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Satellite observation of atmospheric nuclear gamma radiation.

We present a satellite observation of the spectrum of gamma radiation from the Earth's atmosphere in the energy interval from 300 keV to 8.5 MeV. The data were accumulated by the gamma ray spectrometer on the Solar Maximum Mission over 3 1/2 years, from 1980 to 1983. The excellent statistical accuracy of the data allows 20 atmospheric line features to be identified. The features are superimposed on a continuum background which is modeled using a power law with index -1.16. Many of these features contain a blend of more than one nuclear line. All of these lines (with the exception of the 511-keV annihilation line) are Doppler broadened. Line energies and intensities are consistent with production by secondary neutrons interacting with atmospheric 14N and 16O. Although we find no evidence for other production mechanisms, we cannot rule out significant contributions from direct excitation or spallation by primary cosmic ray protons. The relative intensities of the observed line features are in fair agreement with theoretical models; however, existing models are limited by the availability of neutron cross sections, especially at high energies. The intensity and spectrum of photons at energies below the 511-keV line, in excess of a power law continuum, can be explained by Compton scattering of the annihilation line photons in traversing an average of approximately 21 g cm-2 of atmosphere.

Astronomy↗

Interpreting regional myocardial magnetic resonance imaging data: a new method for collation with angiographic findings in patients with coronary artery disease.

The magnetic resonance imaging (MRI) assessment of myocardial function and perfusion is a valuable complementary technique to coronary angiography. We describe a method of presenting and collating regional MRI data with the angiographic findings as annotated by the Green Lane reporting system. Routine clinical use of this approach is likely to increase the accuracy of MRI data interpretation and to influence both medical and interventional treatment strategies.

Coronary Angiography↗

Counterpoint: better radiation treatment of non-small cell lung cancer using new techniques without elective nodal irradiation.

The treatment of non-small cell lung cancer has continued to evolve with the advent of improved staging technologies, chemotherapeutic agents, and methods of radiation delivery. Treatment of clinically uninvolved, regional lymph nodes historically has been delivered in the attempt to cover unseen disease, reduce regional failure, and improve survival. None of these suppositions has been tested nor are they supported by data. With enhanced staging using modalities like positron emission tomography and esophageal ultrasonography, treatment portals can be designed to encompass known disease with greater accuracy and confidence. Data for early-stage non-small cell lung cancer is now increasing and strongly suggest that eliminating elective nodal irradiation does not result in a high incidence of nodal relapse and does not compromise survival. Three-dimensional conformal radiotherapy incorporates better targeting and beam directions to effect smaller treatment volumes that include only clinically evident disease. It provides treatment techniques that maximize tumor dose and minimize normal tissue toxicity. Using smaller fields that do not incorporate elective nodal regions may allow higher doses, and these may help improve local control and survival in a disease where current results are unacceptable.

Carcinoma, Non-Small-Cell Lung↗

Segmentation and intensity estimation of microarray images using a gamma-t mixture model.

MOTIVATION: We present a new approach to the analysis of images for complementary DNA microarray experiments. The image segmentation and intensity estimation are performed simultaneously by adopting a two-component mixture model. One component of this mixture corresponds to the distribution of the background intensity, while the other corresponds to the distribution of the foreground intensity. The intensity measurement is a bivariate vector consisting of red and green intensities. The background intensity component is modeled by the bivariate gamma distribution, whose marginal densities for the red and green intensities are independent three-parameter gamma distributions with different parameters. The foreground intensity component is taken to be the bivariate t distribution, with the constraint that the mean of the foreground is greater than that of the background for each of the two colors. The degrees of freedom of this t distribution are inferred from the data but they could be specified in advance to reduce the computation time. Also, the covariance matrix is not restricted to being diagonal and so it allows for nonzero correlation between R and G foreground intensities. This gamma-t mixture model is fitted by maximum likelihood via the EM algorithm. A final step is executed whereby nonparametric (kernel) smoothing is undertaken of the posterior probabilities of component membership. The main advantages of this approach are: (1) it enjoys the well-known strengths of a mixture model, namely flexibility and adaptability to the data; (2) it considers the segmentation and intensity simultaneously and not separately as in commonly used existing software, and it also works with the red and green intensities in a bivariate framework as opposed to their separate estimation via univariate methods; (3) the use of the three-parameter gamma distribution for the background red and green intensities provides a much better fit than the normal (log normal) or t distributions; (4) the use of the bivariate t distribution for the foreground intensity provides a model that is less sensitive to extreme observations; (5) as a consequence of the aforementioned properties, it allows segmentation to be undertaken for a wide range of spot shapes, including doughnut, sickle shape and artifacts. RESULTS: We apply our method for gridding, segmentation and estimation to cDNA microarray real images and artificial data. Our method provides better segmentation results in spot shapes as well as intensity estimation than Spot and spotSegmentation R language softwares. It detected blank spots as well as bright artifact for the real data, and estimated spot intensities with high-accuracy for the synthetic data. AVAILABILITY: The algorithms were implemented in Matlab. The Matlab codes implementing both the gridding and segmentation/estimation are available upon request. SUPPLEMENTARY INFORMATION: Supplementary material is available at Bioinformatics online.

Algorithms↗

Registration of head volume images using implantable fiducial markers.

In this paper, we describe an extrinsic-point-based, interactive image-guided neurosurgical system designed at Vanderbilt University, Nashville, TN, as part of a collaborative effort among the Departments of Neurological Surgery, Computer Science, and Biomedical Engineering. Multimodal image-to-image (II) and image-to-physical (IP) registration is accomplished using implantable markers. Physical space tracking is accomplished with optical triangulation. We investigate the theoretical accuracy of point-based registration using numerical simulations, the experimental accuracy of our system using data obtained with a phantom, and the clinical accuracy of our system using data acquired in a prospective clinical trial by six neurosurgeons at four medical centers from 158 patients undergoing craniotomies to resect cerebral lesions. We can determine the position of our markers with an error of approximately 0.4 mm in X-ray computed tomography (CT) and magnetic resonance (MR) images and 0.3 mm in physical space. The theoretical registration error using four such markers distributed around the head in a configuration that is clinically practical is approximately 0.5-0.6 mm. The mean CT-physical registration error for the phantom experiments is 0.5 mm and for the clinical data obtained with rigid head fixation during scanning is 0.7 mm. The mean CT-MR registration error for the clinical data obtained without rigid head fixation during scanning is 1.4 mm, which is the highest mean error that we observed. These theoretical and experimental findings indicate that this system is an accurate navigational aid that can provide real-time feedback to the surgeon about anatomical structures encountered in the surgical field.

Brain Diseases↗

Identification and determination of material properties for porohyperelastic analysis of large arteries.

A "porohyperelastic" (PHE) material model is described and the theoretical framework presented that allows identification of the necessary material properties functions for soft arterial tissues. A generalized Fung form is proposed for the PHE constitutive law in which the two fundamental Lagrangian material properties are the effective strain energy density function, W(e), and the hydraulic permeability, kij. The PHE model is based on isotropic forms using W(e) = Ue (phi) = 1/2C0(e phi - 1) and the radial component of permeability, kRR = kRR(phi), with phi = C1'(I1 - 3) + C2'(I2 - 3) + K'(J - 1)2. The methods for determination of these material properties are illustrated using experimental data from in situ rabbit aortas. Three experiments are described to determine parameters in Ue and kRR for the intima and media of the aortas, i.e., (1) undrained tests to determine C0, C1', and C2'; (2) drained tests to determine K'; and (3) steady-state pressurization tests of intact and de-endothelialized vessels to determine intimal and medial permeability (adventitia removed in these models). Data-reduction procedures are presented that allow determination of kRR for the intima and media and Ue for the media using experimental data. The effectiveness and accuracy of these procedures are studied using input "data" from finite element models generated with the ABAQUS program. The isotropic theory and data-reduction methods give good approximations for the PHE properties of in situ aortas. These methods can be extended to include arterial tissue remodeling and anisotropic behavior when appropriate experimental data are available.

Animals↗

A pilot study applying digital radiography for estimating ratio of supported single-root surface area.

BACKGROUND: The prognosis of a tooth with periodontitis is affected by the amount of supporting bone. A key factor in retaining a tooth is the ratio of supported root surface. Currently, root surfaces cannot be accurately measured using conventional dental radiographs, which only measure the length of bone support on proximal surfaces. METHODS: Eight extracted, single-rooted teeth were 3-dimensionally digitized using a contact technique for true surface area measurements. Root length, projection area, and pixel values were then measured on digital radiographs. The accuracy of the ratio estimation of supported surface area from linear, area, and pixel values was calculated and compared. RESULTS: The mean error from linear estimation was 7.9%; the mean error from area estimation was 1.0%; and the mean error from pixel value estimation was 1.3%. One-way analysis of variance (ANOVA) showed significant differences in all estimations while Scheffé's analysis further revealed significant differences only in the linear estimation. CONCLUSIONS: A three-dimensional digitizing device could be used as a non-destructive method of measuring root surface area. The ratio of supported single-root surface area could be estimated with high accuracy from the projected area data acquired on the digital dental radiographs. The thickness data as reflected from the pixel values in the digital images did not improve the estimation accuracy. Estimations using only length data yielded significantly less accuracy. Digital dental x-ray images provide the potential for estimating the ratio of supported root surface efficiently.

Analysis of Variance↗

Clinical versus mechanical prediction: a meta-analysis.

The process of making judgments and decisions requires a method for combining data. To compare the accuracy of clinical and mechanical (formal, statistical) data-combination techniques, we performed a meta-analysis on studies of human health and behavior. On average, mechanical-prediction techniques were about 10% more accurate than clinical predictions. Depending on the specific analysis, mechanical prediction substantially outperformed clinical prediction in 33%-47% of studies examined. Although clinical predictions were often as accurate as mechanical predictions, in only a few studies (6%-16%) were they substantially more accurate. Superiority for mechanical-prediction techniques was consistent, regardless of the judgment task, type of judges, judges' amounts of experience, or the types of data being combined. Clinical predictions performed relatively less well when predictors included clinical interview data. These data indicate that mechanical predictions of human behaviors are equal or superior to clinical prediction methods for a wide range of circumstances.

Decision Making, Computer-Assisted↗

Serum markers and clinical data in diagnosing pancreatic cancer: a contrastive approach.

In order to assess the value of serum markers and simple clinical data in the differential diagnosis of pancreatic cancer, we studied 32 control subjects and 28 patients with pancreatic cancer, 26 with chronic pancreatitis, and 37 with extra-pancreatic diseases. CA 19-9 was found to be the best marker in detecting pancreatic cancer. Among the clinical data, presence and onset of pain attacks, age, and weight loss were selected as the most informative in assessing chronic pancreatic disease. Clinical data correctly classified 88.5% of chronic pancreatitis and 75.0% of pancreatic cancer; serum markers identified pancreatic tumor in 67.9% of the patients. The adjunct of serum markers to clinical data did not improve accuracy in diagnosing chronic pancreatic disease. Since clinical data and serum markers generally become positive at an advanced stage of the disease, early diagnosis of pancreatic cancer is a goal still to be attained.

Adult↗

Evaluation of accuracy and variability of scoring-area-based plaque indices. A laboratory model.

BACKGROUND: Plaque scoring, using a variety of indices and methods, is widely used in clinical dentistry. There is limited information on inter- and intra-examiner variability and almost no data on examiner accuracy. AIMS: The aim of this study, was to determine the inter- and intra-examiner variability and accuracy of 15 examiners, of differing plaque-scoring experience, in recording and judging plaque areas from simulated plaque on tooth charts. METHODS: Plaque, shaded red, was drawn onto tooth charts of 8 simulated "patients" and measured by planimetry by 1 investigator. For each tooth for each "patient", examiners subjectively copied the plaque onto blank charts and scored plaque in 5% increments for the global plaque index. This was repeated on 2 occasions. Drawn plaque areas were determine by the investigator and comparisons made with the actual areas and % scores of plaque. RESULTS: For both plaque recording methods, intra-examiner variability was low and slightly better than inter-examiner variability. Reproducing plaque areas showed a high level of accuracy in most examiners, as was judging areas in 5% increments, albeit slightly less accurate than area drawing. Overall examiner experience had little influence on judging plaque areas. CONCLUSION: The data suggest that area-based plaque indices can be scored or recorded accurately and with minimal variability within or between examiners. The laboratory model could be used to train and assess examiners.

Dental Plaque↗

Captopril-enhanced 99Tcm-MAG3 renal scintigraphy in subjects with suspected renovascular hypertension.

This pilot study was undertaken to generate preliminary data on the accuracy of captopril-enhanced renal scintigraphy with a relatively new radiopharmaceutical, 99Tcm-mercaptoacetyltriglycine (99Tcm-MAG3) for detecting significant renal artery stenosis. Truth data was based either on arteriographic or outcome criteria (blood pressure response to therapy). Twenty-seven subjects with suspected renovascular hypertension were studied with baseline and captopril-enhanced 99Tcm-MAG3 renal scintigraphy and renal arteriography. Scan interpretations were expressed as a probability of a significant renal artery stenosis. Scan interpretations were compared with renal arteriographic results, renal vein renin levels, blood pressure values after renal artery repair, and blood pressure control after 4-26 months of clinical follow-up. Using > or = 50% luminal obstruction on arteriography as the reference standard for renal artery stenosis and a high probability scan representing a positive test, the test sensitivity and specificity were 33 and 97%, respectively (using high or indeterminate probability to represent a positive scan, the test sensitivity and specificity were 67 and 83%, respectively). The negative predictive value of a low probability scan for renal artery stenosis was 80%. However, including a measure of renovascular hypertension (blood pressure response to renal artery repair) as the reference standard, the accuracy of the scan improves, with the negative predictive value of a low probability scan for renovascular hypertension increasing to 97%. Scintigraphic results were also positively correlated with renal vein renin values in a statistically significant fashion (two-tailed Fisher exact test statistic = 6.43, P = 0.0219). Captopril-enhanced 99Tcm-MAG3 renal scintigraphy is a moderately accurate technique for detecting renal artery stenosis. More importantly, our preliminary findings suggest that the scintigraphic technique using 99Tcm-MAG3 appears to predict the blood pressure response to renal artery repair in subjects with suspected renovascular hypertension, thereby separating subjects with haemodynamically insignificant renal artery stenosis from those with renovascular hypertension.

Angiography↗

Clinical effectiveness and cost-effectiveness of tests for the diagnosis and investigation of urinary tract infection in children: a systematic review and economic model.

OBJECTIVES: To determine the diagnostic accuracy of tests for detecting urinary tract infection (UTI) in children under 5 years of age and to evaluate the effectiveness of tests used to investigate further children with confirmed UTI. Also, to evaluate the effectiveness of following up children with UTI and the cost-effectiveness of diagnostic and imaging tests for the diagnosis and follow-up of UTI in children under 5. An additional objective was to develop a preliminary diagnostic algorithm for healthcare professionals. DATA SOURCES: Electronic databases were searched up to the end of 2002/early 2003. Consultation with experts in the field. REVIEW METHODS: A systematic review was undertaken using published guidelines and results were analysed according to test grouping: diagnosis of UTI and further investigation of UTI. The cost-effectiveness results from existing evaluations were synthesised. A separate cost-effectiveness model was developed using the best available evidence, in part derived from the results of the systematic review, to illustrate the potential cost-effectiveness of some alternative management strategies in a UK setting. The results of the systematic review were used to propose diagnostic algorithms for the diagnosis and further investigation of UTI in children. Economic analyses did not contribute directly to the development of these algorithms. RESULTS: The studies included in the review provided very little data on the accuracy of clinical investigations for the diagnosis of UTI, and criteria for clinical suspicion of UTI were not further defined. The majority of studies included in the review found that clean voided midstream urine (CVU) samples had similar accuracy to suprapubic aspiration (SPA) samples when cultured with the advantage of being a non-invasive collection method that can be used in the GP's surgery. Pad, nappy or bag specimens may be appropriate methods for obtaining a urine sample in non-toilet-trained children, although only limited data were available. Although the glucose test was reported to have the highest accuracy in terms of both ruling in and ruling out disease, only a limited number of studies of this test were included and these were conducted over 30 years ago. Dipstick tests are easy to perform in the GP's surgery, give an immediate result and are relatively cheap. The results of the systematic review showed that a dipstick for leucocyte esterase (LE) and nitrite, where both test results are interpreted in combination, was a good test both for ruling in (both positive) and ruling out (both negative) a UTI. A dipstick positive for either LE or nitrite and negative for the other provides inconclusive diagnostic information and further testing is therefore required in these patients. Microscopy is more time consuming and expensive to perform than a dipstick test, but potentially quicker and cheaper than culture. As with dipstick tests, a combination of microscopy for pyuria and bacteriuria can be used accurately to rule in and rule out a UTI. An indeterminate test result is again obtained if microscopy is positive for either pyuria or bacteriuria, and negative for the other. Confirmatory culture is required in these patients. In patients considered to have a UTI, further culture to determine antibiotic sensitivities may be an option to inform treatment decisions. Only one study satisfied the inclusion criteria of the economic review and the review highlighted a number of potential limitations of this study for NHS decision-making. A separate decision-analytic model was therefore developed to provide a more reliable estimate of the optimal strategy regarding the diagnosis and further investigation of children under 5 with suspected UTI from the perspective of the NHS. The economic model found that the optimal diagnostic strategy for children presenting with symptoms suggestive of UTI depends on a number of key factors. These included the relevant subgroup of children concerned, in terms of gender and age, and the health service's maximum willingness to pay for an additional quality-adjusted life-year. CONCLUSIONS: The results of the systematic review were used to derive an algorithm for the diagnosis of UTI in children under 5. This algorithm represents the conclusions of the review in terms of effective practice. There were insufficient data to propose an algorithm for the further investigation of UTI in children under 5. The quality assessment highlighted several areas that could be improved upon in future diagnostic accuracy studies.

Algorithms↗

Improving survival from sudden cardiac arrest: the role of the automated external defibrillator.

CONTEXT: Sudden cardiac death is a major public health problem in the United States, and improving survival after out-of-hospital cardiac arrest has been the subject of intense study. Early defibrillation has been shown to be critical to improving survival. Use of automated external defibrillators (AEDs) has become an important component of emergency medical systems, and recent advances in AED technology have allowed expansion of AED use to nontraditional first responders and the lay public. OBJECTIVES: To examine advancements in AED technology, review the impact of AEDs on time to defibrillation and survival, and explore the future role of AEDs in the effort to improve survival following sudden cardiac arrest. DATA SOURCES: MEDLINE was searched for articles from 1966 through December 2000 (Medical Subject Headings: electric countershock, heart arrest, resuscitation, emergency medical services; keywords: automatic external defibrillator, automated external defibrillator, public access defibrillation). Reference lists of relevant articles, news releases, and product information from manufacturers were also reviewed. STUDY SELECTION: Initial MEDLINE search produced 4816 articles, from which 101 articles were selected for referencing based on having been published in a peer-reviewed journal and on relevance to the subject of the manuscript as determined by all 5 authors. DATA EXTRACTION: All studies were critically reviewed for relevance, accuracy, and quality of data and study design by all authors. DATA SYNTHESIS: Recent advances in AED technology and design have resulted in marked simplification of AED operation, improvements in accuracy and effectiveness, and reductions in cost. Use of AEDs by first responders and laypersons has reduced time to defibrillation and improved survival from sudden cardiac arrest in several communities. Initial studies of the cost-effectiveness of AED use in comparison with other commonly used treatments are favorable. CONCLUSION: The AED represents an efficient method of delivering defibrillation to persons experiencing out-of-hospital cardiac arrest and its use by both traditional and nontraditional first responders appears to be safe and effective. The rapidly expanding role of AEDs in traditional emergency medical systems is supported by the literature, and initial studies of public access to defibrillation offer hope that further improvements in survival after sudden cardiac death can be achieved.

Cost-Benefit Analysis↗

Accuracy of cervical transvaginal sonography in predicting preterm birth: a systematic review.

This review investigates the accuracy with which transvaginal cervical sonography predicts spontaneous preterm birth. Published studies were identified without language restrictions through nine different databases and manual searching of bibliographies of known primary and review articles. Studies were selected if they undertook antenatal transvaginal sonographic cervical assessment among a population of pregnant women with known gestational age of delivery. There were 46 primary articles, which included a total of 31,577 women, consisting of 33 studies in asymptomatic and 13 studies in symptomatic women. Data were extracted for the studies' characteristics and quality. Accuracy data were used to form 2 x 2 contingency tables for various cervical length measurements with birth before 32, 34 and 37 weeks' gestation as the reference standards. Data were stratified according to singleton or twin pregnancy, gestational age at testing, cervical length threshold, and the various reference standards, and were pooled to produce summary estimates of likelihood ratios (LRs). Our review showed that transvaginal cervical sonography identifies women who are at higher risk of spontaneous preterm birth, although there was a wide variation amongst studies with respect to gestational age at testing, definition of threshold of abnormality and definition of reference standard. The most commonly reported sub-group was testing of asymptomatic women at < 20 weeks' gestation using a threshold cervical length of 25 mm with spontaneous preterm birth before 34 weeks' gestation as the reference standard. The summary LR+ for this group was 6.29 (95% CI, 3.29-12.02), with corresponding LR- of 0.79 (95% CI, 0.65-0.95). Both cervical length measurement and funneling, whether alone or in combination, appear to be useful (depending on the threshold chosen to define the abnormality) in predicting spontaneous preterm birth in asymptomatic women. For symptomatic women there was a paucity of data, although the degree of funneling appeared to be predictive of spontaneous preterm birth.

Data Collection↗

Quality assured measurements of animal building emissions: gas concentrations.

Comprehensive field studies were initiated in 2002 to measure emissions of ammonia (NH3), hydrogen sulfide (H2S), carbon dioxide (CO2), methane (CH4), nonmethane hydrocarbons (NMHC), particulate matter <10 microm in diameter, and total suspended particulate from swine and poultry production buildings in the United States. This paper focuses on the quasicontinuous gas concentration measurement at multiple locations among paired barns in seven states. Documented principles, used in air pollution monitoring at industrial sources, were applied in developing quality assurance (QA) project plans for these studies. Air was sampled from multiple locations with each gas analyzed with one high quality commercial gas analyzer that was located in an environmentally controlled on-farm instrument shelter. A nominal 4 L/min gas sampling system was designed and constructed with Teflon wetted surfaces, bypass pumping, and sample line flow and pressure sensors. Three-way solenoids were used to automatically switch between multiple gas sampling lines with > or =10 min sampling intervals. Inside and outside gas sampling probes were between 10 and 115 m away from the analyzers. Analyzers used chemiluminescence, fluorescence, photoacoustic infrared, and photoionization detectors for NH3, H2S, CO2, CH4, and NMHC, respectively. Data were collected using personal computer-based data acquisition hardware and software. This paper discusses the methodology of gas concentration measurements and the unique challenges that livestock barns pose for achieving desired accuracy and precision, data representativeness, comparability and completeness, and instrument calibration and maintenance.

Air Pollutants↗

Estimation of tube potential in mammography from transmission measurements.

A computer program has been used to study the performance of a method for estimating the potential of mammographic x-ray tubes. The method uses measurements of the transmission of the x-ray beam through a series of filters. The transmissions are fitted to values calculated using tables of mammographic x-ray spectra, thus providing an estimate of tube potential. The performance of the method was studied using a Monte Carlo simulation of experimental errors. The number of measurements and the selection of filter material were both varied, and the precision and accuracy were used as performance indicators. It was found that, for a single filter material, the precision was improved by increasing the number of transmission data, but the accuracy was unaffected. The poorest accuracy and precision were obtained when K-edge filters, or filters with very high or very low atomic number were used. Using combinations of two filter materials, a high transmission (25%) K-edge filter in combination with a low transmission (3%) non-K-edge filter produced results comparable to the best results obtained from seven transmission measurements using a single filter material. By reducing the non-K-edge filter transmission to 1%, an accuracy of +/- 0.4% and a precision of +/- 1.4% were achieved at both 25 kV and 30 kV.

Algorithms↗

Video analysis of the deformation and effective mass of gymnastics landing mats.

INTRODUCTION: Landing mats that undergo large area deformation are now essential for the safe completion of landings in gymnastics. The aim of this study was to determine the effective mass, shock transmission time, and deformation characteristics of a mat during impacts using high-speed video and to improve the accuracy of measuring foot-mat contact forces during landing. For validation, the same variables need to be accurately assessed using accelerometer and force plate data. METHODS: A 24-kg impactor with an attached accelerometer was dropped onto the sample mat from various heights. The surface deformation of the mat was recorded using high-speed video, and force data were obtained from a force plate beneath the mat. RESULTS: The maximum vertical deformations were between 0.088 and 0.118 m, with corresponding volume deformation estimates ranging from 0.030 to 0.044 m3. The delay between accelerometer and force plate readings at initial contact was approximately 7 ms. The delay between peak acceleration and peak force was 3 ms. The peak acceleration calculated from the video data was within 2.5% of that recorded via the accelerometer. The effective mass of the mat being accelerated corresponded to forces that ranged from 481 to 930 N, up to 12% of the peak force. CONCLUSIONS: The acceleration estimates obtained from high-speed video were combined with the effective mass estimates from the volume calculation to give peak calculated forces at the bottom of the mat to within -1.1 to +3.7% of the force recorded via the force plate. The use of high-speed video can be used to give data of sufficient accuracy for measuring foot/mat contact forces in gymnastics landings.

Acceleration↗

American Health Information Management Association. Position Statement. Issue: roles of health information managers and coders in patient-focused care.

Patient-focused care is a new model of care delivery organized around the patient instead of the hospital structure. Care is provided by multi-disciplinary teams of healthcare workers on the patient care unit. As many services as possible are brought to the patient, rather than taking the patient to a decentralized department. Successful models have demonstrated increased operational efficiency and greater levels of satisfaction among patients, physicians, and staff members. Administrative tasks done in a variety of departments may be assigned to a member of the care team. Such tasks may include patient registration; insurance verification and financial arrangements; and medical record assembly, analysis, abstracting, and coding. Given the different educational levels and prior training administrative team members may have, careful consideration must be given to assignment of the medical record abstracting and coding functions. The quality of clinical data submitted by all providers in the US is critically important to the future of the nation's healthcare system. Under prospective payment systems, the accuracy of clinical data abstracting and coding has a significant impact on healthcare facilities. But the need for accurate clinical data goes beyond payment systems. As more and more clinical data are being captured and maintained in databases across the country, for uses that may be yet unknown, it is essential that such data be collected consistently and accurately. To assure the quality and validity of health information, only trained, experienced coders should abstract and code the data.(ABSTRACT TRUNCATED AT 250 WORDS)

Medical Record Administrators↗