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PubMedDate not supplied

Improvement of accuracy in a high-capacity, six degree-of-freedom load cell: application to robotic testing of musculoskeletal joints.

This study investigated a previously unaccounted for source of error in a high-capacity, six degree-of-freedom load cell used in multi-degree-of-freedom robotic testing of musculoskeletal joints, an application requiring a load cell with high accuracy in addition to high load capacity. A method of calibration is presented for reducing the error caused by changes in universal force-moment sensor (UFS) orientation within a gravitational field. Uncorrected, this error can exceed a magnitude of 1% of the full-scale load capacity-the manufacturer-stated accuracy of the UFS. Implementation of the calibration protocol reduced this error by approximately 75% for a variety of loading conditions. This improvement in load cell accuracy (while maintaining full load capacity) should improve both the measurement and control of specimen kinetics by robotic/UFS and other biomechanical testing systems.

Bias↗
PubMed2001

Linear degrees of freedom in speech production: analysis of cineradio- and labio-film data and articulatory-acoustic modeling.

The following contribution addresses several issues concerning speech degrees of freedom in French oral vowels, stop, and fricative consonants based on an analysis of tongue and lip shapes extracted from cineradio- and labio-films. The midsagittal tongue shapes have been submitted to a linear decomposition where some of the loading factors were selected such as jaw and larynx position while four other components were derived from principal component analysis (PCA). For the lips, in addition to the more traditional protrusion and opening components, a supplementary component was extracted to explain the upward movement of both the upper and lower lips in [v] production. A linear articulatory model was developed; the six tongue degrees of freedom were used as the articulatory control parameters of the midsagittal tongue contours and explained 96% of the tongue data variance. These control parameters were also used to specify the frontal lip width dimension derived from the labio-film front views. Finally, this model was complemented by a conversion model going from the midsagittal to the area function, based on a fitting of the midsagittal distances and the formant frequencies for both vowels and consonants.

Cineradiography↗
PubMed2005

Freedom from atrial tachyarrhythmias after catheter ablation of atrial fibrillation: a randomized comparison between 2 current ablation strategies.

BACKGROUND: Data on the comparative value of the circumferential pulmonary vein and the segmental pulmonary vein ablation for interventional treatment of atrial fibrillation are limited. We hypothesized that the circumferential pulmonary vein ablation approach was superior to the segmental pulmonary vein ablation approach. METHODS AND RESULTS: One hundred patients with highly symptomatic atrial fibrillation were randomly assigned to undergo either circumferential (n=50) or segmental pulmonary vein ablation (n=50). Freedom from atrial tachyarrhythmias in a 7-day Holter monitoring at 6 months was the primary end point. Secondary end points were freedom of arrhythmia-related symptoms and a composite of pericardial tamponade, thromboembolic complications, and pulmonary vein stenosis (safety end point). On the basis of the results of the 7-day Holter monitoring at 6 months, 21 patients (42%) after circumferential pulmonary vein ablation and 33 patients (66%) after segmental pulmonary vein ablation (P=0.02) were free of atrial tachyarrhythmia episodes. During the 6-month follow-up period, 27 patients (54%) after circumferential pulmonary vein ablation and 41 patients (82%) after segmental pulmonary vein ablation remained free of arrhythmia-related symptoms (P<0.01). No significant difference was found in the safety end point (6 versus 7 events; P=0.77) in the circumferential versus segmental pulmonary vein ablation group, respectively. CONCLUSIONS: This study demonstrates no superiority of the circumferential pulmonary vein ablation over segmental pulmonary vein ablation for treatment of atrial fibrillation in terms of efficacy and safety.

Aged↗
PubMed2005

A survey of mental health leaders one year after the President's New Freedom Commission report.

As part of the 19th annual Rosalynn Carter Symposium on Mental Health Policy, held in 2003, an anonymous online survey of symposium participants was conducted to gain insight into participants' perceptions of the impact on their organizations of the President's New Freedom Commission and its recommendations. The participants were national mental health leaders representing a broad range of mental health agencies and organizations. The results of the survey suggest that the New Freedom Commission has had a substantial impact on the organizations represented at the symposium. Findings on successes and challenges in implementing the recommendations suggest areas for ongoing efforts to transform mental health care.

Administrative Personnel↗
PubMed2002

Patient, therapist, and supervisor in a psychiatric institution: inner freedom and inner structure.

The authors discuss issues concerning the psychotherapeutic process in a psychiatric institution. They develop the concept of the institution as an internalized object in addition to its being an objective object. As such, it has an effect on the inner freedom and the internal structure of the patient, the therapist, and the supervisor. It is claimed that it is crucial for the development of an identity as a psychotherapist that the supervisor be aware of the institution as an inner and real object. The authors raise questions about what kind of "space" is possible in a psychiatric institution and what influence that may have on the therapeutic process. The impact on the therapist's professional identity is discussed. They point to the process of becoming a therapist via supervision and examine some relevant dilemmas. The authors conclude by discussing the duality of inner freedom and internal structure, and their specific manifestations within an institution.

Health Facility Environment↗
PubMed2006

The 6 degrees of freedom kinematics of the knee after anterior cruciate ligament deficiency: an in vivo imaging analysis.

BACKGROUND: Previous studies of knee joint function after anterior cruciate ligament deficiency have focused on measuring anterior-posterior translation and internal-external rotation. Few studies have measured the effects of anterior cruciate ligament deficiency on 6 degrees of freedom knee kinematics in vivo. OBJECTIVE: To measure the 6 degrees of freedom knee kinematics of patients with anterior cruciate ligament deficiency. STUDY DESIGN: Controlled laboratory study. METHODS: The knee joint kinematics of 8 patients with unilateral anterior cruciate ligament rupture was measured during a quasi-static lunge. Kinematics was measured from full extension to 90 degrees of flexion using imaging and 3-dimensional modeling techniques. The healthy, contralateral knee of each patient served as a control. RESULTS: Anterior cruciate ligament deficiency caused a statistically significant anterior shift (approximately 3 mm) and internal rotation of the tibia (approximately 2 degrees ) at low flexion angles. However, ligament deficiency also caused a medial translation of the tibia (approximately 1 mm) between 15 degrees and 90 degrees of flexion. CONCLUSION: The medial shift of the tibia after anterior cruciate ligament deficiency might alter contact stress distributions in the tibiofemoral cartilage near the medial tibial spine. These findings correlate with the observation that osteoarthritis in patients with anterior cruciate ligament injuries is likely to occur in this region. CLINICAL RELEVANCE: The data from this study suggest that future anterior cruciate ligament reconstruction techniques should reproduce not only anterior stability but also medial-lateral stability.

Adult↗
PubMed2005

Suicidal tendencies and attitude towards freedom to choose suicide among Lithuanian schoolchildren: results from three cross-sectional studies in 1994, 1998, and 2002.

BACKGROUND: Suicidal behaviour is increasingly becoming a phenomenon associated with young people and an important public health issue in Lithuania. However, there are very few studies evaluating impact of young peoples' attitudes towards suicide to their suicidal behaviour. A better understanding of the relations among the variables associated with suicidal ideation and threats in the normal population of adolescents may eventually result in a better understanding of the more serious forms of adolescent suicidal behaviour. The aim of the present study was to evaluate prevalence of suicidal tendencies among Lithuanian schoolchildren and to estimate its association with an attitude towards suicide in 1994-2002. METHODS: Three country representative samples of schoolchildren, aged 11, 13 and 15, were surveyed in 1994 (n = 5,428), 1998 (n = 4,513), and 2002 (n = 5,645) anonymously in conformity with the methodology of the World Health Organization Cross--National study on Health Behaviour in School-aged Children (HBSC). RESULTS: About one third of respondents reported about suicidal ideation, plans or attempts to commit suicide. In the study period of eight years, the percentage of adolescents who reported sometime suicidal ideation decreased but the percentage of adolescents who declared serious suicidal behaviour remained on the same high level (8.1%, 9.8% and 8.4% correspondingly in 1994, 1998 and 2002). Moreover, the number of suicidal attempts changed from 1.0% in 1994 to 1.8% in the year 1998 and to 1,7% in the year 2002. The schoolchildren's attitude towards suicide became more agreeable: 36.6%, 41.9% and 62.5% of respondents, correspondingly in 1994, 1998 and 2002, answered that they agree with a person's freedom to make a choice between life and suicide. A multiple logistic regression analysis with low level of suicidality and high level of suicidality versus non suicidal behaviour as dependent variables for gender, age, year of the survey and attitude towards freedom to choose suicide as independent variables approved a significant association between studied covariates over the entire study period. CONCLUSION: Suicidal tendencies are quite frequent among Lithuanian adolescents. An increasing number of schoolchildren are expressing an agreeable attitude towards suicide. The approving attitude towards suicide among adolescents correlates with suicidal ideation and behaviour.

Adolescent↗
PubMed2005

Presentation, diagnoses, mechanisms of injury, and treatment of soldiers injured in Operation Iraqi Freedom: an epidemiological study conducted at two military pain management centers.

UNLABELLED: In recent military conflicts the major source of soldier attrition has not been battle injuries but more mundane causes similar to those encountered in civilian life. In an effort to determine the pain conditions affecting soldiers during wartime, we conducted an observational study among 162 soldiers medically evacuated from Operation Iraqi Freedom who were referred to 2 large pain treatment centers located outside the theaters of combat. Fifty-three percent of soldiers presented with either radicular (n = 49) or axial (n = 37) low back pain, with lumbar herniated disk being the most frequently diagnosed condition (24%). The two most implicated etiologies were exacerbation of a previous pain condition treated with surgery (15%) and motor vehicle accidents(12%). Only 17% of patients were injured during battle. Seventy-two percent of soldiers received at least one nerve block/injection, the most common of which was lumbar epidural steroid administration (22%). Nonsteroidal antiinflammatory drugs were prescribed to 56% of patients, opioids to 49%, and some form of alternative therapy to 17%. Among the 49 patients in whom data were available, only 2% returned to combat duty in Iraq. With the exception of battle-related injuries, the pain conditions suffered during modern warfare seem to be similar to those encountered in civilian pain clinics. To improve the return-to-duty rate, better preventive measures and more aggressive treatment conducted in forward-deployed medical units are recommended. IMPLICATIONS: We conducted an observational study at two large military pain treatment centers among soldiers injured in Operation Iraqi Freedom. Fifty-three percent of soldiers presented with low back pain, with lumbar herniated disk being the most common diagnosis. Only 2% of patients returned to combat duty in Iraq. To improve the return-to-duty rate, better preventive measures and more aggressive treatment in forward-deployed medical units are recommended.

Adult↗
PubMed2004

Six-degrees-of-freedom alignment technique that provides diagnostic misalignment information.

We introduce a new six-degrees-of-freedom alignment technique that enables the precise alignment of two optical device planes. The method combines linear diffraction gratings and cylindrical Fresnel lenses that allow the diagnosis of misalignment in each degree of freedom independently. The technique was used to align two 20 mm x 20 mm fused-silica substrates separated by 17 mm. The worst-case alignment precision was found to be better than +/- 5 microm laterally, +/- 20 microm longitudinally, +/- 0.036 degrees rotationally, and +/- 0.007degrees in tilt.

Journal Article↗
PubMed2000

Branch-point reconstruction in laser beam projection through turbulence with finite-degree-of-freedom phase-only wave-front correction.

Wave-front sensing and deformable mirror control algorithms in adaptive optics systems are designed on the premise that a continuous phase function exists in the telescope pupil that can be conjugated with a deformable mirror for the purpose of projecting a laser beam. However, recent studies of coherent wave propagation through turbulence have shown that under conditions where scintillation is not negligible, a truly continuous phase function does not in general exist as a result of the presence of branch points in the complex optical field. Because of branch points and the associated branch cuts, least-squares wave-front reconstruction paradigms can have large errors. We study the improvement that can be obtained by implementing wave-front reconstructors that can sense the presence of branch points and reconstruct a discontinuous phase function in the context of a laser beam projection system. This study was conducted by fitting a finite-degree-of-freedom deformable mirror to branch-point and least-squares reconstructions of the phase of the beacon field, propagating the corrected field to the beacon plane, and evaluating performance in the beacon plane. We find that the value of implementing branch-point reconstructors with a finite-degree-of-freedom deformable mirror is significant for optical paths that cause saturated log-amplitude fluctuations.

Atmosphere↗
PubMed2000

Electromagnetic degrees of freedom of an optical system

We present a rigorous electromagnetic formalism for defining, evaluating, and optimizing the degrees of freedom of an optical system. The analysis is valid for the delivery of information with electromagnetic waves under arbitrary boundary conditions communicating between domains in three-dimensional space. We show that, although in principle there is an infinity of degrees of freedom, the effective number is finite owing to the presence of noise. This is in agreement with the restricted classical theories that showed this property for specific optical systems and within the scalar and paraxial approximations. We further show that the best transmitting and receiving functions are the solutions of well-defined eigenvalue equations. The present approach is useful for understanding and designing modern optical systems for which the previous approaches are not applicable, as well as for application in inverse and synthesis problems.

Journal Article↗
PubMed2000

Designing serological surveillance programmes to document freedom from disease with special reference to exotic viral diseases of pigs in Denmark.

Surveillance programmes based on laboratory screening tests are increasingly used to document freedom from disease in order to facilitate trade. The following aspects must be considered when designing such programmes: diseases to be selected; epidemiology of the diseases; unit of analysis (animal or herd); target age group (or target farm type); test characteristics and sample size. Issues related to these aspects are discussed and illustrated using the example of serological surveillance for exotic viral diseases in the pig population of Denmark. Sampling designs based on individual animal samples are compared with herd-based sampling (two-stage sampling). While the latter is likely to require a larger sample size, the increased level of information and the reliability of the results obtained are considered to be worth the expense. Issues related to the development of international standards for declaring freedom from disease are discussed. The authors conclude that international standards are desirable, providing that these standards represent scientifically valid principles.

Age Factors↗
PubMedDate not supplied

Psychological health maintenance on Space Station Freedom.

The scheduling of crew rotations for up to 180 days on Space Station Freedom presents a special challenge for behavioral scientists who are tasked with providing psychological support for the crews, their families, and mission flight controllers. Preflight psychological support planning may minimize the negative impact of psychological and social issues on mission success, as well as assist NASA management in making real-time mission planning decisions in the event of a significant social event (for example, the death of a family member). During flight, the combined psychological, emotional, and social stressors on the astronauts must be monitored, along with other aspects of their health. The Health Maintenance Facility (HMF) will have the capability of providing preventive, diagnostic, and therapeutic assistance for significant psychiatric and interpersonal problems which may develop. Psychological support will not end with the termination of the mission. Mental health professionals must be part of the team of medical personnel whose job will be to facilitate the transition--physical and mental--from the space environment back to planet Earth. This paper reviews each phase of mission planning for Space Station Freedom and specifies those factors that may be critical for psychological health maintenance on extended-duration space missions.

Astronauts↗
PubMed1984

Freedom of information: can we afford to be anything but clinical?

Following the introduction of the Freedom of Information Code and Act in Victoria there have been numerous requests seeking the opportunity for patients and ex-patients to view their own records. This paper explores the clinical context within which patients traditionally have had, or not had, access to their own records, and the ways in which this is now altered by freedom of information legislation. The view is put forward that such disclosure in the past has always been within a clinical context whereas now there is potential for legislative intrusion into the psychiatrist/patient relationship of which the patient record is a part. A number of case examples is provided to exemplify the issues involved and the approach that the Victorian Health Commission has taken to resolve some of the difficulties.

Australia↗
PubMed1991

Medulloblastoma: freedom from relapse longer than 8 years--a therapeutic cure?

Seventy-seven patients presenting with medulloblastoma between 1958 and 1986 were treated at Stanford University Medical Center and studied retrospectively. Multimodality therapy utilized surgical extirpation followed by megavoltage irradiation. In 15 cases chemotherapy was used as adjunctive treatment. The 10- and 15-year actuarial survival rates were both 41% with an 18-year maximum follow-up period (median 4.75 years). There were no treatment failures after 8 years of tumor-free survival. Gross total removal of tumor was achieved in 22 patients (32%); the surgical mortality rate was 3.9%. No significant difference was noted in the incidence of metastatic disease between shunted and nonshunted patients. The classical form of medulloblastoma was present in 67% of cases while the desmoplastic subtype was found in 16%. Survival rates were best for patients presenting after 1970, for those with desmoplastic tumors, and for patients receiving high-dose irradiation (greater than or equal to 5000 cGy) to the posterior fossa. Although early data on freedom from relapse suggested a possible beneficial effect from chemotherapy, long-term follow-up results showed no advantage from this modality of treatment. The patterns of relapse and survival were examined; 64% of relapses occurred within the central nervous system, and Collins' rule was applicable in 83% of cases beyond the period of risk. Although patients treated for recurrent disease could be palliated, none were long-term survivors. The study data indicate that freedom from relapse beyond 8 years from diagnosis can be considered as a cure in this disease. Long-term follow-up monitoring is essential to determine efficacy of treatment and to assess survival patterns accurately.

Actuarial Analysis↗
PubMed2004

Gamma knife surgery in the management of brain metastases from lung carcinoma: a retrospective analysis of survival, local tumor control, and freedom from new brain metastasis.

OBJECT: The objective of this retrospective study was to analyze the results of stereotactic radiosurgery performed using a gamma knife in the treatment of 44 consecutive patients with brain metastases from lung carcinoma. METHODS: Forty-four patients with lung carcinoma were treated for metastatic brain tumors by performing radiosurgery with a Leksell Gamma Knife. Twenty-one patients (47.7%) were women and 23 were men. The mean age of the patients was 56 years (range 35-77 years). Twenty-two patients (50%) had solitary tumors and the rest had multiple tumors (two-six lesions). Eighteen patients (40.9%) presented with a recurrent and/or progressive brain disease that previously had been treated with other modalities (surgery, external-beam radiotherapy, or both). Fifteen patients had controlled lung disease and 19 patients had systemic metastases (in lymph nodes, liver, and/or bones) at the time of radiosurgery. The median follow-up period was 18.25 months. All patients were followed up for three different end points: 1) death caused by the disease; 2) clinical and/or radiological evidence of progression of the tumor that had been treated with radiosurgery; and 3) appearance of new lesions. At the last follow-up review, 17 patients (38.6%) were alive and 27 (61.4%) had died. Ten patients (22.7%) died as a result of brain disease (failure of local control or new metastases). Controlled primary disease at the time of detection of metastases and the ability to achieve local tumor control after radiosurgery significantly improved the patient survival (p < 0.01). Control of the treated tumor(s) was achieved in 32 of 44 patients (72 tumors) and 10 patients experienced treatment failure. In addition to the 44 patients comprising the study population, two other patients were treated, but died of lung disease too early in the follow-up period to have been assessed. As of the last follow-up review, no new brain metastasis had occurred in 36 patients (81.8% [includes surviving and nonsurviving patients]). The median duration of overall survival was 7 months, the median period of controlled brain disease was 21 months, and the median period of freedom from new brain metastases was 17 months (95% confidence interval 13-19 months). CONCLUSIONS: Gamma knife surgery has significantly reduced the incidence of mortality from brain disease by effectively accomplishing local tumor control in patients with metastatic lung cancer. Local control and freedom from new brain metastases is not influenced by prior external-beam radiotherapy.

Adult↗
PubMedDate not supplied

Questionable methods of cancer management: the Committee for Freedom of Choice in Medicine, Inc.

The Committee for Freedom of Choice in Medicine is the political arm of several interlocking corporations promoting and/or marketing questionable remedies for cancer and other serious diseases. Operating during the 1970s as the Committee for Freedom of Choice in Cancer Therapy, the organization fought for legalization of laetrile and claimed to have many members. Today the Committee appears to be a small group whose principal activities are speeches and press conferences by its leaders, protests to government agencies, and publication of a small-circulation newsletter.

Complementary Therapies↗