchange (ETDEWEB)

Andres, T; Skeet, A

1995-01-01

SYVAC3 (Systems Variability Analysis Code, generation 3) is a computer program that implements a method called systems variability analysis to analyze the behaviour of a system in the presence of uncertainty. This method is based on simulating the system many times to determine the variation in behaviour it can exhibit. SYVAC3 specializes in systems representing the transport of contaminants, and has several features to simplify the modelling of such systems. It provides a general tool for estimating environmental impacts from the dispersal of contaminants. This report describes a software object type (a generalization of a data type) called Parameter Distribution. This object type is used in SYVAC3, and can also be used independently. Parameter Distribution has the following subtypes: beta distribution; binomial distribution; constant distribution; lognormal distribution; loguniform distribution; normal distribution; piecewise uniform distribution; Triangular distribution; and uniform distribution. Some of these distributions can be altered by correlating two parameter distribution objects. This report provides complete specifications for parameter distributions, and also explains how to use them. It should meet the needs of casual users, reviewers, and programmers who wish to add their own subtypes. (author). 30 refs., 75 tabs., 56 figs.

Medical Typewriting; Business Education: 7705.32.

Science.gov (United States)

Schull, Amy P.

This guide describes a course designed to prepare students for employment as medical records clerks capable of handling all types of medical forms and reports, and using and spelling medical terminology correctly. The need for medical typists is critical. The guide contains enrollment guidelines, performance objectives (i.e., type medical…

Having your radioactive objects identified and collected

International Nuclear Information System (INIS)

2012-12-01

This brochure explains the risks linked with some ancient radioactive objects of domestic use (like radium products of medical use), how to identify them and to have them collected by the French national agency of radioactive wastes (Andra) for further processing. Some advice are given regarding the identification of the objects, their relative hazardousness and the precautions to take for their handling

Self-medication among non-healthcare students of the University of Sharjah, United Arab Emirates

Directory of Open Access Journals (Sweden)

Suleiman Ibrahim Sharif

2014-01-01

Full Text Available Objectives: The objective of the following study is to estimate the prevalence of self-medication among university students and evaluate factors associated with the practice. Materials and Methods: This study was conducted during May, 2012 using a pre-validated questionnaire distributed to 250 students of the 4 years of study at the college of business administration. Data were analyzed using PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc and results are expressed as counts and percentages. Chi-square test was used to evaluate significant association among the study variables and P < 0.05 were considered to be statistically significant. Results: The response rate was 80% and all respondents were Arabs with 114 (57% females and 86 (43% males. Self-medication was practiced by 118 (59% students and most (88.1% of them obtained medications from pharmacies. About 21 (11% respondents self-medicated with antibiotics. Only 34 (17% and 16 (8% of respondents were aware of bacterial resistance and rational drug use respectively. The most common reasons for self-medication were seeking quick relief (134, 67%, physician′s advice of self-management (100, 50%, illness is minor (91, 45.5%. Common reasons against self-medication include risk of misdiagnosis of illness (160, 80%, risk of using the wrong medication (154, 77%, risk of adverse effects (140, 70%. Self-medication was practiced for headache or mild pain, eye and ear symptoms, gastric problems, cold, fever and allergy. Conclusion: Self-medication among non-healthcare students is common with high prevalence. Knowledge of students of reasons for and against self-medication was adequate, but awareness of respondents of rational drug use and risk of bacterial resistance in response to misuse was poor. Orientation courses/workshops directed to university students would be beneficial.

A model for a drug distribution system in remote Australia as a social determinant of health using event structure analysis.

Science.gov (United States)

Rovers, John P; Mages, Michelle D

2017-09-25

The social determinants of health include the health systems under which people live and utilize health services. One social determinant, for which pharmacists are responsible, is designing drug distribution systems that ensure patients have safe and convenient access to medications. This is critical for settings with poor access to health care. Rural and remote Australia is one example of a setting where the pharmacy profession, schools of pharmacy, and regulatory agencies require pharmacists to assure medication access. Studies of drug distribution systems in such settings are uncommon. This study describes a model for a drug distribution system in an Aboriginal Health Service in remote Australia. The results may be useful for policy setting, pharmacy system design, health professions education, benchmarking, or quality assurance efforts for health system managers in similarly remote locations. The results also suggest that pharmacists can promote access to medications as a social determinant of health. The primary objective of this study was to propose a model for a drug procurement, storage, and distribution system in a remote region of Australia. The secondary objective was to learn the opinions and experiences of healthcare workers under the model. Qualitative research methods were used. Semi-structured interviews were performed with a convenience sample of 11 individuals employed by an Aboriginal health service. Transcripts were analyzed using Event Structure Analysis (ESA) to develop the model. Transcripts were also analyzed to determine the opinions and experiences of health care workers. The model was comprised of 24 unique steps with seven distinct components: choosing a supplier; creating a list of preferred medications; budgeting and ordering; supply and shipping; receipt and storage in the clinic; prescribing process; dispensing and patient counseling. Interviewees described opportunities for quality improvement in choosing suppliers, legal issues and

Development of 3-D Medical Image VIsualization System

African Journals Online (AJOL)

User

uses standard 2-D medical imaging inputs and generates medical images of human body parts ... light wave from points on the 3-D object(s) in ... tools, and communication bandwidth cannot .... locations along the track that correspond with.

The development of a National set of Physiology learning objectives ...

African Journals Online (AJOL)

International Journal of Medicine and Health Development ... engagement that can be utilized to design a national set of learning objectives towards improving learning ... Key words: Learning objectives, Nigeria, Medical education, curriculum ...

Multi-objective optimization of inverse planning for accurate radiotherapy

International Nuclear Information System (INIS)

Cao Ruifen; Pei Xi; Cheng Mengyun; Li Gui; Hu Liqin; Wu Yican; Jing Jia; Li Guoli

2011-01-01

The multi-objective optimization of inverse planning based on the Pareto solution set, according to the multi-objective character of inverse planning in accurate radiotherapy, was studied in this paper. Firstly, the clinical requirements of a treatment plan were transformed into a multi-objective optimization problem with multiple constraints. Then, the fast and elitist multi-objective Non-dominated Sorting Genetic Algorithm (NSGA-II) was introduced to optimize the problem. A clinical example was tested using this method. The results show that an obtained set of non-dominated solutions were uniformly distributed and the corresponding dose distribution of each solution not only approached the expected dose distribution, but also met the dose-volume constraints. It was indicated that the clinical requirements were better satisfied using the method and the planner could select the optimal treatment plan from the non-dominated solution set. (authors)

Effectively Indexing Uncertain Moving Objects for Predictive Queries

DEFF Research Database (Denmark)

Zhang, Meihui; Chen, Su; Jensen, Christian Søndergaard

2009-01-01

in more complex and stochastic ways. This paper investigates the possibility of a marriage between moving-object indexing and probabilistic object modelling. Given the distributions of the current locations and velocities of moving objects, we devise an efficient inference method for the prediction...

Medical students’ perception of the learning environment at King Saud University Medical College, Saudi Arabia, using DREEM Inventory

Directory of Open Access Journals (Sweden)

Soliman MM

2017-03-01

Full Text Available Mona M Soliman,1,2 Kamran Sattar,2 Sami Alnassar,3 Faisal Alsaif,4 Khalid Alswat,5 Mohamed Alghonaim,6 Maysoon Alhaizan,7 Nawaf Al-furaih7 1Department of Physiology, 2Department of Medical Education, 3Department of Surgery, College of Medicine, King Saud University, 4Department of Surgery, King Saud University Medical City, 5Department of Internal Medicine, 6Department of Medicine, 7College of Medicine, King Saud University, Riyadh, Saudi Arabia Background: The students’ perception of the learning environment is an important aspect for evaluation and improvement of the educational program. The College of Medicine at King Saud University (KSU reformed its curriculum in 2009 from a traditional to a system-oriented hybrid curriculum.Objective: The objective of the present study was to determine the perception of the second batch (reformed curriculum of medical graduates about the educational environment at the College of Medicine, KSU, using the Dundee Ready Education Environment Measure (DREEM scale.Methods: The fifth year medical students were asked to evaluate the educational program after graduation in May 2014. The questionnaire was distributed to the graduate students electronically. The DREEM questionnaire consisted of 50 items based on Likert’s scale; and five domains, namely, students’ perceptions of learning, perceptions of teachers, academic self-perceptions, perceptions of atmosphere, and social self-perceptions. Data were analyzed using SPSS.Results: A total of 62 students participated in the study. The score for students’ perception of learning among medical students ranged from 2.93 to 3.64 (overall mean score: 40.17. The score for students’ perception of teachers ranged from 2.85 to 4.01 (overall mean score: 33.35. The score for students’ academic self-perceptions ranged from 3.15 to 4.06 (overall mean score: 28.4. The score for students’ perception of atmosphere ranged from 2.27 to 3.91 (overall mean score: 41.32. The

Medical Students' Knowledge about Alcohol and Drug Problems: Results of the Medical Council of Canada Examination

Science.gov (United States)

Kahan, Meldon; Midmer, Deana; Wilson, Lynn; Borsoi, Diane

2006-01-01

Purpose: To determine knowledge of a national sample of medical students about substance withdrawal, screening and early intervention, medical and psychiatric complications of addiction, and treatment options. Methods: Based on learning objectives developed by medical faculty, twenty-two questions on addictions were included in the 1998 Canadian…

A Psychoacoustic-Based Multiple Audio Object Coding Approach via Intra-Object Sparsity

Directory of Open Access Journals (Sweden)

Maoshen Jia

2017-12-01

Full Text Available Rendering spatial sound scenes via audio objects has become popular in recent years, since it can provide more flexibility for different auditory scenarios, such as 3D movies, spatial audio communication and virtual classrooms. To facilitate high-quality bitrate-efficient distribution for spatial audio objects, an encoding scheme based on intra-object sparsity (approximate k-sparsity of the audio object itself is proposed in this paper. The statistical analysis is presented to validate the notion that the audio object has a stronger sparseness in the Modified Discrete Cosine Transform (MDCT domain than in the Short Time Fourier Transform (STFT domain. By exploiting intra-object sparsity in the MDCT domain, multiple simultaneously occurring audio objects are compressed into a mono downmix signal with side information. To ensure a balanced perception quality of audio objects, a Psychoacoustic-based time-frequency instants sorting algorithm and an energy equalized Number of Preserved Time-Frequency Bins (NPTF allocation strategy are proposed, which are employed in the underlying compression framework. The downmix signal can be further encoded via Scalar Quantized Vector Huffman Coding (SQVH technique at a desirable bitrate, and the side information is transmitted in a lossless manner. Both objective and subjective evaluations show that the proposed encoding scheme outperforms the Sparsity Analysis (SPA approach and Spatial Audio Object Coding (SAOC in cases where eight objects were jointly encoded.

Web based 3-D medical image visualization on the PC.

Science.gov (United States)

Kim, N; Lee, D H; Kim, J H; Kim, Y; Cho, H J

1998-01-01

With the recent advance of Web and its associated technologies, information sharing on distribute computing environments has gained a great amount of attention from many researchers in many application areas, such as medicine, engineering, and business. One basic requirement of distributed medical consultation systems is that geographically dispersed, disparate participants are allowed to exchange information readily with each other. Such software also needs to be supported on a broad range of computer platforms to increase the softwares accessibility. In this paper, the development of world-wide-web based medical consultation system for radiology imaging is addressed to provide platform independence and greater accessibility. The system supports sharing of 3-dimensional objects. We use VRML (Virtual Reality Modeling Language), which is the defacto standard in 3-D modeling on the Web. 3-D objects are reconstructed from CT or MRI volume data using a VRML format, which can be viewed and manipulated easily in Web-browsers with a VRML plug-in. A Marching cubes method is used in the transformation of scanned volume data sets to polygonal surfaces of VRML. A decimation algorithm is adopted to reduce the number of meshes in the resulting VRML file. 3-D volume data are often very large in size, hence loading the data on PC level computers requires a significant reduction of the size of the data, while minimizing the loss of the original shape information. This is also important to decrease network delays. A prototype system has been implemented (http://cybernet5.snu.ac.kr/-cyber/mrivrml .html), and several sessions of experiments are carried out.

Medication compliance behavior in psychiatric out‑patients with ...

African Journals Online (AJOL)

Background: Psychotropic medication adherence is a major challenge in psychiatric patients with comorbidity. Objective: The objective was to determine medication adherence behavior among psychiatric out‑patients with psychoactive substance use comorbidity in a Nigerian Tertiary Hospital. Settings and Design: A ...

Medical design anthropology

DEFF Research Database (Denmark)

Ventura, Jonathan; Gunn, Wendy

Barnard and Spencer define medical anthropology in the Encyclopedia of Social and Cultural Anthropology as "Medical anthropology is, as the phrase implies, unavoidably concerned with the paradigm of modern Western medicine, whether implicitly or explicitly" (2002: 541). Recently there is a new...... focus in medical sociology and anthropology, which is patient's practices and influence on wider global health environment (see for example vol. 36(2) of Sociology of Health & Illness). While various social science theoreticians have written about agentic abilities of objects, there is a gap...... in literature concerning various levels of socio-cultural influence of the medical environment through medical products. In our research we have outlined the importance of medical design anthropology (MDA) to the practice and theory of design (Ventura and Gunn, 2016). In this paper, we study the ways in which...

Associations of objectively measured physical activity and abdominal fat distribution.

Science.gov (United States)

Philipsen, Annelotte; Hansen, Anne-Louise Smidt; Jørgensen, Marit Eika; Brage, Søren; Carstensen, Bendix; Sandbaek, Annelli; Almdal, Thomas Peter; Gram, Jeppe; Pedersen, Erling Bjerregaard; Lauritzen, Torsten; Witte, Daniel Rinse

2015-05-01

Visceral adipose tissue (VAT) and physical activity are both independent predictors of Type 2 diabetes. Physical activity and overall obesity are inversely associated with each other. Yet the nature of the association between objectively measured dimensions of physical activity and abdominal fat distribution has not been well characterized. We aimed to do so in a middle-age to elderly population at high risk of diabetes. A cross-sectional analysis of 1134 participants of the ADDITION-PRO study. VAT and subcutaneous adipose tissue (SAT) were assessed one-dimensionally by ultrasonography and physical activity with combined accelerometry and HR monitoring. Linear regression of physical activity energy expenditure (PAEE) and time spent in different physical activity intensity levels on VAT and SAT was performed. Median body mass index (BMI) was 26.6 kg·m and PAEE was 28.1 kJ·kg·d, with 18.9 h·d spent sedentary, 4.5 h·d in light-intensity physical activity, and 0.4 h·d in moderate-intensity physical activity. PAEE was significantly negatively associated with VAT, and in women, PAEE was also significantly negatively associated with SAT. The difference in VAT was -1.1 mm (95% confidence interval [CI] = -1.8 to -0.3) per 10-kJ·kg·d increment, and the corresponding difference in SAT for women was -0.6 mm (95% CI = -1.2 to -0.04) in models adjusted for age, sex, and waist circumference. Exchanging 1 h of light physical activity with moderate physical activity was significantly associated with VAT (-4.5 mm, 95% CI = -7.6 to -1.5). Exchanging one sedentary hour with light physical activity was significantly associated with both VAT (-0.9 mm, 95% CI = -0.1 to -1.8) and SAT (-0.4 mm, 95% CI = -0.0 to -0.7). In this population with low physical activity levels, cross-sectional findings indicate that increasing overall physical activity and decreasing time spent sedentary is important to avoid the accumulation of metabolically deleterious VAT.

The Impact of Health Changes on Labor Supply: Evidence from Merged Data on Individual Objective Medical Diagnosis Codes and Early Retirement Behavior

DEFF Research Database (Denmark)

Christensen, Bent Jesper; Kallestrup-Lamb, Malene

2012-01-01

The justification bias in the estimated impact of health shocks on retirement is mitigated by using objective health measures from a large, register-based longitudinal data set including medical diagnosis codes, along with labor market status, financial, and socio-economic variables. The duration...... until retirement is modeled using single and competing risk specifications, observed and unobserved heterogeneity, and flexible baseline hazards. Wealth is used as a proxy for elapsed duration to mitigate the potential selection bias stemming from conditioning on initial participation. The competing...

Anticorrosional protection in nuclear power station objects

International Nuclear Information System (INIS)

Czarnocki, A.; Kwiatkowski, A.

1976-01-01

The distribution and qualities of chemical protection and demands concerning preparation of the bottom for protecting coats in nuclear power station objects are discussed. The solutions of protections applied abroad and in the objects of ''MARIA'' reactor are presented. (author)

Utopia2000: An Online Learning-Object Management Tool.

Science.gov (United States)

Aspillaga, Macarena

2002-01-01

Describes Utopia2002, a database that contains learning objects that enables faculty to design and develop interactive Web-based instruction. Topics include advanced distributed learning; sharable content objects (SCOs) and sharable content object reference model (SCORM); instructional systems design process; templates; and quality assurance. (LRW)

Hospital ownership and medical services: market mix, spillover effects, and nonprofit objectives.

Science.gov (United States)

Horwitz, Jill R; Nichols, Austin

2009-09-01

Hospitals operate in markets with varied demographic, competitive, and ownership characteristics, yet research on ownership tends to examine hospitals in isolation. Here we examine three hospital ownership types -- nonprofit, for-profit, and government -- and their spillover effects. We estimate the effects of for-profit market share in two ways, on the provision of medical services and on operating margins at the three types of hospitals. We find that nonprofit hospitals' medical service provision systematically varies by market mix. We find no significant effect of market mix on the operating margins of nonprofit hospitals, but find that for-profit hospitals have higher margins in markets with more for-profits. These results fit best with theories in which hospitals maximize their own output.

Home Medication Cabinets and Medication Taking Behavior of the Staffs in a University in China

Science.gov (United States)

Xue, Chengbin; Ye, Juan; Dong, Yuzhen; Xu, Chunmei

2018-01-01

Background: A growing sum of medicines is stored in home medication cabinets in China, with the behavior of self-medication increasing. Although responsible self-medication can help prevent and treat ailments that do not need professional consultation, it bears the risk of misuse of medicines issued on prescription due to inadequate prescription medicine administration. Objective: The objective of this study was to investigate the condition and safety of medication storage and intended self-medication in a University in China. Method: The study was conducted over 10 month period (May 2015-March 2016) and involved a random sample of households. The questionnaire survey and personal insight into household medicine supplies was performed by a team of trained pharmacy staffs. Interviewees (N = 398, aged 16-88 y) were visited door to door and the home medication cabinets were catalogued after the participants were interviewed. Results: The majority (89.71%) households have home medicine cabinets. The total number of medicine items in the 398 households was 5600, with a median of 14 per household. The most frequently encountered categories of registered medicines were cough and cold medcines (47.8%), antibacterials for systemic use (30.0%), topical products for joint and muscular pain(26.1%), vitamins (23.2%), medication for functional gastrointestinal disorders (23.2%), oral and external forms have not kept separately(55.1%). The most treatment related problems recorded were curative effect not ideal (57.9%). 68% of the sample population would choose doctors as medication consultation object about medicines purchased. Conclusion: Large sum of medicines were found per household, with a high prevalence of cough and cold medcines. Public services in China, mainly government and health organizations, need put more effort on educating people on how to store medicines, as well as finding a way to raise awareness of the public in promoting behavioral change about medication

Teaching Medical Ethics in Graduate and Undergraduate Medical Education: A Systematic Review of Effectiveness.

Science.gov (United States)

de la Garza, Santiago; Phuoc, Vania; Throneberry, Steven; Blumenthal-Barby, Jennifer; McCullough, Laurence; Coverdale, John

2017-08-01

One objective was to identify and review studies on teaching medical ethics to psychiatry residents. In order to gain insights from other disciplines that have published research in this area, a second objective was to identify and review studies on teaching medical ethics to residents across all other specialties of training and on teaching medical students. PubMed, EMBASE, and PsycINFO were searched for controlled trials on teaching medical ethics with quantitative outcomes. Search terms included ethics, bioethics, medical ethics, medical students, residents/registrars, teaching, education, outcomes, and controlled trials. Nine studies were found that met inclusion criteria, including five randomized controlled trails and four controlled non-randomized trials. Subjects included medical students (5 studies), surgical residents (2 studies), internal medicine house officers (1 study), and family medicine preceptors and their medical students (1 study). Teaching methods, course content, and outcome measures varied considerably across studies. Common methodological issues included a lack of concealment of allocation, a lack of blinding, and generally low numbers of subjects as learners. One randomized controlled trial which taught surgical residents using a standardized patient was judged to be especially methodologically rigorous. None of the trials incorporated psychiatry residents. Ethics educators should undertake additional rigorously controlled trials in order to secure a strong evidence base for the design of medical ethics curricula. Psychiatry ethics educators can also benefit from the findings of trials in other disciplines and in undergraduate medical education.

Research on dose setting for radiation sterilization of medical device

International Nuclear Information System (INIS)

Zhang Tongcheng; Liu Qingfang; Zhong Hongliang; Mi Zhisu; Wang Chunlei; Jiang Jianping

2002-01-01

Objective: To establish the radiation sterilization dose for medical devices using data of bioburden on the medical device. Methods: Firstly determination of recovery ratio and correction coefficient of the microbiological test method was used according to ISO11737 standard, then determination of bioburden on the products, finally the dose setting was completed based on the Method 1 in ISO11137 standard. Results: Fifteen kinds of medical devices were tested. Bioburden range was from 8.6-97271.2 CFU/device, recovery ration range 54.6%-100%, correction co-efficiency range 1.00-1.83, D 10 distribution from 1.40 to 2.82 kGy, verification dose (dose at SAL = 10 -2 ) range 5.1-17.6 kGy and sterilization dose (dose at SAL 10 -6 ) range 17.5-32.5 kGy. Conclusion: One hundred samples of each kind of product were exposed to the pre-determined verification dose and then the sterility test was performed. Each sterility test showed positive number was not greater than two. This indicated that the sterilization dose established for each kind of product was statistically acceptable

EXPERIENCE IN DEVELOPMENT MEDICAL KITS FOR MEDICAL SERVICES OF THE RUSSIAN FEDERATION ARMED FORCES

OpenAIRE

E. O. Rodionov; Yu. V. Miroshnichenko; V. N. Kononov; A. V. Tikhonov; I. V. Klochkova

2016-01-01

Introduction. The development of modern, complete-standard issue equipment for the Armed Forces Medical Service is an urgent organizational and management task. First aid kits, medical bags, sets of medical equipment, medical kits and packing existed until recently; no longer meet modern requirements for a number of objective reasons. The aim of the study was the formation of programs of development of modern samples of complete-standard-issue equipment. Materials and methods. The study was c...

User Interface Design in Medical Distributed Web Applications.

Science.gov (United States)

Serban, Alexandru; Crisan-Vida, Mihaela; Mada, Leonard; Stoicu-Tivadar, Lacramioara

2016-01-01

User interfaces are important to facilitate easy learning and operating with an IT application especially in the medical world. An easy to use interface has to be simple and to customize the user needs and mode of operation. The technology in the background is an important tool to accomplish this. The present work aims to creating a web interface using specific technology (HTML table design combined with CSS3) to provide an optimized responsive interface for a complex web application. In the first phase, the current icMED web medical application layout is analyzed, and its structure is designed using specific tools, on source files. In the second phase, a new graphic adaptable interface to different mobile terminals is proposed, (using HTML table design (TD) and CSS3 method) that uses no source files, just lines of code for layout design, improving the interaction in terms of speed and simplicity. For a complex medical software application a new prototype layout was designed and developed using HTML tables. The method uses a CSS code with only CSS classes applied to one or multiple HTML table elements, instead of CSS styles that can be applied to just one DIV tag at once. The technique has the advantage of a simplified CSS code, and a better adaptability to different media resolutions compared to DIV-CSS style method. The presented work is a proof that adaptive web interfaces can be developed just using and combining different types of design methods and technologies, using HTML table design, resulting in a simpler to learn and use interface, suitable for healthcare services.

The moral code in Islam and organ donation in Western countries: reinterpreting religious scriptures to meet utilitarian medical objectives.

Science.gov (United States)

Rady, Mohamed Y; Verheijde, Joseph L

2014-06-02

End-of-life organ donation is controversial in Islam. The controversy stems from: (1) scientifically flawed medical criteria of death determination; (2) invasive perimortem procedures for preserving transplantable organs; and (3) incomplete disclosure of information to consenting donors and families. Data from a survey of Muslims residing in Western countries have shown that the interpretation of religious scriptures and advice of faith leaders were major barriers to willingness for organ donation. Transplant advocates have proposed corrective interventions: (1) reinterpreting religious scriptures, (2) reeducating faith leaders, and (3) utilizing media campaigns to overcome religious barriers in Muslim communities. This proposal disregards the intensifying scientific, legal, and ethical controversies in Western societies about the medical criteria of death determination in donors. It would also violate the dignity and inviolability of human life which are pertinent values incorporated in the Islamic moral code. Reinterpreting religious scriptures to serve the utilitarian objectives of a controversial end-of-life practice, perceived to be socially desirable, transgresses the Islamic moral code. It may also have deleterious practical consequences, as donors can suffer harm before death. The negative normative consequences of utilitarian secular moral reasoning reset the Islamic moral code upholding the sanctity and dignity of human life.

Medical ethics and more: ideal theories, non-ideal theories and conscientious objection.

Science.gov (United States)

Luna, Florencia

2015-01-01

Doing 'good medical ethics' requires acknowledgment that it is often practised in non-ideal circumstances! In this article I present the distinction between ideal theory (IT) and non-ideal theory (NIT). I show how IT may not be the best solution to tackle problems in non-ideal contexts. I sketch a NIT framework as a useful tool for bioethics and medical ethics and explain how NITs can contribute to policy design in non-ideal circumstances. Different NITs can coexist and be evaluated vis-à-vis the IT. Additionally, I address what an individual doctor ought to do in this non-ideal context with the view that knowledge of NITs can facilitate the decision-making process. NITs help conceptualise problems faced in the context of non-compliance and scarcity in a better and more realistic way. Deciding which policy is optimal in such contexts may influence physicians' decisions regarding their patients. Thus, this analysis-usually identified only with policy making-may also be relevant to medical ethics. Finally, I recognise that this is merely a first step in an unexplored but fundamental theoretical area and that more work needs to be done. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Acceptability, Feasibility and Feedback Analysis of Perception for Objective Structured Practical Examination As an Assessment Tool in Undergraduate in Competency Based Medical Education

Directory of Open Access Journals (Sweden)

Harsha V. Patil

2016-04-01

Full Text Available Background: There is an increasing tendency to use Objective Structured Practical examination (OSPE as an evaluation tool of practical performance in medical education. Aim and Objectives: The objective of the present study was to determine the acceptability and feasibility of OSPE as an assessment tool of formative examination by feedback analysis in the microbiology nd subject in 2 year MBBS undergraduate students and to discuss the pros and cons of OSPE method. Material and Methods: A well organized comprehensive ten OSPE stations were arranged to assess the practical nd skills of 2 year MBBS students in the department of microbiology. The practical performance skill of 50 second year undergraduate MBBS students were assessed by OSPE for microbiology subject by creating 10 structured stations of OSPE. The stations were written so as to cover major important practical nd microbiology topics of 2 year MBBS. The practical tasks chosen for the OSPE were mapped as per learning objectives of the course and the expected level of learning of the students. Results: A qualitative feedback from the examiners/ observers and the students was taken to assess acceptability feasibility of OSPE assessment. The examiners and the students were asked to rate OSPE by five point Likert scale Questionnaires. For the majority of students (92% and examiners/ observers (100% OSPE session was acceptable (p < 0.001. All examiners perceived OSPE method as feasible assessment tool (p < 0.001. Majority of the examiners and the students were in agreement or strongly in agreement in Likert scale rating for feedback analysis of OSPE session. There was no significant statistical difference among students and examiners/observers (Chi-squre:1.5184; DF:5; p= 0.8234. Conclusions: The OSPE is reliable and reproducible practical assessment tool and yields dependable information about the practical performance capabilities and competence of individual student and can be used as an

Distributed and hierarchical object-based image analysis for damage assessment: a case study of 2008 Wenchuan earthquake, China

Directory of Open Access Journals (Sweden)

Jing Sun

2016-11-01

Full Text Available Object-based image analysis (OBIA is an emerging technique for analyzing remote sensing image based on object properties including spectral, geometry, contextual and texture information. To reduce the computational cost of this comprehensive OBIA and make it more feasible in disaster responses, we developed a unique approach – distributed and hierarchical OBIA approach for damage assessment. This study demonstrated a completed classification of YingXiu town, heavily devastated by the 2008 Wenchuan earthquake using Quickbrid imagery. Two distinctive areas, mountainous areas and urban, were analyzed separately. This approach does not require substantial processing power and large amounts of available memory because image of a large disaster-affected area was split in smaller pieces. Two or more computers could be used in parallel to process and analyze these sub-images based on different requirements. The approach can be applicable in other cases whereas the established set of rules can be adopted in similar study areas. More experiments will be carried out in future studies to prove its feasibility.

Expert Involvement and Adherence to Medical Evidence in Medical Mobile Phone Apps

DEFF Research Database (Denmark)

Subhi, Yousif; Bube, Sarah Hjartbro; Rolskov Bojsen, Signe

2015-01-01

BACKGROUND: Both clinicians and patients use medical mobile phone apps. Anyone can publish medical apps, which leads to contents with variable quality that may have a serious impact on human lives. We herein provide an overview of the prevalence of expert involvement in app development and whether...... or not app contents adhere to current medical evidence. OBJECTIVE: To systematically review studies evaluating expert involvement or adherence of app content to medical evidence in medical mobile phone apps. METHODS: We systematically searched 3 databases (PubMed, The Cochrane Library, and EMBASE......), and included studies evaluating expert involvement or adherence of app content to medical evidence in medical mobile phone apps. Two authors performed data extraction independently. Qualitative analysis of the included studies was performed. RESULTS: Based on inclusion criteria, 52 studies were included...

Tanzania Medical Journal: Submissions

African Journals Online (AJOL)

The Tanzania Medical Journal is a multi – disciplinary journal published two times a year in March - June and September – December. ... To achieve its objectives the journal invites papers on original scientific research, short communications, case reports and letters to the editor, in any branch of medical science. Original ...

Distributed interactive virtual environments for collaborative experiential learning and training independent of distance over Internet2.

Science.gov (United States)

Alverson, Dale C; Saiki, Stanley M; Jacobs, Joshua; Saland, Linda; Keep, Marcus F; Norenberg, Jeffrey; Baker, Rex; Nakatsu, Curtis; Kalishman, Summers; Lindberg, Marlene; Wax, Diane; Mowafi, Moad; Summers, Kenneth L; Holten, James R; Greenfield, John A; Aalseth, Edward; Nickles, David; Sherstyuk, Andrei; Haines, Karen; Caudell, Thomas P

2004-01-01

Medical knowledge and skills essential for tomorrow's healthcare professionals continue to change faster than ever before creating new demands in medical education. Project TOUCH (Telehealth Outreach for Unified Community Health) has been developing methods to enhance learning by coupling innovations in medical education with advanced technology in high performance computing and next generation Internet2 embedded in virtual reality environments (VRE), artificial intelligence and experiential active learning. Simulations have been used in education and training to allow learners to make mistakes safely in lieu of real-life situations, learn from those mistakes and ultimately improve performance by subsequent avoidance of those mistakes. Distributed virtual interactive environments are used over distance to enable learning and participation in dynamic, problem-based, clinical, artificial intelligence rules-based, virtual simulations. The virtual reality patient is programmed to dynamically change over time and respond to the manipulations by the learner. Participants are fully immersed within the VRE platform using a head-mounted display and tracker system. Navigation, locomotion and handling of objects are accomplished using a joy-wand. Distribution is managed via the Internet2 Access Grid using point-to-point or multi-casting connectivity through which the participants can interact. Medical students in Hawaii and New Mexico (NM) participated collaboratively in problem solving and managing of a simulated patient with a closed head injury in VRE; dividing tasks, handing off objects, and functioning as a team. Students stated that opportunities to make mistakes and repeat actions in the VRE were extremely helpful in learning specific principles. VRE created higher performance expectations and some anxiety among VRE users. VRE orientation was adequate but students needed time to adapt and practice in order to improve efficiency. This was also demonstrated successfully

[Medical deontology--historical study].

Science.gov (United States)

Wieckowska, Elzbieta

2003-01-01

The subject of the paper was to present selected publications concerning the medical deontology. Special attention was paid on three of them. Well-known publications Hippocrates' oath formulated in 5th/4th century BC, Majmonides' prayer (12th century) and Polish medical deontology code published in 1994 underwent a comparative analysis. The objective of the analysis was the description of the similarities and differences in the assumptions constituting in the fundamentals of medical deontology. Its formulated in almost one thousand year intervals, as well as assumptions comparison of Polish and universal medical deontology.

A distributed clinical decision support system architecture

Directory of Open Access Journals (Sweden)

Shaker H. El-Sappagh

2014-01-01

Full Text Available This paper proposes an open and distributed clinical decision support system architecture. This technical architecture takes advantage of Electronic Health Record (EHR, data mining techniques, clinical databases, domain expert knowledge bases, available technologies and standards to provide decision-making support for healthcare professionals. The architecture will work extremely well in distributed EHR environments in which each hospital has its own local EHR, and it satisfies the compatibility, interoperability and scalability objectives of an EHR. The system will also have a set of distributed knowledge bases. Each knowledge base will be specialized in a specific domain (i.e., heart disease, and the model achieves cooperation, integration and interoperability between these knowledge bases. Moreover, the model ensures that all knowledge bases are up-to-date by connecting data mining engines to each local knowledge base. These data mining engines continuously mine EHR databases to extract the most recent knowledge, to standardize it and to add it to the knowledge bases. This framework is expected to improve the quality of healthcare, reducing medical errors and guaranteeing the safety of patients by helping clinicians to make correct, accurate, knowledgeable and timely decisions.

A network-based distributed, media-rich computing and information environment

Energy Technology Data Exchange (ETDEWEB)

Phillips, R.L.

1995-12-31

Sunrise is a Los Alamos National Laboratory (LANL) project started in October 1993. It is intended to be a prototype National Information Infrastructure development project. A main focus of Sunrise is to tie together enabling technologies (networking, object-oriented distributed computing, graphical interfaces, security, multi-media technologies, and data-mining technologies) with several specific applications. A diverse set of application areas was chosen to ensure that the solutions developed in the project are as generic as possible. Some of the application areas are materials modeling, medical records and image analysis, transportation simulations, and K-12 education. This paper provides a description of Sunrise and a view of the architecture and objectives of this evolving project. The primary objectives of Sunrise are three-fold: (1) To develop common information-enabling tools for advanced scientific research and its applications to industry; (2) To enhance the capabilities of important research programs at the Laboratory; (3) To define a new way of collaboration between computer science and industrially-relevant research.

Scope and geographical distribution of African medical journals ...

African Journals Online (AJOL)

Design: A search was done for relevant African medical journals on electronic databases, library catalogues and internet sites, and a list was compiled of active journals. A survey was conducted via ... Fifty-one journals were published in English, 7 in French and 1 in Portuguese. Most journals were owned by an association ...

Precise object tracking under deformation

International Nuclear Information System (INIS)

Saad, M.H

2010-01-01

The precise object tracking is an essential issue in several serious applications such as; robot vision, automated surveillance (civil and military), inspection, biomedical image analysis, video coding, motion segmentation, human-machine interface, visualization, medical imaging, traffic systems, satellite imaging etc. This frame-work focuses on the precise object tracking under deformation such as scaling , rotation, noise, blurring and change of illumination. This research is a trail to solve these serious problems in visual object tracking by which the quality of the overall system will be improved. Developing a three dimensional (3D) geometrical model to determine the current pose of an object and predict its future location based on FIR model learned by the OLS. This framework presents a robust ranging technique to track a visual target instead of the traditional expensive ranging sensors. The presented research work is applied to real video stream and achieved high precession results.

Fast neutron radiography of extended biological and medical objects

International Nuclear Information System (INIS)

Duehmke, E.; Greim, L.

1978-01-01

The fast neutron radiography enables us to image extended objects and yields quite different pictures than conventional roentgenograms. Using foils of cellulose nitrate and the track etching technique a γ-ray-insensitive detector is available providing sufficient imaging qualities. One of the biological neutrograms shown in the paper is of special importance because one can see a malignant tumor of the columna vertebralis. This finding was not detectable by roentgenological examination. (orig.) [de

Pattern recognition for cache management in distributed medical imaging environments.

Science.gov (United States)

Viana-Ferreira, Carlos; Ribeiro, Luís; Matos, Sérgio; Costa, Carlos

2016-02-01

Traditionally, medical imaging repositories have been supported by indoor infrastructures with huge operational costs. This paradigm is changing thanks to cloud outsourcing which not only brings technological advantages but also facilitates inter-institutional workflows. However, communication latency is one main problem in this kind of approaches, since we are dealing with tremendous volumes of data. To minimize the impact of this issue, cache and prefetching are commonly used. The effectiveness of these mechanisms is highly dependent on their capability of accurately selecting the objects that will be needed soon. This paper describes a pattern recognition system based on artificial neural networks with incremental learning to evaluate, from a set of usage pattern, which one fits the user behavior at a given time. The accuracy of the pattern recognition model in distinct training conditions was also evaluated. The solution was tested with a real-world dataset and a synthesized dataset, showing that incremental learning is advantageous. Even with very immature initial models, trained with just 1 week of data samples, the overall accuracy was very similar to the value obtained when using 75% of the long-term data for training the models. Preliminary results demonstrate an effective reduction in communication latency when using the proposed solution to feed a prefetching mechanism. The proposed approach is very interesting for cache replacement and prefetching policies due to the good results obtained since the first deployment moments.

A fuzzy automated object classification by infrared laser camera

Science.gov (United States)

Kanazawa, Seigo; Taniguchi, Kazuhiko; Asari, Kazunari; Kuramoto, Kei; Kobashi, Syoji; Hata, Yutaka

2011-06-01

Home security in night is very important, and the system that watches a person's movements is useful in the security. This paper describes a classification system of adult, child and the other object from distance distribution measured by an infrared laser camera. This camera radiates near infrared waves and receives reflected ones. Then, it converts the time of flight into distance distribution. Our method consists of 4 steps. First, we do background subtraction and noise rejection in the distance distribution. Second, we do fuzzy clustering in the distance distribution, and form several clusters. Third, we extract features such as the height, thickness, aspect ratio, area ratio of the cluster. Then, we make fuzzy if-then rules from knowledge of adult, child and the other object so as to classify the cluster to one of adult, child and the other object. Here, we made the fuzzy membership function with respect to each features. Finally, we classify the clusters to one with the highest fuzzy degree among adult, child and the other object. In our experiment, we set up the camera in room and tested three cases. The method successfully classified them in real time processing.

CODAS object monitoring service

International Nuclear Information System (INIS)

Wheatley, M.R.; Rainford, M.

2001-01-01

The primary Control and Data Acquisition System (CODAS) of JET is based on a TCP/IP network of more than 150 computers. The CODAS computers provide the JET machine control and data acquisition for over 70,000 digital and analog signals. The Object Monitoring Service (OMS) is used by applications for monitoring objects for presentation to the JET machine operators and for the operation of individual software components (such as valve state, access control, mimic definition changes and internal data distribution). Each server typically handles connections from around 60 clients monitoring upwards of 2000 objects. Some servers have over 150 clients and 5000 objects. Acquisition libraries are dynamically linked into a running server as required either to acquire data values for objects or to forward requests to other OMS servers. A mechanism involving dynamic linking allows new libraries to be integrated without stopping or changing running software. OMS provides a very reliable and highly successful 'data-type independent' means of monitoring many different objects. It allows applications to take advantage of new data sources, without the need to change existing code

Comparison of medication reconciliation and medication review: errors and clinical importance

DEFF Research Database (Denmark)

Bjeldbak-Olesen, Mette; Danielsen, Anja Gadsbølle; Tomsen, Dorthe Vilstrup

2013-01-01

in the patient record and the EMS. 15% of the discrepancies were potentially serious or fatal, 62% were potentially significant and 23% were potentially non-significant. A total of 129 DRPs were identified by medication review, 1.7 per patient. The most frequent DRPs were sub therapeutic dosage, inappropriate......Introduction: The objective of this study was to compare medication reconciliation and medication review based on number, type and severity of discrepancies and drug-re­lated problems (DRPs), denoted errors. Material and methods: This was a retrospective study conducted at the Department...... of Cardiology, Hillerød Hos­pital. Medication reconciliation compared the prescriptions in patient records, an electronic medication system (EMS) and in discharge summaries (DS). The medication review was based on the EMS. The two methods were performed on the same data material. To assess the clinical...

Dissemination of information on the off-label (unapproved) use of medication: a comparative analysis.

Science.gov (United States)

Jansen, Rita-Marié

2011-03-01

"Off-label" in relation to the use of medication means that a medicine is used in another way or for indications other than those specified in its conditions of registration and reflected in its labelling. The off-label use of medication accounts for an estimated 21 per cent of drug use overall and is an important part of mainstream, legitimate medical practice worldwide. In South Africa, legislation prohibits the dissemination of information regarding the off-label use of medication. There are diverging views on whether pharmaceutical companies should be allowed to distribute scientific publications on off-label uses of approved drugs. Current policy in the United States of America (USA) eases restrictions on the dissemination of information of this nature. The prohibitions existing in South Africa, however, are more comparable with those in European countries. After analysing the different legal positions on the issue, it is submitted that pharmaceutical companies should not be allowed to disseminate information on off-label uses, but that the regulatory authority play an active and leading role in providing the latest, objective medical and scientific information, as well as guidelines on the off-label use of medication. Other related recommendations are also made.

Dosimetric studies for gamma radiation validation of medical devices

International Nuclear Information System (INIS)

Soliman, Y.S.; Beshir, W.B.; Abdel-Fattah, A.A.; Abdel-Rehim, F.

2013-01-01

The delivery and validation of a specified dose to medical devices are key concerns to operators of gamma radiation facilities. The objective of the present study was to characterize the industrial gamma radiation facility and map the dose distribution inside the product-loading pattern during the validation and routine control of the sterilization process using radiochromic films. Cardboard phantoms were designed to achieve the homogeneity of absorbed doses. The uncertainty of the dose delivered during validation of the sterilization process was assessed. - Highlights: ► Using γ-rays for sterilization of hollow fiber dialyzers and blood tubing sets according to ISO 11137, 2006. ► Dosimetry studies of validations of γ-irradiation facility and sterilized medical devices. ► Places of D min and D max have been determined using FWT-60 films. ► Determining the target minimum doses required to meet the desired SAL of 10 −6 for the two products.

The Integrated Medical Model: A Probabilistic Simulation Model Predicting In-Flight Medical Risks

Science.gov (United States)

Keenan, Alexandra; Young, Millennia; Saile, Lynn; Boley, Lynn; Walton, Marlei; Kerstman, Eric; Shah, Ronak; Goodenow, Debra A.; Myers, Jerry G., Jr.

2015-01-01

The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting

Medical Students' Affirmation of Ethics Education

Science.gov (United States)

Lehrmann, Jon A.; Hoop, Jinger; Hammond, Katherine Green; Roberts, Laura Weiss

2009-01-01

Objective: Despite the acknowledged importance of ethics education in medical school, little empirical work has been done to assess the needs and preferences of medical students regarding ethics curricula. Methods: Eighty-three medical students at the University of New Mexico participated in a self-administered written survey including 41 scaled…

Multi-objective possibilistic model for portfolio selection with transaction cost

Science.gov (United States)

Jana, P.; Roy, T. K.; Mazumder, S. K.

2009-06-01

In this paper, we introduce the possibilistic mean value and variance of continuous distribution, rather than probability distributions. We propose a multi-objective Portfolio based model and added another entropy objective function to generate a well diversified asset portfolio within optimal asset allocation. For quantifying any potential return and risk, portfolio liquidity is taken into account and a multi-objective non-linear programming model for portfolio rebalancing with transaction cost is proposed. The models are illustrated with numerical examples.

Predictive Analytics In Healthcare: Medications as a Predictor of Medical Complexity.

Science.gov (United States)

Higdon, Roger; Stewart, Elizabeth; Roach, Jared C; Dombrowski, Caroline; Stanberry, Larissa; Clifton, Holly; Kolker, Natali; van Belle, Gerald; Del Beccaro, Mark A; Kolker, Eugene

2013-12-01

Children with special healthcare needs (CSHCN) require health and related services that exceed those required by most hospitalized children. A small but growing and important subset of the CSHCN group includes medically complex children (MCCs). MCCs typically have comorbidities and disproportionately consume healthcare resources. To enable strategic planning for the needs of MCCs, simple screens to identify potential MCCs rapidly in a hospital setting are needed. We assessed whether the number of medications used and the class of those medications correlated with MCC status. Retrospective analysis of medication data from the inpatients at Seattle Children's Hospital found that the numbers of inpatient and outpatient medications significantly correlated with MCC status. Numerous variables based on counts of medications, use of individual medications, and use of combinations of medications were considered, resulting in a simple model based on three different counts of medications: outpatient and inpatient drug classes and individual inpatient drug names. The combined model was used to rank the patient population for medical complexity. As a result, simple, objective admission screens for predicting the complexity of patients based on the number and type of medications were implemented.

Exploring object-oriented technologies

CERN Multimedia

2000-01-01

Object oriented technologies are the corner stone of modern software development. A piece of software is today conceived, constructed and tested as a set of objects interacting with each other, rather than as a large sequential program. OO is present throughout the whole software life cycle allowing for maintainable code re-use, clean design and manageable complexity. OO is also the seed upon which other technologies are being built and deployed, such as distributed computing, component models, open interoperability, etc.This series of three seminars will provide a pragmatic overview on the main ideas behind OO software development and will explain the inner workings of the most outstanding technologies being built on OO, such as UML, CORBA, Component Models, Agent Oriented Computing, Business Objects, etc.

IMRT optimization with pseudo-biologic objective function

International Nuclear Information System (INIS)

Yi, B. Y.; Ahn, S. D.; Kim, J. H.; Lee, S. W.; Choi, E. K.

2002-01-01

The pseudo-biologic objective function has been proposed for the IMRT optimization. It is similar to the biological objective function in mathematical shape, but uses physical parameters. The pseudo-biologic objective function concept is consisted of the target coverage index (TCI) and the organ score index (OSI), was introduced. The TCI was expressed as the sum of all of the weighted bins of target dose volume histogram (DVH). The weights were given as the normal distribution of which the average is 100 % and the standard deviation is ±. The OSI was expressed as similar way. The average of the normal distribution was 0% of the dose and that of standard deviation was selected as a function of limiting dose and its importance. The objective function could be calculated as the product of the TCI and OSI's. The RTP Tool Box (RTB) was used for this study. The constraints applied in the optimization was intuitively clinical experience based numbers, while the physical objective function asks just numbers which are not necessarily based on the clinic, and the parameters for the biologic objective functions are uncertain. The OSI's from the pseudo-biological function showed better results than from the physical functions, while TCI's showed similar tendency. We could show that the pseudo-biologic function can be used for an IMRT objective function on behalf of the biological objective function

Object-oriented versus logical conventional implementation of a MMIIS

Science.gov (United States)

Forte, Anne-Marie; Bernadet, Maurice; Lavaire, Franck; Bizais, Yves J.

1992-06-01

The main components of a multimodality medical image interpretation system (MMIIS) are: (1) a user interface, (2) an image database, storing image objects along with their description, (3) expert systems (ES) in various medical imaging domains and particularly in image processing (IP), and (4) an IP actor, toolbox of standard IP procedures. To implement such a system, we are building two prototypes: one with an object-oriented (OO) expert system and one with a classical logical expert system. In these two different approaches, we have to model the medical imaging objects and represent them. Both approaches use an OO data model even if its implementation is different in: (1) the characteristics of each ES, in managing knowledge and inferences (uncertainty, non-monotonicity, backward and forward chaining, meta- knowledge), (2) the environment to implement the different experts and to activate IP procedures, and (3) the communication means between the experts and the other components. In the OO approach, an ES based on smalltalk is used, and in the conventional one an adhoc Prolog ES was built. Our goal is to compare their advantages and disadvantages in implementing a MMIIS.

Blue objects in the vicinity of M13. 1

International Nuclear Information System (INIS)

Oganesyan, Eh.Ya.

1978-01-01

Presented are photometric data in the UBV system for 225 objects in the region of 16 square degrees in size, adjacent to M13 cluster. ''Two-colour diagram'' and ''colour-luminosity'' diagram are built, and on their basis analysis of the data obtained is made. Half the objects investigated are subdwarfs. Among others there are white - blue dwarfs conventional stars of the main sequence stars, halo stars, stars of globular clusters and objects, which might be of extragalactic nature. On the basis of object distribution as to brightness and colour, and also according to their visible distribution several different groups can be singled out. Several variable stars are also found as a result of photometric investigation

Scatter and leakage contributions to the out-of-field absorbed dose distribution in water phantom around the medical LINAC radiation beams

International Nuclear Information System (INIS)

Bordy, J.M.; Bessiere, I.; Ostrowsky, A.; Poumarede, B.; Sorel, S.; Vermesse, D.

2013-01-01

This work is carried out within the framework of EURADOS Working Group 9 (WG9) whose general objective is 'to assess non-target organ doses in radiotherapy and the related risks of second cancers, with the emphasis on dosimetry'. The objective of the present work is to provide reference values (i) to evaluate the current methods of deriving three-dimensional dose distributions in and around the target volume using passive dosimeters, (ii) to derive the leakage dose from the head of the medical linear accelerator (LINAC) and the doses due to scattered radiation from the collimator edges and the body (phantom) itself. Radiation qualities of 6, 12 and 20 MV are used with standard calibration conditions described in IAEA TRS 398 and nonstandard conditions at a reference facility at the Laboratoire National Henri Becquerel (CEA LIST/LNE LNHB). An ionisation chamber is used to measure profile and depth dose in especially design water phantom built to enable investigation of doses up to 60 cm from the beam axis. A first set of experiments is carried out with the beam passing through the tank. From this first experiment, penumbra and out-of-field dose profiles including water and collimator scatter and leakage are found over three orders of magnitude. Two further sets of experiments using the same experimental arrangement with the beam outside the tank, to avoid water scatter, are designed to measure collimator scatter and leakage by closing the jaws of the collimator. It is shown that the ratios between water scatter, collimator scatter and leakage depend on the photon energy. Depending on the energy, typical leakage and collimator scatter represents 10-40% and 30-50% of the total out-of-field doses respectively. Water scatter decreases with energy while leakage increases with energy, and collimator scatter varies only slowly with energy. (authors)

Medical Imaging with Neural Networks

International Nuclear Information System (INIS)

Pattichis, C.; Cnstantinides, A.

1994-01-01

The objective of this paper is to provide an overview of the recent developments in the use of artificial neural networks in medical imaging. The areas of medical imaging that are covered include : ultrasound, magnetic resonance, nuclear medicine and radiological (including computerized tomography). (authors)

Voludensitometry. Three dimensional display of medical objects

International Nuclear Information System (INIS)

Darier, P.; Garderet, P.; Grangeat, P.; Matte, P.; Tournier, E.; Villafana, R.

1984-05-01

In order to study the volumic cartography of material density (X-rays imaging), of proton density (RMN imaging) or of specific activity of a marker (γ or β + imaging) a set of calculation results (called voxels) is reconstructed from sensor data collection. Voxels are identified by a triplet of space coordinates and they represent a local estimation of the parameter to be studied. The concepts for representation there upon developed can be extended for any parameter for which additivity is meaningful. The operator has to govern a software in order to work out the documents leading himself to a mental representation of the object. On a display these documents will be either graphics, images or image sequences. The elementary process for elaboration of one image includes: - conditionning the volume: definition of absolute coordinates (geometrical transformations), interactive extraction (surgery) or automation extraction (segmentation) of sub-volumes, contextual organization (sub-volumes ordering, dissolution); - reduction to two dimensions of the information either by spatial integration (radiography), or by surface representation (morphoscopy). This contribution introduces these different concepts showing the way to the design of an interactive display console. Video recorded sequences that have been realised using an experimental software will illustrate the preliminary results [fr

Towards a syntactic analysis of European Portuguese cognate objects

Directory of Open Access Journals (Sweden)

Celda Morgado Choupina

2013-01-01

Full Text Available The present paper aims at discussing selected syntactic aspects of cognate objects in European Portuguese, along the lines of Distributed Morphology (Haugen, 2009. Cognate objects may be readily discovered in numerous human languages, including European Portuguese (Chovia uma chuva miudinha. It is assumed in papers devoted to their English counterparts that they belong to various subclasses. Indeed, some of them are genuine cognates (to sleep a sleep... or hyponyms (to dance a jig; Hale & Keyser, 2002. It turns out that in European Portuguese, they can be split into four different categories: (i genuine cognate objects (chorar um choro..., (ii similar cognate objects (dançar uma dança (iii objects hyponyms (dançar um tango and (iv prepositional cognate objects (morrer de uma morte .... There are, then, significant differences between various classes of cognate objects: whereas the genuine ones call imperatively for a restrictive modifier and a definite article, the remaining ones admit it only optionally. It might be concluded, then, that a lexicalist theory set up along the lines of Hale and Keyser is unable to deal successfully with distributional facts proper to various classes of cognate constructions in European Portuguese. That is why the present study is conducted more in accordance with syntactic principles of Distributed Morphology, with a strong impact of hypotheses put forward by Haugen (2009.

Attitudes towards conscientious objection among community pharmacists in Poland

OpenAIRE

Piecuch, Anna; Gryka, Malwina; Kozłowska-Wojciechowska, Małgorzata

2013-01-01

Background The European Council Resolution 1763 (2010), “The right to conscientious objection in lawful medical care”, provoked a discussion among Polish pharmacists on the necessity for granting them the right to refuse to dispense medicinal products which invoke conscientious objection. Objective To explore attitudes of Polish pharmacists towards the conscience clause. Setting Pharmacies with public e-mail addresses in various parts of Poland (Lower Silesia Province, Mazovia Province, Kuyav...

Going the distance: early results of a distributed medical education initiative for Royal College residencies in Canada.

Science.gov (United States)

Myhre, Douglas L; Hohman, Stacey

2012-01-01

There is a shortage of specialty physicians practising in rural Canada: only 2.4% of Canadian specialist physicians practise rurally. Numerous strategies have been proposed and attempted that aim to increase the number of rural physicians. These include undergraduate and postgraduate distributed medical education opportunities. The Distributed Royal College Initiative at the University of Calgary is increasing the exposure of specialty residents to rural medicine through regional rotations and electives. An assessment of the initial impacts of this programme was made. Specialty residents were sent a voluntary survey following their regional rotation in academic year 2010-2011. The survey measured each resident's satisfaction with the experience, interest in undertaking another rotation and the impact of the rotation on potential rural practice location. The survey asked for written comments on the rotation. Data were analysed using descriptive statistics. A total of 73% (29) of the 40 eligible residents completed the survey that was distributed upon completion of the rotation. In the survey, 45% of respondents indicated they would have been likely to practise in a regional community prior to the experience. This changed to 76% following the rotation. Analysis of the comments revealed strong positive characteristics of the experience across all disciplines. Specialty-based, rural distributed programmes were perceived by the residents as educationally valuable and may be crucial in helping shift attitudes towards rural practice. Specific successful characteristics of the rotations provide direction to increase their quality further. These findings need to be verified in a larger sample.

Superluminal motion of extragalactic objects

Energy Technology Data Exchange (ETDEWEB)

Matveenko, L.I. (AN SSSR, Moscow. Inst. Kosmicheskikh Issledovanij)

1983-07-01

Extragalactic objects with active nuclei are reviewed. Experimental data are obtained with the method of superfar radiointerferometry. The main peculiarities of the complex structure of Seyfert galaxies, quasars and lacertae objects are considered: the distribution of radiobrightness, spectra, alteration of the density of radiation flux and the distance between the components of sources. The superluminal velocities of component divergence observed are explained by different reasons: fast motion of components considerable difference of the Hubble component or non-cosmologic nature of the red shift of objects, effect of echoreflection of radiation, gravitation lens, systematic alteration of the optical thickness of the object, synchronouys radiation of electrons in the dipole magnetic field, as well as different kinematic illusions connected with the final time of signal propagation.

Clinical skills temporal degradation assessment in undergraduate medical education.

Science.gov (United States)

Fisher, Joseph; Viscusi, Rebecca; Ratesic, Adam; Johnstone, Cameron; Kelley, Ross; Tegethoff, Angela M; Bates, Jessica; Situ-Lacasse, Elaine H; Adamas-Rappaport, William J; Amini, Richard

2018-01-01

Medical students' ability to learn clinical procedures and competently apply these skills is an essential component of medical education. Complex skills with limited opportunity for practice have been shown to degrade without continued refresher training. To our knowledge there is no evidence that objectively evaluates temporal degradation of clinical skills in undergraduate medical education. The purpose of this study was to evaluate temporal retention of clinical skills among third year medical students. This was a cross-sectional study conducted at four separate time intervals in the cadaver laboratory at a public medical school. Forty-five novice third year medical students were evaluated for retention of skills in the following three procedures: pigtail thoracostomy, femoral line placement, and endotracheal intubation. Prior to the start of third-year medical clerkships, medical students participated in a two-hour didactic session designed to teach clinically relevant materials including the procedures. Prior to the start of their respective surgery clerkships, students were asked to perform the same three procedures and were evaluated by trained emergency medicine and surgery faculty for retention rates, using three validated checklists. Students were then reassessed at six week intervals in four separate groups based on the start date of their respective surgical clerkships. We compared the evaluation results between students tested one week after training and those tested at three later dates for statistically significant differences in score distribution using a one-tailed Wilcoxon Mann-Whitney U-test for non-parametric rank-sum analysis. Retention rates were shown to have a statistically significant decline between six and 12 weeks for all three procedural skills. In the instruction of medical students, skill degradation should be considered when teaching complex technical skills. Based on the statistically significant decline in procedural skills noted

Load Balanced Mapping of Distributed Objects to Minimize Network Communication

NARCIS (Netherlands)

Stoyenko, Alexander D.; Bosch, J.; Bosch, Jan; Aksit, Mehmet; Marlowe, Thomas J.

1996-01-01

This paper introduces a new load balancing and communica- tion minimizing heuristic used in the Inverse Remote Procedure Call (IRPC) system. While the paper briefly describes the IRPC system, the focus is on the new IRPC assignment heuristic. The IRPC compiler maps a distributed program to a graph

Exploration Medical System Demonstration Project

Science.gov (United States)

Chin, D. A.; McGrath, T. L.; Reyna, B.; Watkins, S. D.

2011-01-01

A near-Earth Asteroid (NEA) mission will present significant new challenges including hazards to crew health created by exploring a beyond low earth orbit destination, traversing the terrain of asteroid surfaces, and the effects of variable gravity environments. Limited communications with ground-based personnel for diagnosis and consultation of medical events require increased crew autonomy when diagnosing conditions, creating treatment plans, and executing procedures. Scope: The Exploration Medical System Demonstration (EMSD) project will be a test bed on the International Space Station (ISS) to show an end-to-end medical system assisting the Crew Medical Officers (CMO) in optimizing medical care delivery and medical data management during a mission. NEA medical care challenges include resource and resupply constraints limiting the extent to which medical conditions can be treated, inability to evacuate to Earth during many mission phases, and rendering of medical care by a non-clinician. The system demonstrates the integration of medical technologies and medical informatics tools for managing evidence and decision making. Project Objectives: The objectives of the EMSD project are to: a) Reduce and possibly eliminate the time required for a crewmember and ground personnel to manage medical data from one application to another. b) Demonstrate crewmember's ability to access medical data/information via a software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities. d) Develop a common data management architecture that allows for scalability, extensibility, and interoperability of data sources and data users. e) Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management f) Provide

Suicidal Thoughts Among Medical Residents with Burnout

NARCIS (Netherlands)

van der Heijden, Frank; Dillingh, Gea; Bakker, Arnold; Prins, Jelle

2008-01-01

Objectives: Recent research showed that medical residents have a high risk for developing burnout. The present study investigates the prevalence of burnout and its relationship with suicidal thoughts among medical residents. Methods: All Dutch medical residents (n = 5126) received a self-report

Significance of Objective Structured Clinical Examinations to Plastic Surgery Residency Training.

Science.gov (United States)

Simmons, Brian J; Zoghbi, Yasmina; Askari, Morad; Birnbach, David J; Shekhter, Ilya; Thaller, Seth R

2017-09-01

Objective structured clinical examinations (OSCEs) have proven to be a powerful tool. They possess more than a 30-year track record in assessing the competency of medical students, residents, and fellows. Objective structured clinical examinations have been used successfully in a variety of medical specialties, including surgery. They have recently found their way into the subspecialty of plastic surgery. This article uses a systematic review of the available literature on OSCEs and their recent use in plastic surgery. It incorporates survey results assessing program directors' views on the use of OSCEs. Approximately 40% of programs surveyed use OSCEs to assess the Accreditation Council for Graduate Medical Education core competencies. We found that 40% use OSCEs to evaluate specific plastic surgery milestones. Objective structured clinical examinations are usually performed annually. They cost anywhere between $100 and more than $1000 per resident. Four milestones giving residents the most difficulties on OSCEs were congenital anomalies, noncancer breast surgery, breast reconstruction, and practice-based learning and improvement. It was determined that challenges with milestones were due to lack of adequate general knowledge and surgical ward patient care, as well as deficits in professionalism and system-based problems. Programs were able to remediate weakness found by OSCEs using a variety of methods. Objective structured clinical examinations offer a unique tool to objectively assess the proficiency of residents in key areas of the Accreditation Council for Graduate Medical Education core competencies. In addition, they can be used to assess the specific milestones that plastic surgery residents must meet. This allows programs to identify and improve identified areas of weakness.

The preparedness of private dental offices and polyclinics for medical emergencies

Science.gov (United States)

Al-Sebaei, Maisa O.; Alkayyal, Moayyad A.; Alsulimani, Abdulelah H.; Alsulaimani, Othman S.; Habib, Weam T.

2015-01-01

Objectives: To assess preparedness for medical emergencies in private dental offices in Jeddah, Kingdom of Saudi Arabia (KSA). Methods: In this cross-sectional study, a survey was distributed to 70 dental offices and polyclinics in Jeddah, Saudi Arabia between October 2013 and January 2014. The questionnaire gathered information on the prevention of medical emergencies, the preparedness of the office personnel, and availability of emergency drugs and equipment. Results: For prevention, 92% (n=65) of the offices reported that they obtain a thorough medical history prior to treatment; however, only 11% (n=8) obtain vital signs for each visit. Using a preparedness percent score (0 to 100), the mean level of preparedness of the office personnel in all surveyed dental offices was 55.2±20. The availability of emergency drugs was 35±35, and equipment was 19±22. Conclusion: We found a deficiency in personnel training, availability of drugs, and emergency equipment in the surveyed dental clinics. More stringent rules and regulations for emergency preparedness must be reinforced to avoid disasters in these clinics. PMID:25737177

Attitude and awareness of medical and dental students towards collaboration between medical and dental practice in Hong Kong.

Science.gov (United States)

Zhang, Shinan; Lo, Edward C M; Chu, Chun-Hung

2015-05-02

Medical-dental collaboration is essential for improving resource efficiency and standards of care. However, few studies have been conducted on it. This study aimed to investigate the attitude and awareness of medical and dental students about collaboration between medical and dental practices in Hong Kong. All medical and dental students in Hong Kong were invited to complete a questionnaire survey at their universities, hospitals and residential halls. It contained 8 questions designed to elicit their attitudes about the collaboration between medical and dental practice. Students were also asked about their awareness of the collaboration between dentistry and medicine. The questionnaires were directly distributed to medical and dental students. The finished questionnaires were immediately collected by research assistants on site. A total of 1,857 questionnaires were distributed and 809 (44%) were returned. Their mean attitude score (SD) towards medical-dental collaboration was 6.37 (1.44). Most students (77%) were aware of the collaboration between medical and dental practice in Hong Kong. They considered that Ear, Nose & Throat, General Surgery and Family Medicine were the 3 most common medical disciplines which entailed collaboration between medical and dental practice. In this study, the medical and dental students in general demonstrated a good attitude and awareness of the collaboration between medical and dental practice in Hong Kong. This established an essential foundation for fostering medical-dental collaboration, which is vital to improving resource efficiency and standards of care.

Medical, psychological and socioeconomic aspects of aging in Poland: assumptions and objectives of the PolSenior project.

Science.gov (United States)

Bledowski, Piotr; Mossakowska, Malgorzata; Chudek, Jerzy; Grodzicki, Tomasz; Milewicz, Andrzej; Szybalska, Aleksandra; Wieczorowska-Tobis, Katarzyna; Wiecek, Andrzej; Bartoszek, Adam; Dabrowski, Andrzej; Zdrojewski, Tomasz

2011-12-01

Both descriptive and longitudinal studies of aging are nowadays a subject of growing interest in different countries worldwide. However, in Poland and other Central-Eastern European countries, such comprehensive, nationally representative, multidimensional studies were never performed in the past in elderly population. The present paper describes the PolSenior project including its objectives, sample selection and structure, methods, fieldwork procedures and study flow. The aim of the project was to examine medical, psychological and socioeconomic aspects of aging in Poland. The research sample included 5695 respondents (2899 males and 2796 females) split into six equally sized age groups of elderly individuals (65-69 years, 70-74 years, 75-79 years, 80-84 years, 85-89 years, 90+years) and one group of subjects just about to enter old age (55-59 years). Subjects were recruited using three stage stratified, proportional draw. The response rate was 42% and ranged from 32% to 61% between provinces. The study consisted of three visits performed by trained nurses including questionnaire survey, comprehensive geriatric assessment and blood and urine sampling. The questionnaire consisted of medical and specific socioeconomic questions. The comprehensive geriatric assessment included blood pressure and anthropometric measurements, as well as selected scales and tests routinely used in the examination of elderly subjects. Blood and urine samples were collected from 4737 and 4526 individuals, respectively. More than 50 biochemical parameters were measured, and DNA was isolated and banked. In a selected group of 1018 subjects, a medical examination by a physician was performed. The self-rated health was lower in females than in males in age groups 70-84, but similar in individuals of both sexes aged 65-69 and 85 years. Besides providing data on health and functioning of elderly population, the PolSenior project aims to analyze interrelationships between different elements of

Predictive medical information and underwriting.

Science.gov (United States)

Dodge, John H

2007-01-01

Medical underwriting involves the application of actuarial science by analyzing medical information to predict the future risk of a claim. The objective is that individuals with like risk are treated in a like manner so that the premium paid is proportional to the risk of future claim.

Objectives for an internship internal medicine : from the Dutch Blueprint (Raamplan 1994) to implementation into a practical logbook

NARCIS (Netherlands)

Raghoebar-Krieger, HMJ; Sleijfer, DT; Kreeftenberg, HG; Hofstee, WKB; Bender, W

1999-01-01

Background: The Dutch Blueprint 1994 (Raamplan 1994) describes the objectives of undergraduate medical education. The Blueprint, developed in order to improve medical education in the Netherlands, is accepted by all Dutch medical schools and has been legislated Aim: Translation of global objectives

Trial use of the Personal Qualities Assessment (PQA) in the entrance examination of a Japanese medical university: similarities to the results in western countries.

Science.gov (United States)

Fukui, Yuriko; Noda, Saeko; Okada, Midori; Mihara, Nakako; Kawakami, Yoriko; Bore, Miles; Munro, Don; Powis, David

2014-01-01

The Personal Qualities Assessment (PQA), developed by the University of Newcastle, Australia to assess the aptitude of future medical professionals, has been used in Western countries. The objective was to investigate whether the PQA is appropriate for Japanese medical school applicants. Two of the PQA tests, Libertarian-Dual-Communitarian moral orientations (Mojac) and Narcissism, Aloofness, Confidence, and Empathy (NACE), were translated into Japanese, and administered at the Tokyo Women's Medical University entrance examinations from 2007 to 2009. The distributions of the applicants' Mojac and NACE scores were close to the normal distribution, and the mean scores did not exhibit a large difference from those in Western countries. The only significant difference was that the mean score of the NACE test was slightly lower than the Western norm. The translated PQA tests may be appropriate for use with Japanese applicants, though further research considering cultural differences is required.

Energy efficiency optimization in distribution transformers considering Spanish distribution regulation policy

International Nuclear Information System (INIS)

Pezzini, Paola; Gomis-Bellmunt, Oriol; Frau-Valenti, Joan; Sudria-Andreu, Antoni

2010-01-01

In transmission and distribution systems, the high number of installed transformers, a loss source in networks, suggests a good potential for energy savings. This paper presents how the Spanish Distribution regulation policy, Royal Decree 222/2008, affects the overall energy efficiency in distribution transformers. The objective of a utility is the maximization of the benefit, and in case of failures, to install a chosen transformer in order to maximize the profit. Here, a novel method to optimize energy efficiency, considering the constraints set by the Spanish Distribution regulation policy, is presented; its aim is to achieve the objectives of the utility when installing new transformers. The overall energy efficiency increase is a clear result that can help in meeting the requirements of European environmental plans, such as the '20-20-20' action plan.

The Integrated Medical Model: A Probabilistic Simulation Model for Predicting In-Flight Medical Risks

Science.gov (United States)

Keenan, Alexandra; Young, Millennia; Saile, Lynn; Boley, Lynn; Walton, Marlei; Kerstman, Eric; Shah, Ronak; Goodenow, Debra A.; Myers, Jerry G.

2015-01-01

The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting

Medical Imaging with Neural Networks

Energy Technology Data Exchange (ETDEWEB)

Pattichis, C [Department of Computer Science, University of Cyprus, Kallipoleos 75, P.O.Box 537, Nicosia (Cyprus); Cnstantinides, A [Department of Electrical Engineering, Imperial College of Science, Technology and Medicine, London SW7 2BT (United Kingdom)

1994-12-31

The objective of this paper is to provide an overview of the recent developments in the use of artificial neural networks in medical imaging. The areas of medical imaging that are covered include : ultrasound, magnetic resonance, nuclear medicine and radiological (including computerized tomography). (authors). 61 refs, 4 tabs.

Usage of emergency contraception between medical related and non-medical related students.

LENUS (Irish Health Repository)

Khalid, A K

2009-04-01

Teenagers and young adultshave the most risk of unplanned pregnancy, due to lack of awareness to see a family planning provider after unprotected sexual intercourse. In addition, nearly one in five physicians is reluctant to provide information regarding Emergency Contraception (EC) to women and this may contribute to their lack of awareness. This study was conducted to assess the knowledge, attitudes and practices regarding the use of EC between medical related students compared to non-medical related students. Data collection was done using questionnaires distributed among students in University College Cork (UCC). 93% of medically related students were aware of EC compared to only 73.5% of non-medically related students. Medical related students also were more aware about the mechanism of action and detailed knowledge of EC compared to the non-medical students. This study has proven that medically related students have more detailed knowledge regarding EC compared to non-medical related students. However, there was no significant difference noted regarding the attitude and practice between the two groups.

Leadership and followership in the healthcare workplace: exploring medical trainees’ experiences through narrative inquiry

Science.gov (United States)

Gordon, Lisi J; Rees, Charlotte E; Ker, Jean S; Cleland, Jennifer

2015-01-01

Objectives To explore medical trainees’ experiences of leadership and followership in the interprofessional healthcare workplace. Design A qualitative approach using narrative interviewing techniques in 11 group and 19 individual interviews with UK medical trainees. Setting Multisite study across four UK health boards. Participants Through maximum variation sampling, 65 medical trainees were recruited from a range of specialties and at various stages of training. Participants shared stories about their experiences of leadership and followership in the healthcare workplace. Methods Data were analysed using thematic and narrative analysis. Results We identified 171 personal incident narratives about leadership and followership. Participants most often narrated experiences from the position of follower. Their narratives illustrated many factors that facilitate or inhibit developing leadership identities; that traditional medical and interprofessional hierarchies persist within the healthcare workplace; and that wider healthcare systems can act as barriers to distributed leadership practices. Conclusions This paper provides new understandings of the multiple ways in which leadership and followership is experienced in the healthcare workplace and sets out recommendations for future leadership educational practices and research. PMID:26628525

Implementation of medical monitor system based on networks

Science.gov (United States)

Yu, Hui; Cao, Yuzhen; Zhang, Lixin; Ding, Mingshi

2006-11-01

In this paper, the development trend of medical monitor system is analyzed and portable trend and network function become more and more popular among all kinds of medical monitor devices. The architecture of medical network monitor system solution is provided and design and implementation details of medical monitor terminal, monitor center software, distributed medical database and two kind of medical information terminal are especially discussed. Rabbit3000 system is used in medical monitor terminal to implement security administration of data transfer on network, human-machine interface, power management and DSP interface while DSP chip TMS5402 is used in signal analysis and data compression. Distributed medical database is designed for hospital center according to DICOM information model and HL7 standard. Pocket medical information terminal based on ARM9 embedded platform is also developed to interactive with center database on networks. Two kernels based on WINCE are customized and corresponding terminal software are developed for nurse's routine care and doctor's auxiliary diagnosis. Now invention patent of the monitor terminal is approved and manufacture and clinic test plans are scheduled. Applications for invention patent are also arranged for two medical information terminals.

MEDIC: medical embedded device for individualized care.

Science.gov (United States)

Wu, Winston H; Bui, Alex A T; Batalin, Maxim A; Au, Lawrence K; Binney, Jonathan D; Kaiser, William J

2008-02-01

Presented work highlights the development and initial validation of a medical embedded device for individualized care (MEDIC), which is based on a novel software architecture, enabling sensor management and disease prediction capabilities, and commercially available microelectronic components, sensors and conventional personal digital assistant (PDA) (or a cell phone). In this paper, we present a general architecture for a wearable sensor system that can be customized to an individual patient's needs. This architecture is based on embedded artificial intelligence that permits autonomous operation, sensor management and inference, and may be applied to a general purpose wearable medical diagnostics. A prototype of the system has been developed based on a standard PDA and wireless sensor nodes equipped with commercially available Bluetooth radio components, permitting real-time streaming of high-bandwidth data from various physiological and contextual sensors. We also present the results of abnormal gait diagnosis using the complete system from our evaluation, and illustrate how the wearable system and its operation can be remotely configured and managed by either enterprise systems or medical personnel at centralized locations. By using commercially available hardware components and software architecture presented in this paper, the MEDIC system can be rapidly configured, providing medical researchers with broadband sensor data from remote patients and platform access to best adapt operation for diagnostic operation objectives.

21 CFR 225.110 - Distribution records.

Science.gov (United States)

2010-04-01

...: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Records and Reports § 225.110 Distribution records. (a) Distribution records permit the manufacturer to relate complaints to specific batches and/or... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Distribution records. 225.110 Section 225.110 Food...

Synchronous Parallel Emulation and Discrete Event Simulation System with Self-Contained Simulation Objects and Active Event Objects

Science.gov (United States)

Steinman, Jeffrey S. (Inventor)

1998-01-01

The present invention is embodied in a method of performing object-oriented simulation and a system having inter-connected processor nodes operating in parallel to simulate mutual interactions of a set of discrete simulation objects distributed among the nodes as a sequence of discrete events changing state variables of respective simulation objects so as to generate new event-defining messages addressed to respective ones of the nodes. The object-oriented simulation is performed at each one of the nodes by assigning passive self-contained simulation objects to each one of the nodes, responding to messages received at one node by generating corresponding active event objects having user-defined inherent capabilities and individual time stamps and corresponding to respective events affecting one of the passive self-contained simulation objects of the one node, restricting the respective passive self-contained simulation objects to only providing and receiving information from die respective active event objects, requesting information and changing variables within a passive self-contained simulation object by the active event object, and producing corresponding messages specifying events resulting therefrom by the active event objects.