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Sample records for serial processing clinic

  1. Spatial serial order processing in schizophrenia.

    Science.gov (United States)

    Fraser, David; Park, Sohee; Clark, Gina; Yohanna, Daniel; Houk, James C

    2004-10-01

    The aim of this study was to examine serial order processing deficits in 21 schizophrenia patients and 16 age- and education-matched healthy controls. In a spatial serial order working memory task, one to four spatial targets were presented in a randomized sequence. Subjects were required to remember the locations and the order in which the targets were presented. Patients showed a marked deficit in ability to remember the sequences compared with controls. Increasing the number of targets within a sequence resulted in poorer memory performance for both control and schizophrenia subjects, but the effect was much more pronounced in the patients. Targets presented at the end of a long sequence were more vulnerable to memory error in schizophrenia patients. Performance deficits were not attributable to motor errors, but to errors in target choice. The results support the idea that the memory errors seen in schizophrenia patients may be due to saturating the working memory network at relatively low levels of memory load.

  2. Development of serial magnification angiography and its clinical significance

    International Nuclear Information System (INIS)

    Sasaki, Tsuneo; Matsubara, Kazuhito; Ishiguchi, Tsuneo; Mashita, Shinichi; Kaii, Osamu

    1979-01-01

    In order to apply serial magnification angiography to clinical examinations so easily, a serial cardioangiography apparatus was equipped with a tube having 0.1 mm focal spot and with DRX-431HD diode. A CAT-FK Type catheter bed (Toshiba) was used as a roentgenographic table and a PUCK film changer was used. Thus, serial magnification angiography can be easily used to clinical examinations, and can be set in a usual x-ray photographic studio. Serial magnification angiography was used to examine the cerebral vessels in 6 patients, vessels of the pulmonary circulation in 1 patient, bronchial arteries in 6 patients, the celiac artery in 18 patients, the superior mesenteric artery in 2 patients, inferior mesenteric artery in 2 patients, the renal artery in 2 patients, and the adrenal vein in 7 patients. Owing to this angiography, minute changes in the vessel in the lesion can be observed and fine neovascularity can be detected. Thus, serial magnification angiography makes diagnoses of vascular disorders easier. (Ichikawa, K.)

  3. Serial Learning Process: Test of Chaining, Position, and Dual-Process Hypotheses

    Science.gov (United States)

    Giurintano, S. L.

    1973-01-01

    The chaining, position, and dual-process hypotheses of serial learning (SL) as well as serial recall, reordering, and relearning of paired-associate learning were examined to establish learning patterns. Results provide evidence for dual-process hypothesis. (DS)

  4. Serial Comparison Processes and Sex Differences in Clerical Speed.

    Science.gov (United States)

    Majeres, Raymond L.

    1988-01-01

    Three experiments were conducted with 91 male and 91 female university students to assess sex differences in performance on speeded matching tests and theory on same-different judgments. Results are interpreted via the dual-process hypothesis of same-difference judgments with sex differences explained in terms of serial comparison processes rather…

  5. Statistical process control for serially correlated data

    NARCIS (Netherlands)

    Wieringa, Jakob Edo

    1999-01-01

    Statistical Process Control (SPC) aims at quality improvement through reduction of variation. The best known tool of SPC is the control chart. Over the years, the control chart has proved to be a successful practical technique for monitoring process measurements. However, its usefulness in practice

  6. Efficient multitasking: parallel versus serial processing of multiple tasks.

    Science.gov (United States)

    Fischer, Rico; Plessow, Franziska

    2015-01-01

    In the context of performance optimizations in multitasking, a central debate has unfolded in multitasking research around whether cognitive processes related to different tasks proceed only sequentially (one at a time), or can operate in parallel (simultaneously). This review features a discussion of theoretical considerations and empirical evidence regarding parallel versus serial task processing in multitasking. In addition, we highlight how methodological differences and theoretical conceptions determine the extent to which parallel processing in multitasking can be detected, to guide their employment in future research. Parallel and serial processing of multiple tasks are not mutually exclusive. Therefore, questions focusing exclusively on either task-processing mode are too simplified. We review empirical evidence and demonstrate that shifting between more parallel and more serial task processing critically depends on the conditions under which multiple tasks are performed. We conclude that efficient multitasking is reflected by the ability of individuals to adjust multitasking performance to environmental demands by flexibly shifting between different processing strategies of multiple task-component scheduling.

  7. Nonlinear Process Fault Diagnosis Based on Serial Principal Component Analysis.

    Science.gov (United States)

    Deng, Xiaogang; Tian, Xuemin; Chen, Sheng; Harris, Chris J

    2018-03-01

    Many industrial processes contain both linear and nonlinear parts, and kernel principal component analysis (KPCA), widely used in nonlinear process monitoring, may not offer the most effective means for dealing with these nonlinear processes. This paper proposes a new hybrid linear-nonlinear statistical modeling approach for nonlinear process monitoring by closely integrating linear principal component analysis (PCA) and nonlinear KPCA using a serial model structure, which we refer to as serial PCA (SPCA). Specifically, PCA is first applied to extract PCs as linear features, and to decompose the data into the PC subspace and residual subspace (RS). Then, KPCA is performed in the RS to extract the nonlinear PCs as nonlinear features. Two monitoring statistics are constructed for fault detection, based on both the linear and nonlinear features extracted by the proposed SPCA. To effectively perform fault identification after a fault is detected, an SPCA similarity factor method is built for fault recognition, which fuses both the linear and nonlinear features. Unlike PCA and KPCA, the proposed method takes into account both linear and nonlinear PCs simultaneously, and therefore, it can better exploit the underlying process's structure to enhance fault diagnosis performance. Two case studies involving a simulated nonlinear process and the benchmark Tennessee Eastman process demonstrate that the proposed SPCA approach is more effective than the existing state-of-the-art approach based on KPCA alone, in terms of nonlinear process fault detection and identification.

  8. Pancreatic pseudocyst-portal vein fistula: Serial imaging and clinical follow-up from pseudocyst to fistula

    Energy Technology Data Exchange (ETDEWEB)

    Jee, Keun Nahn [Dept. of Radiology, Dankook University Hospital, Dankook University College of Medicine, Cheonan (Korea, Republic of)

    2015-03-15

    Pancreatic pseudocyst-portal vein fistula is an extremely rare complication of pancreatitis. Only 18 such cases have been previously reported in the medical literature. However, a serial process from pancreatic pseudocyst to fistula formation has not been described. The serial clinical and radiological findings in a 52-year-old chronic alcoholic male patient with fistula between pancreatic pseudocyst and main portal vein are presented.

  9. [Serial clinical and echocardiographic evaluation in children with Marfan syndrome].

    Science.gov (United States)

    Lopez, Victor Manuel Oporto; Perez, Ana Beatriz Alvarez; Moisés, Valdir Ambrósio; Gomes, Lourdes; Pedreira, Patricia da Silveira; Silva, Célia C; Campos Filho, Orlando; Carvalho, Antônio Carlos C

    2005-11-01

    To describe the clinical cardiac manifestations and temporal evolution of Marfan syndrome in children; to estimate the incidence of annuloaortic ectasia and mitral valve prolapse; and to evaluate tolerability and efficacy of beta-blockers in these patients. During one year, 21 children with Marfan syndrome underwent serial clinical and echocardiographic examinations. Echocardiograms assessed: the presence of mitral valve prolapse, aortic root diameter, mitral and aortic valves regurgitation, and aortic enlargement during beta-blocker therapy. Eleven patients had two measurements of the aortic root taken one year apart. The children were asymptomatic throughout the study. Mitral prolapse was found in 11 (52%) children. Annuloaortic ectasia occurred in 16 (76%) patients and found to be mild in 42.8%, moderate in 9.5%, and severe in 23.8%. One of these patients underwent aortic valve replacement and repair of the ascending aorta by the Bentall-De Bono technique, with good results. Heart rate decreased by 13.6% (from 85 to 73 bpm; p < 0.009) with the use of beta-blockers; however, aortic root diameter increased by 1.4 mm/year (p < 0.02). One child could not be given beta-blockers due to bronchial asthma, and no significant side effects were observed in the remaining children, including one who also had bronchial asthma. The children remained asymptomatic throughout the study, the use of beta-blockers led to a significant decrease in heart rate, and no significant adverse effects were observed. Contrary to the literature, incidence of annuloaortic ectasia was high among the study population, greater than that of mitral valve prolapse, even during beta-blocker therapy.

  10. Infants' Memory Processing of a Serial List: List Length Effects.

    Science.gov (United States)

    Gulya, Michele; Sweeney, Becky; Rovee-Collier, Carolyn

    1999-01-01

    Three experiments demonstrated that increasing the length of a mobile serial list impaired 6-month olds' memory for serial order. Findings indicated that the primacy effect was absent on a 24-hour delayed recognition test and was exhibited on a reactivation test, adding to growing evidence that young infants possess two functionally distinct…

  11. Opportunity recognition: delineating the process and motivators for serial entrepreneurs

    Directory of Open Access Journals (Sweden)

    Boris Urban

    2011-04-01

    Full Text Available Opportunity recognition is a fundamental research issue in entrepreneurship which this paper empirically investigates for serial entrepreneurs. Initially key definitions and boundary conditions of opportunity recognition are explored to elucidate the relevant motivators driving serial entrepreneurs. After operationalising the various concepts, data is collected by surveying serial entrepreneurs (n= 77 based on pre-determined selection criteria. Since the study’s objective is to build solid theory on these new phenomena, descriptive analysis on the empirical results is provided. To test the hypotheses inferential statistics employing parametric and non-parametric tests are used. The findings reveal that the opportunity recognition behaviours are manifest among serial entrepreneurs, with few significant differences on how many new, major businesses have been pursued, or whether they can be said to be successes.

  12. Using Serial and Discrete Digit Naming to Unravel Word Reading Processes.

    Science.gov (United States)

    Altani, Angeliki; Protopapas, Athanassios; Georgiou, George K

    2018-01-01

    During reading acquisition, word recognition is assumed to undergo a developmental shift from slow serial/sublexical processing of letter strings to fast parallel processing of whole word forms. This shift has been proposed to be detected by examining the size of the relationship between serial- and discrete-trial versions of word reading and rapid naming tasks. Specifically, a strong association between serial naming of symbols and single word reading suggests that words are processed serially, whereas a strong association between discrete naming of symbols and single word reading suggests that words are processed in parallel as wholes. In this study, 429 Grade 1, 3, and 5 English-speaking Canadian children were tested on serial and discrete digit naming and word reading. Across grades, single word reading was more strongly associated with discrete naming than with serial naming of digits, indicating that short high-frequency words are processed as whole units early in the development of reading ability in English. In contrast, serial naming was not a unique predictor of single word reading across grades, suggesting that within-word sequential processing was not required for the successful recognition for this set of words. Factor mixture analysis revealed that our participants could be clustered into two classes, namely beginning and more advanced readers. Serial naming uniquely predicted single word reading only among the first class of readers, indicating that novice readers rely on a serial strategy to decode words. Yet, a considerable proportion of Grade 1 students were assigned to the second class, evidently being able to process short high-frequency words as unitized symbols. We consider these findings together with those from previous studies to challenge the hypothesis of a binary distinction between serial/sublexical and parallel/lexical processing in word reading. We argue instead that sequential processing in word reading operates on a continuum

  13. Subject-Verb Agreement in Children and Adults: Serial or Hierarchical Processing?

    Science.gov (United States)

    Negro, Isabelle; Chanquoy, Lucile; Fayol, Michel; Louis-Sidney, Maryse

    2005-01-01

    Two processes, serial and hierarchical, are generally opposed to account for grammatical encoding in language production. In a developmental perspective, the question addressed here is whether the subject-verb agreement during writing is computed serially, once the words are linearly ordered in the sentence, or hierarchically, as soon as the…

  14. Impaired Processing of Serial Order Determines Working Memory Impairments in Alzheimer's Disease.

    Science.gov (United States)

    De Belder, Maya; Santens, Patrick; Sieben, Anne; Fias, Wim

    2017-01-01

    Working memory (WM) problems are commonly observed in Alzheimer's disease (AD), but the affected mechanisms leading to impaired WM are still insufficiently understood. The ability to efficiently process serial order in WM has been demonstrated to be fundamental to fluent daily life functioning. The decreased capability to mentally process serial position in WM has been put forward as the underlying explanation for generally compromised WM performance. Determine which mechanisms, such as order processing, are responsible for deficient WM functioning in AD. A group of AD patients (n = 32) and their partners (n = 25), assigned to the control group, were submitted to an extensive battery of neuropsychological and experimental tasks, assessing general cognitive state and functioning of several aspects related to serial order WM. The results revealed an impaired ability to bind item information to serial position within WM in AD patients compared to controls. It was additionally observed that AD patients experienced specific difficulties with directing spatial attention when searching for item information stored in WM. The processing of serial order and the allocation of attentional resources are both disrupted, explaining the generally reduced WM functioning in AD patients. Further studies should now clarify whether this observation could explain disease-related problems for other cognitive functions such as verbal expression, auditory comprehension, or planning.

  15. Silicon Photonics for Signal Processing of Tbit/s Serial Data Signals

    DEFF Research Database (Denmark)

    Oxenløwe, Leif Katsuo; Ji, Hua; Galili, Michael

    2012-01-01

    In this paper, we describe our recent work on signal processing of terabit per second optical serial data signals using pure silicon waveguides. We employ nonlinear optical signal processing in nanoengineered silicon waveguides to perform demultiplexing and optical waveform sampling of 1.28-Tbit/...

  16. An application of stereoscopy and image processing in forensics: recovering obliterated firearms serial number

    Science.gov (United States)

    da Silva Nunes, L. C.; dos Santos, Paulo Acioly M.

    2004-10-01

    We present an application of the use of stereoscope to recovering obliterated firearms serial number. We investigate a promising new combined cheap method using both non-destructive and destructive techniques. With the use of a stereomicroscope coupled with a digital camera and a flexible cold light source, we can capture the image of the damaged area, and with continuous polishing and sometimes with the help of image processing techniques we could enhance the observed images and they can also be recorded as evidence. This method has already proven to be useful, in certain cases, in aluminum dotted pistol frames, whose serial number is printed with a laser, when etching techniques are not successful. We can also observe acid treated steel surfaces and enhance the images of recovered serial numbers, which sometimes lack of definition.

  17. Selective interference of grasp and space representations with number magnitude and serial order processing.

    Science.gov (United States)

    van Dijck, Jean-Philippe; Fias, Wim; Andres, Michael

    2015-10-01

    It has been proposed that the metrics of space, time and other magnitudes relevant for action are coupled through a generalized magnitude system that also contribute to number representation. Several studies capitalized on stimulus-response compatibility effects to show that numbers map onto left-right representations and grasp representations as a function of their magnitude. However, the tasks typically used do not allow disentangling magnitude from serial order processing. Here, we devised a working memory (WM) task where participants had to remember random sequences of numbers and perform a precision/whole-hand grip (Experiment 1) or a uni-manual left/right button press (Experiment 2) in response to numbers presented during the retention interval. This task does allow differentiating the interference of number magnitude and serial order with each set of responses. Experiment 1 showed that precision grips were initiated faster than whole-hand grips in response to small numbers, irrespective of their serial position in WM. In contrast, Experiment 2 revealed an advantage of right over left button presses as serial position increased, without any influence of number magnitude. These findings demonstrate that grasping and left-right movements overlap with distinct dimensions of number processing. These findings are discussed in the light of different theories explaining the interactions between numbers, space and action.

  18. Availability Evaluation of the serial processes in a Paper Production Industry-A Numerical Approach

    Directory of Open Access Journals (Sweden)

    Archana Sharma

    2010-12-01

    Full Text Available The purpose of this research is to compute availability of the process of a paper production industry consisting of four subsystems. Mathematical formulation of the problem is carried out using probability considerations and the governing differential equations are solved using Runge-Kutta method of order four. Availability of the serial process in the paper production industry have been computed for various choice of failure and repair rates of subsystems of this plant.

  19. Parallel processing data network of master and slave transputers controlled by a serial control network

    Science.gov (United States)

    Crosetto, Dario B.

    1996-01-01

    The present device provides for a dynamically configurable communication network having a multi-processor parallel processing system having a serial communication network and a high speed parallel communication network. The serial communication network is used to disseminate commands from a master processor (100) to a plurality of slave processors (200) to effect communication protocol, to control transmission of high density data among nodes and to monitor each slave processor's status. The high speed parallel processing network is used to effect the transmission of high density data among nodes in the parallel processing system. Each node comprises a transputer (104), a digital signal processor (114), a parallel transfer controller (106), and two three-port memory devices. A communication switch (108) within each node (100) connects it to a fast parallel hardware channel (70) through which all high density data arrives or leaves the node.

  20. Pulse shaping for all-optical signal processing of ultra-high bit rate serial data signals

    DEFF Research Database (Denmark)

    Palushani, Evarist

    The following thesis concerns pulse shaping and optical waveform manipulation for all-optical signal processing of ultra-high bit rate serial data signals, including generation of optical pulses in the femtosecond regime, serial-to-parallel conversion and terabaud coherent optical time division...

  1. Light Video Game Play is Associated with Enhanced Visual Processing of Rapid Serial Visual Presentation Targets.

    Science.gov (United States)

    Howard, Christina J; Wilding, Robert; Guest, Duncan

    2017-02-01

    There is mixed evidence that video game players (VGPs) may demonstrate better performance in perceptual and attentional tasks than non-VGPs (NVGPs). The rapid serial visual presentation task is one such case, where observers respond to two successive targets embedded within a stream of serially presented items. We tested light VGPs (LVGPs) and NVGPs on this task. LVGPs were better at correct identification of second targets whether they were also attempting to respond to the first target. This performance benefit seen for LVGPs suggests enhanced visual processing for briefly presented stimuli even with only very moderate game play. Observers were less accurate at discriminating the orientation of a second target within the stream if it occurred shortly after presentation of the first target, that is to say, they were subject to the attentional blink (AB). We find no evidence for any reduction in AB in LVGPs compared with NVGPs.

  2. Quadratic Polynomial Regression using Serial Observation Processing:Implementation within DART

    Science.gov (United States)

    Hodyss, D.; Anderson, J. L.; Collins, N.; Campbell, W. F.; Reinecke, P. A.

    2017-12-01

    Many Ensemble-Based Kalman ltering (EBKF) algorithms process the observations serially. Serial observation processing views the data assimilation process as an iterative sequence of scalar update equations. What is useful about this data assimilation algorithm is that it has very low memory requirements and does not need complex methods to perform the typical high-dimensional inverse calculation of many other algorithms. Recently, the push has been towards the prediction, and therefore the assimilation of observations, for regions and phenomena for which high-resolution is required and/or highly nonlinear physical processes are operating. For these situations, a basic hypothesis is that the use of the EBKF is sub-optimal and performance gains could be achieved by accounting for aspects of the non-Gaussianty. To this end, we develop here a new component of the Data Assimilation Research Testbed [DART] to allow for a wide-variety of users to test this hypothesis. This new version of DART allows one to run several variants of the EBKF as well as several variants of the quadratic polynomial lter using the same forecast model and observations. Dierences between the results of the two systems will then highlight the degree of non-Gaussianity in the system being examined. We will illustrate in this work the differences between the performance of linear versus quadratic polynomial regression in a hierarchy of models from Lorenz-63 to a simple general circulation model.

  3. Serial headache drawings by children with migraine: correlation with clinical headache status.

    Science.gov (United States)

    Stafstrom, Carl E; Goldenholz, Shira R; Dulli, Douglas A

    2005-10-01

    Children's artistic self-depictions of headache provide valuable insights into their experience of pain and aid in the diagnostic differentiation of headache types. In a previous study, we compared the clinical diagnosis (gold standard) and artistic diagnosis of headaches in 226 children. In approximately 90% of cases, the drawing predicted the clinical diagnosis of migraine versus nonmigraine headache correctly. In the present study, we explored whether headache drawings correlate with clinical improvement after treatment in children with migraine headaches followed longitudinally. Children seen in the Pediatric Neurology Clinic with the chief complaint of headache were asked to draw a picture of what their headache feels like. On subsequent clinic visits, children with the clinical diagnosis of migraine were asked to draw another picture depicting their current headache. The two drawings were compared to assess whether there was improvement; this "artistic response" was then correlated with the child's clinical status (ie, whether the headaches were improved clinically). One hundred eleven children (66 girls, 45 boys) participated in the study, with a mean interval of 5.3 +/- 2.3 (standard error of the mean) months between the first and second visits. The mean age at the first visit was 11.6 +/- 3.1 years. The raters agreed that serial drawings were both improved or both not improved in 99 of the 111 cases (89%; interrater reliability kappa score of 0.767). Fifty-three children had improvements in their headaches and drawings, 3 children had an improved drawing but no clinical headache improvement, 32 children had no improvement in either their drawing or clinical headaches, and 11 children had improved headaches but no improvement in their drawing. The sensitivity of the drawings for clinical improvement was 0.83, and the specificity was 0.91. The predictive value of an improved headache drawing for an improved clinical response was 0.946. There was no

  4. Serial CT and MRI of ischaemic cerebral infarcts: frequency and clinical impact of haemorrhagic transformation

    Energy Technology Data Exchange (ETDEWEB)

    Mayer, T.E.; Brueckmann, H. [Muenchen Univ. (Germany). Abt. fuer Neuroradiologie; Schulte-Altedorneburg, G. [Dept. of Radiology/Neuroradiology, University Medical School of Luebeck (Germany); Droste, D.W. [Dept. of Neurology, University Medical School of Luebeck (Germany)

    2000-04-01

    The frequency, predisposing factors and clinical consequences of haemorrhagic infarcts and damaged blood-brain barrier as shown by contrast enhancement (CE) in ischaemic cerebral infarcts are controversial. We prospectively compared the sensitivity of CT and MRI to haemorrhagic transformation (HT) and CE. We also wished to investigate the clinical significance of HT and factors possibly associated with it. We studied 36 patients with acute ischaemic infarcts in the middle cerebral artery territory during the first 2 weeks after the ictus. After CT and rating of the neurological deficit on admission, serial examinations with clinical neuromonitoring, contrast-enhanced CT and MRI were done on the same day. The occurrence and severity of HT were correlated with CE, stroke mechanism, infarct size, development of neurological deficits and antithrombotic treatment. The frequency of HT detected by MRI was 80 %. CE usually preceded HT or was seen simultaneously. MRI had a higher sensitivity than CT to HT and CE. Severity of HT was positively correlated with infarct size (P < 0.01). HT had no influence on patient's neurological status. Neither the type of antithrombotic treatment nor the stroke mechanism was associated with the severity of HT. No parenchymal haemorrhage occurred. (orig.)

  5. Leukocyte scintigraphy: correlation of serial scintigraphic findings and clinical progression of inflammatory bowel disease

    International Nuclear Information System (INIS)

    Ho, Y.; Kelly, M.J.; Kaliff, V.

    1997-01-01

    Full text: This study was performed (a) to determine whether the clinical progress of individual patients with inflammatory bowel disease mirrored changes in leukocyte scans, and (b) to assess the reasons for significant discrepancies. Two nuclear medicine physicians reviewed 44 white cell scans in 20 consecutive patients (4 males, 18 females) who were referred for two or more leukocyte scans (using either the 111 In Oxine or 99m Tc HMPAO labelling methods) by three gastroenterologists between 1 January 1992 and 1 June 1996. The sequential scanpairs (range 2-18 months apart) were classified by consensus reading as showing no change, more severe or less severe disease. Questionnaires were sent to the referring gastroenterologists to determine whether the overall clinical status of each patient was unchanged, better or worse in the interval between the two scans. There was complete agreement between clinical and scintigraphic assessment in 45% (10/22) of the study pairs. Review of responses of the three individual gastroenterologists showed a wide range of agreement (4/4, 4/5, 2/13). Review of data showed that most disagreement was based on subjective clinical assessment, and hence of uncertain significance. In two patients, however, potentially preventable false negative leukocyte scans occurred in patients with active proctitis. This may be overcome by rigorous attention to ensure complete emptying of radioactivity from the bladder when 99m Tc HMPAO is used. It was concluded that serial leukocyte scans add to clinical assessment but careful technique is needed to avoid false negative scans in the rectum

  6. Clinical Process Intelligence

    DEFF Research Database (Denmark)

    Vilstrup Pedersen, Klaus

    2006-01-01

    .e. local guidelines. From a knowledge management point of view, this externalization of generalized processes, gives the opportunity to learn from, evaluate and optimize the processes. "Clinical Process Intelligence" (CPI), will denote the goal of getting generalized insight into patient centered health...

  7. [Allocation of attentional resource and monitoring processes under rapid serial visual presentation].

    Science.gov (United States)

    Nishiura, K

    1998-08-01

    With the use of rapid serial visual presentation (RSVP), the present study investigated the cause of target intrusion errors and functioning of monitoring processes. Eighteen students participated in Experiment 1, and 24 in Experiment 2. In Experiment 1, different target intrusion errors were found depending on different kinds of letters --romaji, hiragana, and kanji. In Experiment 2, stimulus set size and context information were manipulated in an attempt to explore the cause of post-target intrusion errors. Results showed that as stimulus set size increased, the post-target intrusion errors also increased, but contextual information did not affect the errors. Results concerning mean report probability indicated that increased allocation of attentional resource to response-defining dimension was the cause of the errors. In addition, results concerning confidence rating showed that monitoring of temporal and contextual information was extremely accurate, but it was not so for stimulus information. These results suggest that attentional resource is different from monitoring resource.

  8. The Locus of Serial Processing in Reading Aloud: Orthography-to-Phonology Computation or Speech Planning?

    Science.gov (United States)

    Mousikou, Petroula; Rastle, Kathleen; Besner, Derek; Coltheart, Max

    2015-01-01

    Dual-route theories of reading posit that a sublexical reading mechanism that operates serially and from left to right is involved in the orthography-to-phonology computation. These theories attribute the masked onset priming effect (MOPE) and the phonological Stroop effect (PSE) to the serial left-to-right operation of this mechanism. However,…

  9. Emotional noun processing: an ERP study with rapid serial visual presentation.

    Directory of Open Access Journals (Sweden)

    Shengnan Yi

    Full Text Available Reading is an important part of our daily life, and rapid responses to emotional words have received a great deal of research interest. Our study employed rapid serial visual presentation to detect the time course of emotional noun processing using event-related potentials. We performed a dual-task experiment, where subjects were required to judge whether a given number was odd or even, and the category into which each emotional noun fit. In terms of P1, we found that there was no negativity bias for emotional nouns. However, emotional nouns elicited larger amplitudes in the N170 component in the left hemisphere than did neutral nouns. This finding indicated that in later processing stages, emotional words can be discriminated from neutral words. Furthermore, positive, negative, and neutral words were different from each other in the late positive complex, indicating that in the third stage, even different emotions can be discerned. Thus, our results indicate that in a three-stage model the latter two stages are more stable and universal.

  10. Emotional noun processing: an ERP study with rapid serial visual presentation.

    Science.gov (United States)

    Yi, Shengnan; He, Weiqi; Zhan, Lei; Qi, Zhengyang; Zhu, Chuanlin; Luo, Wenbo; Li, Hong

    2015-01-01

    Reading is an important part of our daily life, and rapid responses to emotional words have received a great deal of research interest. Our study employed rapid serial visual presentation to detect the time course of emotional noun processing using event-related potentials. We performed a dual-task experiment, where subjects were required to judge whether a given number was odd or even, and the category into which each emotional noun fit. In terms of P1, we found that there was no negativity bias for emotional nouns. However, emotional nouns elicited larger amplitudes in the N170 component in the left hemisphere than did neutral nouns. This finding indicated that in later processing stages, emotional words can be discriminated from neutral words. Furthermore, positive, negative, and neutral words were different from each other in the late positive complex, indicating that in the third stage, even different emotions can be discerned. Thus, our results indicate that in a three-stage model the latter two stages are more stable and universal.

  11. The Associative Memory Serial Link Processor of the ALTAS Fast TracKer Processing System

    CERN Document Server

    Sotiropoulou, Calliope Louisa; The ATLAS collaboration

    2017-01-01

    The upgraded trigger system of the ATLAS experiment at LHC will improve the capability of the detectors to select the events with the greatest scientific potential. The FastTracker (FTK) is one of the ATLAS trigger upgrade that is presently under commissioning. FTK is a hardware system that feeds the High Level Trigger with charged particle tracks reconstructed from hits in silicon detectors at the rate of 105 events per second. Once a track candidate is found, the track reconstruction proceeds by matching low resolution hits to predefined patterns. Selected hits matching the predefined pattern are used in a second processing step for a more precise track fitting algorithm. The main processing element of FTK is the Associative Memory (AM) system that is used to perform pattern matching with high degree of parallelism. Its implementation is called the AM Board Serial Link Processor (AMBSLP) and it is a very efficient pattern matching machine that handles massively parallel data. The AMB SLP consists of two typ...

  12. The Associative Memory Serial Link Processor of the ALTAS Fast TracKer Processing System

    CERN Document Server

    Sotiropoulou, Calliope Louisa; The ATLAS collaboration

    2017-01-01

    The upgraded Trigger and Data Acquisition (TDAQ) system of the ATLAS experiment at the LHC will improve the capability of the detector to select the events with the greatest scientific potential. The Fast TracKer (FTK) is one of the ATLAS TDAQ upgrades that is presently under commissioning. FTK is a custom hardware system that feeds the High Level Trigger (HLT) with charged particle tracks reconstructed from hits in silicon detectors at the rate of 105 events per second. The main processing element of FTK is the Associative Memory (AM) system that is used to perform pattern matching with a high degree of parallelism. Its implementation is called the AM Board Serial Link Processor (AMBSLP) and it is a very efficient pattern matching machine that handles in parallel massive data samples. The AMBSLP consists of two types of boards: the Little Associative Memory Board (LAMB), a mezzanine where the AM chips are mounted, and the Associative Memory Board (AMB), a 9U VME motherboard that hosts four LAMB daughter-boar...

  13. Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study.

    Science.gov (United States)

    McInnes, Rhona J; Hoddinott, Pat; Britten, Jane; Darwent, Kirsty; Craig, Leone C A

    2013-05-16

    Exclusive breastfeeding until six months followed by the introduction of solids and continued breastfeeding is recommended by the World Health Organisation. The dominant approach to achieving this has been to educate and support women to start and continue breastfeeding rather than understanding behaviour change processes from a broader perspective. Serial qualitative interviews examined the influences of significant others on women's feeding behaviour. Thirty-six women and 37 nominated significant others participated in 220 interviews, conducted approximately four weekly from late pregnancy to six months after birth. Responses to summative structured questions at the end of each interview asking about significant influences on feeding decisions were compared and contrasted with formative semi-structured data within and between cases. Analysis focused on pivotal points where behaviour changed from exclusive breastfeeding to introducing formula, stopping breastfeeding or introducing solids. This enabled us to identify processes that decelerate or accelerate behaviour change and understand resolution processes afterwards. The dominant goal motivating behaviour change was family wellbeing, rather than exclusive breastfeeding. Rather than one type of significant other emerging as the key influence, there was a complex interplay between the self-baby dyad, significant others, situations and personal or vicarious feeding history. Following behaviour change women turned to those most likely to confirm or resolve their decisions and maintain their confidence as mothers. Applying ecological models of behaviour would enable health service organisation, practice, policy and research to focus on enhancing family efficacy and wellbeing, improving family-centred communication and increasing opportunities for health professionals to be a constructive influence around pivotal points when feeding behaviour changes. A paradigm shift is recommended away from the dominant approach of

  14. Clinical and anatomic pathology effects of serial blood sampling in rat toxicology studies, using conventional or microsampling methods.

    Science.gov (United States)

    Caron, Alexis; Lelong, Christine; Bartels, T; Dorchies, O; Gury, T; Chalier, Catherine; Benning, Véronique

    2015-08-01

    As a general practice in rodent toxicology studies, satellite animals are used for toxicokinetic determinations, because of the potential impact of serial blood sampling on toxicological endpoints. Besides toxicological and toxicokinetic determinations, blood samples obtained longitudinally from a same animal may be used for the assessment of additional parameters (e.g., metabolism, pharmacodynamics, safety biomarkers) to maximize information that can be deduced from rodents. We investigated whether removal of up to 6 × 200 μL of blood over 24h can be applied in GLP rat toxicology studies without affecting the scientific outcome. 8 week-old female rats (200-300 g) were dosed for up to 1 month with a standard vehicle and subjected or not (controls) to serial blood sampling for sham toxicokinetic/ancillary determinations, using miniaturized methods allowing collection of 6 × 50, 100 or 200 μL over 24h. In-life endpoints, clinical pathology parameters and histopathology of organs sensitive to blood volume reduction were evaluated at several time points after completion of sampling. In sampled rats, minimal and reversible changes in red blood cell mass (maximally 15%) and subtle variations in liver enzymes, fibrinogen and neutrophils were not associated with any organ/tissue macroscopic or microscopic correlate. Serial blood sampling (up to 6 × 200 μL over 24h) is compatible with the assessment of standard toxicity endpoints in adult rats. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Do Readers Obtain Preview Benefit from Word n + 2? A Test of Serial Attention Shift versus Distributed Lexical Processing Models of Eye Movement Control in Reading

    Science.gov (United States)

    Rayner, Keith; Juhasz, Barbara J.; Brown, Sarah J.

    2007-01-01

    Two experiments tested predictions derived from serial lexical processing and parallel distributed models of eye movement control in reading. The boundary paradigm (K. Rayner, 1975) was used, and the boundary location was set either at the end of word n - 1 (the word just to the left of the target word) or at the end of word n - 2. Serial lexical…

  16. [Serial clinical examinations as the main approach to dental caries prevention in children].

    Science.gov (United States)

    Skripkina, G I; Garifullina, A Zh

    2015-01-01

    Leading scientific and organizational prerequisites for the feasibility of clinical examination of the entire child population of the Russian Federation to the dentist is, above all, the high prevalence and intensity of dental diseases in children of all ages. As a result of many years of research and follow-up of children of preschool and school age we have proved the need to distinguish a group of children with zero activity of dental caries. The referring criteria are determined according to the results of comprehensive clinical and laboratory examination in order to determine the degree of risk of dental caries and individual caries resistance. The age-specific risk group is settled by "Stop caries" software. In order to optimize the preventive activities children are divided in 5 groups for routine preventive dental care. Unfortunately the efforts of modern dental services aimed at eliminating the consequences of caries process by filling cavities. Individualized preventive approach will increase the effectiveness of preventive measures and save public funds allocated in the amount of compulsory health insurance for pediatric dentistry.

  17. A random walk model for evaluating clinical trials involving serial observations.

    Science.gov (United States)

    Hopper, J L; Young, G P

    1988-05-01

    For clinical trials where the variable of interest is ordered and categorical (for example, disease severity, symptom scale), and where measurements are taken at intervals, it might be possible to achieve a greater discrimination between the efficacy of treatments by modelling each patient's progress as a stochastic process. The random walk is a simple, easily interpreted model that can be fitted by maximum likelihood using a maximization routine with inference based on standard likelihood theory. In general the model can allow for randomly censored data, incorporates measured prognostic factors, and inference is conditional on the (possibly non-random) allocation of patients. Tests of fit and of model assumptions are proposed, and application to two therapeutic trials of gastroenterological disorders are presented. The model gave measures of the rate of, and variability in, improvement for patients under different treatments. A small simulation study suggested that the model is more powerful than considering the difference between initial and final scores, even when applied to data generated by a mechanism other than the random walk model assumed in the analysis. It thus provides a useful additional statistical method for evaluating clinical trials.

  18. Serial diffusion-weighted MRI correlates with clinical course and treatment response in children with intracranial pus collections

    International Nuclear Information System (INIS)

    Fanning, Noel F.; Laffan, Eoghan E.; Shroff, Manohar M.

    2006-01-01

    Accurate assessment of treatment response in children with intracranial pus collections is vital to guide appropriate therapy and reduce morbidity and mortality. To correlate serial MR-measurable changes in diffusion-weighted imaging (DWI) with clinical response to treatment. We retrospectively reviewed clinical notes, conventional MR sequences and DWI in eight children with intracranial pus collections. Trace DWI signal intensity and apparent diffusion coefficient (ADC) values were compared at three time points: at initial diagnosis (eight children, 13 collections), at follow-up during continued clinical infection (three children, sp collections), and at follow-up when clinical infection had resolved (seven children, 12 collections). At initial diagnosis all patients were septic and collections showed restricted diffusion (mean ADC 0.61±0.15 x 10 -3 mm 2 /s). Patients with persistent clinical sepsis at follow-up DWI had collections with persistent low ADC values (0.66±0.21 x 10 -3 mm 2 /s), significantly (P -3 mm 2 /s, P<0.01) compared both to patients with signs of continued sepsis and to normal gray matter values. Persistent restricted diffusion in pus collections correlates with continued sepsis. Treatment response is associated with clinical resolution of sepsis and ADC value elevation significantly above normal gray matter values. (orig.)

  19. Pulmonary mucormycosis. Serial morphologic changes on computed tomography correlate with clinical and pathologic findings

    International Nuclear Information System (INIS)

    Nam, Bo Da; Kim, Tae Jung; Lee, Kyung Soo; Kim, Tae Sung; Chung, Myung Jin; Han, Joungho

    2018-01-01

    To evaluate serial computed tomography (CT) findings of pulmonary mucormycosis correlated with peripheral blood absolute neutrophil count (ANC). Between February 1997 and June 2016, 20 immunocompromised patients (10 males, 10 females; mean age, 48.9 years) were histopathologically diagnosed as pulmonary mucormycosis. On initial (n=20) and follow-up (n=15) CT scans, the patterns of lung abnormalities and their changing features on follow-up scans were evaluated, and the pattern changes were correlated with ANC changes. All patients were immunocompromised. On initial CT scans, nodule (≤3cm)/mass (>3cm) or consolidation with surrounding ground-glass opacity halo (18/20, 90%) was the most common pattern. On follow-up CT, morphologic changes (13/15, 87%) could be seen and they included reversed halo (RH) sign, central necrosis, and air-crescent sign. Although all cases did not demonstrate the regular morphologic changes at the same timeline, various combinations of pattern change could be seen in all patients. Sequential morphologic changes were related with recovering of ANC in 13 of 15 patients. Pulmonary mucormycosis most frequently presents as consolidation or nodule/mass with halo sign at CT. Morphologic changes into RH sign, central necrotic cavity or air-crescent sign occur with treatment and recovery of ANC. (orig.)

  20. Pulmonary mucormycosis. Serial morphologic changes on computed tomography correlate with clinical and pathologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Bo Da; Kim, Tae Jung; Lee, Kyung Soo; Kim, Tae Sung; Chung, Myung Jin [Samsung Medical Centre, Sungkyunkwan University School of Medicine, Department of Radiology and Centre for Imaging Science, Seoul (Korea, Republic of); Han, Joungho [Samsung Medical Centre, Sungkyunkwan University School of Medicine, Department of Pathology, Seoul (Korea, Republic of)

    2018-02-15

    To evaluate serial computed tomography (CT) findings of pulmonary mucormycosis correlated with peripheral blood absolute neutrophil count (ANC). Between February 1997 and June 2016, 20 immunocompromised patients (10 males, 10 females; mean age, 48.9 years) were histopathologically diagnosed as pulmonary mucormycosis. On initial (n=20) and follow-up (n=15) CT scans, the patterns of lung abnormalities and their changing features on follow-up scans were evaluated, and the pattern changes were correlated with ANC changes. All patients were immunocompromised. On initial CT scans, nodule (≤3cm)/mass (>3cm) or consolidation with surrounding ground-glass opacity halo (18/20, 90%) was the most common pattern. On follow-up CT, morphologic changes (13/15, 87%) could be seen and they included reversed halo (RH) sign, central necrosis, and air-crescent sign. Although all cases did not demonstrate the regular morphologic changes at the same timeline, various combinations of pattern change could be seen in all patients. Sequential morphologic changes were related with recovering of ANC in 13 of 15 patients. Pulmonary mucormycosis most frequently presents as consolidation or nodule/mass with halo sign at CT. Morphologic changes into RH sign, central necrotic cavity or air-crescent sign occur with treatment and recovery of ANC. (orig.)

  1. Kinematic and dynamic analysis of a serial-link robot for inspection process in EAST vacuum vessel

    International Nuclear Information System (INIS)

    Peng Xuebing; Yuan Jianjun; Zhang Weijun; Yang Yang; Song Yuntao

    2012-01-01

    Highlights: ► A serial-link robot FIVIR is proposed for inspection of EAST PFCs between plasma shots. ► The FIVIR is a function modular design and has specially designed curvilinear mechanism for axes 4–6. ► The D-H coordinate systems, forward and inverse kinematic model can be easily established and solved for the FIVIR. ► The FIVIR can fulfill the required workspace and has a good dynamic performance in the inspection process. - Abstract: The present paper introduces a serial-link robot which is named flexible in-vessel inspection robot (FIVIR) and developed for Experimental Advanced Superconducting Tokamak (EAST). The task of the robot is to carry process tools, such as viewing camera and leakage detector, to inspect the components installed inside of EAST vacuum vessel. The FIVIR can help to understand the physical phenomena which could be happened in the vacuum vessel during plasma operation and could be one part of EAST remote handling system if needed. The FIVIR was designed with the consideration of having easy control and a good mechanics property which drives it resulted in function modular design. The workspace simulation and kinematic analysis are given in this paper. The dynamic behavior of the FIVIR is studied by multi-body system simulation using ADAMS software. The study result shows the FIVIR has ascendant kinematic and dynamic performance and can fulfill the design requirement for inspection process in EAST vacuum vessel.

  2. Kinematic and dynamic analysis of a serial-link robot for inspection process in EAST vacuum vessel

    Energy Technology Data Exchange (ETDEWEB)

    Peng Xuebing, E-mail: pengxb@ipp.ac.cn [Institute of Plasma Physics, Chinese Academy of Sciences, P.O. Box 1126, Shushanhu Road 350, Hefei, Anhui 230031 (China); Yuan Jianjun; Zhang Weijun [Research Institute of Robotics, Mechanical Engineering School, Shanghai Jiao Tong University, No.800, Dong Chuan Road, Min Hang District, Shanghai 200240 (China); Yang Yang; Song Yuntao [Institute of Plasma Physics, Chinese Academy of Sciences, P.O. Box 1126, Shushanhu Road 350, Hefei, Anhui 230031 (China)

    2012-08-15

    Highlights: Black-Right-Pointing-Pointer A serial-link robot FIVIR is proposed for inspection of EAST PFCs between plasma shots. Black-Right-Pointing-Pointer The FIVIR is a function modular design and has specially designed curvilinear mechanism for axes 4-6. Black-Right-Pointing-Pointer The D-H coordinate systems, forward and inverse kinematic model can be easily established and solved for the FIVIR. Black-Right-Pointing-Pointer The FIVIR can fulfill the required workspace and has a good dynamic performance in the inspection process. - Abstract: The present paper introduces a serial-link robot which is named flexible in-vessel inspection robot (FIVIR) and developed for Experimental Advanced Superconducting Tokamak (EAST). The task of the robot is to carry process tools, such as viewing camera and leakage detector, to inspect the components installed inside of EAST vacuum vessel. The FIVIR can help to understand the physical phenomena which could be happened in the vacuum vessel during plasma operation and could be one part of EAST remote handling system if needed. The FIVIR was designed with the consideration of having easy control and a good mechanics property which drives it resulted in function modular design. The workspace simulation and kinematic analysis are given in this paper. The dynamic behavior of the FIVIR is studied by multi-body system simulation using ADAMS software. The study result shows the FIVIR has ascendant kinematic and dynamic performance and can fulfill the design requirement for inspection process in EAST vacuum vessel.

  3. Investigating the impact of blood pressure increase to the brain using high resolution serial histology and image processing

    Science.gov (United States)

    Lesage, F.; Castonguay, A.; Tardif, P. L.; Lefebvre, J.; Li, B.

    2015-09-01

    A combined serial OCT/confocal scanner was designed to image large sections of biological tissues at microscopic resolution. Serial imaging of organs embedded in agarose blocks is performed by cutting through tissue using a vibratome which sequentially cuts slices in order to reveal new tissue to image, overcoming limited light penetration encountered in microscopy. Two linear stages allow moving the tissue with respect to the microscope objective, acquiring a 2D grid of volumes (1x1x0.3 mm) with OCT and a 2D grid of images (1x1mm) with the confocal arm. This process is repeated automatically, until the entire sample is imaged. Raw data is then post-processed to re-stitch each individual acquisition and obtain a reconstructed volume of the imaged tissue. This design is being used to investigate correlations between white matter and microvasculature changes with aging and with increase in pulse pressure following transaortic constriction in mice. The dual imaging capability of the system allowed to reveal different contrast information: OCT imaging reveals changes in refractive indices giving contrast between white and grey matter in the mouse brain, while transcardial perfusion of FITC or pre-sacrifice injection of Evans Blue shows microsvasculature properties in the brain with confocal imaging.

  4. Serial EEG findings in anti-NMDA receptor encephalitis: correlation between clinical course and EEG.

    Science.gov (United States)

    Ueda, Jun; Kawamoto, Michi; Hikiami, Ryota; Ishii, Junko; Yoshimura, Hajime; Matsumoto, Riki; Kohara, Nobuo

    2017-12-01

    Anti-NMDA receptor encephalitis is a paraneoplastic encephalitis characterised by psychiatric features, involuntary movement, and autonomic instability. Various EEG findings in patients with anti-NMDA receptor encephalitis have been reported, however, the correlation between the EEG findings and clinical course of anti-NMDA receptor encephalitis remains unclear. We describe a patient with anti-NMDA receptor encephalitis with a focus on EEG findings, which included: status epilepticus, generalised rhythmic delta activity, excess beta activity, extreme delta brush, and paroxysmal alpha activity upon arousal from sleep, which we term"arousal alpha pattern". Initially, status epilepticus was observed on the EEG when the patient was comatose with conjugate deviation. The EEG then indicated excess beta activity, followed by the emergence of continuous slow activity, including generalised rhythmic delta activity and extreme delta brush, in the most severe phase. Slow activity gradually faded in parallel with clinical amelioration. Excess beta activity persisted, even after the patient became almost independent in daily activities, and finally disappeared with full recovery. In summary, our patient with anti-NMDA receptor encephalitis demonstrated slow activity on the EEG, including extreme delta brush during the most severe phase, which gradually faded in parallel with clinical amelioration, with excess beta activity persisting into the recovery phase.

  5. The Processing of Somatosensory Information Shifts from an Early Parallel into a Serial Processing Mode: A Combined fMRI/MEG Study.

    Science.gov (United States)

    Klingner, Carsten M; Brodoehl, Stefan; Huonker, Ralph; Witte, Otto W

    2016-01-01

    The question regarding whether somatosensory inputs are processed in parallel or in series has not been clearly answered. Several studies that have applied dynamic causal modeling (DCM) to fMRI data have arrived at seemingly divergent conclusions. However, these divergent results could be explained by the hypothesis that the processing route of somatosensory information changes with time. Specifically, we suggest that somatosensory stimuli are processed in parallel only during the early stage, whereas the processing is later dominated by serial processing. This hypothesis was revisited in the present study based on fMRI analyses of tactile stimuli and the application of DCM to magnetoencephalographic (MEG) data collected during sustained (260 ms) tactile stimulation. Bayesian model comparisons were used to infer the processing stream. We demonstrated that the favored processing stream changes over time. We found that the neural activity elicited in the first 100 ms following somatosensory stimuli is best explained by models that support a parallel processing route, whereas a serial processing route is subsequently favored. These results suggest that the secondary somatosensory area (SII) receives information regarding a new stimulus in parallel with the primary somatosensory area (SI), whereas later processing in the SII is dominated by the preprocessed input from the SI.

  6. The Processing of Somatosensory Information shifts from an early parallel into a serial processing mode: a combined fMRI/MEG study.

    Directory of Open Access Journals (Sweden)

    Carsten Michael Klingner

    2016-12-01

    Full Text Available The question regarding whether somatosensory inputs are processed in parallel or in series has not been clearly answered. Several studies that have applied dynamic causal modeling (DCM to fMRI data have arrived at seemingly divergent conclusions. However, these divergent results could be explained by the hypothesis that the processing route of somatosensory information changes with time. Specifically, we suggest that somatosensory stimuli are processed in parallel only during the early stage, whereas the processing is later dominated by serial processing. This hypothesis was revisited in the present study based on fMRI analyses of tactile stimuli and the application of DCM to magnetoencephalographic (MEG data collected during sustained (260 ms tactile stimulation. Bayesian model comparisons were used to infer the processing stream. We demonstrated that the favored processing stream changes over time. We found that the neural activity elicited in the first 100 ms following somatosensory stimuli is best explained by models that support a parallel processing route, whereas a serial processing route is subsequently favored. These results suggest that the secondary somatosensory area (SII receives information regarding a new stimulus in parallel with the primary somatosensory area (SI, whereas later processing in the SII is dominated by the preprocessed input from the SI.

  7. Design and construction the identification of nitriding plasma process parameters using personal computer based on serial communication

    International Nuclear Information System (INIS)

    Frida Iswinning Diah; Slamet Santosa

    2012-01-01

    Design and construction the identification of process parameters using personal computer based on serial communication PLC M-series has been done. The function of this device is to identify the process parameters of a system (plan), to which then be analyzed and conducted a follow-up given to the plan by the user. The main component of this device is the M-Series T100MD1616 PLC and personal computer (PC). In this device the data plan parameters obtained from the corresponding sensor outputs in the form of voltage or current. While the analog parameter data is adjusted to the ADC analog input of the PLC using a signal conditioning system. Then, as the parameter is processed by the PLC then sent to a PC via RS232 to be displayed in the form of graphs or tables and stored in the database. Software to program the database is created using Visual Basic Programming V-6. The device operation test is performed for the measurement of temperature parameter and vacuum level on the plasma nitriding machine. The results indicate that the device has functioning as an identification device parameters process of plasma nitriding machine. (author)

  8. Editorial Management serials online: construction process, publication and administration with free software solutions

    OpenAIRE

    Andrés Vuotto; María Carolina Rojas; Gladys Vanesa Fernández

    2013-01-01

    Initially raised the main points to consider and develop the planning and construction of an online publication of a scientific nature, emphasizing the process and editorial functions, document preservation, access management, indexing and visibility. In the second part of the paper presents a proposed solution to every aspect previously described, highlighting the work of the information professional and optimizing time, cost and results offered free software, from a concrete experience with...

  9. Global ergonomics strategy in Volkswagen: from the product construction, over the planning until the serial process.

    Science.gov (United States)

    Toledo, Begoña

    2012-01-01

    The Volkswagen Group operates and coordinates the activities of ergonomics from Wolfsburg in Germany and works with its contact persons of every plant and brand of the group towards an integrated proceeding relating to ergonomics. For the ergonomic process it is very important to consider the ergonomics in the whole production process, still from the beginning the conception and construction of the vehicle in the early phases. In these phases there is a big potential to work in the preventive ergonomics and avoid correcting the workstations after start of production. Therefore, it is important to have fluently information in all this phases and identify the potential in each of them. In order to attend these items, Volkswagen has defined different activity fields: coordination of ergonomic standards and the roll-out into all the plants, introducing the ergonomic items in the product development process (PEP), considering the constant improvement of the workplaces in the Volkswagen-Way (KVP and 3P Workshops), taking care of an adequate qualification concept in ergonomics and the intern and extern information exchange within the committees. This topic is established in the industrial engineering of the production area of the group. We are working interdisciplinary with the medical services, human resources, work council and the protection of labor.

  10. Editorial Management serials online: construction process, publication and administration with free software solutions

    Directory of Open Access Journals (Sweden)

    Andrés Vuotto

    2013-10-01

    Full Text Available Initially raised the main points to consider and develop the planning and construction of an online publication of a scientific nature, emphasizing the process and editorial functions, document preservation, access management, indexing and visibility. In the second part of the paper presents a proposed solution to every aspect previously described, highlighting the work of the information professional and optimizing time, cost and results offered free software, from a concrete experience with the system Open Journal System under the journal portal of the Faculty of Humanities at the Universidad Nacional de Mar del Plata.

  11. The effect of the position of atypical character-to-sound correspondences on reading kanji words aloud: Evidence for a sublexical serially operating kanji reading process.

    Science.gov (United States)

    Sambai, Ami; Coltheart, Max; Uno, Akira

    2018-04-01

    In English, the size of the regularity effect on word reading-aloud latency decreases across position of irregularity. This has been explained by a sublexical serially operating reading mechanism. It is unclear whether sublexical serial processing occurs in reading two-character kanji words aloud. To investigate this issue, we studied how the position of atypical character-to-sound correspondences influenced reading performance. When participants read inconsistent-atypical words aloud mixed randomly with nonwords, reading latencies of words with an inconsistent-atypical correspondence in the initial position were significantly longer than words with an inconsistent-atypical correspondence in the second position. The significant difference of reading latencies for inconsistent-atypical words disappeared when inconsistent-atypical words were presented without nonwords. Moreover, reading latencies for words with an inconsistent-atypical correspondence in the first position were shorter than for words with a typical correspondence in the first position. This typicality effect was absent when the atypicality was in the second position. These position-of-atypicality effects suggest that sublexical processing of kanji occurs serially and that the phonology of two-character kanji words is generated from both a lexical parallel process and a sublexical serial process.

  12. Reliability of mechanical and phased-array designs for serial intravascular ultrasound examinations--animal and clinical studies in stented and non-stented coronary arteries.

    Science.gov (United States)

    Tardif, J C; Bertrand, O F; Mongrain, R; Lespérance, J; Grégoire, J; Paiement, P; Bonan, R

    2000-10-01

    Both mechanical and multi-element intravascular ultrasound designs have potential advantages and limitations that may impact on their value for clinical and research purposes. Determination of the reproducibility of measurements is critical before a given system can be used in studies such as regression of atherosclerosis trials. We performed serial intravascular ultrasound imaging with catheters using mechanical and phased-array designs in stented and non-stented coronary arteries in dogs and in patients. Both systems correlated well for areas (r > or = 0.90, p or = 0.84. p mechanical designs for measurements of area (mean difference in dogs and in patients: -0.24 and 0.96 mm2, p mechanical system (r > or = 0.96 for all measurements). The differences in absolute and relative variability between the mechanical and phased-array designs, both for reanalysis of same frames and serial pullbacks, were very small. Although multi-element and mechanical intravascular ultrasound designs are not strictly interchangeable, their similar reproducibility and the small differences in measurements demonstrate that both designs are acceptable alternatives for trials of regression of atherosclerosis. Determination of the variability for serial pullbacks of both designs was also important to assess the statistical power of such trials.

  13. Domain-Generality of Timing-Based Serial Order Processes in Short-Term Memory: New Insights from Musical and Verbal Domains.

    Directory of Open Access Journals (Sweden)

    Simon Gorin

    Full Text Available Several models in the verbal domain of short-term memory (STM consider a dissociation between item and order processing. This view is supported by data demonstrating that different types of time-based interference have a greater effect on memory for the order of to-be-remembered items than on memory for the items themselves. The present study investigated the domain-generality of the item versus serial order dissociation by comparing the differential effects of time-based interfering tasks, such as rhythmic interference and articulatory suppression, on item and order processing in verbal and musical STM domains. In Experiment 1, participants had to maintain sequences of verbal or musical information in STM, followed by a probe sequence, this under different conditions of interference (no-interference, rhythmic interference, articulatory suppression. They were required to decide whether all items of the probe list matched those of the memory list (item condition or whether the order of the items in the probe sequence matched the order in the memory list (order condition. In Experiment 2, participants performed a serial order probe recognition task for verbal and musical sequences ensuring sequential maintenance processes, under no-interference or rhythmic interference conditions. For Experiment 1, serial order recognition was not significantly more impacted by interfering tasks than was item recognition, this for both verbal and musical domains. For Experiment 2, we observed selective interference of the rhythmic interference condition on both musical and verbal order STM tasks. Overall, the results suggest a similar and selective sensitivity to time-based interference for serial order STM in verbal and musical domains, but only when the STM tasks ensure sequential maintenance processes.

  14. Domain-Generality of Timing-Based Serial Order Processes in Short-Term Memory: New Insights from Musical and Verbal Domains.

    Science.gov (United States)

    Gorin, Simon; Kowialiewski, Benjamin; Majerus, Steve

    2016-01-01

    Several models in the verbal domain of short-term memory (STM) consider a dissociation between item and order processing. This view is supported by data demonstrating that different types of time-based interference have a greater effect on memory for the order of to-be-remembered items than on memory for the items themselves. The present study investigated the domain-generality of the item versus serial order dissociation by comparing the differential effects of time-based interfering tasks, such as rhythmic interference and articulatory suppression, on item and order processing in verbal and musical STM domains. In Experiment 1, participants had to maintain sequences of verbal or musical information in STM, followed by a probe sequence, this under different conditions of interference (no-interference, rhythmic interference, articulatory suppression). They were required to decide whether all items of the probe list matched those of the memory list (item condition) or whether the order of the items in the probe sequence matched the order in the memory list (order condition). In Experiment 2, participants performed a serial order probe recognition task for verbal and musical sequences ensuring sequential maintenance processes, under no-interference or rhythmic interference conditions. For Experiment 1, serial order recognition was not significantly more impacted by interfering tasks than was item recognition, this for both verbal and musical domains. For Experiment 2, we observed selective interference of the rhythmic interference condition on both musical and verbal order STM tasks. Overall, the results suggest a similar and selective sensitivity to time-based interference for serial order STM in verbal and musical domains, but only when the STM tasks ensure sequential maintenance processes.

  15. Serial Branches

    DEFF Research Database (Denmark)

    Schindler, Christoph; Tamke, Martin; Tabatabai, Ali

    2013-01-01

    Within a 8-day workshop 19 students of KADK explored the performative potential of naturally angled and forked wood – a desired material until 19th century, but swept away by industrialization and its standardization of processes and materials. The workshop questioned whether contemporary...

  16. Clinical outcomes from an innovative protocol using serial ultrasound imaging and a single MR image to guide brachytherapy for locally advanced cervix cancer.

    Science.gov (United States)

    van Dyk, Sylvia; Narayan, Kailash; Bernshaw, David; Kondalsamy-Chennakesavan, Srinivas; Khaw, Pearly; Lin, Ming Yin; Schneider, Michal

    The aim of this study was to report clinical outcomes in a series of patients who underwent serial ultrasound and a single MRI to plan and verify intracavitary brachytherapy. Data for patients who were referred for curative intent radiotherapy for International Federation of Gynecology and Obstetrics (FIGO) Stage 1-1V cervix cancer between January 2007 and March 2012 were analyzed. All patients received external beam radiotherapy with concurrent chemotherapy and sequential high-dose rate brachytherapy. Brachytherapy was planned and verified using serial ultrasound imaging and a single MRI. Data from 191 patients were available for analyses. The median (range) followup time was 5.08 (0.25-8.25) years. Five-year local control, failure-free survival, cancer-specific survival, and overall survival were 86%, 57.3%, 70% and 63%, respectively. Mean (standard deviation) combined external beam radiotherapy and brachytherapy target doses, equivalent to doses in 2 Gy fractions were 80.4 Gy10 (3.89), median (range) 80 (49-96) Gy10. Grade 3 or greater gastrointestinal, genitourinary, or vaginal late toxicity occurred in 3%, 1.6%, and 2% of patients, respectively. Survival, patterns of failure, and late complication rates were similar to published series of MRI/CT-based brachytherapy practices. This large study demonstrates that favorable treatment outcomes can be obtained using a pragmatic and innovative combination of ultrasound and MR imaging. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  17. Serial changes on MR imaging of herniated lumber discs treated by percutaneous laser nucleotomy. Correlation with early clinical results

    International Nuclear Information System (INIS)

    Hiraishi, Kumiko; Ohmori, Naoki; Kosaka, Riya; Yonezawa, Takumi; Onomura, Toshinobu; Adachi, Itaru; Matsuoka, Takae; Honghan, Gong; Narabayashi, Isamu

    1996-01-01

    Percutaneous Laser Nucleotomy (PLN) is a new treatment for disc herniation applying neodymium: yttrium-aluminum-garnet (Nd : YAG) laser through inserted needle into the center of the disc, with less invasion and shorter hospitalization than conventional open surgery. Serial MR images were observed in 21 patients before and after PLN. Canal occupying ratio (COR) and signal intensity (S.I.) of herniated disc were measured. Recovery rate of symptoms was 57.2%, based on scoring system proposed by the Japanese Orthopaedic Association for low-back pain (JOA score). The successful group (≥30% improvement in JOA score) showed rapid decrease in signal intensity, though the ineffective group ( 2 -weighted sequence. Increase of signal intensity was observed in some patients whose symptoms had become worse. This may correlate with increase of water content and inner pressure on the disc. There was no significant difference between pre- and post-COR; however, more than 10% COR decrease was observed in 7 patients and symptoms improved in these cases. Thus the prognosis of the patients treated with PLN can be assessed by MR findings. (author)

  18. Studies on the clinical course of chronic hepatitis in the patients who underwent serial needle liver biopsies

    International Nuclear Information System (INIS)

    Hirata, Tetsuro

    1984-01-01

    In order to evaluate the changes in biochemical liver function tests and hepatic scintigraphic findings of chronic hepatitis, the author analyzed 35 patients who underwent serial liver biopsies. The results were summerized as follows: 1. Histological deteriorations in chronic hepatitis more inclined to be presented in the scintigraphic abnormalities such as the increased uptake of radioisotope in the spleen and bone marrow than the deteriorations in biochemical liver function tests. Moreover, the increased radioisotope uptake by spleen and bone marrow in hepatic scintigram highly correlated with histological deteriorations. On the other hand, in the cases with histological improvement no scintigraphic improvement was ovserved. 2. Comparing the changes in the result of liver function tests with histological features, biochemical deteriorations significantly correlated with histological deteriorations, although biochemical improvements were not reliable indicators of histological improvements. 3. Changes in biochemical parameters such as serum GOT, GPT, albumin, γ-globulin, TTT and ALP were analyzed by means of Hayashi's second method of quantification and predictive values for histological feactures were calculated. As a result, histological deteriorations were predicted in 89.5% of the cases, but histological improvements were predicted only in 66.7%. In the various biochemical parameters, γ-globulin was considered as most important in predicting histological features and ALP was ranked the second. (J.P.N.)

  19. Developments in Serials: 1977

    Science.gov (United States)

    James, John R.

    1978-01-01

    Discusses issues and developments relating to several aspects of serials, including economics and acquisitions; bibliographic control; automation; education; serials literature and bibliographies; and copyrights. A bibliography is included. (Author/MBR)

  20. 'Serial review on clinical PET tracers'. Manufacturing and quality control of positron emitting radiopharmaceuticals produced by in-house cyclotron

    International Nuclear Information System (INIS)

    Saji, Hideo

    2009-01-01

    In order to establish PET diagnosis as a routine clinical tool, manufacture's compliance with regulations under the Good Manufacturing Practice (GMP) principle for PET radiopharmaceuticals is necessary. For this purpose, the Sub-committee on Medical Application of Positron Emitting Radionuclides, Medical Science and Pharmaceutical Committee of Japan Radioisotopes Association has proposed 'Standards for Compounds Labeled with Emitting Radionuclides Approved as Established Techniques for Medical Use'. This guideline includes the general notices, general rules for preparations, general tests for the quality control, quality of each PET agents, guideline for manufacturing environment and manufacturing process at manufacturing facilities of PET agents. Each facility should have a committee and establish an internal system to account for manufacturing compounds labeled with positron emitting radionuclides produced in the facility, and compile standards by referring to the 'Established Standard Techniques of Labeling Compounds with Emitting Radionuclides for use as Radiopharmaceuticals: approved by the Subcommittee on Medical Application of Cyclotron-Produced Radionuclides (revised in 2009)', in order to maintain the quality of radiopharmaceuticals. (author)

  1. Decreasing Serial Cost Sharing

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter

    The increasing serial cost sharing rule of Moulin and Shenker [Econometrica 60 (1992) 1009] and the decreasing serial rule of de Frutos [Journal of Economic Theory 79 (1998) 245] have attracted attention due to their intuitive appeal and striking incentive properties. An axiomatic characterization...... of the increasing serial rule was provided by Moulin and Shenker [Journal of Economic Theory 64 (1994) 178]. This paper gives an axiomatic characterization of the decreasing serial rule...

  2. Decreasing serial cost sharing

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter Raahave

    2009-01-01

    The increasing serial cost sharing rule of Moulin and Shenker (Econometrica 60:1009-1037, 1992) and the decreasing serial rule of de Frutos (J Econ Theory 79:245-275, 1998) are known by their intuitive appeal and striking incentive properties. An axiomatic characterization of the increasing serial...... rule was provided by Moulin and Shenker (J Econ Theory 64:178-201, 1994). This paper gives an axiomatic characterization of the decreasing serial rule....

  3. Serial or overlapping processing in multitasking as individual preference: Effects of stimulus preview on task switching and concurrent dual-task performance.

    Science.gov (United States)

    Reissland, Jessika; Manzey, Dietrich

    2016-07-01

    Understanding the mechanisms and performance consequences of multitasking has long been in focus of scientific interest, but has been investigated by three research lines more or less isolated from each other. Studies in the fields of the psychological refractory period, task switching, and interruptions have scored with a high experimental control, but usually do not give participants many degrees of freedom to self-organize the processing of two concurrent tasks. Individual strategies as well as their impact on efficiency have mainly been neglected. Self-organized multitasking has been investigated in the field of human factors, but primarily with respect to overall performance without detailed investigation of how the tasks are processed. The current work attempts to link aspects of these research lines. All of them, explicitly or implicitly, provide hints about an individually preferred type of task organization, either more cautious trying to work strictly serially on only one task at a time or more daring with a focus on task interleaving and, if possible, also partially overlapping (parallel) processing. In two experiments we investigated different strategies of task organization and their impact on efficiency using a new measure of overall multitasking efficiency. Experiment 1 was based on a classical task switching paradigm with two classification tasks, but provided one group of participants with a stimulus preview of the task to switch to next, enabling at least partial overlapping processing. Indeed, this preview led to a reduction of switch costs and to an increase of dual-task efficiency, but only for a subgroup of participants. They obviously exploited the possibility of overlapping processing, while the others worked mainly serially. While task-sequence was externally guided in the first experiment, Experiment 2 extended the approach by giving the participants full freedom of task organization in concurrent performance of the same tasks. Fine

  4. End-of-treatment and serial PET imaging in primary mediastinal B-cell lymphoma following dose-adjusted-EPOCH-R: A paradigm shift in clinical decision making.

    Science.gov (United States)

    Melani, Christopher; Advani, Ranjana; Roschewski, Mark; Walters, Kelsey M; Chen, Clara C; Baratto, Lucia; Ahlman, Mark A; Miljkovic, Milos D; Steinberg, Seth M; Lam, Jessica; Shovlin, Margaret; Dunleavy, Kieron; Pittaluga, Stefania; Jaffe, Elaine S; Wilson, Wyndham H

    2018-05-10

    Dose-adjusted-EPOCH-R obviates the need for radiotherapy in most patients with primary mediastinal B-cell lymphoma. End-of-treatment PET, however, does not accurately identify patients at risk of treatment failure, thereby confounding clinical decision making. To define the role of PET in primary mediastinal B-cell lymphoma following dose-adjusted-EPOCH-R, we extended enrollment and follow-up on our published phase II trial and independent series. Ninety-three patients received dose-adjusted-EPOCH-R without radiotherapy. End-of-treatment PET was performed in 80 patients, of whom 57 received 144 serial scans. One nuclear medicine physician from each institution blindly reviewed all scans from their respective institution. End-of-treatment PET was negative (Deauville 1-3) in 55 (69%) patients with one treatment failure (8-year event-free and overall survival of 96.0% and 97.7%). Among 25 (31%) patients with a positive (Deauville 4-5) end-of-treatment PET, there were 5 (20%) treatment failures (8-year event-free and overall survival of 71.1% and 84.3%). Linear regression analysis of serial scans showed a significant decrease in SUVmax in positive end-of-treatment PET non-progressors compared to an increase in treatment failures. Among 6 treatment failures, the median end-of-treatment SUVmax was 15.4 (range, 1.9-21.3) and 4 achieved long-term remission with salvage therapy. Virtually all patients with a negative end-of-treatment PET following dose-adjusted-EPOCH-R achieved durable remissions and should not receive radiotherapy. Among patients with a positive end-of-treatment PET, only 5/25 (20%) had treatment-failure. Serial PET imaging distinguished end-of-treatment PET positive patients without treatment failure, thereby reducing unnecessary radiotherapy by 80%, and should be considered in all patients with an initial positive PET following dose-adjusted-EPOCH-R (NCT00001337). Copyright © 2018, Ferrata Storti Foundation.

  5. System of automated processing of radionuclide investigations (SAPRI-01) in clinical practice

    International Nuclear Information System (INIS)

    Sivachenko, T.P.; Mechev, D.S.; Krupka, I.N.

    1988-01-01

    The author described the results of clinical testing of a system SAPRI-01 designed for automated collection, storage and processing of data on radionuclide investigations. He gave examples of automated processing of RCG and the results of positive scintigraphy of tumors of different sites using 67 Ga-citrate and 99m Tc pertechnetate in statistical and dynamic investigations. Short-comings and ways for updating 4 the system during its serial production were pointed out. The introduction of the system into clinical practice on a wide scale was shown to hold promise

  6. Serial analysis of clinical and imaging indices reveals prolonged efficacy of TNF-α and IL-6 receptor targeted therapies in refractory Takayasu arteritis.

    Science.gov (United States)

    Youngstein, Taryn; Peters, James E; Hamdulay, Shahir S; Mewar, Devesh; Price-Forbes, Alec; Lloyd, Mark; Jeffery, Rachel; Kinderlerer, Anne R; Mason, Justin C

    2014-01-01

    We analysed a large cohort of patients with Takayasu arteritis, seeking robust clinical evidence for prolonged responses to tumour necrosis factor-α (TNF-α) and interleukin-6 receptor (IL-6R) antagonists in severe refractory disease. Case notes from ninety-eight patients with Takayasu arteritis were retrospectively reviewed. Drug treatment, laboratory and serial non-invasive imaging data were analysed, and the Indian Takayasu arteritis activity (ITAS) and damage scores (TADs) calculated. Nine patients were treated with biologic therapies. All had previously received high dose prednisolone and ≥1 conventional immunosuppressant. Five patients had failed cyclophosphamide. The patients prescribed biologics had more extensive arterial injury than the remainder of the cohort and persistent active disease (ITAS range 2-9, CRP 12-206 mg/L, TADs 3--1). Eight patients were prescribed anti-TNF-α therapy, three IL-6R blockade. The mean duration of anti-TNF-α treatment was 42 months (maximum 8 years). One patient developed new arterial stenoses while receiving anti-TNF-α and subsequently achieved disease remission with tocilizumab. Two patients have now demonstrated sustained responses to IL-6R inhibition at 19 and 20 months. Following introduction of biologic therapy, serial non-invasive imaging has revealed no significant progression in arterial injury. A significant fall in CRP (p<0.01), prednisolone dose (p<0.01) and ITAS (p<0.01) was observed, with no increase in TADs. We report for the first time sustained responses to both anti-TNF-α and IL6R antagonists in refractory Takayasu arteritis. As 5/9 patients were cyclophosphamide non-responders, we propose that biologics should now be considered ahead of cyclophosphamide in these young patients.

  7. Adding serial N-terminal pro brain natriuretic peptide measurements to optimal clinical management in outpatients with systolic heart failure

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Videbaek, Lars

    2013-01-01

    AIMS: This study was designed to evaluate a new NT-proBNP monitoring concept in outpatients with systolic heart failure (HF). METHODS AND RESULTS: This was a multicentre, prospective randomized open-label blinded endpoint study. A total of 407 systolic HF patients were allocated to either clinical...

  8. Clinical report writing: Process and perspective

    Science.gov (United States)

    Ewald, H. R.

    1981-01-01

    Clinical report writing in psychology and psychiatry is addressed. Audience/use analysis and the basic procedures of information gathering, diagnosis, and prognosis are described. Two interlinking processes are involved: the process of creation and the process of communication. Techniques for good report writing are presented.

  9. Female serial killing: review and case report.

    Science.gov (United States)

    Frei, Andreas; Völlm, Birgit; Graf, Marc; Dittmann, Volker

    2006-01-01

    Single homicide committed by women is rare. Serial killing is very infrequent, and the perpetrators are usually white, intelligent males with sadistic tendencies. Serial killing by women has, however, also been described. To conduct a review of published literature on female serial killers and consider its usefulness in assessing a presenting case. A literature review was conducted, after searching EMBASE, MEDLINE and PsycINFO. The presenting clinical case is described in detail in the context of the literature findings. Results The literature search revealed few relevant publications. Attempts to categorize the phenomenon of female serial killing according to patterns of and motives for the homicides have been made by some authors. The most common motive identified was material gain or similar extrinsic gratification while the 'hedonistic' sadistic or sexual serial killer seems to be extremely rare in women. There is no consistent theory of serial killing by women, but psychopathic personality traits and abusive childhood experiences have consistently been observed. The authors' case did not fit the description of a 'typical' female serial killer. In such unusual circumstances as serial killing by a woman, detailed individual case formulation is required to make sense of the psychopathology in each case. Publication of cases in scientific journals should be encouraged to advance our understanding of this phenomenon. Copyright (c) 2006 John Wiley & Sons, Ltd.

  10. Clinical processes in behavioral couples therapy.

    Science.gov (United States)

    Fischer, Daniel J; Fink, Brandi C

    2014-03-01

    Behavioral couples therapy is a broad term for couples therapies that use behavioral techniques based on principles of operant conditioning, such as reinforcement. Behavioral shaping and rehearsal and acceptance are clinical processes found across contemporary behavioral couples therapies. These clinical processes are useful for assessment and case formulation, as well as teaching couples new methods of conflict resolution. Although these clinical processes assist therapists in achieving efficient and effective therapeutic change with distressed couples by rapidly stemming couples' corrosive affective exchanges, they also address the thoughts, emotions, and issues of trust and intimacy that are important aspects of the human experience in the context of a couple. Vignettes are provided to illustrate the clinical processes described. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  11. Serial personal digital assistant data capture of health-related quality of life: A randomized controlled trial in a prostate cancer clinic

    Directory of Open Access Journals (Sweden)

    Ritvo Paul

    2007-07-01

    Full Text Available Abstract Background In clinical and research practice linked to prostate cancer treatment, frequent monitoring of patient health-related quality of life (HRQOL is essential. Practical and analytic limitations of paper questionnaire data capture may be overcome with the use of self-administered personal digital assistant (PDA data collection. The objective of this study was to assess the reliability, validity, and feasibility of using PDA in place of paper versions of the International Prostate Symptom Score (IPSS, the Patient Oriented Prostate Cancer Utility Survey (PORPUS, and the International Index of Erectile Function-5 (IIEF-5 in a prostate cancer clinic setting. Methods 152 participants were randomly assigned to one of three conditions: 1 paper followed by PDA survey; 2 PDA followed by paper survey; or 3 PDA followed by PDA survey. Evaluation included an assessment of data quality (internal consistency, test-retest reliability, response correlation, completeness of data, and feasibility (participation rates, time to completion, preference and difficultly/ease of using PDA. Results Internal consistency was similar for both PDA and paper applications. Test-retest reliability was confirmed for PDA repeated administration. Data from paper and PDA questionnaires were strongly correlated. Lower missed item rates were found in PDA administration. 82.8% of participants preferred using the PDA or had no preference. Mean difficulty/ease ratings indicated that participants found the PDA easy to use. Age did not significantly correlate with preference or difficulty. Conclusion The results confirm the adaptability of the IPSS, IIEF-5, and the PORPUS to PDA administration. Similarly, the findings of this study support the feasibility of using PDA technology for HRQOL serial data capture in the prostate cancer patient population.

  12. Short term memory for serial order : Unraveling individual differences in the use of processes and changes across tasks

    NARCIS (Netherlands)

    Gonzalez Marin, G.V.; Bouwmeester, S.; Vermunt, J.K.

    2013-01-01

    In this study we investigated whether we could distinguish the use of specific verbal and visual short term memory (STM) processes in children, or whether the differences in memory performance could be interpreted only in terms of quantitative differences. First, the number of processes involved in

  13. Activating clinical trials: a process improvement approach.

    Science.gov (United States)

    Martinez, Diego A; Tsalatsanis, Athanasios; Yalcin, Ali; Zayas-Castro, José L; Djulbegovic, Benjamin

    2016-02-24

    The administrative process associated with clinical trial activation has been criticized as costly, complex, and time-consuming. Prior research has concentrated on identifying administrative barriers and proposing various solutions to reduce activation time, and consequently associated costs. Here, we expand on previous research by incorporating social network analysis and discrete-event simulation to support process improvement decision-making. We searched for all operational data associated with the administrative process of activating industry-sponsored clinical trials at the Office of Clinical Research of the University of South Florida in Tampa, Florida. We limited the search to those trials initiated and activated between July 2011 and June 2012. We described the process using value stream mapping, studied the interactions of the various process participants using social network analysis, and modeled potential process modifications using discrete-event simulation. The administrative process comprised 5 sub-processes, 30 activities, 11 decision points, 5 loops, and 8 participants. The mean activation time was 76.6 days. Rate-limiting sub-processes were those of contract and budget development. Key participants during contract and budget development were the Office of Clinical Research, sponsors, and the principal investigator. Simulation results indicate that slight increments on the number of trials, arriving to the Office of Clinical Research, would increase activation time by 11 %. Also, incrementing the efficiency of contract and budget development would reduce the activation time by 28 %. Finally, better synchronization between contract and budget development would reduce time spent on batching documentation; however, no improvements would be attained in total activation time. The presented process improvement analytic framework not only identifies administrative barriers, but also helps to devise and evaluate potential improvement scenarios. The strength

  14. CRNL library serials list

    International Nuclear Information System (INIS)

    Alburger, T.P.

    1982-04-01

    A list of 1900 serial publications (periodicals, society transactions and proceedings, annuals and directories, indexes, newspapers, etc.) is presented with volumes and years held by the Main Library. This library is the largest in AECL as well as one of the largest scientific and technical libraries in North America, and functions as a Canadian resource for nuclear information. A main alphabetical list is followed by broad subject field lists representing research interests, and lists of abstract and index serials, general bibliographic serials, conference indexes, press releases, English translations, and original language journals

  15. Step by step control of a deep drawing process with piezo-electric actuators in serial operation

    Directory of Open Access Journals (Sweden)

    Bäume Tobias

    2015-01-01

    Full Text Available Due to the design-driven increase in complexity of forming car body parts, it becomes more difficult to ensure a stable forming process. Piezoelectric actuators can influence the material flow of stamping parts effectively. In this article the implementation of piezoelectric actuators in a large scale sheet metal forming tool of a car manufacturer is described. Additionally, it is shown that part quality can be assessed with the help of triangulation laser sensors, which are mounted on the blankholder. The resulting flange draw-in signals were used to reduce the occurrence of wrinkling or the rate of cracking. It was shown that process control improved the quality of the stamping parts significantly.

  16. Serial Multimodality Imaging and 2-Year Clinical Outcomes of the Novel DESolve Novolimus-Eluting Bioresorbable Coronary Scaffold System for the Treatment of Single De Novo Coronary Lesions.

    Science.gov (United States)

    Abizaid, Alexandre; Costa, Ricardo A; Schofer, Joachim; Ormiston, John; Maeng, Michael; Witzenbichler, Bernhard; Botelho, Roberto V; Costa, J Ribamar; Chamié, Daniel; Abizaid, Andrea S; Castro, Juliana P; Morrison, Lynn; Toyloy, Sara; Bhat, Vinayak; Yan, John; Verheye, Stefan

    2016-03-28

    This study sought to report the late multimodality imaging and clinical outcomes of the novel poly-l-lactic-acid-based DESolve novolimus-eluting bioresorbable coronary scaffold for the treatment of de novo coronary lesions. Bioresorbable scaffolds are an alternative to drug-eluting metallic stents and provide temporary vascular scaffolding, which potentially may allow vessel restoration and reduce the risk of future adverse events. Overall, 126 patients were enrolled at 13 international sites between November 2011 and June 2012. The primary endpoint was in-scaffold late lumen loss at 6 months. Major adverse cardiac events, the main safety endpoint, were defined as the composite of cardiac death, target vessel myocardial infarction, or clinically indicated target lesion revascularization. All patients underwent angiography at 6 months. Serial intravascular ultrasound and optical coherence tomography were performed in a subset of patients. The scaffold device success rate was 97% (n = 122 of 126), and procedural success was 100% (n = 122 of 122). The major adverse cardiac event rate was 3.3% (n = 4 of 122) at 6 months and 7.4% (n = 9 of 122) at 24 months, including 1 probable stent thrombosis within the first month. At 6-month angiographic follow-up, in-scaffold late lumen loss was 0.20 ± 0.32 mm. Paired intravascular ultrasound analysis demonstrated a significant increase in vessel, lumen and scaffold dimensions between post-procedure and 6-month follow-up, and strut-level optical coherence tomography analysis showed full strut coverage in 99 ± 1.7%. Our results showed favorable performance of the DESolve scaffold, effective inhibition of neointimal hyperplasia, and for the first time, early luminal and scaffold growth at 6 months with sustained efficacy and safety through 2 years. (Elixir Medical Clinical Evaluation of the DESolve Novolimus Eluting Bioresorbable Coronary Scaffold System-The DESolve Nx Trial; NCT02086045). Copyright © 2016 American College of

  17. Playing at Serial Acquisitions

    NARCIS (Netherlands)

    J.T.J. Smit (Han); T. Moraitis (Thras)

    2010-01-01

    textabstractBehavioral biases can result in suboptimal acquisition decisions-with the potential for errors exacerbated in consolidating industries, where consolidators design serial acquisition strategies and fight escalating takeover battles for platform companies that may determine their future

  18. Classifying serial killers.

    Science.gov (United States)

    Promish, D I; Lester, D

    1999-11-08

    We attempted to match the appearance and demeanor of 27 serial killers to the postmortem 'signatures' found on their victims' bodies. Our results suggest that a link may exist between postmortem signatures and two complementary appearance-demeanor types.

  19. Application of statistical methods to the quality assurance process in the serial production of containers of type lead Cpb-M and Cpb-G

    International Nuclear Information System (INIS)

    Zuniga Santana, J.F.; Fernadez Rondon, M.; Viant Garrido, E.; Torres Berdeguez, M.B.; Fernadez, A.

    1998-01-01

    Nowadays the statistic has an action change and its applications have to do with all the branches of the scientific knowledge. Constantly new applications arise for the statistic, one of those is in the insurance of the quality of productive processes. The process of serial production of the devices of shielding gamma type CPb-m and CPb-g are carried out in correspondence with the designed methodology and validated in the Department of Technologic Design of the Center of Nuclear Technology (CTN). With view to execute the normative ones national and international for this packing type were designed a System of Insurance of the Quality (SAC) based on the normative ISO composed by a manual of quality and a manual of procedures where is described of detailed way each one of the stages. Presently work different statistical methods are analyzed with the objective of selecting the good one to determine the factors that have bigger influence in to the quality of production of the devices of shielding gamma used by the CENTIS for the packing and transportation of the radioactive preparations

  20. Serial and parallel processing in reading: investigating the effects of parafoveal orthographic information on nonisolated word recognition.

    Science.gov (United States)

    Dare, Natasha; Shillcock, Richard

    2013-01-01

    We present a novel lexical decision task and three boundary paradigm eye-tracking experiments that clarify the picture of parallel processing in word recognition in context. First, we show that lexical decision is facilitated by associated letter information to the left and right of the word, with no apparent hemispheric specificity. Second, we show that parafoveal preview of a repeat of word n at word n + 1 facilitates reading of word n relative to a control condition with an unrelated word at word n + 1. Third, using a version of the boundary paradigm that allowed for a regressive eye movement, we show no parafoveal "postview" effect on reading word n of repeating word n at word n - 1. Fourth, we repeat the second experiment but compare the effects of parafoveal previews consisting of a repeated word n with a transposed central bigram (e.g., caot for coat) and a substituted central bigram (e.g., ceit for coat), showing the latter to have a deleterious effect on processing word n, thereby demonstrating that the parafoveal preview effect is at least orthographic and not purely visual.

  1. Automated radiochemical processing for clinical PET

    International Nuclear Information System (INIS)

    Padgett, H.C.; Schmidt, D.G.; Bida, G.T.; Wieland, B.W.; Pekrul, E.; Kingsbury, W.G.

    1991-01-01

    With the recent emergence of positron emission tomography (PET) as a viable clinical tool, there is a need for a convenient, cost-effective source of the positron emitter-labeled radiotracers labeled with carbon-11, nitrogen-13, oxygen-15, and fluorine-18. These short-lived radioisotopes are accelerator produced and thus, require a cyclotron and radiochemistry processing instrumentation that can be operated 3 in a clinical environment by competant technicians. The basic goal is to ensure safety and reliability while setting new standards for economy and ease of operation. The Siemens Radioisotope Delivery System (RDS 112) is a fully automated system dedicated to the production and delivery of positron-emitter labeled precursors and radiochemicals required to support a clinical PET imaging program. Thus, the entire RDS can be thought of as an automated radiochemical processing apparatus

  2. Serial Austen. Mashingups with Zombies

    Directory of Open Access Journals (Sweden)

    Eleonora Federici

    2017-01-01

    Full Text Available Jane Austen sells. She sells in all possible ways, her novels have been adapted for the cinema and the stage, they have been rewritten as comics and graphic novels. Jane austen is a cultural icon. The interest in her life is so strong that many biographies have been written in order to recover new facts and details. The places where she has lived and the places depicted in her novels have become tourist sites for literary pilgrims. Austen is a cross-over phenomenon, with regency costume balls recreated in her name and an endless proliferation of her works in all media. My essay will investigate Jane Austen and Seth Grahame-Smith’s Pride and Prejudice and Zombies (2009, a mash-up novel which has become a real cultural phenomenon of the last decade and will demonstrate how it can be considered a serial narrative. If as Henry Jenkins asserts, seriality implies the unfolding of a story over time through a process of “chunking” (that is creating meaningful parts of the same story and of “dispersal” (that is breaking the story into more parts and in more genres and media, mash-ups seems to do this.  Austen’s story remains as a “story hook” which pushes the reader to come back to different products for a continuation of the same story. So, if on the one hand, seriality occurs within the same text, the story-telling of Austen’s stories across genres and media is part of a seriality process.

  3. The Windows serial port programming handbook

    CERN Document Server

    Bai, Ying

    2004-01-01

    The fundamentals of serial port communications. Serial port programming in ANSI C and Assembly languages for MS-DOS. Serial ports interface developed in VC++ 6.0. Serial port programming in Visual Basic. Serial port programming in LabVIEW. Serial port programming in MATLAB. Serial port programming in Smalltalk. Serial port programming in Java.

  4. Facial rejuvenation: Serial fat graft transfer

    African Journals Online (AJOL)

    Saad Mohamed Saad Ibrahiem

    2016-02-01

    Feb 1, 2016 ... This a clinical study carried out to test the aesthetic outcome of serial injection of the cryo-preserved fat cells for both aesthetic and reconstructive purposes. Methods: Clinical ..... ucts, devices, or drugs mentioned in this manuscript that might create a ... Adipose stem cells and regenerative medicine. 7th ed.

  5. Serial interprocessor communications system

    International Nuclear Information System (INIS)

    Labiak, W.; Siemens, P.; Bailey, C.

    1980-01-01

    A serial communications system based on the EIA RS232-C standard with modem control lines has been developed. The DLV11-E interface is used for this purpose. All handshaking is done with the modem control lines. This allows totally independent full duplex communication. The message format consists of eight bit data with odd parity and a sixteen bit checksum on the whole message. All communications are fully interrupt driven. A program was written to load a program into a remote LSI-11 using the serial line without bootstrap ROM

  6. Serial Expression Analysis: a web tool for the analysis of serial gene expression data

    Science.gov (United States)

    Nueda, Maria José; Carbonell, José; Medina, Ignacio; Dopazo, Joaquín; Conesa, Ana

    2010-01-01

    Serial transcriptomics experiments investigate the dynamics of gene expression changes associated with a quantitative variable such as time or dosage. The statistical analysis of these data implies the study of global and gene-specific expression trends, the identification of significant serial changes, the comparison of expression profiles and the assessment of transcriptional changes in terms of cellular processes. We have created the SEA (Serial Expression Analysis) suite to provide a complete web-based resource for the analysis of serial transcriptomics data. SEA offers five different algorithms based on univariate, multivariate and functional profiling strategies framed within a user-friendly interface and a project-oriented architecture to facilitate the analysis of serial gene expression data sets from different perspectives. SEA is available at sea.bioinfo.cipf.es. PMID:20525784

  7. A Survey of Electronic Serials Managers Reveals Diversity in Practice

    Directory of Open Access Journals (Sweden)

    Laura Costello

    2014-09-01

    In surveying academic librarians engaged in serials management, the author sought to identify trends and standards in the field, but instead found significant variation in serials budgets and processes amongst the responding libraries. While it is clear that electronic subscriptions are a significant development and now a permanent feature of serials management, decisions to move from print to digital are complex and definitive conclusions about best practices for serials transitions could not be drawn from this study. The survey revealed that institutions have invested in staff and tools for the management of electronic serials, but staffing configurations and tool combinations are also extremely diverse. The author concluded that the lack of standardization in these areas and the disconnect between institution and serials budget size indicated a serials landscape that was highly individualized and customized to each institution’s unique needs.

  8. The communication process in clinical settings.

    Science.gov (United States)

    Mathews, J J

    1983-01-01

    The communication of information in clinical settings is fraught with problems despite avowed common aims of practitioners and patients. Some reasons for the problematic nature of clinical communication are incongruent frames of reference about what information ought to be shared, sociolinguistic differences and social distance between practitioners and patients. Communication between doctors and nurses is also problematic, largely due to differences in ideology between the professions about what ought to be communicated to patients about their illness and who is ratified to give such information. Recent social changes, such as the Patient Bill of Rights and informed consent which assure access to information, and new conceptualizations of the nurse's role, warrant continued study of the communication process especially in regard to what constitutes appropriate and acceptable information about a patient's illness and who ought to give such information to patients. The purpose of this paper is to outline characteristics of communication in clinical settings and to provide a literature review of patient and practitioner interaction studies in order to reflect on why information exchange is problematic in clinical settings. A framework for presentation of the problems employs principles from interaction and role theory to investigate clinical communication from three viewpoints: (1) the level of shared knowledge between participants; (2) the effect of status, role and ideology on transactions; and (3) the regulation of communication imposed by features of the institution.

  9. Serial position effects scoring in the assessment of memory in Alzheimer's disease and major depression

    NARCIS (Netherlands)

    Bemelmans, Karel Jozef

    2009-01-01

    The objective of this thesis was to validate serial position effects (SPE’S) scoring in the Rey Auditory Verbal Learning Test (RAVLT). The RAVLT is a much used clinical method for assessing memory performance, but the method of scoring obfuscates that two memory processes underlie free recall. This

  10. Quality Assessment of Serially Ultradiluted and Agitated Drug Digitalis purpurea by Emission Spectroscopy and Clinical Analysis of Its Effect on the Heart Rate of Indian Bufo melanostictus

    Directory of Open Access Journals (Sweden)

    Anup Sharma

    2013-01-01

    Full Text Available The investigation of ultradiluted (homeopathic drugs is extremely interesting and challenging, and from that point of view this study shows novelty. A study of in vivo changes in heart rate of the Indian Bufo melanostictus caused by commercially available serially ultra-diluted and agitated extract of Digitalis purpurea has been tried in order to understand their pharmacological role. RR interval (of ECG was compared after intraperitoneal administration of serially diluted and agitated Digitalis purpurea extract, diluent rectified spirit, and Digoxin in anesthetized animals. The study revealed statistically significant changes in the heart rate after application of these drugs except in case of Digoxin and the 200th serial dilution of Digitalis purpurea. The duration of RR intervals after application of the drugs was corroborative of the effect of Digoxin and Digitalis purpurea extract up to 30th dilution. Emission spectra were obtained for the experimental ultra-diluted Digitalis purpurea extract and Digoxin to identify and characterize them. The observed RR pattern and emission spectra show an association. The quality assessment of the commercial ultra-diluted organic drugs obtained from natural products may be initiated by monitoring in vivo studies on animal models.

  11. Selection and Serial Entrepreneurs

    DEFF Research Database (Denmark)

    Chen, Jing

    2013-01-01

    There is substantial evidence that serial entrepreneurs outperform de novo entrepreneurs. But is this positive association between prior experience and performance the result of learning by doing or of selection on ability? This paper proposes a strategy that combines the fixed-effects model and IV...... when the analysis focuses on founding new startups in sectors closely related to entrepreneurs' previous ventures....

  12. Selection and Serial Entrepreneurs

    DEFF Research Database (Denmark)

    Chen, Jing

    2011-01-01

    Although it has been broadly evidenced that entrepreneurial experience plays a substantial role in the emergence of serial entrepreneurship, the debate is still going on about whether this relationship should be attributed to learning by doing or instead be explained by selection on ability. This...

  13. Serial private infrastructures

    NARCIS (Netherlands)

    van den Berg, V.A.C.

    2013-01-01

    This paper investigates private supply of two congestible infrastructures that are serial, where the consumer has to use both in order to consume. Four market structures are analysed: a monopoly and 3 duopolies that differ in how firms interact. It is well known that private supply leads too high

  14. Stress in Harmonic Serialism

    Science.gov (United States)

    Pruitt, Kathryn Ringler

    2012-01-01

    This dissertation proposes a model of word stress in a derivational version of Optimality Theory (OT) called Harmonic Serialism (HS; Prince and Smolensky 1993/2004, McCarthy 2000, 2006, 2010a). In this model, the metrical structure of a word is derived through a series of optimizations in which the "best" metrical foot is chosen…

  15. Suicide in serial killers.

    Science.gov (United States)

    Lester, David; White, John

    2010-02-01

    In a sample of 248 killers of two victims in America from 1900 to 2005, obtained from an encyclopedia of serial killers by Newton (2006), those completing suicide did not differ in sex, race, or the motive for the killing from those who were arrested.

  16. Data processing systems for clinical nuclear medicine

    International Nuclear Information System (INIS)

    Winkler, C.; Knopp, R.

    1975-01-01

    The model studies on the above mentioned data processing demonstration systems have shown that the development of a modular process computer with an applicable operation system makes it possible to meet the special demands of any nuclear-medical clinical centre corresponding to its capacity and finances. The respective first draft of the compact system described was discussed by a major circle of competent specialists at the DP-meeting of the Rheinisch-Westfaelische Gesellschaft fuer Nuklearmedizin in 1974. The positive response which the draft was met with confirmes our opinion that in the future equipment of the nuclear-medical institutions with DP-systems the universal applicability of these systems in operation with several participants and the implementation of clinically tested user's software should have priority over all other things. The development of the compact system, which is being carried out with the help of the Federal Ministry for Research and Technology will be instrumental in creating the preconditions necessary. It will be fully available in 1977 and is even expected to be completed in its partial functions (such as camera scanning, renal clearance, evaluation of laboratory data) in 1976 already. (orig.) [de

  17. Malaysian Serials: Issues and Problems.

    Science.gov (United States)

    Bahri, Che Norma

    This paper analyzes the issues and problems while looking at the trends and developments of serials publishing in Malaysia. The first section provides background; topics addressed include the country and people of Malaysia, the history of serials publishing in Malaysia, categories and formats of serials publishing, academic publications,…

  18. CMOS serial link for fully duplexed data communication

    Science.gov (United States)

    Lee, Kyeongho; Kim, Sungjoon; Ahn, Gijung; Jeong, Deog-Kyoon

    1995-04-01

    This paper describes a CMOS serial link allowing fully duplexed 500 Mbaud serial data communication. The CMOS serial link is a robust and low-cost solution to high data rate requirements. A central charge pump PLL for generating multiphase clocks for oversampling is shared by several serial link channels. Fully duplexed serial data communication is realized in the bidirectional bridge by separating incoming data from the mixed signal on the cable end. The digital PLL accomplishes process-independent data recovery by using a low-ratio oversampling, a majority voting, and a parallel data recovery scheme. Mostly, digital approach could extend its bandwidth further with scaled CMOS technology. A single channel serial link and a charge pump PLL are integrated in a test chip using 1.2 micron CMOS process technology. The test chip confirms upto 500 Mbaud unidirectional mode operation and 320 Mbaud fully duplexed mode operation with pseudo random data patterns.

  19. Delaware's first serial killer.

    Science.gov (United States)

    Inguito, G B; Sekula-Perlman, A; Lynch, M J; Callery, R T

    2000-11-01

    The violent murder of Shirley Ellis on November 29, 1987, marked the beginning of the strange and terrible tale of Steven Bryan Pennell's reign as the state of Delaware's first convicted serial killer. Three more bodies followed the first victim, and all had been brutally beaten and sadistically tortured. The body of a fifth woman has never been found. State and county police collaborated with the FBI to identify and hunt down their suspect, forming a task force of over 100 officers and spending about one million dollars. Through their knowledge and experience with other serial killers, the FBI was able to make an amazingly accurate psychological profile of Delaware's serial killer. After months of around-the-clock surveillance, Steven Pennell was arrested on November 29, 1988, one year to the day after the first victim was found. Pennell was found guilty in the deaths of the first two victims on November 29, 1989, and plead no contest to the murder of two others on October 30, 1991. Still maintaining his innocence, he asked for the death penalty so that he could spare his family further agony. Steven Pennell was executed by lethal injection on March 15, 1992.

  20. Implementation of Serial and Parallel Bubble Sort on Fpga

    OpenAIRE

    Purnomo, Dwi Marhaendro Jati; Arinaldi, Ahmad; Priyantini, Dwi Teguh; Wibisono, Ari; Febrian, Andreas

    2016-01-01

    Sorting is common process in computational world. Its utilization are on many fields from research to industry. There are many sorting algorithm in nowadays. One of the simplest yet powerful is bubble sort. In this study, bubble sort is implemented on FPGA. The implementation was taken on serial and parallel approach. Serial and parallel bubble sort then compared by means of its memory, execution time, and utility which comprises slices and LUTs. The experiments show that serial bubble sort r...

  1. [The serial murder: a few theoretical perspectives].

    Science.gov (United States)

    Leistedt, S; Linkowski, P

    2011-01-01

    Despite numbers of publications and effort to try to establish the definition, the classification, the epidemiology, the clinical aspects and the psychopathology of serial killers, a universal consensus seems to say the least. Crime, though reduced in some countries, appears to impact more and more consistent worldwide, generating controversial ideas and a multitude of possible explanations. The serial killer usually presents as a caucasian man, aged between 20 and 40 years, often embedded socially and in his family, but with serious psychiatric, personal and especially family history. Usually acting alone, the serial killer plans a crime well in advance, but sometimes within the scope of impulsivity for a minority, the victim not being previously selected. In the latter case, an actual mental illness like psychosis is found. It is clear from numerous psychopathological studies conducted so far that most serial killers are defined as psychopathic sexual sadists, whose childhood was difficult, if not flouted, punctuated by physical and psychological violence situations. In addition, pervasive fantasies combined with thoughts of death, sex and violence are as much in common with the original acts of which they are the instigators. Beyond a relentless media that is constantly watering the public with stories and pictures depicting them as such, serial killers remain an enigma. We can therefore attempt to answer the various questions raised by this phenomenon, the way these people operate and how we can curb the rise, thanks to the neurobiological and neurophysiological approaches that science offers us.

  2. Broad ion beam serial section tomography

    Energy Technology Data Exchange (ETDEWEB)

    Winiarski, B., E-mail: b.winiarski@manchester.ac.uk [School of Materials, University of Manchester, Manchester M13 9PL (United Kingdom); Materials Division, National Physical Laboratory, Teddington TW11 0LW (United Kingdom); Gholinia, A. [School of Materials, University of Manchester, Manchester M13 9PL (United Kingdom); Mingard, K.; Gee, M. [Materials Division, National Physical Laboratory, Teddington TW11 0LW (United Kingdom); Thompson, G.E.; Withers, P.J. [School of Materials, University of Manchester, Manchester M13 9PL (United Kingdom)

    2017-01-15

    Here we examine the potential of serial Broad Ion Beam (BIB) Ar{sup +} ion polishing as an advanced serial section tomography (SST) technique for destructive 3D material characterisation for collecting data from volumes with lateral dimensions significantly greater than 100 µm and potentially over millimetre sized areas. Further, the associated low level of damage introduced makes BIB milling very well suited to 3D EBSD acquisition with very high indexing rates. Block face serial sectioning data registration schemes usually assume that the data comprises a series of parallel, planar slices. We quantify the variations in slice thickness and parallelity which can arise when using BIB systems comparing Gatan PECS and Ilion BIB systems for large volume serial sectioning and 3D-EBSD data acquisition. As a test case we obtain 3D morphologies and grain orientations for both phases of a WC-11%wt. Co hardmetal. In our case we have carried out the data acquisition through the manual transfer of the sample between SEM and BIB which is a very slow process (1–2 slice per day), however forthcoming automated procedures will markedly speed up the process. We show that irrespective of the sectioning method raw large area 2D-EBSD maps are affected by distortions and artefacts which affect 3D-EBSD such that quantitative analyses and visualisation can give misleading and erroneous results. Addressing and correcting these issues will offer real benefits when large area (millimetre sized) automated serial section BIBS is developed. - Highlights: • In this work we examine how microstructures can be reconstructed in three-dimensions (3D) by serial argon broad ion beam (BIB) milling, enabling much larger volumes (>250×250×100µm{sup 3}) to be acquired than by serial section focused ion beam-scanning electron microscopy (FIB-SEM). • The associated low level of damage introduced makes BIB milling very well suited to 3D-EBSD acquisition with very high indexing rates. • We explore

  3. IMPLEMENTATION OF SERIAL AND PARALLEL BUBBLE SORT ON FPGA

    Directory of Open Access Journals (Sweden)

    Dwi Marhaendro Jati Purnomo

    2016-06-01

    Full Text Available Sorting is common process in computational world. Its utilization are on many fields from research to industry. There are many sorting algorithm in nowadays. One of the simplest yet powerful is bubble sort. In this study, bubble sort is implemented on FPGA. The implementation was taken on serial and parallel approach. Serial and parallel bubble sort then compared by means of its memory, execution time, and utility which comprises slices and LUTs. The experiments show that serial bubble sort required smaller memory as well as utility compared to parallel bubble sort. Meanwhile, parallel bubble sort performed faster than serial bubble sort

  4. Stochastic modeling of a serial killer.

    Science.gov (United States)

    Simkin, M V; Roychowdhury, V P

    2014-08-21

    We analyze the time pattern of the activity of a serial killer, who during 12 years had murdered 53 people. The plot of the cumulative number of murders as a function of time is of "Devil's staircase" type. The distribution of the intervals between murders (step length) follows a power law with the exponent of 1.4. We propose a model according to which the serial killer commits murders when neuronal excitation in his brain exceeds certain threshold. We model this neural activity as a branching process, which in turn is approximated by a random walk. As the distribution of the random walk return times is a power law with the exponent 1.5, the distribution of the inter-murder intervals is thus explained. We illustrate analytical results by numerical simulation. Time pattern activity data from two other serial killers further substantiate our analysis. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. The Effect of Concurrent Semantic Categorization on Delayed Serial Recall

    Science.gov (United States)

    Acheson, Daniel J.; MacDonald, Maryellen C.; Postle, Bradley R.

    2011-01-01

    The influence of semantic processing on the serial ordering of items in short-term memory was explored using a novel dual-task paradigm. Participants engaged in 2 picture-judgment tasks while simultaneously performing delayed serial recall. List material varied in the presence of phonological overlap (Experiments 1 and 2) and in semantic content…

  6. Serial position markers in space: visuospatial priming of serial order working memory retrieval.

    Directory of Open Access Journals (Sweden)

    Maya De Belder

    Full Text Available Most general theories on serial order working memory (WM assume the existence of position markers that are bound to the to-be-remembered items to keep track of the serial order. So far, the exact cognitive/neural characteristics of these markers have remained largely underspecified, while direct empirical evidence for their existence is mostly lacking. In the current study we demonstrate that retrieval from verbal serial order WM can be facilitated or hindered by spatial cuing: begin elements of a verbal WM sequence are retrieved faster after cuing the left side of space, while end elements are retrieved faster after cuing the right side of space. In direct complement to our previous work--where we showed the reversed impact of WM retrieval on spatial processing--we argue that the current findings provide us with a crucial piece of evidence suggesting a direct and functional involvement of space in verbal serial order WM. We outline the idea that serial order in verbal WM is coded within a spatial coordinate system with spatial attention being involved when searching through WM, and we discuss how this account can explain several hallmark observations related to serial order WM.

  7. Serial thallium-201 imaging at rest in patients with unstable and stable angina pectoris: relationship of myocardial perfusion at rest to presenting clinical syndrome

    International Nuclear Information System (INIS)

    Brown, K.A.; Okada, R.D.; Boucher, C.A.; Phillips, H.R.; Strauss, H.W.; Pohost, G.M.

    1983-01-01

    In order to determine whether there are differences in myocardial perfusion at rest among patients with various unstable and stable angina syndromes, serial thallium-201 imaging was performed at rest in 19 patients presenting with rapidly worsening exertional angina (unstable angina, group A), 12 patients with rest angina alone without exertional symptoms (unstable angina, group B), and 34 patients with chronic stable angina. No patient had an episode of angina within 4 hours of study. Nineteen of 19 (100%) patients in group A demonstrated transient defects compared to only 3 of 12 (25%) patients in group B (p less than 0.0001) and 4 of 34 (12%) stable angina patients (p less than 0.0001). The majority of zones demonstrating transient defects in group A were associated with hypokinesis of the corresponding left ventriculogram segment without associated ECG evidence of previous infarction. There were no significant differences in the frequency of persistent thallium defects, severity of angiographic coronary artery disease, or frequency of regional wall motion abnormalities of myocardial segments supplied by stenotic coronary arteries among the three groups of patients. Transient defects have been shown to reflect reduction in regional coronary blood flow to viable myocardium. Therefore, we conclude that regional resting hypoperfusion of viable myocardium is far more common in patients with exertional unstable angina symptoms than in patients with rest angina alone or chronic stable angina

  8. SMALL SERIAL AND SERIAL PRODUCTION MANAGEMENT IN UNSTABLE DEMAND ENVIROUMENT

    Directory of Open Access Journals (Sweden)

    Tsomaeva I. V.

    2014-03-01

    Full Text Available The work presents the methodological approach to production program of the enterprise serial engineering for the current period in the conditions of uncertainty of demand. Here are two problems with this. The first is connected with the formation of the production program of the next quarter, year. Objective could be to stochastic programming, but this task is difficult. Therefore, in this paper we proposed a simple solution. On the basis of statistical historical information about the deviation of actual sales data products from predicted by Monte Carlo generated a lot of production programs. Fixed worst key performance (sales, profit etc. The difference between the values of the planned target and the settlement defines stochastic reserve, to be established at the expense of additional innovations. The second problem is connected with the formation of the production program production in the planned month, taking into account the creation of stocks of production in the conditions when for a short period of time is difficult to build a pattern of change in the quantity demanded by month for serial production, as in some months of the year the products are not produced nor sold. To justify the level of inventories of finished products is information on deviations from the fact plan for past periods. Built function of frequency distribution of the values of deviations. This allows you to further build the methodology for determining the level of production (taking into account the reserves and sales of products that deliver maximum economic effect from the sales in the conditions of a random process of realization of production.

  9. 'Serial review on clinical PET tracers'. Application of health insurance of [15O]oxygen PET and [18F]FDG-PET

    International Nuclear Information System (INIS)

    Torizuka, Kanji

    2009-01-01

    As regards the application required for health insurance of PET, the Ministry of Health, Labour and Welfare indicates the following procedures: first, request a permission to the Ministry of Health, Labour and Welfare for the clinical use of the automatic synthetic instrument for PET drug, approved according to the Pharmaceutical Affairs Law. Second, put into practice the use of PET test, under the highly advanced medicine premises. Then, in case of gathered positive results, the health insurance is approved for this PET test. Thus, following the above mentioned procedures, first, the use of [ 15 O] oxygen PET was approved in April 1996. Second, the use of [ 18 F]FDG-PET was approved in 12 different diseases: epilepsy, ischemic heart disease and 10 different types of cancer, in April 2002. Third, in April 2006, a additional 3 types of cancer were approved. Now, we are in the process to get the health insurance of all kinds of malignant tumors (cancer and sarcoma) except for the early gastric cancer. (author)

  10. Serial Network Flow Monitor

    Science.gov (United States)

    Robinson, Julie A.; Tate-Brown, Judy M.

    2009-01-01

    Using a commercial software CD and minimal up-mass, SNFM monitors the Payload local area network (LAN) to analyze and troubleshoot LAN data traffic. Validating LAN traffic models may allow for faster and more reliable computer networks to sustain systems and science on future space missions. Research Summary: This experiment studies the function of the computer network onboard the ISS. On-orbit packet statistics are captured and used to validate ground based medium rate data link models and enhance the way that the local area network (LAN) is monitored. This information will allow monitoring and improvement in the data transfer capabilities of on-orbit computer networks. The Serial Network Flow Monitor (SNFM) experiment attempts to characterize the network equivalent of traffic jams on board ISS. The SNFM team is able to specifically target historical problem areas including the SAMS (Space Acceleration Measurement System) communication issues, data transmissions from the ISS to the ground teams, and multiple users on the network at the same time. By looking at how various users interact with each other on the network, conflicts can be identified and work can begin on solutions. SNFM is comprised of a commercial off the shelf software package that monitors packet traffic through the payload Ethernet LANs (local area networks) on board ISS.

  11. Serial forced displacement in American cities, 1916-2010.

    Science.gov (United States)

    Fullilove, Mindy Thompson; Wallace, Rodrick

    2011-06-01

    Serial forced displacement has been defined as the repetitive, coercive upheaval of groups. In this essay, we examine the history of serial forced displacement in American cities due to federal, state, and local government policies. We propose that serial forced displacement sets up a dynamic process that includes an increase in interpersonal and structural violence, an inability to react in a timely fashion to patterns of threat or opportunity, and a cycle of fragmentation as a result of the first two. We present the history of the policies as they affected one urban neighborhood, Pittsburgh's Hill District. We conclude by examining ways in which this problematic process might be addressed.

  12. Use of microscopy techniques in failure analysis of the plastic injection molded parts to prevent the risks of serial defects in the assembly processes

    Directory of Open Access Journals (Sweden)

    Braga Ion Cristian

    2017-01-01

    Full Text Available Nowadays, the plastic injected molded parts are components used in the automobile for both exterior and interior. A mechatronic device uses those molded parts for actuating in order to reach some effect; therefore they should be durable and aesthetically satisfying the customer requirements. The aim of this paper is to present the use of microscopy techniques in failure analysis of plastic molded parts as part of a mechatronic device in order to prevent the risks of cracking occurred in the serial assembly production. Due to the constraints, the thin walls are used in some small plastic parts and they can be broken in the next assembly steps, but the detection of the defects is not facile. At the validation of the batch, the sampling parts are tested to simulate the breakage and the tear zone is investigated using microscopy techniques. The information is used as a feedback to adjust the injection parameters, reference samples being created by experiments to support the team to reduce the time for adjusting the parameters.

  13. Real-time monitoring of clinical processes using complex event processing and transition systems.

    Science.gov (United States)

    Meinecke, Sebastian

    2014-01-01

    Dependencies between tasks in clinical processes are often complex and error-prone. Our aim is to describe a new approach for the automatic derivation of clinical events identified via the behaviour of IT systems using Complex Event Processing. Furthermore we map these events on transition systems to monitor crucial clinical processes in real-time for preventing and detecting erroneous situations.

  14. Clinical Application of "The Change Process".

    Science.gov (United States)

    Thompson, Mary L.

    A change process described in the work of Yochelson and Samenow was adapted to students committed as delinquents to a state correctional facility. Their criminal profile accurately described the majority of the offenders. While minor problems continued, their frequency was reduced by as much as nine times. Serious incidents occurred only after the…

  15. Serial SPECT in children with partial epilepsy

    International Nuclear Information System (INIS)

    Hosoya, Machiko; Ushiku, Hideo

    1995-01-01

    We performed serial single-photon emission CT (SPECT) with N-isopropyl-p-( 123 I)-Iodoamphetamine to measure the regional cerebral blood flow (rCBF) in 15 children with partial epilepsy. SPECT showed focal changes in 14 cases. Ten cases had abnormalities in the initial SPECT and another four cases in the second test. The cases with normal rCBF in initial SPECT had been tested in an early phase after the onset, and then decreased rCBF were observed in the second SPECT. The cases with both abnormal rCBF in the initial SPECT and improved rCBF in the second SPECT showed good prognosis in clinico-electrophysiological evolutions. In cases with abnormal changes of rCBF in the second SPECT, clinical prognosis was found to be not so good. These findings suggest that serial SPECT may be used to follow the course of epilepsy. (author)

  16. Applying Statistical Process Control to Clinical Data: An Illustration.

    Science.gov (United States)

    Pfadt, Al; And Others

    1992-01-01

    Principles of statistical process control are applied to a clinical setting through the use of control charts to detect changes, as part of treatment planning and clinical decision-making processes. The logic of control chart analysis is derived from principles of statistical inference. Sample charts offer examples of evaluating baselines and…

  17. Attractive Serial Dependence in the Absence of an Explicit Task.

    Science.gov (United States)

    Fornaciai, Michele; Park, Joonkoo

    2018-03-01

    Attractive serial dependence refers to an adaptive change in the representation of sensory information, whereby a current stimulus appears to be similar to a previous one. The nature of this phenomenon is controversial, however, as serial dependence could arise from biased perceptual representations or from biased traces of working memory representation at a decisional stage. Here, we demonstrated a neural signature of serial dependence in numerosity perception emerging early in the visual processing stream even in the absence of an explicit task. Furthermore, a psychophysical experiment revealed that numerosity perception is biased by a previously presented stimulus in an attractive way, not by repulsive adaptation. These results suggest that serial dependence is a perceptual phenomenon starting from early levels of visual processing and occurring independently from a decision process, which is consistent with the view that these biases smooth out noise from neural signals to establish perceptual continuity.

  18. Fungal myositis in children: serial ultrasonographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Jung Hwa; Lee, Hee Jung; Choi, Jin Soo [Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2003-08-01

    To evaluate serial ultrasonographic findings of fungal myositis in children. Eleven lesions caused by fungal myositis and occurring in six children were included in this study. Eight lesions in five children were histopathologically proven and the other three were clinically diagnosed. Serial ultrasonographic findings were retrospectively evaluated in terms of size, location, margin, internal echotexture and adjacent cortical change occurring during the follow-up period ranging from five days to two months. Three patients (50%) had multiple lesions. The sites of involvment were the thigh (n=4), calf (n=3), chest wall (n=2), abdominal wall (n=1) and forearm (n=1). Initially, diffuse muscular swelling was revealed, with ill-defined hypoechoic lesions confined to the muscle layer (n=8). Follow-up examination of eight lesions over a period of 5-10 days showed that round central echogenic lesions were surrounded by previous slightly echogenic lesions (n=6, 75%). Long-term follow-up of five lesions over a two-month period revealed periosteal thickening in one case (20%), and the peristence of echogenic solid nodules in four (80%). Pathologic examination showed that the central lesions correlated with a fungus ball and the peripheral slightly echogenic lesions corresponded to hematoma and necrosis. Serial ultrasonographic findings of fungal myositis in children revealed relatively constant features in each case. In particular, the findings of muscular necrosis and a fungus ball over a period of 5-14 days were thought to be characteristic.

  19. Fungal myositis in children: serial ultrasonographic findings

    International Nuclear Information System (INIS)

    Kwon, Jung Hwa; Lee, Hee Jung; Choi, Jin Soo

    2003-01-01

    To evaluate serial ultrasonographic findings of fungal myositis in children. Eleven lesions caused by fungal myositis and occurring in six children were included in this study. Eight lesions in five children were histopathologically proven and the other three were clinically diagnosed. Serial ultrasonographic findings were retrospectively evaluated in terms of size, location, margin, internal echotexture and adjacent cortical change occurring during the follow-up period ranging from five days to two months. Three patients (50%) had multiple lesions. The sites of involvment were the thigh (n=4), calf (n=3), chest wall (n=2), abdominal wall (n=1) and forearm (n=1). Initially, diffuse muscular swelling was revealed, with ill-defined hypoechoic lesions confined to the muscle layer (n=8). Follow-up examination of eight lesions over a period of 5-10 days showed that round central echogenic lesions were surrounded by previous slightly echogenic lesions (n=6, 75%). Long-term follow-up of five lesions over a two-month period revealed periosteal thickening in one case (20%), and the peristence of echogenic solid nodules in four (80%). Pathologic examination showed that the central lesions correlated with a fungus ball and the peripheral slightly echogenic lesions corresponded to hematoma and necrosis. Serial ultrasonographic findings of fungal myositis in children revealed relatively constant features in each case. In particular, the findings of muscular necrosis and a fungus ball over a period of 5-14 days were thought to be characteristic

  20. Union Listing via OCLC's Serials Control Subsystem.

    Science.gov (United States)

    O'Malley, Terrence J.

    1984-01-01

    Describes library use of Conversion of Serials Project's (CONSER) online national machine-readable database for serials to create online union lists of serials via OCLC's Serial Control Subsystem. Problems in selection of appropriate, accurate, and authenticated records and prospects for the future are discussed. Twenty sources and sample records…

  1. Orienting and Onboarding Clinical Nurse Specialists: A Process Improvement Project.

    Science.gov (United States)

    Garcia, Mayra G; Watt, Jennifer L; Falder-Saeed, Karie; Lewis, Brennan; Patton, Lindsey

    Clinical nurse specialists (CNSs) have a unique advanced practice role. This article describes a process useful in establishing a comprehensive orientation and onboarding program for a newly hired CNS. The project team used the National Association of Clinical Nurse Specialists core competencies as a guide to construct a process for effectively onboarding and orienting newly hired CNSs. Standardized documents were created for the orientation process including a competency checklist, needs assessment template, and professional evaluation goals. In addition, other documents were revised to streamline the orientation process. Standardizing the onboarding and orientation process has demonstrated favorable results. As of 2016, 3 CNSs have successfully been oriented and onboarded using the new process. Unique healthcare roles require special focus when onboarding and orienting into a healthcare system. The use of the National Association of Clinical Nurse Specialists core competencies guided the project in establishing a successful orientation and onboarding process for newly hired CNSs.

  2. Animated-simulation modeling facilitates clinical-process costing.

    Science.gov (United States)

    Zelman, W N; Glick, N D; Blackmore, C C

    2001-09-01

    Traditionally, the finance department has assumed responsibility for assessing process costs in healthcare organizations. To enhance process-improvement efforts, however, many healthcare providers need to include clinical staff in process cost analysis. Although clinical staff often use electronic spreadsheets to model the cost of specific processes, PC-based animated-simulation tools offer two major advantages over spreadsheets: they allow clinicians to interact more easily with the costing model so that it more closely represents the process being modeled, and they represent cost output as a cost range rather than as a single cost estimate, thereby providing more useful information for decision making.

  3. A common type system for clinical natural language processing

    Directory of Open Access Journals (Sweden)

    Wu Stephen T

    2013-01-01

    Full Text Available Abstract Background One challenge in reusing clinical data stored in electronic medical records is that these data are heterogenous. Clinical Natural Language Processing (NLP plays an important role in transforming information in clinical text to a standard representation that is comparable and interoperable. Information may be processed and shared when a type system specifies the allowable data structures. Therefore, we aim to define a common type system for clinical NLP that enables interoperability between structured and unstructured data generated in different clinical settings. Results We describe a common type system for clinical NLP that has an end target of deep semantics based on Clinical Element Models (CEMs, thus interoperating with structured data and accommodating diverse NLP approaches. The type system has been implemented in UIMA (Unstructured Information Management Architecture and is fully functional in a popular open-source clinical NLP system, cTAKES (clinical Text Analysis and Knowledge Extraction System versions 2.0 and later. Conclusions We have created a type system that targets deep semantics, thereby allowing for NLP systems to encapsulate knowledge from text and share it alongside heterogenous clinical data sources. Rather than surface semantics that are typically the end product of NLP algorithms, CEM-based semantics explicitly build in deep clinical semantics as the point of interoperability with more structured data types.

  4. A common type system for clinical natural language processing.

    Science.gov (United States)

    Wu, Stephen T; Kaggal, Vinod C; Dligach, Dmitriy; Masanz, James J; Chen, Pei; Becker, Lee; Chapman, Wendy W; Savova, Guergana K; Liu, Hongfang; Chute, Christopher G

    2013-01-03

    One challenge in reusing clinical data stored in electronic medical records is that these data are heterogenous. Clinical Natural Language Processing (NLP) plays an important role in transforming information in clinical text to a standard representation that is comparable and interoperable. Information may be processed and shared when a type system specifies the allowable data structures. Therefore, we aim to define a common type system for clinical NLP that enables interoperability between structured and unstructured data generated in different clinical settings. We describe a common type system for clinical NLP that has an end target of deep semantics based on Clinical Element Models (CEMs), thus interoperating with structured data and accommodating diverse NLP approaches. The type system has been implemented in UIMA (Unstructured Information Management Architecture) and is fully functional in a popular open-source clinical NLP system, cTAKES (clinical Text Analysis and Knowledge Extraction System) versions 2.0 and later. We have created a type system that targets deep semantics, thereby allowing for NLP systems to encapsulate knowledge from text and share it alongside heterogenous clinical data sources. Rather than surface semantics that are typically the end product of NLP algorithms, CEM-based semantics explicitly build in deep clinical semantics as the point of interoperability with more structured data types.

  5. Additive manufactured serialization

    Science.gov (United States)

    Bobbitt, III, John T.

    2017-04-18

    Methods for forming an identifying mark in a structure are described. The method is used in conjunction with an additive manufacturing method and includes the alteration of a process parameter during the manufacturing process. The method can form in a unique identifying mark within or on the surface of a structure that is virtually impossible to be replicated. Methods can provide a high level of confidence that the identifying mark will remain unaltered on the formed structure.

  6. CAR-T cells are serial killers.

    Science.gov (United States)

    Davenport, Alexander J; Jenkins, Misty R; Ritchie, David S; Prince, H Miles; Trapani, Joseph A; Kershaw, Michael H; Darcy, Phillip K; Neeson, Paul J

    2015-12-01

    Chimeric antigen receptor (CAR) T cells have enjoyed unprecedented clinical success against haematological malignancies in recent years. However, several aspects of CAR T cell biology remain unknown. We recently compared CAR and T cell receptor (TCR)-based killing in the same effector cell and showed that CAR T cells can not only efficiently kill single tumor targets, they can also kill multiple tumor targets in a sequential manner. Single and serial killing events were not sustained long term due to CAR down-regulation after 20 hours.

  7. Serial murder: An unusual stereotype.

    Science.gov (United States)

    Sane, Mandar R; Mugadlimath, Anand B; Farooqui, Jamebaseer M; Janagond, Anand B; Mishra, Pradeep K

    2017-12-01

    Serial murders attract attention from the media, mental health experts, academia, and the general public. We present a case of serial murders that took place in a limited area and which caused public anxiety and anguish in central India. All the victims were homeless beggars, who were bludgeoned to death (crush injury). Individual murders were initially investigated by different police stations; fortunately, since they sent all the bodies to a common autopsy centre, a forensic pathologist was able to link all the cases, the first person to do so. This emphasises the need for sharing information among police stations and autopsy centres.

  8. Three more semantic serial position functions and a SIMPLE explanation.

    Science.gov (United States)

    Kelley, Matthew R; Neath, Ian; Surprenant, Aimée M

    2013-05-01

    There are innumerable demonstrations of serial position functions-with characteristic primacy and recency effects-in episodic tasks, but there are only a handful of such demonstrations in semantic memory tasks, and those demonstrations have used only two types of stimuli. Here, we provide three more examples of serial position functions when recalling from semantic memory. Participants were asked to reconstruct the order of (1) two cartoon theme song lyrics, (2) the seven Harry Potter books, and (3) two sets of movies, and all three demonstrations yielded conventional-looking serial position functions with primacy and recency effects. The data were well-fit by SIMPLE, a local distinctiveness model of memory that was originally designed to account for serial position effects in short- and long-term episodic memory. According to SIMPLE, serial position functions in both episodic and semantic memory tasks arise from the same type of processing: Items that are more separated from their close neighbors in psychological space at the time of recall will be better remembered. We argue that currently available evidence suggests that serial position functions observed when recalling items that are presumably in semantic memory arise because of the same processes as those observed when recalling items that are presumably in episodic memory.

  9. [Description of clinical thinking by the dual-process theory].

    Science.gov (United States)

    Peña G, Luis

    2012-06-01

    Clinical thinking is a very complex process that can be described by the dual-process theory, it has an intuitive part (that recognizes patterns) and an analytical part (that tests hypotheses). It is vulnerable to cognitive bias that professionals must be aware of, to minimize diagnostic errors.

  10. Errors in the Total Testing Process in the Clinical Chemistry ...

    African Journals Online (AJOL)

    2018-03-01

    Mar 1, 2018 ... testing processes impair the clinical decision-making process. Such errors are ... and external quality control exceeding the target range, (14.4%) and (51.4%) .... version 3.5.3 and transferred to Statistical. Package for the ...

  11. Process control analysis of IMRT QA: implications for clinical trials

    International Nuclear Information System (INIS)

    Pawlicki, Todd; Rice, Roger K; Yoo, Sua; Court, Laurence E; McMillan, Sharon K; Russell, J Donald; Pacyniak, John M; Woo, Milton K; Basran, Parminder S; Boyer, Arthur L; Bonilla, Claribel

    2008-01-01

    The purpose of this study is two-fold: first is to investigate the process of IMRT QA using control charts and second is to compare control chart limits to limits calculated using the standard deviation (σ). Head and neck and prostate IMRT QA cases from seven institutions in both academic and community settings are considered. The percent difference between the point dose measurement in phantom and the corresponding result from the treatment planning system (TPS) is used for analysis. The average of the percent difference calculations defines the accuracy of the process and is called the process target. This represents the degree to which the process meets the clinical goal of 0% difference between the measurements and TPS. IMRT QA process ability defines the ability of the process to meet clinical specifications (e.g. 5% difference between the measurement and TPS). The process ability is defined in two ways: (1) the half-width of the control chart limits, and (2) the half-width of ±3σ limits. Process performance is characterized as being in one of four possible states that describes the stability of the process and its ability to meet clinical specifications. For the head and neck cases, the average process target across institutions was 0.3% (range: -1.5% to 2.9%). The average process ability using control chart limits was 7.2% (range: 5.3% to 9.8%) compared to 6.7% (range: 5.3% to 8.2%) using standard deviation limits. For the prostate cases, the average process target across the institutions was 0.2% (range: -1.8% to 1.4%). The average process ability using control chart limits was 4.4% (range: 1.3% to 9.4%) compared to 5.3% (range: 2.3% to 9.8%) using standard deviation limits. Using the standard deviation to characterize IMRT QA process performance resulted in processes being preferentially placed in one of the four states. This is in contrast to using control charts for process characterization where the IMRT QA processes were spread over three of the

  12. Serial blood pressure measurements

    Directory of Open Access Journals (Sweden)

    N.R. Koehler

    2002-05-01

    Full Text Available The objective of the present investigation was to study the effects of a 60-s interval of venous congestion between two noninvasive measurements of arterial blood pressure (ABP on the fluctuation of ABP, assessed by the standard deviation of the differences between two readings. ABP was measured in 345 successive patients, at rest, four times each. For 269 participants, one pair of readings was obtained with a 60-s interval and the other pair without an interval. For 76 patients, the first pair was read at the same interval, and the second pair had venous congestion interposed and there was no waiting interval. There was no increased ABP oscillation, either when there was no interval between ABP readings, or when venous congestion was interposed compared to pairs of ABP measurements performed with a 60-s interval. There was no increase in ABP oscillations when successive ABP readings were taken without an interval or even with venous congestion interposed. Contrary to the present belief, there seems to be no loss of reliability when blood pressure recordings are taken immediately one after another, in the clinical setting.

  13. Energy Information Data Base: serial titles

    International Nuclear Information System (INIS)

    1980-06-01

    The Department of Energy Technical Information Center (TIC) is responsible for creating bibliographic data bases that are used in the announcement and retrieval of publications dealing with all phases of energy. The TIC interactive information processing system makes use of a number of computerized authorities so that consistency can be maintained and indexes can be produced. One such authority is the Energy Information Data Base: Serial Titles. This authority contains the full and abbreviated journal title, country of publication, CODEN, and certain codes. This revision replaces previous revisions of this document

  14. Rapid serial visual presentation design for cognition

    CERN Document Server

    Spence, Robert

    2013-01-01

    A powerful new image presentation technique has evolved over the last twenty years, and its value demonstrated through its support of many and varied common tasks. Conceptually, Rapid Serial Visual Presentation (RSVP) is basically simple, exemplified in the physical world by the rapid riffling of the pages of a book in order to locate a known image. Advances in computation and graphics processing allow RSVP to be applied flexibly and effectively to a huge variety of common tasks such as window shopping, video fast-forward and rewind, TV channel selection and product browsing. At its heart is a

  15. Processes for Quality Improvements in Radiation Oncology Clinical Trials

    International Nuclear Information System (INIS)

    FitzGerald, T.J.; Urie, Marcia; Ulin, Kenneth; Laurie, Fran; Yorty, Jeffrey C.; Hanusik, Richard; Kessel, Sandy; Jodoin, Maryann Bishop; Osagie, Gani; Cicchetti, M. Giulia; Pieters, Richard; McCarten, Kathleen; Rosen, Nancy

    2008-01-01

    Quality assurance in radiotherapy (RT) has been an integral aspect of cooperative group clinical trials since 1970. In early clinical trials, data acquisition was nonuniform and inconsistent and computational models for radiation dose calculation varied significantly. Process improvements developed for data acquisition, credentialing, and data management have provided the necessary infrastructure for uniform data. With continued improvement in the technology and delivery of RT, evaluation processes for target definition, RT planning, and execution undergo constant review. As we move to multimodality image-based definitions of target volumes for protocols, future clinical trials will require near real-time image analysis and feedback to field investigators. The ability of quality assurance centers to meet these real-time challenges with robust electronic interaction platforms for imaging acquisition, review, archiving, and quantitative review of volumetric RT plans will be the primary challenge for future successful clinical trials

  16. Visual form-processing deficits: a global clinical classification.

    Science.gov (United States)

    Unzueta-Arce, J; García-García, R; Ladera-Fernández, V; Perea-Bartolomé, M V; Mora-Simón, S; Cacho-Gutiérrez, J

    2014-10-01

    Patients who have difficulties recognising visual form stimuli are usually labelled as having visual agnosia. However, recent studies let us identify different clinical manifestations corresponding to discrete diagnostic entities which reflect a variety of deficits along the continuum of cortical visual processing. We reviewed different clinical cases published in medical literature as well as proposals for classifying deficits in order to provide a global perspective of the subject. Here, we present the main findings on the neuroanatomical basis of visual form processing and discuss the criteria for evaluating processing which may be abnormal. We also include an inclusive diagram of visual form processing deficits which represents the different clinical cases described in the literature. Lastly, we propose a boosted decision tree to serve as a guide in the process of diagnosing such cases. Although the medical community largely agrees on which cortical areas and neuronal circuits are involved in visual processing, future studies making use of new functional neuroimaging techniques will provide more in-depth information. A well-structured and exhaustive assessment of the different stages of visual processing, designed with a global view of the deficit in mind, will give a better idea of the prognosis and serve as a basis for planning personalised psychostimulation and rehabilitation strategies. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  17. Tevatron serial data repeater system

    International Nuclear Information System (INIS)

    Ducar, R.J.

    1981-01-01

    A ten megabit per second serial data repeater system has been developed for the 6.28km Tevatron accelerator. The repeaters are positioned at each of the thirty service buildings and accommodate control and abort system communications as well as distribution of the Tevatron time and energy clocks. The repeaters are transparent to the particular protocol of the transmissions. Serial data are encoded locally as unipolar two volt signals employing the self-clocking Manchester Bi-Phase code. The repeaters modulate the local signals to low-power bursts of 50 MHz rf carrier for the 260m transmission between service buildings. The repeaters also demodulate the transmission and restructure the data for local utilization. The employment of frequency discrimination techniques yields high immunity to the characteristic noise spectrum

  18. Nanoflow electrospinning serial femtosecond crystallography

    Energy Technology Data Exchange (ETDEWEB)

    Sierra, Raymond G.; Laksmono, Hartawan [SLAC National Accelerator Laboratory, Menlo Park, CA 94025 (United States); Kern, Jan [Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); SLAC National Accelerator Laboratory, Menlo Park, CA 94025 (United States); Tran, Rosalie; Hattne, Johan [Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Alonso-Mori, Roberto [SLAC National Accelerator Laboratory, Menlo Park, CA 94025 (United States); Lassalle-Kaiser, Benedikt [Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Glöckner, Carina; Hellmich, Julia [Technische Universität Berlin, Strasse des 17 Juni 135, 10623 Berlin (Germany); Schafer, Donald W. [SLAC National Accelerator Laboratory, Menlo Park, CA 94025 (United States); Echols, Nathaniel; Gildea, Richard J.; Grosse-Kunstleve, Ralf W. [Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Sellberg, Jonas [SLAC National Accelerator Laboratory, Menlo Park, CA 94025 (United States); Stockholm University, S-106 91 Stockholm (Sweden); McQueen, Trevor A. [Stanford University, Stanford, CA 94025 (United States); Fry, Alan R.; Messerschmidt, Marc M.; Miahnahri, Alan; Seibert, M. Marvin; Hampton, Christina Y.; Starodub, Dmitri; Loh, N. Duane; Sokaras, Dimosthenis; Weng, Tsu-Chien [SLAC National Accelerator Laboratory, Menlo Park, CA 94025 (United States); Zwart, Petrus H. [Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Glatzel, Pieter [European Synchrotron Radiation Facility, Grenoble (France); Milathianaki, Despina; White, William E. [SLAC National Accelerator Laboratory, Menlo Park, CA 94025 (United States); Adams, Paul D. [Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Williams, Garth J.; Boutet, Sébastien [SLAC National Accelerator Laboratory, Menlo Park, CA 94025 (United States); Zouni, Athina [Technische Universität Berlin, Strasse des 17 Juni 135, 10623 Berlin (Germany); Messinger, Johannes [Umeå Universitet, Umeå (Sweden); Sauter, Nicholas K. [Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Bergmann, Uwe [SLAC National Accelerator Laboratory, Menlo Park, CA 94025 (United States); Yano, Junko; Yachandra, Vittal K. [Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Bogan, Michael J., E-mail: mbogan@slac.stanford.edu [SLAC National Accelerator Laboratory, Menlo Park, CA 94025 (United States); SLAC National Accelerator Laboratory, Menlo Park, CA 94025 (United States)

    2012-11-01

    A low flow rate liquid microjet method for delivery of hydrated protein crystals to X-ray lasers is presented. Linac Coherent Light Source data demonstrates serial femtosecond protein crystallography with micrograms, a reduction of sample consumption by orders of magnitude. An electrospun liquid microjet has been developed that delivers protein microcrystal suspensions at flow rates of 0.14–3.1 µl min{sup −1} to perform serial femtosecond crystallography (SFX) studies with X-ray lasers. Thermolysin microcrystals flowed at 0.17 µl min{sup −1} and diffracted to beyond 4 Å resolution, producing 14 000 indexable diffraction patterns, or four per second, from 140 µg of protein. Nanoflow electrospinning extends SFX to biological samples that necessitate minimal sample consumption.

  19. Nanoflow electrospinning serial femtosecond crystallography

    International Nuclear Information System (INIS)

    Sierra, Raymond G.; Laksmono, Hartawan; Kern, Jan; Tran, Rosalie; Hattne, Johan; Alonso-Mori, Roberto; Lassalle-Kaiser, Benedikt; Glöckner, Carina; Hellmich, Julia; Schafer, Donald W.; Echols, Nathaniel; Gildea, Richard J.; Grosse-Kunstleve, Ralf W.; Sellberg, Jonas; McQueen, Trevor A.; Fry, Alan R.; Messerschmidt, Marc M.; Miahnahri, Alan; Seibert, M. Marvin; Hampton, Christina Y.; Starodub, Dmitri; Loh, N. Duane; Sokaras, Dimosthenis; Weng, Tsu-Chien; Zwart, Petrus H.; Glatzel, Pieter; Milathianaki, Despina; White, William E.; Adams, Paul D.; Williams, Garth J.; Boutet, Sébastien; Zouni, Athina; Messinger, Johannes; Sauter, Nicholas K.; Bergmann, Uwe; Yano, Junko; Yachandra, Vittal K.; Bogan, Michael J.

    2012-01-01

    A low flow rate liquid microjet method for delivery of hydrated protein crystals to X-ray lasers is presented. Linac Coherent Light Source data demonstrates serial femtosecond protein crystallography with micrograms, a reduction of sample consumption by orders of magnitude. An electrospun liquid microjet has been developed that delivers protein microcrystal suspensions at flow rates of 0.14–3.1 µl min −1 to perform serial femtosecond crystallography (SFX) studies with X-ray lasers. Thermolysin microcrystals flowed at 0.17 µl min −1 and diffracted to beyond 4 Å resolution, producing 14 000 indexable diffraction patterns, or four per second, from 140 µg of protein. Nanoflow electrospinning extends SFX to biological samples that necessitate minimal sample consumption

  20. Serial killer: il database mondiale

    Directory of Open Access Journals (Sweden)

    Gaetano parente

    2016-07-01

    Full Text Available The complex and multisided study of serial killers is partly made difficult by the current level of progress that has led these deviant people to evolve in relation to the aspects of shrewdness (concerning the staging and mobility. Despite the important work of some scholars who proposed important theories, all this shows that, concerning serial murders, it is still particularly frequent not to pay attention to links among homicides committed by the same person but in different parts of the world. It is therefore crucial to develop a worldwide database that allows all police forces to access information collected on crime scenes of murders which are particularly absurd and committed without any apparent reason. It will then be up to the profiler, through ad hoc and technologically advanced tools, to collect this information on the crime scene that would be made available to all police forces thanks to the worldwide database.

  1. Notorious Cases of Serial Killers

    Directory of Open Access Journals (Sweden)

    Iosub Elena-Cătălina

    2014-05-01

    Full Text Available The reconstruction of a death scene provides an overall picture of the crime and will indicate the murder as an event or one of a series of events and also the criminal. But when the criminal is declared a serial killer, many questions are raised up. How could a person kill some else without a reason or why people react in such a disorganized way and become so brutal or what made them act like that and so many questions with also so many answers. This project explains the psychology of a murderer, his own way of thinking and acting by presuming that we may accurately discover what is in their minds when they kill. It is about a very complex issue regarding murder investigations, biological factors and psychological profile of a serial killer. Dealing with this problem we will at last reach to the question that could solve finally the puzzle: ―Are serial murderers distorted reflections of society's own values?

  2. Serial murder by healthcare professionals.

    Science.gov (United States)

    Yorker, Beatrice Crofts; Kizer, Kenneth W; Lampe, Paula; Forrest, A R W; Lannan, Jacquetta M; Russell, Donna A

    2008-01-01

    The prosecution of Charles Cullen, a nurse who killed at least 40 patients over a 16-year period, highlights the need to better understand the phenomenon of serial murder by healthcare professionals. The authors conducted a LexisNexis search which yielded 90 criminal prosecutions of healthcare providers that met inclusion criteria for serial murder of patients. In addition we reviewed epidemiologic studies, toxicology evidence, and court transcripts, to provide data on healthcare professionals who have been prosecuted between 1970 and 2006. Fifty-four of the 90 have been convicted; 45 for serial murder, four for attempted murder, and five pled guilty to lesser charges. Twenty-four more have been indicted and are either awaiting trial or the outcome has not been published. The other 12 prosecutions had a variety of legal outcomes. Injection was the main method used by healthcare killers followed by suffocation, poisoning, and tampering with equipment. Prosecutions were reported from 20 countries with 40% taking place in the United States. Nursing personnel comprised 86% of the healthcare providers prosecuted; physicians 12%, and 2% were allied health professionals. The number of patient deaths that resulted in a murder conviction is 317 and the number of suspicious patient deaths attributed to the 54 convicted caregivers is 2113. These numbers are disturbing and demand that systemic changes in tracking adverse patient incidents associated with presence of a specific healthcare provider be implemented. Hiring practices must shift away from preventing wrongful discharge or denial of employment lawsuits to protecting patients from employees who kill.

  3. Semantic processing of EHR data for clinical research.

    Science.gov (United States)

    Sun, Hong; Depraetere, Kristof; De Roo, Jos; Mels, Giovanni; De Vloed, Boris; Twagirumukiza, Marc; Colaert, Dirk

    2015-12-01

    There is a growing need to semantically process and integrate clinical data from different sources for clinical research. This paper presents an approach to integrate EHRs from heterogeneous resources and generate integrated data in different data formats or semantics to support various clinical research applications. The proposed approach builds semantic data virtualization layers on top of data sources, which generate data in the requested semantics or formats on demand. This approach avoids upfront dumping to and synchronizing of the data with various representations. Data from different EHR systems are first mapped to RDF data with source semantics, and then converted to representations with harmonized domain semantics where domain ontologies and terminologies are used to improve reusability. It is also possible to further convert data to application semantics and store the converted results in clinical research databases, e.g. i2b2, OMOP, to support different clinical research settings. Semantic conversions between different representations are explicitly expressed using N3 rules and executed by an N3 Reasoner (EYE), which can also generate proofs of the conversion processes. The solution presented in this paper has been applied to real-world applications that process large scale EHR data. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. [Description of the mental processes occurring during clinical reasoning].

    Science.gov (United States)

    Pottier, P; Planchon, B

    2011-06-01

    Clinical reasoning is a highly complex system with multiple inter-dependent mental activities. Gaining a better understanding of those cognitive processes has two practical implications: for physicians, being able to analyse their own reasoning method may prove to be helpful in diagnostic dead end; for medical teachers, identifying problem-solving strategies used by medical students may foster an appropriate individual feed-back aiming at improving their clinical reasoning skills. On the basis of a detailed literature review, the main diagnostic strategies and their related pattern of mental processes are described and illustrated with a concrete example, going from the patient's complaint to the chosen solution. Inductive, abductive and deductive diagnostic approaches are detailed. Different strategies for collecting data (exhaustive or oriented) and for problem-building are described. The place of problem solving strategies such as pattern-recognition, scheme inductive process, using of clinical script, syndrome grouping and mental hypotheses test is considered. This work aims at breaking up mental activities in process within clinical reasoning reminding that expert reasoning is characterised by the ability to use and structure the whole of these activities in a coherent system, using combined strategies in order to guarantee a better accuracy of their diagnosis. Copyright © 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  5. Galileo - The Serial-Production AIT Challenge

    Science.gov (United States)

    Ragnit, Ulrike; Brunner, Otto

    2008-01-01

    The Galileo Project is one of the most demanding projects of ESA, being Europe's autarkic navigation system and a constellation composed of 30 satellites. This presentation points out the different phases of the project up to the full operational capability and the corresponding launch options with respect to launch vehicles as well as launch configurations. One of the biggest challenges is to set up a small serial 'production line' for the overall integration and test campaign of satellites. This production line demands an optimization of all relevant tasks, taking into account also backup and recovery actions. A comprehensive AIT concept is required, reflecting a tightly merged facility layout and work flow design. In addition a common data management system is needed to handle all spacecraft related documentation and to have a direct input-out flow for all activities, phases and positions at the same time. Process optimization is a well known field of engineering in all small high tech production lines, nevertheless serial production of satellites are still not the daily task in space business and therefore new concepts have to be put in place. Therefore, and in order to meet the satellites overall system optimization, a thorough interface between unit/subsystem manufacturing and satellite AIT must be realized to ensure a smooth flow and to avoid any process interruption, which would directly lead to a schedule impact.

  6. Quick, sensitive serial NMR experiments with Radon transform.

    Science.gov (United States)

    Dass, Rupashree; Kasprzak, Paweł; Kazimierczuk, Krzysztof

    2017-09-01

    The Radon transform is a potentially powerful tool for processing the data from serial spectroscopic experiments. It makes it possible to decode the rate at which frequencies of spectral peaks shift under the effect of changing conditions, such as temperature, pH, or solvent. In this paper we show how it also improves speed and sensitivity, especially in multidimensional experiments. This is particularly important in the case of low-sensitivity techniques, such as NMR spectroscopy. As an example, we demonstrate how Radon transform processing allows serial measurements of 15 N-HSQC spectra of unlabelled peptides that would otherwise be infeasible. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Improving a Dental School's Clinic Operations Using Lean Process Improvement.

    Science.gov (United States)

    Robinson, Fonda G; Cunningham, Larry L; Turner, Sharon P; Lindroth, John; Ray, Deborah; Khan, Talib; Yates, Audrey

    2016-10-01

    The term "lean production," also known as "Lean," describes a process of operations management pioneered at the Toyota Motor Company that contributed significantly to the success of the company. Although developed by Toyota, the Lean process has been implemented at many other organizations, including those in health care, and should be considered by dental schools in evaluating their clinical operations. Lean combines engineering principles with operations management and improvement tools to optimize business and operating processes. One of the core concepts is relentless elimination of waste (non-value-added components of a process). Another key concept is utilization of individuals closest to the actual work to analyze and improve the process. When the medical center of the University of Kentucky adopted the Lean process for improving clinical operations, members of the College of Dentistry trained in the process applied the techniques to improve inefficient operations at the Walk-In Dental Clinic. The purpose of this project was to reduce patients' average in-the-door-to-out-the-door time from over four hours to three hours within 90 days. Achievement of this goal was realized by streamlining patient flow and strategically relocating key phases of the process. This initiative resulted in patient benefits such as shortening average in-the-door-to-out-the-door time by over an hour, improving satisfaction by 21%, and reducing negative comments by 24%, as well as providing opportunity to implement the electronic health record, improving teamwork, and enhancing educational experiences for students. These benefits were achieved while maintaining high-quality patient care with zero adverse outcomes during and two years following the process improvement project.

  8. Non tumoral intracranial expansive processes: clinical tomographic correlation

    International Nuclear Information System (INIS)

    Campos, P.; Herrera, G.; Valneica, F.

    1991-01-01

    Presentation of clinical-tomographic correlation in 111 cases of non tumoral intracranial expansive processes seen between 1984-1988 in the Hospital Cayetano Heredia (Lima, Peru). Emphasis is given fundamentally to: the importance of establishing the organicity of partial and late epilepsy; the high incidence rate of inflammatory infectious processes with CNS compromise in under developing countries; the necessity of making public the importance of two parasitic diseases in the differential diagnosis of non tumoral intracranial expansive processes: free living amebiasis, and toxoplasmosis (especially in association with AIDS). (author)

  9. The relationship between serial sexual murder and autoerotic asphyxiation.

    Science.gov (United States)

    Myers, Wade C; Bukhanovskiy, Alexandr; Justen, Elle; Morton, Robert J; Tilley, John; Adams, Kenneth; Vandagriff, Virgil L; Hazelwood, Robert R

    2008-04-07

    This case series documents and examines the association between autoerotic asphyxiation, sadomasochism, and serial sexual murderers. Autoerotic asphyxiation, along with other paraphilias found in this population, is reviewed. Five cases of serial sexual killers who engaged in autoerotic asphyxiation were identified worldwide: four from the United States and one from Russia. Case reports for each are provided. All (100%) were found to have sexual sadism in addition to autoerotic asphyxiation. Furthermore, two (40%) had bondage fetishism, and two (40%) had transvestic fetishism, consistent with these paraphilias co-occurring in those with autoerotic asphyxiation. Overall the group averaged 4.0 lifetime paraphilias. Some possible relationships were observed between the offenders' paraphilic orientation and their modus operandi, e.g., all of these serial killers strangled victims-suggesting an association between their sadistic and asphyxiative paraphilic interests. The overlap of seemingly polar opposite paraphilias in this sample--sexual sadism and autoerotic asphyxiation--is explored from a historical and clinical perspective. Multiple commonalities shared between these five offenders and serial sexual murderers in general are addressed. A primary limitation of this study is its small sample size and empirical basis; the results may not be generalizable beyond the sample. The findings from this study support the supposition that crime scene behaviors often reflect paraphilic disturbances in those who commit serial sexual homicides.

  10. Fostering new relational experience: clinical process in couple psychotherapy.

    Science.gov (United States)

    Marmarosh, Cheri L

    2014-03-01

    One of the most critical goals for couple psychotherapy is to foster a new relational experience in the session where the couple feels safe enough to reveal more vulnerable emotions and to explore their defensive withdrawal, aggressive attacking, or blaming. The lived intimate experience in the session offers the couple an opportunity to gain integrative insight into their feelings, expectations, and behaviors that ultimately hinder intimacy. The clinical processes that are necessary include empathizing with the couple and facilitating safety within the session, looking for opportunities to explore emotions, ruptures, and unconscious motivations that maintain distance in the relationship, and creating a new relational experience in the session that has the potential to engender integrative insight. These clinical processes will be presented with empirical support. Experts from a session will be used to highlight how these processes influence the couple and promote increased intimacy. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  11. A Typology for Modeling Processes in Clinical Guidelines and Protocols

    Science.gov (United States)

    Tu, Samson W.; Musen, Mark A.

    We analyzed the graphical representations that are used by various guideline-modeling methods to express process information embodied in clinical guidelines and protocols. From this analysis, we distilled four modeling formalisms and the processes they typically model: (1) flowcharts for capturing problem-solving processes, (2) disease-state maps that link decision points in managing patient problems over time, (3) plans that specify sequences of activities that contribute toward a goal, (4) workflow specifications that model care processes in an organization. We characterized the four approaches and showed that each captures some aspect of what a guideline may specify. We believe that a general guideline-modeling system must provide explicit representation for each type of process.

  12. Serial position learning in honeybees.

    Directory of Open Access Journals (Sweden)

    Randolf Menzel

    Full Text Available Learning of stimulus sequences is considered as a characteristic feature of episodic memory since it contains not only a particular item but also the experience of preceding and following events. In sensorimotor tasks resembling navigational performance, the serial order of objects is intimately connected with spatial order. Mammals and birds develop episodic(-like memory in serial spatio-temporal tasks, and the honeybee learns spatio-temporal order when navigating between the nest and a food source. Here I examine the structure of the bees' memory for a combined spatio-temporal task. I ask whether discrimination and generalization are based solely on simple forms of stimulus-reward learning or whether they require sequential configurations. Animals were trained to fly either left or right in a continuous T-maze. The correct choice was signaled by the sequence of colors (blue, yellow at four positions in the access arm. If only one of the possible 4 signals is shown (either blue or yellow, the rank order of position salience is 1, 2 and 3 (numbered from T-junction. No learning is found if the signal appears at position 4. If two signals are shown, differences at positions 1 and 2 are learned best, those at position 3 at a low level, and those at position 4 not at all. If three or more signals are shown these results are corroborated. This salience rank order again appeared in transfer tests, but additional configural phenomena emerged. Most of the results can be explained with a simple model based on the assumption that the four positions are equipped with different salience scores and that these add up independently. However, deviations from the model are interpreted by assuming stimulus configuration of sequential patterns. It is concluded that, under the conditions chosen, bees rely most strongly on memories developed during simple forms of associative reward learning, but memories of configural serial patterns contribute, too.

  13. Nanoflow electrospinning serial femtosecond crystallography

    Science.gov (United States)

    Sierra, Raymond G.; Laksmono, Hartawan; Kern, Jan; Tran, Rosalie; Hattne, Johan; Alonso-Mori, Roberto; Lassalle-Kaiser, Benedikt; Glöckner, Carina; Hellmich, Julia; Schafer, Donald W.; Echols, Nathaniel; Gildea, Richard J.; Grosse-Kunstleve, Ralf W.; Sellberg, Jonas; McQueen, Trevor A.; Fry, Alan R.; Messerschmidt, Marc M.; Miahnahri, Alan; Seibert, M. Marvin; Hampton, Christina Y.; Starodub, Dmitri; Loh, N. Duane; Sokaras, Dimosthenis; Weng, Tsu-Chien; Zwart, Petrus H.; Glatzel, Pieter; Milathianaki, Despina; White, William E.; Adams, Paul D.; Williams, Garth J.; Boutet, Sébastien; Zouni, Athina; Messinger, Johannes; Sauter, Nicholas K.; Bergmann, Uwe; Yano, Junko; Yachandra, Vittal K.; Bogan, Michael J.

    2012-01-01

    An electrospun liquid microjet has been developed that delivers protein microcrystal suspensions at flow rates of 0.14–3.1 µl min−1 to perform serial femtosecond crystallography (SFX) studies with X-ray lasers. Thermolysin microcrystals flowed at 0.17 µl min−1 and diffracted to beyond 4 Å resolution, producing 14 000 indexable diffraction patterns, or four per second, from 140 µg of protein. Nanoflow electrospinning extends SFX to biological samples that necessitate minimal sample consumption. PMID:23090408

  14. Auditory distraction and serial memory: The avoidable and the ineluctable

    Directory of Open Access Journals (Sweden)

    Dylan M Jones

    2010-01-01

    Full Text Available One mental activity that is very vulnerable to auditory distraction is serial recall. This review of the contemporary findings relating to serial recall charts the key determinants of distraction. It is evident that there is one form of distraction that is a joint product of the cognitive characteristics of the task and of the obligatory cognitive processing of the sound. For sequences of sound, distraction appears to be an ineluctable product of similarity-of-process, specifically, the serial order processing of the visually presented items and the serial order coding that is the by-product of the streaming of the sound. However, recently emerging work shows that the distraction from a single sound (one deviating from a prevailing sequence results in attentional capture and is qualitatively distinct from that of a sequence in being restricted in its action to encoding, not to rehearsal of list members. Capture is also sensitive to the sensory task load, suggesting that it is subject to top-down control and therefore avoidable. These two forms of distraction-conflict of process and attentional capture-may be two consequences of auditory perceptual organization processes that serve to strike the optimal balance between attentional selectivity and distractability.

  15. Hemispatial neglect and serial order in verbal working memory.

    Science.gov (United States)

    Antoine, Sophie; Ranzini, Mariagrazia; van Dijck, Jean-Philippe; Slama, Hichem; Bonato, Mario; Tousch, Ann; Dewulf, Myrtille; Bier, Jean-Christophe; Gevers, Wim

    2018-01-09

    Working memory refers to our ability to actively maintain and process a limited amount of information during a brief period of time. Often, not only the information itself but also its serial order is crucial for good task performance. It was recently proposed that serial order is grounded in spatial cognition. Here, we compared performance of a group of right hemisphere-damaged patients with hemispatial neglect to healthy controls in verbal working memory tasks. Participants memorized sequences of consonants at span level and had to judge whether a target consonant belonged to the memorized sequence (item task) or whether a pair of consonants were presented in the same order as in the memorized sequence (order task). In line with this idea that serial order is grounded in spatial cognition, we found that neglect patients made significantly more errors in the order task than in the item task compared to healthy controls. Furthermore, this deficit seemed functionally related to neglect severity and was more frequently observed following right posterior brain damage. Interestingly, this specific impairment for serial order in verbal working memory was not lateralized. We advance the hypotheses of a potential contribution to the deficit of serial order in neglect patients of either or both (1) reduced spatial working memory capacity that enables to keep track of the spatial codes that provide memorized items with a positional context, (2) a spatial compression of these codes in the intact representational space. © 2018 The British Psychological Society.

  16. Adaptive digital image processing in real time: First clinical experiences

    International Nuclear Information System (INIS)

    Andre, M.P.; Baily, N.A.; Hier, R.G.; Edwards, D.K.; Tainer, L.B.; Sartoris, D.J.

    1986-01-01

    The promise of computer image processing has generally not been realized in radiology, partly because the methods advanced to date have been expensive, time-consuming, or inconvenient for clinical use. The authors describe a low-cost system which performs complex image processing operations on-line at video rates. The method uses a combination of unsharp mask subtraction (for low-frequency suppression) and statistical differencing (which adjusts the gain at each point of the image on the basis of its variation from a local mean). The operator interactively adjusts aperture size, contrast gain, background subtraction, and spatial noise reduction. The system is being evaluated for on-line fluoroscopic enhancement, for which phantom measurements and clinical results, including lithotripsy, are presented. When used with a video camera, postprocessing of radiographs was advantageous in a variety of studies, including neonatal chest studies. Real-time speed allows use of the system in the reading room as a ''variable view box.''

  17. Which Parts of a Clinical Process EPR Needs Special Configuration

    DEFF Research Database (Denmark)

    Barlach, Anders; Simonsen, Jesper

    2007-01-01

    Subject: Which parts of an electronic patient record (EPR) can initially form a stable standard solution to be used by all clinicians? And which parts of an EPR can we predict needs initial as well as on-going re-configuration to meet the needs from diverse medical specialties. Purpose: To analyze...... which screen types in a clinical process that can be standard configured and which are subject to initial as well as on-going re-configuration. Methods and results: A pilot-project implementing a fully functional clinical process EPR was configured and used at a neurological ward, replacing all paper...... records 24/7. The analysis characterizes the different types of screens, a total of 243 included in the EPR solution. All screens have been extracted from the application and analyzed for changes – in total 222 changes. Discussion and conclusion: Most screens (87%) are very stable. Few (13%) are subjected...

  18. Detecting fast, online reasoning processes in clinical decision making.

    Science.gov (United States)

    Flores, Amanda; Cobos, Pedro L; López, Francisco J; Godoy, Antonio

    2014-06-01

    In an experiment that used the inconsistency paradigm, experienced clinical psychologists and psychology students performed a reading task using clinical reports and a diagnostic judgment task. The clinical reports provided information about the symptoms of hypothetical clients who had been previously diagnosed with a specific mental disorder. Reading times of inconsistent target sentences were slower than those of control sentences, demonstrating an inconsistency effect. The results also showed that experienced clinicians gave different weights to different symptoms according to their relevance when fluently reading the clinical reports provided, despite the fact that all the symptoms were of equal diagnostic value according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000). The diagnostic judgment task yielded a similar pattern of results. In contrast to previous findings, the results of the reading task may be taken as direct evidence of the intervention of reasoning processes that occur very early, rapidly, and online. We suggest that these processes are based on the representation of mental disorders and that these representations are particularly suited to fast retrieval from memory and to making inferences. They may also be related to the clinicians' causal reasoning. The implications of these results for clinician training are also discussed.

  19. Characteristics of Volunteer Coaches in a Clinical Process Improvement Program.

    Science.gov (United States)

    Morley, Katharine E; Barysauskas, Constance M; Carballo, Victoria; Kalibatas, Orinta; Rao, Sandhya K; Jacobson, Joseph O; Cummings, Brian M

    The Partners Clinical Process Improvement Leadership Program provides quality improvement training for clinicians and administrators, utilizing graduates as volunteer peer coaches for mentorship. We sought to understand the factors associated with volunteer coach participation and gain insight into how to improve and sustain this program. Review of coach characteristics from course database and survey of frequent coaches. Out of 516 Partners Clinical Process Improvement Leadership Program graduates from March 2010 to June 2015, 117 (23%) individuals volunteered as coaches. Sixty-one (52%) individuals coached once, 31 (27%) coached twice, and 25 (21%) coached 3 or more times. There were statistically significant associations between coaching and occupation (P = .005), Partners Clinical Process Improvement Leadership Program course taken (P = .001), and course location (P = .007). Administrators were more likely to coach than physicians (odds ratio: 1.75, P = .04). Reasons for volunteering as a coach included further development of skills, desire to stay involved with program, and enjoying mentoring. Reasons for repeated coaching included maintaining quality improvement skills, expanding skills to a wider variety of projects, and networking. A peer graduate volunteer coach model is a viable strategy for interprofessional quality improvement mentorship. Strategies that support repeat coaching and engage clinicians should be promoted to ensure an experienced and diversified group of coaches.

  20. The Process of Clinical Reasoning among Medical Students

    Directory of Open Access Journals (Sweden)

    Djon Machado Lopes

    Full Text Available ABSTRACT Introduction: Research in the field of medical reasoning has shed light on the reasoning process used by medical students. The strategies in this process are related to the analytical [hypothetical-deductive (HD] and nonanalytic [scheme-inductive (SI] systems, and pattern recognition (PR]. Objective: To explore the clinical reasoning process of students from the fifth year of medical school at the end of the clinical cycle of medical internship, and to identify the strategies used in preparing diagnostic hypotheses, knowledge organization and content. Method: Qualitative research conducted in 2014 at a Brazilian public university with medical interns. Following Stamm's method, a case in internal medicine (IM was built based on the theory of prototypes (Group 1 = 47 interns, in which the interns listed, according to their own perceptions, the signs, symptoms, syndromes, and diseases typical of internal medicine. This case was used for evaluating the clinical reasoning process of Group 2 (30 students = simple random sample obtained with the "think aloud" process. The verbalizations were transcribed and evaluated by Bardin's thematic analysis. The content analysis were approved by two experts at the beginning and at the end of the analysis process. Results: The interns developed 164 primary and secondary hypotheses when solving the case. The SI strategy prevailed with 48.8%, followed by PR (35.4%, HD (12.2%, and mixed (1.8 % each: SI + HD and HD + PR. The students built 146 distinct semantic axes, resulting in an average of 4.8/ participant. During the analysis, 438 interpretation processes were executed (average of 14.6/participant, and 124 combination processes (average of 4.1/participant. Conclusions: The nonanalytic strategies prevailed with the PR being the most used in the development of primary hypotheses (46.8% and the SI in secondary hypotheses (93%. The interns showed a strong semantic network and did three and a half times more

  1. [Clinical application of artificial condylar process for reconstructing temporomandibular joint].

    Science.gov (United States)

    Huang, Xiangdao; Shao, Zhanying; Wang, Fasheng; Duan, Yi

    2012-01-01

    To assess the feasibility and clinical outcomes of artificial condylar process in reconstruction of the temporomandibular joint. Between January 2005 and January 2010, the reconstructions of the temporomandibular joints with artificial condylar process were performed in 10 cases (11 sides, including 7 left sides and 4 right sides). There were 7 males and 3 females with an average age of 50 years (range, 40-68 years). Mandibular condyle defects were caused by mandible tumor in 7 patients with a mean disease duration of 15 months (range, 9-24 months) and by bilateral condylar fractures in 3 patients with the disease duration of 2, 3, and 2 days respectively. According to Neff classification, there were type M and A in 1 case, type M and B in 1 case, and type M in one side and subcondylar fracture in the other side in 1 case. Incisions in all patients healed by first intention, and no complication occurred. All cases were followed up 1 to 4 years, showed facial symmetry and good occluding relation, and the mouth opening was 22-38 mm (mean, 30 mm). No temporomandibular joint clicking or pain and no recurrence of tumor were observed. Most of the artificial condylar process were in good position except 1 deviated from the correct angle slightly. All the patients could have diet normally. The results of temporomandibular joint reconstruction after tumor resection with artificial condylar process are good, but the clinical outcome for intracapsular condylar fracture is expected to be further verified.

  2. A comparison of serial order short-term memory effects across verbal and musical domains.

    Science.gov (United States)

    Gorin, Simon; Mengal, Pierre; Majerus, Steve

    2018-04-01

    Recent studies suggest that the mechanisms involved in the short-term retention of serial order information may be shared across short-term memory (STM) domains such as verbal and visuospatial STM. Given the intrinsic sequential organization of musical material, the study of STM for musical information may be particularly informative about serial order retention processes and their domain-generality. The present experiment examined serial order STM for verbal and musical sequences in participants with no advanced musical expertise and experienced musicians. Serial order STM for verbal information was assessed via a serial order reconstruction task for digit sequences. In the musical domain, serial order STM was assessed using a novel melodic sequence reconstruction task maximizing the retention of tone order information. We observed that performance for the verbal and musical tasks was characterized by sequence length as well as primacy and recency effects. Serial order errors in both tasks were characterized by similar transposition gradients and ratios of fill-in:infill errors. These effects were observed for both participant groups, although the transposition gradients and ratios of fill-in:infill errors showed additional specificities for musician participants in the musical task. The data support domain-general serial order STM effects but also suggest the existence of additional domain-specific effects. Implications for models of serial order STM in verbal and musical domains are discussed.

  3. Serial binary interval ratios improve rhythm reproduction.

    Science.gov (United States)

    Wu, Xiang; Westanmo, Anders; Zhou, Liang; Pan, Junhao

    2013-01-01

    Musical rhythm perception is a natural human ability that involves complex cognitive processes. Rhythm refers to the organization of events in time, and musical rhythms have an underlying hierarchical metrical structure. The metrical structure induces the feeling of a beat and the extent to which a rhythm induces the feeling of a beat is referred to as its metrical strength. Binary ratios are the most frequent interval ratio in musical rhythms. Rhythms with hierarchical binary ratios are better discriminated and reproduced than rhythms with hierarchical non-binary ratios. However, it remains unclear whether a superiority of serial binary over non-binary ratios in rhythm perception and reproduction exists. In addition, how different types of serial ratios influence the metrical strength of rhythms remains to be elucidated. The present study investigated serial binary vs. non-binary ratios in a reproduction task. Rhythms formed with exclusively binary (1:2:4:8), non-binary integer (1:3:5:6), and non-integer (1:2.3:5.3:6.4) ratios were examined within a constant meter. The results showed that the 1:2:4:8 rhythm type was more accurately reproduced than the 1:3:5:6 and 1:2.3:5.3:6.4 rhythm types, and the 1:2.3:5.3:6.4 rhythm type was more accurately reproduced than the 1:3:5:6 rhythm type. Further analyses showed that reproduction performance was better predicted by the distribution pattern of event occurrences within an inter-beat interval, than by the coincidence of events with beats, or the magnitude and complexity of interval ratios. Whereas rhythm theories and empirical data emphasize the role of the coincidence of events with beats in determining metrical strength and predicting rhythm performance, the present results suggest that rhythm processing may be better understood when the distribution pattern of event occurrences is taken into account. These results provide new insights into the mechanisms underlining musical rhythm perception.

  4. Serial binary interval ratios improve rhythm reproduction

    Directory of Open Access Journals (Sweden)

    Xiang eWu

    2013-08-01

    Full Text Available Musical rhythm perception is a natural human ability that involves complex cognitive processes. Rhythm refers to the organization of events in time, and musical rhythms have an underlying hierarchical metrical structure. The metrical structure induces the feeling of a beat and the extent to which a rhythm induces the feeling of a beat is referred to as its metrical strength. Binary ratios are the most frequent interval ratio in musical rhythms. Rhythms with hierarchical binary ratios are better discriminated and reproduced than rhythms with hierarchical non-binary ratios. However, it remains unclear whether a superiority of serial binary over non-binary ratios in rhythm perception and reproduction exists. In addition, how different types of serial ratios influence the metrical strength of rhythms remains to be elucidated. The present study investigated serial binary vs. non-binary ratios in a reproduction task. Rhythms formed with exclusively binary (1:2:4:8, non-binary integer (1:3:5:6, and non-integer (1:2.3:5.3:6.4 ratios were examined within a constant meter. The results showed that the 1:2:4:8 rhythm type was more accurately reproduced than the 1:3:5:6 and 1:2.3:5.3:6.4 rhythm types, and the 1:2.3:5.3:6.4 rhythm type was more accurately reproduced than the 1:3:5:6 rhythm type. Further analyses showed that reproduction performance was better predicted by the distribution pattern of event occurrences within an inter-beat interval, than by the coincidence of events with beats, or the magnitude and complexity of interval ratios. Whereas rhythm theories and empirical data emphasize the role of the coincidence of events with beats in determining metrical strength and predicting rhythm performance, the present results suggest that rhythm processing may be better understood when the distribution pattern of event occurrences is taken into account. These results provide new insights into the mechanisms underlining musical rhythm perception.

  5. Criminal psychological profiling of serial arson crimes.

    Science.gov (United States)

    Kocsis, Richard N; Cooksey, Ray W

    2002-12-01

    The practice of criminal psychological profiling is frequently cited as being applicable to serial arson crimes. Despite this claim, there does not appear to be any empirical research that examines serial arson offence behaviors in the context of profiling. This study seeks to develop an empirical model of serial arsonist behaviors that can be systematically associated with probable offender characteristics. Analysis has produced a model of offence behaviors that identify four discrete behavior patterns, all of which share a constellation of common nondiscriminatory behaviors. The inherent behavioral themes of each of these patterns are explored with discussion of their broader implications for our understanding of serial arson and directions for future research.

  6. Serial fetal abdominal circumference measurements in predicting normal birth weight in gestational diabetes mellitus.

    LENUS (Irish Health Repository)

    Neff, Karl J

    2013-06-24

    To construct a clinical management matrix using serial fetal abdominal circumference measurements (ACMs) that will predict normal birth weight in pregnancies complicated by gestational diabetes (GDM) and reduce unnecessary ultrasound examination in women with GDM.

  7. The clinical nurse specialist as resuscitation process manager.

    Science.gov (United States)

    Schneiderhahn, Mary Elizabeth; Fish, Anne Folta

    2014-01-01

    The purpose of this article was to describe the history and leadership dimensions of the role of resuscitation process manager and provide specific examples of how this role is implemented at a Midwest medical center. In 1992, a medical center in the Midwest needed a nurse to manage resuscitation care. This role designation meant that this nurse became central to all quality improvement efforts in resuscitation care. The role expanded as clinical resuscitation guidelines were updated and as the medical center grew. The role became known as the critical care clinical nurse specialist as resuscitation process manager. This clinical care nurse specialist was called a manager, but she had no direct line authority, so she accomplished her objectives by forming a multitude of collaborative networks. Based on a framework by Finkelman, the manager role incorporated specific leadership abilities in quality improvement: (1) coordination of medical center-wide resuscitation, (2) use of interprofessional teams, (3) integration of evidence into practice, and (4) staff coaching to develop leadership. The manager coordinates resuscitation care with the goals of prevention of arrests if possible, efficient and effective implementation of resuscitation protocols, high quality of patient and family support during and after the resuscitation event, and creation or revision of resuscitation policies for in-hospital and for ambulatory care areas. The manager designs a comprehensive set of meaningful and measurable process and outcome indicators with input from interprofessional teams. The manager engages staff in learning, reflecting on care given, and using the evidence base for resuscitation care. Finally, the manager role is a balance between leading quality improvement efforts and coaching staff to implement and sustain these quality improvement initiatives. Revisions to clinical guidelines for resuscitation care since the 1990s have resulted in medical centers developing improved

  8. KANBAN allocation in a serial suply chain

    Directory of Open Access Journals (Sweden)

    Guillermo Andrés Sánchez C.

    2012-06-01

    Full Text Available The aim of this project is to simulate a Kanban system using N stages with the objective of maintaining an acceptable throughput and mean system time. The document shows the production systems where Kanban is applicable and what the potential benefits are. A serial of simulations will be done using a demand given by a poison distribution with rate λ ^ ext. The simulation aimed to find the best number of withdrawal Kanban on all stages when the values of μ (for exponential distribution of the process and λ ^ ext increase and decrease. At the end of this simulation, the best way to allocate the withdrawal Kanban over N stages with the objective of maintaining acceptable throughput and mean system time will be clearer thus the conclusions of this work will be done.

  9. The process of clinical assessment: cognitions of the evaluator

    Directory of Open Access Journals (Sweden)

    Carmelo Ibáñez Aguirre

    2013-08-01

    Full Text Available The cognitive paradigm of the past few decades opens several new possibilities for psychological evaluation.  The objective of this essay is to emphasize the possibilities related to the quality of self-evaluation, specifically professional self-assessment, meaning a critical analysis of one’s own evaluation process. In this essay, metacognition activities and strategies are examined, as are the ways in which these activities and strategies relate to metacognition and cognitive skills. The intent of this theoretical essay is to offer answers to the clinical evaluator’s professional experience. The results indicate that the clinical professional must consider strategies to improve metacognition and cognitive skills through reflection, self-analysis and self-criticism to improve the quality and efficiency of their work.

  10. Serial CT scannings in herpes simplex encephalitis

    Energy Technology Data Exchange (ETDEWEB)

    Fukushima, M.; Sawada, T.; Kuriyama, Y.; Kinugawa, H.; Yamaguchi, T. (National Cardivascular Center, Osaka (Japan))

    1981-10-01

    Two patients with serologically confirmed herpes simplex encephalitis were studied by serial CT scannings. Case 1, a 60-year-old woman, was admitted to National Cardiovascular Center because of headache, fever, and attacks of Jacksonian seizure. Case 2, a 54-year-old man, was admitted because of fever, consciousness disturbance and right hemiparesis. Pleocytosis (mainly lymphocytes) and elevation of protein content in cerebrospinal fluid were observed in both cases. Both patients presented ''das apallische Syndrom'' one month after admission. The diagnosis of herpes simplex encephalitis was confirmed by typical clinical courses and by greater than fourfold rises in serum antibody titer for herpes simplex virus as well as that in cerebrospinal fluid in case 1. Characteristic CT findings observed in these two cases were summarized as follows: Within a week after the onset, no obvious abnormalities could be detected on CT scans (Case 1). Two weeks after the onset, a large low-density area appeared in the left temporal lobe and in the contralateral insular cortex with midline shift toward the right side (Case 2). One month later, an ill-defined linear and ring-like high-density area (Case 1), or a well-defined high-density area (Case 2), that was enhanced after contrast administration, was observed in the large low-density area in the temporal lobe. These findings were considered as characteristic for hemorrhagic encephalitis. These high-density areas disappeared two months later, however, widespread and intensified low-density areas still remained. In both cases, the basal ganglia and thalamus were completely spared on CT scans. From these observations, it can be concluded that serial CT scannings are quite useful for diagnosis of herpes simplex encephalitis.

  11. Serial CT scannings in herpes simplex encephalitis

    International Nuclear Information System (INIS)

    Fukushima, Masashi; Sawada, Tohru; Kuriyama, Yoshihiro; Kinugawa, Hidekazu; Yamaguchi, Takenori

    1981-01-01

    Two patients with serologically confirmed herpes simplex encephalitis were studied by serial CT scannings. Case 1, a 60-year-old woman, was admitted to National Cardiovascular Center because of headache, fever, and attacks of Jacksonian seizure. Case 2, a 54-year-old man, was admitted because of fever, consciousness disturbance and right hemipare sis. Pleocytosis (mainly lymphocytes) and elevation of protein content in cerebrospinal fluid were observed in both cases. Both patients presented ''das apallische Syndrom'' one month after admission. The diagnosis of herpes simplex encephalitis was confirmed by typical clinical courses and by greater than fourfold rises in serum antibody titer for herpes simplex virus as well as that in cerebrospinal fluid in case 1. Characteristic CT findings observed in these two cases were summarized as follows: Within a week after the onset, no obvious abnormalities could be detected on CT scans (Case 1). Two weeks after the onset, a large low-density area appeared in the left temporal lobe and in the contralateral insular cortex with midline shift toward the right side (Case 2). One month later, an ill-defined linear and ring-like high-density area (Case 1), or a well-defined high-density area (Case 2), that was enhanced after contrast administration, was observed in the large low-density area in the temporal lobe. These findings were considered as characteristic for hemorrhagic encephalitis. These high-density areas disappeared two months later, however, widespread and intensified low-density areas still remained. In both cases, the basal ganglia and thalamus were completely spared on CT scans. From these observations, it can be concluded that serial CT scannings are quite useful for diagnosis of herpes simplex encephalitis. (author)

  12. Woody Allen, serial schlemiel ?

    Directory of Open Access Journals (Sweden)

    Frédérique Brisset

    2011-04-01

    Full Text Available Woody Allen a développé au fil des années une persona cinématographique de schlemiel new-yorkais aisément reconnaissable par le spectateur. Elle marque nombre de ses films, qu’il y apparaisse en tant qu’acteur ou y dirige des substituts comédiens comme déclinaisons de lui-même. Si cette figure prototypique est le fondement de la sérialité dans sa filmographie, il est des traits stylistiques qui en portent trace tout au long de son œuvre : la récurrence annuelle de ses réalisations, la signature formelle symbolisée par ses génériques à la typographie singulière, le rythme de ses dialogues ponctués d’interjections et l’usage de l’autocitation sont autant de procédés qui marquent son cinéma d’un sceau très personnel. Ils fonctionnent comme des clins d’œil au spectateur qui reçoit dès lors LE Woody Allen millésimé comme une invitation à retrouver son microcosme. Ainsi la sérialité se pose comme à la fois initiale et conséquentielle de son système filmique, processus de création unique dans le cinéma américain.Woody Allen has long constructed a cinematographic persona of schlemiel New- Yorker that the audience can easily identify. It impacts most of his films, whether he stars in them or directs “substitute” actors to impersonate his character. If this prototypical figure is the basis of seriality in his cinematography, serial stylistic features can also be found all along his career: the annual recurrence of his productions, the formal signature symbolised by the typography of his singular credit titles, his rhythmical interjection-punctuated dialogues and the use of self-quotation imprint a very personal seal upon his movies. They all work as a recognition signals for the audience who thus receive THE Woody Allen vintage as an invitation to re-enter his microcosm. Seriality is then both initial and consequential to his cinematographic system, a unique creative process in American film history.

  13. Redesigning ambulatory care business processes supporting clinical care delivery.

    Science.gov (United States)

    Patterson, C; Sinkewich, M; Short, J; Callas, E

    1997-04-01

    The first step in redesigning the health care delivery process for ambulatory care begins with the patient and the business processes that support the patient. Patient-related business processes include patient access, service documentation, billing, follow-up, collection, and payment. Access is the portal to the clinical delivery and care management process. Service documentation, charge capture, and payment and collection are supporting processes to care delivery. Realigned provider networks now demand realigned patient business services to provide their members/customers/patients with improved service delivery at less cost. Purchaser mandates for cost containment, health maintenance, and enhanced quality of care have created an environment where every aspect of the delivery system, especially ambulatory care, is being judged. Business processes supporting the outpatient are therefore being reexamined for better efficiency and customer satisfaction. Many health care systems have made major investments in their ambulatory care environment, but have pursued traditional supporting business practices--such as multiple access points, lack of integrated patient appointment scheduling and registration, and multiple patient bills. These are areas that are appropriate for redesign efforts--all with the customer's needs and convenience in mind. Similarly, setting unrealistic expectations, underestimating the effort required, and ignoring the human elements of a patient-focused business service redesign effort can sabotage the very sound reasons for executing such an endeavor. Pitfalls can be avoided if a structured methodology, coupled with a change management process, are employed. Deloitte & Touche Consulting Group has been involved in several major efforts, all with ambulatory care settings to assist with the redesign of their business practices to consider the patient as the driver, instead of the institution providing the care.

  14. Scientific and Technical Serials Holdings Optimization in an Inefficient Market: A LSU Serials Redesign Project Exercise.

    Science.gov (United States)

    Bensman, Stephen J.; Wilder, Stanley J.

    1998-01-01

    Analyzes the structure of the library market for scientific and technical (ST) serials. Describes an exercise aimed at a theoretical reconstruction of the ST-serials holdings of Louisiana State University (LSU) Libraries. Discusses the set definitions, measures, and algorithms necessary in the design of a computer program to appraise ST serials.…

  15. Serial Position Functions in General Knowledge

    Science.gov (United States)

    Kelley, Matthew R.; Neath, Ian; Surprenant, Aimée M.

    2015-01-01

    Serial position functions with marked primacy and recency effects are ubiquitous in episodic memory tasks. The demonstrations reported here explored whether bow-shaped serial position functions would be observed when people ordered exemplars from various categories along a specified dimension. The categories and dimensions were: actors and age;…

  16. The Serial Murderer's Motivations: An Interdisciplinary Review.

    Science.gov (United States)

    DeHart, Dana D.; Mahoney, John M.

    1994-01-01

    Defines serial killer as individual who murders two or more victims over an extended period of time, ranging from days to years, with the crimes often being sexually motivated. Reviews existing motivational theories of serial murder and proposes additional explications from range of disciplines. Presents suggestions for future research and…

  17. Modus operandi of female serial killers.

    Science.gov (United States)

    Wilson, W; Hilton, T

    1998-04-01

    The modus operandi of female serial killers was examined from a chronology of 58 cases in America and 47 cases in 17 other countries, compiled over 25-year intervals. Female serial killers in other countries accounted for a disproportionately greater number of victims, but those in America managed a longer killing career when associated with a low profile modus operandi.

  18. Reframing Serial Murder Within Empirical Research.

    Science.gov (United States)

    Gurian, Elizabeth A

    2017-04-01

    Empirical research on serial murder is limited due to the lack of consensus on a definition, the continued use of primarily descriptive statistics, and linkage to popular culture depictions. These limitations also inhibit our understanding of these offenders and affect credibility in the field of research. Therefore, this comprehensive overview of a sample of 508 cases (738 total offenders, including partnered groups of two or more offenders) provides analyses of solo male, solo female, and partnered serial killers to elucidate statistical differences and similarities in offending and adjudication patterns among the three groups. This analysis of serial homicide offenders not only supports previous research on offending patterns present in the serial homicide literature but also reveals that empirically based analyses can enhance our understanding beyond traditional case studies and descriptive statistics. Further research based on these empirical analyses can aid in the development of more accurate classifications and definitions of serial murderers.

  19. Autoverification process improvement by Six Sigma approach: Clinical chemistry & immunoassay.

    Science.gov (United States)

    Randell, Edward W; Short, Garry; Lee, Natasha; Beresford, Allison; Spencer, Margaret; Kennell, Marina; Moores, Zoë; Parry, David

    2018-05-01

    This study examines effectiveness of a project to enhance an autoverification (AV) system through application of Six Sigma (DMAIC) process improvement strategies. Similar AV systems set up at three sites underwent examination and modification to produce improved systems while monitoring proportions of samples autoverified, the time required for manual review and verification, sample processing time, and examining characteristics of tests not autoverified. This information was used to identify areas for improvement and monitor the impact of changes. Use of reference range based criteria had the greatest impact on the proportion of tests autoverified. To improve AV process, reference range based criteria was replaced with extreme value limits based on a 99.5% test result interval, delta check criteria were broadened, and new specimen consistency rules were implemented. Decision guidance tools were also developed to assist staff using the AV system. The mean proportion of tests and samples autoverified improved from 90% for samples and >95% for tests across all three sites. The new AV system significantly decreased turn-around time and total sample review time (to about a third), however, time spent for manual review of held samples almost tripled. There was no evidence of compromise to the quality of testing process and process improvement methodology was successfully applied to AV systems resulting in an increase in overall test and sample AV by >90%, improved turn-around time, reduced time for manual verification, and with no obvious compromise to quality or error detection. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  20. 78 FR 60885 - Proposed Collection; 60-Day Notice Request: Application Process for Clinical Research Training...

    Science.gov (United States)

    2013-10-02

    ... Notice Request: Application Process for Clinical Research Training and Medical Education at the Clinical... Research Training and Medical Education, NIH Clinical Center, 10 Center Drive, MSC 1158, Bethesda, MD 20892... Process for Clinical Research Training and Medical Education at the Clinical Center and its Impact on...

  1. Serial killers with military experience: applying learning theory to serial murder.

    Science.gov (United States)

    Castle, Tammy; Hensley, Christopher

    2002-08-01

    Scholars have endeavored to study the motivation and causality behind serial murder by researching biological, psychological, and sociological variables. Some of these studies have provided support for the relationship between these variables and serial murder. However, the study of serial murder continues to be an exploratory rather than explanatory research topic. This article examines the possible link between serial killers and military service. Citing previous research using social learning theory for the study of murder, this article explores how potential serial killers learn to reinforce violence, aggression, and murder in military boot camps. As with other variables considered in serial killer research, military experience alone cannot account for all cases of serial murder. Future research should continue to examine this possible link.

  2. Natural born killers?: the development of the sexually sadistic serial killer.

    Science.gov (United States)

    Johnson, B R; Becker, J V

    1997-01-01

    Today's society seems enthralled with serial killers in the news and the media. Forensic psychiatrists often interview serial killers after they have been caught. There are retrospective studies and case reports of individuals who have committed sexually sadistic serial murders. However, there exists a dearth of case reports on adolescents who have expressed serious fantasies about becoming serial killer prior to actualizing their fantasy. This article presents nine clinical cases of 14- to 18-year-olds who have clinically significant fantasies of becoming a serial killer. Similarities exist in these adolescent cases when compared with retrospective studies and case reports of serial killers on the role of sexually sadistic fantasies and actual killings. Since it has been established that sexual paraphilias may develop at a young age, one can surmise that sadistic paraphilias may also develop in some adolescents. The question is posed, can we predict which of these adolescents may go on to actually become serial killers? This article focuses on how the sexually sadistic fantasy can eventually be acted out and possible motives for the act to be repeated multiple times. Finally, recommendations are made about assessing and treating a youngster who expresses violent sexually sadistic killing fantasies so that attempts can be made to interrupt the progression to actual killing.

  3. Serial powering of pixel modules

    International Nuclear Information System (INIS)

    Stockmanns, Tobias; Fischer, Peter; Huegging, Fabian; Peric, Ivan; Runolfsson, O.; Wermes, Norbert

    2003-01-01

    Modern pixel detectors for the next generation of high-energy collider experiments like LHC use readout electronics in deep sub-micron technology. Chips in this technology need a low supply voltage of 2-2.5 V alongside high current consumption to achieve the desired performance. The high supply current leads to significant voltage drops in the long and low mass supply cables so that voltage fluctuations at the chips are induced, when the supply current changes. This problem scales with the number of modules when connected in parallel to the power supplies. An alternative powering scheme connects several modules in series resulting in a higher supply voltage but a lower current consumption of the chain and therefore a much lower voltage drop in the cables. In addition the amount of cables needed to supply the detector is vastly reduced. The concept and features of serial powering are presented and studies of the implementation of this technology as an alternative for the ATLAS pixel detector are shown. In particular, it is shown that the potential risk of powering in series can be addressed and eliminated

  4. Serial powering of pixel modules

    CERN Document Server

    Stockmanns, Tobias; Hügging, Fabian Georg; Peric, I; Runólfsson, O; Wermes, Norbert

    2003-01-01

    Modern pixel detectors for the next generation of high-energy collider experiments like LHC use readout electronics in deep sub- micron technology. Chips in this technology need a low supply voltage of 2-2.5 V alongside high current consumption to achieve the desired performance. The high supply current leads to significant voltage drops in the long and low mass supply cables so that voltage fluctuations at the chips are induced, when the supply current changes. This problem scales with the number of modules when connected in parallel to the power supplies. An alternative powering scheme connects several modules in series resulting in a higher supply voltage but a lower current consumption of the chain and therefore a much lower voltage drop in the cables. In addition the amount of cables needed to supply the detector is vastly reduced. The concept and features of serial powering are presented and studies of the implementation of this technology as an alternative for the ATLAS pixel detector are shown. In par...

  5. [Innovation in healthcare processes and patient safety using clinical simulation].

    Science.gov (United States)

    Rojo, E; Maestre, J M; Díaz-Mendi, A R; Ansorena, L; Del Moral, I

    2016-01-01

    Many excellent ideas are never implemented or generalised by healthcare organisations. There are two related paradigms: thinking that individuals primarily change through accumulating knowledge, and believing that the dissemination of that knowledge within the organisation is the key element to facilitate change. As an alternative, a description and evaluation of a simulation-based inter-professional team training program conducted in a Regional Health Service to promote and facilitate change is presented. The Department of Continuing Education completed the needs assessment using the proposals presented by clinical units and management. Skills and behaviors that could be learned using simulation were selected, and all personnel from the units participating were included. Experiential learning principles based on clinical simulation and debriefing, were used for the instructional design. The Kirkpatrick model was used to evaluate the program. Objectives included: a) decision-making and teamwork skills training in high prevalence diseases with a high rate of preventable complications; b) care processes reorganisation to improve efficiency, while maintaining patient safety; and, c) implementation of new complex techniques with a long learning curve, and high preventable complications rate. Thirty clinical units organised 39 training programs in the 3 public hospitals, and primary care of the Regional Health Service during 2013-2014. Over 1,559 healthcare professionals participated, including nursing assistants, nurses and physicians. Simulation in healthcare to train inter-professional teams can promote and facilitate change in patient care, and organisational re-engineering. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Advanced Bayesian processing of clinical data in nuclear medicine

    International Nuclear Information System (INIS)

    Jirsa, L.

    1999-11-01

    The Bayesian methodology was applied with a view to improving the quality of thyroid gland disease treatment at a nuclear medicine department. The specific tasks included: formulation of the estimation tasks from the theoretical point of view; elaborating algorithms to estimate various physical, medical and dosimetric quantities used in radiodiagnosis and radiotherapy of thyroid gland diseases; testing their numerical precision; testing their numerical stability on a large set of clinical data; implementation of the algorithms at a level applicable in routine conditions of the nuclear medicine department and replace by them the data processing methods used there so far; exploring and testing the quality improvement of the estimates; and in dependence on the results, proposing hints where improvement of the data measurement methodology is necessary

  7. Clinical process in an integrative psychotherapy for self-wounds.

    Science.gov (United States)

    Wolfe, Barry E

    2013-09-01

    In this article, I will briefly describe the clinical process of an integrative psychotherapy for the healing of self-wounds, including its intended interventions and the variability of their application and outcome. Four specific strategies will be considered, including (a) the role of empathy throughout the course of therapy; (b) exposure therapy as a paradigmatic treatment for the treatment of feared thoughts, behavior, and emotions; (c) focusing and other experiential interventions for eliciting self-wounds; and (d) modification and healing of self-wounds with an individualized array of psychodynamic, experiential, and cognitive-behavioral strategies. In addition, we will briefly consider the impact of transference and countertransference on the trajectory of therapy. 2013 APA, all rights reserved

  8. Guide to deliver the elements of the Clinical Caritas Process

    Directory of Open Access Journals (Sweden)

    Luana Tonin

    2017-09-01

    Full Text Available Abstract Objective: To introduce a guide to apply the elements of the Clinical Caritas Process. Methods: It is a study introducing a guide developed to identify the necessary caring actions, aiming to provide transpersonal care. It was designed from a bibliographic review and discussion with peers, who apply the theory underpinning the present study. Results: The instrument features a layout with ten lines and two columns, decoding each structural component in its enunciation with its respective care manifestations. Additionally, it showed to be a facilitator for the use of the Human Caring Theory. Conclusion: It is believed that the guide can be reproduced in order to direct the practice of transpersonal care in different settings of Brazilian nursing. Moreover, it can also be used to teach this theory.

  9. A constrained rasch model of trace redintegration in serial recall.

    Science.gov (United States)

    Roodenrys, Steven; Miller, Leonie M

    2008-04-01

    The notion that verbal short-term memory tasks, such as serial recall, make use of information in long-term as well as in short-term memory is instantiated in many models of these tasks. Such models incorporate a process in which degraded traces retrieved from a short-term store are reconstructed, or redintegrated (Schweickert, 1993), through the use of information in long-term memory. This article presents a conceptual and mathematical model of this process based on a class of item-response theory models. It is demonstrated that this model provides a better fit to three sets of data than does the multinomial processing tree model of redintegration (Schweickert, 1993) and that a number of conceptual accounts of serial recall can be related to the parameters of the model.

  10. Dystrophic Cardiomyopathy: Complex Pathobiological Processes to Generate Clinical Phenotype

    Directory of Open Access Journals (Sweden)

    Takeshi Tsuda

    2017-09-01

    Full Text Available Duchenne muscular dystrophy (DMD, Becker muscular dystrophy (BMD, and X-linked dilated cardiomyopathy (XL-DCM consist of a unique clinical entity, the dystrophinopathies, which are due to variable mutations in the dystrophin gene. Dilated cardiomyopathy (DCM is a common complication of dystrophinopathies, but the onset, progression, and severity of heart disease differ among these subgroups. Extensive molecular genetic studies have been conducted to assess genotype-phenotype correlation in DMD, BMD, and XL-DCM to understand the underlying mechanisms of these diseases, but the results are not always conclusive, suggesting the involvement of complex multi-layers of pathological processes that generate the final clinical phenotype. Dystrophin protein is a part of dystrophin-glycoprotein complex (DGC that is localized in skeletal muscles, myocardium, smooth muscles, and neuronal tissues. Diversity of cardiac phenotype in dystrophinopathies suggests multiple layers of pathogenetic mechanisms in forming dystrophic cardiomyopathy. In this review article, we review the complex molecular interactions involving the pathogenesis of dystrophic cardiomyopathy, including primary gene mutations and loss of structural integrity, secondary cellular responses, and certain epigenetic and other factors that modulate gene expressions. Involvement of epigenetic gene regulation appears to lead to specific cardiac phenotypes in dystrophic hearts.

  11. The effects of nidopallium caudolaterale inactivation on serial-order behaviour in pigeons (Columba livia).

    Science.gov (United States)

    Johnston, Melissa Jane; Clarkson, Andrew N; Gowing, Emma K; Scarf, Damian; Colombo, Mike

    2018-06-06

    Serial-order behaviour is the ability to complete a sequence of responses in a predetermined order to achieve a reward. In birds, serial-order behaviour is thought to be impaired by damage to the nidopallium caudolaterale (NCL). In the current study, we examined the role of the NCL in serial-order behaviour by training pigeons on a 4-item serial-order task and a go/no-go discrimination task. Following training, pigeons were received infusions of 1μl of either tetrodotoxin (TTX) or saline. Saline infusions had no impact on serial-order behaviour whereas TTX infusions resulted in a significant decrease in performance. The serial-order impairments, however, were not the results of errors of any specific error at any specific list item. With respect to the go/no-go discrimination task, saline infusions also had no impact on performance whereas TTX infusions impaired pigeons' discrimination abilities. Given the impairments on the go/no-go discrimination task, which does not require processing of serial-order information, we tentatively conclude that damage to the NCL does not impair serial-order behaviour per se, but rather results in a more generalised impairment that may impact performance across a range of tasks.

  12. Theory of Visual Attention (TVA) applied to mice in the 5-choice serial reaction time task

    DEFF Research Database (Denmark)

    Fitzpatrick, C. M.; Caballero-Puntiverio, M.; Gether, U.

    2017-01-01

    Rationale The 5-choice serial reaction time task (5-CSRTT) is widely used to measure rodent attentional functions. In humans, many attention studies in healthy and clinical populations have used testing based on Bundesen’s Theory of Visual Attention (TVA) to estimate visual processing speeds...... on an individual level. Scopolamine HBr dose-dependently reduced 5-CSRTT attentional performance while also increasing reward collection latency at the highest dose. Upon TVA modelling, scopolamine HBr significantly reduced visual processing speed at both doses, while having less pronounced effects on visual...... modelled using a new three-parameter version of TVA to obtain estimates of visual processing speeds, visual thresholds and motor response baselines in each mouse. Results The parameter estimates for each animal were reliable across sessions, showing that the data were stable enough to support analysis...

  13. Measuring Early Cortical Visual Processing in the Clinic

    Directory of Open Access Journals (Sweden)

    Linda Bowns

    2017-05-01

    Full Text Available We describe a mobile app that measures early cortical visual processing suitable for use in clinics. The app is called Component Extraction and Motion Integration Test (CEMIT. Observers are asked to respond to the direction of translating plaids that move in one of two very different directions. The plaids have been selected so that the plaid components move in one of the directions and the plaid pattern moves in the other direction. In addition to correctly responding to the pattern motion, observers demonstrate their ability to correctly extract the movement (and therefore the orientation of the underlying components at specific spatial frequencies. We wanted to test CEMIT by seeing if we could replicate the broader tuning observed at low spatial frequencies for this type of plaid. Results from CEMIT were robust and successfully replicated this result for 50 typical observers. We envisage that it will be of use to researchers and clinicians by allowing them to investigate specific deficits at this fundamental level of cortical visual processing. CEMIT may also be used for screening purposes where visual information plays an important role, for example, air traffic controllers.

  14. The Productivity Advantage of Serial Entrepreneurs

    DEFF Research Database (Denmark)

    Shaw, Kathryn L.; Sørensen, Anders

    Serial entrepreneurs, who open more than one business, are found to have higher sales and higher productivity than novice entrepreneurs, who open one business. Using panel data on entrepreneurs and their firms from Denmark for 2001-2013, the serial entrepreneur has 67% higher sales than the novice......, but also opens firms that are larger in terms of the initial capital and labor, and thus is 39% more productive. There are subsets of firms that perform especially well – serial entrepreneurs that hold a portfolio of overlapping ongoing firms perform the best, as do those that open as limited liability...

  15. The American Serialization of Lord Jim

    Directory of Open Access Journals (Sweden)

    Stephen Donovan

    2017-12-01

    Full Text Available This essay presents the discovery of the American serialization of Joseph Conrad’s Lord Jim in New York’s Evening Telegram in 1903. This ‘lost’ serialization, it argues, invites a new perspective on Conrad’s early career by foregrounding the role of newspaper serialization and syndication in establishing his literary standing. After surveying the principal differences in the respective reading experiences of the periodical versus the book, it concludes by proposing that the prominence of women among Conrad’s first audiences requires us to reassess the basis for his success in North America and elsewhere.

  16. Some Considerations on Seriality and Synchronicity

    OpenAIRE

    Elena Nechita

    2010-01-01

    This paper presents an overview of the results that have been obtained lately on seriality and synchronicity and their link, in the light of the new theories and within the frame of complexity science.

  17. Some Considerations on Seriality and Synchronicity

    Directory of Open Access Journals (Sweden)

    Elena Nechita

    2010-01-01

    Full Text Available This paper presents an overview of the results that have been obtained lately on seriality and synchronicity and their link, in the light of the new theories and within the frame of complexity science.

  18. Modeling of ETL-Processes and Processed Information in Clinical Data Warehousing.

    Science.gov (United States)

    Tute, Erik; Steiner, Jochen

    2018-01-01

    Literature describes a big potential for reuse of clinical patient data. A clinical data warehouse (CDWH) is a means for that. To support management and maintenance of processes extracting, transforming and loading (ETL) data into CDWHs as well as to ease reuse of metadata between regular IT-management, CDWH and secondary data users by providing a modeling approach. Expert survey and literature review to find requirements and existing modeling techniques. An ETL-modeling-technique was developed extending existing modeling techniques. Evaluation by exemplarily modeling existing ETL-process and a second expert survey. Nine experts participated in the first survey. Literature review yielded 15 included publications. Six existing modeling techniques were identified. A modeling technique extending 3LGM2 and combining it with openEHR information models was developed and evaluated. Seven experts participated in the evaluation. The developed approach can help in management and maintenance of ETL-processes and could serve as interface between regular IT-management, CDWH and secondary data users.

  19. Serial measurements of serum human placental lactogen (hPL) and serial ultrasound examinations in the evaluation of fetal growth

    DEFF Research Database (Denmark)

    Sørensen, Steen; von Tabouillot, D; Schioler, V

    2000-01-01

    Serial serum hPL measurements and serial ultrasound fetometry were compared in the evaluation of fetal growth by relating these two parameters to size at birth and to clinical factors known to influence size at birth. The data were from a prospective study of 1000 consecutive pregnant women...... considered to be at risk for fetal growth retardation with retrospective analysis. Serum hPL was measured by radioimmunoassay and fetal weight estimated by ultrasound every 3 weeks during the last trimester. hPL values were expressed as multiples of the median (MoM) and linear regression analysis of the h......PL MoM values was carried out for each pregnancy to find the slope of the line (hPL-slope); at least 3 serum hPL values were required. The estimated fetal weight and weight-for-age at birth was expressed in Z-scores. The individual intrauterine growth velocity was calculated by regression analysis...

  20. Selection, processing and clinical application of muscle-skeletal tissue

    International Nuclear Information System (INIS)

    Luna Z, D.; Reyes F, M.L.; Lavalley E, C.; Castaneda J, G.

    2007-01-01

    Due to the increase in the average of the world population's life, people die each time to more age, this makes that the tissues of support of the human body, as those muscle-skeletal tissues, when increasing the individual's age go weakening, this in turn leads to the increment of the illnesses like the osteoporosis and the arthritis, that undoubtedly gives as a result more injure of the muscle-skeletal tissues joined a greater number of traffic accidents where particularly these tissues are affected, for that the demand of tissues muscle-skeletal for transplant every day will be bigger. The production of these tissues in the Bank of Radio sterilized Tissues, besides helping people to improve its quality of life saved foreign currencies because most of the muscle-skeletal tissues transplanted in Mexico are of import. The use of the irradiation to sterilize tissues for transplant has shown to be one of the best techniques with that purpose for what the International Atomic Energy Agency believes a Technical cooperation program to establish banks of tissues using the nuclear energy, helping mainly to countries in development. In this work the stages that follows the bank of radio sterilized tissues of the National Institute of Nuclear Research for the cadaverous donor's of muscle-skeletal tissue selection are described, as well as the processing and the clinical application of these tissues. (Author)

  1. New learning following reactivation in the human brain: targeting emotional memories through rapid serial visual presentation.

    Science.gov (United States)

    Wirkner, Janine; Löw, Andreas; Hamm, Alfons O; Weymar, Mathias

    2015-03-01

    Once reactivated, previously consolidated memories destabilize and have to be reconsolidated to persist, a process that might be altered non-invasively by interfering learning immediately after reactivation. Here, we investigated the influence of interference on brain correlates of reactivated episodic memories for emotional and neutral scenes using event-related potentials (ERPs). To selectively target emotional memories we applied a new reactivation method: rapid serial visual presentation (RSVP). RSVP leads to enhanced implicit processing (pop out) of the most salient memories making them vulnerable to disruption. In line, interference after reactivation of previously encoded pictures disrupted recollection particularly for emotional events. Furthermore, memory impairments were reflected in a reduced centro-parietal ERP old/new difference during retrieval of emotional pictures. These results provide neural evidence that emotional episodic memories in humans can be selectively altered through behavioral interference after reactivation, a finding with further clinical implications for the treatment of anxiety disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. 78 FR 79703 - Submission for OMB Review; 30-Day Comment Request: Application Process for Clinical Research...

    Science.gov (United States)

    2013-12-31

    ...; 30-Day Comment Request: Application Process for Clinical Research Training and Medical Education at..., MD, Deputy Director, Office of Clinical Research Training and Medical Education, NIH Clinical Center... Clinical Research Training and Medical Education at the Clinical Center and its Impact on Course and...

  3. Serial network simplifies the design of multiple microcomputer systems

    Energy Technology Data Exchange (ETDEWEB)

    Folkes, D.

    1981-01-01

    Recently there has been a lot of interest in developing network communication schemes for carrying digital data between locally distributed computing stations. Many of these schemes have focused on distributed networking techniques for data processing applications. These applications suggest the use of a serial, multipoint bus, where a number of remote intelligent units act as slaves to a central or host computer. Each slave would be serially addressable from the host and would perform required operations upon being addressed by the host. Based on an MK3873 single-chip microcomputer, the SCU 20 is designed to be such a remote slave device. The capabilities of the SCU 20 and its use in systems applications are examined.

  4. Alur Kerja Tahap Produksi Karakter Animasi Serial 3D Menggunakan Perangkat Lunak Maxon Cinema 4D

    Directory of Open Access Journals (Sweden)

    Ardiyan Ardiyan

    2011-04-01

    Full Text Available 3D Animation serial for television needs have been showed in the national television program, especially fantasy theme and educational program for children. There are so many and sequential needs which tricked by instant and high quality production so the work flow in creating 3D animation serial are facilitating the producers. The article will explain specifically how the software of Maxon Cinema 4D in process production in 3D animation serial. The article will also clarify and focus on how the work flow of Maxon Cinema 4D software in processing production and post-production stages. The writer does research including audio visual tutorial, end-result comparison and rendering time between some software, self-observation of work flow in creating 3D animation serial using Maxon Cinema 4D software and digital literature study (e-book.  

  5. High-Yield Purification, Preservation, and Serial Transplantation of Human Satellite Cells

    Directory of Open Access Journals (Sweden)

    Steven M. Garcia

    2018-03-01

    Full Text Available Summary: Investigation of human muscle regeneration requires robust methods to purify and transplant muscle stem and progenitor cells that collectively constitute the human satellite cell (HuSC pool. Existing approaches have yet to make HuSCs widely accessible for researchers, and as a result human muscle stem cell research has advanced slowly. Here, we describe a robust and predictable HuSC purification process that is effective for each human skeletal muscle tested and the development of storage protocols and transplantation models in dystrophin-deficient and wild-type recipients. Enzymatic digestion, magnetic column depletion, and 6-marker flow-cytometric purification enable separation of 104 highly enriched HuSCs per gram of muscle. Cryostorage of HuSCs preserves viability, phenotype, and transplantation potential. Development of enhanced and species-specific transplantation protocols enabled serial HuSC xenotransplantation and recovery. These protocols and models provide an accessible system for basic and translational investigation and clinical development of HuSCs. : Garcia and colleagues report methods for efficient purification of satellite cells from human skeletal muscle. They use their approaches to demonstrate stem cell functions of endogenous satellite cells and to make human satellite cells accessible for sharing among researchers. Keywords: human satellite cell purification, serial transplantation, satellite cell cryopreservation

  6. Abutment region dosimetry for serial tomotherapy

    International Nuclear Information System (INIS)

    Low, Daniel A.; Mutic, Sasa; Dempsey, James F.; Markman, Jerry; Goddu, S. Murty; Purdy, James A.

    1999-01-01

    Purpose: A commercial intensity modulated radiation therapy system (Corvus, NOMOS Corp.) is presently used in our clinic to generate optimized dose distributions delivered using a proprietary dynamic multileaf collimator (DMLC) (MIMiC) composed of 20 opposed leaf pairs. On our accelerator (Clinac 600C/D, Varian Associates, Inc.) each MIMiC leaf projects to either 1.00 x 0.84 or 1.00 x 1.70 cm 2 (depending on the treatment plan and termed 1 cm or 2 cm mode, respectively). The MIMiC is used to deliver serial (axial) tomotherapy treatment plans, in which the beam is delivered to a nearly cylindrical volume as the DMLC is rotated about the patient. For longer targets, the patient is moved (indexed) between treatments a distance corresponding to the projected leaf width. The treatment relies on precise indexing and a method was developed to measure the precision of indexing devices. A treatment planning study of the dosimetric effects of incorrect patient indexing and concluded that a dose heterogeneity of 10% mm -1 resulted. Because the results may be sensitive to the dose model accuracy, we conducted a measurement-based investigation of the consequences of incorrect indexing using our accelerator. Although the indexing provides an accurate field abutment along the isocenter, due to beam divergence, hot and cold spots will be produced below and above isocenter, respectively, when less than 300 deg. arcs were used. A preliminary study recently determined that for a 290 deg. rotation in 1 cm mode, 15% cold and 7% hot spots were delivered to 7 cm above and below isocenter, respectively. This study completes the earlier work by investigating the dose heterogeneity as a function of position relative to the axis of rotation, arc length, and leaf width. The influence of random daily patient positioning errors is also investigated. Methods and Materials: Treatment plans were generated using 8.0 cm diameter cylindrical target volumes within a homogeneous rectilinear film

  7. Undergraduate nursing students' experience related to their clinical learning environment and factors affecting to their clinical learning process.

    Science.gov (United States)

    Arkan, Burcu; Ordin, Yaprak; Yılmaz, Dilek

    2018-03-01

    Clinical education is an essential part of nursing education. The purpose of this study was to explore nurse students' experiences related to cinical learning environments, factors effecting to clinical learning process. Descriptive qualitative design was used in this study, and data were collected from 2nd class nursing student (n = 14). The study took the form of in-depth interviews between August-October 2015. The qualitative interviews were analyzed by using simple content analysis. Data were analyzed manually. Experiences nurse students are described five themes. The themes of the study are (1) effecting persons to clinical learning, (2) educational atmosphere, (3) students' personal charactering, (4) the impact of education in school, and (5) students' perceptions related to clinical learning. Participants stated that they experienced many difficulties during clinical learning process. All students importantly stated that nurse teacher is very effecting to clinical learning. This study contributes to the literature by providing data on beginner nursing student' experiences about clinical learning process. The data of this present study show to Turkish nursing student is affecting mostly from persons in clinical learning. The data of this present study will guide nurse teacher when they plan to interventions to be performed to support student during clinical learning process. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Clinical Laboratory Data Management: A Distributed Data Processing Solution

    OpenAIRE

    Levin, Martin; Morgner, Raymond; Packer, Bernice

    1980-01-01

    Two turn-key systems, one for patient registration and the other for the clinical laboratory have been installed and linked together at the Hospital of the University of Pennsylvania, forming the nucleus of an evolving distributed Hospital Information System.

  9. The Effect of Concurrent Semantic Categorization on Delayed Serial Recall

    Science.gov (United States)

    Acheson, Daniel J.; MacDonald, Maryellen C.; Postle, Bradley R.

    2010-01-01

    The influence of semantic processing on the serial ordering of items in short-term memory was explored using a novel dual-task paradigm. Subjects engaged in two picture judgment tasks while simultaneously performing delayed serial recall. List material varied in the presence of phonological overlap (Experiments 1 and 2) and in semantic content (concrete words in Experiment 1 and 3; nonwords in Experiments 2 and 3). Picture judgments varied in the extent to which they required accessing visual semantic information (i.e., semantic categorization and line orientation judgments). Results showed that, relative to line orientation judgments, engaging in semantic categorization judgments increased the proportion of item ordering errors for concrete lists but did not affect error proportions for nonword lists. Furthermore, although more ordering errors were observed for phonologically similar relative to dissimilar lists, no interactions were observed between the phonological overlap and picture judgment task manipulations. These results thus demonstrate that lexical-semantic representations can affect the serial ordering of items in short-term memory. Furthermore, the dual-task paradigm provides a new method for examining when and how semantic representations affect memory performance. PMID:21058880

  10. The neural signature of emotional memories in serial crimes.

    Science.gov (United States)

    Chassy, Philippe

    2017-10-01

    Neural plasticity is the process whereby semantic information and emotional responses are stored in neural networks. It is hypothesized that the neural networks built over time to encode the sexual fantasies that motivate serial killers to act should display a unique, detectable activation pattern. The pathological neural watermark hypothesis posits that such networks comprise activation of brain sites that reflect four cognitive components: autobiographical memory, sexual arousal, aggression, and control over aggression. The neural sites performing these cognitive functions have been successfully identified by previous research. The key findings are reviewed to hypothesise the typical pattern of activity that serial killers should display. Through the integration of biological findings into one framework, the neural approach proposed in this paper is in stark contrast with the many theories accounting for serial killers that offer non-medical taxonomies. The pathological neural watermark hypothesis offers a new framework to understand and detect deviant individuals. The technical and legal issues are briefly discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Freeform Optics: current challenges for future serial production

    Science.gov (United States)

    Schindler, C.; Köhler, T.; Roth, E.

    2017-10-01

    One of the major developments in optics industry recently is the commercial manufacturing of freeform surfaces for optical mid- and high performance systems. The loss of limitation on rotational symmetry enables completely new optical design solutions - but causes completely new challenges for the manufacturer too. Adapting the serial production from radial-symmetric to freeform optics cannot be done just by the extension of machine capabilities and software for every process step. New solutions for conventional optics productions or completely new process chains are necessary.

  12. Converting serial networks to Ethernet communications

    Energy Technology Data Exchange (ETDEWEB)

    Rosado, Elroy [Freewave Technologies, Inc., Boulder, CO (United States). Latin America

    2008-07-01

    Many oil and gas producers and pipeline companies find themselves in an awkward position. They have invested millions of dollars in legacy serial communications systems and in most cases, millions more in older SCADA remote terminal units and electronic flow meters. There is a desire throughout most of the industry to convert these systems to Ethernet. This presentation will explore how Ethernet protocol offers advantages over the older serial communications in terms of peer to peer communication, faster polling cycles, and the ability to poll multiple devices at the same time. (author)

  13. Multistage parallel-serial time averaging filters

    International Nuclear Information System (INIS)

    Theodosiou, G.E.

    1980-01-01

    Here, a new time averaging circuit design, the 'parallel filter' is presented, which can reduce the time jitter, introduced in time measurements using counters of large dimensions. This parallel filter could be considered as a single stage unit circuit which can be repeated an arbitrary number of times in series, thus providing a parallel-serial filter type as a result. The main advantages of such a filter over a serial one are much less electronic gate jitter and time delay for the same amount of total time uncertainty reduction. (orig.)

  14. Serial position effects in mild cognitive impairment.

    Science.gov (United States)

    Howieson, Diane B; Mattek, Nora; Seeyle, Adriana M; Dodge, Hiroko H; Wasserman, Dara; Zitzelberger, Tracy; Jeffrey, Kaye

    2011-03-01

    Mild cognitive impairment (MCI) is often associated with the preclinical phase of Alzheimer's disease (AD). Special scoring of word-list recall data for serial position has been suggested to improve discrimination of normal aging from dementia. We examined serial position effects in word-list recall for MCI participants compared to Alzheimer patients and controls. Individuals with MCI, like Alzheimer patients, had a diminished primacy effect in recalling words from a list. No alternative scoring system was better than standard scoring of word-list recall in distinguishing MCI patients from controls. Retention weighted scoring improved the discrimination of MCI and AD groups.

  15. Serial analysis of resected prostate cancer suggests up-regulation of type 1 IGF receptor with disease progression.

    Science.gov (United States)

    Turney, Benjamin W; Turner, Gareth D H; Brewster, Simon F; Macaulay, Valentine M

    2011-05-01

    • To compare immunostaining protocols using different antibodies for the type 1 insulin-like growth factor receptor (IGF-1R) in channel transurethal resection of the prostate (chTURP) chips, and to investigate how IGF-1R expression varies with time in serial prostate cancer specimens from individual patients. • We studied IGF-1R expression in 44 prostate cancer specimens from 18 patients who had undergone serial chTURP at least 3 months apart. • Retrospective analysis of the hospital notes was undertaken to obtain clinical information, including age, Gleason score, prostate-specific antigen (PSA) level, hormone treatment and metastatic disease status at the time of each operation. • After an optimization process using three commercially-available IGF-1R antibodies, we used two antibodies for semiquantititve immunostaining of serial chTURP chips. • Santa Cruz antibody sc713 gave positive staining in IGF-1R null R- cells, and was not used further. Antibodies from Cell Signaling Technology (Beverly, MA, USA) (CS) and NeoMarkers Inc. (Fremont, CA, USA) (NM) did not stain R- cells and, in prostate tissue, showed staining of the glandular epithelium, with negligible stromal staining. All 44 chTURP samples contained identifiable malignant tissue and, of these, 73% and 64% scored moderately or strongly (score 3 or 4) with the CS and NM antibodies respectively. • There was significant correlation of IGF-1R scores of malignant tissue between the two antibodies (P < 0.001). By contrast, staining of benign glands showed poor correlation between antibodies: CS gave significantly weaker staining than malignant epithelium in the same sections (P < 0.001), whereas NM showed poor discrimination between malignant and benign glands. IGF-1R staining scores generated by the CS antibody were used to analyze the clinical data. • Most patients (six of seven) with falling IGF-1R staining scores were responding to androgen deprivation therapy (confirmed by PSA response

  16. Challenges in clinical natural language processing for automated disorder normalization.

    Science.gov (United States)

    Leaman, Robert; Khare, Ritu; Lu, Zhiyong

    2015-10-01

    Identifying key variables such as disorders within the clinical narratives in electronic health records has wide-ranging applications within clinical practice and biomedical research. Previous research has demonstrated reduced performance of disorder named entity recognition (NER) and normalization (or grounding) in clinical narratives than in biomedical publications. In this work, we aim to identify the cause for this performance difference and introduce general solutions. We use closure properties to compare the richness of the vocabulary in clinical narrative text to biomedical publications. We approach both disorder NER and normalization using machine learning methodologies. Our NER methodology is based on linear-chain conditional random fields with a rich feature approach, and we introduce several improvements to enhance the lexical knowledge of the NER system. Our normalization method - never previously applied to clinical data - uses pairwise learning to rank to automatically learn term variation directly from the training data. We find that while the size of the overall vocabulary is similar between clinical narrative and biomedical publications, clinical narrative uses a richer terminology to describe disorders than publications. We apply our system, DNorm-C, to locate disorder mentions and in the clinical narratives from the recent ShARe/CLEF eHealth Task. For NER (strict span-only), our system achieves precision=0.797, recall=0.713, f-score=0.753. For the normalization task (strict span+concept) it achieves precision=0.712, recall=0.637, f-score=0.672. The improvements described in this article increase the NER f-score by 0.039 and the normalization f-score by 0.036. We also describe a high recall version of the NER, which increases the normalization recall to as high as 0.744, albeit with reduced precision. We perform an error analysis, demonstrating that NER errors outnumber normalization errors by more than 4-to-1. Abbreviations and acronyms are found

  17. Optimising the diagnostic imaging process through clinical history documentation

    International Nuclear Information System (INIS)

    Egan, I.; Baird, M.

    2003-01-01

    In the United Kingdom the 1990s were characterised by radiographer role extension including radiographic reporting and the performance of a variety of contrast examinations. In Australia where a privatised health system constrains the role of radiographers, other ways need to be found to improve professional practice and enhance patient care. One such way is for radiographers to develop knowledge and skills in clinical history taking. The paper advocates the development of a formalised approach to clinical history taking that portrays the radiographer as a professional and advocate of patient rights and welfare. The paper examines history taking approaches used by other health care professionals and proposes a clinical history template using five key areas of interview: area and type of symptoms, current history, past history, special considerations and psychosocial/occupational history. Copyright (2003) Australian Institute of Radiography

  18. New developments in electron microscopy for serial image acquisition of neuronal profiles.

    Science.gov (United States)

    Kubota, Yoshiyuki

    2015-02-01

    Recent developments in electron microscopy largely automate the continuous acquisition of serial electron micrographs (EMGs), previously achieved by laborious manual serial ultrathin sectioning using an ultramicrotome and ultrastructural image capture process with transmission electron microscopy. The new systems cut thin sections and capture serial EMGs automatically, allowing for acquisition of large data sets in a reasonably short time. The new methods are focused ion beam/scanning electron microscopy, ultramicrotome/serial block-face scanning electron microscopy, automated tape-collection ultramicrotome/scanning electron microscopy and transmission electron microscope camera array. In this review, their positive and negative aspects are discussed. © The Author 2015. Published by Oxford University Press on behalf of The Japanese Society of Microscopy. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. The eyeball killer: serial killings with postmortem globe enucleation.

    Science.gov (United States)

    Coyle, Julie; Ross, Karen F; Barnard, Jeffrey J; Peacock, Elizabeth; Linch, Charles A; Prahlow, Joseph A

    2015-05-01

    Although serial killings are relatively rare, they can be the cause of a great deal of anxiety while the killer remains at-large. Despite the fact that the motivations for serial killings are typically quite complex, the psychological analysis of a serial killer can provide valuable insight into how and why certain individuals become serial killers. Such knowledge may be instrumental in preventing future serial killings or in solving ongoing cases. In certain serial killings, the various incidents have a variety of similar features. Identification of similarities between separate homicidal incidents is necessary to recognize that a serial killer may be actively killing. In this report, the authors present a group of serial killings involving three prostitutes who were shot to death over a 3-month period. Scene and autopsy findings, including the unusual finding of postmortem enucleation of the eyes, led investigators to recognize the serial nature of the homicides. © 2015 American Academy of Forensic Sciences.

  20. Errors in the Total Testing Process in the Clinical Chemistry ...

    African Journals Online (AJOL)

    2018-03-01

    Mar 1, 2018 ... Analytical errors related to internal and external quality control exceeding the target range, (14.4%) ... indicators to assess errors in the total testing process. The. University ... Evidence showed that the risk of .... Data management and quality control: Pre-test ..... indicators and specifications for key processes.

  1. Defining and reconstructing clinical processes based on IHE and BPMN 2.0.

    Science.gov (United States)

    Strasser, Melanie; Pfeifer, Franz; Helm, Emmanuel; Schuler, Andreas; Altmann, Josef

    2011-01-01

    This paper describes the current status and the results of our process management system for defining and reconstructing clinical care processes, which contributes to compare, analyze and evaluate clinical processes and further to identify high cost tasks or stays. The system is founded on IHE, which guarantees standardized interfaces and interoperability between clinical information systems. At the heart of the system there is BPMN, a modeling notation and specification language, which allows the definition and execution of clinical processes. The system provides functionality to define healthcare information system independent clinical core processes and to execute the processes in a workflow engine. Furthermore, the reconstruction of clinical processes is done by evaluating an IHE audit log database, which records patient movements within a health care facility. The main goal of the system is to assist hospital operators and clinical process managers to detect discrepancies between defined and actual clinical processes and as well to identify main causes of high medical costs. Beyond that, the system can potentially contribute to reconstruct and improve clinical processes and enhance cost control and patient care quality.

  2. Bilateral elongated styloid process: Its anatomical, embryological and clinical implications

    OpenAIRE

    Bagoji Ishwar B, Hadimani Gavishiddappa A, Patil Balasaheb G, Bannur Balappa M,Ambadasu B

    2013-01-01

    The styloid process is a slender, elongated, cylindrical bony projection from temporal bone. It normally varies in length from 2 cm to 3 cm. During a routine demonstration of skull for MBBS students we found the bilateral elongated styloid process in dry human skull. The length of elongation measured on the right and left side was 6.0 & 5.9 cms respectively. Such abnormal elongation of the styloid process may cause compression on a number of vital vessels and nerves related to it, producing i...

  3. Recalling visual serial order for verbal sequences

    NARCIS (Netherlands)

    Logie, R.H.; Saito, S.; Morita, A.; Varma, S.; Norris, D.

    2016-01-01

    We report three experiments in which participants performed written serial recall of visually presented verbal sequences with items varying in visual similarity. In Experiments 1 and 2 native speakers of Japanese recalled visually presented Japanese Kanji characters. In Experiment 3, native speakers

  4. Serial analysis of gene expression (SAGE)

    NARCIS (Netherlands)

    van Ruissen, Fred; Baas, Frank

    2007-01-01

    In 1995, serial analysis of gene expression (SAGE) was developed as a versatile tool for gene expression studies. SAGE technology does not require pre-existing knowledge of the genome that is being examined and therefore SAGE can be applied to many different model systems. In this chapter, the SAGE

  5. Advances in Serials Management. Volume 6.

    Science.gov (United States)

    Hepfer, Cindy, Ed.; Gammon, Julia, Ed.; Malinowski, Teresa, Ed.

    In order to further discussion and support constructive change, this volume presents the following eight papers on various dimensions of serials management: (1) "CD-ROMs, Surveys, and Sales: The OSA [Optical Society of America] Experience" (Frank E. Harris and Alan Tourtlotte); (2) "Management and Integration of Electronic Journals into the…

  6. [Clinical decision making and critical thinking in the nursing diagnostic process].

    Science.gov (United States)

    Müller-Staub, Maria

    2006-10-01

    The daily routine requires complex thinking processes of nurses, but clinical decision making and critical thinking are underestimated in nursing. A great demand for educational measures in clinical judgement related with the diagnostic process was found in nurses. The German literature hardly describes nursing diagnoses as clinical judgements about human reactions on health problems / life processes. Critical thinking is described as an intellectual, disciplined process of active conceptualisation, application and synthesis of information. It is gained through observation, experience, reflection and communication and leads thinking and action. Critical thinking influences the aspects of clinical decision making a) diagnostic judgement, b) therapeutic reasoning and c) ethical decision making. Human reactions are complex processes and in their course, human behavior is interpreted in the focus of health. Therefore, more attention should be given to the nursing diagnostic process. This article presents the theoretical framework of the paper "Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies".

  7. Bilateral elongated styloid process: Its anatomical, embryological and clinical implications

    Directory of Open Access Journals (Sweden)

    Bagoji Ishwar B, Hadimani Gavishiddappa A, Patil Balasaheb G, Bannur Balappa M,Ambadasu B

    2013-04-01

    Full Text Available The styloid process is a slender, elongated, cylindrical bony projection from temporal bone. It normally varies in length from 2 cm to 3 cm. During a routine demonstration of skull for MBBS students we found the bilateral elongated styloid process in dry human skull. The length of elongation measured on the right and left side was 6.0 & 5.9 cms respectively. Such abnormal elongation of the styloid process may cause compression on a number of vital vessels and nerves related to it, producing inflammatory changes that include continuous chronic pain in the pharyngeal region. Mechanical stresses stretching the second brachial arch during fetal development probably induce variable involvement of Reichert’s cartilage in morphogenesis of the styloid process. It is important that clinicians especially dentists and otolaryngologists are aware of the natural variations of the styloid process and do not consider the styloid process with a length of 30 mm as an abnormality or as an anomaly.

  8. Implications of process evaluation for clinical effectiveness and clinical practice in a trial on chronic shoulder complaints.

    NARCIS (Netherlands)

    Geraets, J.J.; Goossens, M.E.J.B.; Haastregt, J.C. van; Groot, I.J.M. de; Bruijn, C.P. de; Bie, R.A. de; Koke, A.J.; Heuvel, W.J.A. van den

    2006-01-01

    OBJECTIVE: The intervention process was evaluated in a randomised clinical trial on the effectiveness of a behavioural Graded Exercise Therapy (GET) programme for patients with chronic shoulder complaints in primary care settings. This process evaluation was done for three reasons: first, to know

  9. Evaluation of clinical image processing algorithms used in digital mammography.

    Science.gov (United States)

    Zanca, Federica; Jacobs, Jurgen; Van Ongeval, Chantal; Claus, Filip; Celis, Valerie; Geniets, Catherine; Provost, Veerle; Pauwels, Herman; Marchal, Guy; Bosmans, Hilde

    2009-03-01

    Screening is the only proven approach to reduce the mortality of breast cancer, but significant numbers of breast cancers remain undetected even when all quality assurance guidelines are implemented. With the increasing adoption of digital mammography systems, image processing may be a key factor in the imaging chain. Although to our knowledge statistically significant effects of manufacturer-recommended image processings have not been previously demonstrated, the subjective experience of our radiologists, that the apparent image quality can vary considerably between different algorithms, motivated this study. This article addresses the impact of five such algorithms on the detection of clusters of microcalcifications. A database of unprocessed (raw) images of 200 normal digital mammograms, acquired with the Siemens Novation DR, was collected retrospectively. Realistic simulated microcalcification clusters were inserted in half of the unprocessed images. All unprocessed images were subsequently processed with five manufacturer-recommended image processing algorithms (Agfa Musica 1, IMS Raffaello Mammo 1.2, Sectra Mamea AB Sigmoid, Siemens OPVIEW v2, and Siemens OPVIEW v1). Four breast imaging radiologists were asked to locate and score the clusters in each image on a five point rating scale. The free-response data were analyzed by the jackknife free-response receiver operating characteristic (JAFROC) method and, for comparison, also with the receiver operating characteristic (ROC) method. JAFROC analysis revealed highly significant differences between the image processings (F = 8.51, p < 0.0001), suggesting that image processing strongly impacts the detectability of clusters. Siemens OPVIEW2 and Siemens OPVIEW1 yielded the highest and lowest performances, respectively. ROC analysis of the data also revealed significant differences between the processing but at lower significance (F = 3.47, p = 0.0305) than JAFROC. Both statistical analysis methods revealed that the

  10. Learning of serial digits leads to frontal activation in functional MR imaging.

    Science.gov (United States)

    Karakaş, Hakki Muammer; Karakaş, Sirel

    2006-03-01

    Clinical studies have shown that performance on the serial digit learning test (SDLT) is dependent upon the mesial temporal lobes, which are responsible for learning and its consolidation. However, an effective SDLT performance is also dependent upon sequencing, temporal ordering, and the utilization of mnemonic strategies. All of these processes are among the functions of the frontal lobes; in spite of this, the relationship between SDLT performance and the frontal lobes has not been demonstrated with previously used mapping techniques. The aim of this study was to investigate the areas of the brain that are activated by SDLT performance. Ten healthy, right handed volunteers (mean age, 20.1 years; SD: 3.3) who had 12 years of education were studied with a 1.0 T MR imaging scanner. BOLD (blood oxygen level dependent) contrast and a modified SDLT were used. Activated loci were automatically mapped using a proportional grid. In learning, the most consistent activation was observed in B-a-7 of the right (80%) and the left hemispheres (50%). In recall, the most consistent activation was observed in B-a-7 of the right hemisphere (60%). Activations were observed in 2.5+/-0.97 Talairach volumes in learning, whereas they encompassed 1.7+/-0.95 volumes in recall. The difference between both phases (learning and recall) regarding total activated volume was significant (p SDLT performance was not related to learning or to recall, but to a function that is common to both of these cognitive processes. A candidate for this common factor may be the executive functions, which also include serial position processing and temporal ordering.

  11. Determination of motive of serial invaders as a stage of serial murders investigation

    Directory of Open Access Journals (Sweden)

    Davydov A.B.

    2017-04-01

    Full Text Available the article discusses the existing classification of motives of serial murderers. The author provides the classification, which is based on the technique of extreme meanings offered by D.A. Leontyev.

  12. The essential guide to Serial ATA and SATA express

    CERN Document Server

    Deming, David A

    2014-01-01

    Used in laptop and desktop computers, low-end servers, and mobile devices, Serial ATA (Advance Technology Attachment), or SATA, is the pervasive disk storage technology in use today. SATA has also penetrated the enterprise computing environment by adding hardware components for fail-over, extending command processing capabilities, and increasing device performance and link speeds. If you work in a data center or manage your company's storage resources, you will likely encounter storage solutions that require SATA software or hardware.In this book, leading storage networking technologist David

  13. An integrated model of clinical reasoning: dual-process theory of cognition and metacognition.

    Science.gov (United States)

    Marcum, James A

    2012-10-01

    Clinical reasoning is an important component for providing quality medical care. The aim of the present paper is to develop a model of clinical reasoning that integrates both the non-analytic and analytic processes of cognition, along with metacognition. The dual-process theory of cognition (system 1 non-analytic and system 2 analytic processes) and the metacognition theory are used to develop an integrated model of clinical reasoning. In the proposed model, clinical reasoning begins with system 1 processes in which the clinician assesses a patient's presenting symptoms, as well as other clinical evidence, to arrive at a differential diagnosis. Additional clinical evidence, if necessary, is acquired and analysed utilizing system 2 processes to assess the differential diagnosis, until a clinical decision is made diagnosing the patient's illness and then how best to proceed therapeutically. Importantly, the outcome of these processes feeds back, in terms of metacognition's monitoring function, either to reinforce or to alter cognitive processes, which, in turn, enhances synergistically the clinician's ability to reason quickly and accurately in future consultations. The proposed integrated model has distinct advantages over other models proposed in the literature for explicating clinical reasoning. Moreover, it has important implications for addressing the paradoxical relationship between experience and expertise, as well as for designing a curriculum to teach clinical reasoning skills. © 2012 Blackwell Publishing Ltd.

  14. A Health Science Process Framework for Comprehensive Clinical Functional Assessment

    Science.gov (United States)

    2014-02-01

    Adaptability Inventory-4 • Rancho Los Amigos Cognitive Scale - Inpatient • Rancho Los Amigos Cognitive Scale - Outpatient • Satisfaction with Life...and policies e580 Health services, systems and policies e585 Education and training services, systems and policies e590 Labour and employment services...consistently reported a high degree of satisfaction with the process, and demonstrated a high level of interest in the exercise. In conjunction with the

  15. Flight and Operational Medicine Clinic (FOMC) Task Process Mapping

    Science.gov (United States)

    2014-03-01

    AHLTA YES 81 Signs off on the paperwork Tailor 469 to individual workplace Completes quality review and ensures standards are followed Is...condition 31, 37, 81? Complete evaluation Present 469 within 5 days of positive pregnancy test Is condition duty/fitness? NO End Process YES Send to...duty or mobility Document visit and restrictions in AHLTA YES 81 Signs off on the paperwork Tailor 469 to individual workplace Completes

  16. Understanding implementation processes of clinical pathways and clinical practice guidelines in pediatric contexts: a study protocol

    Directory of Open Access Journals (Sweden)

    Scott Shannon D

    2011-12-01

    Full Text Available Abstract Background Canada is among the most prosperous nations in the world, yet the health and wellness outcomes of Canadian children are surprisingly poor. There is some evidence to suggest that these poor health outcomes are partly due to clinical practice variation, which can stem from failure to apply the best available research evidence in clinical practice, otherwise known as knowledge translation (KT. Surprisingly, clinical practice variation, even for common acute paediatric conditions, is pervasive. Clinical practice variation results in unnecessary medical treatments, increased suffering, and increased healthcare costs. This study focuses on improving health outcomes for common paediatric acute health concerns by evaluating strategies that improve KT and reduce clinical practice variation. Design/Methods Using a multiple case study design, qualitative and quantitative data will be collected from four emergency departments in western Canada. Data sources will include: pre- and post-implementation focus group data from multidisciplinary healthcare professionals; individual interviews with the local champions, KT intervention providers, and unit/site leaders/managers; Alberta Context Tool (ACT survey data; and aggregated patient outcome data. Qualitative and quantitative data will be systematically triangulated, and matrices will be built to do cross-case comparison. Explanations will be built about the success or lack of success of the clinical practice guidelines (CPG and clinical pathways (CPs uptake based upon the cross-case comparisons. Significance This study will generate new knowledge about the potential causal mechanisms and factors which shape implementation. Future studies will track the impact of the CPG/CPs implementation on children's health outcome, and healthcare costs.

  17. Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.

    Science.gov (United States)

    Somers, Annemie; Claus, Barbara; Vandewoude, Koen; Petrovic, Mirko

    2016-03-01

    This article summarizes the experience with the development of clinical pharmacy services in the Ghent University Hospital in Belgium. Implementation of clinical pharmacy services in Belgian hospitals has not been evident because these activities were initially not structurally financed. The aim is to describe the strengths and weaknesses of the clinical pharmacy development process, and the milestones that enhanced the progress. Furthermore, the organisation of clinical pharmacy in the Ghent University Hospital is explained, including back- and front-office activities, seamless pharmaceutical care and medication safety improvement. Some working methods, procedures and tools are explained for different clinical pharmacy services. In particular, the clinical pharmacy projects for geriatric patients as well as the preparation of clinical pharmacy services for the accreditation process are explained. We also reflect on the organisation model and the future development of clinical pharmacy, taking into consideration facilitators and potential barriers.

  18. Utilization of a Clinical Trial Management System for the Whole Clinical Trial Process as an Integrated Database: System Development.

    Science.gov (United States)

    Park, Yu Rang; Yoon, Young Jo; Koo, HaYeong; Yoo, Soyoung; Choi, Chang-Min; Beck, Sung-Ho; Kim, Tae Won

    2018-04-24

    Clinical trials pose potential risks in both communications and management due to the various stakeholders involved when performing clinical trials. The academic medical center has a responsibility and obligation to conduct and manage clinical trials while maintaining a sufficiently high level of quality, therefore it is necessary to build an information technology system to support standardized clinical trial processes and comply with relevant regulations. The objective of the study was to address the challenges identified while performing clinical trials at an academic medical center, Asan Medical Center (AMC) in Korea, by developing and utilizing a clinical trial management system (CTMS) that complies with standardized processes from multiple departments or units, controlled vocabularies, security, and privacy regulations. This study describes the methods, considerations, and recommendations for the development and utilization of the CTMS as a consolidated research database in an academic medical center. A task force was formed to define and standardize the clinical trial performance process at the site level. On the basis of the agreed standardized process, the CTMS was designed and developed as an all-in-one system complying with privacy and security regulations. In this study, the processes and standard mapped vocabularies of a clinical trial were established at the academic medical center. On the basis of these processes and vocabularies, a CTMS was built which interfaces with the existing trial systems such as the electronic institutional review board health information system, enterprise resource planning, and the barcode system. To protect patient data, the CTMS implements data governance and access rules, and excludes 21 personal health identifiers according to the Health Insurance Portability and Accountability Act (HIPAA) privacy rule and Korean privacy laws. Since December 2014, the CTMS has been successfully implemented and used by 881 internal and

  19. Using Unified Modelling Language (UML) as a process-modelling technique for clinical-research process improvement.

    Science.gov (United States)

    Kumarapeli, P; De Lusignan, S; Ellis, T; Jones, B

    2007-03-01

    The Primary Care Data Quality programme (PCDQ) is a quality-improvement programme which processes routinely collected general practice computer data. Patient data collected from a wide range of different brands of clinical computer systems are aggregated, processed, and fed back to practices in an educational context to improve the quality of care. Process modelling is a well-established approach used to gain understanding and systematic appraisal, and identify areas of improvement of a business process. Unified modelling language (UML) is a general purpose modelling technique used for this purpose. We used UML to appraise the PCDQ process to see if the efficiency and predictability of the process could be improved. Activity analysis and thinking-aloud sessions were used to collect data to generate UML diagrams. The UML model highlighted the sequential nature of the current process as a barrier for efficiency gains. It also identified the uneven distribution of process controls, lack of symmetric communication channels, critical dependencies among processing stages, and failure to implement all the lessons learned in the piloting phase. It also suggested that improved structured reporting at each stage - especially from the pilot phase, parallel processing of data and correctly positioned process controls - should improve the efficiency and predictability of research projects. Process modelling provided a rational basis for the critical appraisal of a clinical data processing system; its potential maybe underutilized within health care.

  20. An Investigation of Selective College and University Libraries' Serial Arrangement.

    Science.gov (United States)

    Kesler, Elizabeth Gates; Teborek, Gay

    Data from a survey on serials arrangement procedures and policies at academic libraries was used by the University of Rhode Island (URI) Library in changing current serials policies. Ten libraries, four of which have similar serial holdings and user populations to URI, responded to a questionnaire. Information was obtained on classification versus…

  1. Sensing the Opaque : Seriality and the Aesthetics of Televisual Form

    NARCIS (Netherlands)

    Dasgupta, S.; Kelleter, F.

    2017-01-01

    Recent work on TV seriality focuses on the deference of meaning through narrative extension. Contemporary seriality, it has been argued, exploits this expanding textuality to construct complicated narratives that tip the pleasures of seriality toward detecting the meaning of the plot's

  2. Serial Millisecond Crystallography of Membrane Proteins.

    Science.gov (United States)

    Jaeger, Kathrin; Dworkowski, Florian; Nogly, Przemyslaw; Milne, Christopher; Wang, Meitian; Standfuss, Joerg

    2016-01-01

    Serial femtosecond crystallography (SFX) at X-ray free-electron lasers (XFELs) is a powerful method to determine high-resolution structures of pharmaceutically relevant membrane proteins. Recently, the technology has been adapted to carry out serial millisecond crystallography (SMX) at synchrotron sources, where beamtime is more abundant. In an injector-based approach, crystals grown in lipidic cubic phase (LCP) or embedded in viscous medium are delivered directly into the unattenuated beam of a microfocus beamline. Pilot experiments show the application of microjet-based SMX for solving the structure of a membrane protein and compatibility of the method with de novo phasing. Planned synchrotron upgrades, faster detectors and software developments will go hand-in-hand with developments at free-electron lasers to provide a powerful methodology for solving structures from microcrystals at room temperature, ligand screening or crystal optimization for time-resolved studies with minimal or no radiation damage.

  3. [Personality disorders, psychopathy and serial killers].

    Science.gov (United States)

    Morana, Hilda C P; Stone, Michael H; Abdalla-Filho, Elias

    2006-10-01

    To illustrate the basic characteristics of several specific personality disorders, focusing mainly in antisocial personality disorder. The differences between antisocial personality disorder and psychopathy are highlighted. Serial killers and its psychopathic aspects are also discussed. A bibliographic review was completed in order to outline convergences and divergences among different authors about this controversial issue, especially those concerning the possibility of treatment. While anti-social personality disorder is a medical diagnosis, the term "psychopathy" (which belongs to the sphere of forensic psychiatry) may be understood as a "legal diagnosis". It is not still possible to identify an effective treatment for serial killers. Personality disorders, especially of the antisocial type, still represent a formidable challenge to forensic psychiatry today. Questions as yet unanswered include the best and most humane place for patients with this condition and the nature of a standardised treatment recommendation.

  4. Serial auditory-evoked potentials in the diagnosis and monitoring of a child with Landau-Kleffner syndrome.

    Science.gov (United States)

    Plyler, Erin; Harkrider, Ashley W

    2013-01-01

    A boy, aged 2 1/2 yr, experienced sudden deterioration of speech and language abilities. He saw multiple medical professionals across 2 yr. By almost 5 yr, his vocabulary diminished from 50 words to 4, and he was referred to our speech and hearing center. The purpose of this study was to heighten awareness of Landau-Kleffner syndrome (LKS) and emphasize the importance of an objective test battery that includes serial auditory-evoked potentials (AEPs) to audiologists who often are on the front lines of diagnosis and treatment delivery when faced with a child experiencing unexplained loss of the use of speech and language. Clinical report. Interview revealed a family history of seizure disorder. Normal social behaviors were observed. Acoustic reflexes and otoacoustic emissions were consistent with normal peripheral auditory function. The child could not complete behavioral audiometric testing or auditory processing tests, so serial AEPs were used to examine central nervous system function. Normal auditory brainstem responses, a replicable Na and absent Pa of the middle latency responses, and abnormal slow cortical potentials suggested dysfunction of auditory processing at the cortical level. The child was referred to a neurologist, who confirmed LKS. At age 7 1/2 yr, after 2 1/2 yr of antiepileptic medications, electroencephalographic (EEG) and audiometric measures normalized. Presently, the child communicates manually with limited use of oral information. Audiologists often are one of the first professionals to assess children with loss of speech and language of unknown origin. Objective, noninvasive, serial AEPs are a simple and valuable addition to the central audiometric test battery when evaluating a child with speech and language regression. The inclusion of these tests will markedly increase the chance for early and accurate referral, diagnosis, and monitoring of a child with LKS which is imperative for a positive prognosis. American Academy of Audiology.

  5. Data processing for registered multimodal images and its clinical application

    International Nuclear Information System (INIS)

    Toyama, Hinako; Kobayashi, Akio; Uemura, Kouji

    1998-01-01

    We have developed two kinds of data processing methods for co-registered PET and MR images. The 3D-brain surface, representing the cortical rim in the transaxial images, was projected on a 2D-plane by utilizing Mollweide projection, which is an area-conserving method of displaying the globe as a world map. A quantitative ROI analysis on the brain surface and 3D superimposed surface display were performed by means of the 2D projection image. A clustered brain image was created by referring to the clustered 3D correlation map of resting CBF, the acetazolamide response and the hyperventilatory response, where each pixel in the brain was labeled with the color representing its cluster number. With this method, the stage of hemodynamic deficiency was evaluated in a patient with the occlusion of internal carotid artery. The differences in the brain images obtained before and after revascularized surgery was also evaluated. (author)

  6. Nutritional effects of the serial transverse enteroplasty procedure in experimental short bowel syndrome

    DEFF Research Database (Denmark)

    Kaji, Tatsuru; Tanaka, Hiroaki; Wallace, Laurie E

    2009-01-01

    The serial transverse enteroplasty (STEP) procedure appears beneficial clinically, but the mechanism(s) underlying these effects remains unclear. The present study evaluated the nutritional, hormonal, and morphologic effects of the STEP procedure in a rodent model of short bowel syndrome....

  7. Natural Language Processing Technologies in Radiology Research and Clinical Applications

    Science.gov (United States)

    Cai, Tianrun; Giannopoulos, Andreas A.; Yu, Sheng; Kelil, Tatiana; Ripley, Beth; Kumamaru, Kanako K.; Rybicki, Frank J.

    2016-01-01

    The migration of imaging reports to electronic medical record systems holds great potential in terms of advancing radiology research and practice by leveraging the large volume of data continuously being updated, integrated, and shared. However, there are significant challenges as well, largely due to the heterogeneity of how these data are formatted. Indeed, although there is movement toward structured reporting in radiology (ie, hierarchically itemized reporting with use of standardized terminology), the majority of radiology reports remain unstructured and use free-form language. To effectively “mine” these large datasets for hypothesis testing, a robust strategy for extracting the necessary information is needed. Manual extraction of information is a time-consuming and often unmanageable task. “Intelligent” search engines that instead rely on natural language processing (NLP), a computer-based approach to analyzing free-form text or speech, can be used to automate this data mining task. The overall goal of NLP is to translate natural human language into a structured format (ie, a fixed collection of elements), each with a standardized set of choices for its value, that is easily manipulated by computer programs to (among other things) order into subcategories or query for the presence or absence of a finding. The authors review the fundamentals of NLP and describe various techniques that constitute NLP in radiology, along with some key applications. ©RSNA, 2016 PMID:26761536

  8. Natural Language Processing Technologies in Radiology Research and Clinical Applications.

    Science.gov (United States)

    Cai, Tianrun; Giannopoulos, Andreas A; Yu, Sheng; Kelil, Tatiana; Ripley, Beth; Kumamaru, Kanako K; Rybicki, Frank J; Mitsouras, Dimitrios

    2016-01-01

    The migration of imaging reports to electronic medical record systems holds great potential in terms of advancing radiology research and practice by leveraging the large volume of data continuously being updated, integrated, and shared. However, there are significant challenges as well, largely due to the heterogeneity of how these data are formatted. Indeed, although there is movement toward structured reporting in radiology (ie, hierarchically itemized reporting with use of standardized terminology), the majority of radiology reports remain unstructured and use free-form language. To effectively "mine" these large datasets for hypothesis testing, a robust strategy for extracting the necessary information is needed. Manual extraction of information is a time-consuming and often unmanageable task. "Intelligent" search engines that instead rely on natural language processing (NLP), a computer-based approach to analyzing free-form text or speech, can be used to automate this data mining task. The overall goal of NLP is to translate natural human language into a structured format (ie, a fixed collection of elements), each with a standardized set of choices for its value, that is easily manipulated by computer programs to (among other things) order into subcategories or query for the presence or absence of a finding. The authors review the fundamentals of NLP and describe various techniques that constitute NLP in radiology, along with some key applications. ©RSNA, 2016.

  9. Fractional Flow Reserve Assessment of a Significant Coronary Stenosis Masked by a Downstream Serial Lesion

    Directory of Open Access Journals (Sweden)

    Lawrence Yu-Min Liu

    2016-01-01

    Full Text Available Fractional flow reserve (FFR has been recognized as an effective tool to determine functional significance in intermediate coronary lesions and FFR-guided percutaneous coronary intervention (PCI improves clinical outcomes. However, hemodynamic interaction between serial stenoses within one coronary artery complicates the assessment of functional severity of each individual lesion. We present a case in which FFR measurement by intracoronary bolus injection of adenosine helps to make appropriate revascularization decision in serial stenoses when the procedures are performed systemically and properly.

  10. Automated detection of multiple sclerosis lesions in serial brain MRI

    International Nuclear Information System (INIS)

    Llado, Xavier; Ganiler, Onur; Oliver, Arnau; Marti, Robert; Freixenet, Jordi; Valls, Laia; Vilanova, Joan C.; Ramio-Torrenta, Lluis; Rovira, Alex

    2012-01-01

    Multiple sclerosis (MS) is a serious disease typically occurring in the brain whose diagnosis and efficacy of treatment monitoring are vital. Magnetic resonance imaging (MRI) is frequently used in serial brain imaging due to the rich and detailed information provided. Time-series analysis of images is widely used for MS diagnosis and patient follow-up. However, conventional manual methods are time-consuming, subjective, and error-prone. Thus, the development of automated techniques for the detection and quantification of MS lesions is a major challenge. This paper presents an up-to-date review of the approaches which deal with the time-series analysis of brain MRI for detecting active MS lesions and quantifying lesion load change. We provide a comprehensive reference source for researchers in which several approaches to change detection and quantification of MS lesions are investigated and classified. We also analyze the results provided by the approaches, discuss open problems, and point out possible future trends. Lesion detection approaches are required for the detection of static lesions and for diagnostic purposes, while either quantification of detected lesions or change detection algorithms are needed to follow up MS patients. However, there is not yet a single approach that can emerge as a standard for the clinical practice, automatically providing an accurate MS lesion evolution quantification. Future trends will focus on combining the lesion detection in single studies with the analysis of the change detection in serial MRI. (orig.)

  11. Automated detection of multiple sclerosis lesions in serial brain MRI

    Energy Technology Data Exchange (ETDEWEB)

    Llado, Xavier; Ganiler, Onur; Oliver, Arnau; Marti, Robert; Freixenet, Jordi [University of Girona, Computer Vision and Robotics Group, Girona (Spain); Valls, Laia [Dr. Josep Trueta University Hospital, Department of Radiology, Girona (Spain); Vilanova, Joan C. [Girona Magnetic Resonance Center, Girona (Spain); Ramio-Torrenta, Lluis [Dr. Josep Trueta University Hospital, Institut d' Investigacio Biomedica de Girona, Multiple Sclerosis and Neuroimmunology Unit, Girona (Spain); Rovira, Alex [Vall d' Hebron University Hospital, Magnetic Resonance Unit, Department of Radiology, Barcelona (Spain)

    2012-08-15

    Multiple sclerosis (MS) is a serious disease typically occurring in the brain whose diagnosis and efficacy of treatment monitoring are vital. Magnetic resonance imaging (MRI) is frequently used in serial brain imaging due to the rich and detailed information provided. Time-series analysis of images is widely used for MS diagnosis and patient follow-up. However, conventional manual methods are time-consuming, subjective, and error-prone. Thus, the development of automated techniques for the detection and quantification of MS lesions is a major challenge. This paper presents an up-to-date review of the approaches which deal with the time-series analysis of brain MRI for detecting active MS lesions and quantifying lesion load change. We provide a comprehensive reference source for researchers in which several approaches to change detection and quantification of MS lesions are investigated and classified. We also analyze the results provided by the approaches, discuss open problems, and point out possible future trends. Lesion detection approaches are required for the detection of static lesions and for diagnostic purposes, while either quantification of detected lesions or change detection algorithms are needed to follow up MS patients. However, there is not yet a single approach that can emerge as a standard for the clinical practice, automatically providing an accurate MS lesion evolution quantification. Future trends will focus on combining the lesion detection in single studies with the analysis of the change detection in serial MRI. (orig.)

  12. From animal cruelty to serial murder: applying the graduation hypothesis.

    Science.gov (United States)

    Wright, Jeremy; Hensley, Christopher

    2003-02-01

    Although serial murder has been recorded for centuries, limited academic attention has been given to this important topic. Scholars have attempted to examine the causality and motivations behind the rare phenomenon of serial murder. However, scant research exists which delves into the childhood characteristics of serial murderers. Using social learning theory, some of these studies present supporting evidence for a link between childhood animal cruelty and adult aggression toward humans. Based on five case studies of serial murderers, we contribute to the existing literature by exploring the possible link between childhood cruelty toward animals and serial murder with the application of the graduation hypothesis.

  13. Clinical Processes - The Killer Application for Constraint-Based Process Interactions

    DEFF Research Database (Denmark)

    Jiménez-Ramírez, Andrés; Barba, Irene; Reichert, Manfred

    2018-01-01

    . The scenario is subject to complex temporal constraints and entails the need for coordinating the constraint-based interactions among the processes related to a patient treatment process. As demonstrated in this work, the selected real process scenario can be suitably modeled through a declarative approach....... examples. However, to the best of our knowledge, they have not been used to model complex, real-world scenarios that comprise constraints going beyond control-flow. In this paper, we propose the use of a declarative language for modeling a sophisticated healthcare process scenario from the real world......For more than a decade, the interest in aligning information systems in a process-oriented way has been increasing. To enable operational support for business processes, the latter are usually specified in an imperative way. The resulting process models, however, tend to be too rigid to meet...

  14. Assessing Working Memory in Mild Cognitive Impairment with Serial Order Recall.

    Science.gov (United States)

    Emrani, Sheina; Libon, David J; Lamar, Melissa; Price, Catherine C; Jefferson, Angela L; Gifford, Katherine A; Hohman, Timothy J; Nation, Daniel A; Delano-Wood, Lisa; Jak, Amy; Bangen, Katherine J; Bondi, Mark W; Brickman, Adam M; Manly, Jennifer; Swenson, Rodney; Au, Rhoda

    2018-01-01

    Working memory (WM) is often assessed with serial order tests such as repeating digits backward. In prior dementia research using the Backward Digit Span Test (BDT), only aggregate test performance was examined. The current research tallied primacy/recency effects, out-of-sequence transposition errors, perseverations, and omissions to assess WM deficits in patients with mild cognitive impairment (MCI). Memory clinic patients (n = 66) were classified into three groups: single domain amnestic MCI (aMCI), combined mixed domain/dysexecutive MCI (mixed/dys MCI), and non-MCI where patients did not meet criteria for MCI. Serial order/WM ability was assessed by asking participants to repeat 7 trials of five digits backwards. Serial order position accuracy, transposition errors, perseverations, and omission errors were tallied. A 3 (group)×5 (serial position) repeated measures ANOVA yielded a significant group×trial interaction. Follow-up analyses found attenuation of the recency effect for mixed/dys MCI patients. Mixed/dys MCI patients scored lower than non-MCI patients for serial position 3 (p Mixed/dys MCI patients also produced more transposition errors than both groups (p order parameters obtained from the BDT may provide a useful operational definition as well as additional diagnostic information regarding working memory deficits in MCI.

  15. Emotional prosody of task-irrelevant speech interferes with the retention of serial order.

    Science.gov (United States)

    Kattner, Florian; Ellermeier, Wolfgang

    2018-04-09

    Task-irrelevant speech and other temporally changing sounds are known to interfere with the short-term memorization of ordered verbal materials, as compared to silence or stationary sounds. It has been argued that this disruption of short-term memory (STM) may be due to (a) interference of automatically encoded acoustical fluctuations with the process of serial rehearsal or (b) attentional capture by salient task-irrelevant information. To disentangle the contributions of these 2 processes, the authors investigated whether the disruption of serial recall is due to the semantic or acoustical properties of task-irrelevant speech (Experiment 1). They found that performance was affected by the prosody (emotional intonation), but not by the semantics (word meaning), of irrelevant speech, suggesting that the disruption of serial recall is due to interference of precategorically encoded changing-state sound (with higher fluctuation strength of emotionally intonated speech). The authors further demonstrated a functional distinction between this form of distraction and attentional capture by contrasting the effect of (a) speech prosody and (b) sudden prosody deviations on both serial and nonserial STM tasks (Experiment 2). Although serial recall was again sensitive to the emotional prosody of irrelevant speech, performance on a nonserial missing-item task was unaffected by the presence of neutral or emotionally intonated speech sounds. In contrast, sudden prosody changes tended to impair performance on both tasks, suggesting an independent effect of attentional capture. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  16. The effect and complication of botulinum toxin type a injection with serial casting for the treatment of spastic equinus foot.

    Science.gov (United States)

    Lee, Sook Joung; Sung, In Young; Jang, Dae Hyun; Yi, Jin Hwa; Lee, Jin Ho; Ryu, Ju Seok

    2011-06-01

    To identify the effect of serial casting combined with Botulinum toxin type A (BTX-A) injection on spastic equinus foot. Twenty-nine children with cerebral palsy who had equinus foot were recruited from the outpatient clinic of Rehabilitation Medicine. The children were divided into 2 groups, one of which received serial casting after BTX-A injection, and the other which only received BTX-A injection. Serial casting started 3 weeks after the BTX-A injection, and was changed weekly for 3 times. Spasticity of the ankle joint was evaluated using the modified Ashworth scale (MAS), and the modified Tardieu scale (MTS). Gait pattern was measured using the physician's rating scale (PRS). The degree of ankle dorsiflexion and the MAS improved significantly until 12 weeks following the BTX-A injection in the serial casting group (pcasting. Our study demonstrated that the effect of BTX-A injection with serial casting was superior and lasted longer than the effect of BTX-A injection only in patients with spastic equinus foot. We therefore recommend BTX-A injection with serial casting for the treatment of equinus foot. However, physicians must also consider the possible complications associated with serial casting.

  17. Serial 5-Year Evaluation of Side Branches Jailed by Bioresorbable Vascular Scaffolds Using 3-Dimensional Optical Coherence Tomography: Insights From the ABSORB Cohort B Trial (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions).

    Science.gov (United States)

    Onuma, Yoshinobu; Grundeken, Maik J; Nakatani, Shimpei; Asano, Taku; Sotomi, Yohei; Foin, Nicolas; Ng, Jaryl; Okamura, Takayuki; Wykrzykowska, Joanna J; de Winter, Robbert J; van Geuns, Robert-Jan; Koolen, Jacques; Christiansen, Evald; Whitbourn, Robert; McClean, Dougal; Smits, Pieter; Windecker, Stephan; Ormiston, John A; Serruys, Patrick W

    2017-09-01

    The long-term fate of Absorb bioresorbable vascular scaffold (Abbott Vascular, Santa Clara, CA) struts jailing side branch ostia has not been clarified. We therefore evaluate serially (post-procedure and at 6 months, 1, 2, 3, and 5 years) the appearance and fate of jailed Absorb bioresorbable vascular scaffold struts. We performed 3-dimensional optical coherence tomographic analysis of the ABSORB Cohort B trial (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions) up to 5 years using a novel, validated cut-plane analysis method. We included 29 patients with a total of 85 side branch ostia. From the 12 ostia which could be assessed in true serial fashion, 7 showed a pattern of initial decrease in the ostial area free from struts, followed by an increase in strut-free ostial area toward the end of the 5 years of follow-up. In a repeated-measures analysis with time as fixed variable and ostial area free from struts as dependent variable, we showed a numeric decrease in the estimated ostial area free from struts from 0.75 mm 2 (baseline) to 0.68 mm 2 (first follow-up visit at 6 months or 1 year) and 0.63 mm 2 (second follow-up visit at 2 or 3 years). However, from the second visit to the 5-year follow-up visit, there was a statistically significant increase from 0.63 to 0.89 mm 2 ( P =0.001). Struts overlying an ostium divided the ostium into compartments, and the number of these compartments decreased over time. This study showed that in most cases, the side branch ostial area free from struts initially decreased. However, with full scaffold bioresorption, the ostial area free from scaffold increased between 2 to 3 years and 5 years in the vast majority of patients. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00856856. © 2017 American Heart Association, Inc.

  18. Addressing Clinical Faculty Need: Creating a Process and Evaluation for Peer Review of Practice

    Directory of Open Access Journals (Sweden)

    Jean Y. Moon

    2014-01-01

    Full Text Available Objectives: To describe the evolving process and evaluate the perceived value of peer review for clinical faculty. Methods: Using a 5-point Likert scale, clinical faculty rated the value of an electronic peer review process by completing an electronic 30 item survey across six areas of clinical faculty practice-related activity. Based on feedback, modifications were made and faculty were re-surveyed the following year. Results: Initially, 78% of faculty found peer review to be beneficial, mostly in the area of practice development and portions of practice dissemination. After modifications, 45% found peer review to be beneficial. Conclusions: Clinical faculty are challenged to leverage their practice into teaching and scholarly activities; however, clinical faculty often need feedback to accomplish this. Although the peer review process was designed to address perceived needs of clinical faculty, the process is dynamic and needs further refinement. Overall, clinical faculty find value in a peer review process. This evaluation of peer review illustrates the challenges to provide feedback across six key areas of clinical faculty activity.   Type: Original Research

  19. Intentional Modelling: A Process for Clinical Leadership Development in Mental Health Nursing.

    Science.gov (United States)

    Ennis, Gary; Happell, Brenda; Reid-Searl, Kerry

    2016-05-01

    Clinical leadership is becoming more relevant for nurses, as the positive impact that it can have on the quality of care and outcomes for consumers is better understood and more clearly articulated in the literature. As clinical leadership continues to become more relevant, the need to gain an understanding of how clinical leaders in nursing develop will become increasingly important. While the attributes associated with effective clinical leadership are recognized in current literature there remains a paucity of research on how clinical leaders develop these attributes. This study utilized a grounded theory methodology to generate new insights into the experiences of peer identified clinical leaders in mental health nursing and the process of developing clinical leadership skills. Participants in this study were nurses working in a mental health setting who were identified as clinical leaders by their peers as opposed to identifying them by their role or organizational position. A process of intentional modeling emerged as the substantive theory identified in this study. Intentional modeling was described by participants in this study as a process that enabled them to purposefully identify models that assisted them in developing the characteristics of effective clinical leaders as well as allowing them to model these characteristics to others. Reflection on practice is an important contributor to intentional modelling. Intentional modelling could be developed as a framework for promoting knowledge and skill development in the area of clinical leadership.

  20. Implementation of a Multichannel Serial Data Streaming Algorithm using the Xilinx Serial RapidIO Solution

    Science.gov (United States)

    Doxley, Charles A.

    2016-01-01

    In the current world of applications that use reconfigurable technology implemented on field programmable gate arrays (FPGAs), there is a need for flexible architectures that can grow as the systems evolve. A project has limited resources and a fixed set of requirements that development efforts are tasked to meet. Designers must develop robust solutions that practically meet the current customer demands and also have the ability to grow for future performance. This paper describes the development of a high speed serial data streaming algorithm that allows for transmission of multiple data channels over a single serial link. The technique has the ability to change to meet new applications developed for future design considerations. This approach uses the Xilinx Serial RapidIO LOGICORE Solution to implement a flexible infrastructure to meet the current project requirements with the ability to adapt future system designs.

  1. A combination of process of care and clinical target among type 2 diabetes mellitus patients in general medical clinics and specialist diabetes clinics at hospital levels.

    Science.gov (United States)

    Sieng, Sokha; Hurst, Cameron

    2017-08-07

    This study compares a combination of processes of care and clinical targets among patients with type 2 diabetes mellitus (T2DM) between specialist diabetes clinics (SDCs) and general medical clinics (GMCs), and how differences between these two types of clinics differ with hospital type (community, provincial and regional). Type 2 diabetes mellitus patient medical records were collected from 595 hospitals (499 community, 70 provincial, 26 regional) in Thailand between April 1 to June 30, 2012 resulting in a cross-sectional sample of 26,860 patients. Generalized linear mixed modeling was conducted to examine associations between clinic type and quality of care. The outcome variables of interest were split into clinical targets and process of care. A subsequent subgroup analysis was conducted to examine if the nature of clinical target and process of care differences between GMCs and SDCs varied with hospital type (regional, provincial, community). Regardless of the types of hospitals (regional, provincial, or community) patients attending SDCs were considerably more likely to have eye and foot exam. In terms of larger hospitals (regional and provincial) patients attending SDCs were more likely to achieve HbA1c exam, All FACE exam, BP target, and the Num7Q. Interestingly, SDCs performed better than GMCs at only provincial hospitals for LDL-C target and the All7Q. Finally, patients with T2DM who attended community hospital-GMCs had a better chance of achieving the blood pressure target than patients who attended community hospital-SDCs. Specialized diabetes clinics outperform general medical clinics for both regional and provincial hospitals for all quality of care indicators and the number of quality of care indicators achieved was never lower. However, this better performance of SDC was not observed in community hospital. Indeed, GMCs outperformed SDCs for some quality of care indicators in the community level setting.

  2. Serial album validation for promotion of infant body weight control

    Directory of Open Access Journals (Sweden)

    Nathalia Costa Gonzaga Saraiva

    2018-05-01

    Full Text Available ABSTRACT Objective: to validate the content and appearance of a serial album for children aged from 7 to 10 years addressing the topic of prevention and control of body weight. Method: methodological study with descriptive nature. The validation process was attended by 33 specialists in educational technologies and/or in excess of infantile weight. The agreement index of 80% was the minimum considered to guarantee the validation of the material. Results: most of the specialists had a doctoral degree and a graduate degree in nursing. Regarding content, illustrations, layout and relevance, all items were validated and 69.7% of the experts considered the album as great. The overall agreement validation index for the educational technology was 0.88. Only the script-sheet 3 did not reach the cutoff point of the content validation index. Changes were made to the material, such as title change, inclusion of the school context and insertion of nutritionist and physical educator in the story narrated in the album. Conclusion: the proposed serial album was considered valid by experts regarding content and appearance, suggesting that this technology has the potential to contribute in health education by promoting healthy weight in the age group of 7 to 10 years.

  3. Serial sectioning methods for 3D investigations in materials science.

    Science.gov (United States)

    Zankel, Armin; Wagner, Julian; Poelt, Peter

    2014-07-01

    A variety of methods for the investigation and 3D representation of the inner structure of materials has been developed. In this paper, techniques based on slice and view using scanning microscopy for imaging are presented and compared. Three different methods of serial sectioning combined with either scanning electron or scanning ion microscopy or atomic force microscopy (AFM) were placed under scrutiny: serial block-face scanning electron microscopy, which facilitates an ultramicrotome built into the chamber of a variable pressure scanning electron microscope; three-dimensional (3D) AFM, which combines an (cryo-) ultramicrotome with an atomic force microscope, and 3D FIB, which delivers results by slicing with a focused ion beam. These three methods complement one another in many respects, e.g., in the type of materials that can be investigated, the resolution that can be obtained and the information that can be extracted from 3D reconstructions. A detailed review is given about preparation, the slice and view process itself, and the limitations of the methods and possible artifacts. Applications for each technique are also provided. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Volume imaging NDE and serial sectioning of carbon fiber composites

    Science.gov (United States)

    Hakim, Issa; Schumacher, David; Sundar, Veeraraghavan; Donaldson, Steven; Creuz, Aline; Schneider, Rainer; Keller, Juergen; Browning, Charles; May, Daniel; Ras, Mohamad Abo; Meyendorf, Norbert

    2018-04-01

    A composite material is a combination of two or more materials with very different mechanical, thermal and electrical properties. The various forms of composite materials, due to their high material properties, are widely used as structural materials in the aviation, space, marine, automobile, and sports industries. However, some defects like voids, delamination, or inhomogeneous fiber distribution that form during the fabricating processes of composites can seriously affect the mechanical properties of the composite material. In this study, several imaging NDE techniques such as: thermography, high frequency eddy current, ultrasonic, x-ray radiography, x-ray laminography, and high resolution x-ray CT were conducted to characterize the microstructure of carbon fiber composites. Then, a 3D analysis was implemented by the destructive technique of serial sectioning for the same sample tested by the NDE methods. To better analyze the results of this work and extract a clear volume image for all features and defects contained in the composite material, an intensive comparison was conducted among hundreds of 3D-NDE and multi serial sections' scan images showing the microstructure variation.

  5. In vivo serial sampling of epididymal sperm in mice.

    Science.gov (United States)

    Del Val, Gonzalo Moreno; Robledano, Patricia Muñoz

    2013-07-01

    This study was undertaken to refine the techniques of in vivo collection of sperm in the mouse. The principal objective was to offer a viable, safe and reliable method for serial collection of in vivo epididimary sperm through the direct puncture of the epididymis. Six C57Bl/6J males were subjected to the whole experiment. First we obtain a sperm sample of the right epididymis, and perform a vasectomy on the left side. This sample was used in an in vitro fertilization (IVF) experiment while the males were individually housed for 10 days to let them recover from the surgery, and then their fertility was tested with natural matings until we obtained a litter of each one. After that, the animals were subjected another time to the same process (sampling, recover and natural mating). The results of these experiments were a fertilization average value of 56.7%, and that all the males had a litter in the first month after the natural matings. This study documented the feasibility of the epididimary puncture technique to in vivo serial sampling of sperm in the mouse.

  6. Short-Term Memory and Auditory Processing Disorders: Concurrent Validity and Clinical Diagnostic Markers

    Science.gov (United States)

    Maerlender, Arthur

    2010-01-01

    Auditory processing disorders (APDs) are of interest to educators and clinicians, as they impact school functioning. Little work has been completed to demonstrate how children with APDs perform on clinical tests. In a series of studies, standard clinical (psychometric) tests from the Wechsler Intelligence Scale for Children, Fourth Edition…

  7. Clinical Natural Language Processing in languages other than English: opportunities and challenges.

    Science.gov (United States)

    Névéol, Aurélie; Dalianis, Hercules; Velupillai, Sumithra; Savova, Guergana; Zweigenbaum, Pierre

    2018-03-30

    Natural language processing applied to clinical text or aimed at a clinical outcome has been thriving in recent years. This paper offers the first broad overview of clinical Natural Language Processing (NLP) for languages other than English. Recent studies are summarized to offer insights and outline opportunities in this area. We envision three groups of intended readers: (1) NLP researchers leveraging experience gained in other languages, (2) NLP researchers faced with establishing clinical text processing in a language other than English, and (3) clinical informatics researchers and practitioners looking for resources in their languages in order to apply NLP techniques and tools to clinical practice and/or investigation. We review work in clinical NLP in languages other than English. We classify these studies into three groups: (i) studies describing the development of new NLP systems or components de novo, (ii) studies describing the adaptation of NLP architectures developed for English to another language, and (iii) studies focusing on a particular clinical application. We show the advantages and drawbacks of each method, and highlight the appropriate application context. Finally, we identify major challenges and opportunities that will affect the impact of NLP on clinical practice and public health studies in a context that encompasses English as well as other languages.

  8. Serials collection management in recessionary times

    CERN Document Server

    Lawson, Karen G

    2015-01-01

    Strategic planning, collaboration, continual stewardship, best practices, and re-engineering can provide librarians with a toolkit of innovative strategies that meets the worst of economic times with bold, persistent experimentation. This book covers the implications for libraries of a broad range of technological and economic challenges. These challenges include the fallout from the global economic crisis, the positioning of usage statistics, the advent of open access scholarship, database management, responding to budgetary constrictions and general access to serials. Taken as a whole, this

  9. Inverse Kinematics of a Serial Robot

    Directory of Open Access Journals (Sweden)

    Amici Cinzia

    2016-01-01

    Full Text Available This work describes a technique to treat the inverse kinematics of a serial manipulator. The inverse kinematics is obtained through the numerical inversion of the Jacobian matrix, that represents the equation of motion of the manipulator. The inversion is affected by numerical errors and, in different conditions, due to the numerical nature of the solver, it does not converge to a reasonable solution. Thus a soft computing approach is adopted to mix different traditional methods to obtain an increment of algorithmic convergence.

  10. Personality disorders, psychopathy and serial killers

    OpenAIRE

    Morana, Hilda C P; Stone, Michael H; Abdalla-Filho, Elias

    2006-01-01

    OBJETIVO: Apresentar as características básicas dos diversos transtornos específicos de personalidade, mas centrando-se no transtorno de personalidade anti-social, fazendo sua diferenciação com psicopatia. O estudo ainda se propõe a abordar a figura do serial killer, apontando a presença de aspectos psicopáticos no homicídio seriado. MÉTODO: Uma revisão bibliográfica foi feita no sentido de se abordar convergências e divergências entre diversos autores sobre um assunto tão polêmico, sobretudo...

  11. The primacy model: a new model of immediate serial recall.

    Science.gov (United States)

    Page, M P; Norris, D

    1998-10-01

    A new model of immediate serial recall is presented: the primacy model. The primacy model stores order information by means of the assumption that the strength of activation of successive list items decreases across list position to form a primacy gradient. Ordered recall is supported by a repeated cycle of operations involving a noisy choice of the most active item followed by suppression of the chosen item. Word-length and list-length effects are attributed to a decay process that occurs both during input, when effective rehearsal is prevented, and during output. The phonological similarity effect is attributed to a second stage of processing at which phonological confusions occur. The primacy model produces accurate simulations of the effects of word length, list length, and phonological similarity.

  12. Kinematic Gait Changes Following Serial Casting and Bracing to Treat Toe Walking in a Child With Autism.

    Science.gov (United States)

    Barkocy, Marybeth; Dexter, James; Petranovich, Colleen

    2017-07-01

    To evaluate the effectiveness of serial casting in a child with autism spectrum disorder (ASD) exhibiting a toe-walking gait pattern with equinus contractures. Although many children with ASD toe walk, little research on physical therapy interventions exists for this population. Serial casting has been validated for use in idiopathic toe walking to increase passive dorsiflexion and improve gait, but not for toe walking in children with ASD. Serial casting followed by ankle-foot orthosis use was implemented to treat a child with ASD who had an obligatory equinus gait pattern. Gait analysis supported improvements in kinematic, spatial, and temporal parameters of gait, and the child maintained a consistent heel-toe gait at 2-year follow-up. STATEMENT OF CONCLUSION AND RECOMMENDATIONS FOR CLINICAL PRACTICE:: Serial casting followed by ankle-foot orthosis use is a viable treatment option for toe walking in children with ASD.

  13. Modelling and performance analysis of clinical pathways using the stochastic process algebra PEPA.

    Science.gov (United States)

    Yang, Xian; Han, Rui; Guo, Yike; Bradley, Jeremy; Cox, Benita; Dickinson, Robert; Kitney, Richard

    2012-01-01

    Hospitals nowadays have to serve numerous patients with limited medical staff and equipment while maintaining healthcare quality. Clinical pathway informatics is regarded as an efficient way to solve a series of hospital challenges. To date, conventional research lacks a mathematical model to describe clinical pathways. Existing vague descriptions cannot fully capture the complexities accurately in clinical pathways and hinders the effective management and further optimization of clinical pathways. Given this motivation, this paper presents a clinical pathway management platform, the Imperial Clinical Pathway Analyzer (ICPA). By extending the stochastic model performance evaluation process algebra (PEPA), ICPA introduces a clinical-pathway-specific model: clinical pathway PEPA (CPP). ICPA can simulate stochastic behaviours of a clinical pathway by extracting information from public clinical databases and other related documents using CPP. Thus, the performance of this clinical pathway, including its throughput, resource utilisation and passage time can be quantitatively analysed. A typical clinical pathway on stroke extracted from a UK hospital is used to illustrate the effectiveness of ICPA. Three application scenarios are tested using ICPA: 1) redundant resources are identified and removed, thus the number of patients being served is maintained with less cost; 2) the patient passage time is estimated, providing the likelihood that patients can leave hospital within a specific period; 3) the maximum number of input patients are found, helping hospitals to decide whether they can serve more patients with the existing resource allocation. ICPA is an effective platform for clinical pathway management: 1) ICPA can describe a variety of components (state, activity, resource and constraints) in a clinical pathway, thus facilitating the proper understanding of complexities involved in it; 2) ICPA supports the performance analysis of clinical pathway, thereby assisting

  14. Integrating complex business processes for knowledge-driven clinical decision support systems.

    Science.gov (United States)

    Kamaleswaran, Rishikesan; McGregor, Carolyn

    2012-01-01

    This paper presents in detail the component of the Complex Business Process for Stream Processing framework that is responsible for integrating complex business processes to enable knowledge-driven Clinical Decision Support System (CDSS) recommendations. CDSSs aid the clinician in supporting the care of patients by providing accurate data analysis and evidence-based recommendations. However, the incorporation of a dynamic knowledge-management system that supports the definition and enactment of complex business processes and real-time data streams has not been researched. In this paper we discuss the process web service as an innovative method of providing contextual information to a real-time data stream processing CDSS.

  15. Serial position curves in free recall.

    Science.gov (United States)

    Laming, Donald

    2010-01-01

    The scenario for free recall set out in Laming (2009) is developed to provide models for the serial position curves from 5 selected sets of data, for final free recall, and for multitrial free recall. The 5 sets of data reflect the effects of rate of presentation, length of list, delay of recall, and suppression of rehearsal. Each model accommodates the serial position curve for first recalls (where those data are available) as well as that for total recalls. Both curves are fit with the same parameter values, as also (with 1 exception) are all of the conditions compared within each experiment. The distributions of numbers of recalls are also examined and shown to have variances increased above what would be expected if successive recalls were independent. This is taken to signify that, in those experiments in which rehearsals were not recorded, the retrieval of words for possible recall follows the same pattern that is observed following overt rehearsal, namely, that retrieval consists of runs of consecutive elements from memory. Finally, 2 sets of data are examined that the present approach cannot accommodate. It is argued that the problem with these data derives from an interaction between the patterns of (covert) rehearsal and the parameters of list presentation.

  16. Malingering, coaching, and the serial position effect.

    Science.gov (United States)

    Suhr, Julie A

    2002-01-01

    The normal pattern of performance on list-learning tasks is to recall more words from the beginning (primacy) and end (recency) of the list. This pattern is also seen in patients with closed head injury, but malingerers tend to recall less words from the beginning of word lists, leading to a suppressed primacy effect. The present study examined this pattern on both learning trials and delayed recall of the Auditory Verbal Learning Test (AVLT) in 34 persons performing with normal effort, 38 naive malingerers, 33 warned malingerers, and 29 head-injured patients. Both malingering groups had lower scores on the primacy portion of the list during learning trials, while normals and head-injured patients had normal serial position curves. During delayed recall, normals and head-injured patients did better than the two malingering groups on middle and recency portions of the list. Findings suggest that the serial position effect during learning trials may be a useful pattern of performance to watch for when suspicious of malingering.

  17. Rapid-Sequence Serial Sexual Homicides.

    Science.gov (United States)

    Schlesinger, Louis B; Ramirez, Stephanie; Tusa, Brittany; Jarvis, John P; Erdberg, Philip

    2017-03-01

    Serial sexual murderers have been described as committing homicides in a methodical manner, taking substantial time between offenses to elude the authorities. The results of our study of the temporal patterns (i.e., the length of time between homicides) of a nonrandom national sample of 44 serial sexual murderers and their 201 victims indicate that this representation may not always be accurate. Although 25 offenders (56.8%) killed with longer than a 14-day period between homicides, a sizeable subgroup was identified: 19 offenders (43.2%) who committed homicides in rapid-sequence fashion, with fewer than 14 days between all or some of the murders. Six offenders (13.6%) killed all their victims in one rapid-sequence, spree-like episode, with homicides just days apart or sometimes two murders in the same day. Thirteen offenders (29.5%) killed in one or two rapid-sequence clusters (i.e., more than one murder within a 14-day period, as well as additional homicides with greater than 14 days between each). The purpose of our study was to describe this subgroup of rapid-sequence offenders who have not been identified until now. These findings argue for accelerated forensic assessments of dangerousness and public safety when a sexual murder is detected. Psychiatric disorders with rapidly occurring symptom patterns, or even atypical mania or mood dysregulation, may serve as exemplars for understanding this extraordinary group of offenders. © 2017 American Academy of Psychiatry and the Law.

  18. Sequential processing deficits in schizophrenia: relationship to neuropsychology and genetics.

    Science.gov (United States)

    Hill, S Kristian; Bjorkquist, Olivia; Carrathers, Tarra; Roseberry, Jarett E; Hochberger, William C; Bishop, Jeffrey R

    2013-12-01

    Utilizing a combination of neuropsychological and cognitive neuroscience approaches may be essential for characterizing cognitive deficits in schizophrenia and eventually assessing cognitive outcomes. This study was designed to compare the stability of select exemplars for these approaches and their correlations in schizophrenia patients with stable treatment and clinical profiles. Reliability estimates for serial order processing were comparable to neuropsychological measures and indicate that experimental serial order processing measures may be less susceptible to practice effects than traditional neuropsychological measures. Correlations were moderate and consistent with a global cognitive factor. Exploratory analyses indicated a potentially critical role of the Met allele of the Catechol-O-methyltransferase (COMT) Val158Met polymorphism in externally paced sequential recall. Experimental measures of serial order processing may reflect frontostriatal dysfunction and be a useful supplement to large neuropsychological batteries. © 2013.

  19. [Modeling a clinical process for differentiated thyroid cancer health care in Hospital Base Valdivia, Chile].

    Science.gov (United States)

    Ávila-Schwerter, C; Torres-Andrade, M C; Méndez, C A; Márquez-Manzano, M

    2016-01-01

    To design a clinical process model in the management of differentiated thyroid cancer in order to improve accessibility to this treatment. Based on modified Participatory Action Research, a model design process was conducted using a literature review and meetings with organisations committed to the redesigning process, and to agree an improved and feasible process. The process map was constructed by participatory action including, characterisation of the value chain, fault detection in the flow of the process, relevant documents and process for proposing modifications and approvals necessary for this purpose. Links were established between the main process and the support and strategic processes. The participatory model helped to cut the waiting times for diagnosis and treatment of this disease from 12 to 4 months. For each unit to be able to fully visualise the map of the process and understand their contribution as a set of integrated contributions and not fragmented, helps in the comprehensive management of patients and operation processes based on the hierarchical and dominant organisational model in Chilean hospitals. To analyse and remodel clinical processes by participatory action helps to limit failures in the fluidity of care of the patients, by presenting each participating unit with a general view of the process, the problems, and the possible solutions. Furthermore, this approach helps to clarify the process in order to make it more efficient, to harmonise relationships, and to improve coordination in order to optimise patient care. Copyright © 2015 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Representation of Item Position in Immediate Serial Recall: Evidence from Intrusion Errors

    Science.gov (United States)

    Fischer-Baum, Simon; McCloskey, Michael

    2015-01-01

    In immediate serial recall, participants are asked to recall novel sequences of items in the correct order. Theories of the representations and processes required for this task differ in how order information is maintained; some have argued that order is represented through item-to-item associations, while others have argued that each item is…

  1. Serial correlation of quality control data--on the use of proper control charts

    DEFF Research Database (Denmark)

    Winkel, P; Zhang, Nevin

    2004-01-01

    Biochemical quality control (QC) data have been reported to be autocorrelated. Serial correlation may increase the rate of false alarms if the traditional exponentially weighted moving average (EWMA) control chart to monitoring the process mean is used. False alarms are the focus of this paper......, where an alarm is defined as the occurrence of a QC value outside the three standard deviation control limits....

  2. 77 FR 66920 - Registration of Claims to Copyright: Group Registration of Serial Issues Filed Electronically

    Science.gov (United States)

    2012-11-08

    ... registered on a single application and for a single fee. The group registration privilege is contingent upon... was limited to basic registrations, i.e., claims in single works, while the capacity to process online... of related serials. Revisions to the electronic registration system will upgrade the capacity of the...

  3. A Rational Analysis of the Effects of Memory Biases on Serial Reproduction

    Science.gov (United States)

    Xu, Jing; Griffiths, Thomas L.

    2010-01-01

    Many human interactions involve pieces of information being passed from one person to another, raising the question of how this process of information transmission is affected by the cognitive capacities of the agents involved. Bartlett (1932) explored the influence of memory biases on the "serial reproduction" of information, in which one…

  4. Analysis of Existing Guidelines for the Systematic Planning Process of Clinical Registries.

    Science.gov (United States)

    Löpprich, Martin; Knaup, Petra

    2016-01-01

    Clinical registries are a powerful method to observe the clinical practice and natural disease history. In contrast to clinical trials, where guidelines and standardized methods exist and are mandatory, only a few initiatives have published methodological guidelines for clinical registries. The objective of this paper was to review these guidelines and systematically assess their completeness, usability and feasibility according to a SWOT analysis. The results show that each guideline has its own strengths and weaknesses. While one supports the systematic planning process, the other discusses clinical registries in great detail. However, the feasibility was mostly limited and the special requirements of clinical registries, their flexible, expandable and adaptable technological structure was not addressed consistently.

  5. CAMAC serial highway interface for the LSI-11

    International Nuclear Information System (INIS)

    Lau, N.H.

    1980-01-01

    A CAMAC Serial Highway Interface has been designed for the Local Control and Instrumentation System of the Mirror Fusion Test Facility. There are over 50 distinguishable systems in the facility, each of which consists of the LSI-11 computer, fiber optic communication links, and the CAMAC system. The LSI-11 computer includes a 32k memory, serial modem interface and the CAMAC Serial Highway Interface

  6. SERIAL TELEVISI DEXTER SEBAGAI ANAKRONISME DALAM SASTRA POPULER

    OpenAIRE

    Ida Rochani Adi

    2014-01-01

    In the popular literature context, this study aims to investigate: (1) how the formulation of the characterization of Dexter in the television serial Dexter violates the tradition of literary characterization, and (2) how the formula of moral values is dramatized through Dexter, who is a sociopath, psychopath, serial killer, and person without moral. The research object was the television serial Dexter, which ranks five in popularity in the world. The data were collected by documenting 84 epi...

  7. Representation of the serial killer on the Italian Internet.

    Science.gov (United States)

    Villano, P; Bastianoni, P; Melotti, G

    2001-10-01

    The representation of serial killers was examined from the analysis of 317 Web pages in the Italian language to study how the psychological profiles of serial killers are described on the Italian Internet. The correspondence analysis of the content of these Web pages shows that in Italy the serial killer is associated with words such as "monster" and "horror," which suggest and imply psychological perversion and aberrant acts. These traits are peculiar for the Italian scenario.

  8. An analysis of clinical reasoning through a recent and comprehensive approach: the dual-process theory.

    Science.gov (United States)

    Pelaccia, Thierry; Tardif, Jacques; Triby, Emmanuel; Charlin, Bernard

    2011-03-14

    Clinical reasoning plays a major role in the ability of doctors to make diagnoses and decisions. It is considered as the physician's most critical competence, and has been widely studied by physicians, educationalists, psychologists and sociologists. Since the 1970s, many theories about clinical reasoning in medicine have been put forward. This paper aims at exploring a comprehensive approach: the "dual-process theory", a model developed by cognitive psychologists over the last few years. After 40 years of sometimes contradictory studies on clinical reasoning, the dual-process theory gives us many answers on how doctors think while making diagnoses and decisions. It highlights the importance of physicians' intuition and the high level of interaction between analytical and non-analytical processes. However, it has not received much attention in the medical education literature. The implications of dual-process models of reasoning in terms of medical education will be discussed.

  9. An analysis of clinical reasoning through a recent and comprehensive approach: the dual-process theory

    Directory of Open Access Journals (Sweden)

    Thierry Pelaccia

    2011-03-01

    Full Text Available Context. Clinical reasoning plays a major role in the ability of doctors to make diagnoses and decisions. It is considered as the physician's most critical competence, and has been widely studied by physicians, educationalists, psychologists and sociologists. Since the 1970s, many theories about clinical reasoning in medicine have been put forward.Purpose. This paper aims at exploring a comprehensive approach: the “dual-process theory”, a model developed by cognitive psychologists over the last few years.Discussion. After 40 years of sometimes contradictory studies on clinical reasoning, the dual-process theory gives us many answers on how doctors think while making diagnoses and decisions. It highlights the importance of physicians’ intuition and the high level of interaction between analytical and non-analytical processes. However, it has not received much attention in the medical education literature. The implications of dual-process models of reasoning in terms of medical education will be discussed.

  10. Utilization of the Nursing Process to Foster Clinical Reasoning During a Simulation Experience

    Directory of Open Access Journals (Sweden)

    Amanda Lambie

    2015-11-01

    Full Text Available Nursing practice includes complex reasoning and multifaceted decision making with minimal standardized guidance in how to evaluate this phenomenon among nursing students. Learning outcomes related to the clinical reasoning process among novice baccalaureate nursing students during a simulation experience were evaluated. Nursing process records were utilized to evaluate and foster the development of clinical reasoning in a high-fidelity medical-surgical simulation experience. Students were unable to describe and process pertinent patient information appropriately prior to the simulation experience. Students’ ability to identify pertinent patient cues and plan appropriate patient care improved following the simulation. The learning activity afforded a structured opportunity to identify cues, prioritize the proper course of nursing interventions, and engage in collaboration among peers. The simulation experience provides faculty insight into the students’ clinical reasoning processes, while providing students with a clear framework for successfully accomplishing learning outcomes.

  11. Essential processes for cognitive behavioral clinical supervision: Agenda setting, problem-solving, and formative feedback.

    Science.gov (United States)

    Cummings, Jorden A; Ballantyne, Elena C; Scallion, Laura M

    2015-06-01

    Clinical supervision should be a proactive and considered endeavor, not a reactive one. To that end, supervisors should choose supervision processes that are driven by theory, best available research, and clinical experience. These processes should be aimed at helping trainees develop as clinicians. We highlight 3 supervision processes we believe should be used at each supervision meeting: agenda setting, encouraging trainee problem-solving, and formative feedback. Although these are primarily cognitive-behavioral skills, they can be helpful in combination with other supervision models. We provide example dialogue from supervision exchanges, and discuss theoretical and research support for these processes. Using these processes not only encourages trainee development but also models for them how to use the same processes and approaches with clients. (c) 2015 APA, all rights reserved).

  12. A psychological profile of a serial killer: a case report.

    Science.gov (United States)

    Dogra, T D; Leenaars, Antoon A; Chadha, R K; Manju, Mehta; Lalwani, Sanjeev; Sood, Mamta; Lester, David; Raina, Anupuma; Behera, C

    2012-01-01

    Serial killers have always fascinated society. A serial killer is typically defined as a perpetrator who murders three or more people over a period of time. Most reported cases of serial killers come from the United States and Canada. In India, there are few reported cases. We present, to the best of our knowledge, the first Indian case in the literature. The present case is of a 28-year-old man, Surinder Koli. The Department of Forensic Medicine & Toxicology, All India Institute of Medical Sciences, New Delphi handled the forensic study. We present a most unique psychological investigation into the mind of a serial killer.

  13. Malignant sex and aggression: an overview of serial sexual homicide.

    Science.gov (United States)

    Myers, W C; Reccoppa, L; Burton, K; McElroy, R

    1993-01-01

    Serial murderers have attracted considerable attention in the popular press and criminal justice field, but scientific literature about these individuals is limited. This article provides an overview, from a psychiatric perspective, of serial sexual homicide, one type of serial killing. Characteristics of this type of murder and of these offenders are discussed. Defining qualities and diagnoses applicable to serial sexual killers are reviewed. Various etiologic theories are discussed, with emphasis on the role of fantasy and psychodynamic explanations. Governmental agencies involved in combating this type of crime, along with the role of mental health professionals in criminal profiling, are presented. Finally, the authors explore the reaction of society to this phenomenon.

  14. Registered nurses' clinical reasoning skills and reasoning process: A think-aloud study.

    Science.gov (United States)

    Lee, JuHee; Lee, Young Joo; Bae, JuYeon; Seo, Minjeong

    2016-11-01

    As complex chronic diseases are increasing, nurses' prompt and accurate clinical reasoning skills are essential. However, little is known about the reasoning skills of registered nurses. This study aimed to determine how registered nurses use their clinical reasoning skills and to identify how the reasoning process proceeds in the complex clinical situation of hospital setting. A qualitative exploratory design was used with a think-aloud method. A total of 13 registered nurses (mean years of experience=11.4) participated in the study, solving an ill-structured clinical problem based on complex chronic patients cases in a hospital setting. Data were analyzed using deductive content analysis. Findings showed that the registered nurses used a variety of clinical reasoning skills. The most commonly used skill was 'checking accuracy and reliability.' The reasoning process of registered nurses covered assessment, analysis, diagnosis, planning/implementation, and evaluation phase. It is critical that registered nurses apply appropriate clinical reasoning skills in complex clinical practice. The main focus of registered nurses' reasoning in this study was assessing a patient's health problem, and their reasoning process was cyclic, rather than linear. There is a need for educational strategy development to enhance registered nurses' competency in determining appropriate interventions in a timely and accurate fashion. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. The process and organizational characteristics of memory clinics in Israel in 2007.

    Science.gov (United States)

    Werner, Perla; Goldstein, Dovrat; Heinik, Jeremia

    2009-01-01

    We previously described the characteristics and activities of 25 memory clinics in Israel in 1998 using a mail survey. Questionnaires assessing the administrative structure of the clinics, patient characteristics, processes and methods used, and outcomes of the assessment were mailed again in 2007 to 35 memory clinics. Overall, the general operating characteristics of the clinics in 2007 were found to be similar to those reported in the previous survey conducted in 1998. The assessment process in 2007 was shorter than in 1998 (mean time=1.92 and 3.12 h, respectively), although both surveys were based on an interdisciplinary team, including a physician, a nurse and a social worker. However, in 2007 the teams were more wide-ranging. A wider variety of instruments were reported in the more recent survey. Most of the clinics in both surveys reported that family members were involved at all stages of the assessment. Medication treatment was the main outcome reported by the clinics in both surveys. There has been a development in the process and organizational characteristics of memory clinics in Israel over the years, probably as a consequence of the development of knowledge in the area of cognitive deterioration.

  16. [The balanced scorecard used as a management tool in a clinical laboratory: internal business processes indicators].

    Science.gov (United States)

    Salinas La Casta, Maria; Flores Pardo, Emilio; Uris Selles, Joaquín

    2009-01-01

    to propose a set of indicators as a management tool for a clinical laboratory, by using the balanced scorecard internal business processes perspective. indicators proposed are obtained from different sources; external proficiency testing of the Valencia Community Government, by means of internal surveys and laboratory information system registers. One year testing process proportion indicators results are showed. internal management indicators are proposed (process, appropriateness and proficiency testing). The process indicators results show gradual improvement since its establishment. after one years of using a conceptually solid Balanced Scorecard Internal business processes perspective indicators, the obtained results validate the usefulness as a laboratory management tool.

  17. Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice Guidelines and Quality Certification Do Not Avert Variability in Clinical Practice.

    Science.gov (United States)

    Torras, M G; Canals, E; Jurado-Bruggeman, D; Marín-Borras, S; Macià, M; Jové, J; Boladeras, A M; Muñoz-Montplet, C; Molero, J; Picón, C; Puigdemont, M; Aliste, L; Torrents, A; Guedea, F; Borras, J M

    2018-06-01

    The therapeutic approach to cancer is complex and multidisciplinary. Radiotherapy is among the essential treatments, whether used alone or in conjunction with other therapies. This study reports a clinical audit of the radiotherapy process to assess the process of care, evaluate adherence to agreed protocols and measure the variability to improve therapeutic quality for rectal cancer. Multicentre retrospective cohort study in a representative sample of patients diagnosed with rectal cancer in the Institut Català d'Oncologia, a comprehensive cancer centre with three different settings. We developed a set of indicators to assess the key areas of the radiotherapy process. The clinical audit consisted of a review of a random sample of 40 clinical histories for each centre. The demographic profile, histology and staging of patients were similar between centres. The MRI reports did not include the distance from tumour to mesorectal fascia (rCRM) in 38.3% of the cases. 96.7% of patients received the planned dose, and 57.4% received it at the planned time. Surgery followed neoadjuvant treatment in 96.7% of the patients. Among this group, postoperative CRM was recorded in 65.5% of the cases and was negative in 93.4% of these. With regard to the 34.5% (n = 40) of cases where no CRM value was stated, there were differences between the centres. Mean follow-up was 3.4 (SD 0.6) years, and overall survival at four years was 81.7%. The audit revealed a suboptimal degree of adherence to clinical practice guidelines. Significant variability between centres exists from a clinical perspective but especially with regard to organization and process. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Continuous Heterogeneous Photocatalysis in Serial Micro-Batch Reactors.

    Science.gov (United States)

    Pieber, Bartholomäus; Shalom, Menny; Antonietti, Markus; Seeberger, Peter H; Gilmore, Kerry

    2018-01-29

    Solid reagents, leaching catalysts, and heterogeneous photocatalysts are commonly employed in batch processes but are ill-suited for continuous-flow chemistry. Heterogeneous catalysts for thermal reactions are typically used in packed-bed reactors, which cannot be penetrated by light and thus are not suitable for photocatalytic reactions involving solids. We demonstrate that serial micro-batch reactors (SMBRs) allow for the continuous utilization of solid materials together with liquids and gases in flow. This technology was utilized to develop selective and efficient fluorination reactions using a modified graphitic carbon nitride heterogeneous catalyst instead of costly homogeneous metal polypyridyl complexes. The merger of this inexpensive, recyclable catalyst and the SMBR approach enables sustainable and scalable photocatalysis. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Serial analysis of gene expression (SAGE) in rat liver regeneration

    International Nuclear Information System (INIS)

    Cimica, Velasco; Batusic, Danko; Haralanova-Ilieva, Borislava; Chen, Yonglong; Hollemann, Thomas; Pieler, Tomas; Ramadori, Giuliano

    2007-01-01

    We have applied serial analysis of gene expression for studying the molecular mechanism of the rat liver regeneration in the model of 70% partial hepatectomy. We generated three SAGE libraries from a normal control liver (NL library: 52,343 tags), from a sham control operated liver (Sham library: 51,028 tags), and from a regenerating liver (PH library: 53,061 tags). By SAGE bioinformatics analysis we identified 40 induced genes and 20 repressed genes during the liver regeneration. We verified temporal expression of such genes by real time PCR during the regeneration process and we characterized 13 induced genes and 3 repressed genes. We found connective tissue growth factor transcript and protein induced very early at 4 h after PH operation before hepatocytes proliferation is triggered. Our study suggests CTGF as a growth factor signaling mediator that could be involved directly in the mechanism of liver regeneration induction

  20. Serialization and persistent objects turning data structures into efficient databases

    CERN Document Server

    Soukup, Jiri

    2014-01-01

    Recently, the pressure for fast processing and efficient storage of large data with complex?relations increased beyond the capability of traditional databases. Typical examples include iPhone applications, computer aided design - both electrical and mechanical, biochemistry applications, and incremental compilers. Serialization, which is sometimes used in such situations is notoriously tedious and error prone.In this book, Jiri Soukup and Petr Macha?ek show in detail how to write programs which store their internal data automatically and transparently to disk. Together with special data structure libraries which treat relations among objects as first-class entities, and with a UML class-diagram generator, the core application code is much simplified. The benchmark chapter shows a typical example where persistent data is faster by the order of magnitude than with a traditional database, in both traversing and accessing the data.The authors explore and exploit advanced features of object-oriented languages in a...

  1. Depression and pain: testing of serial multiple mediators.

    Science.gov (United States)

    Wongpakaran, Tinakon; Wongpakaran, Nahathai; Tanchakvaranont, Sitthinant; Bookkamana, Putipong; Pinyopornpanish, Manee; Wannarit, Kamonporn; Satthapisit, Sirina; Nakawiro, Daochompu; Hiranyatheb, Thanita; Thongpibul, Kulvadee

    2016-01-01

    Despite the fact that pain is related to depression, few studies have been conducted to investigate the variables that mediate between the two conditions. In this study, the authors explored the following mediators: cognitive function, self-sacrificing interpersonal problems, and perception of stress, and the effects they had on pain symptoms among patients with depressive disorders. An analysis was performed on the data of 346 participants with unipolar depressive disorders. The 17-item Hamilton Depression Rating Scale, Mini-Mental State Examination, the pain subscale of the health-related quality of life (SF-36), the self-sacrificing subscale of the Inventory of Interpersonal Problems, and the Perceived Stress Scale were used. Parallel multiple mediator and serial multiple mediator models were used. An alternative model regarding the effect of self-sacrificing on pain was also proposed. Perceived stress, self-sacrificing interpersonal style, and cognitive function were found to significantly mediate the relationship between depression and pain, while controlling for demographic variables. The total effect of depression on pain was significant. This model, with an additional three mediators, accounted for 15% of the explained variance in pain compared to 9% without mediators. For the alternative model, after controlling for the mediators, a nonsignificant total direct effect level of self-sacrificing was found, suggesting that the effect of self-sacrificing on pain was based only on an indirect effect and that perceived stress was found to be the strongest mediator. Serial mediation may help us to see how depression and pain are linked and what the fundamental mediators are in the chain. No significant, indirect effect of self-sacrificing on pain was observed, if perceived stress was not part of the depression and/or cognitive function mediational chain. The results shown here have implications for future research, both in terms of testing the model and in

  2. Communication and interoperability for serial comparison in continuous health care--the new challenges.

    Science.gov (United States)

    Zywietz, Christoph

    2004-01-01

    The evolution of information technology and of telematics and increasing efforts to establish an electronic health record stimulate the development and introduction of new concepts in health care. However, compared to other application areas, e.g., tourism, banking, commerce etc. the use of information technology in health care is still of limited success. In hospitals as well in ambulatory medicine (General Practitioner systems) computers are often only used for administrative purposes. Fully operational Hospital Information Systems (HIS) are rare and often island solutions. The situation is somewhat better for department systems (DIS), e.g., where image analysis, processing of biochemical data or of biosignals is in the clinical focus. Even before we have solved the various problems in health care data processing and management within the "conventional" care institutions new challenges are coming up with concepts of telemedicine for assisted and non-assisted home care for patients with chronic diseases or people at high risk. The major challenges for provision of tele-monitoring and alarming services are improvement of communication and interoperability of devices and care providers. A major obstacle in achieving such goals are lack of standards for devices as well for procedures and a lack of databases with information on "normal" variability of many medical parameters to be monitored by serial comparison in continuous medical care. Some of these aspects will be discussed in more detail.

  3. Learning and memory for sequences of pictures, words, and spatial locations: an exploration of serial position effects.

    Science.gov (United States)

    Bonk, William J; Healy, Alice F

    2010-01-01

    A serial reproduction of order with distractors task was developed to make it possible to observe successive snapshots of the learning process at each serial position. The new task was used to explore the effect of several variables on serial memory performance: stimulus content (words, blanks, and pictures), presentation condition (spatial information vs. none), semantically categorized item clustering (grouped vs. ungrouped), and number of distractors relative to targets (none, equal, double). These encoding and retrieval variables, along with learning attempt number, affected both overall performance levels and the shape of the serial position function, although a large and extensive primacy advantage and a small 1-item recency advantage were found in each case. These results were explained well by a version of the scale-independent memory, perception, and learning model that accounted for improved performance by increasing the value of only a single parameter that reflects reduced interference from distant items.

  4. Serial crystallography captures enzyme catalysis in copper nitrite reductase at atomic resolution from one crystal

    Directory of Open Access Journals (Sweden)

    Sam Horrell

    2016-07-01

    Full Text Available Relating individual protein crystal structures to an enzyme mechanism remains a major and challenging goal for structural biology. Serial crystallography using multiple crystals has recently been reported in both synchrotron-radiation and X-ray free-electron laser experiments. In this work, serial crystallography was used to obtain multiple structures serially from one crystal (MSOX to study in crystallo enzyme catalysis. Rapid, shutterless X-ray detector technology on a synchrotron MX beamline was exploited to perform low-dose serial crystallography on a single copper nitrite reductase crystal, which survived long enough for 45 consecutive 100 K X-ray structures to be collected at 1.07–1.62 Å resolution, all sampled from the same crystal volume. This serial crystallography approach revealed the gradual conversion of the substrate bound at the catalytic type 2 Cu centre from nitrite to nitric oxide, following reduction of the type 1 Cu electron-transfer centre by X-ray-generated solvated electrons. Significant, well defined structural rearrangements in the active site are evident in the series as the enzyme moves through its catalytic cycle, namely nitrite reduction, which is a vital step in the global denitrification process. It is proposed that such a serial crystallography approach is widely applicable for studying any redox or electron-driven enzyme reactions from a single protein crystal. It can provide a `catalytic reaction movie' highlighting the structural changes that occur during enzyme catalysis. The anticipated developments in the automation of data analysis and modelling are likely to allow seamless and near-real-time analysis of such data on-site at some of the powerful synchrotron crystallographic beamlines.

  5. Development of clinical process measures for pediatric burn care: Understanding variation in practice patterns.

    Science.gov (United States)

    Kazis, Lewis E; Sheridan, Robert L; Shapiro, Gabriel D; Lee, Austin F; Liang, Matthew H; Ryan, Colleen M; Schneider, Jeffrey C; Lydon, Martha; Soley-Bori, Marina; Sonis, Lily A; Dore, Emily C; Palmieri, Tina; Herndon, David; Meyer, Walter; Warner, Petra; Kagan, Richard; Stoddard, Frederick J; Murphy, Michael; Tompkins, Ronald G

    2018-04-01

    There has been little systematic examination of variation in pediatric burn care clinical practices and its effect on outcomes. As a first step, current clinical care processes need to be operationally defined. The highly specialized burn care units of the Shriners Hospitals for Children system present an opportunity to describe the processes of care. The aim of this study was to develop a set of process-based measures for pediatric burn care and examine adherence to them by providers in a cohort of pediatric burn patients. We conducted a systematic literature review to compile a set of process-based indicators. These measures were refined by an expert panel of burn care providers, yielding 36 process-based indicators in four clinical areas: initial evaluation and resuscitation, acute excisional surgery and critical care, psychosocial and pain control, and reconstruction and aftercare. We assessed variability in adherence to the indicators in a cohort of 1,076 children with burns at four regional pediatric burn programs in the Shriners Hospital system. The percentages of the cohort at each of the four sites were as follows: Boston, 20.8%; Cincinnati, 21.1%; Galveston, 36.0%; and Sacramento, 22.1%. The cohort included children who received care between 2006 and 2010. Adherence to the process indicators varied both across sites and by clinical area. Adherence was lowest for the clinical areas of acute excisional surgery and critical care, with a range of 35% to 48% across sites, followed by initial evaluation and resuscitation (range, 34%-60%). In contrast, the clinical areas of psychosocial and pain control and reconstruction and aftercare had relatively high adherence across sites, with ranges of 62% to 93% and 71% to 87%, respectively. Of the 36 process indicators, 89% differed significantly in adherence between clinical sites (p measures represents an important step in the assessment of clinical practice in pediatric burn care. Substantial variation was observed

  6. Viscous hydrophilic injection matrices for serial crystallography

    Directory of Open Access Journals (Sweden)

    Gabriela Kovácsová

    2017-07-01

    Full Text Available Serial (femtosecond crystallography at synchrotron and X-ray free-electron laser (XFEL sources distributes the absorbed radiation dose over all crystals used for data collection and therefore allows measurement of radiation damage prone systems, including the use of microcrystals for room-temperature measurements. Serial crystallography relies on fast and efficient exchange of crystals upon X-ray exposure, which can be achieved using a variety of methods, including various injection techniques. The latter vary significantly in their flow rates – gas dynamic virtual nozzle based injectors provide very thin fast-flowing jets, whereas high-viscosity extrusion injectors produce much thicker streams with flow rates two to three orders of magnitude lower. High-viscosity extrusion results in much lower sample consumption, as its sample delivery speed is commensurate both with typical XFEL repetition rates and with data acquisition rates at synchrotron sources. An obvious viscous injection medium is lipidic cubic phase (LCP as it is used for in meso membrane protein crystallization. However, LCP has limited compatibility with many crystallization conditions. While a few other viscous media have been described in the literature, there is an ongoing need to identify additional injection media for crystal embedding. Critical attributes are reliable injection properties and a broad chemical compatibility to accommodate samples as heterogeneous and sensitive as protein crystals. Here, the use of two novel hydrogels as viscous injection matrices is described, namely sodium carboxymethyl cellulose and the thermo-reversible block polymer Pluronic F-127. Both are compatible with various crystallization conditions and yield acceptable X-ray background. The stability and velocity of the extruded stream were also analysed and the dependence of the stream velocity on the flow rate was measured. In contrast with previously characterized injection media, both new

  7. Applying Process Improvement Methods to Clinical and Translational Research: Conceptual Framework and Case Examples.

    Science.gov (United States)

    Daudelin, Denise H; Selker, Harry P; Leslie, Laurel K

    2015-12-01

    There is growing appreciation that process improvement holds promise for improving quality and efficiency across the translational research continuum but frameworks for such programs are not often described. The purpose of this paper is to present a framework and case examples of a Research Process Improvement Program implemented at Tufts CTSI. To promote research process improvement, we developed online training seminars, workshops, and in-person consultation models to describe core process improvement principles and methods, demonstrate the use of improvement tools, and illustrate the application of these methods in case examples. We implemented these methods, as well as relational coordination theory, with junior researchers, pilot funding awardees, our CTRC, and CTSI resource and service providers. The program focuses on capacity building to address common process problems and quality gaps that threaten the efficient, timely and successful completion of clinical and translational studies. © 2015 The Authors. Clinical and Translational Science published by Wiley Periodicals, Inc.

  8. Handbook of serial communications interfaces a comprehensive compendium of serial digital input/output (I/O) standards

    CERN Document Server

    Frenzel, Louis

    2015-01-01

    This book catalogs the most popular and commonly used serial-port interfaces and provides details on the specifications and the latest standards, enabling you to select an interface for a new design or verify that an interface is working correctly. Each chapter is based on a different interface and is written in an easy to follow, standard format. With this book you will learn: The most widely used serial interfacesHow to select the best serial interface for a specific application or designThe trade-offs between data rate and distance (length or range)The operation and benefits of serial

  9. An analysis of clinical reasoning through a recent and comprehensive approach: the dual-process theory

    OpenAIRE

    Pelaccia, Thierry; Tardif, Jacques; Triby, Emmanuel; Charlin, Bernard

    2011-01-01

    Context: Clinical reasoning plays a major role in the ability of doctors to make diagnoses and decisions. It is considered as the physician’s most critical competence, and has been widely studied by physicians, educationalists, psychologists and sociologists. Since the 1970s, many theories about clinical reasoning in medicine have been put forward. Purpose: This paper aims at exploring a comprehensive approach: the ‘‘dual-process theory’’, a model developed by co...

  10. Medical subdomain classification of clinical notes using a machine learning-based natural language processing approach

    OpenAIRE

    Weng, Wei-Hung; Wagholikar, Kavishwar B.; McCray, Alexa T.; Szolovits, Peter; Chueh, Henry C.

    2017-01-01

    Background The medical subdomain of a clinical note, such as cardiology or neurology, is useful content-derived metadata for developing machine learning downstream applications. To classify the medical subdomain of a note accurately, we have constructed a machine learning-based natural language processing (NLP) pipeline and developed medical subdomain classifiers based on the content of the note. Methods We constructed the pipeline using the clinical ...

  11. Designing a clinical audit tool to measure processes of pregnancy care

    Directory of Open Access Journals (Sweden)

    Wallace EM

    2011-12-01

    Full Text Available Suzanne V Sinni1, Wendy M Cross2, Euan M Wallace1,31Department of Obstetrics and Gynaecology, Monash University and Southern Health, Monash Medical Centre, Clayton, Victoria, 2School of Nursing and Midwifery, Monash University, Clayton, Victoria, 3The Ritchie Centre, Monash Institute of Medical Research, Monash University, Clayton, Victoria, AustraliaAbstract: This paper reports the development of a clinical audit tool as part of a larger project to evaluate a new maternity service, underpinned by a patient safety framework.Aim: The aim of this work is to describe the development of a clinical audit tool that measures the process of pregnancy care, and its application.Background: There are many reports about outcomes of healthcare provision, however there are limited studies examining the process of care. There is also limited evidence linking clinical audit with improvements in care delivery. Pregnancy care was chosen because there are well defined and agreed clinical standards against which to measure the delivery of pregnancy care. A clinical audit using these standards addresses both gaps in the literature.Methods: Standard methodological processes were used to develop the audit tool. Literature informed the processes. Data were collected in 2009–2010 using the tool described in the paper. Reliability testing was completed in September 2011.Results: An audit tool to measure pregnancy care was developed and applied to 354 health records to enable analysis of adherence to organizational expectations of care. Reliability testing of the tool achieved an overall kappa of 0.896.Conclusion: Developing an audit tool based on processes described in the literature is labor intensive and resource dependent, however it results in a robust, reliable, valid tool that can be used in diverse maternity services. Stakeholder participation from the outset ensures ongoing engagement for the duration of a clinically based project spanning several years

  12. Natural language processing systems for capturing and standardizing unstructured clinical information: A systematic review.

    Science.gov (United States)

    Kreimeyer, Kory; Foster, Matthew; Pandey, Abhishek; Arya, Nina; Halford, Gwendolyn; Jones, Sandra F; Forshee, Richard; Walderhaug, Mark; Botsis, Taxiarchis

    2017-09-01

    We followed a systematic approach based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify existing clinical natural language processing (NLP) systems that generate structured information from unstructured free text. Seven literature databases were searched with a query combining the concepts of natural language processing and structured data capture. Two reviewers screened all records for relevance during two screening phases, and information about clinical NLP systems was collected from the final set of papers. A total of 7149 records (after removing duplicates) were retrieved and screened, and 86 were determined to fit the review criteria. These papers contained information about 71 different clinical NLP systems, which were then analyzed. The NLP systems address a wide variety of important clinical and research tasks. Certain tasks are well addressed by the existing systems, while others remain as open challenges that only a small number of systems attempt, such as extraction of temporal information or normalization of concepts to standard terminologies. This review has identified many NLP systems capable of processing clinical free text and generating structured output, and the information collected and evaluated here will be important for prioritizing development of new approaches for clinical NLP. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. The process and challenges of obtaining and sustaining clinical placements for nursing and allied health students.

    Science.gov (United States)

    Taylor, Christine; Angel, Liz; Nyanga, Lucy; Dickson, Cathy

    2017-10-01

    To describe the process and challenges from a project that aimed to develop processes, source new placements and place students primarily in the discipline of nursing, but also occupational therapy, physiotherapy, podiatry, social work, and speech therapy. Clinical experience in health facilities is an essential element of health professional education, yet globally, there is a lack of clinical placements to meet demands. Educational providers are seeking placements in nontraditional facilities, yet little has been reported on the challenges in the process of procuring clinical placements. The project used a descriptive approach within a quality implementation framework. The project was guided by the quality implementation framework that included four critical steps: considerations of the host setting, structuring the implementation, supporting the implementation and improving future applications. A total of 115 new student placements were finalised across six health disciplines, including elderly care, nongovernment organisations and general practice. Sixty-two nursing students were placed in the new placements during the project. Challenges included communication, the time-consuming nature of the process and 'gatekeeping' blocks to obtaining placements. Recommendations included the importance of personal interaction in developing and maintaining relationships, and the need for clear communication processes and documentation. Potential areas for research are also given. There is great potential for growth in establishing new placements outside the traditional placement facilities for nursing and allied health and for expanding already existing nonhospital placements. Clinical professional experiences are essential to any nursing or allied health programme. There is an increasing demand for, and global lack of, clinical placements for nursing and allied health students. The results provide nursing and allied health educators and managers a framework for planning

  14. Raster-scanning serial protein crystallography using micro- and nano-focused synchrotron beams

    Energy Technology Data Exchange (ETDEWEB)

    Coquelle, Nicolas [Université Grenoble Alpes, IBS, 38044 Grenoble (France); CNRS, IBS, 38044 Grenoble (France); CEA, IBS, 38044 Grenoble (France); Brewster, Aaron S. [Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Kapp, Ulrike; Shilova, Anastasya; Weinhausen, Britta [European Synchrotron Radiation Facility, BP 220, 38043 Grenoble (France); Burghammer, Manfred, E-mail: burgham@esrf.fr [European Synchrotron Radiation Facility, BP 220, 38043 Grenoble (France); Ghent University, Ghent B-9000 (Belgium); Colletier, Jacques-Philippe, E-mail: burgham@esrf.fr [Université Grenoble Alpes, IBS, 38044 Grenoble (France); CNRS, IBS, 38044 Grenoble (France); CEA, IBS, 38044 Grenoble (France)

    2015-05-01

    A raster scanning serial protein crystallography approach is presented, that consumes as low ∼200–700 nl of sedimented crystals. New serial data pre-analysis software, NanoPeakCell, is introduced. High-resolution structural information was obtained from lysozyme microcrystals (20 µm in the largest dimension) using raster-scanning serial protein crystallography on micro- and nano-focused beamlines at the ESRF. Data were collected at room temperature (RT) from crystals sandwiched between two silicon nitride wafers, thereby preventing their drying, while limiting background scattering and sample consumption. In order to identify crystal hits, new multi-processing and GUI-driven Python-based pre-analysis software was developed, named NanoPeakCell, that was able to read data from a variety of crystallographic image formats. Further data processing was carried out using CrystFEL, and the resultant structures were refined to 1.7 Å resolution. The data demonstrate the feasibility of RT raster-scanning serial micro- and nano-protein crystallography at synchrotrons and validate it as an alternative approach for the collection of high-resolution structural data from micro-sized crystals. Advantages of the proposed approach are its thriftiness, its handling-free nature, the reduced amount of sample required, the adjustable hit rate, the high indexing rate and the minimization of background scattering.

  15. Strategy for 90% autoverification of clinical chemistry and immunoassay test results using six sigma process improvement.

    Science.gov (United States)

    Randell, Edward W; Short, Garry; Lee, Natasha; Beresford, Allison; Spencer, Margaret; Kennell, Marina; Moores, Zoë; Parry, David

    2018-06-01

    Six Sigma involves a structured process improvement strategy that places processes on a pathway to continued improvement. The data presented here summarizes a project that took three clinical laboratories from autoverification processes that allowed between about 40% to 60% of tests being auto-verified to more than 90% of tests and samples auto-verified. The project schedule, metrics and targets, a description of the previous system and detailed information on the changes made to achieve greater than 90% auto-verification is presented for this Six Sigma DMAIC (Design, Measure, Analyze, Improve, Control) process improvement project.

  16. A simulation framework for mapping risks in clinical processes: the case of in-patient transfers.

    Science.gov (United States)

    Dunn, Adam G; Ong, Mei-Sing; Westbrook, Johanna I; Magrabi, Farah; Coiera, Enrico; Wobcke, Wayne

    2011-05-01

    To model how individual violations in routine clinical processes cumulatively contribute to the risk of adverse events in hospital using an agent-based simulation framework. An agent-based simulation was designed to model the cascade of common violations that contribute to the risk of adverse events in routine clinical processes. Clinicians and the information systems that support them were represented as a group of interacting agents using data from direct observations. The model was calibrated using data from 101 patient transfers observed in a hospital and results were validated for one of two scenarios (a misidentification scenario and an infection control scenario). Repeated simulations using the calibrated model were undertaken to create a distribution of possible process outcomes. The likelihood of end-of-chain risk is the main outcome measure, reported for each of the two scenarios. The simulations demonstrate end-of-chain risks of 8% and 24% for the misidentification and infection control scenarios, respectively. Over 95% of the simulations in both scenarios are unique, indicating that the in-patient transfer process diverges from prescribed work practices in a variety of ways. The simulation allowed us to model the risk of adverse events in a clinical process, by generating the variety of possible work subject to violations, a novel prospective risk analysis method. The in-patient transfer process has a high proportion of unique trajectories, implying that risk mitigation may benefit from focusing on reducing complexity rather than augmenting the process with further rule-based protocols.

  17. Short- and long-term memory contributions to immediate serial recognition: evidence from serial position effects.

    Science.gov (United States)

    Purser, Harry; Jarrold, Christopher

    2010-04-01

    A long-standing body of research supports the existence of separable short- and long-term memory systems, relying on phonological and semantic codes, respectively. The aim of the current study was to measure the contribution of long-term knowledge to short-term memory performance by looking for evidence of phonologically and semantically coded storage within a short-term recognition task, among developmental samples. Each experimental trial presented 4-item lists. In Experiment 1 typically developing children aged 5 to 6 years old showed evidence of phonologically coded storage across all 4 serial positions, but evidence of semantically coded storage at Serial Positions 1 and 2. In a further experiment, a group of individuals with Down syndrome was investigated as a test case that might be expected to use semantic coding to support short-term storage, but these participants showed no evidence of semantically coded storage and evidenced phonologically coded storage only at Serial Position 4, suggesting that individuals with Down syndrome have a verbal short-term memory capacity of 1 item. Our results suggest that previous evidence of semantic effects on "short-term memory performance" does not reflect semantic coding in short-term memory itself, and provide an experimental method for researchers wishing to take a relatively pure measure of verbal short-term memory capacity, in cases where rehearsal is unlikely.

  18. Utilization of serial resources in libraries of selected tertiary ...

    African Journals Online (AJOL)

    Information Impact: Journal of Information and Knowledge Management ... security personnel for adequate monitoring of the serial materials, as well as the need for authors and stakeholders in education to donate more serial materials in order to enrich the collections in the library and enhance academic performance.

  19. Effects of Serial Rehearsal Training on Memory Search

    Science.gov (United States)

    McCauley, Charley; And Others

    1976-01-01

    Half the subjects were trained to use a serial rehearsal strategy during target set storage and half were given no strategy training. The results indicate that the rate of memory search is IQ-related, and that serial rehearsal training facilitates memory search when rehearsal is covert. (Author/BW)

  20. Indexing Serialized Fiction: May the Force Be with You.

    Science.gov (United States)

    Barr, Melissa M.

    The adult novel offers indexers an unusual opportunity to create a serialized fiction index. This research paper involved designing and creating a Character Index, Thesaurus, Glossary, and Abstract (with descriptors) for 21 novels based on the "Star Wars" movies. The novels are an unusual example of serialized fiction featuring main…

  1. Antisocial personality disorder, sexual sadism, malignant narcissism, and serial murder.

    Science.gov (United States)

    Geberth, V J; Turco, R N

    1997-01-01

    This paper examines the research on serial murder and its relationship to antisocial personality disorder and sexual sadism. The concept of malignant narcissism is also discussed. Case studies of serial killers are examined regarding the nature of sexual violation and crime scene behavior.

  2. [Narrative Pedagogy in Nursing Education: The Essence of Clinical Nursing Process Recording].

    Science.gov (United States)

    Chao, Yu-Mei Y; Chiang, Hsien-Hsien

    2017-02-01

    Clinical nursing process recording (CNPR) has been shown to be an effective tool for facilitating student-centered teaching and learning in nursing education. Yet, the essence and process of this tool have yet to be sufficiently explored and clarified. To explore the essence of CNPR in the contexts of clinical teaching and learning. Reflective analysis was used as the phenomenological approach to analyze the qualitative data, which were transcribed from the oral responses of the six participants who were attending the Clinical Nursing Education Forum. A total of five sessions of the Clinical Nursing Education Forums were conducted. The content of the Clinical Nursing Education Forums consisted of a series of 12 narrative writings of CNPR that were written by a senior student and read and commented on by the student's clinical instructor. Three groups of the essence and process of clinical teaching and learning were inductively identified as: (a) mobilizing autonomous, self-directed learning behavior from self-writing and re-storying; (b) establishing the student-instructor dialogical relationship from mutual localization; and (c) co-creating a learning environment in education and in clinical practice. When used as an interactive teaching and learning tool, CNPR promotes mutual understanding by re-locating the self in the coexisting roles of student nurse, instructor, and patient in a series of nursing care situations. This re-location facilitates students' self-directed learning, enhances the abilities of asking question, waiting for and accompany with the instructor; and promotes the self-care capabilities of patients.

  3. Informing Hospital Change Processes through Visualization and Simulation: A Case Study at a Children's Emergency Clinic.

    Science.gov (United States)

    Persson, Johanna; Dalholm, Elisabeth Hornyánszky; Johansson, Gerd

    2014-01-01

    To demonstrate the use of visualization and simulation tools in order to involve stakeholders and inform the process in hospital change processes, illustrated by an empirical study from a children's emergency clinic. Reorganization and redevelopment of a hospital is a complex activity that involves many stakeholders and demands. Visualization and simulation tools have proven useful for involving practitioners and eliciting relevant knowledge. More knowledge is desired about how these tools can be implemented in practice for hospital planning processes. A participatory planning process including practitioners and researchers was executed over a 3-year period to evaluate a combination of visualization and simulation tools to involve stakeholders in the planning process and to elicit knowledge about needs and requirements. The initial clinic proposal from the architect was discarded as a result of the empirical study. Much general knowledge about the needs of the organization was extracted by means of the adopted tools. Some of the tools proved to be more accessible than others for the practitioners participating in the study. The combination of tools added value to the process by presenting information in alternative ways and eliciting questions from different angles. Visualization and simulation tools inform a planning process (or other types of change processes) by providing the means to see beyond present demands and current work structures. Long-term involvement in combination with accessible tools is central for creating a participatory setting where the practitioners' knowledge guides the process. © 2014 Vendome Group, LLC.

  4. Classification of processes involved in sharing individual participant data from clinical trials.

    Science.gov (United States)

    Ohmann, Christian; Canham, Steve; Banzi, Rita; Kuchinke, Wolfgang; Battaglia, Serena

    2018-01-01

    Background: In recent years, a cultural change in the handling of data from research has resulted in the strong promotion of a culture of openness and increased sharing of data. In the area of clinical trials, sharing of individual participant data involves a complex set of processes and the interaction of many actors and actions. Individual services/tools to support data sharing are available, but what is missing is a detailed, structured and comprehensive list of processes/subprocesses involved and tools/services needed. Methods : Principles and recommendations from a published data sharing consensus document are analysed in detail by a small expert group. Processes/subprocesses involved in data sharing are identified and linked to actors and possible services/tools. Definitions are adapted from the business process model and notation (BPMN) and applied in the analysis. Results: A detailed and comprehensive list of individual processes/subprocesses involved in data sharing, structured according to 9 main processes, is provided. Possible tools/services to support these processes/subprocesses are identified and grouped according to major type of support. Conclusions: The list of individual processes/subprocesses and tools/services identified is a first step towards development of a generic framework or architecture for sharing of data from clinical trials. Such a framework is strongly needed to give an overview of how various actors, research processes and services could form an interoperable system for data sharing.

  5. Highlights in radiation measuring technique's - Serial Micro Channel SMC 2100

    International Nuclear Information System (INIS)

    Kandler, M.; Hoffmann, Ch.

    2002-01-01

    The Serial Micro Channel SMC 2100 offers an ''intelligent stand alone'' electronics for the radiation measuring technique's. First it is designed of being connected to a serial interface RS232 of a PC. With a RS485 serial interface on a PC, a network structure can be generated. It has all functional modules which are necessary for the measurement of detector signals. Hence it is possible to directly connect any detector for radiation measurement to a PC, laptop, or notebook. All variations can be operated without PC support too. It has a modular structure and consists of two blocks, the functional modules and the basic modules. The Serial Micro Channel SMC 2100 may be directly coupled to a detector, which therefore makes the realisation of an ''intelligent radiation detector'' with serial link RS232 or RS485. (orig.)

  6. Serial Entrepreneurship, Learning by Doing and Self-selection

    DEFF Research Database (Denmark)

    Rocha, Vera; Carneiro, Anabela; Varum, Celeste

    2015-01-01

    of the person-specific effect, using information on individuals’ past histories in paid employment, confirm that serial entrepreneurs exhibit, on average, a larger person-specific effect than non-serial business owners. Moreover, ignoring serial entrepreneurs’ self-selection overestimates learning by doing......It remains a question whether serial entrepreneurs typically perform better than their novice counterparts owing to learning by doing effects or mostly because they are a selected sample of higher-than-average ability entrepreneurs. This paper tries to unravel these two effects by exploring a novel...... empirical strategy based on continuous time duration models with selection. We use a large longitudinal matched employer-employee dataset that allows us to identify about 220,000 individuals who have left their first entrepreneurial experience, out of which over 35,000 became serial entrepreneurs. We...

  7. SERIAL TELEVISI DEXTER SEBAGAI ANAKRONISME DALAM SASTRA POPULER

    Directory of Open Access Journals (Sweden)

    Ida Rochani Adi

    2014-06-01

    Full Text Available In the popular literature context, this study aims to investigate: (1 how the formulation of the characterization of Dexter in the television serial Dexter violates the tradition of literary characterization, and (2 how the formula of moral values is dramatized through Dexter, who is a sociopath, psychopath, serial killer, and person without moral. The research object was the television serial Dexter, which ranks five in popularity in the world. The data were collected by documenting 84 episodes of the serial having been broadcast since 2006. They were analyzed by means of content analysis and qualitative descriptive techniques. Based on the findings, the conclusions are as follows. First, there is a violation or anachronism of characterization through the main character in the serial. Second, the dramatized moral values still contain conventional values although they are in different forms.

  8. Dyslexic children show short-term memory deficits in phonological storage and serial rehearsal: an fMRI study.

    Science.gov (United States)

    Beneventi, Harald; Tønnessen, Finn Egil; Ersland, Lars

    2009-01-01

    Dyslexia is primarily associated with a phonological processing deficit. However, the clinical manifestation also includes a reduced verbal working memory (WM) span. It is unclear whether this WM impairment is caused by the phonological deficit or a distinct WM deficit. The main aim of this study was to investigate neuronal activation related to phonological storage and rehearsal of serial order in WM in a sample of 13-year-old dyslexic children compared with age-matched nondyslexic children. A sequential verbal WM task with two tasks was used. In the Letter Probe task, the probe consisted of a single letter and the judgment was for the presence or absence of that letter in the prior sequence of six letters. In the Sequence Probe (SP) task, the probe consisted of all six letters and the judgment was for a match of their serial order with the temporal order in the prior sequence. Group analyses as well as single-subject analysis were performed with the statistical parametric mapping software SPM2. In the Letter Probe task, the dyslexic readers showed reduced activation in the left precentral gyrus (BA6) compared to control group. In the Sequence Probe task, the dyslexic readers showed reduced activation in the prefrontal cortex and the superior parietal cortex (BA7) compared to the control subjects. Our findings suggest that a verbal WM impairment in dyslexia involves an extended neural network including the prefrontal cortex and the superior parietal cortex. Reduced activation in the left BA6 in both the Letter Probe and Sequence Probe tasks may be caused by a deficit in phonological processing. However, reduced bilateral activation in the BA7 in the Sequence Probe task only could indicate a distinct working memory deficit in dyslexia associated with temporal order processing.

  9. Integrating utilization-focused evaluation with business process modeling for clinical research improvement.

    Science.gov (United States)

    Kagan, Jonathan M; Rosas, Scott; Trochim, William M K

    2010-10-01

    New discoveries in basic science are creating extraordinary opportunities to design novel biomedical preventions and therapeutics for human disease. But the clinical evaluation of these new interventions is, in many instances, being hindered by a variety of legal, regulatory, policy and operational factors, few of which enhance research quality, the safety of study participants or research ethics. With the goal of helping increase the efficiency and effectiveness of clinical research, we have examined how the integration of utilization-focused evaluation with elements of business process modeling can reveal opportunities for systematic improvements in clinical research. Using data from the NIH global HIV/AIDS clinical trials networks, we analyzed the absolute and relative times required to traverse defined phases associated with specific activities within the clinical protocol lifecycle. Using simple median duration and Kaplan-Meyer survival analysis, we show how such time-based analyses can provide a rationale for the prioritization of research process analysis and re-engineering, as well as a means for statistically assessing the impact of policy modifications, resource utilization, re-engineered processes and best practices. Successfully applied, this approach can help researchers be more efficient in capitalizing on new science to speed the development of improved interventions for human disease.

  10. An application of business process method to the clinical efficiency of hospital.

    Science.gov (United States)

    Leu, Jun-Der; Huang, Yu-Tsung

    2011-06-01

    The concept of Total Quality Management (TQM) has come to be applied in healthcare over the last few years. The process management category in the Baldrige Health Care Criteria for Performance Excellence model is designed to evaluate the quality of medical services. However, a systematic approach for implementation support is necessary to achieve excellence in the healthcare business process. The Architecture of Integrated Information Systems (ARIS) is a business process architecture developed by IDS Scheer AG and has been applied in a variety of industrial application. It starts with a business strategy to identify the core and support processes, and encompasses the whole life-cycle range, from business process design to information system deployment, which is compatible with the concept of healthcare performance excellence criteria. In this research, we apply the basic ARIS framework to optimize the clinical processes of an emergency department in a mid-size hospital with 300 clinical beds while considering the characteristics of the healthcare organization. Implementation of the case is described, and 16 months of clinical data are then collected, which are used to study the performance and feasibility of the method. The experience gleaned in this case study can be used a reference for mid-size hospitals with similar business models.

  11. CLAMP - a toolkit for efficiently building customized clinical natural language processing pipelines.

    Science.gov (United States)

    Soysal, Ergin; Wang, Jingqi; Jiang, Min; Wu, Yonghui; Pakhomov, Serguei; Liu, Hongfang; Xu, Hua

    2017-11-24

    Existing general clinical natural language processing (NLP) systems such as MetaMap and Clinical Text Analysis and Knowledge Extraction System have been successfully applied to information extraction from clinical text. However, end users often have to customize existing systems for their individual tasks, which can require substantial NLP skills. Here we present CLAMP (Clinical Language Annotation, Modeling, and Processing), a newly developed clinical NLP toolkit that provides not only state-of-the-art NLP components, but also a user-friendly graphic user interface that can help users quickly build customized NLP pipelines for their individual applications. Our evaluation shows that the CLAMP default pipeline achieved good performance on named entity recognition and concept encoding. We also demonstrate the efficiency of the CLAMP graphic user interface in building customized, high-performance NLP pipelines with 2 use cases, extracting smoking status and lab test values. CLAMP is publicly available for research use, and we believe it is a unique asset for the clinical NLP community. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Serial 5-Year Evaluation of Side Branches Jailed by Bioresorbable Vascular Scaffolds Using 3-Dimensional Optical Coherence Tomography: Insights From the ABSORB Cohort B Trial (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions)

    NARCIS (Netherlands)

    Onuma, Y.; Grundeken, M.J.; Nakatani, S.; Asano, T.; Sotomi, Y.; Foin, N.; Ng, J.; Okamura, T.; Wykrzykowska, J.J.; Winter, R.J. de; Geuns, R.J.M. van; Koolen, J.; Christiansen, E.; Whitbourn, R.; McClean, D.; Smits, P; Windecker, S.; Ormiston, J.A.; Serruys, P.W.

    2017-01-01

    BACKGROUND: The long-term fate of Absorb bioresorbable vascular scaffold (Abbott Vascular, Santa Clara, CA) struts jailing side branch ostia has not been clarified. We therefore evaluate serially (post-procedure and at 6 months, 1, 2, 3, and 5 years) the appearance and fate of jailed Absorb

  13. Serial 5-Year Evaluation of Side Branches Jailed by Bioresorbable Vascular Scaffolds Using 3-Dimensional Optical Coherence Tomography Insights From the ABSORB Cohort B Trial (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions)

    NARCIS (Netherlands)

    Onuma, Yoshinobu; Grundeken, Maik J.; Nakatani, Shimpei; Asano, Taku; Sotomi, Yohei; Foin, Nicolas; Ng, Jaryl; Okamura, Takayuki; Wykrzykowska, Joanna J.; de Winter, Robbert J.; van Geuns, Robert-Jan; Koolen, Jacques; Christiansen, Evald; Whitbourn, Robert; McClean, Dougal; Smits, Pieter; Windecker, Stephan; Ormiston, John A.; Serruys, Patrick W.

    2017-01-01

    Background-The long-term fate of Absorb bioresorbable vascular scaffold (Abbott Vascular, Santa Clara, CA) struts jailing side branch ostia has not been clarified. We therefore evaluate serially (post-procedure and at 6 months, 1, 2, 3, and 5 years) the appearance and fate of jailed Absorb

  14. Long-Term Resolution of Severe Ankle Contractures Using Botulinum Toxin, Serial Casting, Splinting, and Motor Retraining.

    Science.gov (United States)

    Leung, Joan; Stroud, Katarina

    2018-01-01

    Purpose: Serial casting for ankle contractures is traditionally performed in prone, a position that patients may not easily tolerate. Also, although serial casting is effective in correcting contracture, its effect dissipates quickly. This case report describes a procedure for performing casting for ankle contractures in a supine or sitting position. It also describes a process that enables the effect of serial casting to be maintained long term. Client Description: The client was an adult who had suffered traumatic brain injury and severe bilateral ankle contractures. Intervention: He received botulinum toxin and serial casting for his bilateral ankle contractures, one ankle at 8 months and the other at 13 months after the injury. He then underwent a programme of splinting and motor training. Measures and Outcome: The client gained more than 40° dorsiflexion for both ankles after receiving botulinum toxin injections and serial casting. The improvement in ankle range enabled him to progress to walking practice. Ankle splinting was gradually reduced. On discharge at 25 months post-injury, the ankle joint range was maintained. Implications: The use of botulinum toxin and serial casting, followed by an intensive programme of splinting and motor training, may be an option to consider for effective long-term resolution of severe contractures after acquired brain injury.

  15. Disciplined Decision Making in an Interdisciplinary Environment: Some Implications for Clinical Applications of Statistical Process Control.

    Science.gov (United States)

    Hantula, Donald A.

    1995-01-01

    Clinical applications of statistical process control (SPC) in human service organizations are considered. SPC is seen as providing a standard set of criteria that serves as a common interface for data-based decision making, which may bring decision making under the control of established contingencies rather than the immediate contingencies of…

  16. Validating the extract, transform, load process used to populate a large clinical research database.

    Science.gov (United States)

    Denney, Michael J; Long, Dustin M; Armistead, Matthew G; Anderson, Jamie L; Conway, Baqiyyah N

    2016-10-01

    Informaticians at any institution that are developing clinical research support infrastructure are tasked with populating research databases with data extracted and transformed from their institution's operational databases, such as electronic health records (EHRs). These data must be properly extracted from these source systems, transformed into a standard data structure, and then loaded into the data warehouse while maintaining the integrity of these data. We validated the correctness of the extract, load, and transform (ETL) process of the extracted data of West Virginia Clinical and Translational Science Institute's Integrated Data Repository, a clinical data warehouse that includes data extracted from two EHR systems. Four hundred ninety-eight observations were randomly selected from the integrated data repository and compared with the two source EHR systems. Of the 498 observations, there were 479 concordant and 19 discordant observations. The discordant observations fell into three general categories: a) design decision differences between the IDR and source EHRs, b) timing differences, and c) user interface settings. After resolving apparent discordances, our integrated data repository was found to be 100% accurate relative to its source EHR systems. Any institution that uses a clinical data warehouse that is developed based on extraction processes from operational databases, such as EHRs, employs some form of an ETL process. As secondary use of EHR data begins to transform the research landscape, the importance of the basic validation of the extracted EHR data cannot be underestimated and should start with the validation of the extraction process itself. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Setting up a randomized clinical trial in the UK: approvals and process.

    Science.gov (United States)

    Greene, Louise Eleanor; Bearn, David R

    2013-06-01

    Randomized clinical trials are considered the 'gold standard' in primary research for healthcare interventions. However, they can be expensive and time-consuming to set up and require many approvals to be in place before they can begin. This paper outlines how to determine what approvals are required for a trial, the background of each approval and the process for obtaining them.

  18. Comparing the radiosensitivity of cervical and thoracic spinal cord using the relative seriality model

    International Nuclear Information System (INIS)

    Adamus-Gorka, M.; Lind, B.K.; Brahme, A.

    2003-01-01

    Spinal cord is one of the most important normal tissues that are aimed to be spared during radiation therapy of cancer. This organ has been known for its strongly serial character and its high sensitivity to radiation. In order to compare the sensitivity of different parts of spinal cord, the early data (1970's) for radiation myelopathy available in the literature could be used. In the present study the relative seriality model (Kallman et al. 1992) has been fitted to two different sets of clinical data for spinal cord irradiation: radiation myelitis of cervical spinal cord after treating 248 patients for malignant disease of head and neck (Abbatucci et al. 1978) and radiation myelitis of thoracic spinal cord after radiation treating 43 patients with lung carcinoma (Reinhold et al. 1976). The maximum likelihood method was applied for the fitting and the corresponding parameters together with their 68% confidence intervals calculated for each of the datasets respectively. The alpha-beta ratio for the thoracic survival was also obtained. On the basis of the present study the following conclusions can be drawn: 1. radiation myelopathy is a strongly serial endpoint, 2. it appears to be differences in radiosensitivity between the cervical and thoracic region of spinal cord, 3. thoracic spinal cord revealed very serial characteristic of dose response, while the cervical myelopathy seems to be a bit less serial endpoint, 4. the dose-response curve is much steeper in case of myelopathy of cervical spinal cord, due to the much higher gamma value for this region. This work compares the fitting of NTCP model to the cervical and thoracic regions of the spinal cord and shows quite different responses. In the future more data should be tested for better understanding the mechanism of spinal cord sensitivity to radiation

  19. Task based synthesis of serial manipulators

    Directory of Open Access Journals (Sweden)

    Sarosh Patel

    2015-05-01

    Full Text Available Computing the optimal geometric structure of manipulators is one of the most intricate problems in contemporary robot kinematics. Robotic manipulators are designed and built to perform certain predetermined tasks. There is a very close relationship between the structure of the manipulator and its kinematic performance. It is therefore important to incorporate such task requirements during the design and synthesis of the robotic manipulators. Such task requirements and performance constraints can be specified in terms of the required end-effector positions, orientations and velocities along the task trajectory. In this work, we present a comprehensive method to develop the optimal geometric structure (DH parameters of a non-redundant six degree of freedom serial manipulator from task descriptions. In this work we define, develop and test a methodology to design optimal manipulator configurations based on task descriptions. This methodology is devised to investigate all possible manipulator configurations that can satisfy the task performance requirements under imposed joint constraints. Out of all the possible structures, the structures that can reach all the task points with the required orientations are selected. Next, these candidate structures are tested to see whether they can attain end-effector velocities in arbitrary directions within the user defined joint constraints, so that they can deliver the best kinematic performance. Additionally least power consuming configurations are also identified.

  20. Serial neuroradiological studies in focal cerebritis

    International Nuclear Information System (INIS)

    Hatta, S.; Mochizuki, H.; Kuru, Y.; Miwa, H.; Kondo, T.; Mori, H.; Mizuno, Y.

    1994-01-01

    We report serial neuroradiological studies in a patient with focal cerebritis in the head of the left caudate nucleus. On the day after the onset of symptoms, CT showed an ill-defined low density lesion. The lack of contrast enhancement appeared to be the most important finding for differentiating focal cerebritis from an encapsulated brain abscess or a tumour. MRI two days later revealed the centre of the lesion to be of slightly low intensity on T1-weighted inversion recovery (IR) images and very low intensity on T2-weighted spin echo images, which appeared to correspond to the early cerebritis stage of experimentally induced cerebritis and brain abscess. Ten days after the onset of symptoms, CT revealed a thin ring of enhancement in the head of the caudate nucleus, and a similar small ring was seen in the hypothalamus 16 days after the onset, corresponding to the late cerebritis stage. MRI nine days later revealed ill-defined high signal lesions within the involved area on the T1-weighted IR images. To our knowledge, this is the first published MRI documentation of the early cerebritis stage developing into an encapsulated brain abscess. The mechanisms underlying of these radiographic changes are discussed. (orig.)

  1. Clinical, information and business process modeling to promote development of safe and flexible software.

    Science.gov (United States)

    Liaw, Siaw-Teng; Deveny, Elizabeth; Morrison, Iain; Lewis, Bryn

    2006-09-01

    Using a factorial vignette survey and modeling methodology, we developed clinical and information models - incorporating evidence base, key concepts, relevant terms, decision-making and workflow needed to practice safely and effectively - to guide the development of an integrated rule-based knowledge module to support prescribing decisions in asthma. We identified workflows, decision-making factors, factor use, and clinician information requirements. The Unified Modeling Language (UML) and public domain software and knowledge engineering tools (e.g. Protégé) were used, with the Australian GP Data Model as the starting point for expressing information needs. A Web Services service-oriented architecture approach was adopted within which to express functional needs, and clinical processes and workflows were expressed in the Business Process Execution Language (BPEL). This formal analysis and modeling methodology to define and capture the process and logic of prescribing best practice in a reference implementation is fundamental to tackling deficiencies in prescribing decision support software.

  2. MO-C-17A-10: Comparison of Dose Deformable Accumulation by Using Parallel and Serial Approaches

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Z; Li, M; Wong, J [Morristown Medical Center, Morristown, NJ (United States)

    2014-06-15

    Purpose: The uncertainty of dose accumulation over multiple CT datasets with deformable fusion may have significant impact on clinical decisions. In this study, we investigate the difference of two dose summation approaches involving deformable fusion. Methods: Five patients, four external beam and one brachytherapy(BT), were chosen for the study. The BT patient was treated with CT-based HDR. The CT image sets acquired in the imageguidance process (8-11 CTs/patient) were used to determine the dose delivered to the four external beam patients. (prostate, pelvis, lung and head and neck). For the HDR patient (cervix), five CT image sets and the corresponding BT plans were used. In total 44 CT datasets and RT dose/plans were imported into the image fusion software MiM (6.0.4) for analysis.For each of the five clinical cases, the dose from each fraction was accumulated into the primary CT dataset by using both Parallel and Serial approaches. The dose-volume histogram (DVH) for CTV and selected organs-at-risks (OAR) were generated. The D95(CTV), OAR(mean) and OAR(max) for the four external beam cases the D90(CTV), and the max dose to bladder and rectum for the BT case were compared. Results: For the four external beam patients, the difference in D95(CTV) were <1.2% PD between the parallel and the serial approaches. The differences of the OAR(mean) and the OAR(max ) range from 0 to 3.7% and <1% PD respectively. For the HDR patient, the dose difference for D90 is 11% PD while that of the max dose to bladder and rectum were 11.5% and 23.3% respectively. Conclusion: For external beam treatments, the parallel and serial approaches have <5% difference probably because tumor volume and OAR have less changes from fraction to fraction. For the brachytherapy case, >10% dose difference between the two approaches was observed as significant volume changes of tumor and OAR were observed among treatment fractions.

  3. TU-F-12A-01: Quantitative Non-Linear Compartment Modeling of 89Zr- and 124I- Labeled J591 Monoclonal Antibody Kinetics Using Serial Non-Invasive Positron Emission Tomography Imaging in a Pre-Clinical Human Prostate Cancer Mouse Model

    Energy Technology Data Exchange (ETDEWEB)

    Fung, EK; Cheal, SM; Chalasani, S; Fareedy, SB; Punzalan, B; Humm, JL; Osborne, JR; Larson, SM; Zanzonico, PB [Memorial Sloan Kettering Cancer Center, New York, NY (United States); Otto, B; Bander, NH [Weill Cornell Medical College, New York, NY (United States)

    2014-06-15

    Purpose: To examine the binding kinetics of human IgG monoclonal antibody J591 which targets prostate-specific membrane antigen (PSMA) in a pre-clinical mouse cancer model using quantitative PET compartmental analysis of two radiolabeled variants. Methods: PSMA is expressed in normal human prostate, and becomes highly upregulated in prostate cancer, making it a promising therapeutic target. Two forms of J591, radiolabeled with either {sup 89}Zr or {sup 124}I, were prepared. {sup 89}Zr is a radiometal that becomes trapped in the cell upon internalization by the antigen-antibody complex, while radioiodine leaves the cell. Mice with prostate cancer xenografts underwent non-invasive serial imaging on a Focus 120 microPET up to 144 hours post-injection of J591. A non-linear compartmental model describing the binding and internalization of antibody in tumor xenograft was developed and applied to the PET-derived time-activity curves. The antibody-antigen association rate constant (ka), total amount of antigen per gram tumor (Ag-total), internalization rate of antibody-antigen complex, and efflux rate of radioisotope from tumor were fitted using the model. The surface-bound and the internalized activity were also estimated. Results: Values for ka, Ag-total, and internalization rate were found to be similar regardless of radiolabel payload used. The efflux rate, however, was ∼ 9-fold higher for {sup 124}I-J591 than for {sup 89}Zr-J591. Time-dependent surface-bound and internalized radiotracer activity were similar for both radiolabels at early times post-injection, but clearly differed beyond 24 hours. Conclusion: Binding and internalization of J591 to PSMA-expressing tumor xenografts were similar when radiolabeled with either {sup 89}Zr or {sup 124}I payload. The difference in efflux of radioactivity from tumor may be attributable to differential biological fate intracellularly of the radioisotopes. This has great significance for radioimmunotherapy and antibody

  4. New methods for clinical pathways-Business Process Modeling Notation (BPMN) and Tangible Business Process Modeling (t.BPM).

    Science.gov (United States)

    Scheuerlein, Hubert; Rauchfuss, Falk; Dittmar, Yves; Molle, Rüdiger; Lehmann, Torsten; Pienkos, Nicole; Settmacher, Utz

    2012-06-01

    Clinical pathways (CP) are nowadays used in numerous institutions, but their real impact is still a matter of debate. The optimal design of a clinical pathway remains unclear and is mainly determined by the expectations of the individual institution. The purpose of the here described pilot project was the development of two CP (colon and rectum carcinoma) according to Business Process Modeling Notation (BPMN) and Tangible Business Process Modeling (t.BPM). BPMN is an established standard for business process modelling in industry and economy. It is, in the broadest sense, a computer programme which enables the description and a relatively easy graphical imaging of complex processes. t.BPM is a modular construction system of the BPMN symbols which enables the creation of an outline or raw model, e.g. by placing the symbols on a spread-out paper sheet. The thus created outline can then be transferred to the computer and further modified as required. CP for the treatment of colon and rectal cancer have been developed with support of an external IT coach. The pathway was developed in an interdisciplinary and interprofessional manner (55 man-days over 15 working days). During this time, necessary interviews with medical, nursing and administrative staffs were conducted as well. Both pathways were developed parallel. Subsequent analysis was focussed on feasibility, expenditure, clarity and suitability for daily clinical practice. The familiarization with BPMN was relatively quick and intuitive. The use of t.BPM enabled the pragmatic, effective and results-directed creation of outlines for the CP. The development of both CP was finished from the diagnostic evaluation to the adjuvant/neoadjuvant therapy and rehabilitation phase. The integration of checklists, guidelines and important medical or other documents is easily accomplished. A direct integration into the hospital computer system is currently not possible for technical reasons. BPMN and t.BPM are sufficiently

  5. A clinical data warehouse-based process for refining medication orders alerts.

    Science.gov (United States)

    Boussadi, Abdelali; Caruba, Thibaut; Zapletal, Eric; Sabatier, Brigitte; Durieux, Pierre; Degoulet, Patrice

    2012-01-01

    The objective of this case report is to evaluate the use of a clinical data warehouse coupled with a clinical information system to test and refine alerts for medication orders control before they were fully implemented. A clinical decision rule refinement process was used to assess alerts. The criteria assessed were the frequencies of alerts for initial prescriptions of 10 medications whose dosage levels depend on renal function thresholds. In the first iteration of the process, the frequency of the 'exceeds maximum daily dose' alerts was 7.10% (617/8692), while that of the 'under dose' alerts was 3.14% (273/8692). Indicators were presented to the experts. During the different iterations of the process, 45 (16.07%) decision rules were removed, 105 (37.5%) were changed and 136 new rules were introduced. Extensive retrospective analysis of physicians' medication orders stored in a clinical data warehouse facilitates alert optimization toward the goal of maximizing the safety of the patient and minimizing overridden alerts.

  6. Investigation of the causes of clinical symptom aggravation in process of intravenous thrombolysis with alteplase

    Directory of Open Access Journals (Sweden)

    LI Chen-hua

    2013-04-01

    Full Text Available Objective To explore the causes of aggravation of microcirculation disorders in the process of intravenous thrombolysis with alteplase and the clinical outcomes. Methods The clinical data of the aggravated signs and symptoms of 13 cases treated by alteplase were reported, and the onset characteristics and clinical outcomes were analysed to summarize emergency experiences. Results There were 13 patients with stenosis of intracranial large arteries occurred perforating branch infarctions caused by the blocking of carried arteries (8 cases in internal carotid system, 5 cases in vertebral-basilar system. In the process of thrombolytic therapy, main aggravated presentations including cortical ischemic symptom, quadriplegia, exacerbated disturbance of consciousness were seen. Imaging examinations showed multiple new petechial ischemic foci in cortex and watershed region or increasing of infarct foci in cerebellum and brain stem. The prognosis was favorable after expectant treatment. NIHSS score was 8.69 ± 3.42 at 24 h after treatment, and mRS score was 0.94 ±0.37 at 3 month-follow-up. Neurologic deficit and quality of life were evidently improved. Conclusion In the course of intravenous thrombolytic therapy with alteplase. Aggravated clinical signs and symptoms may be related to various factors. Emboli disintegration inducing microcirculation disorder is inferred to be the main cause. For patients presenting aggravated signs and symptoms in thrombolysis process, favorable outcomes may occur as long as intensive care and timely treatment are performed.

  7. PORNOGRAFI DALAM SERIAL ANIME ANAK (ANALISIS SEMIOTIKA DALAM SERIAL CRAYON SHIN CHAN

    Directory of Open Access Journals (Sweden)

    - Sangidun

    2017-01-01

    Full Text Available Crayon Shin Chan, a Japanese two-dimension animation series broadcast in one of private Indonesian TVs, is categorized into child’s program since it is broadcast at child’s prime time, Sunday 08.30 a.m. In spite of its broadcast time, this series consist of symbols directed not for children, such as some acts that are not appropriate to be done by children, especially in Indonesia. Moreover, adult symbols of sex are also found in the program. For this reason it will be interesting to analyze it using semiotic analysis. Semiotics is the study of symbol and its meaning which its principle concept is that both signifier and signified consist of symbols and are related to denotation and connotation.   Crayon Shin Chan merupakan serial animasi dua dimensi yang tayang di salah satu stasiun televisi swasta di Indonesia. Ini merupakan produk animasi 2 dimensi yang diimpor dari Jepang. Di Indonesia, serial ini masuk dalam kategori acara anak. Hal ini dapat dilihat dari jam penayangannya yang merupakan waktu prime time bagi anak, yakni pada hari minggu pukul 08.30. Akan tetapi, pada serial ini banyak simbol-simbol yang mengarah pada tayangan yang bukan untuk anak-anak, yakni adeganadegan yang tidak pantas dilakukan oleh anak khususnya di Indonesia. Serta adanya pula simbol-simbol yang mengarah pada tayangan berbau dewasa. Tentu akan menarik jika tayangan ini diteliti menggunakan analisis semiotika. Semiotika sendiri merupakan kajian ilmu mengenai tanda dan makna. Yang pada prinsipnya, konsep penting seperti penanda (signifier dan petanda (signified sama-sama terdiri dari tanda dan terkait dengan denotasi dan konotasi.

  8. Transtornos de personalidade, psicopatia e serial killers Personality disorders, psychopathy and serial killers

    Directory of Open Access Journals (Sweden)

    Hilda C P Morana

    2006-10-01

    Full Text Available OBJETIVO: Apresentar as características básicas dos diversos transtornos específicos de personalidade, mas centrando-se no transtorno de personalidade anti-social, fazendo sua diferenciação com psicopatia. O estudo ainda se propõe a abordar a figura do serial killer, apontando a presença de aspectos psicopáticos no homicídio seriado. MÉTODO: Uma revisão bibliográfica foi feita no sentido de se abordar convergências e divergências entre diversos autores sobre um assunto tão polêmico, sobretudo quanto à viabilidade de tratamento dessa clientela forense. RESULTADOS: Enquanto o transtorno de personalidade anti-social é um diagnóstico médico, pode-se entender o termo "psicopatia", pertencente à esfera psiquiátrico-forense, como um "diagnóstico legal". Não se pode falar ainda de tratamento eficaz para os chamados "serial killers". CONCLUSÃO: Os transtornos de personalidade, especialmente o tipo anti-social, representam ainda hoje um verdadeiro desafio para a psiquiatria forense. O local mais adequado e justo para seus portadores, bem como recomendação homogênea e padronizada de tratamento são questões ainda não respondidas.OBJECTIVE: To illustrate the basic characteristics of several specific personality disorders, focusing mainly in antisocial personality disorder. The differences between antisocial personality disorder and psychopathy are highlighted. Serial killers and its psychopathic aspects are also discussed. METHOD: A bibliographic review was completed in order to outline convergences and divergences among different authors about this controversial issue, especially those concerning the possibility of treatment. RESULTS: While anti-social personality disorder is a medical diagnosis, the term "psychopathy" (which belongs to the sphere of forensic psychiatry may be understood as a "legal diagnosis". It is not still possible to identify an effective treatment for serial killers. CONCLUSION: Personality disorders

  9. Serials cataloging at the turn of the century

    CERN Document Server

    Williams, James W

    2014-01-01

    An overview of the research topics and trends that have appeared over the last five years, Serials Cataloging at the Turn of the Century doesn't just tell you that there has been a lot of change--that the information environment is something of a chameleon, always beguiling and slipping out of grasp. Instead, it gives you the plain facts on the specific challenges serials catalogers have been facing and how they're meeting adversity head-on, ready to gain the advantage in the rumble with proliferating information and formats.Comprehensive, resource-packed, and easy-to-digest, Serials Catalogin

  10. The serial message-passing schedule for LDPC decoding algorithms

    Science.gov (United States)

    Liu, Mingshan; Liu, Shanshan; Zhou, Yuan; Jiang, Xue

    2015-12-01

    The conventional message-passing schedule for LDPC decoding algorithms is the so-called flooding schedule. It has the disadvantage that the updated messages cannot be used until next iteration, thus reducing the convergence speed . In this case, the Layered Decoding algorithm (LBP) based on serial message-passing schedule is proposed. In this paper the decoding principle of LBP algorithm is briefly introduced, and then proposed its two improved algorithms, the grouped serial decoding algorithm (Grouped LBP) and the semi-serial decoding algorithm .They can improve LBP algorithm's decoding speed while maintaining a good decoding performance.

  11. Serial CSTR digester configuration for improving biogas production from manure

    DEFF Research Database (Denmark)

    Boe, Kanokwan; Angelidaki, Irini

    2009-01-01

    distribution ratio of 80/20 and 90/10, and total HRT of 15 days. The results showed that the serial CSTR could obtain 11% higher biogas yield compared to the single CSTR. The increased biogas yield in the serial CSTR was mainly from the second reactor, which accounted for 16% and 12% of total biogas yield......A new configuration of manure digesters for improving biogas production has been investigated in laboratory scale. A single thermophilic continuous-flow stirred tank reactor (CSTR) operated with a hydraulic retention time (HRT) of 15 days was compared to a serial CSTR configuration with volume...

  12. A simulation framework for mapping risks in clinical processes: the case of in-patient transfers

    Science.gov (United States)

    Ong, Mei-Sing; Westbrook, Johanna I; Magrabi, Farah; Coiera, Enrico; Wobcke, Wayne

    2011-01-01

    Objective To model how individual violations in routine clinical processes cumulatively contribute to the risk of adverse events in hospital using an agent-based simulation framework. Design An agent-based simulation was designed to model the cascade of common violations that contribute to the risk of adverse events in routine clinical processes. Clinicians and the information systems that support them were represented as a group of interacting agents using data from direct observations. The model was calibrated using data from 101 patient transfers observed in a hospital and results were validated for one of two scenarios (a misidentification scenario and an infection control scenario). Repeated simulations using the calibrated model were undertaken to create a distribution of possible process outcomes. The likelihood of end-of-chain risk is the main outcome measure, reported for each of the two scenarios. Results The simulations demonstrate end-of-chain risks of 8% and 24% for the misidentification and infection control scenarios, respectively. Over 95% of the simulations in both scenarios are unique, indicating that the in-patient transfer process diverges from prescribed work practices in a variety of ways. Conclusions The simulation allowed us to model the risk of adverse events in a clinical process, by generating the variety of possible work subject to violations, a novel prospective risk analysis method. The in-patient transfer process has a high proportion of unique trajectories, implying that risk mitigation may benefit from focusing on reducing complexity rather than augmenting the process with further rule-based protocols. PMID:21486883

  13. Clinical intuition in the nursing process and decision-making-A mixed-studies review.

    Science.gov (United States)

    Melin-Johansson, Christina; Palmqvist, Rebecca; Rönnberg, Linda

    2017-12-01

    To review what is characteristic of registered nurses' intuition in clinical settings, in relationships and in the nursing process. Intuition is a controversial concept and nurses believe that there are difficulties in how they should explain their nursing actions or decisions based on intuition. Much of the evidence from the body of research indicates that nurses value their intuition in a variety of clinical settings. More information on how nurses integrate intuition as a core element in daily clinical work would contribute to an improved understanding on how they go about this. Intuition deserves a place in evidence-based activities, where intuition is an important component associated with the nursing process. An integrative review strengthened with a mixed-studies review. Literature searches were conducted in the databases CINAHL, PubMed and PsycINFO, and literature published 1985-2016 were included. The findings in the studies were analysed with content analysis, and the synthesis process entailed a reasoning between the authors. After a quality assessment, 16 studies were included. The analysis and synthesis resulted in three categories. The characteristics of intuition in the nurse's daily clinical activities include application, assertiveness and experiences; in the relationships with patients' intuition include unique connections, mental and bodily responses, and personal qualities; and in the nursing process include support and guidance, component and clues in decision-making, and validating decisions. Intuition is more than simply a "gut feeling," and it is a process based on knowledge and care experience and has a place beside research-based evidence. Nurses integrate both analysis and synthesis of intuition alongside objective data when making decisions. They should rely on their intuition and use this knowledge in clinical practice as a support in decision-making, which increases the quality and safety of patient care. We find that intuition plays a

  14. Comparative analysis of serial and parallel laser patterning of Ag nanowire thin films

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Harim; Lee, Myeongkyu, E-mail: myeong@yonsei.ac.kr

    2017-03-31

    Highlights: • Serial and parallel laser patterning of Ag nanowire thin films is comparatively analyzed. • AgNW film can be directly patterned by a spatially-modulated pulsed Nd:YAG laser beam. • An area of 2.24 cm{sup 2} can be simultaneously patterned by a single pulse with energy of 350 mJ. - Abstract: Ag nanowire (AgNW) films solution-coated on a glass substrate were laser-patterned in two different ways. For the conventional serial process, a pulsed ultraviolet laser of 30 kHz repetition rate and ∼20 ns pulse width was employed as the laser source. For parallel patterning, the film was directly irradiated by a spatially-modulated Nd:YAG laser beam that has a low repetition rate of 10 kHz and a shorter pulse width of 5 ns. While multiple pulses with energy density ranging from 3 to 9 J/cm{sup 2} were required to pattern the film in the serial process, a single pulse with energy density of 0.16 J/cm{sup 2} completely removed AgNWs in the parallel patterning. This may be explained by the difference in patterning mechanism. In the parallel process using short pulses of 5 ns width, AgNWs can be removed in their solid state by the laser-induced thermo-elastic force, while they should be evaporated in the serial process utilizing a high-repetition rate laser. Important process parameters such as threshold energy density, speed, and available feature sizes are comparatively discussed for the two patterning.

  15. Serial rotatostereography - A new diagnostic method

    International Nuclear Information System (INIS)

    Ottomo, Michinori; Nakanishi, Takeshi.

    1986-01-01

    In the previous study using cine, a cine film stereoprojector showed the adjacent two frames of cine film simultaneously, such as frames 1 and 2, 2 and 3, 3 and 4, and so on, consecutively. Because some intracranial lesions require emergency surgery immediately after angiography, a real time display method of serial rotatostereography was necessary. In order to show the consecutive adjacent two frames of a video disc simultaneously, using the same method as with the cine stereoprojector, a video disc recorder (VDR) (VM-1000M) and two video memories (Image Σ) were required. This VDR has the ability of advancing, stopping, and reversing the display of memories. A control unit was manufactured in order to display these memories advancing and reversing continuously. As a result of this continuous semirotation stereo display, the anteroposterior projection was reversed, showing the posteroanterior view during ''reversing mode''. Thus a lead relay circuit was manufactured to prevent this phenomenon. Recording was done using a memory disc recorder (FOM 2200F), which has the ability of recording 10,000 frames per disc. Each frame can also be recorded on imaging film using O · X Multi Camera 400X. Finally, stereoscopic views of cerebral circulation, using a single injection of contrast media and rapid rotation of the gantry, were obtained using two cathode-ray tubes (CRTs) and a stereoviewer (Continuous Semi-rotation Classical Stereo Display Method). Stereoscopic views were also obtained using a single CRT, which displayed the images in a semirotating fashion similar to a oscillating fan head (Continuous Semi-rotation New Stereo Display Method). (J.P.N.)

  16. Serial-omics characterization of equine urine.

    Directory of Open Access Journals (Sweden)

    Min Yuan

    Full Text Available Horse urine is easily collected and contains molecules readily measurable using mass spectrometry that can be used as biomarkers representative of health, disease or drug tampering. This study aimed at analyzing microliter levels of horse urine to purify, identify and quantify proteins, polar metabolites and non-polar lipids. Urine from a healthy 12 year old quarter horse mare on a diet of grass hay and vitamin/mineral supplements with limited pasture access was collected for serial-omics characterization. The urine was treated with methyl tert-butyl ether (MTBE and methanol to partition into three distinct layers for protein, non-polar lipid and polar metabolite content from a single liquid-liquid extraction and was repeated two times. Each layer was analyzed by high performance liquid chromatography-high resolution tandem mass spectrometry (LC-MS/MS to obtain protein sequence and relative protein levels as well as identify and quantify small polar metabolites and lipids. The results show 46 urine proteins, many related to normal kidney function, structural and circulatory proteins as well as 474 small polar metabolites but only 10 lipid molecules. Metabolites were mostly related to urea cycle and ammonia recycling as well as amino acid related pathways, plant diet specific molecules, etc. The few lipids represented triglycerides and phospholipids. These data show a complete mass spectrometry based-omics characterization of equine urine from a single 333 μL mid-stream urine aliquot. These omics data help serve as a baseline for healthy mare urine composition and the analyses can be used to monitor disease progression, health status, monitor drug use, etc.

  17. Serial Myocardial Imaging after a Single Dose of Thallium-201

    Directory of Open Access Journals (Sweden)

    Takahiko Kamata

    2014-10-01

    Full Text Available Although thallium-201 exercise scintigraphy has been established for the detection of myocardial ischemia and viability, little is known regarding the myocardial thallium-201 kinetics during angioplasty. Herein, we report a 77-year old man with angina pectoris, in whom serial myocardial imaging after a single dose of thallium-201 was helpful in identifying not only the culprit lesion and myocardial viability, but also the dynamic changes in myocardial perfusion during angioplasty. Thallium-201 images after exercise showed a perfusion defect in the inferior wall, with a trivial redistribution 3 hours after the exercise and a marked improvement 24 hours later. Coronary angiography, performed 27 hours after exercise scintigraphy, showed severe stenosis in the right coronary artery. Guidewire crossing of the lesion interrupted the antegrade flow, which was restored after balloon dilation and stent implantation. Thallium-201 images, 2 hours after angioplasty (i.e., 30 hours after exercise, showed a decreased tracer uptake in the inferior wall, which improved the next day (i.e., 48 hours after exercise. Cardiac biomarkers were negative in the clinical course.

  18. Describing the clinical reasoning process: application of a model of enablement to a pediatric case.

    Science.gov (United States)

    Furze, Jennifer; Nelson, Kelly; O'Hare, Megan; Ortner, Amanda; Threlkeld, A Joseph; Jensen, Gail M

    2013-04-01

    Clinical reasoning is a core tenet of physical therapy practice leading to optimal patient care. The purpose of this case was to describe the outcomes, subjective experience, and reflective clinical reasoning process for a child with cerebral palsy using the International Classification of Functioning, Disability, and Health (ICF) model. Application of the ICF framework to a 9-year-old boy with spastic triplegic cerebral palsy was utilized to capture the interwoven factors present in this case. Interventions in the pool occurred twice weekly for 1 h over a 10-week period. Immediately post and 4 months post-intervention, the child made functional and meaningful gains. The family unit also developed an enjoyment of exercising together. Each individual family member described psychological, emotional, or physical health improvements. Reflection using the ICF model as a framework to discuss clinical reasoning can highlight important factors contributing to effective patient management.

  19. Workshop on using natural language processing applications for enhancing clinical decision making: an executive summary.

    Science.gov (United States)

    Pai, Vinay M; Rodgers, Mary; Conroy, Richard; Luo, James; Zhou, Ruixia; Seto, Belinda

    2014-02-01

    In April 2012, the National Institutes of Health organized a two-day workshop entitled 'Natural Language Processing: State of the Art, Future Directions and Applications for Enhancing Clinical Decision-Making' (NLP-CDS). This report is a summary of the discussions during the second day of the workshop. Collectively, the workshop presenters and participants emphasized the need for unstructured clinical notes to be included in the decision making workflow and the need for individualized longitudinal data tracking. The workshop also discussed the need to: (1) combine evidence-based literature and patient records with machine-learning and prediction models; (2) provide trusted and reproducible clinical advice; (3) prioritize evidence and test results; and (4) engage healthcare professionals, caregivers, and patients. The overall consensus of the NLP-CDS workshop was that there are promising opportunities for NLP and CDS to deliver cognitive support for healthcare professionals, caregivers, and patients.

  20. A serial killer of elderly women: analysis of a multi-victim homicide investigation.

    Science.gov (United States)

    Campobasso, Carlo P; Colonna, Massimo F; Carabellese, Felice; Grattagliano, Ignazio; Candelli, Chiara; Morton, Robert J; Catanesi, Roberto

    2009-03-10

    Between 1995 and 1997, in the territories of Southern Italy, there were fifteen murders of elderly women over the age of 70 years old. Initially, however, not all the murders were attributed to a single serial killer. The majority of the victims were stabbed multiple times in the neck, except for three cases in which the cause of death was manual strangulation. There was evidence of sexual assault in only one of the cases. All the victims were discovered in their own apartments, which were located on the ground level, with no signs of forced entry. In most of the cases, the offender stole money and/or jewellery. A multi-disciplinary team reviewed the cases during the investigation and created a profile of the killer. The team determined that the method of operation was completely unusual for the local criminal element. They suggested that the perpetrator could be an immigrant, who committed the murders for sexual motivation and who may have been arrested previously for sex-related incidents. On 15th September 1997, a suspect was arrested. He was identified as Ben Mohamed Ezzedine Sebai, a 35-year-old white male, originally from Tunisia. He was charged and convicted of four of the murders and was given a life sentence. In 2005, Sebai confessed to the murders of four additional elderly women, for which nine other people had already been previously tried and convicted, among them, a man who committed suicide in jail. In 2007, Sebai finally confessed to committing fifteen murders that occurred between 1995 and 1997. Sebai also admitted to experiencing sexual gratification at every homicide scene, even though there was no physical proof at most of the crime scenes. The goal of this article is to illustrate a little-known but noteworthy case concerning a serial sexual killer of elderly women that occurred in Southern Italy, highlighting the method of operation, the victim selection process, and the injuries inflicted. The article will also discuss his motivation, the

  1. Serial consolidation of orientation information into visual short-term memory.

    Science.gov (United States)

    Liu, Taosheng; Becker, Mark W

    2013-06-01

    Previous research suggests that there is a limit to the rate at which items can be consolidated in visual short-term memory (VSTM). This limit could be due to either a serial or a limited-capacity parallel process. Historically, it has proven difficult to distinguish between these two types of processes. In the present experiment, we took a novel approach that allowed us to do so. Participants viewed two oriented gratings either sequentially or simultaneously and reported one of the gratings' orientation via method of adjustment. Performance was worse for the simultaneous than for the sequential condition. We fit the data with a mixture model that assumes performance is limited by a noisy memory representation plus random guessing. Critically, the serial and limited-capacity parallel processes made distinct predictions regarding the model's guessing and memory-precision parameters. We found strong support for a serial process, which implies that one can consolidate only a single orientation into VSTM at a time.

  2. The clinical reasoning process in randomized clinical trials with patients with non-specific neck pain is incomplete: A systematic review.

    Science.gov (United States)

    Maissan, Francois; Pool, Jan; de Raaij, Edwin; Mollema, Jürgen; Ostelo, Raymond; Wittink, Harriet

    2018-06-01

    Primarily to evaluate the completeness of the description of the clinical reasoning process in RCTs with patients with non-specific neck pain with an argued or diagnosed cause i.e. an impairment or activity limitation. Secondly, to determine the association between the completeness of the clinical reasoning process and the degree of risk of bias. Pubmed, Cinahl and PEDro were systematically searched from inception to July 2016. RCTs (n = 122) with patients with non-specific neck pain receiving physiotherapy treatment published in English were included. Data extraction included study characteristics and important features of the clinical reasoning process based on the Hypothesis-Oriented Algorithm for Clinicians II (HOAC II)]. Thirty-seven studies (30%) had a complete clinical reasoning process of which 8 (6%) had a 'diagnosed cause' and 29 (24%) had an 'argued cause'. The Spearmans rho association between the extent of the clinical reasoning process and the risk of bias was -0.2. In the majority of studies (70%) the described clinical reasoning process was incomplete. A very small proportion (6%) had a 'diagnosed cause'. Therefore, a better methodological quality does not necessarily imply a better described clinical reasoning process. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Serial gadolinium-enhanced magnetic resonance imaging in patients with multiple sclerosis treated with mitoxantrone

    International Nuclear Information System (INIS)

    Krapf, H.; Mauch, E.; Fetzer, U.; Laufen, H.; Kornhuber, H.H.

    1995-01-01

    Serial gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) was used to monitor the effect of mitoxantrone in ten patients with rapidly deteriorating multiple sclerosis (MS). MRI was performed as a baseline and thereafter at 1, 3, 6, 9, 12 and 24 months. The total number of Gd-enhancing lesions diminished from 169 at baseline to 10 after 1 year and to 5 after 2 years. This reduction and the percentage of follow-up MRI studies showing no Gd enhancement were more pronounced than in other MRI studies of the natural course of MS. Measured with quantitative neurological scales, only one patient showed deterioration after 2 years; nevertheless, the changes in MRI were much more marked than those observed clinically. Serial Gd-MRI therefore, seems necessary for documenting efficacy in future therapeutic trails. (orig.)

  4. Theory of Visual Attention (TVA) applied to mice in the 5-choice serial reaction time task.

    Science.gov (United States)

    Fitzpatrick, C M; Caballero-Puntiverio, M; Gether, U; Habekost, T; Bundesen, C; Vangkilde, S; Woldbye, D P D; Andreasen, J T; Petersen, A

    2017-03-01

    The 5-choice serial reaction time task (5-CSRTT) is widely used to measure rodent attentional functions. In humans, many attention studies in healthy and clinical populations have used testing based on Bundesen's Theory of Visual Attention (TVA) to estimate visual processing speeds and other parameters of attentional capacity. We aimed to bridge these research fields by modifying the 5-CSRTT's design and by mathematically modelling data to derive attentional parameters analogous to human TVA-based measures. C57BL/6 mice were tested in two 1-h sessions on consecutive days with a version of the 5-CSRTT where stimulus duration (SD) probe length was varied based on information from previous TVA studies. Thereafter, a scopolamine hydrobromide (HBr; 0.125 or 0.25 mg/kg) pharmacological challenge was undertaken, using a Latin square design. Mean score values were modelled using a new three-parameter version of TVA to obtain estimates of visual processing speeds, visual thresholds and motor response baselines in each mouse. The parameter estimates for each animal were reliable across sessions, showing that the data were stable enough to support analysis on an individual level. Scopolamine HBr dose-dependently reduced 5-CSRTT attentional performance while also increasing reward collection latency at the highest dose. Upon TVA modelling, scopolamine HBr significantly reduced visual processing speed at both doses, while having less pronounced effects on visual thresholds and motor response baselines. This study shows for the first time how 5-CSRTT performance in mice can be mathematically modelled to yield estimates of attentional capacity that are directly comparable to estimates from human studies.

  5. Serial recording of median nerve stimulated subcortical somatosensory evoked potentials (SEPs) in developing brain death.

    Science.gov (United States)

    Buchner, H; Ferbert, A; Hacke, W

    1988-01-01

    Subcortical somatosensory evoked potentials (SEPs) to median nerve stimulation were recorded serially in 35 patients during the evolution towards brain death and in brain death. Neuropathological alterations of the central nervous system down to the C1/C2 spinal cord segment in brain death are well known. SEP components supposed to be generated above this level should be lost in brain death, while components generated below should not be altered. Erb's point, scalp and neck potentials were recorded at C3/4, or over the spinous process C7, using an Fz reference. In 10 patients additional montages, including spinous process C2-Fz, a non-cephalic reference (Fz-contralateral shoulder) and a posterior to anterior neck montage (spinous process C7-jugulum) were used. The cephalic referenced N9 and N11 peaks remained unchanged until brain death. N9 and N11 decreased in parallel in amplitude and increased in latency after systemic effects like hypoxia or hypothermia occurred. The cephalic referenced 'N14' decreased in amplitude and increased in latency after the clinical brain death syndrome was observed, while N13 in the posterior to anterior neck montage remained unchanged. The alteration of 'N14' went parallel to the decrease of the P14 amplitude. The subcortical SEPs in the cephalic referenced lead are supposed to be a peak composed by a horizontally orientated dorsal horn generated N13 and a rostrally orientated P14 arising at the level of the foramen magnum. The deterioration of the non-cephalic referenced P14 and of its cephalic referenced reflection 'N14' seems to provide an additional objective criterion for the diagnosis of brain death.

  6. Visualizing complex processes using a cognitive-mapping tool to support the learning of clinical reasoning.

    Science.gov (United States)

    Wu, Bian; Wang, Minhong; Grotzer, Tina A; Liu, Jun; Johnson, Janice M

    2016-08-22

    Practical experience with clinical cases has played an important role in supporting the learning of clinical reasoning. However, learning through practical experience involves complex processes difficult to be captured by students. This study aimed to examine the effects of a computer-based cognitive-mapping approach that helps students to externalize the reasoning process and the knowledge underlying the reasoning process when they work with clinical cases. A comparison between the cognitive-mapping approach and the verbal-text approach was made by analyzing their effects on learning outcomes. Fifty-two third-year or higher students from two medical schools participated in the study. Students in the experimental group used the computer-base cognitive-mapping approach, while the control group used the verbal-text approach, to make sense of their thinking and actions when they worked with four simulated cases over 4 weeks. For each case, students in both groups reported their reasoning process (involving data capture, hypotheses formulation, and reasoning with justifications) and the underlying knowledge (involving identified concepts and the relationships between the concepts) using the given approach. The learning products (cognitive maps or verbal text) revealed that students in the cognitive-mapping group outperformed those in the verbal-text group in the reasoning process, but not in making sense of the knowledge underlying the reasoning process. No significant differences were found in a knowledge posttest between the two groups. The computer-based cognitive-mapping approach has shown a promising advantage over the verbal-text approach in improving students' reasoning performance. Further studies are needed to examine the effects of the cognitive-mapping approach in improving the construction of subject-matter knowledge on the basis of practical experience.

  7. When to trust our learners? Clinical teachers' perceptions of decision variables in the entrustment process.

    Science.gov (United States)

    Duijn, Chantal C M A; Welink, Lisanne S; Bok, Harold G J; Ten Cate, Olle T J

    2018-06-01

    Clinical training programs increasingly use entrustable professional activities (EPAs) as focus of assessment. However, questions remain about which information should ground decisions to trust learners. This qualitative study aimed to identify decision variables in the workplace that clinical teachers find relevant in the elaboration of the entrustment decision processes. The findings can substantiate entrustment decision-making in the clinical workplace. Focus groups were conducted with medical and veterinary clinical teachers, using the structured consensus method of the Nominal Group Technique to generate decision variables. A ranking was made based on a relevance score assigned by the clinical teachers to the different decision variables. Field notes, audio recordings and flip chart lists were analyzed and subsequently translated and, as a form of axial coding, merged into one list, combining the decision variables that were similar in their meaning. A list of 11 and 17 decision variables were acknowledged as relevant by the medical and veterinary teacher groups, respectively. The focus groups yielded 21 unique decision variables that were considered relevant to inform readiness to perform a clinical task on a designated level of supervision. The decision variables consisted of skills, generic qualities, characteristics, previous performance or other information. We were able to group the decision variables into five categories: ability, humility, integrity, reliability and adequate exposure. To entrust a learner to perform a task at a specific level of supervision, a supervisor needs information to support such a judgement. This trust cannot be credited on a single case at a single moment of assessment, but requires different variables and multiple sources of information. This study provides an overview of decision variables giving evidence to justify the multifactorial process of making an entrustment decision.

  8. Lexical Access in L2 Speech Production: a controlled serial search task

    Directory of Open Access Journals (Sweden)

    Gicele Vergine Vieira

    2017-09-01

    Full Text Available When it comes to lexical access in L2 speech production, working memory (WM seems to play a central role as for less automatized procedures require more WM capacity to be executed (Prebianca, 2007. With that in mind, this paper aims at claiming that bilingual lexical access qualifies as a controlled serial strategic search task susceptible to individual differences in WM capacity. Evidence in support of such claim is provided by the results of AUTHOR's (2010 study conducted so as to investigate the relationship between L2 lexical access, WMC and L2 proficiency. AUTHOR's (2010 findings indicate that bilingual lexical access entails underlying processes such as cue generation, set delimitation, serial search and monitoring, which to be carried out, require the allocation of attention. Attention is limited and, as a result, only higher spans were able to perform these underlying processes automatically.

  9. B-Type Natriuretic Peptide: From Posttranslational Processing to Clinical Measurement

    DEFF Research Database (Denmark)

    Goetze, Jens P

    2012-01-01

    BACKGROUND:Plasma cardiac natriuretic peptides and peptide fragments from their molecular precursors are markers of heart disease. Clinical studies have defined the current diagnostic utility of these markers, whereas biochemical elucidation of peptide structure and posttranslational processing has...... revealed new plasma peptide forms of potential clinical use.CONTENT:Natriuretic propeptide structures undergo variable degrees of endo- and exoproteolytic cleavages as well as amino acid modifications, which leave the plasma phase of the peptides highly heterogeneous and dependent on cardiac......-atrial natriuretic peptide and pro-B-type natriuretic peptide are useful plasma markers in heart failure. New data have defined cardiac myocytes as competent endocrine cells in posttranslational processing and cellular secretion....

  10. Processes influencing the development of graduate nurse capabilities in clinical risk management: an Australian study.

    Science.gov (United States)

    Johnstone, Megan-Jane; Kanitsaki, Olga

    2006-01-01

    To explore and describe key processes influencing the development of graduate nurse capabilities in clinical risk management (CRM). This study was undertaken using an exploratory descriptive case study method. Four sample units of analysis were used, notably: 2 cohorts of graduate nurses (n = 11) undertaking a 12-month graduate nurse transition program; key stakeholders (n = 34), that is, nurse unit managers, clinical teachers, preceptors, a quality manager, a librarian, and senior nurse administrators employed by the participating health service; patient outcome data; and pertinent literature. Data strongly suggested that graduate nurse capabilities in CRM were most influenced not by their supposed lack of clinical knowledge and skills but by their lack of corporate knowledge. The failure to provide new graduate nurses with pertinent information on CRM at the beginning of their employment and thereafter at pertinent intervals during the graduate nurse year program aslo hindered the development of their capabilities to manage clinical risk. Management and educational processes pertinent to informing and involving new graduate nurses in a hospital's local CRM program (including information about the organization's local policies and procedures) need to be implemented systematically at the very beginning of a new graduate's employment and thereafter throughout the remainder of the graduate nurse year.

  11. The role of clinician emotion in clinical reasoning: Balancing the analytical process.

    Science.gov (United States)

    Langridge, Neil; Roberts, Lisa; Pope, Catherine

    2016-02-01

    This review paper identifies and describes the role of clinicians' memory, emotions and physical responses in clinical reasoning processes. Clinical reasoning is complex and multi-factorial and key models of clinical reasoning within musculoskeletal physiotherapy are discussed, highlighting the omission of emotion and subsequent physical responses and how these can impact upon a clinician when making a decision. It is proposed that clinicians should consider the emotions associated with decision-making, especially when there is concern surrounding a presentation. Reflecting on practice in the clinical environment and subsequently applying this to a patient presentation should involve some acknowledgement of clinicians' physical responses, emotions and how they may play a part in any decision made. Presenting intuition and gut-feeling as separate reasoning methods and how these processes co-exist with other more accepted reasoning such as hypothetico-deductive is also discussed. Musculoskeletal physiotherapy should consider the elements of feelings, emotions and physical responses when applying reflective practice principles. Furthermore, clinicians dealing with difficult and challenging presentations should look at the emotional as well as the analytical experience when justifying decisions and learning from practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. [Informed consent process in clinical trials: Insights of researchers, patients and general practitioners].

    Science.gov (United States)

    Giménez, Nuria; Pedrazas, David; Redondo, Susana; Quintana, Salvador

    2016-10-01

    Adequate information for patients and respect for their autonomy are mandatory in research. This article examined insights of researchers, patients and general practitioners (GPs) on the informed consent process in clinical trials, and the role of the GP. A cross-sectional study using three questionnaires, informed consent reviews, medical records, and hospital discharge reports. GPs, researchers and patients involved in clinical trials. Included, 504 GPs, 108 researchers, and 71 patients. Consulting the GP was recommended in 50% of the informed consents. Participation in clinical trials was shown in 33% of the medical records and 3% of the hospital discharge reports. GPs scored 3.54 points (on a 1-10 scale) on the assessment of the information received by the principal investigator. The readability of the informed consent sheet was rated 8.03 points by researchers, and the understanding was rated 7.68 points by patients. Patient satisfaction was positively associated with more time for reflection. GPs were not satisfied with the information received on the participation of patients under their in clinical trials. Researchers were satisfied with the information they offered to patients, and were aware of the need to improve the information GPs received. Patients collaborated greatly towards biomedical research, expressed satisfaction with the overall process, and minimised the difficulties associated with participation. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  13. Increasing clinical, satisfaction, and financial performance through nurse-driven process improvement.

    Science.gov (United States)

    Sims, Caroline E

    2003-02-01

    Providers and regulatory agencies are increasing their demands for hospitals to document clinical quality and customer satisfaction at a decreased cost. Nurse leaders search for ways to meet these requirements while retaining their most valuable resource: healthcare workers (especially nurses). First-line leadership struggles with balancing quality, cost-effectiveness, and staff retention. The author discusses the planning, methodology, implementation, and outcomes of a staff driven process improvement initiative.

  14. Depression and pain: testing of serial multiple mediators

    Directory of Open Access Journals (Sweden)

    Wongpakaran T

    2016-07-01

    function were found to significantly mediate the relationship between depression and pain, while controlling for demographic variables. The total effect of depression on pain was significant. This model, with an additional three mediators, accounted for 15% of the explained variance in pain compared to 9% without mediators. For the alternative model, after controlling for the mediators, a nonsignificant total direct effect level of self-sacrificing was found, suggesting that the effect of self-sacrificing on pain was based only on an indirect effect and that perceived stress was found to be the strongest mediator.Conclusion: Serial mediation may help us to see how depression and pain are linked and what the fundamental mediators are in the chain. No significant, indirect effect of self-sacrificing on pain was observed, if perceived stress was not part of the depression and/or cognitive function mediational chain. The results shown here have implications for future research, both in terms of testing the model and in clinical application. Keywords: depressive disorder, mediator, serial mediation, multiple mediation

  15. Fast Grasp Contact Computation for a Serial Robot

    Science.gov (United States)

    Shi, Jianying (Inventor); Hargrave, Brian (Inventor); Diftler, Myron A. (Inventor)

    2015-01-01

    A system includes a controller and a serial robot having links that are interconnected by a joint, wherein the robot can grasp a three-dimensional (3D) object in response to a commanded grasp pose. The controller receives input information, including the commanded grasp pose, a first set of information describing the kinematics of the robot, and a second set of information describing the position of the object to be grasped. The controller also calculates, in a two-dimensional (2D) plane, a set of contact points between the serial robot and a surface of the 3D object needed for the serial robot to achieve the commanded grasp pose. A required joint angle is then calculated in the 2D plane between the pair of links using the set of contact points. A control action is then executed with respect to the motion of the serial robot using the required joint angle.

  16. BRAIN Journal - Some Considerations on Seriality and Synchronicity

    OpenAIRE

    Elena Nechita

    2017-01-01

    ABSTRACT This paper presents an overview of the results that have been obtained lately on seriality and synchronicity and their link, in the light of the new theories and within the frame of complexity science.

  17. Serials Management In Polytechnic Libraries in Nigeria: A ...

    African Journals Online (AJOL)

    Serials Management In Polytechnic Libraries in Nigeria: A Comparative Study of Kaduna Polytechnic And Yaba College of Technology Libraries. ... Samaru Journal of Information Studies. Journal Home · ABOUT THIS JOURNAL · Advanced ...

  18. Energy information data base. Serial titles, February 1978--June 1979

    International Nuclear Information System (INIS)

    1979-06-01

    This supplement contains changes and additions to TID-4579-R10 (the authority list for serial titles used by TIC), and is intended to be used with that publication. Supplements are cumulative until another revision is issued

  19. Fault tolerance based on serial communication of FPGA

    International Nuclear Information System (INIS)

    Peng Jing; Fang Zongliang; Xu Quanzhou; Hu Jiewei; Ma Guizhen

    2012-01-01

    There maybe appear mistake in serial communication. This paper was described the intellectual detector of γ dose ratemeter communication with FPGA. The software of FPGA designed the code about fault tolerance, prevented mistake effectively. (authors)

  20. Using Behavior Sequence Analysis to Map Serial Killers' Life Histories.

    Science.gov (United States)

    Keatley, David A; Golightly, Hayley; Shephard, Rebecca; Yaksic, Enzo; Reid, Sasha

    2018-03-01

    The aim of the current research was to provide a novel method for mapping the developmental sequences of serial killers' life histories. An in-depth biographical account of serial killers' lives, from birth through to conviction, was gained and analyzed using Behavior Sequence Analysis. The analyses highlight similarities in behavioral events across the serial killers' lives, indicating not only which risk factors occur, but the temporal order of these factors. Results focused on early childhood environment, indicating the role of parental abuse; behaviors and events surrounding criminal histories of serial killers, showing that many had previous convictions and were known to police for other crimes; behaviors surrounding their murders, highlighting differences in victim choice and modus operandi; and, finally, trial pleas and convictions. The present research, therefore, provides a novel approach to synthesizing large volumes of data on criminals and presenting results in accessible, understandable outcomes.

  1. Avaliação clínico-cardiológica e ecocardiográfica, seqüencial, em crianças portadoras da síndrome de Marfan Serial clinical and echocardiographic evaluation in children with Marfan syndrome

    Directory of Open Access Journals (Sweden)

    Victor Manuel Oporto Lopez

    2005-11-01

    Full Text Available OBJETIVO: Descrever a apresentação clínica cardiológica e a evolução temporal, estimar a incidência de ectasia ânulo-aórtica e de prolapso da valva mitral, e avaliar a tolerância e a efetividade dos betabloqueadores em crianças com síndrome de Marfan. MÉTODOS: Foram submetidas a exame clínico e ecocardiográfico seriado, durante um ano, 21 crianças com síndrome de Marfan. No ecocardiograma foram analisados: presença de prolapso mitral, diâmetro da raiz aórtica, refluxos das valvas mitral e aórtica, e o crescimento dos diâmetros aórticos na vigência de betabloqueadores. Em 11 pacientes foi possível obter duas medidas da raiz aórtica no intervalo de um ano. RESULTADOS: Durante o estudo as crianças não apresentaram sintomas. Prolapso mitral foi encontrado em 11 (52% crianças. Ectasia ânulo-aórtica ocorreu em 16 (76% pacientes, sendo de grau discreto em 42,8%, moderado em 9,5%, e importante em 23,8%. Um desses pacientes foi submetido com sucesso à cirurgia de Bentall DeBono. Com o uso de betabloqueador a freqüência cardíaca diminuiu 13,6% (de 85 para 73 bpm; p OBJECTIVE: To describe the clinical cardiac manifestations and temporal evolution of Marfan syndrome in children; to estimate the incidence of annuloaortic ectasia and mitral valve prolapse; and to evaluate tolerability and efficacy of beta-blockers in these patients. METHODS: During one year, 21children with Marfan syndrome underwent serial clinical and echocardiographic examinations. Echocardiograms assessed: the presence of mitral valve prolapse, aortic root diameter, mitral and aortic valves regurgitation, and aortic enlargement during beta-blocker therapy. Eleven patients had two measurements of the aortic root taken one year apart. RESULTS: The children were asymptomatic throughout the study. Mitral prolapse was found in 11 (52% children. Annuloaortic ectasia occurred in 16 (76% patients and found to be mild in 42.8%, moderate in 9.5%, and severe in 23

  2. Serial position effects in patients with mild cognitive impairment and early and moderate Alzheimer's disease compared with healthy comparison subjects.

    Science.gov (United States)

    Moser, B; Deisenhammer, E A; Marksteiner, J; Papousek, I; Fink, A; Weiss, E M

    2014-01-01

    This study aimed to investigate whether the serial position effects in memory can differentiate patients with different subtypes of mild cognitive impairment (MCI) from healthy controls and patients with different stages of Alzheimer's disease (AD). The serial position effects was tested with the CERAD word list task in 184 persons (39 healthy control subjects, 15 amnestic MCI single domain subjects, 23 amnestic MCI multiple domain subjects, 31 nonamnestic MCI subjects, 45 early or mild AD patients, and 31 moderate AD patients). With progression of dementia, memory deficits increased and the impairment in the primacy effect during the learning trials advanced, whereas the recall of recent items was less impaired. The serial position profile of nonamnestic MCI patients resembled that of healthy control subjects, whereas amnestic MCI patients showed poorer performance in all 3 positions but no significant difference as a function of serial word position. Analyses of the serial position effect may be a useful complement to clinical neuropsychological measures for distinguishing amnestic MCI patients from normal aging and patients with different stages of dementia. © 2013 S. Karger AG, Basel.

  3. Ethically-based clinical decision-making in physical therapy: process and issues.

    Science.gov (United States)

    Finch, Elspeth; Geddes, E Lynne; Larin, Hélène

    2005-01-01

    The identification and consideration of relevant ethical issues in clinical decision-making, and the education of health care professionals (HCPs) in these skills are key factors in providing quality health care. This qualitative study explores the way in which physical therapists (PTs) integrate ethical issues into clinical practice decisions and identifies ethical themes used by PTs. A purposive sample of eight PTs was asked to describe a recent ethically-based clinical decision. Transcribed interviews were coded and themes identified related to the following categories: 1) the integration of ethical issues in the clinical decision-making process, 2) patient welfare, 3) professional ethos of the PT, and 4) health care economics and business practices. Participants readily described clinical situations involving ethical issues but rarely identified specific conflicting ethical issues in their description. Ethical dilemmas were more frequently resolved when there were fewer emotional sequelae associated with the dilemma, and the PT had a clear understanding of professional ethos, valued patient autonomy, and explored a variety of alternative actions before implementing one. HCP students need to develop a clear professional ethos and an increased understanding of the economic factors that will present ethical issues in practice.

  4. 'You can't just hit a button': an ethnographic study of strategies to repurpose data from advanced clinical information systems for clinical process improvement.

    Science.gov (United States)

    Morrison, Cecily; Jones, Matthew; Jones, Rachel; Vuylsteke, Alain

    2013-04-10

    Current policies encourage healthcare institutions to acquire clinical information systems (CIS) so that captured data can be used for secondary purposes, including clinical process improvement. Such policies do not account for the extra work required to repurpose data for uses other than direct clinical care, making their implementation problematic. This paper aims to analyze the strategies employed by clinical units to use data effectively for both direct clinical care and clinical process improvement. Ethnographic methods were employed. A total of 54 contextual interviews with health professionals spanning various disciplines and 18 hours of observation were carried out in 5 intensive care units in England using an advanced CIS. Case studies of how the extra work was achieved in each unit were derived from the data and then compared. We found that extra work is required to repurpose CIS data for clinical process improvement. Health professionals must enter data not required for clinical care and manipulation of this data into a machine-readable form is often necessary. Ambiguity over who should be responsible for this extra work hindered CIS data usage for clinical process improvement. We describe 11 strategies employed by units to accommodate this extra work, distributing it across roles. Seven of these motivated data entry by health professionals and four addressed the machine readability of data. Many of the strategies relied heavily on the skill and leadership of local clinical customizers. To realize the expected clinical process improvements by the use of CIS data, clinical leaders and policy makers need to recognize and support the redistribution of the extra work that is involved in data repurposing. Adequate time, funding, and appropriate motivation are needed to enable units to acquire and deliver the necessary skills in CIS customization.

  5. Direct kinematics solution architectures for industrial robot manipulators: Bit-serial versus parallel

    Science.gov (United States)

    Lee, J.; Kim, K.

    1991-01-01

    A Very Large Scale Integration (VLSI) architecture for robot direct kinematic computation suitable for industrial robot manipulators was investigated. The Denavit-Hartenberg transformations are reviewed to exploit a proper processing element, namely an augmented CORDIC. Specifically, two distinct implementations are elaborated on, such as the bit-serial and parallel. Performance of each scheme is analyzed with respect to the time to compute one location of the end-effector of a 6-links manipulator, and the number of transistors required.

  6. Direct kinematics solution architectures for industrial robot manipulators: Bit-serial versus parallel

    Science.gov (United States)

    Lee, J.; Kim, K.

    A Very Large Scale Integration (VLSI) architecture for robot direct kinematic computation suitable for industrial robot manipulators was investigated. The Denavit-Hartenberg transformations are reviewed to exploit a proper processing element, namely an augmented CORDIC. Specifically, two distinct implementations are elaborated on, such as the bit-serial and parallel. Performance of each scheme is analyzed with respect to the time to compute one location of the end-effector of a 6-links manipulator, and the number of transistors required.

  7. Serial correlation of quality control data--on the use of proper control charts

    DEFF Research Database (Denmark)

    Winkel, P; Zhang, Nevin

    2004-01-01

    Biochemical quality control (QC) data have been reported to be autocorrelated. Serial correlation may increase the rate of false alarms if the traditional exponentially weighted moving average (EWMA) control chart to monitoring the process mean is used. False alarms are the focus of this paper, w......, where an alarm is defined as the occurrence of a QC value outside the three standard deviation control limits....

  8. Serial completely stirred tank reactors for improving biogas production and substance degradation during anaerobic digestion of corn stover.

    Science.gov (United States)

    Li, YuQian; Liu, ChunMei; Wachemo, Akiber Chufo; Yuan, HaiRong; Zou, DeXun; Liu, YanPing; Li, XiuJin

    2017-07-01

    Several completely stirred tank reactors (CSTR) connected in series for anaerobic digestion of corn stover were investigated in laboratory scale. Serial anaerobic digestion systems operated at a total HRT of 40days, and distribution of HRT are 10+30days (HRT10+30d), 20+20days (HRT20+20d), and 30+10days (HRT30+10d) were compared to a conventional one-step CSTR at the same HRT of 40d. The results showed that in HRT10+30d serial system, the process became very unstable at organic load of 50gTS·L -1 . The HRT20+20d and HRT30+10d serial systems improved methane production by 8.3-14.6% compared to the one-step system in all loads of 50, 70, 90gTS·L -1 . The conversion rates of total solid, cellulose, and hemicellulose were increased in serial anaerobic digestion systems compared to single system. The serial systems showed more stable process performance in high organic load. HRT30+10d system showed the best biogas production and conversions among all systems. Copyright © 2017. Published by Elsevier Ltd.

  9. Potential value of serial cerebral SPECT scanning in the evaluation of psychiatric illness

    International Nuclear Information System (INIS)

    Notardonato, H.; Gonzalez-Avilez, A.; Van Heertum, R.L.; O'Connell, R.A.; Yudd, A.P.

    1989-01-01

    Cerebral SPECT imaging has the potential to make an important contribution to clinical psychiatry. Cerebral SPECT scanning, stimulated by the work with PET, is readily available and much less expensive than PET. This paper reports a case demonstrating the potential value of cerebral SPECT scanning with I-123 IMP, specifically in the serial evaluation of a schizophrenic patient with auditory hallucinations. The initial scan revealed focal areas of increased uptake in the caudate nuclei of the basal ganglia, and in the right temporal lobe. After pharmacological treatment with clinical improvement, the follow-up SPECT scan demonstrated significant improvement in the distribution of the radiopharmaceutical

  10. How Do We Write about Performance in Serial Television?

    OpenAIRE

    Elliott Logan

    2015-01-01

    Television studies has produced few sustained analyses of performance in serial television. Yet film studies scholarship has shown how attending to the integration of performances with other aspects of film style is crucial to the interpretation and appreciation of expression and meaning in filmed narrative fictions. However, as a particle form of filmed serial narrative, series television raises a number of questions about performance that will not necessarily be satisfyingly addressed by th...

  11. Comparing student clinical self-efficacy and team process outcomes for a DEU, blended, and traditional clinical setting: A quasi-experimental research study.

    Science.gov (United States)

    Plemmons, Christina; Clark, Michele; Feng, Du

    2018-03-01

    Clinical education is vital to both the development of clinical self-efficacy and the integration of future nurses into health care teams. The dedicated education unit clinical teaching model is an innovative clinical partnership, which promotes skill development, professional growth, clinical self-efficacy, and integration as a team member. Blended clinical teaching models are combining features of the dedicated education unit and traditional clinical model. The aims of this study are to explore how each of three clinical teaching models (dedicated education unit, blended, traditional) affects clinical self-efficacy and attitude toward team process, and to compare the dedicated education unit model and blended model to traditional clinical. A nonequivalent control-group quasi-experimental design was utilized. The convenience sample of 272 entry-level baccalaureate nursing students included 84 students participating in a dedicated education unit model treatment group, 66 students participating in a blended model treatment group, and 122 students participating in a traditional model control group. Perceived clinical self-efficacy was evaluated by the pretest/posttest scores obtained on the General Self-Efficacy scale. Attitude toward team process was evaluated by the pretest/posttest scores obtained on the TeamSTEPPS® Teamwork Attitude Questionnaire. All three clinical teaching models resulted in significant increases in both clinical self-efficacy (p=0.04) and attitude toward team process (p=0.003). Students participating in the dedicated education unit model (p=0.016) and students participating in the blended model (pteam process among entry-level baccalaureate nursing students. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Audit filters for improving processes of care and clinical outcomes in trauma systems.

    Science.gov (United States)

    Evans, Christopher; Howes, Daniel; Pickett, William; Dagnone, Luigi

    2009-10-07

    Traumatic injuries represent a considerable public health burden with significant personal and societal costs. The care of the severely injured patient in a trauma system progresses along a continuum that includes numerous interventions being provided by a multidisciplinary group of healthcare personnel. Despite the recent emphasis on quality of care in medicine, there has been little research to direct trauma clinicians and administrators on how optimally to monitor and improve upon the quality of care delivered within a trauma system. Audit filters are one mechanism for improving quality of care and are defined as specific clinical processes or outcomes of care that, when they occur, represent unfavorable deviations from an established norm and which prompt review and feedback. Although audit filters are widely utilized for performance improvement in trauma systems they have not been subjected to systematic review of their effectiveness. To determine the effectiveness of using audit filters for improving processes of care and clinical outcomes in trauma systems. Our search strategy included an electronic search of the Cochrane Injuries Group Specialized Register, the Cochrane EPOC Group Specialized Register, CENTRAL (The Cochrane Library 2008, Issue 4), MEDLINE, PubMed, EMBASE, CINAHL, and ISI Web of Science: (SCI-EXPANDED and CPCI-S). We handsearched the Journal of Trauma, Injury, Annals of Emergency Medicine, Academic Emergency Medicine, and Injury Prevention. We searched two clinical trial registries: 1) The World Health Organization International Clinical Trials Registry Platform and, 2) Clinical Trials.gov. We also contacted content experts for further articles. The most recent electronic search was completed in December 2008 and the handsearch was completed up to February 2009. We searched for randomized controlled trials, controlled clinical trials, controlled before-and-after studies, and interrupted time series studies that used audit filters as an

  13. How Do We Write about Performance in Serial Television?

    Directory of Open Access Journals (Sweden)

    Elliott Logan

    2015-05-01

    Full Text Available Television studies has produced few sustained analyses of performance in serial television. Yet film studies scholarship has shown how attending to the integration of performances with other aspects of film style is crucial to the interpretation and appreciation of expression and meaning in filmed narrative fictions. However, as a particle form of filmed serial narrative, series television raises a number of questions about performance that will not necessarily be satisfyingly addressed by the direct adoption and application of approaches to writing about performance that have been honed in regard to film. How, then, do we write about performance in television serials in ways that recognise and accommodate the form’s relationship to film, while at the same time appropriately acknowledging and responding to long-form television’s serial status? To examine the difficulties and opportunities of approaching performance in serial television this way, the article conducts close readings of various pieces of television studies writing on performance, by scholars such as Jason Mittell, Sue Turnbull, George Toles, and Steven Peacock. Their work brings into view film and television’s points of common relation, and the distinctive challenges, achievements, and rewards of appreciating the best television serials, and the performances in them.

  14. Challenges of microtome‐based serial block‐face scanning electron microscopy in neuroscience

    Science.gov (United States)

    WANNER, A. A.; KIRSCHMANN, M. A.

    2015-01-01

    Summary Serial block‐face scanning electron microscopy (SBEM) is becoming increasingly popular for a wide range of applications in many disciplines from biology to material sciences. This review focuses on applications for circuit reconstruction in neuroscience, which is one of the major driving forces advancing SBEM. Neuronal circuit reconstruction poses exceptional challenges to volume EM in terms of resolution, field of view, acquisition time and sample preparation. Mapping the connections between neurons in the brain is crucial for understanding information flow and information processing in the brain. However, information on the connectivity between hundreds or even thousands of neurons densely packed in neuronal microcircuits is still largely missing. Volume EM techniques such as serial section TEM, automated tape‐collecting ultramicrotome, focused ion‐beam scanning electron microscopy and SBEM (microtome serial block‐face scanning electron microscopy) are the techniques that provide sufficient resolution to resolve ultrastructural details such as synapses and provides sufficient field of view for dense reconstruction of neuronal circuits. While volume EM techniques are advancing, they are generating large data sets on the terabyte scale that require new image processing workflows and analysis tools. In this review, we present the recent advances in SBEM for circuit reconstruction in neuroscience and an overview of existing image processing and analysis pipelines. PMID:25907464

  15. Four-hour processing of clinical/diagnostic specimens for electron microscopy using microwave technique.

    Science.gov (United States)

    Giberson, R T; Demaree, R S; Nordhausen, R W

    1997-01-01

    A protocol for routine 4-hour microwave tissue processing of clinical or other samples for electron microscopy was developed. Specimens are processed by using a temperature-restrictive probe that can be set to automatically cycle the magnetron to maintain any designated temperature restriction (temperature maximum). In addition, specimen processing during fixation is performed in 1.7-ml microcentrifuge tubes followed by subsequent processing in flow-through baskets. Quality control is made possible during each step through the addition of an RS232 port to the microwave, allowing direct connection of the microwave oven to any personal computer. The software provided with the temperature probe enables the user to monitor time and temperature on a real-time basis. Tissue specimens, goat placenta, mouse liver, mouse kidney, and deer esophagus were processed by conventional and microwave techniques in this study. In all instances, the results for the microwave-processed samples were equal to or better than those achieved by routine processing techniques.

  16. Does registration of serial MRI improve diagnosis of dementia?

    International Nuclear Information System (INIS)

    Barnes, Josephine; Kennedy, Jonathan; Barker, Suzie; Lehmann, Manja; Nordstrom, R.C.; Smith, Joseph R.; Rossor, Martin N.; Fox, Nick C.; Mitchell, L.A.; Bastos-Leite, Antonio J.; Frost, Chris; Garde, Ellen

    2010-01-01

    We aimed to assess the value of a second MR scan in the radiological diagnosis of dementia. One hundred twenty subjects with clinical follow-up of at least 1 year with two scans were selected from a cognitive disorders clinic. Scans were reviewed as a single first scan (method A), two unregistered scans presented side-by-side (method B) and a registered pair (method C). Scans were presented to two neuroradiologists and a clinician together with approximate scan interval (if applicable) and age. Raters decided on a main and subtype diagnosis. There was no evidence that differences between methods (expressed as relative odds of a correct response) differed between reviewers (p = 0.17 for degenerative condition or not, p = 0.5 for main diagnosis, p = 0.16 for subtype). Accordingly, results were pooled over reviewers. For distinguishing normal/non-progressors from degenerative conditions, the proportions correctly diagnosed were higher with methods B and C than with A (p = 0.001, both tests). The difference between method B and C was not statistically significant (p = 0.18). For main diagnosis, the proportion of correct diagnoses were highest with method C for all three reviewers; however, this was not statistically significant comparing with method A (p = 0.23) or with method B (p = 0.16). For subtype diagnosis, there was some evidence that method C was better than method A (p = 0.01) and B (p = 0.048). Serial MRI and registration may improve visual diagnosis in dementia. (orig.)

  17. Structural and Process Factors That Influence Clinical Nurse Specialist Role Implementation.

    Science.gov (United States)

    Kilpatrick, Kelley; Tchouaket, Eric; Carter, Nancy; Bryant-Lukosius, Denise; DiCenso, Alba

    2016-01-01

    The aim of this study was to examine the influence of structure and process on clinical nurse specialist (CNS) role implementation. We conducted a secondary analysis of cross-sectional survey data. The study was performed in Canada. The authors included 445 of 471 questionnaires (94.5%) of graduate-prepared CNSs. Based on Donabedian's framework, we conducted a secondary analysis of CNS responses using hierarchical regression. The internal consistency of the 6 CNS role dimensions and team dynamics subscales was excellent. The use of a framework to guide CNS role implementation influences all the role dimensions. Employer understanding of the CNS role, working in an urban catchment area, specialty certification, and more years in a CNS role had a direct positive influence on team dynamics. Full-time employment exerted a direct negative influence on this dimension. Furthermore, team dynamics (as a mediator variable), seeing patients in practice, and having an office in the clinical unit exerted a direct positive influence on the clinical dimension. Having an annual performance appraisal and a job description exerted a direct negative influence on the clinical dimension. Employer understanding, working in an urban area, full-time employment, and specialty certification had an indirect effect on the clinical dimension. Accountability to a nonnurse manager exerted a direct negative influence on the education dimension. The research and scholarly/professional development dimensions were influenced by more years in a CNS role. Accountability to a nurse manager exerted a direct positive influence on the organizational leadership dimension; unionization and seeing patients in practice had a direct negative influence on this dimension. Seeing patients in practice and full-time employment exerted a direct positive influence on the consultation dimension. The identification of structures and processes that influence CNS role implementation may inform strategies used by

  18. Protein Turnover Measurements in Human Serum by Serial Immunoaffinity LC-MS/MS.

    Science.gov (United States)

    Farrokhi, Vahid; Chen, Xiaoying; Neubert, Hendrik

    2018-02-01

    The half-life of target proteins is frequently an important parameter in mechanistic pharmacokinetic and pharmacodynamic (PK/PD) modeling of biotherapeutics. Clinical studies for accurate measurement of physiologically relevant protein turnover can reduce the uncertainty in PK/PD model-based predictions, for example, of the therapeutic dose and dosing regimen in first-in-human clinical trials. We used a targeted mass spectrometry work flow based on serial immunoaffinity enrichment ofmultiple human serum proteins from a [5,5,5- 2 H 3 ]-L-leucine tracer pulse-chase study in healthy volunteers. To confirm the reproducibility of turnover measurements from serial immunoaffinity enrichment, multiple aliquots from the same sample set were subjected to protein turnover analysis in varying order. Tracer incorporation was measured by multiple-reaction-monitoring mass spectrometry and target turnover was calculated using a four-compartment pharmacokinetic model. Five proteins of clinical or therapeutic relevance including soluble tumor necrosis factor receptor superfamily member 12A, tissue factor pathway inhibitor, soluble interleukin 1 receptor like 1, soluble mucosal addressin cell adhesion molecule 1, and muscle-specific creatine kinase were sequentially subjected to turnover analysis from the same human serum sample. Calculated half-lives ranged from 5-15 h; however, no tracer incorporation was observed for mucosal addressin cell adhesion molecule 1. The utility of clinical pulse-chase studies to investigate protein turnover can be extended by serial immunoaffinity enrichment of target proteins. Turnover analysis from serum and subsequently from remaining supernatants provided analytical sensitivity and reproducibility for multiple human target proteins in the same sample set, irrespective of the order of analysis. © 2017 American Association for Clinical Chemistry.

  19. Long-term effects of serial anodal tDCS on motion perception in subjects with occipital stroke measured in the unaffected visual hemifield

    Directory of Open Access Journals (Sweden)

    Manuel C Olma

    2013-06-01

    Full Text Available Transcranial direct current stimulation (tDCS is a novel neuromodulatory tool that has seen early transition to clinical trials, although the high variability of these findings necessitates further studies in clincally-relevant populations. The majority of evidence into effects of repeated tDCS is based on research in the human motor system, but it is unclear whether the long-term effects of serial tDCS are motor-specific or transferable to other brain areas. This study aimed to examine whether serial anodal tDCS over the visual cortex can exogenously induce long-term neuroplastic changes in the visual cortex. However, when the visual cortex is affected by a cortical lesion, up-regulated endogenous neuroplastic adaptation processes may alter the susceptibility to tDCS. To this end, motion perception was investigated in the unaffected hemifield of subjects with unilateral visual cortex lesions. Twelve subjects with occipital ischaemic lesions participated in a within-subject, sham-controlled, double-blind study. MRI-registered sham or anodal tDCS (1.5 mA, 20 minutes was applied on five consecutive days over the visual cortex. Motion perception was tested before and after stimulation sessions and at 14- and 28-day follow-up. After a 16-day interval an identical study block with the other stimulation condition (anodal or sham tDCS followed. Serial anodal tDCS over the visual cortex resulted in an improvement in motion perception, a function attributed to MT/V5. This effect was still measurable at 14- and 28-day follow-up measurements. Thus, this may represent evidence for long-term tDCS-induced plasticity and has implications for the design of studies examining the time course of tDCS effects in both the visual and motor systems.

  20. “It’s Always the Same, and It’s Always Different” Mythologisation and the Serial Killer in Henry: Portrait of a Serial Killer.

    OpenAIRE

    Smyth, David A.

    2015-01-01

    Serial killers are important in American horror because of their ability to exist between ‘myth’ and ‘reality’. The serial killer is one of the most important American myths, but it is one firmly rooted in real life: unlike Paul Bunyan or Superman, serial killers do exist. This essay examines the relationship between the ‘myth’ and the ‘reality’ of serial killers, and the complex relationship between the American public and the serial killer, using Henry: Portrait of a Serial K...

  1. Collection, transport and general processing of clinical specimens in Microbiology laboratory.

    Science.gov (United States)

    Sánchez-Romero, M Isabel; García-Lechuz Moya, Juan Manuel; González López, Juan José; Orta Mira, Nieves

    2018-02-06

    The interpretation and the accuracy of the microbiological results still depend to a great extent on the quality of the samples and their processing within the Microbiology laboratory. The type of specimen, the appropriate time to obtain the sample, the way of sampling, the storage and transport are critical points in the diagnostic process. The availability of new laboratory techniques for unusual pathogens, makes necessary the review and update of all the steps involved in the processing of the samples. Nowadays, the laboratory automation and the availability of rapid techniques allow the precision and turn-around time necessary to help the clinicians in the decision making. In order to be efficient, it is very important to obtain clinical information to use the best diagnostic tools. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  2. Manufacturing human mesenchymal stem cells at clinical scale: process and regulatory challenges.

    Science.gov (United States)

    Jossen, Valentin; van den Bos, Christian; Eibl, Regine; Eibl, Dieter

    2018-05-01

    Human mesenchymal stem cell (hMSC)-based therapies are of increasing interest in the field of regenerative medicine. As economic considerations have shown, allogeneic therapy seems to be the most cost-effective method. Standardized procedures based on instrumented single-use bioreactors have been shown to provide billion of cells with consistent product quality and to be superior to traditional expansions in planar cultivation systems. Furthermore, under consideration of the complex nature and requirements of allogeneic hMSC-therapeutics, a new equipment for downstream processing (DSP) was successfully evaluated. This mini-review summarizes both the current state of the hMSC production process and the challenges which have to be taken into account when efficiently producing hMSCs for the clinical scale. Special emphasis is placed on the upstream processing (USP) and DSP operations which cover expansion, harvesting, detachment, separation, washing and concentration steps, and the regulatory demands.

  3. Process evaluation of a pilot evidence-based Polycystic Ovary Syndrome clinic in the Torres Strait.

    Science.gov (United States)

    Boyle, Jacqueline; Hollands, Grace; Beck, Sarah; Hampel, Gaynor; Wapau, Hylda; Arnot, Marissa; Browne, Louise; Teede, Helena J; Moran, Lisa J

    2017-06-01

    Polycystic ovary syndrome (PCOS) is a chronic endocrine syndrome in reproductive-aged women which is very common among Aboriginal and Torres Strait Islander women. The objective of this study was to conduct a process evaluation of a pilot clinic on Thursday Island which aimed to provide a comprehensive evidence-based service for women with PCOS throughout the Torres Strait. Mixed-method evaluation at 12 months comprising a medical record audit, semi-structured interviews and focus group discussions. Primary care. Audit of n = 11 clinics (n = 36 women), qualitative semi-structured interviews with n = 8 clinicians and focus group discussions with n = 8 women. (i) Fidelity to evidence-based guidelines, (ii) barriers and enablers to women using the service, (iii) the ability to meet the needs of women and the community. The clinic was largely successful in providing evidence-based care with up to 78% of women receiving recommended cardiometabolic screening, 100% emotional screening and 89% lifestyle management despite the remoteness of the clinic and limited financial and human resources. Health care providers report sustainability of the clinic will be dependent on factors including staffing, administrative support and inclusion of Aboriginal and Torres Strait Islander health workers. While the clinic has been largely successful there are areas identified for potential improvement and to facilitate sustainability which should be considered before up-scaling this model to a national level. These include systems, administrative and staffing support, engaging with other community services to facilitate lifestyle changes and ongoing engagement and upskilling of Aboriginal and Torres Strait Islander health care providers. © 2016 National Rural Health Alliance Inc.

  4. Randomized clinical trials as reflexive-interpretative process in patients with rheumatoid arthritis: a qualitative study.

    Science.gov (United States)

    de Jorge, Mercedes; Parra, Sonia; de la Torre-Aboki, Jenny; Herrero-Beaumont, Gabriel

    2015-08-01

    Patients in randomized clinical trials have to adapt themselves to a restricted language to capture the necessary information to determine the safety and efficacy of a new treatment. The aim of this study was to explore the experience of patients with rheumatoid arthritis after completing their participation in a biologic therapy randomized clinical trial for a period of 3 years. A qualitative approach was used. The information was collected using 15 semi-structured interviews of patients with rheumatoid arthritis. Data collection was guided by the emergent analysis until no more relevant variations in the categories were found. The data were analysed using the grounded theory method. The objective of the patients when entering the study was to improve their quality of life by initiating the treatment. However, the experience changed the significance of the illness as they acquired skills and practical knowledge related to the management of their disease. The category "Interactional Empowerment" emerged as core category, as it represented the participative experience in a clinical trial. The process integrates the follow categories: "weight of systematisation", "working together", and the significance of the experience: "the duties". Simultaneously these categories evolved. The clinical trial monitoring activities enabled patients to engage in a reflexive-interpretative mechanism that transformed the emotional and symbolic significance of their disease and improved the empowerment of the patient. A better communicative strategy with the health professionals, the relatives of the patients, and the community was also achieved.

  5. From brief gaps to very long pauses: temporal isolation does not benefit serial recall.

    Science.gov (United States)

    Nimmo, Lisa M; Lewandowsky, Stephan

    2005-12-01

    Theoretical explanations of short-term memory for serial order can be classified on the basis of whether or not they invoke time as a causal variable. According to time-based accounts, such as temporal distinctiveness theories, there is an intimate link between time and memory. Event-based theories, by contrast, postulate processes such as interference or rehearsal to account for seemingly temporal phenomena in short-term memory. We report an experiment that examined whether extended temporal isolation benefits serial recall performance. Regardless of whether the participants were quiet or performed articulatory suppression during list presentation, temporal isolation did not benefit memory even if items were separated from their neighbors by up to 7 sec. These findings challenge time-based theories of short-term memory.

  6. The inpatient evaluation and treatment of a self-professed budding serial killer.

    Science.gov (United States)

    Reisner, Andrew D; McGee, Mark; Noffsinger, Stephen G

    2003-02-01

    The authors present the case of a man who was hospitalized after claiming that he was about to become a serial killer. The patient presented with extensive written homicidal fantasies and homicidal intentions without evidence of actual homicidal acts. In addition to routine assessments, hospital staff members used case conferences, psychological testing, outside forensic consultation, and a forensic review process to make decisions regarding diagnosis, treatment planning, and discharge. The patient was discharged after 8 months of inpatient treatment and was apparently free of homicidal impulses or symptoms of severe mental illness. A 2-year court commitment allowed for the enactment and potential enforcement of a discharge plan that was endorsed by the patient, the hospital, and community care providers. The authors review diagnostic and risk management issues. Comparisons with known features of typical serial killers are made.

  7. The default network and self-generated thought: component processes, dynamic control, and clinical relevance

    Science.gov (United States)

    Andrews-Hanna, Jessica R.; Smallwood, Jonathan; Spreng, R. Nathan

    2014-01-01

    Though only a decade has elapsed since the default network was first emphasized as being a large-scale brain system, recent years have brought great insight into the network’s adaptive functions. A growing theme highlights the default network as playing a key role in internally-directed—or self-generated—thought. Here, we synthesize recent findings from cognitive science, neuroscience, and clinical psychology to focus attention on two emerging topics as current and future directions surrounding the default network. First, we present evidence that self-generated thought is a multi-faceted construct whose component processes are supported by different subsystems within the network. Second, we highlight the dynamic nature of the default network, emphasizing its interaction with executive control systems when regulating aspects of internal thought. We conclude by discussing clinical implications of disruptions to the integrity of the network, and consider disorders when thought content becomes polarized or network interactions become disrupted or imbalanced. PMID:24502540

  8. The functional determinants of short-term memory: Evidence from perceptual-motor interference in verbal serial recall.

    Science.gov (United States)

    Hughes, Robert W; Marsh, John E

    2017-04-01

    A functional, perceptual-motor, account of serial short-term memory (STM) is examined by investigating the way in which an irrelevant spoken sequence interferes with verbal serial recall. Even with visual list-presentation, verbal serial recall is particularly susceptible to disruption by irrelevant spoken stimuli that have the same identity as-but that are order-incongruent with-the to-be-remembered items. We test the view that such interference is because of the obligatory perceptual organization of the spoken stimuli yielding a sequence that competes with a subvocal motor-plan assembled to support the reproduction of the to-be-remembered list. In support of this view, the interference can be eliminated without changing either the identities or objective serial order of the spoken stimuli but merely by promoting a subjective perceptual organization that strips them of their order-incongruent relation to the to-be-remembered list (Experiment 1). The interference is also eliminated if subvocal motor sequence-planning is impeded via articulatory suppression (Experiment 2). The results are in line with the view that performance-limits in verbal serial STM are because of having to exploit perceptual and motor processes for purposes for which they did not evolve, not the inherently limited capacity of structures or mechanisms dedicated to storage. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  9. Processing methods for photoacoustic Doppler flowmetry with a clinical ultrasound scanner

    Science.gov (United States)

    Bücking, Thore M.; van den Berg, Pim J.; Balabani, Stavroula; Steenbergen, Wiendelt; Beard, Paul C.; Brunker, Joanna

    2018-02-01

    Photoacoustic flowmetry (PAF) based on time-domain cross correlation of photoacoustic signals is a promising technique for deep tissue measurement of blood flow velocity. Signal processing has previously been developed for single element transducers. Here, the processing methods for acoustic resolution PAF using a clinical ultrasound transducer array are developed and validated using a 64-element transducer array with a -6 dB detection band of 11 to 17 MHz. Measurements were performed on a flow phantom consisting of a tube (580 μm inner diameter) perfused with human blood flowing at physiological speeds ranging from 3 to 25 mm / s. The processing pipeline comprised: image reconstruction, filtering, displacement detection, and masking. High-pass filtering and background subtraction were found to be key preprocessing steps to enable accurate flow velocity estimates, which were calculated using a cross-correlation based method. In addition, the regions of interest in the calculated velocity maps were defined using a masking approach based on the amplitude of the cross-correlation functions. These developments enabled blood flow measurements using a transducer array, bringing PAF one step closer to clinical applicability.

  10. [Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies].

    Science.gov (United States)

    Müller-Staub, Maria; Stuker-Studer, Ursula

    2006-10-01

    Case studies, based on actual patients' situations, provide a method of clinical decision making to foster critical thinking in nurses. This paper describes the method and process of group case studies applied in continuous education settings. This method bases on Balints' case supervision and was further developed and combined with the nursing diagnostic process. A case study contains different phases: Pre-phase, selection phase, case delineation and case work. The case provider narratively tells the situation of a patient. This allows the group to analyze and cluster signs and symptoms, to state nursing diagnoses and to derive nursing interventions. Results of the case study are validated by applying the theoretical background and critical appraisal of the case provider. Learning effects of the case studies were evaluated by means of qualitative questionnaires and analyzed according to Mayring. Findings revealed the following categories: a) Patients' problems are perceived in a patient centred way, accurate nursing diagnoses are stated and effective nursing interventions implemented. b) Professional nursing tasks are more purposefully perceived and named more precise. c) Professional nursing relationship, communication and respectful behaviour with patients were perceived in differentiated ways. The theoretical framework is described in the paper "Clinical decision making and critical thinking in the nursing diagnostic process". (Müller-Staub, 2006).

  11. Process Evaluation of a Community Garden at an Urban Outpatient Clinic.

    Science.gov (United States)

    Milliron, Brandy-Joe; Vitolins, Mara Z; Gamble, Elizabeth; Jones, Robert; Chenault, Margaret C; Tooze, Janet A

    2017-08-01

    In addition to expediting patient recovery, community gardens that are associated with medical facilities can provide fresh produce to patients and their families, serve as a platform for clinic-based nutrition education, and help patients develop new skills and insights that can lead to positive health behavior change. While community gardening is undergoing resurgence, there is a strong need for evaluation studies that employ valid and reliable measures. The objective of this study was to conduct a process evaluation of a community garden program at an urban medical clinic to estimate the prevalence of patient awareness and participation, food security, barriers to participation, and personal characteristics; garden volunteer satisfaction; and clinic staff perspectives in using the garden for patient education/treatment. Clinic patients (n = 411) completed a community garden participation screener and a random sample completed a longer evaluation survey (n = 152); garden volunteers and medical staff completed additional surveys. Among patients, 39% had heard of and 18% had received vegetables from the garden; the greatest barrier for participation was lack of awareness. Volunteers reported learning about gardening, feeling more involved in the neighborhood, and environmental concern; and medical staff endorsed the garden for patient education/treatment. Comprehensive process evaluations can be utilized to quantify benefits of community gardens in medical centers as well as to point out areas for further development, such as increasing patient awareness. As garden programming at medical centers is formalized, future research should include systematic evaluations to determine whether this unique component of the healthcare environment helps improve patient outcomes.

  12. Analysis of assembly serial number usage in domestic light-water reactors

    International Nuclear Information System (INIS)

    Reich, W.J.; Moore, R.S.

    1991-05-01

    Domestic light-water reactor (LWR) fuel assemblies are identified by a serial number that is placed on each assembly. These serial numbers are used as identifiers throughout the life of the fuel. The uniqueness of assembly serial numbers is important in determining their effectiveness as unambiguous identifiers. The purpose of this study is to determine what serial numbering schemes are used, the effectiveness of these schemes, and to quantify how many duplicate serial numbers occur on domestic LWR fuel assemblies. The serial numbering scheme adopted by the American National Standards Institute (ANSI) ensures uniqueness of assembly serial numbers. The latest numbering scheme adopted by General Electric (GE), was also found to be unique. Analysis of 70,971 fuel assembly serial numbers from permanently discharged fuel identified 11,948 serial number duplicates. Three duplicate serial numbers were found when analysis focused on duplication within the individual fuel inventory at each reactor site, but these were traced back to data entry errors and will be corrected by the Energy Information Administration (EIA). There were also three instances where the serial numbers used to identify assemblies used for hot cell studies differed from the serial numbers reported to the EIA. It is recommended that fuel fabricators and utilities adhere to the ANSI serial numbering scheme to ensure serial number uniqueness. In addition, organizations collecting serial number information, should request that all known serial numbers physically attached or associated with each assembly be reported and identified by the corresponding number scheme. 10 refs., 5 tabs

  13. Working memory and hearing aid processing: Literature findings, future directions, and clinical applications

    Directory of Open Access Journals (Sweden)

    Pamela eSouza

    2015-12-01

    Full Text Available Working memory—the ability to process and store information—has been identified as an important aspect of speech perception in difficult listening environments. Working memory can be envisioned as a limited-capacity system which is engaged when an input signal cannot be readily matched to a stored representation or template. This mismatch is expected to occur more frequently when the signal is degraded. Because working memory capacity varies among individuals, those with smaller capacity are expected to demonstrate poorer speech understanding when speech is degraded, such as in background noise. However, it is less clear whether (and how working memory should influence practical decisions, such as hearing treatment. Here, we consider the relationship between working memory capacity and response to specific hearing aid processing strategies. Three types of signal processing are considered, each of which will alter the acoustic signal: fast-acting wide-dynamic range compression, which smooths the amplitude envelope of the input signal; digital noise reduction, which may inadvertently remove speech signal components as it suppresses noise; and frequency compression, which alters the relationship between spectral peaks. For fast-acting wide-dynamic range compression, a growing body of data suggests that individuals with smaller working memory capacity may be more susceptible to such signal alterations, and may receive greater amplification benefit with low alteration processing. While the evidence for a relationship between wide-dynamic range compression and working memory appears robust, the effects of working memory on perceptual response to other forms of hearing aid signal processing are less clear cut. We conclude our review with a discussion of the opportunities (and challenges in translating information on individual working memory into clinical treatment, including clinically-feasible measures of working memory.

  14. Working Memory and Hearing Aid Processing: Literature Findings, Future Directions, and Clinical Applications.

    Science.gov (United States)

    Souza, Pamela; Arehart, Kathryn; Neher, Tobias

    2015-01-01

    Working memory-the ability to process and store information-has been identified as an important aspect of speech perception in difficult listening environments. Working memory can be envisioned as a limited-capacity system which is engaged when an input signal cannot be readily matched to a stored representation or template. This "mismatch" is expected to occur more frequently when the signal is degraded. Because working memory capacity varies among individuals, those with smaller capacity are expected to demonstrate poorer speech understanding when speech is degraded, such as in background noise. However, it is less clear whether (and how) working memory should influence practical decisions, such as hearing treatment. Here, we consider the relationship between working memory capacity and response to specific hearing aid processing strategies. Three types of signal processing are considered, each of which will alter the acoustic signal: fast-acting wide-dynamic range compression, which smooths the amplitude envelope of the input signal; digital noise reduction, which may inadvertently remove speech signal components as it suppresses noise; and frequency compression, which alters the relationship between spectral peaks. For fast-acting wide-dynamic range compression, a growing body of data suggests that individuals with smaller working memory capacity may be more susceptible to such signal alterations, and may receive greater amplification benefit with "low alteration" processing. While the evidence for a relationship between wide-dynamic range compression and working memory appears robust, the effects of working memory on perceptual response to other forms of hearing aid signal processing are less clear cut. We conclude our review with a discussion of the opportunities (and challenges) in translating information on individual working memory into clinical treatment, including clinically feasible measures of working memory.

  15. Impact of molecular imaging on the diagnostic process in a memory clinic.

    Science.gov (United States)

    Ossenkoppele, Rik; Prins, Niels D; Pijnenburg, Yolande A L; Lemstra, Afina W; van der Flier, Wiesje M; Adriaanse, Sofie F; Windhorst, Albert D; Handels, Ron L H; Wolfs, Claire A G; Aalten, Pauline; Verhey, Frans R J; Verbeek, Marcel M; van Buchem, Mark A; Hoekstra, Otto S; Lammertsma, Adriaan A; Scheltens, Philip; van Berckel, Bart N M

    2013-07-01

    [(11)C]Pittsburgh compound B ([(11)C]PIB) and [(18)F]-2-fluoro-2-deoxy-D-glucose ([(18)F]FDG) PET measure fibrillar amyloid-β load and glucose metabolism, respectively. We evaluated the impact of these tracers on the diagnostic process in a memory clinic population. One hundred fifty-four patients underwent paired dynamic [(11)C]PIB and static [(18)F]FDG PET scans shortly after completing a standard dementia screening. Two-year clinical follow-up data were available for 39 patients. Parametric PET images were assessed visually and results were reported to the neurologists responsible for the initial diagnosis. Outcome measures were (change in) clinical diagnosis and confidence in that diagnosis before and after disclosing PET results. [(11)C]PIB scans were positive in 40 of 66 (61%) patients with a clinical diagnosis of Alzheimer's disease (AD), 5 of 18 (28%) patients with frontotemporal dementia (FTD), 4 of 5 (80%) patients with Lewy body dementia, and 3 of 10 (30%) patients with other dementias. [(18)F]FDG uptake patterns matched the clinical diagnosis in 38 of 66 (58%) of AD patients, and in 6 of 18 (33%) FTD patients. PET results led to a change in diagnosis in 35 (23%) patients. This only occurred when prior diagnostic certainty was Diagnostic confidence increased from 71 ± 17% before to 87 ± 16% after PET (p diagnostic work-up, especially when prior diagnostic confidence is low. Copyright © 2013 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  16. Serial computed tomography and its uses in the diagnosis of pathological changes in the liver, pancreas and kidneys

    International Nuclear Information System (INIS)

    Schmiedel, R.

    1983-01-01

    The investigations described were carried out in such a way as to fulfil the defined requirements of serial computed tomography like short periods of measurement, high scanning frequency and intravasal bolus injection of a contrast medium that would readily be excreted by the renal route. In this connection, the following questions were of particular interest: 1. Is computed serial tomography able to provide better clues to tissue identification and the distinction between normal and pathological structures in the liver, pancreas and kidneys? 2. Would it be possible to obtain information as to the degree of vascularisation in space-occupying pathological processes in the liver, pancreas and kidneys? 3. Is serial computed tomography a useful tool to diagnose specific pathological changes in the liver, pancreas and kidneys? 4. Would this investigation permit predictions to be made about the functional performance of the liver, pancreas and kidneys? (orig./MG) [de

  17. B-Type Natriuretic Peptide: From Posttranslational Processing to Clinical Measurement

    DEFF Research Database (Denmark)

    Goetze, Jens P

    2012-01-01

    BACKGROUND:Plasma cardiac natriuretic peptides and peptide fragments from their molecular precursors are markers of heart disease. Clinical studies have defined the current diagnostic utility of these markers, whereas biochemical elucidation of peptide structure and posttranslational processing has...... pathophysiology and capacity. An ongoing characterization of the molecular heterogeneity may not only help us to appreciate the biosynthetic capacity of the endocrine heart but may also lead to the discovery of new and more disease-specific targets for future molecular diagnosis.SUMMARY:Peptides derived from pro...

  18. Medical subdomain classification of clinical notes using a machine learning-based natural language processing approach.

    Science.gov (United States)

    Weng, Wei-Hung; Wagholikar, Kavishwar B; McCray, Alexa T; Szolovits, Peter; Chueh, Henry C

    2017-12-01

    The medical subdomain of a clinical note, such as cardiology or neurology, is useful content-derived metadata for developing machine learning downstream applications. To classify the medical subdomain of a note accurately, we have constructed a machine learning-based natural language processing (NLP) pipeline and developed medical subdomain classifiers based on the content of the note. We constructed the pipeline using the clinical NLP system, clinical Text Analysis and Knowledge Extraction System (cTAKES), the Unified Medical Language System (UMLS) Metathesaurus, Semantic Network, and learning algorithms to extract features from two datasets - clinical notes from Integrating Data for Analysis, Anonymization, and Sharing (iDASH) data repository (n = 431) and Massachusetts General Hospital (MGH) (n = 91,237), and built medical subdomain classifiers with different combinations of data representation methods and supervised learning algorithms. We evaluated the performance of classifiers and their portability across the two datasets. The convolutional recurrent neural network with neural word embeddings trained-medical subdomain classifier yielded the best performance measurement on iDASH and MGH datasets with area under receiver operating characteristic curve (AUC) of 0.975 and 0.991, and F1 scores of 0.845 and 0.870, respectively. Considering better clinical interpretability, linear support vector machine-trained medical subdomain classifier using hybrid bag-of-words and clinically relevant UMLS concepts as the feature representation, with term frequency-inverse document frequency (tf-idf)-weighting, outperformed other shallow learning classifiers on iDASH and MGH datasets with AUC of 0.957 and 0.964, and F1 scores of 0.932 and 0.934 respectively. We trained classifiers on one dataset, applied to the other dataset and yielded the threshold of F1 score of 0.7 in classifiers for half of the medical subdomains we studied. Our study shows that a supervised

  19. Tracking the footsteps: a constructivist grounded theory of the clinical reasoning processes that registered nurses use to recognise delirium.

    Science.gov (United States)

    El Hussein, Mohamed; Hirst, Sandra

    2016-02-01

    To construct a grounded theory that explains the clinical reasoning processes that registered nurses use to recognise delirium while caring for older adults in acute care settings. Delirium is often under-recognised in acute care settings; this may stem from underdeveloped clinical reasoning processes. Little is known about registered nurses' clinical reasoning processes in complex situations such as delirium recognition. Seventeen registered nurses working in acute care settings were interviewed. Concurrent data collection and analysis, constant comparative analysis and theoretical sampling were conducted in 2013-2014. A grounded theory approach was used to analyse interview data about the clinical reasoning processes of registered nurse in acute hospital settings. The core category that emerged from data was 'Tracking the footsteps'. This refers to the common clinical reasoning processes that registered nurses in this study used to recognise delirium in older adults in acute care settings. It depicted the process of continuously trying to catch the state of delirium in older adults. Understanding the clinical reasoning processes that contribute to delirium under-recognition provides a strategy by which this problem can be brought to the forefront of awareness and intervention by registered nurses. Registered nurses could draw from the various processes identified in this research to develop their clinical reasoning practice to enhance their effective assessment strategies. Delirium recognition by registered nurses will contribute to quality care to older adults. © 2016 John Wiley & Sons Ltd.

  20. Clinical cognition and diagnostic error: applications of a dual process model of reasoning.

    Science.gov (United States)

    Croskerry, Pat

    2009-09-01

    Both systemic and individual factors contribute to missed or delayed diagnoses. Among the multiple factors that impact clinical performance of the individual, the caliber of cognition is perhaps the most relevant and deserves our attention and understanding. In the last few decades, cognitive psychologists have gained substantial insights into the processes that underlie cognition, and a new, universal model of reasoning and decision making has emerged, Dual Process Theory. The theory has immediate application to medical decision making and provides an overall schema for understanding the variety of theoretical approaches that have been taken in the past. The model has important practical applications for decision making across the multiple domains of healthcare, and may be used as a template for teaching decision theory, as well as a platform for future research. Importantly, specific operating characteristics of the model explain how diagnostic failure occurs.

  1. How can usability measurement affect the re-engineering process of clinical software procedures?

    Science.gov (United States)

    Terazzi, A; Giordano, A; Minuco, G

    1998-01-01

    As a consequence of the dramatic improvements achieved in information technology standards in terms of single hardware and software components, efforts in the evaluation processes have been focused on the assessment of critical human factors, such as work-flow organisation, man-machine interaction and, in general, quality of use, or usability. This trend is particularly valid when applied to medical informatics, since the human component is the basis of the information processing system in health care context. With the aim to establish an action-research project on the evaluation and assessment of clinical software procedures which constitute an integrated hospital information system, the authors adopted this strategy and considered the measurement of perceived usability as one of the main goals of the project itself: the paper reports the results of this experience.

  2. Audit of the informed consent process as a part of a clinical research quality assurance program.

    Science.gov (United States)

    Lad, Pramod M; Dahl, Rebecca

    2014-06-01

    Audits of the informed consent process are a key element of a clinical research quality assurance program. A systematic approach to such audits has not been described in the literature. In this paper we describe two components of the audit. The first is the audit of the informed consent document to verify adherence with federal regulations. The second component is comprised of the audit of the informed consent conference, with emphasis on a real time review of the appropriate communication of the key elements of the informed consent. Quality measures may include preparation of an informed consent history log, notes to accompany the informed consent, the use of an informed consent feedback tool, and the use of institutional surveys to assess comprehension of the informed consent process.

  3. [Landmark-based automatic registration of serial cross-sectional images of Chinese digital human using Photoshop and Matlab software].

    Science.gov (United States)

    Su, Xiu-yun; Pei, Guo-xian; Yu, Bin; Hu, Yan-ling; Li, Jin; Huang, Qian; Li, Xu; Zhang, Yuan-zhi

    2007-12-01

    This paper describes automatic registration of the serial cross-sectional images of Chinese digital human by projective registration method based on the landmarks using the commercially available software Photoshop and Matlab. During cadaver embedment for acquisition of the Chinese digital human images, 4 rods were placed parallel to the vertical axis of the frozen cadaver to allow orientation. Projective distortion of the rod positions on the cross-sectional images was inevitable due to even slight changes of the relative position of the camera. The original cross-sectional images were first processed using Photoshop software firstly to obtain the images of the orientation rods, and the centroid coordinate of every rod image was acquired with Matlab software. With the average coordinate value of the rods as the fiducial point, two-dimensional projective transformation coefficient of each image was determined. Projective transformation was then carried out and projective distortion from each original serial image was eliminated. The rectified cross-sectional images were again processed using Photoshop to obtain the image of the first orientation rod, the coordinate value of first rod image was calculated using Matlab software, and the cross-sectional images were cut into images of the same size according to the first rod spatial coordinate, to achieve automatic registration of the serial cross-sectional images. sing Photoshop and Matlab softwares, projective transformation can accurately accomplish the image registration for the serial images with simpler calculation processes and easier computer processing.

  4. Priorities for methodological research on patient and public involvement in clinical trials: A modified Delphi process.

    Science.gov (United States)

    Kearney, Anna; Williamson, Paula; Young, Bridget; Bagley, Heather; Gamble, Carrol; Denegri, Simon; Muir, Delia; Simon, Natalie A; Thomas, Stephen; Elliot, Jim T; Bulbeck, Helen; Crocker, Joanna C; Planner, Claire; Vale, Claire; Clarke, Mike; Sprosen, Tim; Woolfall, Kerry

    2017-12-01

    Despite increasing international interest, there is a lack of evidence about the most efficient, effective and acceptable ways to implement patient and public involvement (PPI) in clinical trials. To identify the priorities of UK PPI stakeholders for methodological research to help resolve uncertainties about PPI in clinical trials. A modified Delphi process including a two round online survey and a stakeholder consensus meeting. In total, 237 people registered of whom 219 (92%) completed the first round. One hundred and eighty-seven of 219 (85%) completed the second; 25 stakeholders attended the consensus meeting. Round 1 of the survey comprised 36 topics; 42 topics were considered in round 2 and at the consensus meeting. Approximately 96% of meeting participants rated the top three topics as equally important. These were as follows: developing strong and productive working relationships between researchers and PPI contributors; exploring PPI practices in selecting trial outcomes of importance to patients; and a systematic review of PPI activity to improve the accessibility and usefulness of trial information (eg participant information sheets) for participants. The prioritized methodological research topics indicate important areas of uncertainty about PPI in trials. Addressing these uncertainties will be critical to enhancing PPI. Our findings should be used in the planning and funding of PPI in clinical trials to help focus research efforts and minimize waste. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  5. [The diagnostic process in spina bifida: parents perception and viewpoint of clinical specialists].

    Science.gov (United States)

    Herb, G; Streeck, S

    1995-01-01

    This is a study of the subjective experience of communicative understanding between parents of spina bifida children and medical personnel. Research methods include content analysis of data from semi-structured interviews, a questionnaire to explore the quality of life as well as conversation analytic reconstructions of the "real" communication processes during outpatient clinic which were tape-recorded. Results of the interviews with parents and personnel demonstrate the great relevance of the quality of the relationship in the providing of clinical care; equally important is that the relationship between parents and clinic staff is shaped in a reciprocal fashion. Discrepancies in the perceptions of parents and personnel indicate individual reality constructions. It is desirable that parents and personnel construct a shared reality during their interaction. With respect to this end, the emotional resources of personnel should be regarded as competences and drawn upon more systematically. The parents' role as "experts" should be validated and their active participation in the construction of the communicative situation - which is normally determined by the institution - should be encouraged.

  6. Towards automated processing of clinical Finnish: sublanguage analysis and a rule-based parser.

    Science.gov (United States)

    Laippala, Veronika; Ginter, Filip; Pyysalo, Sampo; Salakoski, Tapio

    2009-12-01

    In this paper, we present steps taken towards more efficient automated processing of clinical Finnish, focusing on daily nursing notes in a Finnish Intensive Care Unit (ICU). First, we analyze ICU Finnish as a sublanguage, identifying its specific features facilitating, for example, the development of a specialized syntactic analyser. The identified features include frequent omission of finite verbs, limitations in allowed syntactic structures, and domain-specific vocabulary. Second, we develop a formal grammar and a parser for ICU Finnish, thus providing better tools for the development of further applications in the clinical domain. The grammar is implemented in the LKB system in a typed feature structure formalism. The lexicon is automatically generated based on the output of the FinTWOL morphological analyzer adapted to the clinical domain. As an additional experiment, we study the effect of using Finnish constraint grammar to reduce the size of the lexicon. The parser construction thus makes efficient use of existing resources for Finnish. The grammar currently covers 76.6% of ICU Finnish sentences, producing highly accurate best-parse analyzes with F-score of 91.1%. We find that building a parser for the highly specialized domain sublanguage is not only feasible, but also surprisingly efficient, given an existing morphological analyzer with broad vocabulary coverage. The resulting parser enables a deeper analysis of the text than was previously possible.

  7. Automated pre-processing and multivariate vibrational spectra analysis software for rapid results in clinical settings

    Science.gov (United States)

    Bhattacharjee, T.; Kumar, P.; Fillipe, L.

    2018-02-01

    Vibrational spectroscopy, especially FTIR and Raman, has shown enormous potential in disease diagnosis, especially in cancers. Their potential for detecting varied pathological conditions are regularly reported. However, to prove their applicability in clinics, large multi-center multi-national studies need to be undertaken; and these will result in enormous amount of data. A parallel effort to develop analytical methods, including user-friendly software that can quickly pre-process data and subject them to required multivariate analysis is warranted in order to obtain results in real time. This study reports a MATLAB based script that can automatically import data, preprocess spectra— interpolation, derivatives, normalization, and then carry out Principal Component Analysis (PCA) followed by Linear Discriminant Analysis (LDA) of the first 10 PCs; all with a single click. The software has been verified on data obtained from cell lines, animal models, and in vivo patient datasets, and gives results comparable to Minitab 16 software. The software can be used to import variety of file extensions, asc, .txt., .xls, and many others. Options to ignore noisy data, plot all possible graphs with PCA factors 1 to 5, and save loading factors, confusion matrices and other parameters are also present. The software can provide results for a dataset of 300 spectra within 0.01 s. We believe that the software will be vital not only in clinical trials using vibrational spectroscopic data, but also to obtain rapid results when these tools get translated into clinics.

  8. A conceptual model for the development process of confirmatory adaptive clinical trials within an emergency research network.

    Science.gov (United States)

    Mawocha, Samkeliso C; Fetters, Michael D; Legocki, Laurie J; Guetterman, Timothy C; Frederiksen, Shirley; Barsan, William G; Lewis, Roger J; Berry, Donald A; Meurer, William J

    2017-06-01

    Adaptive clinical trials use accumulating data from enrolled subjects to alter trial conduct in pre-specified ways based on quantitative decision rules. In this research, we sought to characterize the perspectives of key stakeholders during the development process of confirmatory-phase adaptive clinical trials within an emergency clinical trials network and to build a model to guide future development of adaptive clinical trials. We used an ethnographic, qualitative approach to evaluate key stakeholders' views about the adaptive clinical trial development process. Stakeholders participated in a series of multidisciplinary meetings during the development of five adaptive clinical trials and completed a Strengths-Weaknesses-Opportunities-Threats questionnaire. In the analysis, we elucidated overarching themes across the stakeholders' responses to develop a conceptual model. Four major overarching themes emerged during the analysis of stakeholders' responses to questioning: the perceived statistical complexity of adaptive clinical trials and the roles of collaboration, communication, and time during the development process. Frequent and open communication and collaboration were viewed by stakeholders as critical during the development process, as were the careful management of time and logistical issues related to the complexity of planning adaptive clinical trials. The Adaptive Design Development Model illustrates how statistical complexity, time, communication, and collaboration are moderating factors in the adaptive design development process. The intensity and iterative nature of this process underscores the need for funding mechanisms for the development of novel trial proposals in academic settings.

  9. Human talent development processes in a specialty clinic in Pasto, Colombia

    Directory of Open Access Journals (Sweden)

    Jeraldine Milena Matabajoy-Montilla

    2018-01-01

    Full Text Available Introduction: Workers in the organization play a fundamental role in meeting the corporate objectives. In this sense, it is important to identify the processes of human talent development in the health sector since they contribute to human and organizational development. Objective: The processes of human talent development training, quality of work life, occupational health, organizational climate and performance evaluation were characterized in a specialty clinic in the city of Pasto, Colombia. Materials and methods: The study was addressed from the quantitative paradigm of descriptive type with a sample of 211 collaborators. The scale called "perception of human talent development processes" was built, whose Alfa de Cronbach was 0.97. Results: The results were systematized in the statistical program IBM SPSS statistics. Statistically significant differences were found in the training category (in the categories of needs detection, plan and programmes, training evaluation and follow-up, quality of working life (in the sub-categories: meaning of work and labor commitment and performance evaluation (in the subcategories: methods and results. Conclusions: The need to continue strengthening the processes of training, quality of work life and evaluation of performance is recognized.

  10. The value of serial FDG PET on therapeutic evaluation and relapse monitoring of lung cancer

    International Nuclear Information System (INIS)

    Zhu Zhaohui; Cheng Wuying; Cui Ruixue; Chen Xin; Hao Li; Dang Yonghong; Zhe Fu; Wang Bocheng

    2004-01-01

    Purpose: A retrospective study was designed to investigate the value of serial FDG PET on therapeutic evaluation and relapse monitoring of lung cancer, and the influence factors to the evaluation and follow-up were also analyzed. Methods: Nineteen patients with confirmed lung cancer were included in the study, and they accepted a total of 87 FDG PET scans, with 3 to 12 times for each patient. The follow-up intervals of FDG PET varied from 14 days to 32 months, and 51 of 68 intervals were within 6 months with a mean of 3.3 months. The PET images of serial studies were analyzed with both visual and semi-quantitative Methods, and they were compared with other imaging techniques (CT, MRI and/or bone scan) and clinical follow-ups. Results: By providing metabolic information, FDG PET detected tumors with high contrast to normal tissue, and the serial examinations helped 9 patients in detecting and evaluating lesions in areas with complicated anatomic structures, such as lung hilus, mediastinum, supraclavicular and abdomen. PET also showed more accuracy and sensitivity than bone scan, CT or MRI in evaluation of bone metastases in two cases. Serial FDG PET was also helpful to the cases in complicated conditions with necrosis, fibrosis or changes of anatomic structures after multiple therapies. In two cases, the follow-up studies confirmed the metastases in the incision wound, which had increasing uptake while it decreased in the repairing wound tissue. By analyzing metabolism of the lesions, PET also showed changes in 3 cases, while they were unconcluded by CT and/or MRI. In some circumstances, benign uptake of FDG influenced the evaluation and monitoring. Inflammation after radiotherapy showed high uptake in 7 cases, and influenced the evaluation of therapy in the serial examinations. Recent use of granulocyte clone stimulation factor (G-CSF) caused diffuse high uptake in bone marrow, and it covered the bone metastases in one case. And in other two cases, diffuse high

  11. Clinical information modeling processes for semantic interoperability of electronic health records: systematic review and inductive analysis.

    Science.gov (United States)

    Moreno-Conde, Alberto; Moner, David; Cruz, Wellington Dimas da; Santos, Marcelo R; Maldonado, José Alberto; Robles, Montserrat; Kalra, Dipak

    2015-07-01

    This systematic review aims to identify and compare the existing processes and methodologies that have been published in the literature for defining clinical information models (CIMs) that support the semantic interoperability of electronic health record (EHR) systems. Following the preferred reporting items for systematic reviews and meta-analyses systematic review methodology, the authors reviewed published papers between 2000 and 2013 that covered that semantic interoperability of EHRs, found by searching the PubMed, IEEE Xplore, and ScienceDirect databases. Additionally, after selection of a final group of articles, an inductive content analysis was done to summarize the steps and methodologies followed in order to build CIMs described in those articles. Three hundred and seventy-eight articles were screened and thirty six were selected for full review. The articles selected for full review were analyzed to extract relevant information for the analysis and characterized according to the steps the authors had followed for clinical information modeling. Most of the reviewed papers lack a detailed description of the modeling methodologies used to create CIMs. A representative example is the lack of description related to the definition of terminology bindings and the publication of the generated models. However, this systematic review confirms that most clinical information modeling activities follow very similar steps for the definition of CIMs. Having a robust and shared methodology could improve their correctness, reliability, and quality. Independently of implementation technologies and standards, it is possible to find common patterns in methods for developing CIMs, suggesting the viability of defining a unified good practice methodology to be used by any clinical information modeler. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Process-based quality management for clinical implementation of adaptive radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Noel, Camille E.; Santanam, Lakshmi; Parikh, Parag J.; Mutic, Sasa, E-mail: smutic@radonc.wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri 63110 (United States)

    2014-08-15

    Purpose: Intensity-modulated adaptive radiotherapy (ART) has been the focus of considerable research and developmental work due to its potential therapeutic benefits. However, in light of its unique quality assurance (QA) challenges, no one has described a robust framework for its clinical implementation. In fact, recent position papers by ASTRO and AAPM have firmly endorsed pretreatment patient-specific IMRT QA, which limits the feasibility of online ART. The authors aim to address these obstacles by applying failure mode and effects analysis (FMEA) to identify high-priority errors and appropriate risk-mitigation strategies for clinical implementation of intensity-modulated ART. Methods: An experienced team of two clinical medical physicists, one clinical engineer, and one radiation oncologist was assembled to perform a standard FMEA for intensity-modulated ART. A set of 216 potential radiotherapy failures composed by the forthcoming AAPM task group 100 (TG-100) was used as the basis. Of the 216 failures, 127 were identified as most relevant to an ART scheme. Using the associated TG-100 FMEA values as a baseline, the team considered how the likeliness of occurrence (O), outcome severity (S), and likeliness of failure being undetected (D) would change for ART. New risk priority numbers (RPN) were calculated. Failures characterized by RPN ≥ 200 were identified as potentially critical. Results: FMEA revealed that ART RPN increased for 38% (n = 48/127) of potential failures, with 75% (n = 36/48) attributed to failures in the segmentation and treatment planning processes. Forty-three of 127 failures were identified as potentially critical. Risk-mitigation strategies include implementing a suite of quality control and decision support software, specialty QA software/hardware tools, and an increase in specially trained personnel. Conclusions: Results of the FMEA-based risk assessment demonstrate that intensity-modulated ART introduces different (but not necessarily

  13. Process-based quality management for clinical implementation of adaptive radiotherapy

    International Nuclear Information System (INIS)

    Noel, Camille E.; Santanam, Lakshmi; Parikh, Parag J.; Mutic, Sasa

    2014-01-01

    Purpose: Intensity-modulated adaptive radiotherapy (ART) has been the focus of considerable research and developmental work due to its potential therapeutic benefits. However, in light of its unique quality assurance (QA) challenges, no one has described a robust framework for its clinical implementation. In fact, recent position papers by ASTRO and AAPM have firmly endorsed pretreatment patient-specific IMRT QA, which limits the feasibility of online ART. The authors aim to address these obstacles by applying failure mode and effects analysis (FMEA) to identify high-priority errors and appropriate risk-mitigation strategies for clinical implementation of intensity-modulated ART. Methods: An experienced team of two clinical medical physicists, one clinical engineer, and one radiation oncologist was assembled to perform a standard FMEA for intensity-modulated ART. A set of 216 potential radiotherapy failures composed by the forthcoming AAPM task group 100 (TG-100) was used as the basis. Of the 216 failures, 127 were identified as most relevant to an ART scheme. Using the associated TG-100 FMEA values as a baseline, the team considered how the likeliness of occurrence (O), outcome severity (S), and likeliness of failure being undetected (D) would change for ART. New risk priority numbers (RPN) were calculated. Failures characterized by RPN ≥ 200 were identified as potentially critical. Results: FMEA revealed that ART RPN increased for 38% (n = 48/127) of potential failures, with 75% (n = 36/48) attributed to failures in the segmentation and treatment planning processes. Forty-three of 127 failures were identified as potentially critical. Risk-mitigation strategies include implementing a suite of quality control and decision support software, specialty QA software/hardware tools, and an increase in specially trained personnel. Conclusions: Results of the FMEA-based risk assessment demonstrate that intensity-modulated ART introduces different (but not necessarily

  14. Using natural language processing and machine learning to identify gout flares from electronic clinical notes.

    Science.gov (United States)

    Zheng, Chengyi; Rashid, Nazia; Wu, Yi-Lin; Koblick, River; Lin, Antony T; Levy, Gerald D; Cheetham, T Craig

    2014-11-01

    Gout flares are not well documented by diagnosis codes, making it difficult to conduct accurate database studies. We implemented a computer-based method to automatically identify gout flares using natural language processing (NLP) and machine learning (ML) from electronic clinical notes. Of 16,519 patients, 1,264 and 1,192 clinical notes from 2 separate sets of 100 patients were selected as the training and evaluation data sets, respectively, which were reviewed by rheumatologists. We created separate NLP searches to capture different aspects of gout flares. For each note, the NLP search outputs became the ML system inputs, which provided the final classification decisions. The note-level classifications were grouped into patient-level gout flares. Our NLP+ML results were validated using a gold standard data set and compared with the claims-based method used by prior literatures. For 16,519 patients with a diagnosis of gout and a prescription for a urate-lowering therapy, we identified 18,869 clinical notes as gout flare positive (sensitivity 82.1%, specificity 91.5%): 1,402 patients with ≥3 flares (sensitivity 93.5%, specificity 84.6%), 5,954 with 1 or 2 flares, and 9,163 with no flare (sensitivity 98.5%, specificity 96.4%). Our method identified more flare cases (18,869 versus 7,861) and patients with ≥3 flares (1,402 versus 516) when compared to the claims-based method. We developed a computer-based method (NLP and ML) to identify gout flares from the clinical notes. Our method was validated as an accurate tool for identifying gout flares with higher sensitivity and specificity compared to previous studies. Copyright © 2014 by the American College of Rheumatology.

  15. Economic efficiency of countries' clinical review processes and competitiveness on the market of human experimentation.

    Science.gov (United States)

    Ippoliti, Roberto

    2013-01-01

    Clinical research is a specific phase of pharmaceutical industry's production process in which companies test candidate drugs on patients to collect clinical evidence about safety and effectiveness. Information is essential to obtain manufacturing authorization from the national drug agency and, in this way, make profits on the market. Considering this activity, however, the public stakeholder has to face a conflict of interests. On the one side, there is society's necessity to make advances in medicine and, of course, to promote pharmaceutical companies' investments in this specific phase (new generation). On the other side, there is the duty to protect patients involved in these experimental treatments (old generation). To abide by this moral duty, a protection system was developed through the years, based on two legal institutions: informed consent and institutional review board. How should an efficient protection system that would take human experimentation into account be shaped? Would it be possible for the national protection system of patients' rights to affect the choice of whether to develop a clinical trial in a given country or not? Looking at Europe and considering a protection system that is shaped around institutional review boards, this article is an empirical work that tries to give answers to these open questions. It shows how a protection system that can minimize the time necessary to start a trial can positively affect pharmaceutical clinical research, that is, the choice of pharmaceutical companies to start innovative medical treatments in a given country. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  16. [Study of continuous quality improvement for clinical laboratory processes via the platform of Hospital Group].

    Science.gov (United States)

    Song, Wenqi; Shen, Ying; Peng, Xiaoxia; Tian, Jian; Wang, Hui; Xu, Lili; Nie, Xiaolu; Ni, Xin

    2015-05-26

    The program of continuous quality improvement in clinical laboratory processes for complete blood count (CBC) was launched via the platform of Beijing Children's Hospital Group in order to improve the quality of pediatric clinical laboratories. Fifteen children's hospitals of Beijing Children's Hospital group were investigated using the method of Chinese adapted continuous quality improvement with PDCA (Plan-Do-Check-Action). The questionnaire survey and inter-laboratory comparison was conducted to find the existing problems, to analyze reasons, to set forth quality targets and to put them into practice. Then, targeted training was conducted to 15 children's hospitals and the second questionnaire survey, self examinations by the clinical laboratories was performed. At the same time, the Group's online internal quality control platform was established. Overall effects of the program were evaluated so that lay a foundation for the next stage of PDCA. Both quality of control system documents and CBC internal quality control scheme for all of clinical laboratories were improved through this program. In addition, standardization of performance verification was also improved, especially with the comparable verification rate of precision and internal laboratory results up to 100%. In terms of instrument calibration and mandatory diagnostic rates, only three out of the 15 hospitals (20%) failed to pass muster in 2014 from 46.67% (seven out of the 15 hospitals) in 2013. The abnormal data of intraday precision variance coefficients of the five CBC indicator parameters (WBC, RBC, Hb, Plt and Hct) of all the 15 laboratories accounted for 1.2% (2/165) in 2014, a marked decrease from 9.6% (14/145) in 2013. While the number of the hospitals using only one horizontal quality control object for daily quality control has dropped to three from five. The 15 hospitals organized a total of 263 times of training in 2014 from 101 times in 2013, up 160%. The quality improvement program for

  17. Piezoelectric micromotor based on the structure of serial bending arms.

    Science.gov (United States)

    Tong, Jianhua; Cui, Tianhong; Shao, Peige; Wang, Liding

    2003-09-01

    This paper presents a new piezoelectric micromotor based on the structure of serial bending arms. Serial bending arms are composed of two piezoelectric bimorphs with one end fixed and the other end free, driven by two signals of a biased square wave with a phase difference of pi/2. The free end of a cantilever arm will move along an elliptic orbit so that the cantilever is used to drive a cylinder rotor. The rotor's end surface contacts the free end of the cantilever, resulting in the rotor's rotation. There are six serial bending arms anchored on the base. The driving mechanism of the micromotor is proposed and analyzed. A new micromotor prototype, 5 mm in diameter, has been fabricated and characterized. The maximum rotational speed reaches 325 rpm, and the output torque is about 36.5 microNm.

  18. Numerical discrepancy between serial and MPI parallel computations

    Directory of Open Access Journals (Sweden)

    Sang Bong Lee

    2016-09-01

    Full Text Available Numerical simulations of 1D Burgers equation and 2D sloshing problem were carried out to study numerical discrepancy between serial and parallel computations. The numerical domain was decomposed into 2 and 4 subdomains for parallel computations with message passing interface. The numerical solution of Burgers equation disclosed that fully explicit boundary conditions used on subdomains of parallel computation was responsible for the numerical discrepancy of transient solution between serial and parallel computations. Two dimensional sloshing problems in a rectangular domain were solved using OpenFOAM. After a lapse of initial transient time sloshing patterns of water were significantly different in serial and parallel computations although the same numerical conditions were given. Based on the histograms of pressure measured at two points near the wall the statistical characteristics of numerical solution was not affected by the number of subdomains as much as the transient solution was dependent on the number of subdomains.

  19. A combination strategy for tracking the serial criminal

    Science.gov (United States)

    He, Chuan; Zhang, Yuan-Biao; Wan, Jiadi; Yu, Wenjing

    2010-08-01

    We build a Geographic Profiling Model to generate the criminal's geographical profile, by combining two complementary strategies: the Spatial Distribution Strategy and the Probability Distance Strategy. In the first strategy, we designate the mean of all the known crime sites as the anchor point, and build a Standard Deviational Ellipse Model, considering the effect of landscape. In the second strategy, we take many factors such as the buffer zone and distance decay theory into consideration and calculate the probability of the offender's residence in a certain area by using the Bayesian Theorem and the Rossmo Algorithm. Then, we combine the result of two strategies and get three search areas suit different conditions of the police to track the serial criminal. Apply the model to the English serial killer Peter Sutcliffe's case, the calculation result shows that the model can effectively be used to track serial criminal.

  20. Co-simulation of dynamic systems in parallel and serial model configurations

    International Nuclear Information System (INIS)

    Sweafford, Trevor; Yoon, Hwan Sik

    2013-01-01

    Recent advancement in simulation software and computation hardware make it realizable to simulate complex dynamic systems comprised of multiple submodels developed in different modeling languages. The so-called co-simulation enables one to study various aspects of a complex dynamic system with heterogeneous submodels in a cost-effective manner. Among several different model configurations for co-simulation, synchronized parallel configuration is regarded to expedite the simulation process by simulation multiple sub models concurrently on a multi core processor. In this paper, computational accuracies as well as computation time are studied for three different co-simulation frameworks : integrated, serial, and parallel. for this purpose, analytical evaluations of the three different methods are made using the explicit Euler method and then they are applied to two-DOF mass-spring systems. The result show that while the parallel simulation configuration produces the same accurate results as the integrated configuration, results of the serial configuration, results of the serial configuration show a slight deviation. it is also shown that the computation time can be reduced by running simulation in the parallel configuration. Therefore, it can be concluded that the synchronized parallel simulation methodology is the best for both simulation accuracy and time efficiency.

  1. Monitoring of benzene-induced hematotoxicity in mice by serial leukocyte counting using a microcavity array.

    Science.gov (United States)

    Hosokawa, Masahito; Asami, Marie; Yoshino, Tomoko; Tsujimura, Noriyuki; Takahashi, Masayuki; Nakasono, Satoshi; Tanaka, Tsuyoshi; Matsunaga, Tadashi

    2013-02-15

    Monitoring of hematotoxicity, which requires serial blood collection, is difficult to carry out in small animals due to a lack of non-invasive, individual animal-appropriate techniques that enable enumeration of leukocyte subsets from limited amounts of whole blood. In this study, a microfluidic device equipped with a microcavity array that enables highly efficient separation of leukocytes from submicroliters of whole blood was applied for hematotoxicity monitoring in mice. The microcavity array can specifically separate leukocytes from whole blood based on differences in the size and deformability between leukocytes and other blood cells. Mouse leukocytes recovered on aligned microcavities were continuously processed for image-based immunophenotypic analysis. Our device successfully recovered almost 100% of mouse leukocytes in 0.1 μL of whole blood without the effect of serial blood collection such as changes in body weight and total leukocyte count. We assessed benzene-associated hematotoxicity in mice using this system. Mice were administered with benzene once daily and the depression of leukocyte numbers induced in individual mice was successfully monitored from tail vein blood collected every other day for 2 weeks. Serial monitoring of the leukocyte number in individual mice will contribute to the understanding of hematotoxicity and reduction of the number of animal experiment trials. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. S3-1: The Serial Dependence of Visual Perception

    Directory of Open Access Journals (Sweden)

    David Whitney

    2012-10-01

    Full Text Available In our moment-to-moment perceptual experience, visual scenes can change, but objects rarely spontaneously come into or out of existence. The visual system may therefore delicately balance the need to optimize sensitivity to image changes (e.g., by adapting to changes in color, orientation, object identity, etc with the desire to represent the temporal continuity of objects—the likelihood that objects perceived at this moment tend to exist in subsequent moments. One way that the visual system may promote such stability is through the introduction of serial dependence to visual perception: by biasing the current percept toward what was seen at previous moments, the brain could compensate for variability in visual input that might otherwise disrupt perceptual continuity. Here, in two sets of experiments, we tested for serial dependence in visual perception of orientation and facial expression. We found that on a given trial, a subject's perception of the orientation of a grating reflected not only the currently viewed stimulus, but also a systematic attraction toward the orientations of the previously viewed stimuli. We found the same serial dependence in the perception of facial expression. This perceptual attraction extended over several trials and seconds, and displayed clear tuning to the difference (in orientation or facial expression between the sequential stimuli. Furthermore, serial dependence in object perception was spatially specific and selective to the attended object within a scene. Several control experiments showed that the perceptual serial dependence we report cannot be explained by effects of priming, known hysteresis effects, visual short-term memory, or expectation. Our results reveal a systematic influence of recent visual experiences on perception at any given moment: visual percepts, even of unambiguous stimuli, are attracted toward what was previously seen. We propose that such serial dependence helps to maintain

  3. Successfully Managed Acute Transverse Myelitis Related to Scrub Typhus and Serial Image Findings.

    Science.gov (United States)

    Yun, Jae Sung; Song, Ji Soo; Choi, Eun Jung; Hwang, Jeong-Hwan; Lee, Chang-Seop; Park, Eun Hae

    2017-03-01

    AbstractCentral nervous system involvement manifesting as meningitis or meningoencephalitis is a known complication of scrub typhus, but very few spinal cord lesions such as acute transverse myelitis (ATM) have been reported in association with this disease. Scrub typhus patients with a spinal lesion present with neurologic symptoms including dysuria, motor, and sensory weakness. Herein, we describe a rare case of ATM associated with scrub typhus. Clinical characteristics, cerebrospinal fluid cytology, Orientia tsutsugamushi serum antibody titer, and serial magnetic resonance imaging scans resulted in a diagnosis of ATM associated with scrub typhus.

  4. Synchronic Seriality: The Dissolving of Diegetic Borders Through Metalepsis

    Directory of Open Access Journals (Sweden)

    Paige M. Piper

    2015-12-01

    Full Text Available In dialogue with Gérard Genette’s literary concept of metalepsis to television, this paper considers instances of meta-textual actor/character portrayals in serial narratives to show that meta-narrative intrusion fosters a greater empathetic link between the spectator and character, whilst simultaneously inviting the viewer to appreciate the technique as an artifice-aware gesture. The fluidity of diegetic borders brought on by the conflation of performer/performance replicates Baudrillard’s simulacra, creating a synchronic form of seriality and transcending rigid genre classifications.

  5. Serial MRI studies using gadolinium DTPA in active multiple sclerosis

    International Nuclear Information System (INIS)

    Miller, D.H.; Johnson, G.; Barnes, D.; Rudge, P.; McDonald, W.I.

    1988-01-01

    It has been suggested that blood brain barrier (BBB) impairment is a necessary early event in the pathogenesis of the multiple sclerosis (MS) lesions. To evaluate such an hypothesis in vivo would require: (1) serial imaging studies using a modality with high sensitivity for detecting plaques; (2) a contrast enhancing agent which demonstrates BBB impairment. A serial magnetic resonance imaging (MRI) study was undertaken of a group of MS patients using the contrast agent gadolinium-DTPA. As it has been suggested that T 1 and T 2 relaxation times are longer in acute than chronic MS lesions, these were also measured. 3 refs.; 1 figure

  6. IT-based Value Creation in Serial Acquisitions

    DEFF Research Database (Denmark)

    Henningsson, Stefan; Yetton, Philip

    2013-01-01

    serial acquirers realize IT-based value, we integrate and model the findings on individual acquisitions from the extant literature, and extend that model to explain the effects of sequential acquisitions in a growth-by-acquisition strategy. This extended model, drawing on the Resource-Based Theory......The extant research on post-acquisition IT integration analyzes how acquirers realize IT-based value in individual acquisitions. However, serial acquirers make 60% of acquisitions. These acquisitions are not isolated events, but are components in growth-by-acquisition programs. To explain how...

  7. Native sulfur/chlorine SAD phasing for serial femtosecond crystallography

    International Nuclear Information System (INIS)

    Nakane, Takanori; Song, Changyong; Suzuki, Mamoru; Nango, Eriko; Kobayashi, Jun; Masuda, Tetsuya; Inoue, Shigeyuki; Mizohata, Eiichi; Nakatsu, Toru; Tanaka, Tomoyuki; Tanaka, Rie; Shimamura, Tatsuro; Tono, Kensuke; Joti, Yasumasa; Kameshima, Takashi; Hatsui, Takaki; Yabashi, Makina; Nureki, Osamu; Iwata, So; Sugahara, Michihiro

    2015-01-01

    Sulfur SAD phasing facilitates the structure determination of diverse native proteins using femtosecond X-rays from free-electron lasers via serial femtosecond crystallography. Serial femtosecond crystallography (SFX) allows structures to be determined with minimal radiation damage. However, phasing native crystals in SFX is not very common. Here, the structure determination of native lysozyme from single-wavelength anomalous diffraction (SAD) by utilizing the anomalous signal of sulfur and chlorine at a wavelength of 1.77 Å is successfully demonstrated. This sulfur SAD method can be applied to a wide range of proteins, which will improve the determination of native crystal structures

  8. Evaluation of the clinical process in a critical care information system using the Lean method: a case study

    Directory of Open Access Journals (Sweden)

    Yusof Maryati Mohd

    2012-12-01

    Full Text Available Abstract Background There are numerous applications for Health Information Systems (HIS that support specific tasks in the clinical workflow. The Lean method has been used increasingly to optimize clinical workflows, by removing waste and shortening the delivery cycle time. There are a limited number of studies on Lean applications related to HIS. Therefore, we applied the Lean method to evaluate the clinical processes related to HIS, in order to evaluate its efficiency in removing waste and optimizing the process flow. This paper presents the evaluation findings of these clinical processes, with regards to a critical care information system (CCIS, known as IntelliVue Clinical Information Portfolio (ICIP, and recommends solutions to the problems that were identified during the study. Methods We conducted a case study under actual clinical settings, to investigate how the Lean method can be used to improve the clinical process. We used observations, interviews, and document analysis, to achieve our stated goal. We also applied two tools from the Lean methodology, namely the Value Stream Mapping and the A3 problem-solving tools. We used eVSM software to plot the Value Stream Map and A3 reports. Results We identified a number of problems related to inefficiency and waste in the clinical process, and proposed an improved process model. Conclusions The case study findings show that the Value Stream Mapping and the A3 reports can be used as tools to identify waste and integrate the process steps more efficiently. We also proposed a standardized and improved clinical process model and suggested an integrated information system that combines database and software applications to reduce waste and data redundancy.

  9. Automated segmentation of ventricles from serial brain MRI for the quantification of volumetric changes associated with communicating hydrocephalus in patients with brain tumor

    Science.gov (United States)

    Pura, John A.; Hamilton, Allison M.; Vargish, Geoffrey A.; Butman, John A.; Linguraru, Marius George

    2011-03-01

    Accurate ventricle volume estimates could improve the understanding and diagnosis of postoperative communicating hydrocephalus. For this category of patients, associated changes in ventricle volume can be difficult to identify, particularly over short time intervals. We present an automated segmentation algorithm that evaluates ventricle size from serial brain MRI examination. The technique combines serial T1- weighted images to increase SNR and segments the means image to generate a ventricle template. After pre-processing, the segmentation is initiated by a fuzzy c-means clustering algorithm to find the seeds used in a combination of fast marching methods and geodesic active contours. Finally, the ventricle template is propagated onto the serial data via non-linear registration. Serial volume estimates were obtained in an automated robust and accurate manner from difficult data.

  10. Room-temperature macromolecular serial crystallography using synchrotron radiation

    Directory of Open Access Journals (Sweden)

    Francesco Stellato

    2014-07-01

    Full Text Available A new approach for collecting data from many hundreds of thousands of microcrystals using X-ray pulses from a free-electron laser has recently been developed. Referred to as serial crystallography, diffraction patterns are recorded at a constant rate as a suspension of protein crystals flows across the path of an X-ray beam. Events that by chance contain single-crystal diffraction patterns are retained, then indexed and merged to form a three-dimensional set of reflection intensities for structure determination. This approach relies upon several innovations: an intense X-ray beam; a fast detector system; a means to rapidly flow a suspension of crystals across the X-ray beam; and the computational infrastructure to process the large volume of data. Originally conceived for radiation-damage-free measurements with ultrafast X-ray pulses, the same methods can be employed with synchrotron radiation. As in powder diffraction, the averaging of thousands of observations per Bragg peak may improve the ratio of signal to noise of low-dose exposures. Here, it is shown that this paradigm can be implemented for room-temperature data collection using synchrotron radiation and exposure times of less than 3 ms. Using lysozyme microcrystals as a model system, over 40 000 single-crystal diffraction patterns were obtained and merged to produce a structural model that could be refined to 2.1 Å resolution. The resulting electron density is in excellent agreement with that obtained using standard X-ray data collection techniques. With further improvements the method is well suited for even shorter exposures at future and upgraded synchrotron radiation facilities that may deliver beams with 1000 times higher brightness than they currently produce.

  11. Serial diffusion-weighted imaging in MELAS

    International Nuclear Information System (INIS)

    Ohshita, T.; Oka, M.; Imon, Y.; Watanabe, C.; Katayama, S.; Yamaguchi, S.; Kajima, T.; Mimori, Y.; Nakamura, S.

    2000-01-01

    Clinical features of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) resemble those of cerebral infarcts, but the pathogenesis of infarct-like lesions is not fully understood. To characterise these infarct-like lesions, we studied two patients with MELAS using diffusion-weighted (DWI) MRI before and after stroke-like episodes and measured the apparent diffusion coefficient (ADC) in the new infarct-like lesions. These gave high signal on DWI and had much higher ADC than normal-appearing regions. The ADC remained high even 30 days after a stroke-like episode then decreased in lesions, with or without abnormality as shown by conventional MRI. We speculate that early elevation of ADC in the acute or subacute phase reflects vasogenic rather than cytotoxic edema. The ADC of the lesions, which disappeared almost completely with clinical improvement, returned to normal levels, which may reflect tissue recovery without severe damage. To our knowledge, this is the first study of DWI in MELAS. (orig.)

  12. Non-clinical studies in the process of new drug development - Part II: Good laboratory practice, metabolism, pharmacokinetics, safety and dose translation to clinical studies.

    Science.gov (United States)

    Andrade, E L; Bento, A F; Cavalli, J; Oliveira, S K; Schwanke, R C; Siqueira, J M; Freitas, C S; Marcon, R; Calixto, J B

    2016-12-12

    The process of drug development involves non-clinical and clinical studies. Non-clinical studies are conducted using different protocols including animal studies, which mostly follow the Good Laboratory Practice (GLP) regulations. During the early pre-clinical development process, also known as Go/No-Go decision, a drug candidate needs to pass through several steps, such as determination of drug availability (studies on pharmacokinetics), absorption, distribution, metabolism and elimination (ADME) and preliminary studies that aim to investigate the candidate safety including genotoxicity, mutagenicity, safety pharmacology and general toxicology. These preliminary studies generally do not need to comply with GLP regulations. These studies aim at investigating the drug safety to obtain the first information about its tolerability in different systems that are relevant for further decisions. There are, however, other studies that should be performed according to GLP standards and are mandatory for the safe exposure to humans, such as repeated dose toxicity, genotoxicity and safety pharmacology. These studies must be conducted before the Investigational New Drug (IND) application. The package of non-clinical studies should cover all information needed for the safe transposition of drugs from animals to humans, generally based on the non-observed adverse effect level (NOAEL) obtained from general toxicity studies. After IND approval, other GLP experiments for the evaluation of chronic toxicity, reproductive and developmental toxicity, carcinogenicity and genotoxicity, are carried out during the clinical phase of development. However, the necessity of performing such studies depends on the new drug clinical application purpose.

  13. Virulence-associated genome mutations of murine rotavirus identified by alternating serial passages in mice and cell cultures.

    Science.gov (United States)

    Tsugawa, Takeshi; Tatsumi, Masatoshi; Tsutsumi, Hiroyuki

    2014-05-01

    Although significant clinical efficacy and safety of rotavirus vaccines were recently revealed in many countries, the mechanism of their attenuation is not well understood. We passaged serially a cell culture-adapted murine rotavirus EB strain in mouse pups or in cell cultures alternately and repeatedly and fully sequenced all 11 genes of 21 virus samples passaged in mice or in cell cultures. Sequence analysis revealed that mouse-passaged viruses that regained virulence almost consistently acquired four kinds of amino acid (aa) substitutions in VP4 and substitution in aa 37 (Val to Ala) in NSP4. In addition, they gained and invariably conserved the 3' consensus sequence in NSP1. The molecular changes occurred along with the acquisition of virulence during passages in mice and then disappeared following passages in cell cultures. Intraperitoneal injection of recombinant NSP4 proteins confirmed the aa 37 site as important for its diarrheagenic activity in mice. These genome changes are likely to be correlated with rotavirus virulence. Serial passage of a virulent wild-type virus in vitro often results in loss of virulence of the virus in an original animal host, while serial passage of a cell culture-adapted avirulent virus in vivo often gains virulence in an animal host. Actually, live attenuated virus vaccines were originally produced by serial passage in cell cultures. Although clinical efficacy and safety of rotavirus vaccines were recently revealed, the mechanism of their attenuation is not well understood. We passaged serially a murine rotavirus by alternating switch of host (mice or cell cultures) repeatedly and sequenced the eleven genes of the passaged viruses to identify mutations associated with the emergence or disappearance of virulence. Sequence analysis revealed that changes in three genes (VP4, NSP1, and NSP4) were associated with virulence in mice. Intraperitoneal injection of recombinant NSP4 proteins confirmed its diarrheagenic activity in mice

  14. Virulence-Associated Genome Mutations of Murine Rotavirus Identified by Alternating Serial Passages in Mice and Cell Cultures

    Science.gov (United States)

    Tatsumi, Masatoshi; Tsutsumi, Hiroyuki

    2014-01-01

    ABSTRACT Although significant clinical efficacy and safety of rotavirus vaccines were recently revealed in many countries, the mechanism of their attenuation is not well understood. We passaged serially a cell culture-adapted murine rotavirus EB strain in mouse pups or in cell cultures alternately and repeatedly and fully sequenced all 11 genes of 21 virus samples passaged in mice or in cell cultures. Sequence analysis revealed that mouse-passaged viruses that regained virulence almost consistently acquired four kinds of amino acid (aa) substitutions in VP4 and substitution in aa 37 (Val to Ala) in NSP4. In addition, they gained and invariably conserved the 3′ consensus sequence in NSP1. The molecular changes occurred along with the acquisition of virulence during passages in mice and then disappeared following passages in cell cultures. Intraperitoneal injection of recombinant NSP4 proteins confirmed the aa 37 site as important for its diarrheagenic activity in mice. These genome changes are likely to be correlated with rotavirus virulence. IMPORTANCE Serial passage of a virulent wild-type virus in vitro often results in loss of virulence of the virus in an original animal host, while serial passage of a cell culture-adapted avirulent virus in vivo often gains virulence in an animal host. Actually, live attenuated virus vaccines were originally produced by serial passage in cell cultures. Although clinical efficacy and safety of rotavirus vaccines were recently revealed, the mechanism of their attenuation is not well understood. We passaged serially a murine rotavirus by alternating switch of host (mice or cell cultures) repeatedly and sequenced the eleven genes of the passaged viruses to identify mutations associated with the emergence or disappearance of virulence. Sequence analysis revealed that changes in three genes (VP4, NSP1, and NSP4) were associated with virulence in mice. Intraperitoneal injection of recombinant NSP4 proteins confirmed its

  15. Data processing system for small and medium sized clinical chemistry and nuclear medical units

    Energy Technology Data Exchange (ETDEWEB)

    Mariss, P; Haubold, E; Porth, A J

    1987-06-01

    A computer system, in clinical use for over 5 years, with a group practice specializing in laboratory-nuclear medicine is described for its hardware and software configuration. In addition to the conventional tasks of a computer system (patient data acquisition, issuance of worklists, result input, plausibility control, quality assurance, findings documentation), an integrated word processing system was developed for nuclear medicine in-vitro and in-vivo diagnosis. In addition, the computer system masters major administrative tasks, such as private and panel accounts, account reminders payments to suppliers, etc. the hardware and data bank are designed in a manner which permits direct data access over a period of 18 to 21 months.

  16. Optimizing resource allocation and patient flow: process analysis and reorganization in three chemotherapy outpatient clinics.

    Science.gov (United States)

    Holmes, Morgan; Bodie, Kelly; Porter, Geoffrey; Sullivan, Victoria; Tarasuk, Joy; Trembley, Jodie; Trudeau, Maureen

    2010-01-01

    Optimizing human and physical resources is a major concern for cancer care decision-makers and practitioners. This issue is particularly acute in the context of ambulatory out patient chemotherapy clinics, especially when - as is the case almost everywhere in the industrialized world - the number of people requiring systemic therapy is increasing while budgets, staffing and physical space remain static. Recent initiatives at three hospital-based chemotherapy units - in Halifax, Toronto and Kingston - shed light on the value of process analysis and reorganization for using existing human and physical resources to their full potential, improving patient flow and enhancing patient satisfaction. The steps taken in these settings are broadly applicable to other healthcare settings and would likely result in similar benefits in those environments.

  17. Characterization of Change and Significance for Clinical Findings in Radiology Reports Through Natural Language Processing.

    Science.gov (United States)

    Hassanpour, Saeed; Bay, Graham; Langlotz, Curtis P

    2017-06-01

    We built a natural language processing (NLP) method to automatically extract clinical findings in radiology reports and characterize their level of change and significance according to a radiology-specific information model. We utilized a combination of machine learning and rule-based approaches for this purpose. Our method is unique in capturing different features and levels of abstractions at surface, entity, and discourse levels in text analysis. This combination has enabled us to recognize the underlying semantics of radiology report narratives for this task. We evaluated our method on radiology reports from four major healthcare organizations. Our evaluation showed the efficacy of our method in highlighting important changes (accuracy 99.2%, precision 96.3%, recall 93.5%, and F1 score 94.7%) and identifying significant observations (accuracy 75.8%, precision 75.2%, recall 75.7%, and F1 score 75.3%) to characterize radiology reports. This method can help clinicians quickly understand the key observations in radiology reports and facilitate clinical decision support, review prioritization, and disease surveillance.

  18. Formalize clinical processes into electronic health information systems: Modelling a screening service for diabetic retinopathy.

    Science.gov (United States)

    Eguzkiza, Aitor; Trigo, Jesús Daniel; Martínez-Espronceda, Miguel; Serrano, Luis; Andonegui, José

    2015-08-01

    Most healthcare services use information and communication technologies to reduce and redistribute the workload associated with follow-up of chronic conditions. However, the lack of normalization of the information handled in and exchanged between such services hinders the scalability and extendibility. The use of medical standards for modelling and exchanging information, especially dual-model based approaches, can enhance the features of screening services. Hence, the approach of this paper is twofold. First, this article presents a generic methodology to model patient-centered clinical processes. Second, a proof of concept of the proposed methodology was conducted within the diabetic retinopathy (DR) screening service of the Health Service of Navarre (Spain) in compliance with a specific dual-model norm (openEHR). As a result, a set of elements required for deploying a model-driven DR screening service has been established, namely: clinical concepts, archetypes, termsets, templates, guideline definition rules, and user interface definitions. This model fosters reusability, because those elements are available to be downloaded and integrated in any healthcare service, and interoperability, since from then on such services can share information seamlessly. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Recommendations for CAMAC Serial Highway drivers and LAM Graders for the SCC-L2 Serial Crate Controller

    International Nuclear Information System (INIS)

    1978-01-01

    The functional requirements of Drivers for the CAMAC Serial Highway defined in IEEE Standard 595-1976 are described. The description is independent of the implementation, and in particular no assumption is made about the boundary between hardware and software within the Driver. Topics covered are the user interface, the supporting system services required, demand handling, and a detailed discussion of the message analysis for various levels of error recovery. An appendix describes the recommended features of LAM Graders for use with the Serial Crate Controller Type L2 of IEEE Std 595-1976

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

    Science.gov (United States)

    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

  1. Quality improvement tools and processes.

    Science.gov (United States)

    Lau, Catherine Y

    2015-04-01

    The Model for Improvement and the Plan-Do-Study-Act cycle is a popular quality improvement (QI) tool for health care providers to successfully lead QI projects and redesign care processes. This tool has several distinct components that must be addressed in sequence to organize and critically evaluate improvement activities. Unlike other health sciences clinical research, QI projects and research are based on dynamic hypotheses that develop into observable, serial tests of change with continuous collection and feedback of performance data to stakeholders. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Kiondo Bag Boutique: A Serial Case for Introductory Financial Accounting

    Science.gov (United States)

    Siriwardane, Harshini P.

    2014-01-01

    Kiondo Bag Boutique is a hypothetical serial case involving a start-up retail business. The case evolves from an ambitious business idea to a successful business. Through the evolving business, the importance of accounting information is highlighted. Different iterations are used to illustrate the role of accounting in serving and managing…

  3. 'American Psycho': a double portrait of serial yuppie Patrick Bateman

    NARCIS (Netherlands)

    Kooijman, J.; Laine, T.

    2003-01-01

    Kooijman and Laine analyze Mary Harron's "American Psycho," a 2000 film adaptation of the 1980s satirical novel by Bret Easton Ellis in which Patrick Bateman, a narcissistic Wall Street young urban professional ("yuppie"), assumes an alternate identity as a serial killer. The authors examine the

  4. The stand-alone test and decreasing serial cost sharing

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Thorlund-Petersen, Lars

    2000-01-01

    The rule of decreasing serial cost sharing defined in de Frutos [1] over the class of concave cost functions may violate the important stand-alone test. Sufficient conditions for the test to be satisfied are given, in terms of individual rationality as well as coalitional stability...

  5. Serials Management by Microcomputer: The Potential of DBMS.

    Science.gov (United States)

    Vogel, J. Thomas; Burns, Lynn W.

    1984-01-01

    Describes serials management at Philadelphia College of Textiles and Science library via a microcomputer, a file manager called PFS, and a relational database management system called dBase II. Check-in procedures, programing with dBase II, "static" and "active" databases, and claim procedures are discussed. Check-in forms are…

  6. Phonological Similarity in Serial Recall: Constraints on Theories of Memory

    Science.gov (United States)

    Lewandowsky, Stephan; Farrell, Simon

    2008-01-01

    In short-term serial recall, similar-sounding items are remembered more poorly than items that do not sound alike. When lists mix similar and dissimilar items, performance on the dissimilar items is of considerable theoretical interest. Farrell and Lewandowsky [Farrell, S., & Lewandowsky, S. (2003). Dissimilar items benefit from phonological…

  7. Development of parallel/serial program analyzing tool

    International Nuclear Information System (INIS)

    Watanabe, Hiroshi; Nagao, Saichi; Takigawa, Yoshio; Kumakura, Toshimasa

    1999-03-01

    Japan Atomic Energy Research Institute has been developing 'KMtool', a parallel/serial program analyzing tool, in order to promote the parallelization of the science and engineering computation program. KMtool analyzes the performance of program written by FORTRAN77 and MPI, and it reduces the effort for parallelization. This paper describes development purpose, design, utilization and evaluation of KMtool. (author)

  8. Asymmetric binding in serial memory for verbal and spatial information

    NARCIS (Netherlands)

    Guerard, Katherine; Morey, Candice C.; Lagace, Sebastien; Tremblay, Sebastien

    As the number of studies showing that items can be retained as bound representations in memory increases, researchers are beginning to investigate how the different features are bound together. In the present study, we examined the relative importances of the verbal and spatial features in serial

  9. FPGA based fast synchronous serial multi-wire links synchronization

    Science.gov (United States)

    Pozniak, Krzysztof T.

    2013-10-01

    The paper debates synchronization method of multi-wire, serial link of constant latency, by means of pseudo-random numbers generators. The solution was designed for various families of FPGA circuits. There were debated synchronization algorithm and functional structure of parameterized transmitter and receiver modules. The modules were realized in VHDL language in a behavioral form.

  10. Asymmetrical learning between a tactile and visual serial RT task

    NARCIS (Netherlands)

    Abrahamse, E.L.; van der Lubbe, Robert Henricus Johannes; Verwey, Willem B.

    2007-01-01

    According to many researchers, implicit learning in the serial reaction-time task is predominantly motor based and therefore should be independent of stimulus modality. Previous research on the task, however, has focused almost completely on the visual domain. Here we investigated sequence learning

  11. Serial assessment of doxorubicin cardiomyopathy with the computerized scintillation probe

    International Nuclear Information System (INIS)

    Strashun, A.; Goldsmith, S.J.; Horowitz, S.F.

    1982-01-01

    Cardiac function was serially monitored in 55 patients receiving adriamycin chemotherapy over 18 months with quantitative radionuclide assessment by both a nonimaging computerized scintillation probe and gamma camera-computer imaging. Interval ejection fraction change was comparable with both techniques and predicted incipient cardiotoxicity. Probe data revealed ejection fraction decline was antedated by decline left ventricular emptying and filling rates

  12. Using identification in entertainment-education drama serials to ...

    African Journals Online (AJOL)

    The study used two entertainment-education drama serials which were designed using Albert Bandura's theoretical framework to communicate positive messages of women's rights to real life audiences in select communities. The study sought to find out if there was any significant relationship i.e. identification between TV ...

  13. Counterbalancing for Serial Order Carryover Effects in Experimental Condition Orders

    Science.gov (United States)

    Brooks, Joseph L.

    2012-01-01

    Reactions of neural, psychological, and social systems are rarely, if ever, independent of previous inputs and states. The potential for serial order carryover effects from one condition to the next in a sequence of experimental trials makes counterbalancing of condition order an essential part of experimental design. Here, a method is proposed…

  14. Mixed-List Phonological Similarity Effects in Delayed Serial Recall

    Science.gov (United States)

    Farrell, Simon

    2006-01-01

    Recent experiments have shown that placing dissimilar items on lists of phonologically similar items enhances accuracy of ordered recall of the dissimilar items [Farrell, S., & Lewandowsky, S. (2003). Dissimilar items benefit from phonological similarity in serial recall. "Journal of Experimental Psychology: Learning, Memory, and Cognition," 29,…

  15. Electronic conductance of quantum wire with serial periodic potential structures

    International Nuclear Information System (INIS)

    Fayad, Hisham M.; Shabat, Mohammed M.; Abdus Salam International Centre for Theoretical Physics, Trieste

    2000-08-01

    A theory based on the total transfer matrix is presented to investigate the electronic conductance in a quantum wire with serial periodic potentials. We apply the formalism in computation of the electronic conductance in a wire with different physical parameters of the wire structure. The numerical results could be used in designing some future quantum electronic devices. (author)

  16. Analysis of aging in lager brewing yeast during serial repitching.

    Science.gov (United States)

    Bühligen, Franziska; Lindner, Patrick; Fetzer, Ingo; Stahl, Frank; Scheper, Thomas; Harms, Hauke; Müller, Susann

    2014-10-10

    Serial repitching of brewing yeast inoculates is an important economic factor in the brewing industry, as their propagation is time and resource intensive. Here, we investigated whether replicative aging and/or the population distribution status changed during serial repitching in three different breweries with the same brewing yeast strain but different abiotic backgrounds and repitching regimes with varying numbers of reuses. Next to bud scar numbers the DNA content of the Saccharomyces pastorianus HEBRU cells was analyzed. Gene expression patterns were investigated using low-density microarrays with genes for aging, stress, storage compound metabolism and cell cycle. Two breweries showed a stable rejuvenation rate during serial repitching. In a third brewery the fraction of virgin cells varied, which could be explained with differing wort aeration rates. Furthermore, the number of bud scars per cell and cell size correlated in all 3 breweries throughout all runs. Transcriptome analyses revealed that from the 6th run on, mainly for the cells positive gene expression could be seen, for example up-regulation of trehalose and glycogen metabolism genes. Additionally, the cells' settling in the cone was dependent on cell size, with the lowest and the uppermost cone layers showing the highest amount of dead cells. In general, cells do not progressively age during extended serial repitching. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Whole-pattern fitting technique in serial femtosecond nanocrystallography

    Directory of Open Access Journals (Sweden)

    Ruben A. Dilanian

    2016-03-01

    Full Text Available Serial femtosecond X-ray crystallography (SFX has created new opportunities in the field of structural analysis of protein nanocrystals. The intensity and timescale characteristics of the X-ray free-electron laser sources used in SFX experiments necessitate the analysis of a large collection of individual crystals of variable shape and quality to ultimately solve a single, average crystal structure. Ensembles of crystals are commonly encountered in powder diffraction, but serial crystallography is different because each crystal is measured individually and can be oriented via indexing and merged into a three-dimensional data set, as is done for conventional crystallography data. In this way, serial femtosecond crystallography data lie in between conventional crystallography data and powder diffraction data, sharing features of both. The extremely small sizes of nanocrystals, as well as the possible imperfections of their crystallite structure, significantly affect the diffraction pattern and raise the question of how best to extract accurate structure-factor moduli from serial crystallography data. Here it is demonstrated that whole-pattern fitting techniques established for one-dimensional powder diffraction analysis can be feasibly extended to higher dimensions for the analysis of merged SFX diffraction data. It is shown that for very small crystals, whole-pattern fitting methods are more accurate than Monte Carlo integration methods that are currently used.

  18. Benchmarking Usage Statistics in Collection Management Decisions for Serials

    Science.gov (United States)

    Tucker, Cory

    2009-01-01

    Usage statistics are an important metric for making decisions on serials. Although the University of Nevada, Las Vegas (UNLV) Libraries have been collecting usage statistics, the statistics had not frequently been used to make decisions and had not been included in collection development policy. After undergoing a collection assessment, the…

  19. Serials use in a College of Agriculture Education Library | Adzobu ...

    African Journals Online (AJOL)

    Serials use in a College of Agriculture Education Library. J Adzobu, JA Opare. Abstract. No Abstract. Ghana Library Journal Vol. 20 (1) 2008: pp. 81-88. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Article Metrics. Metrics Loading ... Metrics powered by PLOS ALM

  20. Child serial murder-psychodynamics: closely watched shadows.

    Science.gov (United States)

    Turco, R

    2001-01-01

    There is a malignant transformation in object relations resulting in an identification with an omnipotent and cruel object resulting in an identity transformation. If the tension, desperation, and dissociation increase, serial murder becomes spree murder. The presence of pathological narcissism and psychopathic tendencies are of diagnostic significance in understanding the murderer's personality functioning and motivation to kill. Meloy (1988) considered the degree of sadism and aggression combined with narcissistic qualities to reflect the "malignancy" of the psychopathic disturbance where gratification (of aggression) occurs in the service of narcissistic functioning--that is, cruelty toward others in the form of a triumphant victory over a rejecting object. Meloy also believes that dissociation is ubiquitious in the psychopath. The initial murder of the serial murderer may reflect a "new identity." The pathological object-relations of narcissism and the malignant narcissism are important diagnostic indicators in the personality functioning of serial killers and the occurrence of these phenomena is a significant factor in the formation of the personalities of serial killers, their inner motivations, and their pattern of commission.

  1. Serial Killers: Academic Libraries Respond to Soaring Costs.

    Science.gov (United States)

    McCarthy, Paul

    1994-01-01

    Discusses ways in which academic libraries are responding to rising costs of serials. Topics addressed include pricing by publishers; the effect of journal cancellations on research activities; interlibrary loans and document delivery services; coordinated cancelling; electronic journals; and experiences at the University of Arizona. (LRW)

  2. The Rise in Consumerism: The Year's Work in Serials, 1990.

    Science.gov (United States)

    Lonberger, Jana

    1991-01-01

    Examines major issues and trends in serials management represented in the literature published during 1990. Topics covered include the pricing crisis; publishing and scholarly communication; cancellation projects; technological developments and alternatives to print; claiming and replacement activities; acquisitions and collection development;…

  3. Process mining routinely collected electronic health records to define real-life clinical pathways during chemotherapy.

    Science.gov (United States)

    Baker, Karl; Dunwoodie, Elaine; Jones, Richard G; Newsham, Alex; Johnson, Owen; Price, Christopher P; Wolstenholme, Jane; Leal, Jose; McGinley, Patrick; Twelves, Chris; Hall, Geoff

    2017-07-01

    There is growing interest in the use of routinely collected electronic health records to enhance service delivery and facilitate clinical research. It should be possible to detect and measure patterns of care and use the data to monitor improvements but there are methodological and data quality challenges. Driven by the desire to model the impact of a patient self-test blood count monitoring service in patients on chemotherapy, we aimed to (i) establish reproducible methods of process-mining electronic health records, (ii) use the outputs derived to define and quantify patient pathways during chemotherapy, and (iii) to gather robust data which is structured to be able to inform a cost-effectiveness decision model of home monitoring of neutropenic status during chemotherapy. Electronic Health Records at a UK oncology centre were included if they had (i) a diagnosis of metastatic breast cancer and received adjuvant epirubicin and cyclosphosphamide chemotherapy or (ii) colorectal cancer and received palliative oxaliplatin and infusional 5-fluorouracil chemotherapy, and (iii) were first diagnosed with cancer between January 2004 and February 2013. Software and a Markov model were developed, producing a schematic of patient pathways during chemotherapy. Significant variance from the assumed care pathway was evident from the data. Of the 535 patients with breast cancer and 420 with colorectal cancer there were 474 and 329 pathway variants respectively. Only 27 (5%) and 26 (6%) completed the planned six cycles of chemotherapy without having unplanned hospital contact. Over the six cycles, 169 (31.6%) patients with breast cancer and 190 (45.2%) patients with colorectal cancer were admitted to hospital. The pathways of patients on chemotherapy are complex. An iterative approach to addressing semantic and data quality issues enabled the effective use of routinely collected patient records to produce accurate models of the real-life experiences of chemotherapy patients and

  4. Usability of clinical decision support system as a facilitator for learning the assistive technology adaptation process.

    Science.gov (United States)

    Danial-Saad, Alexandra; Kuflik, Tsvi; Weiss, Patrice L Tamar; Schreuer, Naomi

    2016-01-01

    The aim of this study was to evaluate the usability of Ontology Supported Computerized Assistive Technology Recommender (OSCAR), a Clinical Decision Support System (CDSS) for the assistive technology adaptation process, its impact on learning the matching process, and to determine the relationship between its usability and learnability. Two groups of expert and novice clinicians (total, n = 26) took part in this study. Each group filled out system usability scale (SUS) to evaluate OSCAR's usability. The novice group completed a learning questionnaire to assess OSCAR's effect on their ability to learn the matching process. Both groups rated OSCAR's usability as "very good", (M [SUS] = 80.7, SD = 11.6, median = 83.7) by the novices, and (M [SUS] = 81.2, SD = 6.8, median = 81.2) by the experts. The Mann-Whitney results indicated that no significant differences were found between the expert and novice groups in terms of OSCAR's usability. A significant positive correlation existed between the usability of OSCAR and the ability to learn the adaptation process (rs = 0.46, p = 0.04). Usability is an important factor in the acceptance of a system. The successful application of user-centered design principles during the development of OSCAR may serve as a case study that models the significant elements to be considered, theoretically and practically in developing other systems. Implications for Rehabilitation Creating a CDSS with a focus on its usability is an important factor for its acceptance by its users. Successful usability outcomes can impact the learning process of the subject matter in general, and the AT prescription process in particular. The successful application of User-Centered Design principles during the development of OSCAR may serve as a case study that models the significant elements to be considered, theoretically and practically. The study emphasizes the importance of close collaboration between the developers and

  5. ICT-Enabled Time-Critical Clinical Practices: Examining the Affordances of an Information Processing Solution

    Directory of Open Access Journals (Sweden)

    Leonard Hoon

    2015-11-01

    Full Text Available In this paper, we present a case study of a decision-support system deployment at The Alfred Hospital, in Melbourne, Australia. This work outlines Information and Communications Technology (ICT affordances and their actualisations in time-critical clinical practices to enable better information processing. From our study findings, we present a stage-wise model describing the role played by ICT in the context of the Trauma Centre practices. This addresses a knowledge gap surrounding the role and impact of ICT in the delivery of quality improvements to processes and culture in time-critical environments, amid increasing expenditure on ICT globally. Our model has implications for research and practice, such that we observe for the first time how information standards, synergy and renewal are developed between the system and its users in order to reduce error rates in the healthcare context. Through the study findings, we demonstrate that healthcare quality can be further refined as ICT allows for knowledge dissemination and informs existing practices.

  6. General practitioners' decision to refer patients to dietitians: insight into the clinical reasoning process.

    Science.gov (United States)

    Pomeroy, Sylvia E M; Cant, Robyn P

    2010-01-01

    The aim of this project was to describe general practitioners' (GPs') decision-making process for reducing nutrition risk in cardiac patients through referring a patient to a dietitian. The setting was primary care practices in Victoria. The method we employed was mixed methods research: in Study 1, 30 GPs were interviewed. Recorded interviews were transcribed and narratives analysed thematically. Study 2 involved a survey of statewide random sample of GPs. Frequencies and analyses of variance were used to explore the impact of demographic variables on decisions to refer. We found that the referral decision involved four elements: (i) synthesising management information; (ii) forecasting outcomes; (iii) planning management; and (iv) actioning referrals. GPs applied cognitive and collaborative strategies to develop a treatment plan. In Study 2, doctors (248 GPs, 30%) concurred with identified barriers/enabling factors for patients' referral. There was no association between GPs' sex, age or hours worked per week and referral factors. We conclude that a GP's judgment to offer a dietetic referral to an adult patient is a four element reasoning process. Attention to how these elements interact may assist clinical decision making. Apart from the sole use of prescribed medications/surgical procedures for cardiac care, patients offered a dietetic referral were those who were considered able to commit to dietary change and who were willing to attend a dietetic consultation. Improvements in provision of patients' nutrition intervention information to GPs are needed. Further investigation is justified to determine how to resolve this practice gap.

  7. Serial millisecond crystallography of membrane and soluble protein microcrystals using synchrotron radiation.

    Science.gov (United States)

    Martin-Garcia, Jose M; Conrad, Chelsie E; Nelson, Garrett; Stander, Natasha; Zatsepin, Nadia A; Zook, James; Zhu, Lan; Geiger, James; Chun, Eugene; Kissick, David; Hilgart, Mark C; Ogata, Craig; Ishchenko, Andrii; Nagaratnam, Nirupa; Roy-Chowdhury, Shatabdi; Coe, Jesse; Subramanian, Ganesh; Schaffer, Alexander; James, Daniel; Ketwala, Gihan; Venugopalan, Nagarajan; Xu, Shenglan; Corcoran, Stephen; Ferguson, Dale; Weierstall, Uwe; Spence, John C H; Cherezov, Vadim; Fromme, Petra; Fischetti, Robert F; Liu, Wei

    2017-07-01

    Crystal structure determination of biological macromolecules using the novel technique of serial femtosecond crystallography (SFX) is severely limited by the scarcity of X-ray free-electron laser (XFEL) sources. However, recent and future upgrades render microfocus beamlines at synchrotron-radiation sources suitable for room-temperature serial crystallography data collection also. Owing to the longer exposure times that are needed at synchrotrons, serial data collection is termed serial millisecond crystallography (SMX). As a result, the number of SMX experiments is growing rapidly, with a dozen experiments reported so far. Here, the first high-viscosity injector-based SMX experiments carried out at a US synchrotron source, the Advanced Photon Source (APS), are reported. Microcrystals (5-20 µm) of a wide variety of proteins, including lysozyme, thaumatin, phycocyanin, the human A 2A adenosine receptor (A 2A AR), the soluble fragment of the membrane lipoprotein Flpp3 and proteinase K, were screened. Crystals suspended in lipidic cubic phase (LCP) or a high-molecular-weight poly(ethylene oxide) (PEO; molecular weight 8 000 000) were delivered to the beam using a high-viscosity injector. In-house data-reduction (hit-finding) software developed at APS as well as the SFX data-reduction and analysis software suites Cheetah and CrystFEL enabled efficient on-site SMX data monitoring, reduction and processing. Complete data sets were collected for A 2A AR, phycocyanin, Flpp3, proteinase K and lysozyme, and the structures of A 2A AR, phycocyanin, proteinase K and lysozyme were determined at 3.2, 3.1, 2.65 and 2.05 Å resolution, respectively. The data demonstrate the feasibility of serial millisecond crystallography from 5-20 µm crystals using a high-viscosity injector at APS. The resolution of the crystal structures obtained in this study was dictated by the current flux density and crystal size, but upcoming developments in beamline optics and the planned APS

  8. Serial millisecond crystallography of membrane and soluble protein microcrystals using synchrotron radiation

    Directory of Open Access Journals (Sweden)

    Jose M. Martin-Garcia

    2017-07-01

    Full Text Available Crystal structure determination of biological macromolecules using the novel technique of serial femtosecond crystallography (SFX is severely limited by the scarcity of X-ray free-electron laser (XFEL sources. However, recent and future upgrades render microfocus beamlines at synchrotron-radiation sources suitable for room-temperature serial crystallography data collection also. Owing to the longer exposure times that are needed at synchrotrons, serial data collection is termed serial millisecond crystallography (SMX. As a result, the number of SMX experiments is growing rapidly, with a dozen experiments reported so far. Here, the first high-viscosity injector-based SMX experiments carried out at a US synchrotron source, the Advanced Photon Source (APS, are reported. Microcrystals (5–20 µm of a wide variety of proteins, including lysozyme, thaumatin, phycocyanin, the human A2A adenosine receptor (A2AAR, the soluble fragment of the membrane lipoprotein Flpp3 and proteinase K, were screened. Crystals suspended in lipidic cubic phase (LCP or a high-molecular-weight poly(ethylene oxide (PEO; molecular weight 8 000 000 were delivered to the beam using a high-viscosity injector. In-house data-reduction (hit-finding software developed at APS as well as the SFX data-reduction and analysis software suites Cheetah and CrystFEL enabled efficient on-site SMX data monitoring, reduction and processing. Complete data sets were collected for A2AAR, phycocyanin, Flpp3, proteinase K and lysozyme, and the structures of A2AAR, phycocyanin, proteinase K and lysozyme were determined at 3.2, 3.1, 2.65 and 2.05 Å resolution, respectively. The data demonstrate the feasibility of serial millisecond crystallography from 5–20 µm crystals using a high-viscosity injector at APS. The resolution of the crystal structures obtained in this study was dictated by the current flux density and crystal size, but upcoming developments in beamline optics and the

  9. Serial volumetric registration of pulmonary CT studies

    Science.gov (United States)

    Silva, José Silvestre; Silva, Augusto; Sousa Santos, Beatriz

    2008-03-01

    Detailed morphological analysis of pulmonary structures and tissue, provided by modern CT scanners, is of utmost importance as in the case of oncological applications both for diagnosis, treatment, and follow-up. In this case, a patient may go through several tomographic studies throughout a period of time originating volumetric sets of image data that must be appropriately registered in order to track suspicious radiological findings. The structures or regions of interest may change their position or shape in CT exams acquired at different moments, due to postural, physiologic or pathologic changes, so, the exams should be registered before any follow-up information can be extracted. Postural mismatching throughout time is practically impossible to avoid being particularly evident when imaging is performed at the limiting spatial resolution. In this paper, we propose a method for intra-patient registration of pulmonary CT studies, to assist in the management of the oncological pathology. Our method takes advantage of prior segmentation work. In the first step, the pulmonary segmentation is performed where trachea and main bronchi are identified. Then, the registration method proceeds with a longitudinal alignment based on morphological features of the lungs, such as the position of the carina, the pulmonary areas, the centers of mass and the pulmonary trans-axial principal axis. The final step corresponds to the trans-axial registration of the corresponding pulmonary masked regions. This is accomplished by a pairwise sectional registration process driven by an iterative search of the affine transformation parameters leading to optimal similarity metrics. Results with several cases of intra-patient, intra-modality registration, up to 7 time points, show that this method provides accurate registration which is needed for quantitative tracking of lesions and the development of image fusion strategies that may effectively assist the follow-up process.

  10. Is Serial Testing Required to Diagnose Imported Malaria in the Era of Rapid Diagnostic Tests?

    Science.gov (United States)

    Pasricha, Janet M.; Juneja, Surender; Manitta, Joseph; Whitehead, Susan; Maxwell, Ellen; Goh, Wai-Keong; Pasricha, Sant-Rayn; Eisen, Damon P.

    2013-01-01

    Exclusion of malaria traditionally requires three negative serial thick and thin blood films. However, many clinical laboratories now routinely perform rapid diagnostic tests (RDTs) in addition to blood films when malaria is suspected. We sought to determine whether serial testing is necessary in this setting. We examined 388 cases of malaria diagnosed during 1999–2010 at three laboratories in Melbourne, Australia. For each case, we ascertained whether the diagnosis was made on initial or follow-up testing. Nine cases (3.5%) were diagnosed after a negative initial blood film and RDT: 7 Plasmodium vivax, 1 P. ovale, and 1 P. falciparum. Of four case-patients with P. vivax in which clinical data were available, all had recent exposure to antimalarial medication. Our data suggest that among patients who have not received recent anti-malarial therapy, and when RDTs are performed and blood films are prepared, most malaria diagnoses are made by using the first set of tests. PMID:23208885

  11. The value of serial personal photographs in timing the onset of unilateral cataracts in children.

    Science.gov (United States)

    Sawhney, Gagan K; Hutchinson, Amy K; Lambert, Scott R

    2009-10-01

    To determine the value of serial personal photographs in timing the onset of unilateral cataracts in children over 6 months of age. Personal photographs from children with unilateral cataracts who underwent cataract extraction and intraocular lens implantation when > or =6 months of age were reviewed. Photographs were evaluated for changes in the red reflex, which might indicate the presence of a cataract. Twelve children underwent cataract surgery at a mean age of 37 months. They were followed for a mean of 32 months. Ten children were diagnosed as having an acquired cataract by photographic review documenting a previously normal red reflex. The visual acuity in the affected eye of 4 of these children improved to > or =20/60. Cataracts were visible on photographs prior to clinical diagnosis in 6 patients, from 0.5 to 22 months prior to clinical diagnosis. Visual outcomes did not relate closely to the photographically documented duration of the cataract prior to treatment. Photographs were not helpful in timing the onset of cataract in 2 children due to the poor quality of the images. Serial personal photographs are sometimes helpful in determining whether cataracts are acquired. However, the usefulness of personal photographs alone in predicting the visual outcome after cataract surgery was limited in this small, retrospective study.

  12. Separating Business Logic from Medical Knowledge in Digital Clinical Workflows Using Business Process Model and Notation and Arden Syntax.

    Science.gov (United States)

    de Bruin, Jeroen S; Adlassnig, Klaus-Peter; Leitich, Harald; Rappelsberger, Andrea

    2018-01-01

    Evidence-based clinical guidelines have a major positive effect on the physician's decision-making process. Computer-executable clinical guidelines allow for automated guideline marshalling during a clinical diagnostic process, thus improving the decision-making process. Implementation of a digital clinical guideline for the prevention of mother-to-child transmission of hepatitis B as a computerized workflow, thereby separating business logic from medical knowledge and decision-making. We used the Business Process Model and Notation language system Activiti for business logic and workflow modeling. Medical decision-making was performed by an Arden-Syntax-based medical rule engine, which is part of the ARDENSUITE software. We succeeded in creating an electronic clinical workflow for the prevention of mother-to-child transmission of hepatitis B, where institution-specific medical decision-making processes could be adapted without modifying the workflow business logic. Separation of business logic and medical decision-making results in more easily reusable electronic clinical workflows.

  13. Reconstructing genealogies of serial samples under the assumption of a molecular clock using serial-sample UPGMA.

    Science.gov (United States)

    Drummond, A; Rodrigo, A G

    2000-12-01

    Reconstruction of evolutionary relationships from noncontemporaneous molecular samples provides a new challenge for phylogenetic reconstruction methods. With recent biotechnological advances there has been an increase in molecular sequencing throughput, and the potential to obtain serial samples of sequences from populations, including rapidly evolving pathogens, is fast being realized. A new method called the serial-sample unweighted pair grouping method with arithmetic means (sUPGMA) is presented that reconstructs a genealogy or phylogeny of sequences sampled serially in time using a matrix of pairwise distances. The resulting tree depicts the terminal lineages of each sample ending at a different level consistent with the sample's temporal order. Since sUPGMA is a variant of UPGMA, it will perform best when sequences have evolved at a constant rate (i.e., according to a molecular clock). On simulated data, this new method performs better than standard cluster analysis under a variety of longitudinal sampling strategies. Serial-sample UPGMA is particularly useful for analysis of longitudinal samples of viruses and bacteria, as well as ancient DNA samples, with the minimal requirement that samples of sequences be ordered in time.

  14. Smart grid serialization comparison: Comparision of serialization for distributed control in the context of the Internet of Things

    DEFF Research Database (Denmark)

    Petersen, Bo Søborg; Bindner, Henrik W.; You, Shi

    2017-01-01

    within a given timeframe, especially in the context of the Internet of Things, using low-bandwidth data connections and constrained devices. The paper shows that there are better alternatives than XML & JAXB and gives guidance in choosing the most appropriate serialization format and library depending...

  15. The Associative Memory Serial Link Processor for the Fast TracKer (FTK) at ATLAS

    International Nuclear Information System (INIS)

    Andreani, A; Citterio, M; Liberali, V; Annovi, A; Beretta, M; Beccherle, R; Crescioli, F; Biesuz, N; Billereau, W; Combe, J M; Cipriani, R; Citraro, S; Donati, S; Giannetti, P; Luciano, P; Colombo, A; Dimas, D; Gentsos, C; Kordas, K; Lanza, A

    2014-01-01

    The Fast TracKer (FTK) is an extremely powerful and very compact processing unit, essential for efficient Level 2 trigger selection in future high-energy physics experiments at the LHC. FTK employs Associative Memories (AM) to perform pattern recognition; input and output data are transmitted over serial links at 2 Gbit/s to reduce routing congestion at the board level. Prototypes of the AM chip and of the AM board have been manufactured and tested, in preparation of the imminent design of the final version

  16. FPGA Based Test Module for Error Bit Evaluation in Serial Links

    Directory of Open Access Journals (Sweden)

    J. Kolouch

    2006-04-01

    Full Text Available A test module for serial links is described. In the link transmitter, one module generates pseudorandom pulse signal that is transmitted by the link. Second module located in the link receiver generates the same signal and compares it to the received signal. Errors caused by the signal transmission can be then detected and results sent to a master computer for further processing like statistical evaluation. The module can be used for long-term error monitoring without need for human operator presence.

  17. Ease of adoption of clinical natural language processing software: An evaluation of five systems.

    Science.gov (United States)

    Zheng, Kai; Vydiswaran, V G Vinod; Liu, Yang; Wang, Yue; Stubbs, Amber; Uzuner, Özlem; Gururaj, Anupama E; Bayer, Samuel; Aberdeen, John; Rumshisky, Anna; Pakhomov, Serguei; Liu, Hongfang; Xu, Hua

    2015-12-01

    In recognition of potential barriers that may inhibit the widespread adoption of biomedical software, the 2014 i2b2 Challenge introduced a special track, Track 3 - Software Usability Assessment, in order to develop a better understanding of the adoption issues that might be associated with the state-of-the-art clinical NLP systems. This paper reports the ease of adoption assessment methods we developed for this track, and the results of evaluating five clinical NLP system submissions. A team of human evaluators performed a series of scripted adoptability test tasks with each of the participating systems. The evaluation team consisted of four "expert evaluators" with training in computer science, and eight "end user evaluators" with mixed backgrounds in medicine, nursing, pharmacy, and health informatics. We assessed how easy it is to adopt the submitted systems along the following three dimensions: communication effectiveness (i.e., how effective a system is in communicating its designed objectives to intended audience), effort required to install, and effort required to use. We used a formal software usability testing tool, TURF, to record the evaluators' interactions with the systems and 'think-aloud' data revealing their thought processes when installing and using the systems and when resolving unexpected issues. Overall, the ease of adoption ratings that the five systems received are unsatisfactory. Installation of some of the systems proved to be rather difficult, and some systems failed to adequately communicate their designed objectives to intended adopters. Further, the average ratings provided by the end user evaluators on ease of use and ease of interpreting output are -0.35 and -0.53, respectively, indicating that this group of users generally deemed the systems extremely difficult to work with. While the ratings provided by the expert evaluators are higher, 0.6 and 0.45, respectively, these ratings are still low indicating that they also experienced

  18. Serial cranial computed-tomography scans in children with leukemia given two different forms of central nervous system therapy

    International Nuclear Information System (INIS)

    Ochs, J.J.; Parvey, L.S.; Whitaker, J.N.; Bowman, W.P.; Ch'ien, L.; Campbell, M.; Coburn, T.

    1983-01-01

    Cranial computed tomography (CT) was used to estimate the frequency and permanence of brain abnormalities in 108 consecutive children with acute lymphoblastic leukemia (ALL). Fifty-five patients received cranial irradiation (1,800 rad) with intrathecal methotrexate (RT group) and 53 patients received intravenous and intrathecal methotrexate without irradiation (IVIT group). Continuation treatment included sequential drug pairs for the RT group and periodic IVIT methotrexate for the other group. After 12 to 24 months of serial evaluation, five (9%) of the 55 patients in the RT group have had CT scan abnormalities, compared to 10 (19%) of 52 in the IVIT group (p . 0.171). Fourteen of the 15 patients with CT scan abnormalities had focal or diffuse white-matter hypodensity; these have reverted to normal in most cases, reflecting a dynamic process. While such CT findings are of concern and may be an early indicator of central nervous system toxicity, this remains to be proven. Therapy should not be altered on the basis of abnormal CT scans alone but in the context of the entire clinical situation

  19. Serial superficial digital flexor tendon biopsies for diagnosing and monitoring collagenase-induced tendonitis in horses

    Directory of Open Access Journals (Sweden)

    José C. de Lacerda Neto

    2013-06-01

    Full Text Available The purpose of this investigation was to demonstrate the feasibility of a biopsy technique by performing serial evaluations of tissue samples of the forelimb superficial digital flexor tendon (SDFT in healthy horses and in horses subjected to superficial digital flexor tendonitis induction. Eight adult horses were evaluated in two different phases (P, control (P1 and tendonitis-induced (P2. At P1, the horses were subjected to five SDFT biopsies of the left forelimb, with 24 hours (h of interval. Clinical and ultrasonographic (US examinations were performed immediately before the tendonitis induction, 24 and 48 h after the procedure. The biopsied tendon tissues were analyzed through histology. P2 evaluations were carried out three months later, when the same horses were subjected to tendonitis induction by injection of bacterial collagenase into the right forelimb SDFT. P2 clinical and US evaluations, and SDFT biopsies were performed before, and after injury induction at the following time intervals: after 24, 48, 72 and 96 h, and after 15, 30, 60, 90, 120 and 150 days. The biopsy technique has proven to be easy and quick to perform and yielded good tendon samples for histological evaluation. At P1 the horses did not show signs of localised inflammation, pain or lameness, neither SDFT US alterations after biopsies, showing that the biopsy procedure per se did not risk tendon integrity. Therefore, this procedure is feasible for routine tendon histological evaluations. The P2 findings demonstrate a relation between the US and histology evaluations concerning induced tendonitis evolution. However, the clinical signs of tendonitis poorly reflected the microscopic tissue condition, indicating that clinical presentation is not a reliable parameter for monitoring injury development. The presented method of biopsying SDFT tissue in horses enables the serial collection of material for histological analysis causing no clinical signs and tendon damage seen

  20. Ranking serials in oceanography: An analysis based on the Indian contributions and their citations

    Digital Repository Service at National Institute of Oceanography (India)

    Tapaswi, M.P.; Maheswarappa, B.S.

    An analysis of serials preferred and cited in various communications by the Indian oceanographers during 1963 to 1992 is presented. A shift in preference of serials from general sciences to oceanography (interdisciplinary) and to core subject...