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.

Characterizing Physical Properties of Wetting Paper by Air Coupled Ultrasound and Light

This thesis reports investigations into the paper wetting process and its effects on the surface roughness and the out-of-plane (ZD) stiffness of machine-made paper. The aim of this work was to test the feasibility of employing air-borne ultrasound methods to determine surface roughness (by reflection) and ZD stiffness (by through transmission) of paper during penetration of distilled water, isopropanol and their mixtures. Air-borne ultrasound provides a non-contacting way to evaluate sample structure and mechanics during the liquid penetration event. Contrary to liquid immersion techniques, an air-borne measurement allows studying partial wetting of paper. In addition, two optical methods were developed to reveal the liquid location in paper during wetting. The laser light through transmission method was developed to monitor the liquid location in partially wetted paper. The white light reflection method was primarily used to monitor the penetration of the liquid front in the thickness direction. In the latter experiment the paper was fully wetted. The main results of the thesis were: 1) Liquid penetration induced surface roughening was quantified by monitoring the ultrasound reflection from the paper surface. 2) Liquid penetration induced stiffness alteration in the ZD of paper could be followed by measuring the change in the ultrasound ZD resonance in paper. 3) Through transmitted light revealed the liquid location in the partially wetted paper. 4) Liquid movement in the ZD of the paper could be observed by light reflection. The results imply that the presented ultrasonic means can without contact measure the alteration of paper roughness and stiffness during liquid transport. These methods can help avoiding over engineering the paper which reduces raw material and energy consumption in paper manufacturing. The presented optical means can estimate paper specific wetting properties, such as liquid penetration speed, transport mechanisms and liquid location within the paper structure. In process monitoring, these methods allow process tuning and manufacturing of paper with engineered liquid transport characteristics. With such knowledge the paper behaviour during printing can be predicted. These findings provide new methods for paper printing, surface sizing, and paper coating research.

Macroseismology as a Component of Seismicity Assessments in an Intraplate Region: Studies of Northern Europe with Emphasis on Finland

This work focuses on the role of macroseismology in the assessment of seismicity and probabilistic seismic hazard in Northern Europe. The main type of data under consideration is a set of macroseismic observations available for a given earthquake. The macroseismic questionnaires used to collect earthquake observations from local residents since the late 1800s constitute a special part of the seismological heritage in the region. Information of the earthquakes felt on the coasts of the Gulf of Bothnia between 31 March and 2 April 1883 and on 28 July 1888 was retrieved from the contemporary Finnish and Swedish newspapers, while the earthquake of 4 November 1898 GMT is an example of an early systematic macroseismic survey in the region. A data set of more than 1200 macroseismic questionnaires is available for the earthquake in Central Finland on 16 November 1931. Basic macroseismic investigations including preparation of new intensity data point (IDP) maps were conducted for these earthquakes. Previously disregarded usable observations were found in the press. The improved collection of IDPs of the 1888 earthquake shows that this event was a rare occurrence in the area. In contrast to earlier notions it was felt on both sides of the Gulf of Bothnia. The data on the earthquake of 4 November 1898 GMT were augmented with historical background information discovered in various archives and libraries. This earthquake was of some concern to the authorities, because extra fire inspections were conducted in three towns at least, i.e. Tornio, Haparanda and Piteå, located in the centre of the area of perceptibility. This event posed the indirect hazard of fire, although its magnitude around 4.6 was minor on the global scale. The distribution of slightly damaging intensities was larger than previously outlined. This may have resulted from the amplification of the ground shaking in the soft soil of the coast and river valleys where most of the population was found. The large data set of the 1931 earthquake provided an opportunity to apply statistical methods and assess methodologies that can be used when dealing with macroseismic intensity. It was evaluated using correspondence analysis. Different approaches such as gridding were tested to estimate the macroseismic field from the intensity values distributed irregularly in space. In general, the characteristics of intensity warrant careful consideration. A more pervasive perception of intensity as an ordinal quantity affected by uncertainties is advocated. A parametric earthquake catalogue comprising entries from both the macroseismic and instrumental era was used for probabilistic seismic hazard assessment. The parametric-historic methodology was applied to estimate seismic hazard at a given site in Finland and to prepare a seismic hazard map for Northern Europe. The interpretation of these results is an important issue, because the recurrence times of damaging earthquakes may well exceed thousands of years in an intraplate setting such as Northern Europe. This application may therefore be seen as an example of short-term hazard assessment.

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.

Aerosol Particle Formation: Meteorological and Synoptic Processes behind the Event

Aerosol particles in the atmosphere are known to significantly influence ecosystems, to change air quality and to exert negative health effects. Atmospheric aerosols influence climate through cooling of the atmosphere and the underlying surface by scattering of sunlight, through warming of the atmosphere by absorbing sun light and thermal radiation emitted by the Earth surface and through their acting as cloud condensation nuclei. Aerosols are emitted from both natural and anthropogenic sources. Depending on their size, they can be transported over significant distances, while undergoing considerable changes in their composition and physical properties. Their lifetime in the atmosphere varies from a few hours to a week. New particle formation is a result of gas-to-particle conversion. Once formed, atmospheric aerosol particles may grow due to condensation or coagulation, or be removed by deposition processes. In this thesis we describe analyses of air masses, meteorological parameters and synoptic situations to reveal conditions favourable for new particle formation in the atmosphere. We studied the concentration of ultrafine particles in different types of air masses, and the role of atmospheric fronts and cloudiness in the formation of atmospheric aerosol particles. The dominant role of Arctic and Polar air masses causing new particle formation was clearly observed at Hyytiälä, Southern Finland, during all seasons, as well as at other measurement stations in Scandinavia. In all seasons and on multi-year average, Arctic and North Atlantic areas were the sources of nucleation mode particles. In contrast, concentrations of accumulation mode particles and condensation sink values in Hyytiälä were highest in continental air masses, arriving at Hyytiälä from Eastern Europe and Central Russia. The most favourable situation for new particle formation during all seasons was cold air advection after cold-front passages. Such a period could last a few days until the next front reached Hyytiälä. The frequency of aerosol particle formation relates to the frequency of low-cloud-amount days in Hyytiälä. Cloudiness of less than 5 octas is one of the factors favouring new particle formation. Cloudiness above 4 octas appears to be an important factor that prevents particle growth, due to the decrease of solar radiation, which is one of the important meteorological parameters in atmospheric particle formation and growth. Keywords: Atmospheric aerosols, particle formation, air mass, atmospheric front, cloudiness

Detecting drift from event streams of unpredictable business processes

Existing business process drift detection methods do not work with event streams. As such, they are designed to detect inter-trace drifts only, i.e. drifts that occur between complete process executions (traces), as recorded in event logs. However, process drift may also occur during the execution of a process, and may impact ongoing executions. Existing methods either do not detect such intra-trace drifts, or detect them with a long delay. Moreover, they do not perform well with unpredictable processes, i.e. processes whose logs exhibit a high number of distinct executions to the total number of executions. We address these two issues by proposing a fully automated and scalable method for online detection of process drift from event streams. We perform statistical tests over distributions of behavioral relations between events, as observed in two adjacent windows of adaptive size, sliding along with the stream. An extensive evaluation on synthetic and real-life logs shows that our method is fast and accurate in the detection of typical change patterns, and performs significantly better than the state of the art.

Analysis of Atmospheric Particle Formation Events

Atmospheric aerosol particle formation events can be a significant source for tropospheric aerosols and thus influence the radiative properties and cloud cover of the atmosphere. This thesis investigates the analysis of aerosol size distribution data containing particle formation events, describes the methodology of the analysis and presents time series data measured inside the Boreal forest. This thesis presents a methodology to identify regional-scale particle formation, and to derive the basic characteristics such as growth and formation rates. The methodology can also be used to estimate concentration and source rates of the vapour causing particle growth. Particle formation was found to occur frequently in the boreal forest area over areas covering up to hundreds of kilometers. Particle formation rates of boreal events were found to be of the order of 0.01-5 cm^-3 s^-1, while the nucleation rates of 1 nm particles can be a few orders of magnitude higher. The growth rates of over 3 nm sized particles were of the order of a few nanometers per hour. The vapor concentration needed to sustain such growth is of the order of 10^7--10^8 cm^-3, approximately one order of magnitude higher than sulphuric acid concentrations found in the atmosphere. Therefore, one has to assume that other vapours, such as organics, have a key role in growing newborn particles to sizes where they can become climatically active. Formation event occurrence shows a clear annual variation with peaks in summer and autumns. This variation is similar to the variation exhibited the obtained formation rates of particles. The growth rate, on the other hand, reaches its highest values during summer. This difference in the annual behavior, and the fact that no coupling between the growth and formation process could be identified, suggest that these processes might be different ones, and that both are needed for a particle formation burst to be observed.

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.

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.