980 resultados para Thompson, John
Resumo:
The histological grading of cervical intraepithelial neoplasia (CIN) remains subjective, resulting in inter- and intra-observer variation and poor reproducibility in the grading of cervical lesions. This study has attempted to develop an objective grading system using automated machine vision. The architectural features of cervical squamous epithelium are quantitatively analysed using a combination of computerized digital image processing and Delaunay triangulation analysis; 230 images digitally captured from cases previously classified by a gynaecological pathologist included normal cervical squamous epithelium (n = 30), koilocytosis (n = 46), CIN 1 (n = 52), CIN 2 (n = 56), and CIN 3 (n=46). Intra- and inter-observer variation had kappa values of 0.502 and 0.415, respectively. A machine vision system was developed in KS400 macro programming language to segment and mark the centres of all nuclei within the epithelium. By object-oriented analysis of image components, the positional information of nuclei was used to construct a Delaunay triangulation mesh. Each mesh was analysed to compute triangle dimensions including the mean triangle area, the mean triangle edge length, and the number of triangles per unit area, giving an individual quantitative profile of measurements for each case. Discriminant analysis of the geometric data revealed the significant discriminatory variables from which a classification score was derived. The scoring system distinguished between normal and CIN 3 in 98.7% of cases and between koilocytosis and CIN 1 in 76.5% of cases, but only 62.3% of the CIN cases were classified into the correct group, with the CIN 2 group showing the highest rate of misclassification. Graphical plots of triangulation data demonstrated the continuum of morphological change from normal squamous epithelium to the highest grade of CIN, with overlapping of the groups originally defined by the pathologists. This study shows that automated location of nuclei in cervical biopsies using computerized image analysis is possible. Analysis of positional information enables quantitative evaluation of architectural features in CIN using Delaunay triangulation meshes, which is effective in the objective classification of CIN. This demonstrates the future potential of automated machine vision systems in diagnostic histopathology. Copyright (C) 2000 John Wiley and Sons, Ltd.
Resumo:
Volume III of the new eleven-volume edition of Milton's Complete Works provides a definitive scholarly edition of all of Milton's shorter poems in English, Latin, Italian, and Greek, as well as his Mask, taken from both published and manuscript sources. It includes his 1645 Poems complete with all prefatory materials, thus illuminating the ways in which author, publisher, and print shop shaped this volume. It then presents all the new poems added in the 1673 edition (with the new Table of Contents), as well as the poems omitted from both editions. A careful collation of textual variants among these sources as well as the 1637 anonymous publication of Milton's Mask is provided. The Bridgewater manuscript of Milton's Mask (probably close to the acting version) and his working copy from the Trinity Manuscript, with its many alterations and additions, are transcribed in their entirety, so that the various versions may be compared and studied.
A special feature of this edition is a new translation of Milton's many Latin and Greek poems that is both accurate and attentive to their literary qualities. This is augmented by a detailed and comprehensive commentary that highlights classical, vernacular, and neo-Latin parallels. A poetic translation of Milton's six Italian sonnets and Canzone is also supplied. In addition, the Appendices contain all the versions of Milton's shorter poems in all the contemporary manuscript and printed sources, so they may be examined in relation to their specific contexts. The transcription of all the versions of Milton's poems in the Trinity Manuscript allows in several cases, notably 'Lycidas' and 'At a Solemn Music,' for examination of the evolution of these poems as Milton weighed choiced of diction and sound qualities, enabling further understanding of his poetic practices.
Barbara Lewalski is responsible for text, textual apparatus, and commentary pertaining to the vernacular poems in all sections of this edition including the appendices, and manuscript transcriptions (with the exception of A Maske), as well as the Occasions, Vernacular Poems,and Textual Introductions. Estelle Haan is responsible for text, textual apparatus, and commentary for the Poemata in all sections of this edition,and for the Poemata Introduction. She has also provided all translations from Latin, Italian, and Greek in the Testimonia, Poemata, and associated commentary, and transcriptions of the BL Damon, the Bodleian AdJoannem Rousium, and A Maske from the Trinity and Bridgewater manuscripts. Andrew McNeillie has provided poetic translations for Milton’s Italian sonnets, and Jason Rosenblatt has provided some Hebrew text and commentary pertaining to Milton’s Psalm translations.John Cunningham has transcribed Henry Lawes’ music for Milton’s masque, with commentary (Appendix E). Biblical references are taken from the King James (Authorized) Version.
Resumo:
Background
Over the past ten years MRSA has become endemic in hospitals and is associated with increased healthcare costs. Critically ill patients are most at risk, in part because of the number of invasive therapies that they require in the intensive care unit (ICU). Washing with 5% tea tree oil (TTO) has been shown to be effective in removing MRSA on the skin. However, to date, no trials have evaluated the potential of TTO body wash to prevent MRSA colonization or infection. In addition, detecting MRSA by usual culture methods is slow. A faster method using a PCR assay has been developed in the laboratory, but requires evaluation in a large number of patients.
Methods/Design
This study protocol describes the design of a multicentre, phase II/III prospective open-label randomized controlled clinical trial to evaluate whether a concentration of 5% TTO is effective in preventing MRSA colonization in comparison with a standard body wash (Johnsons Baby Softwash) in the ICU. In addition we will evaluate the cost-effectiveness of TTO body wash and assess the effectiveness of the PCR assay in detecting MRSA in critically ill patients. On admission to intensive care, swabs from the nose and groin will be taken to screen for MRSA as per current practice. Patients will be randomly assigned to be washed with the standard body wash or TTO body wash. On discharge from the unit, swabs will be taken again to identify whether there is a difference in MRSA colonization between the two groups.
Discussion
If TTO body wash is found to be effective, widespread implementation of such a simple colonization prevention tool has the potential to impact on patient outcomes, healthcare resource use and patient confidence both nationally and internationally.
Trial Registration
[ISRCTN65190967]
