TOWARDS THE JOINT USE OF ICD AND ICF: A CALL FOR CONTRIBUTION

Background: To optimize patient functioning, rehabilitation professionals often rely on measurements of functioning as well as on classifications. Although the International Classification of Diseases (ICD) and the International Classification of Functioning, Disability and Health (ICF) are used, their joint use has yet to become an established practice. To encourage their joint use in daily practice, the World Health Organization (WHO) has invited all rehabilitation practitioners worldwide to support the ICD-11 revision process by identifying the ICF categories that correspond to specific rehabilitation-relevant health conditions. The first step in completing this task, generating the list of these health conditions, was taken at a February 2012 workshop in Sao Paulo, Brazil. Objectives: The objectives of this paper are to present the results of the Sao Paulo workshop, and to invite practitioners to participate in the ICD-ICF joint use initiative. Discussion: Alternating plenary and small working group sessions were held and 103 rehabilitation-relevant health conditions were identified. With this list available, WHO together with the International Society of Physical and Rehabilitation Medicine (ISPRM), is reaching out to clinicians of all rehabilitation disciplines to take on the challenge of identifying the ICF categories for at least one of the health conditions listed.

Urothelial neoplasms of the urinary bladder occurring in young adult and pediatric patients: a comprehensive review of literature with implications for patient management

Bladder urothelial carcinoma is typically a disease of older individuals and rarely occurs below the age of 40 years. There is debate and uncertainty in the literature regarding the clinicopathologic characteristics of bladder urothelial neoplasms in younger patients compared with older patients, although no consistent age criteria have been used to define "younger" age group categories. Use of the World Health Organization 2004/International Society of Urological Pathology 1998 grading nomenclature and recent molecular studies highlight certain unique features of bladder urothelial neoplasms in young patients, particularly in patients below 20 years of age. In this meta-analysis and review, the clinical, pathologic, and molecular features and risk factors of bladder urothelial neoplasms in patients 40 years or less are presented and analyzed according to decades of presentation. Similar to older patients, bladder urothelial neoplasms in patients 40 years or younger occur more common in male patients, present mainly with gross painless hematuria, and are more commonly located at bladder trigone/ureteral orifices, but in contrast have a greater chance for unifocality. Delay in diagnosis of bladder urothelial neoplasms seems not to be uncommon in younger patients probably because of its relative rarity and the predominance of benign causes of hematuria in this age group causing hesitancy for an aggressive work-up. Most tumors in patients younger than 40 years were low grade. The incidence of low-grade tumors was the lowest in the first 2 decades of life, with incremental increase of the percentage of high-grade tumors with increasing age decades. Classification according to the World Health Organization 2004/International Society of Urological Pathology grading system identified papillary urothelial neoplasms of low malignant potential to be relatively frequent among bladder tumors of young patients particularly in the teenage years. Similar to grade, there was marked predominance of low stage tumors in the first 2 decades of life with gradual inclusion of few higher stage and metastatic tumors in the 2 older decades. Bladder urothelial neoplasms occurring in patients <20 years of age lack or have a much lower incidence of aberrations in chromosome 9, FGFR3, p53, and microsatellite instability and have fewer epigenetic alterations. Tumor recurrence and deaths were infrequent in the first 2 decades and increased gradually in each successive decade, likely influenced by the increased proportion of higher grade and higher stage tumors. Our review of the literature shows that urothelial neoplasms of the bladder occurring in young patients exhibit unique pathologic and molecular features that translate to its more indolent behavior; this distinction is most pronounced in patients <20 years. Our overall inferences have potential implications for choosing appropriate noninvasive diagnostic and surveillance modalities, whenever feasible, and for selecting suitable treatment strategies that factor in quality of life issues vital to younger patients.

Three-dimensional surface reconstruction within noncontact diffuse optical tomography using structured light

A main field in biomedical optics research is diffuse optical tomography, where intensity variations of the transmitted light traversing through tissue are detected. Mathematical models and reconstruction algorithms based on finite element methods and Monte Carlo simulations describe the light transport inside the tissue and determine differences in absorption and scattering coefficients. Precise knowledge of the sample's surface shape and orientation is required to provide boundary conditions for these techniques. We propose an integrated method based on structured light three-dimensional (3-D) scanning that provides detailed surface information of the object, which is usable for volume mesh creation and allows the normalization of the intensity dispersion between surface and camera. The experimental setup is complemented by polarization difference imaging to avoid overlaying byproducts caused by inter-reflections and multiple scattering in semitransparent tissue.

Combining Bottom-up and Top-down Generation of Interactive Knowledge Maps for Enterprise Search

Our research project develops an intranet search engine with concept- browsing functionality, where the user is able to navigate the conceptual level in an interactive, automatically generated knowledge map. This knowledge map visualizes tacit, implicit knowledge, extracted from the intranet, as a network of semantic concepts. Inductive and deductive methods are combined; a text ana- lytics engine extracts knowledge structures from data inductively, and the en- terprise ontology provides a backbone structure to the process deductively. In addition to performing conventional keyword search, the user can browse the semantic network of concepts and associations to find documents and data rec- ords. Also, the user can expand and edit the knowledge network directly. As a vision, we propose a knowledge-management system that provides concept- browsing, based on a knowledge warehouse layer on top of a heterogeneous knowledge base with various systems interfaces. Such a concept browser will empower knowledge workers to interact with knowledge structures.

Computed Ultrasound Tomography in Echo mode (CUTE) of speed of sound for diagnosis and for aberration correction in pulse-echo sonography

Sound speed as a diagnostic marker for various diseases of human tissue has been of interest for a while. Up to now, mostly transmission ultrasound computed tomography (UCT) was able to detect spatially resolved sound speed, and its promise as a diagnostic tool has been demonstrated. However, UCT is limited to acoustically transparent samples such as the breast. We present a novel technique where spatially resolved detection of sound speed can be achieved using conventional pulse-echo equipment in reflection mode. For this purpose, pulse-echo images are acquired under various transmit beam directions and a two-dimensional map of the sound speed is reconstructed from the changing phase of local echoes using a direct reconstruction method. Phantom results demonstrate that a high spatial resolution (1 mm) and contrast (0.5 % of average sound speed) can be achieved suitable for diagnostic purposes. In comparison to previous reflection-mode based methods, CUTE works also in a situation with only diffuse echoes, and its direct reconstruction algorithm enables real-time application. This makes it suitable as an addition to conventional clinical ultrasound where it has the potential to benefit diagnosis in a multimodal approach. In addition, knowledge of the spatial distribution of sound speed allows full aberration correction and thus improved spatial resolution and contrast of conventional B-mode ultrasound. © (2014) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.

A review of antithrombotic therapy and the rationale and design of the randomized edoxaban in patients with peripheral artery disease (ePAD) trial adding edoxaban or clopidogrel to aspirin after femoropopliteal endovascular intervention.

Compared with the coronary setting, knowledge about antithrombotic therapies after endovascular treatment (EVT) is inadequate in patients with peripheral artery disease (PAD). Based on a review of trials and guidelines, which is summarized in this article, there is scant evidence that antithrombotic drugs improve outcome after peripheral EVT. To address this knowledge gap, the randomized, open-label, multinational edoxaban in patients with Peripheral Artery Disease (ePAD) study (ClinicalTrials.gov identifier NCT01802775) was designed to explore the safety and efficacy of a combined regimen of antiplatelet therapy with clopidogrel and anticoagulation with edoxaban, a selective and direct factor Xa inhibitor, both combined with aspirin. As of July 2014, 203 patients (144 men; mean age 67 years) from 7 countries have been enrolled. These patients have been allocated to once-daily edoxaban [60 mg for 3 months (or 30 mg in the presence of factors associated with increased exposure)] or clopidogrel (75 mg/d for 3 months). All patients received aspirin (100 mg/d) for the 6-month duration of the study. The primary safety endpoint is major or clinically relevant nonmajor bleeding; the primary efficacy endpoint is restenosis or reocclusion at the treated segment(s) measured at 1, 3, and 6 months using duplex ultrasound scanning. All outcomes will be assessed and adjudicated centrally in a masked fashion. The ePAD study is the first of its kind to investigate a combined regimen of antiplatelet therapy and anticoagulation through factor Xa inhibition with edoxaban.

The care of adults with congenital heart disease across the globe: Current assessment and future perspective

The number of adults with congenital heart disease (CHD) has increased markedly over the past few decades as a result of astounding successes in pediatric cardiac care. Nevertheless, it is now well understood that CHD is not cured but palliated, such that life-long expert care is required to optimize outcomes. All countries in the world that experience improved survival in CHD must face new challenges inherent to the emergence of a growing and aging CHD population with changing needs and medical and psychosocial issues. Founded in 1992, the International Society for Adult Congenital Heart Disease (ISACHD) is the leading global organization of professionals dedicated to pursuing excellence in the care of adults with CHD worldwide. Recognizing the unique and varied issues involved in caring for adults with CHD, ISACHD established a task force to assess the current status of care for adults with CHD across the globe, highlight major challenges and priorities, and provide future direction. The writing committee consisted of experts from North America, South America, Europe, South Asia, East Asia, and Oceania. The committee was divided into subgroups to review key aspects of adult CHD (ACHD) care. Regional representatives were tasked with investigating and reporting on relevant local issues as accurately as possible, within the constraints of available data. The resulting ISACHD position statement addresses changing patterns of worldwide epidemiology, models of care and organization of care, education and training, and the global research landscape in ACHD.

An Analysis of the Impact of 2.0 Tools and Technologies on Organizational Processes

In this paper, the authors present results from a study on the usage rate of 2.0 tools and technologies among Spanish enterprises. The main objective of the study is to analyze, from the perceptions of executives, the influence of social software tools on a set of business processes. This analysis has been made using two graphic tools: the “2.0 Success Matrix” and the “Tool’s Footprint”. Both the review of literature and the empirical work have lead to important findings and conclusions.

KATS: A Knowledge Acquisition Tool Based on Electronic Document Processing

This paper describes a particular knowledge acquisition tool for the construction and maintenance of the knowledge model of an intelligent system for emergency management in the field of hydrology. This tool has been developed following an innovative approach directed to end-users non familiarized in computer oriented terminology. According to this approach, the tool is conceived as a document processor specialized in a particular domain (hydrology) in such a way that the whole knowledge model is viewed by the user as an electronic document. The paper first describes the characteristics of the knowledge model of the intelligent system and summarizes the problems that we found during the development and maintenance of such type of model. Then, the paper describes the KATS tool, a software application that we have designed to help in this task to be used by users who are not experts in computer programming. Finally, the paper shows a comparison between KATS and other approaches for knowledge acquisition.

Contribución al conocimiento de los primeros geotécnicos del siglo XX

Leyendo distintos artículos en la Revista de Obras Públicas (Jiménez Salas, 1945) uno recuerda a las grandes figuras como Coulomb (1773), Poncelet (1840), Rankine (1856), Culmann (1866), Mohr (1871), Boussinesq (1876) y otros muchos, que construyeron la base de un conocimiento que poco a poco irían facilitando la complicada tarea que suponía la construcción. Pero sus avances eran aproximaciones que presentaban notables diferencias frente al comportamiento de la naturaleza. Esas discrepancias con la naturaleza llegó un momento que se hicieron demasiado patentes. Importantes asientos en la construcción de los modernos edificios, rotura de presas de materiales sueltos y grandes corrimientos de tierras, por ejemplo durante la construcción del canal de Panamá, llevaron a la Sociedad Americana de Ingenieros Civiles (ASCE) a crear un comité que analizase las prácticas de la construcción de la época. Hechos similares se producían en Europa, por ejemplo en desmontes para ferrocarriles, que en el caso de Suecia supusieron unas cuantiosas perdidas materiales y humanas. El ingeniero austriaco-americano Karl Terzaghi (1883) había podido comprobar, en su práctica profesional, la carencia de conocimientos para afrontar muchos de los retos que la naturaleza ofrecía. Inicialmente buscó la respuesta en la geología pero encontró que ésta carecía de la definición necesaria para la práctica de la ingeniería, por lo que se lanzó a una denodada tarea investigadora basada en el método experimental. Comenzó en 1917 con escasos medios, pero pronto llegó a desarrollar algunos ensayos que le permitieron establecer los primeros conceptos de una nueva ciencia, la Mecánica de Suelos. Ciencia que ve la luz en 1925 con la publicación de su libro Erdbaumechanik auf bodenphysikalischer Grundlage. Rápidamente otras figuras empezaron a hacer sus contribuciones científicas y de divulgación, como es el caso del ingeniero austriaco-americano Arthur Casagrande (1902), cuya iniciativa de organizar el primer Congreso Internacional de Mecánica de Suelos e Ingeniería de Cimentaciones proporcionó el altavoz que necesitaba esa nueva ciencia para su difusión. Al mismo tiempo, más figuras internacionales se fueron uniendo a este período de grandes avances e innovadores puntos de vista. Figuras como Alec Skempton (1914) en el Reino Unido, Ralph Peck (1912) en los Estados Unidos o Laurits Bjerrum (1918) en Noruega sobresalieron entre los grandes de la época. Esta tesis investiga las vidas de estos geotécnicos, artífices de múltiples avances científicos de la nueva ciencia denominada Mecánica de Suelos. Todas estas grandes figuras de la geotecnia fueron presidentes, en distintos periodos, de la Sociedad Internacional de Mecánica de Suelos e Ingeniería de Cimentaciones. Se deja constancia de ello en las biografías que han sido elaboradas a partir de fuentes de variada procedencia y de los datos cruzados encontrados sobre estos extraordinarios geotécnicos. Así, las biografías de Terzaghi, Casagrande, Skempton, Peck y Bjerrum contribuyen no solo a su conocimiento individual sino que constituyen conjuntamente un punto de vista privilegiado para la comprensión de los acontecimientos vividos por la Mecánica de Suelos en el segundo tercio del siglo XX, extendiéndose en algunos casos hasta los albores del siglo XXI. Las aportaciones científicas de estos geotécnicos encuentran también su lugar en la parte técnica de esta tesis, en la que sus contribuciones individuales iniciales que configuran los distintos capítulos conservan sus puntos de vista originales, lo que permite tener una visión de los principios de la Mecánica de Suelos desde su mismo origen. On reading several articles in the journal, Revista de Obras Públicas (Jiménez Salas, 1945), one recalls such leading figures as Coulomb (1773), Poncelet (1840), Rankine (1856), Culmann (1866), Mohr (1871) and Boussinesq (1876) among many others, who created the basis of scientific knowledge that would make the complicated task of construction progressively easier. However, their advances were approximations which suffered considerable discrepancies when faced with the behaviour of the forces of nature. There came a time when such discrepancies became all too evident. Substantial soil settlements when constructing modern buildings, embankment dam failures and grave landslides, during the construction of the Panama Canal for example, led the American Society of Civil Engineers (ASCE) to form a committee in order to analyse construction practices of the time. Similar incidents had taken place in Europe, for example with railway slides, which in the case of Sweden, had resulted in heavy losses in both materials and human lives. During the practice of his career, the Austrian-American engineer Karl Terzaghi (1883) had encountered the many challenges posed by the forces of nature and the lack of knowledge at his disposal with which to overcome them. Terzaghi first sought a solution in geology only to discover that this lacked the necessary accuracy for the practice of engineering. He therefore threw himself into tireless research based on the experimental method. He began in 1917 on limited means but soon managed to develop several tests, which would allow him to establish the basic fundamentals of a new science; Soil Mechanics, a science which first saw the light of day on the publication of Terzaghi’s book, Erdbaumechanik auf bodenphysikalischer Grundlage. Other figures were quick to make their own scientific contributions. Such was the case of Austrian-American engineer, Arthur Casagrande (1902), whose initiative to organize the first International Congress of Soil Mechanics and Foundation Engineering provided the springboard that this science needed. At the same time, other international figures were becoming involved in this period of great advances and innovative concepts. Figures including the likes of Alec Skempton (1914) in the United Kingdom, Ralph Peck (1912) in the United States, and Laurits Bjerrum (1918) in Norway stood out amongst the greatest of their time. This thesis investigates the lives of these geotechnical engineers to whom we are indebted for a great many scientific advances in this new science known as Soil Mechanics. Moreover, each of these eminent figures held the presidency of the International Society of Soil Mechanics and Foundation Engineering, record of which can be found in their biographies, drawn from diverse sources, and by crosschecking and referencing all the available information on these extraordinary geotechnical engineers. Thus, the biographies of Terzaghi, Casagrande, Skempton, Peck and Bjerrum not only serve to provide knowledge on the individual, but moreover, as a collective, they present us with an exceptional insight into the important developments which took place in Soil Mechanics in the second third of the 20th century, and indeed, in some cases, up to the dawn of the 21st. The scientific contributions of these geotechnical engineers also find their place in the technical part of this thesis in which the initial individual contributions which make up several chapters retain their original approaches allowing us a view of the principles of Soil Mechanics from its very beginnings.

Mendel, a database of nomenclature for sequenced plant genes

The Mendel database contains names for plant-wide families of sequenced plant genes. The names have either been approved by the Commission on Plant Gene Nomenclature (CPGN), an organization of the International Society for Plant Molecular Biology (ISPMB), or are identified as provisional or temporary names. Mendel also identifies the corresponding genes in individual species of plants. Mendel can be searched through the mirror sites at Cornell (http://genome.cornell.edu/cgi-bin/WebAce/webace?db=mendel) and Stanford (http://genome-www.stanford.edu/Mendel/). In addition, parts of Mendel can be downloaded from the CPGN Web site (http://mbclserver.rutgers.edu/CPGN/).