102 resultados para Lacrimal duct obstruction diagnosis


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Slavoj Zizek's work has been highly influential in the formulation of an emerging consensus among Lacanian social researchers, that we live in a society of generalised perversion whose initial fruits are the corrosion of democracy and the recent financial crisis. This position rests upon a notion of modern subjectivity that connects ‘commodity fetishism’ with clinical perversion in a pathological configuration, so that social theoretical identification of crisis tendencies, evaluative language about moral problems and diagnostic categories from the Lacanian clinic can be combined in a single figure. In this article, we question the series of conceptual links that constitute this position, tracing them from Zizek’s critique in his short work on the global financial crisis and his broader restatement of this analysis in the recent Living in the End Times, through the moment of his announcement of the notion of ‘generalised perversion’ in The Ticklish Subject, all the way back to fundamental propositions outlined in his earliest work. Our argument progresses through three claims. First, we show in the evolution of this position that it leads Zizek to equivocate in his diagnosis of contemporary society between two mutually exclusive categories (‘psychosis’ and ‘perversion’), indicating an antinomy in his work that is resolved in favour of ‘generalised perversion’ on empirical, not logical, grounds. Secondly, we offer a critical resolution of the antinomy through a critique of what we argue is Zizek’s mistaken over-extension of psychoanalytic reason beyond its legitimate scope of application. Finally, we point to some of the political implications of the way that Zizek speculatively resolves his logical difficulties, by analysing the consequences of his claim that generalised social perversion - the problem to be solved - involves a dethroning of the communal ego ideal. A communitarian streak, implicit in the potential conflation of moral denunciation with psychoanalytic diagnosis that the rhetoric of ‘perversion’ invokes, runs through Zizek’s work on capitalism, we propose in conclusion.

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What we need to know
• How is breathlessness perceived and defined in older people?
• What impact does breathlessness have on quality of life?
• Can history taking and physical examination be tailored to efficiently cover all the organ systems associated with
breathlessness?
• Can a self- or carer-rated questionnaire be used to identify asthma in patients with breathlessness?
What we need to do
• Develop self- and carer-rated questionnaires that measure change in function and quality of life before and after
treatment.
• Validate objective measures of physical function and airflow that are sufficiently sensitive to measure change with
treatment.
• Develop a diagnostic guideline in general practice that includes measures of mood and cognitive function and
involves carers where necessary.
• Provide rehabilitation and restorative care services.

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This study compares the effectiveness of Bayesian networks versus Decision Trees in modeling the Integral Theory of Female Urinary Incontinence diagnostic algorithm. Bayesian networks and Decision Trees were developed and trained using data from 58 adult women presenting with urinary incontinence symptoms. A Bayesian Network was developed in collaboration with an expert specialist who regularly utilizes a non-automated diagnostic algorithm in clinical practice. The original Bayesian network was later refined using a more connected approach. Diagnoses determined from all automated approaches were compared with the diagnoses of a single human expert. In most cases, Bayesian networks were found to be at least as accurate as the Decision Tree approach. The refined Connected Bayesian Network was found to be more accurate than the Original Bayesian Network accurately discriminated between diagnoses despite the small sample size. In contrast, the Connected and Decision Tree approaches were less able to discriminate between diagnoses. The Original Bayesian Network was found to provide an excellent basis for graphically communicating the correlation between symptoms and laxity defects in a given anatomical zone. Performance measures in both networks indicate that Bayesian networks could provide a potentially useful tool in the management of female pelvic floor dysfunction. Before the technique can be utilized in practice, well-established learning algorithms should be applied to improve network structure. A larger training data set should also improve network accuracy, sensitivity, and specificity.

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This discourse analytic study sits at the intersection of everyday communications with young people in mental health settings and the enduring sociological critique of diagnoses in psychiatry. The diagnosis of borderline personality disorder (BPD) is both contested and stigmatized, in mental health and general health settings. Its legitimacy is further contested within the specialist adolescent mental health setting. In this setting, clinicians face a quandary regarding the application of adult diagnostic criteria to an adolescent population, aged less than 18 years. This article presents an analysis of interviews undertaken with Child and Adolescent Mental Health Services (CAMHS) clinicians in two publicly funded Australian services, about their use of the BPD diagnosis. In contrast with notions of primacy of diagnosis or of transparency in communications, doctors, nurses and allied health clinicians resisted and subverted a diagnosis of BPD in their work with adolescents. We delineate specific social and discursive strategies that clinicians displayed and reflected on, including: team rules which discouraged diagnostic disclosure; the lexical strategy of hedging when using the diagnosis; the prohibition and utility of informal ‘borderline talk’ among clinicians; and reframing the diagnosis with young people. For clinicians, these strategies legitimated their scepticism and enabled them to work with diagnostic uncertainty, in a population identified as vulnerable. For adolescent identities, these strategies served to forestall a BPD trajectory, allowing room for troubled adolescents to move and grow. These findings illuminate how the contest surrounding this diagnosis in principle is expressed in everyday clinical practice.

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Phosphorylated sperm proteins are crucial for sperm maturation and capacitation as a priori to their fertilization with eggs. In the freshwater prawn, Macrobrachium rosenbergii, a male reproduction-related protein (Mar-Mrr) was known to be expressed only in the spermatic ducts as a protein with putative phosphorylation and may be involved in sperm capacitation in this species. We investigated further the temporal and spatial expression of the Mar-Mrr gene using RT-PCR and in situ hybridization and the characteristics and fate of the protein using immunblotting and immunocytochemistry. The Mar-Mrr gene was first expressed in 4-week-old post larvae and the protein was produced in epithelial cells lining the spermatic ducts, at the highest level in the proximal region and decreased in the middle and distal parts. The native protein had a MW of 17 kDa and a high degree of serine/threonine phosphorylation. It was transferred from the epithelial cells to become a major protein at the anterior region of the sperm. We suggest that it is involved in sperm capacitation and fertilization in this open thelycal species and this is being investigated.

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Background The diagnosis of displacement in scaphoid fractures is notorious for poor interobserver reliability.

Questions/purposes We tested whether training can improve interobserver reliability and sensitivity, specificity, and accuracy for the diagnosis of scaphoid fracture displacement on radiographs and CT scans.

Methods Sixty-four orthopaedic surgeons rated a set of radiographs and CT scans of 10 displaced and 10 nondisplaced scaphoid fractures for the presence of displacement, using a web-based rating application. Before rating, observers were randomized to a training group (34 observers) and a nontraining group (30 observers). The training group received an online training module before the rating session, and the nontraining group did not. Interobserver reliability for training and nontraining was assessed by Siegel’s multirater kappa and the Z-test was used to test for significance.

Results There was a small, but significant difference in the interobserver reliability for displacement ratings in favor of the training group compared with the nontraining group. Ratings of radiographs and CT scans combined resulted in moderate agreement for both groups. The average sensitivity, specificity, and accuracy of diagnosing displacement of scaphoid fractures were, respectively, 83%, 85%, and 84% for the nontraining group and 87%, 86%, and 87% for the training group. Assuming a 5% prevalence of fracture displacement, the positive predictive value was 0.23 in the nontraining group and 0.25 in the training group. The negative predictive value was 0.99 in both groups.

Conclusions Our results suggest training can improve interobserver reliability and sensitivity, specificity and accuracy for the diagnosis of scaphoid fracture displacement, but the improvements are slight. These findings are encouraging for future research regarding interobserver variation and how to reduce it further.

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This paper proposes a hybrid system that integrates the SOM (Self Organizing Map) neural network, the kMER (kernel-based Maximum Entropy learning Rule) algorithm and the Probabilistic Neural Network (PNN) for data visualization and classification. The rationales of this hybrid SOM-kMER-PNN model are explained, and the applicability of the proposed model is demonstrated using two benchmark data sets and a real-world application to fault detection and diagnosis. The outcomes show that the hybrid system is able to achieve comparable classification rates when compared to those from a number of existing classifiers and, at the same time, to produce meaningful visualization of the data sets.

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Artificial neural networks have a good potential to be employed for fault diagnosis and condition monitoring problems in complex processes. In this paper, the applicability of the fuzzy ARTMAP (FAM) neural network as an intelligent learning system for fault detection and diagnosis in a power generation plant is described. The process under scrutiny is the circulating water (CW) system, with specific attention to the conditions of heat transfer and tube blockage in the CW system. A series of experiments has been conducted systematically to investigate the effectiveness of FAM in fault detection and diagnosis tasks. In addition, a set of domain rules has been extracted from the trained FAM network so that its predictions can be explained and justified. The outcomes demonstrate the benefits of employing FAM as an intelligent fault detection and diagnosis tool with an explanatory capability for monitoring and diagnosing complex processes in power generation plants.