The clinical reasoning characteristics of diagnostic experts

The aim of this study was to identify and describe the clinical reasoning characteristics of diagnostic experts. A group of 21 experienced general practitioners were asked to complete the Diagnostic Thinking Inventory (DTI) and a set of 10 clinical reasoning problems (CRPs) to evaluate their clinical reasoning. Both the DTI and the CRPs were scored, and the CRP response patterns of each GP examined in terms of the number and type of errors contained in them. Analysis of these data showed that six GPs were able to reach the correct diagnosis using significantly less clinical information than their colleagues. These GPs also made significantly fewer interpretation errors but scored lower on both the DTI and the CRPs. Additionally, this analysis showed that more than 20% of misdiagnoses occurred despite no errors being made in the identification and interpretation of relevant clinical information. These results indicate that these six GPs diagnose efficiently, effectively and accurately using relatively few clinical data and can therefore be classified as diagnostic experts. They also indicate that a major cause of misdiagnoses is failure to properly integrate clinical data. We suggest that increased emphasis on this step in the reasoning process should prove beneficial to the development of clinical reasoning skill in undergraduate medical students.

Snow characteristics in Dronning Maud Land, Antarctica

Snow cover is very sensitive to climate change and has a large feedback effect on the climate system due to the high albedo. Snow covers almost all surfaces in Antarctica and small changes in snow properties can mean large changes in absorbed radiation. In the ongoing discussion of climatic change, the mass balance of Antarctica has received increasing focus during recent decades, since its reaction to global warming strongly influences sea-level change. The aim of the present work was to examine the spatial and temporal variations in the physical and chemical characteristics of surface snow and annual accumulation rates in western Dronning Maud Land, Antarctica. The data were collected along a 350-km-long transect from the coast to the plateau during the years 1999-2004 as a part of the Finnish Antarctic Research Programme (FINNARP). The research focused on the most recent annual accumulation in the coastal area. The results show that the distance from the sea, and the moisture source, was the most predominant factor controlling the variations in both physical (conductivity, grain size, oxygen isotope ratio and accumulation) and chemical snow properties. The sea-salt and sulphur-containing components predominated in the coastal region. The local influences of nunataks and topographic highs were also visible on snow. The variations in all measured properties were wide within single sites mostly due to redistribution by winds and sastrugi topography, which reveals the importance of the spatially representative measurements. The mean accumulations occurred on the ice shelf, in the coastal region and on the plateau: 312 ± 28, 215 ± 43 and 92 ± 25 mm w.e., respectively. Depth hoar layers were usually found under the thin ice crust and were associated with a low dielectric constant and high concentrations of nitrate. Taking into account the vast size of the Antarctic ice sheet and its geographic characteristics, it is important to extend investigation of the distribution of surface snow properties and accumulation to provide well-documented data.

IMIA working group on health record banking - How complex systems can cooperate towards having individual's consolidated data

This workshop aims at discussing alternative approaches to resolving the problem of health information fragmentation, partially resulting from difficulties of health complex systems to semantically interact at the information level. In principle, we challenge the current paradigm of keeping medical records where they were created and discuss an alternative approach in which an individual's health data can be maintained by new entities whose sole responsibility is the sustainability of individual-centric health records. In particular, we will discuss the unique characteristics of the European health information landscape. This workshop is also a business meeting of the IMIA Working Group on Health Record Banking.

Thermal Characteristics of SrO-2B(2)O(3) Glasses

Transparent SrO-2B(2)O(3) (SBO) glasses were fabricated via the conventional melt-quenching technique. X-ray diffraction (XRD) and differential thermal analysis (DTA) studies carried out on the as-quenched glasses confirmed their amorphous and glassy nature, respectively. The thermal parameters were evaluated for the as-quenched glass-plates using non-isothermal DTA experiments. The average values of the activation energies for the glass transition and crystallization of these glasses were 800 +/- 10 kJ/mol and 298 +/- 10 kJ/mol respectively. The values of the kinetic parameters that were obtained by different non-isothermal techniques were in close agreement.

Vibration characteristics and damage detection in a suspension bridge

Suspension bridges are flexible and vibration sensitive structures that exhibit complex and multi-modal vibration. Due to this, the usual vibration based methods could face a challenge when used for damage detection in these structures. This paper develops and applies a mode shape component specific damage index (DI) to detect and locate damage in a suspension bridge with pre-tensioned cables. This is important as suspension bridges are large structures and damage in them during their long service lives could easily go un-noticed. The capability of the proposed vibration based DI is demonstrated through its application to detect and locate single and multiple damages with varied locations and severity in the cables of the suspension bridge. The outcome of this research will enhance the safety and performance of these bridges which play an important role in the transport network.

A genetic algorithm with characteristic amplification through multiple geographically isolated populations and varied fitness landscapes

This paper proposes a new approach, wherein multiple populations are evolved on different landscapes. The problem statement is broken down, to describe discrete characteristics. Each landscape, described by its fitness landscape is used to optimize or amplify a certain characteristic or set of characteristics. Individuals from each of these populations are kept geographically isolated from each other Each population is evolved individually. After a predetermined number of evolutions, the system of populations is analysed against a normalized fitness function. Depending on this score and a predefined merging scheme, the populations are merged, one at a time, while continuing evolution. Merging continues until only one final population remains. This population is then evolved, following which the resulting population will contain the optimal solution. The final resulting population will contain individuals which have been optimized against all characteristics as desired by the problem statement. Each individual population is optimized for a local maxima. Thus when populations are merged, the effect is to produce a new population which is closer to the global maxima.

A genetic algorithm with characteristic amplification through multiple geographically isolated populations and varied fitness landscapes

This paper proposes a new approach, wherein multiple populations are evolved on different landscapes. The problem statement is broken down, to describe discrete characteristics. Each landscape, described by its fitness landscape is used to optimize or amplify a certain characteristic or set of characteristics. Individuals from each of these populations are kept geographically isolated from each other Each population is evolved individually. After a predetermined number of evolutions, the system of populations is analysed against a normalized fitness function. Depending on this score and a predefined merging scheme, the populations are merged, one at a time, while continuing evolution. Merging continues until only one final population remains. This population is then evolved, following which the resulting population will contain the optimal solution. The final resulting population will contain individuals which have been optimized against all characteristics as desired by the problem statement. Each individual population is optimized for a local maxima. Thus when populations are merged, the effect is to produce a new population which is closer to the global maxima.

Aerosol characteristics and radiative impacts over the Arabian Sea during the intermonsoon season: Results from ARMEX field campaign

During the second phase of the Arabian Sea Monsoon Experiment (ARMEX-II), extensive measurements of spectral aerosol optical depth, mass concentration, and mass size distribution of ambient aerosols as well as mass concentration of aerosol black carbon (BC) were made onboard a research vessel during the intermonsoon period (i.e., when the monsoon winds are in transition from northeasterlies to westerlies/ southwesterlies) over the Arabian Sea (AS) adjoining the Indian Peninsula. Simultaneous measurements of spectral aerosol optical depths (AODs) were made at different regions over the adjoining Indian landmass. Mean AODs (at 500-nm wavelength) over the ocean (similar to0.44) were comparable to those over the coastal land (similar to0.47), but were lower than the values observed over the plateau regions of central Indian Peninsula (similar to0.61). The aerosol properties were found to respond distinctly with respect to change in the trajectories, with higher optical depths and flatter AOD spectra associated with trajectories indicating advection from west Asia, and northwest and west-coastal India. On average, BC constituted only similar to2.2% to total aerosol mass compared to the climatological values of similar to6% over the coastal land during the same season. These data are used to characterize the physical properties of aerosols and to assess the resulting short-wave direct aerosol forcing. The mean values were similar to27 W m(-2) at the surface and -12 W m(-2) at the top of the atmosphere (TOA), resulting in a net atmospheric forcing of +15 W m(-2). The forcing also depended on the region from where the advection predominates. The surface and atmospheric forcing were in the range -40 to -57 W m(-2) and +27 to +39 W m(-2), respectively, corresponding to advection from the west Asian and western coastal India where they were as low as -19 and +10 W m(-2), respectively, when the advection was mainly from the Bay of Bengal and from central/peninsular India. In all these cases, the net atmospheric forcing (heating) efficiency was lower than the values reported for northern Indian Ocean during northern winter, which is attributed to the reduced BC mass fraction.

Non local scale effects on ultrasonic wave characteristics nanorods

In this paper, the nonlocal elasticity theory has been incorporated into classical Euler-Bernoulli rod model to capture unique features of the nanorods under the umbrella of continuum mechanics theory. The strong effect of the nonlocal scale has been obtained which leads to substantially different wave behaviors of nanorods from those of macroscopic rods. Nonlocal Euler-Bernoulli bar model is developed for nanorods. Explicit expressions are derived for wavenumbers and wave speeds of nanorods. The analysis shows that the wave characteristics are highly over estimated by the classical rod model, which ignores the effect of small-length scale. The studies also shows that the nonlocal scale parameter introduces certain band gap region in axial wave mode where no wave propagation occurs. This is manifested in the spectrum cures as the region where the wavenumber tends to infinite (or wave speed tends to zero). The results can provide useful guidance for the study and design of the next generation of nanodevices that make use of the wave propagation properties of single-walled carbon nanotubes. (C) 2010 Elsevier B.V. All rights reserved.

Terahertz wave characteristics of a single-walled carbon nanotube containing a fluid flow using the nonlocal Timoshenko beam model

This paper presents the effect of nonlocal scaling parameter on the terahertz wave propagation in fluid filled single walled carbon nanotubes (SWCNTs). The SWCNT is modeled as a Timoshenko beam,including rotary inertia and transverse shear deformation by considering the nonlocal scale effects. A uniform fluid velocity of 1000 m/s is assumed. The analysis shows that, for a fluid filled SWCNT, the wavenumbers of flexural and shear waves will increase and the corresponding wave speeds will decrease as compared to an empty SWCNT. The nonlocal scale parameter introduces certain band gap region in both flexural and shear wave mode where no wave propagation occurs. This is manifested in the wavenumber plots as the region where the wavenumber tends to infinite (or wave speed tends to zero). The frequency at which this phenomenon occurs is called the ``escape frequency''. The effect of fluid density on the terahertz wave propagation in SWCNT is also studied and the analysis shows that as the fluid becomes denser, the wave speeds will decrease. The escape frequency decreases with increase in nonlocal scaling parameter, for both wave modes. We also show that the effect of fluid density and velocity are negligible on the escape frequencies of flexural and shear wave modes. (C) 2010 Elsevier B.V. All rights reserved.

A silicon micromachined photonic band gap cell, characteristics and an application

A novel PBG cell based on micromachining of Silicon using wet anisotropic etching has been considered. Since this is based on etching of the Silicon substrate, it is amenable to fabrication with standard Silicon processes and integration with millimeter wave circuits. We characterize this kind of PBG cell by full wave simulations using a time domain code. For the purpose of characterization, the scenario of a 50 ohm microstrip line placed on a Silicon substrate which is anisotropically etched to create patterns with sloping walls is considered. This is shown to produce the well known PBG response of stop bands in certain frequency bands. We look at the variation in the transmission coefficient (S-21) response as the number of periods, length based average fill factor and depth of micromachining are varied. One application of a low pass filter has been proposed and simulated results are given.

Conformational characteristics of asparaginyl residues in proteins

Backbone conformations at 1064 asparaginyl residues in 123 non-homologous, high-resolution X-ray structures of proteins were analysed. Asn adopts conformations in left-handed x-helical region and other partially allowed regions in the Ramachandran map more readily than any other non-glycyl residue. Asn conformational clusters in the (phi,psi) regions of left-handed alpha-helix, right-handed alpha-helix and extended (beta) strands were investigated in detail for their occurrence in various secondary structures, especially in beta-turn regions. Preferences were observed for Asn conformations in different positions in various beta-turn types, including the first and fourth positions of the turn. Asparaginyl residues with extended conformations are found to occur frequently in irregular regions, although they are expected to occur predominantly in extended strands or in the third position of type II beta-turns. Asn conformations at the N-cap positions of helices strongly prefer extended conformation than alpha(L), which seems to be characteristic of non-glycyl residues at that position. In the linkers connecting two extended strands and those connecting an alpha-helix and an extended strand, Asn with alpha(L) or alpha(R) conformation is more favoured than Asn with the beta-conformation. Analysis of Asn-Asn doublets and Asn-X-Asn triplets permitted identification of conformational families in such sequences. Results of this investigation provide useful hints in modelling Asn-rich regions in proteins such as malaria parasite coat protein. (C) Munksgaard 1994.