Assessing distractors and teamwork during surgery: developing an event-based method for direct observation

OBJECTIVE: To develop a behavioural observation method to simultaneously assess distractors and communication/teamwork during surgical procedures through direct, on-site observations; to establish the reliability of the method for long (>3 h) procedures. METHODS: Observational categories for an event-based coding system were developed based on expert interviews, observations and a literature review. Using Cohen's κ and the intraclass correlation coefficient, interobserver agreement was assessed for 29 procedures. Agreement was calculated for the entire surgery, and for the 1st hour. In addition, interobserver agreement was assessed between two tired observers and between a tired and a non-tired observer after 3 h of surgery. RESULTS: The observational system has five codes for distractors (door openings, noise distractors, technical distractors, side conversations and interruptions), eight codes for communication/teamwork (case-relevant communication, teaching, leadership, problem solving, case-irrelevant communication, laughter, tension and communication with external visitors) and five contextual codes (incision, last stitch, personnel changes in the sterile team, location changes around the table and incidents). Based on 5-min intervals, Cohen's κ was good to excellent for distractors (0.74-0.98) and for communication/teamwork (0.70-1). Based on frequency counts, intraclass correlation coefficient was excellent for distractors (0.86-0.99) and good to excellent for communication/teamwork (0.45-0.99). After 3 h of surgery, Cohen's κ was 0.78-0.93 for distractors, and 0.79-1 for communication/teamwork. DISCUSSION: The observational method developed allows a single observer to simultaneously assess distractors and communication/teamwork. Even for long procedures, high interobserver agreement can be achieved. Data collected with this method allow for investigating separate or combined effects of distractions and communication/teamwork on surgical performance and patient outcomes.

Object-Based Customization of Learning Content: Potentials and Pitfalls

Specification consortia and standardization bodies concentrate on e-Learning objects to en-sure reusability of content. Learning objects may be collected in a library and used for deriv-ing course offerings that are customized to the needs of different learning communities. How-ever, customization of courses is possible only if the logical dependencies between the learn-ing objects are known. Metadata for describing object relationships have been proposed in several e-Learning specifications. This paper discusses the customization potential of e-Learning objects but also the pitfalls that exist if content is customized inappropriately.

A full pedigree based method for the statistical assessment of genetic anticipation

Genetic anticipation is defined as a decrease in age of onset or increase in severity as the disorder is transmitted through subsequent generations. Anticipation has been noted in the literature for over a century. Recently, anticipation in several diseases including Huntington's Disease, Myotonic Dystrophy and Fragile X Syndrome were shown to be caused by expansion of triplet repeats. Anticipation effects have also been observed in numerous mental disorders (e.g. Schizophrenia, Bipolar Disorder), cancers (Li-Fraumeni Syndrome, Leukemia) and other complex diseases. ^ Several statistical methods have been applied to determine whether anticipation is a true phenomenon in a particular disorder, including standard statistical tests and newly developed affected parent/affected child pair methods. These methods have been shown to be inappropriate for assessing anticipation for a variety of reasons, including familial correlation and low power. Therefore, we have developed family-based likelihood modeling approaches to model the underlying transmission of the disease gene and penetrance function and hence detect anticipation. These methods can be applied in extended families, thus improving the power to detect anticipation compared with existing methods based only upon parents and children. The first method we have proposed is based on the regressive logistic hazard model. This approach models anticipation by a generational covariate. The second method allows alleles to mutate as they are transmitted from parents to offspring and is appropriate for modeling the known triplet repeat diseases in which the disease alleles can become more deleterious as they are transmitted across generations. ^ To evaluate the new methods, we performed extensive simulation studies for data simulated under different conditions to evaluate the effectiveness of the algorithms to detect genetic anticipation. Results from analysis by the first method yielded empirical power greater than 87% based on the 5% type I error critical value identified in each simulation depending on the method of data generation and current age criteria. Analysis by the second method was not possible due to the current formulation of the software. The application of this method to Huntington's Disease and Li-Fraumeni Syndrome data sets revealed evidence for a generation effect in both cases. ^

Benthic cover map of Heron Reef derived from a high-spatial-resolution multi-spectral satellite image using object based image analysis

Providing accurate maps of coral reefs where the spatial scale and labels of the mapped features correspond to map units appropriate for examining biological and geomorphic structures and processes is a major challenge for remote sensing. The objective of this work is to assess the accuracy and relevance of the process used to derive geomorphic zone and benthic community zone maps for three western Pacific coral reefs produced from multi-scale, object-based image analysis (OBIA) of high-spatial-resolution multi-spectral images, guided by field survey data. Three Quickbird-2 multi-spectral data sets from reefs in Australia, Palau and Fiji and georeferenced field photographs were used in a multi-scale segmentation and object-based image classification to map geomorphic zones and benthic community zones. A per-pixel approach was also tested for mapping benthic community zones. Validation of the maps and comparison to past approaches indicated the multi-scale OBIA process enabled field data, operator field experience and a conceptual hierarchical model of the coral reef environment to be linked to provide output maps at geomorphic zone and benthic community scales on coral reefs. The OBIA mapping accuracies were comparable with previously published work using other methods; however, the classes mapped were matched to a predetermined set of features on the reef.

Toward Multi-Scale Object-Based Data Fusion

This paper proposes a new methodology for object based 2-D data fu- sion, with a multiscale character. This methodology is intended to be use in agriculture, specifically in the characterization of the water status of different crops, so as to have an appropriate water management at a farm-holding scale. As a first approach to its evaluation, vegetation cover vigor data has been integrated with texture data. For this purpose, NDVI maps have been calculated using a multispectral image and Lacunarity maps from the panchromatic image. Preliminary results show this methodology is viable in the integration and management of large volumes of data, which characterize the behavior of agricultural covers at farm-holding scale.

Multiscale object-based classification of satellite images merging multispectral information with panchromatic textural features

Once admitted the advantages of object-based classification compared to pixel-based classification; the need of simple and affordable methods to define and characterize objects to be classified, appears. This paper presents a new methodology for the identification and characterization of objects at different scales, through the integration of spectral information provided by the multispectral image, and textural information from the corresponding panchromatic image. In this way, it has defined a set of objects that yields a simplified representation of the information contained in the two source images. These objects can be characterized by different attributes that allow discriminating between different spectral&textural patterns. This methodology facilitates information processing, from a conceptual and computational point of view. Thus the vectors of attributes defined can be used directly as training pattern input for certain classifiers, as for example artificial neural networks. Growing Cell Structures have been used to classify the merged information.

A knowledge-based method for generating summaries of spatial movement in geographic areas

In this article we describe a method for automatically generating text summaries of data corresponding to traces of spatial movement in geographical areas. The method can help humans to understand large data streams, such as the amounts of GPS data recorded by a variety of sensors in mobile phones, cars, etc. We describe the knowledge representations we designed for our method and the main components of our method for generating the summaries: a discourse planner, an abstraction module and a text generator. We also present evaluation results that show the ability of our method to generate certain types of geospatial and temporal descriptions.

A PCR-based method for discriminating between high molecular weight glutenin subunits Bx7 and Bx7* in Triticum aestivum L

The correct assignment of high molecular weight glutenin subunit variants is a key task in wheat breeding. However, the traditional analysis by protein electrophoresis is sometimes difficult and not very precise. This work describes a novel DNA marker for the accurate discrimination between the Glu-B1 locus subunits Bx7 and Bx7*. The analysis of one hundred and forty two bread wheat cultivars from different countries has highlighted a great number of misclassifications in the literature that could lead to wrong conclusions in studies of the relationship between glutenin composition and wheat quality.

Spatial and thematic assessment of object- based forest stands delineation using OFA-matrix

Validación de la cartografía generada del terreno a partir de una nuevo sistema de validación propuesto

Object-based image analysis for mapping Natura 2000 habitats.

Clasificación de una imagen de alta resolución "Quickbird" con la técnica de análisis de imágenes en base a objetos.

A study of a soft computing based method for 3D scenario reconstruction

Several recent works deal with 3D data in mobile robotic problems, e.g., mapping. Data comes from any kind of sensor (time of flight, Kinect or 3D lasers) that provide a huge amount of unorganized 3D data. In this paper we detail an efficient approach to build complete 3D models using a soft computing method, the Growing Neural Gas (GNG). As neural models deal easily with noise, imprecision, uncertainty or partial data, GNG provides better results than other approaches. The GNG obtained is then applied to a sequence. We present a comprehensive study on GNG parameters to ensure the best result at the lowest time cost. From this GNG structure, we propose to calculate planar patches and thus obtaining a fast method to compute the movement performed by a mobile robot by means of a 3D models registration algorithm. Final results of 3D mapping are also shown.

A PCR based method to detect Russula spp. in soil samples and Limodorum abortivum roots in Mediterranean environments

Aim of study. Orchidaceae has the largest number of species of any family in the plant kingdom. This family is subject to a high risk of extinction in natural environments, such as natural parks and protected areas. Recent studies have shown the prevalence of many species of orchids to be linked to fungal soil diversity, due to their myco-heterotrophic behaviour. Plant communities determine fungal soil diversity, and both generate optimal conditions for orchid development. Area of study. The work was carried out in n the two most important natural parks in Alicante (Font Roja and Sierra Mariola), in South-eastern of Spain. Material and Methods. We designed a molecular tool to monitor the presence of Russula spp. in soil and orchids roots, combined with phytosociological methods. Main results. Using a PCR-based method, we detected the presence in the soil and Limodorum abortivum orchid roots of the mycorrhizal fungi Russula spp. The species with highest coverage was Quercus rotundifolia in areas where the orchid was present. Research highlights. We present a useful tool based on PCR to detect the presence of Russula spp. in a natural environment. These results are consistent with those obtained in different studies that linked the presence of the mycorrhizal fungi Russula spp. in roots of the species Limodorum and the interaction between these fungal species and Quercus ilex trees in Mediterranean forest environments.