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PubMed2002

Electronic procedure logs: taking it further.

OBJECTIVE: To create an electronic procedural logbook with enhanced user interactivity and usefulness as an educational resource. DESCRIPTION: From our own work on electronic student logbooks and other studies, it is clear that compliance with complete and valid data entry remains a challenge. Without direct and visible benefit, students are reluctant to spend time logging all their cases. We developed an interactive procedural logbook using Microsoft Embedded Visual Basic and Metrowerks CodeWarrior. Interface design focused on rapid data entry with minimum requirement for text, and field-level automation where possible. We loaded it onto a mixed platform of personal digital assistants (PDAs)--Compaq iPaq Pocket PCs and HandEra 330 PalmOS devices. Our rural residents were supplied with the devices of their choice. Various built-in educational reference resources included: (1) contextual help options about each procedure, which contained diagrams and pictures; (2) diagnostic and fee coding so they could see how poorly some procedures pay; and (3) Quick Tips relevant to each procedure, which can be easily modified by the preceptor. Preceptor evaluations and comments can be entered rapidly. Using built-in database conduits, data are automatically collected from each device on every HotSync with the desktop. Data can then be collated and analyzed using Microsoft Access or via secure Web access. DISCUSSION: Improved compliance has been dramatic-one resident logged 250 procedures in just two months. However, not all residents have been successful in establishing seamless synchronization, and the resulting data loss has caused frustration. The evidence indicates the need to implement central data collection and backup right from the outset. Central data collection provides many advantages. The program director has better information for future applications. Preceptor evaluations are now spread over many interactions and yet can be collated and analyzed. Quick Tips have been very popular-we have been able to collect the tips and redistribute them. Focus-group feedback from the residents has shown that the rich data in the logbook's reference component improved its usefulness and popularity as an educational tool. Choice of device type is important for user acceptance because devotees of one platform are reluctant to switch to another. Cross-platform development does slow the process but is increasingly easy with the latest software design tools, such as AppForge. These new tools have enabled us to explore further improvements in data entry. Digital ink provides the ability to capture annotated diagrams and preceptor signatures. Voice input is built in with these devices, and our software now allows for voice annotation for more detailed commentary by preceptors or student. The compressed digital sound file is collected along with the data and transcribed centrally (on-device voice recognition is not feasible yet). Point-of-care accessibility has been the key attraction of using these devices for logging encounter data. This project demonstrates that it is important to explore all multimodal interactive capabilities to provide a truly rich educational tool.

Electronic Data Processing↗
PubMed2006

Reasons, assessments and actions taken: sex and age differences in uses of Internet health information.

The Internet is transforming the way in which consumers approach their health care needs. Sex and age are influential aspects of one's health as well as disease risk and are thus integral components of the emerging picture of health information seekers. Using data from Surveying the Digital Future, Year 4, a nationally representative, longitudinal telephone survey of Americans 12 years of age and older (n = 2010), we examine the reasons for, assessments of and actions taken as a result of health information found online among men and women and older and younger people. Although we tend to think of the Internet as a young person's technology, the percent of adults 60 years of age and older is similar to that of adolescents using the Internet as a health care information resource, thus suggesting an untapped opportunity with online interventions for older adults. Nonetheless, as age increases so too does the report of frustration with the experience. Men are more likely to report a positive seeking experience than women. Differences in Internet use fail to explain these observed sex and age differences in the seeking experience. Across the spectrum of age, sex and Internet skill, Internet health information seeking appears to enhance the patient-provider relationship.

Adolescent↗
PubMed2006

Prying apart a water molecule with anionic H-bonding: a comparative spectroscopic study of the X-.H2O (X = OH, O, F, Cl, and Br) binary complexes in the 600-3800 cm(-1) region.

A detailed picture of the structural distortions suffered by a water molecule in direct contact with small inorganic anions (e.g., X = halide) is emerging from a series of recent vibrational spectroscopy studies of the gas-phase X-.H2O binary complexes. The extended spectral coverage (600-3800 cm(-1)) presently available with tabletop laser systems, when combined with versatile argon "messenger" techniques for acquiring action spectra of cold complexes, now provides a comprehensive survey of how the interaction evolves from an ion-solvent configuration into a three-center, two-electron covalent bond as the proton affinity of the anion increases. We focus on the behavior of H2O in the X-.H2O (X = Br, Cl, F, O, and OH) complexes, which all adopt asymmetric structures where one hydrogen atom is H-bonded to the ion while the other is free. The positions and intensities of the bands clearly reveal the mechanical consequences of both (zero-point) vibrationally averaged and infrared photoinduced excess charge delocalization mediated by intracluster proton transfer (X-.H2O --> HX.OH-). The fundamentals of the shared proton stretch become quite intense, for example, and exhibit extreme red-shifts as the intracluster proton-transfer process becomes available, first in the vibrationally excited states (F-.H2O) and then finally at the zero-point level (OH-.H2O). In the latter case, the loss of the water molecule's independent character is confirmed through the disappearance of the approximately 1600 cm(-1) HOH intramolecular bending transition and the dramatic (>3000 cm(-1)) red-shift of the shared proton stretch. An unexpected manifestation of vibrationally mediated charge transfer is also observed in the low frequency region, where the 2 <-- 0 overtones of the out-of-plane frustrated rotation of the water are remarkably intense in the Cl-.H2O and Br-.H2O spectra. This effect is traced to changes in the charge distribution along the X-.O axis as the shared proton is displaced perpendicular to it, reducing the charge transfer character of the H-bonding interaction and giving rise to a large quadratic contribution to the dipole moment component that is parallel to the bond axis. Thus, all of these systems are found to exhibit distinct spectral characteristics that can be directly traced to the crucial role of vibrationally mediated charge redistribution within the complex.

Journal Article↗
PubMed2005

Comparative experiments on learning information extractors for proteins and their interactions.

OBJECTIVE: Automatically extracting information from biomedical text holds the promise of easily consolidating large amounts of biological knowledge in computer-accessible form. This strategy is particularly attractive for extracting data relevant to genes of the human genome from the 11 million abstracts in Medline. However, extraction efforts have been frustrated by the lack of conventions for describing human genes and proteins. We have developed and evaluated a variety of learned information extraction systems for identifying human protein names in Medline abstracts and subsequently extracting information on interactions between the proteins. METHODS AND MATERIAL: We used a variety of machine learning methods to automatically develop information extraction systems for extracting information on gene/protein name, function and interactions from Medline abstracts. We present cross-validated results on identifying human proteins and their interactions by training and testing on a set of approximately 1000 manually-annotated Medline abstracts that discuss human genes/proteins. RESULTS: We demonstrate that machine learning approaches using support vector machines and maximum entropy are able to identify human proteins with higher accuracy than several previous approaches. We also demonstrate that various rule induction methods are able to identify protein interactions with higher precision than manually-developed rules. CONCLUSION: Our results show that it is promising to use machine learning to automatically build systems for extracting information from biomedical text. The results also give a broad picture of the relative strengths of a wide variety of methods when tested on a reasonably large human-annotated corpus.

Algorithms↗
PubMed1995

[Traits of personality in hypochondriacal subjects].

Among the several mental originated clinical syndromes, hypochondria is not still well understood and listed. Indeed, hypochondria is often a complicating element in other psychopathological pictures; a slight form of hypochondria can appear in phobic-obsessing neurosis, and a worse one at the beginning of psychosis. The Authors, trying to explain the complex questions about diagnosis and prognosis of hypochondria, look for common personality traits in these patients. The research instrument was the Adjective Check List (ACL), a psychological test highly standardized and diffused, composed of 300 adjectives, or adjectival sentences, used to describe a person's attributes. The ACL was given to 65 subjects divided into two groups. The first group was made of 15 subjects, 10 women and 5 men, ambulatory treated at the Psychiatric Clinic in Trieste for the following diagnosis: psychosis (4 persons), depressing syndrome (3 persons), hypochondria (6 persons), obsessive neurosis (1 persons), anxiety syndrome (1 person). The second group was made of 50 subjects, 28 women and 22 men, diagnosed as hypochondriac by their medical officers. The results point out that some personality traits rising above the others are suggesting for an apathetical patient, not ready to accept himself, easily overcome by everyday life problems. These subjects are introverted, intolerant to frustrations, and inclined to take refuge in their own imaginary world, not able to self-governing. In the considered group the Authors find a moderate tendency to change, and it could be interpreted like a good prognostic element for a psychotherapeutic treatment.

Female↗
PubMed1988

The Munich Personality Test (MPT)--a short questionnaire for self-rating and relatives' rating of personality traits: formal properties and clinical potential.

The Munich Personality Test (MPT) is a brief questionnaire for the assessment of six personality dimensions proper (Extraversion, Neuroticism, Frustration Tolerance, Rigidity, Isolation Tendency, Esoteric Tendencies), one additional scale (Schizoidia, composed of the two shortest scales, Isolation Tendency and Esoteric Tendencies); an Orientation towards Social Norms, which might bias the rating, and the Motivation to perform the rating adequately can be ascertained by means of two control scales. There are two test versions, one for self-rating, the other one for a rating by a key person from the subject's social surroundings ("relatives' rating"). The instruction of both scales explicitly relates to times of mental and physical health in order to reduce the influence of symptoms of a disease on the values of the scales. The data presented indicate a highly consistent factorial structure of self-ratings and relatives' ratings, a significant concordance of both kind of ratings, a sufficient to marked degree of internal consistency of the test scales depending on the number of items in the scales, a fair degree of retest reliability after approximately 1 year and also, though less markedly, after around 7 years in psychiatric patients, and significant differences between groups of psychiatric patients and healthy subjects in all personality scales proper, partially depending on the type of the mental disorder. Judging from relatives' ratings and from other authors' data obtained in recovered patients, these differences cannot be fully explained by the influence of symptoms on the ratings. On the other hand, secondary changes of personality after brain damage have been demonstrated by other authors using a modified testing procedure. On the whole, the MPT offers a fairly differentiated picture of the personality structure in mental patients and healthy subjects.

Adult↗
PubMed2000

Makers of the early Aurignacian of Europe.

Despite intensive study and a number of remarkable discoveries in the last two decades of the 20th century, our understanding of the cultural and biological processes that resulted in the emergence of the Upper Paleolithic and the establishment of modern humans in Interpleniglacial Europe remains far from complete. There is active debate concerning the timing and location of the origins of the Aurignacian, the nature of the origins of Initial Upper Paleolithic industries (whether by autochthonous development or through acculturation by Aurignacian peoples), the timing of the appearance of early modern humans and the disappearance of the Neandertals, and the relationship of archeologically defined cultures to these different types of hominids. Frustrating our attempts to address these latter two questions is a general paucity of taxonomically diagnostic human fossil material from early Upper Paleolithic contexts. We undertake here a review of the human fossil record of Interpleniglacial Europe, and its archeological and chronological context, to clarify to the extent possible the nature of the relationship between hominid groups and the earliest Upper Paleolithic artifact industries, particularly the early Aurignacian. Although substantial difficulties involved in interpreting the fossil, archeological, and geochronological records of this time period prohibit making any definitive statements, a number of observations are suggested by the current data: 1) the Middle Paleolithic of Europe appears to have been made exclusively by Neandertals; 2) Initial Upper Paleolithic industries (with the exception of the Bachokirian) appear to have their roots in the late Middle Paleolithic industries of their respective regions; 3) all of the human fossils yet recovered from Initial Upper Paleolithic (except the Bachokirian) contexts for which any diagnostic morphology is present have their greatest morphological affinities with Neandertals and not early modern humans; 4) modern humans were almost certainly established in Europe by ca. 32 ky BP, with a strong possibility that they were there by ca. 36 ky BP. Claims for an appearance before 36 ky BP cannot be substantiated with currently available evidence; 5) the hypothesis that modern humans are uniquely associated with the Aurignacian cannot yet be refuted. Aurignacian-associated human fossils (including those from the Bachokirian) for which any diagnostic morphology is present have their greatest affinities with early modern Europeans and not Neandertals; and 6) Neandertals and modern humans coexisted in Europe for at least 2,000-4,000 years, and perhaps for 8,000-10,000 years or longer. The overall picture is one of an extended period of cultural contact, involving some degree of genetic exchange, between Neandertals and early modern Europeans.

Animals↗
PubMedDate not supplied

Surviving collapsed structure entrapment after earthquakes: a "time-to-rescue" analysis.

INTRODUCTION: Massive earthquakes often cause structures to collapse, trapping victims under dense rubble for long periods of time. Commonly, this spurs resource intensive, dangerous, and frustrating attempts to find and extricate live victims. The search and rescue phase usually is maintained for many days beyond the last "save," potentially diverting critical attention and resources away from the pressing needs of non-trapped survivors and the devastated community. This recurring phenomenon is driven by the often-unanswered question "Can anyone still be alive under there?" The maximum survival time in entrapment is an important issue for responders, yet little formal research has been conducted on this issue. Knowing the maximum survival time in entrapment helps responders: (1) decide whether or not they should continue to assign limited resources to search and rescue activities; (2) assess the safety risks versus the benefits; (3) determine when search and rescue activities no longer are indicated; and (4) time and pace the important transition to community recovery efforts. METHODS: The time period of 1985-2004 was selected for investigation. Medline and Lexis-Nexis databases were searched for earthquake events that occurred within this timeframe. Medical literature articles providing time-torescue data for victims of earthquakes were identified. Lexis-Nexis reports were scanned to select those with time-to-rescue data for victims of earthquakes. Reports from both databases were examined for information that might contribute to prolonged survival of entrapped individuals. RESULTS: A total of 34 different earthquake events met study criteria. Forty-eight medical articles containing time-to-rescue data were identified. Of these, the longest time to rescue was "13-19 days" post-event (secondhand data and the author is not specific). The second longest time to rescue in the medical articles was 8.7 days (209 hours). Twenty-five medical articles report multiple rescues that occurred after two days (48 hours). Media reports describe rescues occurring beyond Day 2 in 18 of 34 earthquakes. Of these, the longest reliably reported survival is 14 days after impact, with the next closest having survived 13 days. The average maximum times reported from these 18 earthquakes was 6.8 days (median = 5.75 days). The event with the most media reports of distinct rescue events was the 1999 Marmara, Turkey earthquake (43 victims). Times range from 0.5 days (12 hours) to 6.2 days (146 hours) for this event. Both databases provide little formal data to develop detailed insight into factors affecting survivability during entrapment. CONCLUSIONS: A thorough search of the English-language medical literature and media accounts provides a provocative picture of numerous survivors beyond 48 hours of entrapment under rubble, with a few successfully enduring entrapment of 13-14 days. These data are not necessarily applicable to non-earthquake collapsed-structure events. For incident managers and their medical advisors, the study findings and discussion may be useful for post-impact decision-making and in establishing and/or revising incident priorities as the response evolves.

Confined Spaces↗