An integrated system for 3D hip joint reconstruction from 2D X-rays: a preliminary validation study

The acquisition of conventional X-ray radiographs remains the standard imaging procedure for the diagnosis of hip-related problems. However, recent studies demonstrated the benefit of using three-dimensional (3D) surface models in the clinical routine. 3D surface models of the hip joint are useful for assessing the dynamic range of motion in order to identify possible pathologies such as femoroacetabular impingement. In this paper, we present an integrated system which consists of X-ray radiograph calibration and subsequent 2D/3D hip joint reconstruction for diagnosis and planning of hip-related problems. A mobile phantom with two different sizes of fiducials was developed for X-ray radiograph calibration, which can be robustly detected within the images. On the basis of the calibrated X-ray images, a 3D reconstruction method of the acetabulum was developed and applied together with existing techniques to reconstruct a 3D surface model of the hip joint. X-ray radiographs of dry cadaveric hip bones and one cadaveric specimen with soft tissue were used to prove the robustness of the developed fiducial detection algorithm. Computed tomography scans of the cadaveric bones were used to validate the accuracy of the integrated system. The fiducial detection sensitivity was in the same range for both sizes of fiducials. While the detection sensitivity was 97.96% for the large fiducials, it was 97.62% for the small fiducials. The acetabulum and the proximal femur were reconstructed with a mean surface distance error of 1.06 and 1.01 mm, respectively. The results for fiducial detection sensitivity and 3D surface reconstruction demonstrated the capability of the integrated system for 3D hip joint reconstruction from 2D calibrated X-ray radiographs.

Patient satisfaction and nursing staff work satisfaction in an urban public teaching hospital

This study examined the level of patient satisfaction and nursing staff work satisfaction at an urban public hospital in the Southwestern United States. The primary objectives of this study were to determine: (1) the level of overall patient satisfaction and satisfaction with specific dimensions of hospital care; (2) the differences in patient satisfaction according to demographic characteristics (age, gender, ethnicity, and education completed) and predispositional factors (perceived health status, perceived level of pain, prior contact with the hospital, and hospital image) and the relative importance of each variable on patient satisfaction; (3) the level of overall work satisfaction and satisfaction with specific dimensions of work experienced by the medical/surgical nursing staff; (4) the differences in work satisfaction experienced by the nursing staff based on demographic variables (age, gender, ethnicity, and marital status) and professional factors (education completed, staff position, the number of years employed with the hospital, and number of years employed in nursing) and the relative importance of each variable on work satisfaction; and (5) to determine the effect of the nursing work milieu on patient and staff satisfaction.^ The study findings showed that patients experienced a moderate to low level of satisfaction with the dimensions of hospital care (admission process, daily care, information, nursing care, physician care, other hospital staff, living arrangements, and overall care). Of the eight dimensions of care, patients reported a relatively positive level of satisfaction (75 percent or better) with only one dimension: physician care. Ethnicity, perceived health status, and hospital image were significantly related to patient satisfaction. Hispanic patients, those who were in good health, and those who felt the hospital had a good image in their community were most satisfied with hospital care. Patients also reported areas of hospital care that needed the most improvement. Responses included: rude staff, better nursing care, and better communication.^ Findings from the nursing satisfaction survey indicated a low level of satisfaction with the dimensions of work (autonomy, pay, professional status, interaction, task requirements, and organizational policies). Only one dimension of work, professional status, received a mean satisfaction score in the positive range. Additionally, staff members were unanimously dissatisfied with their salaries. Frequently mentioned work-related problems reported by the staff included: staffing shortages, heavy patient loads. and excessive paperwork.^ The nursing milieu appeared to have had a significant effect on the satisfaction levels of patients nursing staff employees. The nursing staff were often short staffed, which increased the patient-to-nurse ratio. Consequently, patients did not receive the amount of attention and care they expected from the nursing staff. Crowded patient rooms allowed for little personal space and privacy. Dissatisfaction with living conditions served to influence patients' attitudes and satisfaction levels. These frustrations were often directed toward their primary caregivers, the nursing staff. Consequently, the nursing milieu appeared to directly affect and influence the satisfaction levels of both patients and staff. (Abstract shortened by UMI). ^

Knowledge, beliefs, risk behaviors, and social skills for HIV/STD prevention in junior college students (grades 11--12) in Bombay, India

1230 year 11 and 12 college students, modal age 16 and 17, in three colleges in Bombay, India, were studied on sexual behaviors or risk of sexual behaviors, beliefs about sex, HIV/STD knowledge, perceived norms regarding sexual behaviors, and the relationships between social skills/anxieties in HIV/STD prevention and actual and anticipated sexual behaviors. A quantitative questionnaire examining HIV/STD risk behaviors, knowledge, attitudes and beliefs, and the AIDS Social Assertiveness Scale (ASAS) were administered to these 1230 college students. Data indicated that 8% of males and 1% of females had had sexual experience, but over one third were not sure at all of being able to abstain from sexual activity with either steady or casual partners. Perceived norms were slanted toward sexual abstinence for the majority of the sample. Knowledge of protective effects of condoms was high, although half of those who had had sex did not use condoms. Logistic regression showed knowledge was higher among males, those who believed it was OK to have sex with a steady partner and that they should not wait until they were older, those who believed that condoms should be used even if the partner is known, and those who believed it was acceptable to have multiple partners. Gender differences in sexual activity and beliefs about sexual activity showed males were less likely to believe in abstaining from sexual activity. The 5 scales of the ASAS were scored and compared on ANOVA on: those who had had sexual experience (HS), those who anticipated being unable to refuse sex (AS), and those who did not anticipate problems in refusing sex (DS). Those in the AS group had greater anxieties about refusing sexual or other risk behaviors than HS and DS groups. There were greater anxieties about dealing with condoms in the AS and DS groups compared with the HS group. Confiding sexual or HIV/STD-related problems to significant others was more anxiety-provoking for the AS group compared with the HS group, and the AS group were more anxious about interactions with people with HIV. Factor analysis produced the same 5 factors as those found in previous studies. Of these, condom interactions and confiding in significant others were most anxiety provoking, and condom interactions most variable based on demographic and attitudinal factors.^ This age group is appropriate for HIV/STD reduction education given the low rate of sexual activity but despite knowledge of the importance of condom use, social skills to apply this knowledge are lacking. Social skills training in sexual negotiations, condom negotiations, and confiding HIV/STD-related concerns to significant others should reduce the risks of Indian college students having unwanted or unprotected sex. ^

HIV und Komorbidität

Antiretroviral therapy (ART) has improved quality of life and increased life expectancy of HIV-infected individuals. Opportunistic diseases are less common, and mortality has declined. Consequently, patterns of mortality and morbidity are changing among the HIV-positive population. The focus of care has shifted to ART-related problems and to various non-AIDS diseases. Such comorbidities, often occurring sequentially or concurrently, may be the consequences of long term ART toxicity, a state of chronic inflammation due to HIV infection, lifestyle-related risks for disease, and aging. The emergence of non-AIDS related conditions highlights the important role of primary care physicians, especially of those with extensive experience in HIV management.

Quality of life after pulmonary embolism: validation of the French version of the PEmb-QoL questionnaire.

BackgroundThe PEmb-QoL is a validated 40-item questionnaire to quantify health-related quality of life in patients having experienced pulmonary embolism (PE). It covers six health dimensions: frequency of complaints, activities of daily living limitations, work-related problems, social limitations, intensity of complaints, and emotional complaints. Originally developed in Dutch and English, we sought to prospectively validate the psychometric properties of a French version of the PEmb-QoL.MethodsWe performed a forward and backward translation of the English version of the PEmb-QoL into French. French-speaking consecutive adult patients with an acute, objectively confirmed PE admitted to the emergency department of a Swiss university hospital between 08/2009 and 09/2011 were recruited telephonically. We used standard psychometric tests and criteria to evaluate the acceptability, reliability, and validity of the French version of the PEmb-QoL. We also performed an exploratory factor analysis.ResultsOverall, 102 patients were enrolled in the study. The French version of the PEmb-QoL showed good reliability (internal consistency, item¿total and inter-item correlations), reproducibility (test-retest reliability), and validity (convergent, discriminant) in French-speaking patients with PE. The exploratory factor analysis suggested three underlying dimensions: limitations in daily activity (items 4b-m, 5a-d), symptoms (items 1a-h and 7), and emotional complaints (items 9a-f and j).ConclusionWe successfully validated the French version of the PEmb-QoL questionnaire in patients with PE. Our results show that the PEmb-QoL is a valuable tool for assessing health-related quality of life after PE in French-speaking patients.

Quality of life after pulmonary embolism: Prospective validation of the German version of the PEmb-QoL questionnaire.

BACKGROUND The Pulmonary Embolism Quality of Life questionnaire (PEmb-QoL) is a 40-item questionnaire to measure health-related quality of life in patients with pulmonary embolism. It covers six 6 dimensions: frequency of complaints, limitations in activities of daily living, work-related problems, social limitations, intensity of complaints, and emotional complaints. Originally developed in Dutch and English, we prospectively validated a German version of the PEmb-QoL. METHODS A forward-backward translation of the English version of the PEmb-QoL into German was performed. German-speaking consecutive adult patients aged ≥18 years with an acute, objectively confirmed pulmonary embolism discharged from a Swiss university hospital (01/2011-06/2013) were recruited telephonically. Established psychometric tests and criteria were used to evaluate the acceptability, reliability, and validity of the German PEmb-QoL questionnaire. To assess the underlying dimensions, an exploratory factor analysis was performed. RESULTS Overall, 102 patients were enrolled in the study. The German version of the PEmb-QoL showed a good internal consistency (Cronbach's alpha ranging from 0.72 to 0.96), item-total (0.53-0.95) and inter-item correlations (>0.4), and test-retest reliability (intra-class correlation coefficients 0.59-0.89) for the dimension scores. A moderate correlation of the PEmb-QoL with SF-36 dimension and summary scores (0.21-0.83) indicated convergent validity, while low correlations of PEmb-QoL dimensions with clinical characteristics (-0.16-0.37) supported discriminant validity. The exploratory factor analysis suggested four underlying dimensions: limitations in daily activities, symptoms, work-related problems, and emotional complaints. CONCLUSION The German version of the PEmb-QoL questionnaire is a valid and reliable disease-specific measure for quality of life in patients with pulmonary embolism.

BAYESIAN STATISTICAL METHODS IN GENE-ENVIRONMENT AND GENE-GENE INTERACTION STUDIES

Complex diseases such as cancer result from multiple genetic changes and environmental exposures. Due to the rapid development of genotyping and sequencing technologies, we are now able to more accurately assess causal effects of many genetic and environmental factors. Genome-wide association studies have been able to localize many causal genetic variants predisposing to certain diseases. However, these studies only explain a small portion of variations in the heritability of diseases. More advanced statistical models are urgently needed to identify and characterize some additional genetic and environmental factors and their interactions, which will enable us to better understand the causes of complex diseases. In the past decade, thanks to the increasing computational capabilities and novel statistical developments, Bayesian methods have been widely applied in the genetics/genomics researches and demonstrating superiority over some regular approaches in certain research areas. Gene-environment and gene-gene interaction studies are among the areas where Bayesian methods may fully exert its functionalities and advantages. This dissertation focuses on developing new Bayesian statistical methods for data analysis with complex gene-environment and gene-gene interactions, as well as extending some existing methods for gene-environment interactions to other related areas. It includes three sections: (1) Deriving the Bayesian variable selection framework for the hierarchical gene-environment and gene-gene interactions; (2) Developing the Bayesian Natural and Orthogonal Interaction (NOIA) models for gene-environment interactions; and (3) extending the applications of two Bayesian statistical methods which were developed for gene-environment interaction studies, to other related types of studies such as adaptive borrowing historical data. We propose a Bayesian hierarchical mixture model framework that allows us to investigate the genetic and environmental effects, gene by gene interactions (epistasis) and gene by environment interactions in the same model. It is well known that, in many practical situations, there exists a natural hierarchical structure between the main effects and interactions in the linear model. Here we propose a model that incorporates this hierarchical structure into the Bayesian mixture model, such that the irrelevant interaction effects can be removed more efficiently, resulting in more robust, parsimonious and powerful models. We evaluate both of the 'strong hierarchical' and 'weak hierarchical' models, which specify that both or one of the main effects between interacting factors must be present for the interactions to be included in the model. The extensive simulation results show that the proposed strong and weak hierarchical mixture models control the proportion of false positive discoveries and yield a powerful approach to identify the predisposing main effects and interactions in the studies with complex gene-environment and gene-gene interactions. We also compare these two models with the 'independent' model that does not impose this hierarchical constraint and observe their superior performances in most of the considered situations. The proposed models are implemented in the real data analysis of gene and environment interactions in the cases of lung cancer and cutaneous melanoma case-control studies. The Bayesian statistical models enjoy the properties of being allowed to incorporate useful prior information in the modeling process. Moreover, the Bayesian mixture model outperforms the multivariate logistic model in terms of the performances on the parameter estimation and variable selection in most cases. Our proposed models hold the hierarchical constraints, that further improve the Bayesian mixture model by reducing the proportion of false positive findings among the identified interactions and successfully identifying the reported associations. This is practically appealing for the study of investigating the causal factors from a moderate number of candidate genetic and environmental factors along with a relatively large number of interactions. The natural and orthogonal interaction (NOIA) models of genetic effects have previously been developed to provide an analysis framework, by which the estimates of effects for a quantitative trait are statistically orthogonal regardless of the existence of Hardy-Weinberg Equilibrium (HWE) within loci. Ma et al. (2012) recently developed a NOIA model for the gene-environment interaction studies and have shown the advantages of using the model for detecting the true main effects and interactions, compared with the usual functional model. In this project, we propose a novel Bayesian statistical model that combines the Bayesian hierarchical mixture model with the NOIA statistical model and the usual functional model. The proposed Bayesian NOIA model demonstrates more power at detecting the non-null effects with higher marginal posterior probabilities. Also, we review two Bayesian statistical models (Bayesian empirical shrinkage-type estimator and Bayesian model averaging), which were developed for the gene-environment interaction studies. Inspired by these Bayesian models, we develop two novel statistical methods that are able to handle the related problems such as borrowing data from historical studies. The proposed methods are analogous to the methods for the gene-environment interactions on behalf of the success on balancing the statistical efficiency and bias in a unified model. By extensive simulation studies, we compare the operating characteristics of the proposed models with the existing models including the hierarchical meta-analysis model. The results show that the proposed approaches adaptively borrow the historical data in a data-driven way. These novel models may have a broad range of statistical applications in both of genetic/genomic and clinical studies.

Subjective well -being as predictor of mortality, heart disease, and obesity: Prospective evidence from the Alameda County Study

Based on the World Health Organization's (1965) definition of health, understanding of health requires understanding of positive psychological states. Subjective Well-being (SWB) is a major indicator of positive psychological states. Up to date, most studies of SWB have been focused on its distributions and determinants. However, study of its consequences, especially health consequences, is lacking. This dissertation research examined Subjective Well-being, as operationally defined by constructs drawn from the framework of Positive Psychology, and its sub-scores (Positive Feelings and Negative Feelings) as predictors of three major health outcomes—mortality, heart disease, and obesity. The research used prospective data from the Alameda County Study over 29 years (1965–1994), based on a stratified, randomized, representative sample of the general public in Alameda County, California (Baseline N = 6928). ^ Multivariate analyses (Survival analyses using sequential Cox Proportional Hazard models in the cases of mortality and heart disease, and sequential Logistic Regression analyses in the case of obesity) were performed as the main methods to evaluate the associations of the predictors and the health outcomes. The results revealed that SWB reduced risks of all-cause mortality, natural-cause mortality, and cardiovascular mortality. Positive feelings not only had an even stronger protective effect against all-cause, natural-cause and cardiovascular mortality, but also predicted decreased unnatural-cause mortality which includes deaths from suicide, homicide, accidents, mental disorders, drug dependency, as well as alcohol-related liver diseases. These effects were significant even after adjusted for age, gender, education, and various physical health measures, and, in the case of cardiovascular mortality, obesity and health practices (alcohol consumption, smoking, and physical activities). However, these two positive psychological indicators, SWB and positive feelings, did not predict obesity. And negative feelings had no significant effect on any of the health outcomes evaluated, i.e., all-cause mortality, natural- and unnatural-cause mortality, cardiovascular mortality, or obesity, after covariates were controlled. These findings were discussed (1) in comparison with relevant existing studies, (2) in terms of their implications in health research and promotion, (3) in terms of the independence of positive and negative feelings, and (4) from a Positive Psychology perspective and its significance in Public Health research and practice. ^

Text Comprehension And roduction in University Students: Text Reformulation

This paper sets out to report on findings about features of task-specific reformulation observed in university students in the middle stretch of the Psychology degree course (N=58) and in a reference group of students from the degree courses in Modern Languages, Spanish and Library Studies (N=33) from the National University of La Plata (Argentina). Three types of reformulation were modeled: summary reformulation, comprehensive and productive reformulation.The study was based on a corpus of 621 reformulations rendered from different kinds of text. The versions obtained were categorised according to the following criteria: presence or absence of normative, morphosyntactic and semantic difficulties. Findings show that problems arise particularly with paraphrase and summary writing. Observation showed difficulties concerning punctuation, text cohesion and coherence , and semantic distortion or omission as regards extracting and/or substituting gist, with limited lexical resources and confusion as to suitability of style/register in writing. The findings in this study match those of earlier, more comprehensive research on the issue and report on problems experienced by a significant number of university students when interacting with both academic texts and others of a general nature. Moreover, they led to questions, on the one hand, as to the nature of such difficulties, which appear to be production-related problems and indirectly account for inadequate text comprehension, and on the other hand, as to the features of university tuition when it comes to text handling.

Text Comprehension And roduction in University Students: Text Reformulation

This paper sets out to report on findings about features of task-specific reformulation observed in university students in the middle stretch of the Psychology degree course (N=58) and in a reference group of students from the degree courses in Modern Languages, Spanish and Library Studies (N=33) from the National University of La Plata (Argentina). Three types of reformulation were modeled: summary reformulation, comprehensive and productive reformulation.The study was based on a corpus of 621 reformulations rendered from different kinds of text. The versions obtained were categorised according to the following criteria: presence or absence of normative, morphosyntactic and semantic difficulties. Findings show that problems arise particularly with paraphrase and summary writing. Observation showed difficulties concerning punctuation, text cohesion and coherence , and semantic distortion or omission as regards extracting and/or substituting gist, with limited lexical resources and confusion as to suitability of style/register in writing. The findings in this study match those of earlier, more comprehensive research on the issue and report on problems experienced by a significant number of university students when interacting with both academic texts and others of a general nature. Moreover, they led to questions, on the one hand, as to the nature of such difficulties, which appear to be production-related problems and indirectly account for inadequate text comprehension, and on the other hand, as to the features of university tuition when it comes to text handling.

Text Comprehension And roduction in University Students: Text Reformulation

This paper sets out to report on findings about features of task-specific reformulation observed in university students in the middle stretch of the Psychology degree course (N=58) and in a reference group of students from the degree courses in Modern Languages, Spanish and Library Studies (N=33) from the National University of La Plata (Argentina). Three types of reformulation were modeled: summary reformulation, comprehensive and productive reformulation.The study was based on a corpus of 621 reformulations rendered from different kinds of text. The versions obtained were categorised according to the following criteria: presence or absence of normative, morphosyntactic and semantic difficulties. Findings show that problems arise particularly with paraphrase and summary writing. Observation showed difficulties concerning punctuation, text cohesion and coherence , and semantic distortion or omission as regards extracting and/or substituting gist, with limited lexical resources and confusion as to suitability of style/register in writing. The findings in this study match those of earlier, more comprehensive research on the issue and report on problems experienced by a significant number of university students when interacting with both academic texts and others of a general nature. Moreover, they led to questions, on the one hand, as to the nature of such difficulties, which appear to be production-related problems and indirectly account for inadequate text comprehension, and on the other hand, as to the features of university tuition when it comes to text handling.

The lead salt quantum dot intermediate band solar cell

We propose a new kind of quantum dot (QD) materials for the implementation of the intermediate band solar cell (IBSC) [1]. The materials are formed by lead salt QDs of the family IV-VI (PbTe, PbSe or PbS) embedded in a semiconductor of the family II-VI (Cd1-xMgxTe, CdxZn1-xTe, and CdS1-xSex or ZnSe1-xTex, respectively). These QDs are not nucleated due to lattice mismatch, as it is the case of the InAs/GaAs QD material system grown by the Stranski-Krastanov (S-K) mode. In these materials, the QDs precipitate due to the difference in lattice type: the QD lead salt material crystallizes in the rocksalt structure, while the II-VI host material has the zincblende structure [2]. Therefore, it is possible to use lattice-matched QD/host combinations, avoiding all the strain-related problems found in previous QD-IBSC developments. In this paper we discuss the properties of the lead salt QD materials and propose that they are appropriate to overcome the fundamental drawbacks of present III-V-based QD-IBSC prototypes. We also calculate the band diagram for some examples of IV-VI/II-VI QD materials. The detailed balance efficiency limit of QD-IBSCs based on the studied materials is found to be over 60% under maximum concentration.

Wireless Optical Communications for Intra-Spacecraft Networks Based on OCDMA with Random Optical Codes

In recent years, spacial agencies have shown a growing interest in optical wireless as an alternative to wired and radio-frequency communications. The use of these techniques for intra-spacecraft communications reduces the effect of take-off acceleration and vibrations on the systems by avoiding the need for rugged connectors and provides a significant mass reduction. Diffuse transmission also eases the design process as terminals can be placed almost anywhere without a tight planification to ensure the proper system behaviour. Previous studies have compared the performance of radio-frequency and infrared optical communications. In an intra-satellite environment optical techniques help reduce EMI related problems, and their main disadvantages - multipath dispersion and the need for line-of-sight - can be neglected due to the reduced cavity size. Channel studies demonstrate that the effect of the channel can be neglected in small environments if data bandwidth is lower than some hundreds of MHz.

Numerical simulation of tangling in jet engine turbines

The numerical analysis of certain safety related problems presents serious difficulties, since the large number of components present leads to huge finite elementmodels that can only be solved by using large and expensive computers or by making rough approaches to the problem. Tangling, or clashing, in the turbine of a jet engine airplane is an example of such problems. This is caused by the crash and friction between rotor and stator blades in the turbine after an eventual shaft failure. When facing the study of an event through numerical modelling, the accurate simulation of this problem would require the engineer to model all the rotor and stator blades existing in the turbine stage, using a small element size in all pieces. Given that the number of stator and rotor blades is usually around 200, such simulations would require millions of elements. This work presents a new numerical methodology, specifically developed for the accurate modelling of the tangling problem that, depending on the turbine configuration, is able to reduce the number of nodes up to an order of magnitude without losing accuracy. The methodology, which benefits from the cyclic configuration of turbines, is successfully applied to the numerical analysis of a hypothetical tangling event in a turbine, providing valuable data such as the rotating velocity decrease of the turbine, the braking torque and the damage suffered by the blades. The methodology is somewhat general and can be applied to any problem in which damage caused by the interaction between a rotating and static piece is to be analysed.

Don't blame the economists. It is an inverse problem!

The seriousness of the current crisis urgently demands new economic thinking that breaks the austerity vs. deficit spending circle in economic policy. The core tenet of the paper is that the most important problems that natural and social science are facing today are inverse problems, and that a new approach that goes beyond optimization is necessary. The approach presented here is radical in the sense that it identifies the roots in key assumptions in economic theory such as optimal behavior and stability to provide an inverse thinking perspective to economic modeling, of use in economic and financial stability policy. The inverse problem provides a truly multidisciplinary platform where related problems from different disciplines can be studied under a common approach with comparable results.