Diagnostic performance on briefly presented digital pathology images

Background: Identifying new and more robust assessments of proficiency/expertise (finding new "biomarkers of expertise") in histopathology is desirable for many reasons. Advances in digital pathology permit new and innovative tests such as flash viewing tests and eye tracking and slide navigation analyses that would not be possible with a traditional microscope. The main purpose of this study was to examine the usefulness of time-restricted testing of expertise in histopathology using digital images.
Methods: 19 novices (undergraduate medical students), 18 intermediates (trainees), and 19 experts (consultants) were invited to give their opinion on 20 general histopathology cases after 1 s and 10 s viewing times. Differences in performance between groups were measured and the internal reliability of the test was calculated.
Results: There were highly significant differences in performance between the groups using the Fisher's least significant difference method for multiple comparisons. Differences between groups were consistently greater in the 10-s than the 1-s test. The Kuder-Richardson 20 internal reliability coefficients were very high for both tests: 0.905 for the 1-s test and 0.926 for the 10-s test. Consultants had levels of diagnostic accuracy of 72% at 1 s and 83% at 10 s.
Conclusions: Time-restricted tests using digital images have the potential to be extremely reliable tests of diagnostic proficiency in histopathology. A 10-s viewing test may be more reliable than a 1-s test. Over-reliance on "at a glance" diagnoses in histopathology is a potential source of medical error due to over-confidence bias and premature closure.

PTF11iqb: cool supergiant mass-loss that bridges the gap between Type IIn and normal supernovae

PTF11iqb was initially classified as a TypeIIn event caught very early after explosion. It showed narrow Wolf-Rayet (WR) spectral features on day 2, but the narrow emission weakened quickly and the spectrum morphed to resemble those of Types II-L and II-P. At late times, Halpha emission exhibited a complex, multipeaked profile reminiscent of SN1998S. In terms of spectroscopic evolution, we find that PTF11iqb was a near twin of SN~1998S, although with weaker interaction with circumstellar material (CSM) at early times, and stronger CSM interaction at late times. We interpret the spectral changes as caused by early interaction with asymmetric CSM that is quickly (by day 20) enveloped by the expanding SN ejecta photosphere, but then revealed again after the end of the plateau when the photosphere recedes. The light curve can be matched with a simple model for weak CSM interaction added to the light curve of a normal SN~II-P. This plateau requires that the progenitor had an extended H envelope like a red supergiant, consistent with the slow progenitor wind speed indicated by narrow emission. The cool supergiant progenitor is significant because PTF11iqb showed WR features in its early spectrum --- meaning that the presence of such WR features in an early SN spectrum does not necessarily indicate a WR-like progenitor. [abridged] Overall, PTF11iqb bridges SNe~IIn with weaker pre-SN mass loss seen in SNe II-L and II-P, implying a continuum between these types.

Preparing assessments and examinations. Common errors and good practice.

Assessment forms an important part of the student learning experience and students place a high value on the quality of feedback that they receive from academic staff on where they might improve on their examinations or assignments. However while feedback is important the quality of the actual assessment itself before students undertake an examination or commence writing an assignment is also important. It is imperative that students are clear in their understanding of what is expected of them in order to achieve a particular grade and that there is lack of ambiguity in examinations or assignments. Biggs (2003) highlighted the importance of clarity in what students are expected to be able to do at the end of a unit of study, and that intended learning outcomes should be clearly aligned to the assessment and communicated to students so that they can structure their learning activities to optimize their assessment performance. However as Rust (2002) highlighted there are often inconsistencies in assessment practices ranging from a mis-match of assessment and learning outcomes to the inclusion of additional learning criteria and lack of clarity in the instructions. Such inconsistencies and unacceptable errors in examination papers can undermine student confidence in the assessment process
In order to try and minimise such inconsistencies an internal assessment group was set up October 2013 within the School of Nursing and Midwifery at Queens University Belfast, consisting of representative academic staff from across the range of undergraduate and post graduate courses in nursing and midwifery. The assessment group was to be a point of reference for all school examinations with a particular remit to develop an assessment strategy for all nursing and midwifery programmes and to ensure that all assessments comply with current best practice and with Nursing and Midwifery Council (NMC) requirements.
Aim
This paper aims to highlight some examples of good practice and common errors that were found in assignments and examinations that were submitted to the assessment group for review.
References

Biggs. J. (2003) Teaching for Quality Learning at University – What the Student Does 2nd Edition SRHE / Open University Press, Buckingham.
Rust, C.( 2002) The impact of assessment on student learning, Active Learning in Higher education Vol3(2):145-158

An evaluation of the effectiveness of an algorithm intervention in reducing inappropriate faecal samples sent for Clostridium difficile testing.

Background: Clostridium difficile (C. difficile) is a leading cause of infectious diarrhoea in hospitals. Sending faecal samples for testing expedites diagnosis and appropriate treatment. Clinical suspicion of C. difficile based on patient history, signs and symptoms is the basis for sampling. Sending faecal samples from patients with diarrhoea ‘just in case’ the patient has C. difficile may be an indication of poor clinical management.

Aim: To evaluate the effectiveness of an intervention by an Infection Prevention and Control Team (IPCT) in reducing inappropriate faecal samples sent for C. difficile testing.

Method: An audit of numbers of faecal samples sent before and after a decision-making algorithm was introduced. The number of samples received in the laboratory was retrospectively counted for 12-week periods before and after an algorithm was introduced.
Findings: There was a statistically significant reduction in the mean number of faecal samples sent post the algorithm. Results were compared to a similar intervention carried out in 2009 in which the same message was delivered by a memorandum. In 2009 the memorandum had no effect on the overall number of weekly samples being sent.

Conclusion: An algorithm intervention had an effect on the number of faecal samples being sent for C. difficile testing and thus contributed to the effective use of the laboratory service.

Evaluation of an improved atomic data basis for carbon in UEDGE emission modeling for L-mode plasmas in DIII-D

New scaled carbon atomic electron-impact excitation data is utilized to evaluate comparisons between experimental measurements and fluid emission modeling of detached plasmas at DIII-D. The C I and C II modeled emission lines for 909.8 and 514.7 nm were overestimated by a factor of 10-20 than observed experimentally for the inner leg, while the outer leg was within a factor of 2. Due to higher modeled emissions, a previous study using the UEDGE code predicted that a higher amount of carbon was required to achieve a detached outboard divertor plasma in L-mode at DIII-D. The line emission predicted by using the new scaled carbon data yields closer results when compared against experiment. We also compare modeling and measurements of Dα emission from neutral deuterium against predictions from newly calculated R-Matrix with pseudostates data available at the ADAS database. © 2013 Published by Elsevier B.V.

Continuing the fight in reducing the risk of surgical site infections in the perioperative environment

Assessing risk has become part of the process of supporting patients andmaintaining safety in the healthcare setting. The risk of healthcare associatedinfections (HCAIs) has long been well documented and surgical site infection (SSI)is recognised as one of the most prevalent (Tanner & Khan 2008, Wilson 2013a).

Narrative Personae and Visual Signs: Reading Leonard’s intimate photo-memoir. a/b: Auto/Biography Studies.

: In this paper, I look at Joanne Leonard’s Being in Pictures and engage in a critical dialogue with an assemblage of visual and textual narratives that comprise her intimate photo memoir. In doing this I draw on Hannah Arendt’s take on narratives as tangible traces of uniqueness and plurality, political traits par excellence in the cultural histories of the human condition. Being aware of my role as a reader/viewer/interpreter of a woman artist’s auto/biographical narratives, I move beyond dilemmas of representation or questions of unveiling “the real Leonard”. The artist is instead configured as a narrative persona, whose narratives respond to three interrelated themes of inquiry, namely the visualization of spatial technologies, vulnerability and the gendering of memory. Key words: gendered memories, narrative persona, spatial technologies, photo memoir, vulnerability

As rela��ões interpessoais, stress e grau de satisfa��ão da assistência domiciliária nos enfermeiros e cuidadores informais

Disserta��ão de mest., Psicologia (Psicologia da Sa��de), Faculdade de Ciências Humanas e Sociais, Univ. do Algarve, 2011

An Evening of Opera Excerpts November 22, 23, 1971

Concert program for An Evening of Opera Excerpts, Nov 22, 23, 1971

Migration, Space and Transnational Identities: The British in South Africa

This timely text explores the lives, histories and identities of white British-born immigrants in South Africa, twenty years after the post-apartheid Government took office. Drawing on over sixty in depth biographical interviews and ethnographic work in Johannesburg, Pietermaritzburg and Cape Town, Daniel Conway and Pauline Leonard analyse how British immigrants' relate to, participate in and embody South Africa's complex racial and political history. Through their everyday lives, political and social attitudes, relationships with the places and spaces of South Africa, as well as their expectations of the future, the complexities of their transnational, raced and classed identities and senses of belonging are revealed. Migration, Space and Transnational Identities makes an important contribution to sociological, geographical, political and anthropological debates on transnational migration, whiteness, Britishness and lifestyle, tourism and labour migration.

La Cène ou la figure du banquet comme image de crise morale chez Zeng Fanzhi

Les yeux et les masques sont prévalents dans les oeuvres du peintre chinois contemporain Zeng Fanzhi (né en 1964), comme métaphore du jeu de pouvoir qui oppose les individus à l’appareil social et politique. Son oeuvre La Cène, d’après Leonard de Vinci, est un exemple frappant de cette préoccupation. Cet essai examine l’utilisation par l’artiste de cette représentation occidentale d’une crise morale (une trahison qui mène à la mort du Christ) pour exprimer la dystopie qui marque la Chine contemporaine. L’interprétation par Zeng de l’oeuvre de Vinci témoigne d’une compréhension profonde de sa signification à la Renaissance comme conflit entre le pouvoir terrestre et spirituel, auquel il surimpose la fonction du banquet dans la culture chinoise comme lieu de lutte politique. Un nihilisme détaché imprègne ce travail, à l’instar de l’interprétation métaphorique du banquet de Platon par Søren Kierkegaard, In Vino Veritas.

Subgroup-specific structural variation across 1,000 medulloblastoma genomes.

Medulloblastoma, the most common malignant paediatric brain tumour, is currently treated with nonspecific cytotoxic therapies including surgery, whole-brain radiation, and aggressive chemotherapy. As medulloblastoma exhibits marked intertumoural heterogeneity, with at least four distinct molecular variants, previous attempts to identify targets for therapy have been underpowered because of small samples sizes. Here we report somatic copy number aberrations (SCNAs) in 1,087 unique medulloblastomas. SCNAs are common in medulloblastoma, and are predominantly subgroup-enriched. The most common region of focal copy number gain is a tandem duplication of SNCAIP, a gene associated with Parkinson's disease, which is exquisitely restricted to Group 4α. Recurrent translocations of PVT1, including PVT1-MYC and PVT1-NDRG1, that arise through chromothripsis are restricted to Group 3. Numerous targetable SCNAs, including recurrent events targeting TGF-β signalling in Group 3, and NF-κB signalling in Group 4, suggest future avenues for rational, targeted therapy.

"Adversaria" du ministre protestant de Larroque.

Note autographe "Ce manuscrit est un recueil original des lectures de feu M. de Larroque un des plus habiles ministres protestans du 17e siecle, sur plusieurs matieres ecclesiastiques, escrit de sa propre main. C'est Mr. son fils, qui ne luy cede en rien pour la doctrine, et qui a eu le bonheur d'embrasser la religion catholique encore jeune, qui m'en fit present le 8 novembre 1704. Fr. Leonard A. d. M. priez Dieu pour moy" (2)

Français 33

Contient : 1° « Decades de TITUS LIVIUS », traduction de « PIERRE BERCEUR » ; 2° Immédiatement après la première décade : « Le Livre de la première guerre punique, que fist et compilla un notable clere d'Ytallie, nommé maistre LEONARD DE ARETIO (L'ARETIN), en l'an mil.CCCCXLV. ou environ » ; traduction de « JEHAN LEVESQUE »

Recueil de lettres et de pièces originales, et de copies de pièces indiquées comme telles dans le dépouillement qui suit.

Contient : 1 Lettre de « l'advoyé et conseil de la ville de Berne... au roy tres cristien [François Ier]... Datum VIIa junii, anno etc. XXVI° » ; 2 Lettre du roi d'Angleterre « HENRY [VIII]... à... nostre... tres amé frere... le roy Françoys [Ier] de France... Escripte à nostre manoir de Grenewiche, le IIIIme jour de january, l'an mil V.C.XXVI » ; 3 Lettre du roi d'Angleterre « HENRY [VIII]... à nostre tres cher et grand amy, le grand maistre de France... Donné à nostre chasteau de Wyndesore, le XXXe jour de may, l'an XV.C.XXIX » ; 4 Lettre de « Dom JOHAM [III]... rey de Portugual... ao muito homrado et manifiquo Memoransy, gram mestre del rey de Framça... Esprita em Lixboa, a vinte e tres dias de jungo de 1530 » ; 5 Lettre latine des « universe Helvetiorum lige Alemanie superioris oratores in Lucerna congregati... serenissimo domino duci et excellentissimis dominis senatoribus reipublice Venetorum... Datum in universali dieta Lucerne, celebrata die primo februarii, anno M.V.C.XXIIII » ; 6 Lettre de « l'advoyé et conseil de la ville de Berne... à monseigneur... le mareschal de Montmarancy,... Donné ce VIII de mars, anno etc. XXVI° » ; 7 Lettre de « CHARLES DE BOURBON [duc DE VENDOME]... à mon cousin monseigneur le grant maistre... De La Fere, le XIIIme de novembre » ; 8 Lettre de « PHILIPPES,... duc DE NEMOUX,... à monseigneur le grand maestre mon nepveu... De Blandy, ce XXIIe de juing » ; 9 Lettre de « P. DE VILLERS L'YLE ADAM,... à monseigneur... le mareschal de Montmorency,... De Viterbe, le IIII d'octobre » ; 10 Lettre de « CLAUDE [DE LORRAINE, duc DE GUISE]... à monseigneur le grant maistre... Escript à Esclaron, le XXVIII° jour d'apvril » ; 11 Lettre de P. DE VILLERS L'YLE ADAM,... maistre de Rhoddes... à monseigneur le grand maistre... De Corneto, le dernier de jung » ; 12 Lettre du maréchal DE « CHABANNES,... à monseigneur le mareschal de Montmorency,... A La Palisse, ce XXVe jour de novembre » ; 13 « Coppie des lettres de l'Empereur au pape, touchant la convocation du concile » ; 14 Requête du « duc DE LONGUEVILLE,... au roy » ; 15 « Estat de compaignies de gens d'ordonnance desquelles le roy nostre sire a ordonné estre faict monstre et paiement pour deux quartiers le XXme du mois d'aoust » ; 16 Lettre de « P. CLERMONT, P[IERRE FILLEUL], arcevesque d'Aix, GUYON DE CLERMONT, DE PONCHIER, TESTU, FILZET, R. DEMAZIS », députés des états du Languedoc, « à monseigneur... le grant maistre, gouverneur et lieutenant general du roy en Languedoc » ; 17 Lettre de « JEHAN DE LEVIS,... à monseigneur... le grand maistre... Escript à Carcassonne, le Xme jour de decembre » ; 18 Lettre de « D'HUMIERES, SAINT ANDRÉ, RENÉ DE COSSÉ,... à monseigneur... le grant maistre... De Moussay, ce dimanche matin » ; 19 « Responce faicte par madame l'archiduchesse, le VIIIe jour de mars... à... l'ambassadeur du roy tres chrestien » ; 20 Lettre de « PERRENOT,... à messrs de Lanette et Des Nouvelles,... De Valladolid, le XXVe de mars 1537 » ; 21 Lettre du parlement de Toulouse, signée : « DE BORRASSOT,... Au roy... Escript à Thoulouse... le XVIme jour de juillet » ; 22 Lettre du parlement de Toulouse, signée : « DE BORRASSOT,... à monseigneur... de Montmorency, grant maistre de France, gouverneur et lieutenant general du roy en Languedoc... Escript à Thoulouse... le VIIe jour de mars » ; 23 Lettre du parlement de Toulouse, signée : « DE BORRASSOT,... à monseigneur... le grant maistre de France... Escript à Thoulouse... le VIIe jour de septembre » ; 24 Lettre de « l'advoyé et conseill de la ville de Frybourg » au roi François Ier. « Datum XXVIIa jullii, anno etc. XXX° » ; 25 Sauf-conduit délivré par « Paulus,... episcopus Curiensis... domino de Rochapet,... Datum in civitate Curiensi, nona die mensis jullii, anno etc. vicesimo secundo » ; 26 Lettre de « l'advoyé et conseill de la ville de Frybourg... à monseigneur... le grand maistre... Datum XXVIIa septembris, anno etc. XXX° » ; 27 Lettre de « l'advoyé, petit et grant conseil de la ville de Frybourg... à monseigneur... le grand maistre de France... Cest le XVIIIe de febvrier, anno etc. XXVII° » ; 28 Lettre latine des « magne lige Alamanie superioris oratores... domino de Momoransi et Rosciapot, mareschallo Francie... Ex urbe Bernensi... octava die augusti, anno etc. XXIII° » ; 29 Lettre des « orateurs des ligues, au lieu de Nostre-Dame des Hermites assemblez... à... monseigneur le grand maistre... Escript à Lucerne... l'an mil V.C. et XXVIII, le VIIIe jour d'aoust » ; 30 Lettre de « l'advoyé et conseyl de la ville de Frybourg... à... monseigneur le grandt maystre... Datum XXVIIa septembris, anno etc. XXX° » ; 31 Lettre, en latin, de « MATHIAS GARUNCKS, minister seu judex generalis lige grise... domino marxiallo de Franzia, domino de Memoranzy,... Datum ex Jantho in liga grisa, die octava mensis februarii, anno 1524 » ; 32 « Ordonnance » du roi FRANÇOIS II « pour la publication de la monstre en robbe de la gendarmerye pour le quartier de juillet, aoust et septembre 1559 » ; 33 Lettre de « MONTEJEHAN,... à monseigneur... le grant maistre... Escript au camp prez Turin, ce Xme jour de may » ; 34 Lettre de M. D'«HUMYERES,... à ma fille, madame de La Rochepot,... De Parnay, ce vendredy XXVIme jour de septembre » ; 35 Compte des espèces fournies « par le general de Normandie... es mains de... Le Coincte et Guilhen,... ce jourduy dernier jour... de may... à Bayonne » ; 36 Lettre de « SUPERSAX,... à monseigneur... le grant maistre de France... C'est à Sion, le jour Sanct Thomas l'apostre » ; 37 Lettre, en italien, de « JOANNI ANTONIO URSINO,... allo illustrissimo... gran maestro di Francia... Ex castro nostro Insule, 9 junii 1535 » ; 38 Lettre, en italien, de « GREGORIO CASALE,... allo illustrissimo... gran maestro di Franza... Di Bologna, alli II di novembre M.D.XXVIII » ; 39 Lettre, en italien, de « LEONARD PIUMBO,... a lo illustrissimo... monsignore lo gran mastro... De Casale, XX octobre 1530 » ; 40 Lettre, en italien, de « GUILLEAUME DUBELLAY et JOACHIN DE VAULX,... al illustrissimo... gran maestro de Francia... Da Londra, XVIII septembre M.D.XXX » ; 41 Lettre, en italien, de « GREGORIO CASALE,... allo illustrissimo... mons. lo gran mastro di Francia... Di Bologna, alli XIII di decembre M.D.XXIX » ; 42 Lettre, en italien, de « GREGORIO CASALE,... allo illustrissimo... mons. lo gran mastro di Francia... In Bologna, alli XXIII di dicembre M.D.XXIX » ; 43 Lettre, en italien, de « GREGORIO CASALE,... al illustrissimo... gran maestro di Franza... Di Bologna, alli XXIII di ottobre M.D.XVIII » ; 44 Lettre, en italien, de « JOHANNES, episcopus Staphileus... all' illustrissimo... mons. il gran maestro de Franza... De Viterbo, alli 2 de juglio 1528 » ; 45 « Advis de Florence... a di 30 di marzo 1530... Copia » ; 46 Lettre, en italien, de « GREGORIO CASALE,... allo illustrissimo... gran mastro... D'Orviecto, alli XXIII di maggio M.D.XXVIII ». Suivie de la « copia di lettera di un secretario del duca di Ferrara al conte Roberto Buschera, ambassadore del duca appresso N. S., alli XVIII di maggio » ; 47 Lettre de « GALEATIO VESCONTE,... al signore gran maestro... In Parixe, a li 5 de mazo 1528 »